A Good Man, A Good Death

A Good Man, A Good Death
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At 3:15 PM PST today, Friday, May 15, 2009 my long time mentor and beloved friend, Edwin Shneidman, pioneer in the study, prevention and intervention of suicide and suicidal behavior died at age 91 as he would have wished, peacefully at home. To appreciate the magnitude of his being able to do that you need to read: Waiting for the End, Alone and Unafraid and if you want to read the story behind that story, you will want to read the Neiman Foundation for Journalism at Harvard interview with Tom Curwen.

Ed was the founder of The American Association of Suicidology and Professor of Thanatology at UCLA. He authored, co-authored or edited nineteen books on the topic.

I had the occasion to visit him - not as often as I should have -over the past several physically painful years of his life. I believe one of his greatest accomplishments is that he managed to meet all the ten "Criteria for a Good Death" that he set forth in an article with that title published in June, 2007 in Suicide and Life-Threatening Behavior published by The American Association of Suicidology.

1. Natural. There are four modes of death--natural, accident, suicide and homicide (NASH). Any survivor would prefer a loved one's death to be natural. No Suicide is a good death.

2. Mature. After age 70. Near the pinnacle of mental functioning but old enough to have experienced and savored life.

3. Expected. Neither sudden nor unexpected. Survivors-to-be do not like to be surprised. A good death should have about a weeks lead time.

4. Honorable. Filled with honorifics but not dwelling on past failures. Death begins an ongoing obituary, a memory in the minds of the survivors. The Latin phrase is: De mortuis nil nisi bonum (Of the dead [speak] nothing but good).

5. Prepared. A living trust, prepaid funeral arrangements. That the decedent had given thought and made arrangements for the necessary legalities surrounding death.

6. Accepted. "Willing the obligatory," that is, accepting the immutables of chance and nature and fate; not raging into the night; acceding to nature's unnegotiable demands.

7. Civilized. To have some of your loved ones physically present. That the dying scene be enlivened by fresh flowers, beautiful pictures, and cherished music.

8. Generative. To pass down the wisdom of the tribe to younger generations; to write; to have shared memories and histories; to act like a beneficent sage.

9. Rueful. To cherish the emotional state which is a bittersweet admixture of sadness, yearning, nostalgia, regret, appreciation, and thoughtfulness. To avoid depression, surrender, or collapse; to die with some projects left to be done; by example, to teach the paradigm that no life is completely complete.

10. Peaceable. That the dying scene be filled with amicability and love, that physical pain be controlled as much as competent medical care can provide. Each death an ennobling icon of the human race.

Ever the articulate humorous iconoclast, I think Ed would have eschewed the pomp and circumstance I ellaborated above and prefer that I had just said that he hoped he had simply followed the dictum of his mentor, Henry A. Murray: "A good death is dying so as to be as little a pain in the ass to your family as possible."

I will be forever grateful to Ed who early in my career had enough confidence in me to entrust some of the most suicidal patients from the UCLA in patient wards when they needed to be discharged, but were still suicidal. He did it with a simple phone call: "Hello Mark, this is Ed. I am sitting with a lovely young woman. She's in a lot of pain. You can help her. SEE her."

I also owe Ed a singular skill to help such people when he told me: "Mark, if you listen for hurt, fear and pain, it is always there. And when the other person feels you listening and feeling them, they will lower their guard, open their minds and hearts to you, allow you to enter and comfort them and if you're fortunate, will let you walk them out of hell." I put Ed's sage advice about listening to good use with the most suicidal patient I had ever seen when I experienced "A Breakthrough Moment for Us Both."

And Ed, regarding being "as little a pain in the ass to your family possible"... I think you actually pulled that off.

Now it's time to thank you for how many millions of people your life work has helped to face death and to bid farewell to you Ed, using the same words you would use when I would leave your home during recent visits: "Goodbye dear man."

Be at peace, I will miss you.

Read Los Angeles Times obituary, May 18, 2009.

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