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Insight Into The Last Words

Discussion in 'Snippets of Life (Non-Fiction)' started by Viswamitra, Nov 22, 2019.

  1. Viswamitra

    Viswamitra IL Hall of Fame

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    A clinical psychologist when he was sick with the flu, he used to jokingly remind his wife that he wanted Beethoven’s “Ode to Joy” played at his deathbed. Later, he was lying in his study with his body besieged by cancer and his consciousness cradled in morphine, uninterested in music and refusing food as he dwindled away over three weeks and said to his wife, “Thank you, and I love you, and enough.” When she came downstairs the next morning, she found him dead. He used to be a prolific poetry writer, but his end-of-life speech often didn’t make sense. “There is so much so in sorrow,” he said at one point. “Let me down from here and I have lost my modality” he said at another occasion. Being a lifelong atheist, he began hallucinating angels and complaining about the crowded room- even though no one was there. His daughter Lisa Smartt kept track of his utterances, being a poet herself, she appreciated his unmoored syntax and surreal imagery. Eventually, she wrote a book, Words on the Threshold, published in early 2017, about the linguistic patterns in 2,000 utterances from 181 dying people, including her father.

    It turns out that vanishingly few have ever examined these actual linguistic patterns, and to find any sort of rigor, one had to go back to 1921, to the work of the American anthropologist Arthur MacDonald. Arthur found that military men had the “relatively highest number of requests, directions, or admonition.” While philosophers (who included mathematicians and educators) had the most “questions, answers, and exclamations.”

    Final Gifts, a book published in 1992 by the hospice nurses Maggie Callanan and Patricia Kelley, and Final Conversations, published in 2007 by Maureen Keeley, a Texas State University communication-studies scholar, and Julie Yingling, Professor emerita at Humboldt State University, aim to sharpen the skills of the living for having important, meaningful conversations with the dying. “As the person gets weaker and sleepier, communication with others often becomes more subtle.” Callanan and Kelley wrote. “Even when people are too weak to speak, or have lost consciousness, they can hear; hearing is the last sense to fade.”

    “Most people whisper and they generally are brief with single word and that is all they have energy for” Keeley said. Medication, dry mouth and dentures prevent them communicating fluently. Many of them die in silence particularly if they have advanced dementia or Alzheimer’s that robbed them of language years earlier. A nurse from the hospice indicated that the last words of dying men often resembled each other and almost everyone is calling for “Mommy” or “Mama” with the last breath.”

    It is the interaction with the dying that gets etched in the mind and many times when a family member calls the name of the dying person, he or she opens her eyes and die instantly. The living person remembers how the person’s eyes quivered before death.

    One common pattern Lisa Smartt noted from her father was, he used pronouns such as it and this, which didn’t clearly refer to anything. One time he said, “I want to pull these down to earth somehow…. I really don’t know…. No more earth binding.” What did these refer to? His sense of his body in space seemed to be shifting. “I got to go down there. I have to go down”, he said, even though there was nothing below him. He also repeated words and phrases, often ones that made no sense. “The green dimensions! The green dimensions!” (Repeating is common in the speech of people with dementia and those who are delirious). Lisa Smartt found that repetitions often expressed themes such as gratitude and resistance to death. But there were also unexpected motifs, such as circles, numbers, and motions. “I have got to get off, get off! Off of this life“, her father had said.

    One dying person talked about a train struck at a station, then days later referred to the repaired train, and then weeks later to how the train was moving northward. Another said, “Oh, there is a boxing champion standing by my bed” that just sounds like hallucination. But when he repeated it, living people were wondering why this narrative was going on. But these narratives could be clinically helpful, as these kinds of stories moved towards resolution, which might reflect a person’s sense of the impending end.

    In Final Gifts, Callanan and Kelly note that, “the dying often use the metaphor of travel to alert those around them that it is time for them to die.” A 17-year-old dying of cancer, distraught because she can’t find the map. “If I could find the map, I could go home! Where is the map? I want to go home”, she said.

    Even basic description of language at the end of life would not only advance linguistic understanding but also provide a host of benefits to those who work with the dying, and the dying themselves. Experts told me that a more detailed road map of changes could help counter people’s fear of death and provide them with some sense of control. Experts believe that a more detailed road map of changes could help counter people’s fear of death and provide them with some sense of control. It could also offer insight into how to communicate better with the dying. Differences in cultural metaphors could be included in training for hospice nurses who may not share the same cultural frame as their patients.

    End-of-life communication will only become more relevant as life lengthens and deaths happen more frequently in institutions. Most people in developed countries won’t die as quickly and abruptly as their ancestors did. Most deaths will happen in hospitals, hospices, or nursing homes overseen by team of medical, social, psychological and spiritual consultants. Like everyone focuses the attention on quality of life, it is extremely critical to focus on quality of care when a person is dying due to terminal illness. For that, when the patients’ communication is restricted, one should be able to understand and assimilate their needs not only their medical requirements but also other needs. One can only hope that a journey is comfortable if the preparation for the journey is comfortable.

    Let me end this write up with an excellent poem written by John O-Donohue in “Anam Cara: A book of Celtic Wisdom”

    A Blessing for Death

    "I pray that you will have the blessing of being consoled and sure about your own death.
    May you know in your soul that there is no need to be afraid.
    When your time comes, may you be given every blessing and shelter that you need.
    May there be a beautiful welcome for you in the home that you are going to.
    You are not going somewhere strange. You are going back to the home that you never left.
    May you have a wonderful urgency to live your life to the full.
    May you live compassionately and creatively and transfigure everything that is negative within you and about you.
    When you come to die may it be after a long life.
    May you be peaceful and happy in the presence of those who really care for you.
    May your going be sheltered and your welcome assured.
    May your soul smile in the embrace of your anam cara."
     
    Last edited: Nov 22, 2019
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  2. Viswamitra

    Viswamitra IL Hall of Fame

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    This thread was written as requested by @Amica. Those who are interested in reading this, kindly do so and give your insight, experiences and further additions to enrich this thread. Those who are afraid of reading about death, please stay away. This thread is not about me but about understanding the language of those who are dying. As a mark of respect for them, please don't use sarcastic videos, audios, languages in this thread. Kindly use specific threads intended for general comments about all the writers and their contents, if required.
     
    Dhamini, Mistt and Amica like this.
  3. sokanasanah

    sokanasanah IL Hall of Fame

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  4. Amica

    Amica IL Hall of Fame

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    Thank you so much, Viswa. I really do appreciate your making time to write this.

    It's a fascinating subject. Interpretation of anyone's words, especially if they are incoherent, depends so much on the belief system of the interpreter. I hadn't given this much thought till I came across your post in "Transition." I hadn't realized there was a pattern to deathbed utterances. Lots of food for thought in your snippet!

    BTW, I don't click "like" on your posts in the Transition thread because it seems inappropriate given the content. Although, of course, I read it regularly.

    So, thank you!
    .
     
  5. Viswamitra

    Viswamitra IL Hall of Fame

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    Soka,

    Rosebud, a childhood memory or something else? It is a mystery.
     
  6. Viswamitra

    Viswamitra IL Hall of Fame

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    @Amica,

    Thank you for your response. As a family member, the last words of those who die, is always a puzzle. It looks like most of their utterances are focused inwards or about their journey or a strongly etched memory flash. I wish there are more studies to understand the pattern which might help both patients and the family members. Who knows, it might make a big impact in palliative care?
     
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  7. Greenbay

    Greenbay Gold IL'ite

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    Death intrigues me. I lost my father before I turned 5.5, so had no idea what it meant. Since I was the son and my older siblings were daughters, I was asked to perform certain rituals though I didn’t have thread ceremony then. I lost my dearest mother when I was vacationing in Maine in 2008. So could not even reach India before her funeral but was the one to perform the rituals. Mourning period is 13 days but for me, it extended to months and years. I often wondered what she would have liked to convey as departing words to me. She used to come in my dreams everyday for the first few months after her departure. It is probably my imagination that I have seen some shadow around the house as though she is watching me.

    Lucky are the ones who could spend valuable quality time with their loved ones before that final journey.

    @Viswamitra sir, many thanks for this write up.
     
  8. shravs3

    shravs3 IL Hall of Fame

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    When my grandpa passed away most of the family members reached the previous day. Some of us where in the hall and only my aunt was in room beside him. She said during those final moments he was smiling before leaving this world.
    Death bed is one of the scariest and saddest things to experience. I shiver if I think about such things.
     
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  9. Viswamitra

    Viswamitra IL Hall of Fame

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    @Greenbay,

    Thank you for your response and for sharing your experience of facing your father's death at a very young age when you couldn't even comprehend the impact of such tragedy. Hats off to you for handling the rituals at that age. I am so sorry to hear about your inability to reach on time for your mother's funeral. No wonder, your mourning extended months and years thinking about your mom. I talked to my mom three days in a row when she was in the hospital when she recovered from loss of sodium but Skype call next day made me feel that she was not recognizing anything. Before, I could get ready to leave, she passed away. However, I reached on time to be part of the funeral even though I have an elder brother. I gave a word to her that I would be with her if something were to happen and I fulfilled that promise. This happened in 2017.

    The feeling that they are out of pain and well received wherever they are gives us a sigh of relief. I am sure the parents wish us well and especially when they are not around, they bless us more.
     
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  10. Viswamitra

    Viswamitra IL Hall of Fame

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    @shravs3,

    You are still too young to think about death and perhaps that is why deathbed is scary and sad things to experience for you. However, as I grew older and when I began to see people of my age group or even people younger than me pass away, it brings realization to me that everyday is precious gift and I count my blessings for my good health. It makes me explore to understand the process of death so that I could be courageous when I need to handle it.
     
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