I can tell when I’m struggling because I find myself dwelling on death a lot. Historically the concept of death has terrified me, and I can’t say I’ve come very far in overcoming this. Though I’ve realized the fear runs heavy in me, I haven’t really wanted to uncover that stone. I’ve wondered for a while now whether this particular fear is at the root of some of my anxiety.
During a recent counseling session, the therapist and I started talking about my fear of death. I can get kind of revved up when I try this. “Why go there? Nothing good comes from that,” I say to myself. I haven’t found anything very helpful about trying to put words to this fear, this inevitable reality that we all face. Usually, I use a number of techniques to get away from the topic if it’s gnawing at me — typical phone distraction, numb it away with a beer or two, pull up a podcast.
What I think I really mean when I say “fear of death” is loss of a dear loved one, especially my wife. I don’t so much worry about my own death, though I often put myself in the shoes of my patients and consider the burden many of them are carrying. I think, “Man, I don’t think I could do what they’re doing.” Somewhere along the way I picked up this idea that death was final, unwanted, the end of the fun, the end of easy, the start of suffering. Suffering scares me. At some point after high school the thought of losing my closest people started freaking me out.
I’ve slowly realized my fear has deeper layers. It’s not just the fear of death or being told I have a terminal illness or something like that. The deeper layer is doubt about my resilience. Would I be resilient enough to handle that pain? There aren’t a lot of things in life where I’m saying, “I have no idea if I could handle that.” I feel pretty capable, but this fear — this thing I can’t control — this is a unique place where I honestly wonder if I’d be okay. Would it send me over the edge? Would I become just a shell of myself? Would I make it out, and how?
Have you ruminated on certain questions about your great fears? I mean those questions without many truly satisfying answers, questions that seem vague and philosophical and not really worth bringing up with others – you just hope asking the question itself is what brings some peace by simply engaging it. Mine are these: What is a “normal” level of fear or anxiety when considering death? Does spirituality really help me here? If even Jesus wanted the cup to pass, am I alright if I too want that? Am I causing this, or is this a thorn I’ve been “given” that I’m supposed to learn from?
I know as an emergency medicine physician I’m supposed to have eloquent words for my encounters with death and suffering, but words often don’t translate to feelings, ya know? I know the words to say about my fear, but I don’t know how to actually feel differently about my fear, which is what I really want.
Last week I had a patient brought in by ambulance under CPR. This happens a lot, but something less common stood out to me: she was only 40. I learned pretty quick that she had 3 kids, whom she was with when she collapsed. I have a vivid memory from residency of a healthy pregnant woman brought in under CPR who most likely died because of a sudden blood clot in her lungs. Her husband must have been my age, and I watched him absolutely lose it while we tried everything unsuccessfully. PTSD is real, and I felt leveled for a while after that. I kept playing the scenario out in my head except with Melanie as the young pregnant woman. Coding this woman last week reminded me of the fears and stress I felt after that pregnant woman passed.
During those first few minutes after the 40-year-old woman arrived, someone told me her husband had arrived. Once I could leave for a minute, I quickly went to talk to the husband in the hallway. Things were super bleak. “I’m just not ready to say goodbye,” he said after a big sigh with his hand on his forehead. After a long time and a lot of effort, we called it, the room completely trashed and our techs sweating from an hour of CPR. Outside, the husband shook my undeserving hand and I gave him her necklace. “I’m going to need this,” he said. Mostly out of not knowing what else to say but sensing he didn’t want to be left alone yet, I asked about his kids and where they were and how his wife had been doing the last few days. He answered as he sat in a chair someone had brought him. He asked what I thought had caused her death. Somewhere in there, I gave a sterile and lame explanation of what autopsies can and can't tell us, and I remember him generously saying he understood and asking, “By when do I need to make that decision?”
He was able to think into the future even just a little; he wasn’t so stuck. He had a wider perspective somewhere in there, the kind I subconsciously feared I wouldn’t have in his shoes. He seemed to acknowledge there was going to be a ton of pain in the coming season, but he also seemed stronger than I thought I would have been. Who knows - no one really prepares for those moments and no one knows how to respond - but at least in my head, this man was clearly reeling but was obviously brave. His life could accept this new reality, eventually anyway.
Sometimes God uses something we’ve experienced numerous times in the past to suddenly open our eyes to something new that was in front of us the whole time. My colleagues and I see death at work pretty frequently. Gosh, I’d even been through the unexpected death of my dad a few years ago, and I watched Mom and my brother bravely mourn and come out the other side. But nothing “clicked” in that for me at the time — it didn’t seem to really combat my fear of death like you’d expect. It’s why when someone tells you a fear they have, you can’t always jump to logic: “But XYZ happened, and that turned out fine…” Sometimes it just takes a while for the layers to be peeled back.
I now see my fear has actually been about how I’d respond to the suffering – would I have the strength to handle it, to make it matter and not let it consume me. I don’t think it’s realistic to not have fears, but I have to believe God will gift me the courage and perspective to face them. I have to believe God whispers “You’d be okay” to us when we dwell on our fears. Where we naturally doubt our own abilities, we lean on our communities, which are full of people whose experiences going through hard things are trustworthy and provide hope. When that husband shows bravery, shows a perspective I need, and seems to trust he’ll ultimately be okay despite the pain, I get a little less afraid of my fear.
- Conor M.