After reading When Someone You Love Is Dying, I would concur with the blurb on the back cover: “Few people are equipped by nature or by temperament to face the needs of a person who is dying. It is only when someone we know or love is dying that we struggle to learn how to respond. This is a book to help the person who is ready and willing to learn.
“Ruth Kopp, a specialist in clinical oncology, has written this book on the basis of her considerable experience with terminally ill patients. It is a handbook for the patients themselves, for those who counsel them, for their friends and loved ones, and for people in the medical profession who care for them.
“The shadow of death brings with it a sense of helplessness. With such a handbook as this, we need no longer feel that there is nothing we can do. Dr. Kopp is able to equip those who are dealing with terminal illness to understand and respond, using the resources God has given. ‘We are not at sea in a rudderless ship, nor are we totally alone.’”
What impressed me most about When Someone You Love Is Dying was the practical wisdom of the author, her solid grounding in the Word of God, which she weaves throughout the book, and her generous use of real-life case-studies. I also appreciated that she has treated enough terminally ill patients of all ages, both Christians and non-Christians, that she does not stereotype them, nor stereotype their families or doctors.
Looking back in my life, I wish I’d had the insights of this book when I was dealing with the death of my father in 1967 and my mother in 1996. However, I probably wouldn’t have been ready for them anyway. Looking forward in my life, I would be extremely pleased to have Dr. Kopp as my physician or the physician of one of my close loved-ones in a life-threatening health situation.
The table of contents will give you a good idea of what this book is about:
Section One: Denial in Terminal Illness
- Why are we afraid to die?
- I don’t believe it!
- The importance of “not yet” denial
- Responses to denial
- Christians’ responses to denial
Section Two: The Patient and His Doctor
- Selecting an ideal doctor
- It’s up to you, now
- The ideal patient/doctor relationship
Section Three: Terminal illness and the family
- The importance of communicating the diagnosis
- When a child becomes terminally ill
- When the family faces a parent’s terminal illness
- Till death do us part
Section Four: Responses to Terminal Illness
- The Christian’s response to terminal illness
- The role of anger in terminal illness
- Let’s make a deal
Section Five: As Death Approaches
- Preparing for death
- Waiting for death
- Facing death as a Christian
As I sometimes do in my reviews, I’m concluding with a number of direct quotes. For many of you this will be more than you want to read, but for others of you they may be helpful.
- “In today’s society, we live in what can be called a death-denying culture. By and large, we deal with our fear of death by denying the very fact of death.”
- “… the (dying) individual is alone. He usually hides his triumphs and his defeats, his insights and his feelings carefully, lest he upset, shock, or inconvenience those around him. He waits passively, allowing himself to be cared for, treated, and ‘worked on’ and carries on little discussion because he is afraid to lose the few people who come to treat him and spend time with him.”
- “Why are we afraid to die? Because death severs our ties to the familiar, because the time of death is uncertain, and because death is basically an unknown.” (The author develops each of these reasons.)
- “When an individual learns he has a fatal disease, his initial reaction is typically, ‘I don’t believe it!’ The same disbelieving reaction occurs in close friends or family members of the person diagnosed as having a fatal disease.”
- Denial can produce “partial deafness”, “deafness to long-term treatment”, “blindness to symptoms,” and “blindness in waiting.” “Denial effectively allows us to put off facing unpalatable facts.”
- “Initial denial tends to be a mixed blessing. While giving the individual time to gather his resources to face an emotional upheaval, it can also encourage costly, time-consuming procrastination in treatment that can have disastrous effects. So, denial needs to be handled in such a way that the terminally ill individual receives the best possible treatment as early as possible without undue emotional trauma.”
- “Inappropriate denial can be very difficult to live with, whether the denial is in the one who is ill, possibly causing him to treat his illness in an unwise fashion, or in the family, making it impossible for the dying individual to have meaningful conversations with the family and thus prepare himself and them for his death!”
- “Challenging statements made by a terminally ill individual in denial only results in anger and hostility. Yet agreeing to something that is obviously untrue can be harmful and for, for me at least, unpleasant. The ‘wait and see’ response gives me and the patient time to deal with the situation.”
- “Instead of rushing to reassure a loved-one that things are going well, when he asks, ‘Did the doctor say anything about how I’m doing? Offer him an opportunity to tell you how he thinks things are going. ‘What did he tell you?’ you might ask. ‘What do you think he means? Do you think that things are going well?’ This approach will open up the opportunity for him to talk.”
- In the chapter “Selecting an Ideal Doctor, the author writes, “Your doctor should assume responsibility.” “Your doctor should believe in your treatment.” “Your doctor should be willing to care for you. “Your doctor should recognize the importance of teamwork.” “Your doctor should be sensitive to your personhood.” “Your doctor should be honest.” “Your doctor should be communicative.” “Your doctor should be emotionally supportive … open-minded … maintain a sense of humor … reassuring … always keep medical costs in mind … family-centered.”
- “Although the ideal doctor is competent and be able to meet your particular needs, if he is a Christian, so much the better. As a Christian, he is in close touch with the Great Physician, trusting not only his own medical judgment and up-to-date knowledge, but also depending on God’s leading from day to day. He is not ashamed to ask God for direction in his decisions. He will pray about you, for you, and with you (if you wish), and acknowledge God’s help in all he does.”
- In the chapter “It’s Up To You, Now,” Kopp gives several “guidelines for becoming the ideal patient.” You will “exhibit intelligent interest in your own health, learn your diagnosis and medications, become somewhat familiar with your tests, list important phone numbers, assume responsibility for treatment, respect your doctor’s opinions, not ask impossible questions, not pressure your doctor to judge another doctor, be cooperative in referrals, not use your doctor as a pawn, show genuine feelings, look to others besides your doctor for emotional support, and be willing to work toward a good relationship with your doctor.”
- Regarding “important principles in the doctor/patient relationship”: “Allow your doctor to make decisions. Realize that some decision deal with emotionally packed issues. Be open to learning. Realize that your family communication is the family’s responsibility. Encourage a necessary family/doctor relationship. Prepare questions. Learn what’s important. Plan for the emergency. Take notes.”
- “What to do when doctor/patient communication fails”: “Confront your doctor when necessary.” “Choose a go-between.” “If you must, switch doctors.”
- “I believe that a dying individual has the right to be told, in meaningful terms: that he has a serious and probably fatal illness. He should know his diagnosis and have a fairly good idea of its implications so that he can deal with the facts as he sees fit.”
- “One of the crucial factors in the care and well-being of a dying individual is the support and comfort he receives from his family. Except in the case of a severe emotional illness in one or more family members, such as depression or schizophrenia, lack of communication is the greatest barrier to realizing the full support and strength of the family during the strain of terminal illness.”
- In the chapter “When a Child Becomes Terminally Ill” the author gives valuable advice to the parents on “how to avoid marriage breakdown.” “Recognize anger and blame.” “Recognize areas of self-blame.” “Communication despite tremendous physical work.” “Remember that marriage will go on.” “Recognize that terminal illness is exhausting.” “Set aside special time for each other.” “Maintain sexual intimacy.” “Reciprocate acts of love.”
- How parents can relate to their children: ”Avoid using illness to gain leverage.” “Do things as a family whenever possible”.” Keep the other children informed.” “Be aware of the other children’s reactions.” “Allow room for friction.” “Don’t depend too heavily on the children.” “Express love.” “Present a true picture of God.” “Be willing to say ‘I don’t know.’” “Work to achieve balance in all areas.”
- “Every child in the family handles the impending death of a parent differently.”
- In the chapter “Till Death Do Us Part” the author gives the following advice when either the husband or the wife is facing a fatal disease: “Recognize emotional stress.” “Understand the mother/father role.” “Recognize physical stress.” “Write details down.” “Encourage open expression.” “ Contrast feelings of guilt and blame.” “Budget time and energy.” “Recognize the need for physical closeness.” “Realize the importance of touch.”
- “When the true nature of their terminal illness sinks in, many Christians are overwhelmed with their absolute helplessness before a cruel and unjust fate. They feel vulnerable and powerless, and these feelings lead to frustration and anger. They look to God for help and may find that He is silent.” (Lots of great biblical insights in this chapter!)
- “Anger plays a real role in the course of terminal illness. Despite opinions to the contrary, anger is not automatically or necessarily a sin. It just happens. Sometimes anger is appropriate and appropriately expressed. For example, anger can result in great personal benefit when we express it openly to God and allow Him to respond to it. In this situation, we may find ourselves face to face with Him in a new and wonderful way.”
- “Bargaining is an emotional buffer similar to denial. People who bargain are aware of the real nature of their nature. However, they are not quite ready to fully accept the truth and try to ‘make a deal.’”
- “When we discover that we have a terminal illness each of us experiences what I have chosen to call preparatory grief. As the name implies, preparatory grief consists of two parts – preparation for death (‘final arrangements’) and mourning.”
- “The mourning aspect of the preparatory grief and the necessary preparations for death, will, of course, depend on the age of the dying individual.”
- The author does a good job of looking at the above topic from the standpoint of different age groups – children up to 6, preadolescents (7-12), adolescents (13-19), young adults, middle-age adults, and older adults.
- Likewise in the chapter entitled “waiting for death” the author deals with the subjects by these age categories.
- In the final chapter “Facing Death as a Christian” the author stresses the importance of “communicating openly and honestly with others and with God.”
- She declares: “Write things down.” “Become aware of and recognize feelings.” “Express love and appreciation.” “Realize that good can come from terminal illness.” “Recognize the strain of terminal illness.” “Admit mistakes and continue on.”
- The last two pages of the book called “The Final Challenge” contain many beautiful biblical and personal insights from Dr. Kopp.