I always felt the biggest privilege of being in Medicine was two fold. The opportunity to be present at the births of strangers and the even bigger privilege of being part of the deaths of strangers. At these two moments what is tangible is that we cease to be strangers. There is a collapse of time and space into an experience that has no description in my lexicon and I have no desire to borrow from religions.

In the case of death this magic of timelessness often lasts for some time before the moment of death. It is the acceptance the article speaks of and I concur that the pace of personal growth in the time before death in the terminally ill is astounding and almost universal, in my experience. To be witness to it was to be gifted with insight into the folly of the living including oneself. It didn’t allow an epiphany of change for me but it did shine a strobe light on something and profound loss of health can offer that window with a familiar view.  I consider the time of physical restriction I experienced the key to slowing down my existence and regaining the synchronicity of living in my own time rather than “ahead of my time” as my mentor once described my habit. Presence, those precious moments of timelessness are what modern humans run away from in their frenetic lives with their tumultuous thought processes and frenzy of doing, producing and living up to some bizarre expectations of early templates.

Covid, I hope, has the potential for gifts as well as real losses and expanding societal inequity. The slowing of people’s lives, the enforced pause and potential for reflection has something synonymous with the abrupt loss of healthy physicality, a standing still and eventually finding oneself several steps behind where you thought you existed.

Death is something our culture uses to speed the manic pace of existence and oil the wheels of the insane race of Capitalism. We never talk of it, we are taught to fear it and we run as if speed can elude it. It and birth are all we have that bind the population of strangers together yet we act as if we are immortal and focus on difference and complexity blinding ourselves to the very simplicity which is within our grasp every moment of our lives. We are all terminal, transient, fragile yet we are duped to living as if we are quite different, automatons focused on ever higher productivity.

When we are stopped in our tracks we are focused on a return to our status quo to how we were before to the “me” we know. The gift is the space to question who that was.

My dying patients sadly couldn’t very often carry their loved ones sight into the new place they found through the open window.  Their loved ones had been flung into their own torture of confrontation with transience. As an attendant, however, with the task of care there were precious moments of counsel, not advice from me but an invitation from the dying into their newfound place of peace and pure love. Love for life itself and love for everything around them including me, a stranger who had not yet grasped this peace. It was like being taken by the hand as a small child and learning to walk for the first time.

There was often an aura around the person which did affect the family and friends. Sadly many families did not partake of this energy until the final hours or minutes, if at all, but we do talk of it in our culture and increasingly people are urged to be present at the moment of death because we recognise a healing for the living in doing so. One of the tragedies of Covid is the absence of this opportunity for loved ones in wave one. We may handle it differently with less restrictions on PPE availability, but I digress. Death from Covid is far from the beauty of the peace often achieved by patients in a slower trajectory of what we describe as “ terminal illness” .

Like your consideration in discussing your appreciation of the stresses of work in the NHS and responsibilities as a Dr in a culture where the buck tends to land at one door, I really appreciate your openness in talking about death. I genuinely believe it is only by accepting that there is a final chapter to our personal story that we can focus on the most technicolour plot in the body of the text of our own lives. It clears the fog and gives choice clarity and banishes that time waster, regret, and allows us to savour time and reach for the rarefied moments in the experience of the ordinary.

The most inspiring people I met in my work were children with life limiting illness. They never stepped on to the conveyor belt of productivity and blindness but were truly living their moments. What was magical was that their experience extended beyond them to the family members who cared for them. There were often broken marriages and one parent who had not been able to cope with the inevitability which had to be owned for the child’s life and their own life and had distanced themselves but those who were wrapped around the child were often at peace in a very special way. The most obvious cases were those children with Cystic fibrosis. Perhaps the reality of physical restriction from a very young age resulted in a slower pace in their lives allowing them to catch more rainbows than most of us do in a whole life?

My current challenge is work towards my acceptance of my dad’s chosen nirvana which is to lie in his bed listening to Classic music. When I can accept his death during his life I will see clearly that I am in fact providing him with the environment for his perfect life at this point. There is always another challenge.

As to my own life it is of course a jumble of momentary choices and often too little peace of mind but I have teachers, my dad, my sheep, my chickens, Nenya, you, Justine, Jason, Hazel, Inez, rooks, the tides and the weather.