Why are we so afraid of death?
Ira Byock, MD was the Director of Palliative Medicine at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire and is currently Professor of Anesthesiology and Community & Family Medicine at Dartmouth Medical School.
Dr. Byock has authored numerous articles on the ethics and practice of hospice, palliative and end-of-life care. His first book, Dying Well, (1997) has become a standard in the field. His most recent book, The Four Things That Matter Most, (2004) is used as a counseling tool widely by palliative care and hospice programs, as well as within pastoral care.
Dr. Byock has been a consistent advocate for the voice and rights of dying patients and their families. He has been the recipient of the National Hospice Organization’s Person of the Year (1995), the National Coalition of Cancer Survivorship’s Natalie Davis Spingarn Writers Award (2000), the American College of CHEST Physicians Roger Bone Memorial Lecture Award (2003) and the Outstanding Colleague Award (2008) of the National Association of Catholic Chaplains.
Question: Why are we so afraid of death?
Ira Byock: Well, I do think it’s partly a human thing, I mean partly anthropologically, frankly biologically there is some hardwiring to avoid death. We fear, we have a fright or flight impulse or response built within us, a hormonally and neurochemically and the like. But I think it has become more exaggerated at least during the later part of the last century, during the last half of the last century, certainly I was born in 1951, and I know my parents talked about how in the 1930s it began to become apparent that there were dramatic miracles happening in medicine that people would comeback from the hospital after an ammonia or a serious urinary infection that should have killed them but with the advent of sulfa and penicillin’s and the like, people were just dramatically rescued and came back well from the hospital.
And then cardiac care got better and people didn’t die quite so quickly from heart attacks, and surgical care got so much better. And so as the power of medicines fueled by scientific advances became frankly dramatic, people culturally began to learn that the best care possible for anyone who you love and is seriously ill is to put them in the hospital. And frankly even better later in the century was to have them in the intensive care unit. And then it was the best hospitals, you don’t just want any hospital, you wanted the best hospital. So the American way of dying has gradually become dying in the hospital maybe in the intensive care unit, maybe even better still at the referral centre hospitals ICU.
Again there has been no ill intension, quite the contrary but it turns out that nowadays 20% of Americans die during a hospitalization that included an ICU admission. Many Americans, that’s a fifth of all American deaths. Many Americans are dying tether to machines, actually having their arms restrained so they don’t pull out their breathing tubes and the like, similarly 50% of people dying in hospitals, and 30% or so in nursing homes. This is not the way anybody really wants it, but we have never had a cultural conversation about what a healthy last chapter of life looks like, what that would actually look like to be taking the best care possible of one another professionally and socially in a way that is not always seeking to prolong life, and it corporates this notion that dying is going to happen at some point.
Recorded on: March 21, 2008
Why are we so afraid of death?
Learn how to redesign your job for maximum reward.
- Broaching the question "What is my purpose?" is daunting – it's a grandiose idea, but research can make it a little more approachable if work is where you find your meaning. It turns out you can redesign your job to have maximum purpose.
- There are 3 ways people find meaning at work, what Aaron Hurst calls the three elevations of impact. About a third of the population finds meaning at an individual level, from seeing the direct impact of their work on other people. Another third of people find their purpose at an organizational level. And the last third of people find meaning at a social level.
- "What's interesting about these three elevations of impact is they enable us to find meaning in any job if we approach it the right way. And it shows how accessible purpose can be when we take responsibility for it in our work," says Hurst.
Erik Verlinde has been compared to Einstein for completely rethinking the nature of gravity.
- The Dutch physicist Erik Verlinde's hypothesis describes gravity as an "emergent" force not fundamental.
- The scientist thinks his ideas describe the universe better than existing models, without resorting to "dark matter".
- While some question his previous papers, Verlinde is reworking his ideas as a full-fledged theory.
TuSimple, an autonomous trucking company, has also engaged in test programs with the United States Postal Service and Amazon.
PAUL RATJE / Contributor
- This week, UPS announced that it's working with autonomous trucking startup TuSimple on a pilot project to deliver cargo in Arizona using self-driving trucks.
- UPS has also acquired a minority stake in TuSimple.
- TuSimple hopes its trucks will be fully autonomous — without a human driver — by late 2020, though regulatory questions remain.