Searching for calm in the storm of mankind
Reflections of an assisted dying pharmacist
The weather while walking today was wild. My face is still tingling.
A bonus of this was less pedestrian traffic. Only the David Goggins devotees, owners of rambunctious dogs, and those with an appreciation of the bitter sweetness of life step out in it.
I put myself firmly in that last category.
I’d never felt so seen as when I was reading
’s Bittersweet book earlier this year. While aspects of Quiet resonated deeply with me, I don’t tick the ‘quiet’ box on the introvert checklist. But an appreciation for the longing and ability to sit with melancholy? That’s me through and through.I fully embraced that feeling today in my music selection. David Gray’s album A Century Ends.
The song Gathering Dust transports me back to sitting on a bus travelling along a highway in Slovakia. Alongside me was my recently appointed ex boyfriend.
We’d come to the UK together around six months earlier for a working holiday. We proceeded to break up less than a month into the trip. A conscious uncoupling at a time when Chris Martin and Gwyneth Paltrow were still blissful newlyweds. Prior to that we’d been together for around five years or so. My first serious boyfriend since leaving high school and my best friend. Obviously still friends enough to be travelling around Europe together though.
It was a rainy day and the landscape was bleak. He handed me the iPod earphones and told me “You’ve got to listen to this song. I mean really listen to it, please”.
It put words to what we’d both been feeling. Acknowledgment of a chapter in life that had reached its natural conclusion. Not because of anything bad. Just, because.
When I listen to the song now, it doesn’t bring a sense of nostalgia or any sort of regret. It brings a weird sense of gratitude for that time in my life and an appreciation of how we’re able to move forward.
Sometimes I like sitting in this feeling of seeing beauty and sadness at the same time. The ephemeral nature of things. I think it’s what makes Barbie an amazing art house movie, even though it’s been painted as frivolous pop. The scene with the Billie Eilish song evokes what it is to be human.
It’s also why I couldn’t stay working in assisted dying any longer than I did.
Most people who access assisted dying in South Australia are approved for self administration. They’re provided with an oral medication at a dose that will end their life, if and when they choose to use it. There isn’t a requirement for a doctor or any other health professional to be present when they self-administer. And so, it’s really important they feel confident and capable to undertake the self administration process independently.
As one of the assisted dying pharmacists, it was my responsibility to provide the person not only with the medication, but the confidence and capability to self-administer. Effective communication was a critical part of the job.
Handing over the assisted dying medication involves providing a lot of practical information. Getting to a place where people can take in this practical information when they’re in a heightened emotional state can be a bit tricky.
In the book Super Communicators,
explains that there are three types of conversations: practical, emotional, and social. Aligning to the same type of conversation is one of the things that makes communication go well.I’m not saying that I’m a super communicator, and it certainly wasn’t something I did intentionally at the time, but as I reflect on my experiences now I can see that this is one of the things that occurred when things went smoothly. I’d arrive at the person’s home or hospital room, make a quick assessment of where they were at, and do my best to tailor my approach to their needs.
Some people were straight into the practical conversation. Like the guy who yelled “Fuck off!” as soon as I entered his darkened room, followed by “Can you close the front door? She’s talking so loud the whole bloody street’ll hear!”. What can I say, an asshole in life doesn’t suddenly become an angel just because they get closer to death.
The practically minded interactions were very straight forward, not unlike the handover of a new car. We’d get quickly down to business and be out of their way as efficiently as possible. These types of encounters were the easiest to leave behind.
But professional transactions don’t work for everyone. Definitely not for those who with heightened emotions. And there were plenty of those where the tears were present or close to flowing before you even walked in the door. To launch into the details of self-administration in these circumstances would be a waste of everyone’s time. The information wash over them.
In these circumstances it felt most appropriate to acknowledge how they were feeling and allow time for them to feel at ease before launching into the practicalities. I was OK with this. I’m alright with maintaining personal distance and simply hold space to feel what they need to feel without absorbing it too much.
The ones that I found most difficult to leave behind were those who were looking for a social conversation to start things off. This is how I think I’d probably behave if I were in that situation. It’d feel pretty awkward having a stranger visiting your home to talk about death while providing the ominous life ending medication.
I think the reason these encounters imprinted on me the most is because I’m just not very good at faking social connections. As I mentioned earlier, I may not be quiet but I am at heart a hardcore introvert. I loathe superficial small talk. I do, however, absolutely love authentic conversations.
It doesn’t take much to find an entry point for a social connection when you’re in someone’s home. There are literally clues all around you. Whether it be the neatly edged lawn, the exotic embroideries, the carefully constructed supports for the fruit trees, the travel trinkets, the paintings of naked ladies, the creepy doll collection, the overflowing bookshelf, the sporting memorabilia, or the shed full of racing cars. My curiosity and serial hobbyist nature had never been so handy. I could always find something to make people feel more at ease and fast track the building of rapport.
I think it helped that I was genuinely interested. I find people endlessly fascinating- even the assholes. In fact, sometimes the assholes have the most interesting stories. Even the ones who tell you you’re loud (he eventually warmed up and got talking).
And that’s how it would go a lot of the time. I’d have a one off interactions with a small group of people that started off nervous, gradually became more social, and ended up very intimate as we talked in detail about practicalities of death and dying. An immense privilege, but not without cost.
For me, I think the biggest cost was my ability to invest in the social relationships I needed to thrive. I greatly value social interaction, but it drains me of energy. While working in assisted dying, I felt like my whole social energy budget was being consumed by professional interactions. And it started to show.
I prioritised my relationships with my husband and kids, but outside of that I became pretty non-communicative and antisocial. I forgot birthdays. I avoided phone calls. I was in a big time social energy deficit. And to be honest, I don’t think I’m back in the black just yet.
But, I’ve got enough self awareness to detect early signals of a problem. And so, I moved on.
Now I find myself in the early phases of another life chapter. It evokes the same kind of feelings as when I listen to Gathering Dust. I’m appreciative for what the experience brought me and grateful that I can take it with me as I move forward.
What’s new for me is this feeling of being hyper tuned into the bitter sweet. Which is why I’m here writing about it, really. I feel it’s a bit beyond my creative capabilities to express these feelings in words, so I’m going to close by stealing the words of another song on the David Gray album I was listening to earlier today, Let the Truth Sting:
What I say, what I think
What I put down in ink
I'm only trying to find a way to understand
And I mean no harm
I'm just searching for calm
In the storm of mankind
I was talking to my therapist yesterday about assisted dying and we agreed how unfortunate it is that our civilisation has forgotten how to talk about death. One hundred and fifty years ago, it was common to have your loved ones and your children die. You had no choice but to talk about it. But now everyone is afraid to talk and we make up euphemisms to avoid even saying the word out loud. It was a relief just to have someone to talk freely with. We wondered if, maybe, they should teach it at school.
I wonder what it is like to be the person having that final conversation. I wonder where the conversation goes and how it ends. We told our oncologist of our fears about dying and she told us how, for most people, it’s peaceful and I will most likely just slow down, getting tired and sleeping more until, one day, I won't wake up. We walked out of her office with big smiles and were practically skipping all the way home. I wonder if all her conversations about death are like that.
Our conversations with my oncologist are filled with joy and sadness, laughter and tears — or just tears. I wonder how it is with her other patients and if the sad conversations get hard to bear after a while. I’m filled with admiration for her and for you. It’s an angel’s work.