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DYING WELL by Ira Byock

DYING WELL

The Prospect for Growth at the End of Life

By Ira Byock

Pub Date: Jan. 27th, 1997
ISBN: 1-57322-051-5
Publisher: Riverhead

 A hospice doctor's wrenching stories of dying patients and their families, which dramatically illustrate his belief that the transition to death can be one of life's most meaningful experiences. Byock, a specialist in palliative care who directs a hospice in Missoula, Mont., has chosen stories that represent a wide range of experiences, each focusing on some aspect of human growth. Pseudonymns are used throughout except for Byock's moving account of his own father's death and the story of the Merseal family, whose dying son was the subject of a 1996 HBO documentary. What is crystal clear in all of them is that the full experience of dying is not captured from a purely medical perspective. Without proper medical care, dying can be agonizing, but relief of physical pain, which Byock contends is always possible, is by no means the whole picture. In his experience, emotional pain is more intense and requires more skillful intervention. Dying well, says Byock, involves reaching certain landmarks, which he encourages his patients to achieve: asking forgiveness, accepting forgiveness, expressing love, acknowledging self-worth, and saying good-bye. One of the hardest to read of Byock's stories describes the death of Terry, a 31-year-old mother with cancer who cannot reach these landmarks and suffers greatly. Her story also illustrates the fine distinction between hastening death and ensuring comfort. Byock, who argues that the euthanasia debate has distracted our attention from more logical and humane approaches, is not afraid to give his considered opinions about assisted suicide, vegetative states, and feeding tubes. Often reminiscent of Michael Kearney's recent Mortally Wounded (p. 1029), which described that doctor's work with patients in an Irish hospice, this is another powerful argument in favor of the hospice movement and rejection of the Kevorkian approach.