The doctor is the familiar of death. When we call for a doctor, we are asking him to cure us and to relieve our suffering, but if he cannot cure us, we are also asking him to witness our dying. He is the living intermediary between us and the multitudinous dead. He belongs to use and he has belonged to them. And the hard but real comfort they offer through him is still that of fraternity.

For physicians and health care providers, dealing with a terminal diagnosis can be difficult, because many still view a patient’s death as a failure, instead of part of the life cycle. However, there comes a time when a patient has a terminal diagnosis, when as a physician you know there is nothing more you can do to stop the disease process. These are the times when a test, a study, or an x-ray will not make a difference. Even with all of the modern medicine and technical skills, we can only strive to make a person more comfortable and help them in their final stage of life.

It is only when we truly know and understand that we have a limited time on earth—and that we have no way of knowing when our time is up—that we will begin to live each day to the fullest, as if it was the only one we had.

Dying is more than a physiologic process of the cessation of life. It can be a time of great personal discovery and connecting for the dying and those caring for them. People who are in the dying process continue to need intimate, natural and honest relation-ships. This time can be one for rekindling or enrich-ing friendships. It can also serve as a new way of exchanging and expressing love, a means of aiding in reconciliation and trans-form-ing experience for those involved. Most significantly, dying teaches us to focus on the moment and to cherish simple things.

In being with a dying person, it is helpful to trust your innate compassion and intuition to lead the way to care for the person. Rather than worrying about finding exactly the right words, it is more important to connect with the person and let them know you care. Bring your strengths and vulnerability when dealing with the dying. It's all right to show emotion and to cry. It is also important in their final days, find the balance between talking and listening, being sure to slow down and share the silence.

Other advice for approaching a dying person include:

• Remember to focus the person, not the illness.
• Listen, unconditionally and attentively.
• Have empathy for the person’s suffering.
• Learn how to be with emotional pain rather than trying to alleviate it.
• Allow expression of feelings—guilt, anger, sorrow, depression—without judgment.
• Share your own feelings, experiences and emotions if it seems appropriate.
• Honor the spiritual dimensions and cultural aspects of the dying process.
• Reduce distractions to create a calming and peaceful environment.
• Simple acts of compassion can be more precious than gifts to the dying person.

Be yourself and relate person to person.
Be ready to listen again and again.
Be respectful.
Be aware of feelings and non-verbal cues.
Be present.
Be comfortable with silence.
Be real.
Be human.
Be genuine.
Most of all—Be there.

Resources:
Dyer, K. Healers & Healing. July 6, 1998. Available at: http://www.journeyofhearts.org/kirstimd/healers.htm
Ostaseski F. How to be with a Dying Person. On Our Own Terms. 2000, Educational Broadcasting Corporation/Public Affairs Television, Inc. Available at: http://www.pbs.org/wnet/onourownterms/tools/index.html .
Being a Supportive Friend to A Grieving Person, North Central Florida Hospice, Inc. 1996.
Rabow MW, McPhee SJ. Beyond breaking bad news: how to help patient who suffer. WJM 1999:171:260-263. Available as PDF file at:
 http://www.ewjm.com/cgi/reprint/171/4/260  .