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Humanities at the Bedside

Endings - Session A

My Death

a poem by Raymond Carver

If I'm lucky, I'll be wired every whichway
in a hospital bed. Tubes running into
my nose. But try not to be scared of me, friends!
I'm telling you right now that this is okay.
It's little enough to ask for at the end.
Someone, I hope, will have phoned everyone
to say, "Come quick, he's failing!"
And they will come. And there will be time for me
to bid goodbye to each of my loved ones.
If I'm lucky, they'll step forward
and I'll be able to see them one last time
and take that memory with me.
Sure, they might lay eyes on me and want to run away
and howl. But instead, since they love me,
they'll lift my hand and say "Courage"
or "It's going to be all right."
And they're right. It is all right.
It's just fine. If you only knew how happy you've made me!
I just hope my luck holds, and I can make
some sign of recognition.
Open and close my eyes as if to say,
"Yes, I hear you. I understand you."
I may even manage something like this:
"I love you too. Be happy."
I hope so! But i don't want to ask for too much.
If I'm unlucky, as I deserve, well, I'll just
drop over, like that, without any chance
for farewell, or to press anyone's hand.
Or say how much I cared for you and enjoyed
your company all these years. In any case,
try not to mourn for me too much. I want you to know
I was happy when I was here.
And remember I told you this a while ago - April 1984.
But be glad for me if I can die in the presence
of friends and family. If this happens, believe me,
I came out ahead. I didn't lose this one.

Guiding discussion:

 

  • What is the tone of the poem, and how does it compare with your experiences with caring for dying patients in the emergency department?
  • The narrator, a dying patient, focuses on those things that, in his eyes, would count towards a good death. How well do we attend to these needs of dying patients in the emergency department?
  • Do we focus too much on “saving” patients and leaping towards biomedical interventions?
  •  Are these conversations taking place as much as they should in our practice?
  • Do you feel we’re comfortable initiating these discussions?
  • If not, what barriers exist, and what steps could we take on systemic and local level to nourish those skills and improve this area of care.

 

Exercise:

  • The narrator hopes his “luck holds” and he can “make some sign of recognition.”
  • Have you thought about your own death, that is, what would count as an ideal scene where you take your last breaths? Is it at a hospital or at home? Who’s there? What type of death are you most afraid of?
  • For 5-10 minutes write about these feelings. You don’t have to share this writing with others, but consider what we would cherish and fear most in our own death, and how to what degree they enter into our conversations and actions with patients and their families.

 

 

Background on writer:
Raymond Carver was a poet and short-story writer who died of lung cancer at age 50. From an article in the New York Times after his death: “Mr. Carver published 10 books of prose and poetry in a career shadowed by alcoholism, poverty, a broken marriage and cancer.”
 

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