The Four Ways People Die

Mark Starmach writes on Medium about the four ways people die and how to do it well. Dr. Yvonne McMaster, a retired palliative care physician, explains that basically, there is sudden death (rare) and the others are variations on how even and long the decline is, from slow, gentle slope to periods of being better and worse to slow followed by fast.

[P]alliative care is somewhere in the background. It’s supportive medicine and therapy in the form of symptom-controlling medication, rehabilitation, and counsel, which doesn’t necessarily cure illness, but does make it easier to cope or recover. Curative and palliative efforts complement each other. Curative care makes you get better, but palliative care makes you feel better, kind of like how a sore throat lozenge soothes your throat even if it doesn’t “cure” the cause of the soreness.

As we get older, however, many of us develop conditions that are life-limiting, chronic, or terminal. (Life itself is a terminal condition, as Yvonne likes to remind me.) And this is when palliative care comes more into the foreground, focusing on a patient’s quality of life, symptoms, and emotional wellbeing, as well as the welfare of their loved ones. It doesn’t focus on curing but it isn’t “giving up,” and it doesn’t necessarily mean that death is imminent; many people receive palliative care for years.

It also isn’t the same as euthanasia.

Dr. McMaster talks about "a good death."

A good death is one as painless as possible.

A good death is one with friends and loved ones by your side and medical assistance within arm’s reach.

A good death is one where you are looked after in accordance to your values and wishes, seamlessly, as you’re moved from institution to institution.

But there’s another element to a good death, which I see as a common theme across all of Yvonne’s stories: a sense of closure.