Courage is a mighty word. We love the idea of courage. We look for it in all situations to lift us up from our daily lives. We see many examples, military examples, civilian examples, examples of the medical personnel battling on the front lines in COVID-19, and with every illness. Courage for us is often about fighting for life or its truisms: preserving the honorable virtues of the sanctity of life.
So its easy to forget about the courage of facing mortality. In my experience with hospice, I find that it takes a remarkable person to accept reality as it is. And we do get these remarkable individuals: a patient whose family wanted her to choose aggressive treatment for locally invasive pancreatic cancer, but who chose hospice instead; the patient with a leg sarcoma whose bypass graft for perfusion failed with critical ischemia, but who chose full comfort over going back again to the hospital.
One might say that since death is inevitable how is it a choice to face it? Therein lies the key. The choice is in how you face the ultimate reality of death. It is commensurate to how you faced reality in life - with denial and faulty coping mechanisms, or with proactive acceptance? Do you face the truth with a mind to reverse what can be reversed and work with what cannot? Do you accept that mortality is ultimately non-negotiable and that it will happen to you, too? Do you believe that dying may have a purpose and that good palliative care can smoothen out the course of death? Or do you fight reality, internally and externally, unwilling to accept the insult of decline.
It isn't that we overcome our fear of dying. This may very well be impossible - and destructive to our purpose. A fear of death is likely the most useful spur in our lives to use our minds and bodies for achievement. But, if overcoming fear is not an option, facing our fear is. And choosing hospice is one way of facing the fear of mortality. Choosing hospice, acknowledging your mortality, accepting your imminent transition to the next phase without knowing the how, why, and exact when it will happen, is an incredible manifestation of bravery.
To all those patients who face their mortality with grace, dignity, and humility, I salute you for your heroism.