Losing someone you really love is a painful feeling and one of the most difficult experiences in our lives, yet no one is exempt from it. The rich or the poor, the powerful or the marginalised, the end of the life of a loved one brings the same degree of agony and suffering to all.
Not all goodbyes are final, but no one can truly foresee what waits around the next dark corner to say with certainty how long or short the final stage may last.
It is understandable how complex an act of visiting a loved one who is nearing the end of life is, and for most, it would be a soul-crushing moment like no other. The dilemma is real when you don’t want them to leave you, yet feel helpless seeing them in chronic pain and suffering.
Many would even flee the situation to avoid such confrontations, not knowing how to handle it with grace. While it is not all black and white, the fact is, what if they might need your presence and support. Of course, most of us are not trained enough to face serious life-limiting illnesses, let alone be prepared for saying goodbye forever.
On the other hand, things can sometimes go wrong, which may ultimately harm the patient or their family members. At the same time, be mindful that not everyone wants to talk about their disease journey. Hence, the simplest and least one can do is just to listen actively and hold their hands if possible.
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While we often think of holding hands as just an emotional gesture, it is deeply ingrained in our evolutionary logic and neuroscience. When the organs start to shut down, and cognitive functions like speech, thoughts and memory fade, the tactile system remains one of the final functional bridges that connects us with the other person. Therefore, being with them and comforting them with even such little gestures matters a lot.
In her book ‘The Four Things That Matter Most’, Ira Byock says there are four powerful things one can say to someone during their end-of-life care, which I often borrow in my clinical practice. They are simple yet have seen their power in real life on so many occasions and cannot vouch enough for these four golden lines. She encourages us to say..
Please forgive me
I forgive you
Thank you and
I love you.
These four statements are also echoed by the eminent palliative physician Prof. B. J. Miller in his book A Beginner’s Guide to the End. He writes, “Many people long to hear these four sentences, and they can help mend even long-fractured relationships.”
According to Ira Byock, at first, you need to ask for forgiveness, or you can forgive them, even if it may look like an extremely difficult task. We need to understand that it is human to make mistakes, and that defines who we really are. If one can do that, it enhances the sense of worth and definitely transforms lives. By providing forgiveness, we bring healing to ourselves and to the person who is being forgiven. It is surely one of the most powerful acts a mature person can do, especially during such times, when the window of opportunity is narrow, and it may be now or never
Secondly, you need to express gratitude to someone you love if you get a chance during this phase, especially when they are still able to understand and comprehend things. This is an explicit way to show how much you care and consider them. By showing appreciation, you are expressing your positive state of mind for all the goodness the other person has shown you. It can be one of the greatest virtues of humans as social beings, as it plays an important role not only in mental health, but also in the emotional and social well-being of both the giver and the receiver through a better closure to all.
Thirdly, you need to tell them and express how much you love them. It is a way to show how your relationship with them mattered. Sometimes it is difficult to put into words to express your love and affection that you may have for the person. But sometimes words are not necessary for certain relationships. In such a situation, you can be there and express your unconditional love and support in unique ways that you both understand.
When the end is near, time ceases to be a flow and becomes a luxury; each breath becomes a lingering goodbye, and these are the only moments that truly remain, where every second is vital.
(The author is a psycho-oncologist at Manipal Hospital, Old Airport Road, Bengaluru)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
