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Clif Cleaveland, MD
26 March 2009
The March 16th issue of New Yorker magazine includes
three pages of poetry written by John Updike during the final weeks
of his life. He died on January 27 this year. The poems capture
better than anything I've read the reflections of a person who
knows that he will soon die. If you do not subscribe to the New
Yorker, track a copy down at your public library and read this
remarkable verse. The poems deal with the mystery and the majesty
of life. They do not offer easy answers. They point to the
critical, sustaining role of the relationships that we build.
On a number of occasions, the nature of my profession placed me
at the bedside of conscious people who were aware that death was
close at hand. The first such experience occurred more than forty
years ago in the Nashville VA Hospital when a man with wide-spread
lung cancer eased away in the presence of his wife and me. He spoke
in the days leading up to his death of his boyhood, his hard
service in Europe during World War II, and his second wife to whom
he had been married for a short time. He had no fear of death. His
regret was separation from the woman he loved.
Across the hall, a highly decorated hero of World War I lingered
for several more weeks, surrounded by three generations of his
family who revered him and gathered to talk with him until his
In the early 1970s, a cancer-stricken widow with a 12 year old
son prepared him for her death by gradually introducing him into
the family she had chosen to raise him. In her final weeks in the
St. Barnabas nursing facility she read The Autobiography of
Russell Bertrand in the mornings and instructed her son in the
Years later, another lady fought to a standstill an overwhelming
breast cancer so that she could walk down the aisle at her
daughter's wedding. The evening prior to her death she spoke very
frankly about the pain she had faced each day. She, too, had no
fear of death; it would, in fact, be a release from suffering. She
would miss her family and the opportunity to hold unborn
Another veteran, he of the war in Viet Nam, spoke of broken
marriages, of a drug-habit that he had finally conquered, of the
mother who had never given up on him. He thought of his buddies in
his platoon, especially the ones who were killed in action. This
unit was his extended family.
I never saw fear in these encounters. Whether the person who was
soon to die was devout or casual in a particular religious faith or
professed no formal belief at all, her principal concern focused
upon the people who would survive her. Regrets centered around loss
of that companionship and the shared celebrations of weddings,
graduations, promotions, and births. The other common concern of a
dying person was the hope of not becoming a burden to loved
On a few occasions, a spouse or family members wanted to keep a
dying, loved one ignorant of her impending death. This, in my
opinion, is cruel. It denies a dying person the chance to reflect
and to put an emotional house in order. It precludes the
opportunity to express love or forgiveness that may have been
postponed. When the dying person inevitably learns that that she is
dying, mistrust of family and care-givers ensues. Relationships are
strained at the very time that they are most vital.
I urge you to read John Updike's poetic gift to us.
Contact Clif Cleaveland at firstname.lastname@example.org.