How we die

How We Die: Sherwin Nuland on the Lifelong Art of Making Our Final Moments Meaningful

"To lament that we shall not be alive a hundred years hence, is the same folly as to be sorry we were not alive a hundred years ago,"Montaigne wrote in his timeless meditation on death and the art of living. And yet in the half millennium since his day, we've made paltry progress on coming to such nonchalant terms with the reality of death. We are still profoundly unprepared when it strikes our loved ones andparalyzed by the prospect of our own demise. Our discomfort with "the idea of a permanent unconsciousness in which there is neither void nor vacuum – in which there is simply nothing" is what surgeon, bioethicist, essayist, and Yale professor Sherwin Nuland (1930–2014) explores with astonishing wisdom and sensitivity in his soul-stretching 1993 book How We Die: Reflections of Life's Final Chapter (public library) – a dimensional treatise on death and an effort to "demythologize the process of dying," fusing philosophical reflections on its most universal aspects with the specialized complexities occasioned by the six most common disease categories implicated in modern death.

But Nuland's hard-earned professional expertise, his life's work in medicine and understanding the human condition, is merely the byproduct of his unforgiving personal brush with death – Nuland lost his mother to colon cancer a week after his eleventh birthday, a tragedy that shaped his life. "All that I have become and much that I have not become, I trace directly or indirectly to her death," he reflects. This book itself was written less than a year after Nuland lost his brother to the same disease that had claimed their mother's life.

Nuland writes:

Everyone wants to know the details of dying, though few are willing to say so. Whether to anticipate the events of our own final illness or better to comprehend what is happening to a mortally stricken loved one… we are lured by thoughts of life’s ending… To most people, death remains a hidden secret, as eroticized at it is feared. We are irresistibly attracted by the very anxieties we find most terrifying; we are drawn to them by a primitive excitement that arises from flirtation with danger. Moths and flames, mankind and death – there is little difference.