The hospital where staff treat fear of death as well as physical pain

Yes, I've read/watched most of those and I believe they are just entertainment. I can perfectly envision people living happy, long lives. These books and shows have manufactured conflict for drama.

(Edited to add: Sorry, too long of a post here. I didn’t bother to renew my domain this year)

A timely piece I can relate to. currently starting my second week in a (US) hospital oncology ward after my 11th cycle of chemo. I was first diagnosed with stage iv colon cancer and after chemo, surgery, resections and stubbornness was NED from 2018 to 2025. The return is inoperable and I was given “six months to a year”.

I asked if I’d be in pain when death came, and he said that I wouldn’t likely be - it would just be feeling more and more tired. That’s basically what’s been happening.

The chemo itself hasn’t given me direct side effects like skin lesions or mouth sores, nor much nausea. The secondary effects on my kidneys (which were already doing poorly before this started) and liver (cirrhosis) plus the metastases in lymph nodes and lung leads to edema. Diuretics helped but flushed out my potassium, so there several months where they trying to balance those electrolytes.

Anyway, a lot of my swelling was reduced (and they took 4L from two rounds of draining my lungs) but for some ungodly reason my scrotal sack decided it wanted to play too, and became the size and consistency of one of those half size basketballs you can win at fairs. it’s so bad that I actually requested a catheter. The swelling makes walking or anything else really painful.

The oncology wing I’m in doesn’t seem soaked in the kind of depressing, institutional green malaise of slightly older hospitals but it isn’t a “nice place” to die (I don’t expect to do that this visit in any case). The older woman (70?) two doors down though - seems to be in constant pain and in and out of lucidity, shouting at everyone. Usually a phrase gets stuck on repeat for a few hours - the most heartbreaking was “mommy get my mommy I’m sorry mommy I’m a bad girl mommy stop it” yelled loudly for hours.

This is a generic hospital though. Memorial Sloan-Kettering in NYC has a patient day lounge and lots of projects for child patients and patients families. Still not even approaching the quality described

Sorry, rambling. Probably my way of compartmentalizing the anxiety.

The other thing I wanted to say is that I really liked Christopher Hitchens “Mortality” and that Terry Pratchett’s very relatable death character shows up in all of his books. My favorite quote is from “Small Gods” as Death comes for the protagonist at the very end:

> “Ah. There really is a desert. Does everyone get this?” said Brutha. WHO KNOWS? “And what is at the end of the desert?” JUDGMENT. Brutha considered this. “Which end?” Death grinned and stepped aside.

Maybe I’m not afraid of death because as a devout atheist - well yea, we all get to do that at some point.

Agreed. Planning well can lessen this fear.

> increasing conversation in the medical community[0] about living past one’s health-span for years

Sure. This doesn't reflect the popular discourse, which is more concerned with fantastical edge cases.

> fear death significantly less than others

Totally agree.

> Only about half of terminally ill patients feel clinically significant death anxiety

Massive difference between death anxiety, which crosses into dreadful anticipation of a future state, and fear, which is more of a present concern. I fear getting hit by a car. I'm not really concerned with it most of the time. (And when I am, it's fleeting and limmited.)

When you say fearing death, I think you mean obsessing over death. That, I agree, is unhealthy. Fear, more generally, is an unpleasantness that results from dangers or threats. Death is very clearly a danger and threat. Contemplating it doesn't need to be uncomfortable. But it's dedidedly unnatural, if alluring, to consider one's own death monotonoically. (For what it's worth, this is closer to my experience. But I also know I have a high risk tolerance, and have to consciously keep an eye on that.)

That was a difficult read for me - after watching my father die peacefully, and with dignity in a wonderful hospice I can't help but admire the doctors, nurses and other practicioners who dedicate their life to caring for people at the end of theirs.

What angers me is that not everyone gets to experience a dignified death; the hospice where my father stayed relies on charitable donations to do their vital work - a death like this should be table stakes for an advanced economy, but alas, it's not.