Life and Death

Dear Shekinah’s Substack “The Worst” Subscribers,

This is Adam, Shekinah’s husband, again offering a short preface to what has turned out to be Shekinah’s final post to “The Worst.”

For those who did not see yesterday’s post, Shekinah passed away last week, surrounded by her loved ones and tender hospice care in her final days. To publish this particular piece posthumously illuminates its prescience, although Shekinah did not write it with the direct knowledge, or plan, that it would be her final piece. Then again, she wrote every one of these reflections as though it might have been her last, which, really, is how she lived every day of her life, certainly the 2,536 days that I knew her. She is now as home as the universe will allow, and, I know that she will continue to be happy to be amongst us. -Adam

I have a controversial revelation. It’s ridden steadily in my head and heart over the last 15 years or so as my personal experiences as a patient mesh with my professional experiences as a physician. The field of palliative care, which I love, and have benefitted from greatly, talks often about how important it is to ensure that a patient has a “good death.”

There is no such thing as a good death.

I came as close as I have to death last November. Sitting up was enormously difficult so I stayed mostly lying on my side. I would fluently wax in and out of consciousness. My son would walk up to me level with the bed until he could stare at my face. There was music, family, friends, the lovely social workers and chaplain, who helped put what the next world could bring into as much perspective as one might have in this one. I felt like I would disappear. Periodically. When would it happen, really? Has this been my goodbye, or would there be another, or another? Was there some last thing that I had yet to think of or do? I cried many times every day.

I didn’t have any physical pain. I couldn’t think of any last grudges, last forgiveness that remained for me. And yet, I would leave my 5-year-old son. I would leave my husband and true companion. There was no negotiating this. What was so good?

What on earth would make this a good death? The opposite of bad here just does not seem to me to be good. Would it need to be without pain, without fear, without desire, without hesitation? This to me seems to be without the humanity that exists in those of us that are dying, more something we say to comfort the still living.

Perhaps we can focus on the things that are most wanted at the end of our lives. We’ll never be back to report whether a death was good, satisfactory, or terrible. The moment-by-moment that we inhabit the humanity that suits us best in these often difficult moments, perhaps we may only support ourselves and each other to say there’s striving for an end of life that matches what we most hope for. It’s probably different for each of us. We’re not bad. We’re not good. We are human and we aim to be as home as the universe will allow.