Cover image for Dying : a guide for helping and coping
Dying : a guide for helping and coping
Shepard, Martin, 1934-
Personal Author:
Publication Information:
Sag Harbor, NY : The Permanent Press, 2000.
Physical Description:
208 pages : illustrations ; 22 cm

Format :


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Material Type
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Item Holds
BF789.D4 S478 2000 Adult Non-Fiction Open Shelf

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Dying is a guide to not only dealing with the death of loved ones, but an exploration of facing one's own death. It is a book designed to amplify and challenge one's own perception of the dying process and death itself in order to allay fears and help one, hopefully, to build a richer spiritual foundation.It is a practical book designed to teach tools for honest and open communication between the dying and one's family and friends, a book that offers suggestions on everything from the most challenging and painful aspects such as bereavement to the everyday choices of pain alleviation, funerals, hospital stays, alternative treatment, financial problems, and caring at home for the terminally ill.Throughout the book, Dr. Shepard utilizes not only the perceptions of sages throughout the ages, but his own interviews with both dying patients and families which are moving, comforting, and enlightening.

Reviews 2

Booklist Review

Shepard, a psychiatrist, bases this guide on the experiences of his patients and his father. He states the theme early: "Most of us start off at a disadvantage because we regard death as a calamity." Honesty, open communication, and freed emotions, however, can be the foundation of a comfortable and comforting death. Shepard interviews patients and family members alike to elucidate how anxieties, blockages, and dislikes are brought out and either dispersed or accepted. Acknowledging that no one is perfect, Shepard shows that imperfections can be dealt with successfully in most cases. Good relationships are essential. The patient must trust that the physician will answer questions clearly and without sugarcoating. Family members must make the best of the time remaining to the patient. Finally, the dying person must be responsible for attaining personal peace of mind. Shepard also gives practical advice on wills, cremation, and funeral homes. The accompanying line drawings of the sick and dying, done by Shepard's father during his final illness, fit the book perfectly. --William Beatty

Publisher's Weekly Review

Anyone facing a terminal prognosisÄas helper, friend, relative, patient or health-care professionalÄ will find useful lessons in psychiatrist Shepard's look at how to deal well with impending death. Patients want to know how others have felt; family members want to know what to do. Some health-care professionals could use advice on what to disclose, and how, and to whom, and when. Most of the volume alternates straightforward adviceÄcouched so as to reach a broad audienceÄwith brief interviews with patients or their intimates. A law student now recovering from a malignant melanoma recollects his diagnosis and surgery. A 65-year-old contractor with myeloma illustrates how "one can... know the truth and still be optimistic." "Karen," a nurse, describes how she has coped with Hodgkin's diseaseÄand how her husband seems to have practiced denial. And a cheery middle-aged nun explains, in fairly ecumenical terms, how she takes care of herself and keeps her outlook bright. Shepard (Fritz) includes an invaluable, if brief, section on the legal, practical and financial aspects of dying and being a survivorÄwills, insurance, pensions, planning a funeral. Hospice care deserves and gets its own chapter; so does bereavementÄ"Deborah" describes the aftermath of her father's suicide; "David" describes his life as a widowed single parent. Boxed quotes and last words from famous and semifamous artists, wits and thinkers (Shakespeare, Browning, F.H. Bradley) adorn every chapterÄleading up to a concluding section of meditations penned by Shepard himself: e.g., "None of us will ever get out of this world alive." Several chapters of this admirable book feature line drawings by Shepard's father, who died in 1972, soon after completing them. Large print edition rights sold to Thorndike. (July) FYI: Shepard is the cofounder and copublisher of the Permanent Press. (c) Copyright PWxyz, LLC. All rights reserved



Chapter One Someone You Love Is Dying The act of dying is also one of the acts of life. --Marcus Aurelius I live near a bay in Eastern Long Island in an area populated by farmers, beachcombers, and a host of wild animals. One sees hundreds of rabbits every year, but never any dead ones. Pheasants walk among the rye grass and potato fields. Occasionally one is struck by a passing car. "Poor bird," I momentarily grieve, and pass on, aware only that all other pheasants I've encountered are always quite vital and alive. One summer, the body of a swan lay in the field across the street. I assumed it broke its neck on a high-tensions wire and died, unnaturally, for whoever sees a dead bird unless a bizarre accident has occurred?     Like humans, the other beasts that inhabit this world have a habit of dying privately, beyond the sight of passersby. It has been calculated that each square mile of temperate sky contains twenty-five million insects that fly and float in a great column of air. They die relatively quickly. Some are buried in the bellies of their fellow creatures; others disintegrate and fall to earth, but it all takes place without our noticing.     Most of us start off at a disadvantage because we regard death as a calamity. When we, our relatives, or our friends are confronted with a fatal illness, we view it as a serious affront; some unnatural act or divine unfairness that, with better luck, precautions, or more competent medical care might have been prevented. For all of our being a part of a vast, expiring horde of humanity, where sixty million people die each year, we are reluctant to abandon the concept of death as some strange and avoidable catastrophe. We search for causes instead of accepting mortality as part of the cycle of life.     Now, someone you love is dying, and you're not quite sure how to react. You want to be helpful, but you're uncertain as to what helpfulness consists of. You feel a jumble of emotions. Despondency, helplessness, anxiety, resentfulness, guilt, and aversion are natural. So is the feeling of being overwhelmed.     You must wonder, of course, how the dying person feels, and yet you are reluctant to ask. You probably try to emit a basic optimism whether it is felt or not. Have you shared your own apprehensions? Or do you avoid the subject entirely?     What you feel and what you do depends upon the ill person as much as upon you. It is important to understand his or her thoughts and feelings as well as your own. You are, to an extent, like dancing partners exerting subtle influences upon each other, guiding at times and following a lead on other occasions. The dying one and you can exchange real feelings, playact, support, encourage, or burden each other, depending upon your individual temperaments and awarenesses. Coping with your emotions is intimately related to coping with the other person's, for like mirrors, we tend to reflect each other.     How we ultimately respond is dependent not only upon past history, but also upon how we typically deal with both adversity and the unfamiliar. We bemoan our misfortune, are fearful, grow angry, shed tears, or use the occasion as a growing experience. Those who have witnessed death before, who have been close to a dying relative or friend and have shared experiences of what it was like, are in a better position to act constructively, for familiarity dispels many dreadful fantasies. With firsthand knowledge you learn that the reactions of the dying are less harrowing than you might have imagined. Dying people make good teachers, if we allow them to talk to us. They not only help us to judge death as a natural process but let us know what comforts and what distresses them in their last months, weeks, or hours.     My background includes medical school, a general internship, and fourteen years of psychiatric training and practice. During that time I've had ample opportunity to physically attend the dying and, later on, to hear tales told by the bereaved. None of these experiences, though, were as helpful as living out my father's dying with him. By our open sharing of reactions and concerns I soon realized that he was the authority on death, not I. Freed from the need to play "expert," I became an appreciative student. Among the things he taught me was that death was neither as painful nor as terrifying as I had been led to believe.     It is not easy to have such intimate contact with death. People may not wish to die out of sight, yet most of them do. Studies have shown that the great majority of dying humans wish to die at home, in familiar circumstances, surrounded by family and friends. Yet, we typically shunt off our relatives to nursing homes and hospitals where they expire without us. The Center for Death Education Research at the University of Minnesota surveyed 560 hospital deaths and discovered that in most instances no family members were present at the bedside; that survivors generally learned about the passing through the phone call of some nurse or clerk. This traditional isolation is not only the dying person's loss but ours as well, for we are deprived of an opportunity to learn some fundamental lessons.     It is this lack of familiarity with the subject of death, and a fear of unknown elements, that contributes in large measure to our feelings of dread and indignity when death impinges upon us. The greater our familiarity, the less our terror. The less our terror, the greater the likelihood that we can provide comfort to friends and family who face death, and the greater the probability that we can survive their passing with minimal distress on our own part. It will also make one more comfortable with his or her own eventual death.     To overcome our fears we must also understand those factors that reinforce them. The child has to contend with stories of bogeymen who haunt the night. The adult is subjected to constant reminders of violent endings on films, television, and in the newspapers. Religion tells us that we will suffer the tortures of hell for our sins upon earth. Freud and Marx, who both dismiss belief in an afterlife as nothing more than myth, undermine whatever comfort we might gain through thoughts of immortality.     Dying is an attempt at reappraisal. It proposes to give practical information regarding the everyday details involved in preparing for death, ways of minimizing fear, grief, and the difficulties of the postmortem period. It provides a forum in which people can share their firsthand experiences so that the unfamiliar need no longer hold such dread. It is also a book that encourages alternatives to the traditional ways in which we treat our dying, by focusing upon alternate dialogues, treatments, and locales in which dying itself may occur.     The circumstances of death today are too frequently anonymous and ignominious. Death ought to be the punctuation point of life, not some obscure footnote. If we are to help make "death with dignity" a reality rather than a slogan, let us begin to listen to those who have faced it. They are the ones who are likely to tell us how it's done. Copyright © 2000 Martin Shepard. All rights reserved.