Over the past four decades our ideas about the human dying process have developed, formed by at least four major thinkers: Cicely Saunders, originator of the hospice movement, Elizabeth Kubler-Ross (Death and Dying), Irving Byock (The Four Things that Matter Most), and Mitch Albom (Tuesdays with Morrie, The Five People You Meet in Heaven). Art Buchwald's "Too Soon To Say Goodbye" belongs next to these four in the death section of your library, sharing with them a focus on examining the death process without judgment and with open-minded curiosity.
Buchwald's medical problems started with a stroke in 2000, which led to chronic renal failure and the amputation of one leg. He learned in January 2006 that his condition had been worsened by the development of acute renal failure and was now life-threatening. His options were thrice weekly dialysis or death, estimated to occur within two weeks. Buchwald was subjected to twelve dialysis treatments and then opted out, choosing a hospice in Washington, DC as his home until he died. He dictated this book as a diary of his experiences and feelings in the hospice, fully accepting his approaching death and intensely curious as to what it would be like. He was keen on sharing all of his experiences with those actually present in his life, as well as with us, his readers. During the eleven months between his death sentence and his actual demise January 17, 2007), he enjoyed meeting friends and celebrities in the common room of his hospice and recording TV interviews and messages to be played to audiences and family after his death. He also went shopping for cremation urns, wrote a commentary on the high price of funerals, lined up speakers for his Memorial Service, received cheesecakes by the dozen from well-meaning friends, rallied for a summer vacation at his home on Martha's Vineyard, and reflected on his life. While Buchwald briefly mentions the trauma of having a remote father and an absentee institutionalized bipolar mother, he does not dwell on his insecure years in foster care and his recurrent depressions. His attention is on a confident understanding of the reason he was put on earth: to make people laugh. The Pulitzer Prize winning humorist is at peace within himself due to his understanding of his raison d'etre and this is a gift which many, including Eddie (The Five People You Meet in Heaven) do not receive until after death, if ever. Buchwald enters his final year of life already well into Kubler-Ross's acceptance stage. We have no glimpse of denial or bargaining. He is true to himself, making us laugh until the end. He is unafraid.
This book will be of interest to all who work with the human mind and spirit, but particularly to those who identify with Consultation-Liaison Psychiatry and who consult on the dying. It is also appropriate for the elderly or those approaching death, serving as a source of optimism and an invitation to discussion of a subject that may be otherwise difficult.
Dr. Bazemore is Associate Professor of Psychiatry and Family Medicine at the University of Massachusetts Medical School, Worcester, Massachusetts.
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