Compared with being born, death should be straightforward. As easy as falling off blog or returning home.
But nothing you can say to your patient can ever be relied upon to tame death's mistery. Luckily this is not required for a good death. But preparing people for death is more than control of terminal symptoms. It depends on understanding your own view of death. Something to be avoided at all costs?- or the yummiest chocolate in a rather uneven box? Tracking your own evolving views helps sensitize yourself to issues that confront your patient. Learn from your patients shamlessly. After all, rendering this service to you (and hence to others) may be your patient's last and only gift to humanity. A shared dialogue may be worth ten times its weight in morphine. Dying from pneumonia ( the old man's friend) one patient said:" I want to do this right..." This is a great starting point. Reflect on how to build on this universal (but rarely expressed) hope.
Death has got something of a bad press recently, but note that death is Nature's master stroke, albeit a cruel one, because it allows genotypes space to try on new phenotypes. The time comes in the life of any organ or person when it is better to start from scratch rather than carry on with the weight anf muddle of endless accretions. Our bodies and minds are these perishable phenotypes - the froth, that always turns to scum, on the wave of our genes. These genes are not really our genes. It is we who belong to them for a few decades. It is one of Nature's great insults that she should prefer to put all her eggs in the basket of a defenceless, incompetent neonate rather than in the tried and tested custody of our own superb minds. But as our neurofibrils begin to tangle, and that neonate walks to a wisdom that eludes us, we are forced to give Nature credit for her daring idea. Of course, Nature, in her careless way, can get it wrong: people often die in the wrong order (one of our chief roles is to prevent this mis-ordering of death, not the phenomenon of death itself).
So we must admit that, on reflexion, dying is a bliliant idea, and one that it is most unlikely we could ever have thought of ourselves. (Clinical Medicine, Oxford,2010)