When the end is near, the focus should be on the good things in life, writes terminally ill Stephen Wealthall.

Why rage against dying? Life would be no fun if I couldn't misquote Dylan Thomas, the finest spoken poet of the 20th century. But why should we rage against dying? After all, it happens to us all and is part of life, just like birth and the seven ages we pass through.

Naturally we all want to put it off, as I do when now contemplating its approach, but is it really something to rage at, or ignore and only talk about behind people's backs in hushed tones?

My own experience of life has been a good one, and other than the concern I feel for leaving my loved ones saddened, and them having to carry on the tasks that (being a man) I know I could do better, I feel no rage, anger or sense of injustice.

Of course it would be nice to continue to write the articles and stories that are still in my head, add to my sculptures and artwork and website stories, create new gardens, sail the Gulf and spend a longer time with my beloveds. But life has given me so many good things that I can't honestly feel picked upon.


Like all of us (well, perhaps not those who spent their lives seeking fame and power) I can look back on my life and see that even the difficult times produced unexpected bonuses, and that watching a tui bathing in the dog's water bowl as I write this is immensely more satisfying than fame, power or immoderate wealth.

Stephen Wealthall finds watching a tui bathing in the dog's water bowl immensely more satisfying than fame, power or immoderate wealth.
Stephen Wealthall finds watching a tui bathing in the dog's water bowl immensely more satisfying than fame, power or immoderate wealth.

I spent a lot of my medical career dealing with people who were contemplating the death of a loved one or facing death themselves, and mostly, even in those days before co-ordinated terminal care, there was dignity, acceptance and an ability to talk and even joke about it.

In my first hospital job I had care of 150 what were then called "geriatric patients" as well as 50 acute medical patients, and so I saw a lot of death. But rarely did I see people rail or rage against dying. I took tea whenever I could with these old souls, and one week an aged Sergeant Dispenser (medic) from the Boer War shook my hand when I said goodbye and said that I wouldn't be seeing him next week. I said "Why not?" as he was in the same health as he had been for five years. He replied he would be dead before next week, and as he was a wise and experienced man I did not argue with him. I was not surprised to be called to sign his death certificate a few days later. He faced and acknowledged death in the same routine way as he signed for his pension each week.

Later in my career, having spent several years caring for children with incurable birth defects, I used my experiences of death and dying to formulate an approach to "Love, Grief, Death and Deformity" which could be taught to trainee doctors and health professionals, an area which was then virtually ignored in health training curriculums.

I always started by saying that anybody who wished to be excused the course attendance could do so, if they could convince me that they had read the complete works of Charles Dickens, as his finely drawn observations of life and death could say far better than my course what they needed to know. Over the years I was pleased to have several take up the offer. Despite the course's foreboding title, most undergraduate and postgraduate students appeared to benefit from just bringing the topic out into the open.

The approach of death should focus the mind on the good things, not on the suffering (present-day terminal care avoids most of this) or lost opportunities. No need to dwell entirely in the past but let those memories and achievements that are really important dwell near the surface of your soul.

Remember the first time you netted a tadpole, caught a fish or patted a puppy. Bring back the first time you went out for a meal with a lover. How about the time you made something (dress, dish, artwork, garden, craft, hobby, work achievement, parent activity, sport, caring) that was really good?

What about the time you stayed awake all night with a new-found love or realised that your love might last for ever? How about watching the garden you grew, or the sport you loved, achieve its finest hour? What was the best time with family and children?

People either tend to ignore the approach of death altogether or become mystical about it, when what is really needed is acknowledgement of its reality and imminence. My cultural background (West Riding of Yorkshire) makes openness and honesty the most important philosophies of life and so I am lucky that I have had a background that makes those things come naturally. I don't think such an approach is self-deception any more than the use of morphine is a cop-out in the face of intractable pain.

Finally, make each day you have left be remembered by those around you as something of value. There is always something good to be seen, felt, smelt, tasted, read, thought or heard, but we may have to actively seek them out, and however small they are, like the tui's bath, store them up and let people around you know that you are still enjoying things and that the dying of the light holds no fears.

Stephen Wealthall is a paediatrician, educationalist and artWorker and writer of Greenhithe who has recently been diagnosed with widespread cancer which can be palliated but not cured.