Full text of nephrologist Fahad Saeed’s talk: What dying patients taught this doctor about the fear of death at TEDxRochester conference.
Listen to the MP3 Audio here:
Dr. Fahad Saeed – Nephrologist & Palliative Care Specialist
During recent years, medical science has made considerable advances.
The latest study published in one of the most prestigious medical journals has totally changed the way we think about living. This study showed that life may not be survivable.
And the chart here shows 100% of us will die. It’s not me saying it; it’s science.
While talking about your death, I am perhaps exposing you to one of your worst fears and one of mine. I’m a researcher; I’m a kidney doctor. I’m also a palliative care and hospice doctor.
Being someone who deals with death and dying on a day-to-day basis does not make me any better or worse than the rest of you when it comes to facing my own mortality. We’re all in this together.
Let me share with you my own journey with the fear of death.
I am an immigrant to this country, which is now my country. I came here after completing my medical school. I still remember that one cold night in New York City when I had no place to live, I had budgeted ten dollars a day to survive for next five months.
I was roaming the streets, wearing a light jacket. Clearly I had underestimated the severity of cold weather in New York. During that night, there was a time when I thought I was going to die on the streets of a foreign country.
Just to give you an update in case you didn’t notice: I am alive. But that night, exposure to my own mortality made me curious about how people cope with their death; how is it possible that one day we’re here in this world and the next we may not be?
So today I am going to tell you how to conquer your fear of death. On this important issue in my more than a decade long medical training experience, this is what I’ve learned. Nothing. Nobody taught me how to cope with the fear of death.
I have dreams and aspirations that can be shattered at any moment by my death. I’ve three young children and I wish to raise them to be good human beings. I aspire to do better and make a tiny impact in the field of medicine and help my fellow human beings.
But the reality is I’m scared of dying. And I am even more afraid of losing my loved ones. At one of the family gatherings, my mom who was approaching her seventies made a comment; she said “I don’t know how long I’m going to be with you all.” As soon as she uttered those words, my siblings and I immediately said, “No mom, you’ll be okay.”
I was a trained medical professional, and I said that. Can you believe that? I couldn’t get the truth out, because I was so afraid of losing her.
I felt totally inadequate. I couldn’t discuss my own mom’s end of life wishes — something that I do on a regular basis for my patients. So I really wanted to learn how people cope with the fear of death.
And I was very fortunate to learn it from the best teachers: my dying patients. These are my teachers; these are my heroes.
Myfirst hero’s name, we’ll call him Jerome. He and I met in my kidney clinic. He was in his 70s. He was wearing blue jeans and a black polo shirt. It was a very busy day. But there was something different about this office visit.
As soon as I entered the room I felt at peace. Over the next 25 minutes or so, I completed my history, physical examination. And then I asked him, “Are you a religious or a spiritual person?”
He said, “No.”
I remained persistent and made a rather risky move. I said “When I’m in your presence, I feel peace, and typically I feel this way in the presence of very religious and spiritual people.”
He smiled, and said “It’s because I don’t sweat the small stuff.”
I became even more curious, and I said “What do you mean by that?”
And then he told me a story. When he was in his 50s, one day his son and his family were visiting him. He was in two storey… he was on the first floor of his two-storey house, enjoying his morning breakfast, reading a newspaper. He was on the first floor; his son’s family were on the second.
Suddenly he heard his grandkids and daughters were screaming at the top of their voices, and he had no idea what was happening. So he immediately rushed upstairs. And there he saw something that would be the worst nightmare of any parent. His son had hung himself.
Jerome said, “Doc, over the next few minutes, I had to take care of my grandkids, my daughter-in-law, called 911 and untie my son. Once I’d done that I am fearless. I know why I’m here in this world. I am here to take care of my grandkids and help other children live and learn life. I totally know what living means to me.”
Jerome’s kidneys were working at less than 10%, but he chose against dialysis, because that did not fit into his way of living. So this was Jerome: caring for children was important; everything else was trivial.
My second hero, we’ll call her Betsy. She was in her 30s when her son was born. During a routine medical check-up, her doctor found a lump in her breast, said it probably wasn’t something but still recommended a few tests. After the results came in, she went back to see her doctor.
But the tone of the room was quite different this time. The doctor told her, “I’m very concerned that you might have a breast cancer. We need to do a biopsy.”
After those results came back, Betsy was diagnosed to have stage 2 cancer. Her whole life changed. She was worried… worried about her life, her family, a job, but mostly she was worried about her little baby, Harry who was only a few months old at that time.
Over the next several months she underwent surgery, received chemotherapy, received radiation. And amidst all of this, Harry had started to sit up and say his first word: “Mommy.”
Betsy celebrated Harry’s first birthday in the hospital. Luckily her cancer responded to the treatment and went into remission. Life returned to normal. She took a vacation, resumed her job.
And a few years passed. One day she woke up with an intense headache, called her doctor who did a few scans and told her that her cancer had come back. It was now in her brain, liver.
Betsy had stage-four breast cancer but she never lost hope. She kept fighting… fighting for her life, fighting for her son.
Over the next couple of years, she received different forms of chemotherapies but her cancer kept growing, and eventually became incurable.
One day she went to her cancer doctor who told her that she may have only a few more months to live, and she should consider hospice. Betsy had lost the fight of her life and she accepted this with a ton of grace and courage.
But she had not lost a fight for her son and she was totally committed to prepare her son for her eventual death and their reunion in heaven.
So over the next several weeks, she wrote birthday cards for him, recorded video messages for him, so he could watch them at the key moments of his life.
Betsy eventually died. But her last wish… her four-year-old son Harry was laying on her chest while she passed away. So this was Betsy. There was no fear in her end-of-life journey… only love and a strong sense of purpose.
I am not as brave as Jerome who didn’t sweat the small stuff. I’m not as brave as Betsy who kept fighting till the end. But these heroes inspired me to go back to my mom and talk about her end-of-life wishes during.
One evening walk I said to her: “Mom, how is it possible that one day we’re here in this world and the next we may not be.” This simple phrase allowed her to open up to me and express her end-of-life wishes to me.
As a medical doctor, too often I see dying and terminally ill patients struggling with embracing their mortality and expressing their end-of-life wishes to their loved ones. Caught between the fear of death and hope for life, unfortunately they choose burdensome treatments that are unlikely to prolong their survival or improve their quality of life in a meaningful way.
Making decisions for them on their behalf can be traumatizing for families who may later suffer from guilt and depression. So in a way my mom gave me a gift by discussing her end-of-life wishes with me. But I had to be courageous and be ready to receive that gift.
And interestingly when we spoke about her mortality, my anxiety about losing her also went down. And now I am more committed to honor her end-of-life wishes if her time comes before mine.
Jerome coped with his fear of death by clearly knowing what living meant to him. Betsy coped with her fear of death by having a lot of love and a strong sense of purpose during the last few months of her life.
My mentor and one of the pioneers in the field of palliative care doctor Timothy Cole says, “You die the way you live your life.” Makes sense.
How could you change during the last few days of your life? If I live a life full of fear, my end is going to be no different. If I live a life full of love and a sense of purpose, I die the same way.
So today I ask you: What does living mean for each of you? What does dying mean? Are these different things… are the opposite ends of the same rope called life.
Today give yourself permission not to live a life filled with fear, live a life filled with love, sense of meaning and purpose.
Resources for Further Reading:
- How to Overcome Indecision: Nuala Walsh (Transcript)
- The Girl Who Fell From The Sky: Emma Carey (Transcript)
- John Lennox: The Truth About AI, Consciousness, and God (Transcript)
- How to Hack Your Brain When You’re in Pain: Amy Baxter (Transcript)
- How To Talk To The Worst Parts Of Yourself: Karen Faith (Transcript)