Dr Sarah Winch is dying to talk
Dr Sarah Winch’s husband Lincoln Winch died four months after being diagnosed with kidney cancer. He was 48 years of age. The experience inspired Sarah to write Best Death Possible: A guide to dying in Australia. Sarah is adding three new chapters to the book, which will be republished in October 2017 under the new title Romance and Reality: How to get the best death possible in Australia.
Sarah is head of the discipline of Medical Ethics, Law and Professionalism at the School of Medicine, The University of Queensland. She is also CEO of Health Ethics Australia, a not-for-profit charity, that focuses on improving death literacy for every day Australians and compassion safety for clinicians.
Below, she answers questions from the Dying to Talk Discussion Starter. For support in discussing your end-of-life wishes with your loved ones, download it from www.dyingtotalk.org.au
If you had a condition that you could not recover from, what would be important to you, towards the end of your life?
Since my husband died, relatively suddenly in 2008, I have thought and written about this topic constantly. So much of what happens at end of life is context driven. If you had asked me this question eight years ago, I would have been terrified at the thought of leaving my children orphans. Now they are adults I view this differently. That said, it would be important for me that my end of life is a continuation of how I live now, according to my values of honesty, care and respect. My relationships are fundamental to my well-being, so I would schedule catch ups with those I love the most and tell them how privileged I have felt having them in my life. I would walk by the river and enjoy the outdoors. If I could still write, I would do my whole of life version of “Five Things I Know Now” (which is at the end of each chapter of Best Death Possible) for posterity. Having a busy end-of-life plan, and excellent symptom control by a palliative care professional will be critically important!
Are there any pets that you would like to see or be with you, if this is possible?
Definitely! Jasper is beside me in the recent photograph above looking particularly handsome. He is a gentle, loyal, old Shar Pei (Chinese wrinkly dog). I sincerely hope we move to allowing beloved pets to visit hospitals where most people die. Barriers can be overcome. The infection argument is utterly flawed; pets in beds prompts everyone to wash their hands more often!
Would you prefer a quiet environment or do you prefer activity and chatter around you?
Something quiet, with a lovely garden view where you can see trees, flowers, the sky, clouds and the moon at night would be perfect. This is very grounding for me. It helps reinforce that we are all part of a much bigger universe. We are here for a good time, not a long one!
Would you like music to be playing and if so, what style or what music?
I love pop music especially “ABBA”. “Dancing Queen” is great but I would not want to distress the visitors or staff with “Fernando”. “Night Changes” by One Direction and “Shake it Off” by Taylor Swift may be inspiring, especially if Jasper is with me as he tends to slobber (although he will be wearing his neckerchief to visit).
If possible would it be important to you to have time outside?
Absolutely! The ability to get out into the wider natural world is a fabulous option at end of life. I remember sitting with my husband in a park, looking up at the clouds, drinking a milkshake, eating sausage rolls and talking in the days before he died. It was such a simple thing to do, but very powerful and is now a treasured memory.
Would you prefer to be surrounded by lots of family and friends, or would you prefer one or two closest people to be with you?
I am on record about the importance of support teams (personal and professional) in getting a good death. In my personal support team will be my close friends who are highly death literate, pleasantly direct, clever, and innovative (an essential combination if I want my dog with me). Plus they enjoy champagne and dark chocolate which we can share. My beautiful children will also be there. They are gentle truth tellers and will ensure there are no unnecessary or disingenuous behaviours to inhibit my version of a good death.
Are there any cultural or religious practices you would like to observe?
There is nothing special I need in this regard. I hope there is an afterlife, so I can commune once again with my dead husband and friends, but it doesn’t influence how I want to die.
Is there anyone particular you would like to see or talk to?
I try and keep in regular contact with those I love. I plan to say goodbye to most of my friends and will just have my small support team (including Jasper) with me.
Is there anything else you can think of that you would like?
I want to die in a hospital or a hospice, rather than at home. It can be a heavy burden for those caring for the dying at home, as they become carers. I don’t want this for my children. Many good deaths happen in hospitals and mine is going to be one of them! I just need to convince them to let my dog in with me!
What is on your bucket list of things you would like to do or achieve before you die?
I don’t have a bucket list. I use my husband’s approach of a “reverse bucket list”. These are things I would never want to do again, or people I would not want to be around. I try to incorporate that into my daily living. I do things that bring me joy every day and I pursue friendships with friends and family I respect and love. This is where I put my energy. None of us know what is in the future, so I don’t put what I can do today off for tomorrow.
How did you feel during the process of completing this form? Was there anything about the process that interested or surprised you?
I enjoyed completing the form and feel death-prepared! I did wonder given all this thinking and planning whether I will die suddenly and none of it will come about. The unexpected does tend to happen in my life!