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The final thoughts of people facing death

Young woman with terminal cancer using a laptop, writing about what it is like to be dying

A new study into the thoughts and emotions of people facing the end of life has revealed that patients with terminal illnesses experience more positive emotions in their final days than we might imagine.

Assistant professor Kurt Gray and a team of colleagues at the University of North Carolina have used computer algorithms to analyze blogs and poetry written by people who knew they were about to die. The findings show that positive words and emotions are more frequent than we might expect, and actually increase in frequency the closer the person comes to death.

The writing used for the study was taken from the blogs of people dying from terminal cancer or amyotrophic lateral sclerosis (ALS) – also known as Lou Gehrig’s disease. The researchers compared the emotional tone of these blogs to pieces of writing by volunteers asked to imagine that they were dying.

“Humans are incredibly adaptive – both physically and emotionally – and we go about our daily lives whether we’re dying or not,” said Dr. Gray.

“When we imagine our emotions as we approach death, we think mostly of sadness and terror. In our imagination, dying is lonely and meaningless, but the final blog posts of terminally ill patients…are filled with love, social connection, and meaning.”

One of the blogs cited in the study gave an intimate account of the final days of life: “All water and nutrition now through gravity bags – drip, drip, drip. Need assistance for every movement. Surrounded here by so much love and care I feel I am ready for the next step.

“I have no regrets at all – I have had a full life, touched and been touched by such wonderful family and friends. So if there is to be a final lesson for me it is that love is the ultimate gift – love and honesty.”

“While such positivity seems strange in someone so near death, our work shows that it is actually fairly typical,” Dr. Gray explained.

Commenting on the new study, Nathan Heflick, a psychologist at the University of Lincoln, explained while it doesn’t suggest that people who are dying never experience negative feelings, it reflects that our own fears and perceptions of what dying will be like are not entirely accurate.

“People who are not dying seem to think dying will be way worse than the people experiencing death think it is,” said Dr. Heflick.

“It suggests that thinking about death more readily – being more aware of it – might help people when coping with their own mortality.”

However, more research is needed. Dr. Heflick added that because the participants of the study were blogging, they might be putting on a brave face: “I can imagine if I were chronically ill and posting my words online for all to hear for all eternity—I’d be tempted to make myself seem far happier, more courageous and stable than I possibly would be. If nothing else, you’d want those close to you to not feel worse for you.”

The blogs of people during their final days have received praise and admiration in recent years, shining a light on the reality of living with a terminal illness. Last year, media outlets across the world reported on the blog of 25-year-old Dmitrij Panov. Writing with bittersweet humour and blunt honesty under the title ‘Dying with Swag’, Dmitrij chronicled his experience of dying from a cancerous brain tumour.

Back in 2013, Cris Guitierrez, also known as Sirenita, wrote a blog post for Open Salon detailing her final thoughts. Although the blog was unfinished when she died from complications of pancreatic cancer, it’s a hopeful, loving final article:

“I don’t feel horrified and anguished that there will be no more Sirenita. Sirenita was a certain organization of molecules, energies, spirit, intellect, memories, skills – all available on a menu. When I die there will be another Sirenita, or someone very much like this Sirenita. The world will not be the less for it.

“But for myself, tragedy, anguish – these have no room in my heart. I just want to die in not too much pain, surrounded by the ones I love. I want to help them find what peace they can in the time remaining.”