Before the advent of medical technology, leaving this life was fairly straight forward, though not always pleasant. The majority of interventions centered around comfort. That’s exactly what happened to my uncle Ed.

Uncle Ed was a bigger than life Norwegian fisherman with a red beard and an infectious flare for life. But out of nowhere, his robust life was brought to an end when he was diagnosed with terminal cancer and given only a few months to live. Wisely he retreated to the sanctuary of my grandmother’s house for his final days. The news of his leaving spread quickly in their immigrant community and a procession of family and friends began. They showed up at all hours to tell stories, drink beer, laugh, cry, pray and be part of his leaving. This daily ritual continued until he died.

Then they held his wake and for three days family and friends came to my grandmother’s house at all hours and told stories, drank beer, laughed, cried, prayed and comforted each other as well as his sister, my grandmother. Even as a child, I knew that this was the way to go, how I hoped my life might end, surrounded by the comfort of family and friends.

But leaving is not what it use to be given the reality of medical technology. A new metaphor has captured our focus and muddied our decisions about our aging parent’s final exit not to mention our own. Leaving has been usurped by lasting.

This shift in the balance of power at the end of life carries enormous consequences for adult children and their aging parents. Already feeling guilty about not doing enough, adult children are now confronted with a medical technology that haunts them with the question “is this where you stop?” Lasting has become the new benchmark for our collective efforts to fight the good fight. No one wants to let anyone down. While medicine is in the business of preserving life, no one really knows, amid machines, drugs, and heroic procedures that suspend leaving, when we have had enough.

This not a dilemma any of us can unwind; our generation owns it. But we can reframe how we think about the technology option to keep from being unfairly biased towards lasting at all costs. While the question of lasting, to what degree and at what cost, is vital to the discussion, an equally compelling question is “what is quality of the leaving?” This query reminds us that the final act is not just a battle against biology to extract more time, but a profound reconsideration of the entire journey. In leaving lies potentially the most important insights and conversations of a life time. As such, the question provides us a much needed counterbalance in the struggle to determine what is enough. It reduces the need for technological heroics to prove anything and champions low-tech conversations from the heart.

This is what uncle Ed’s passing taught me. It was the same lesson I was to learn years later in my medical career: cure when possible…comfort always. At middle age it becomes all to clear that there is no cure for leaving, and that the comfort of family and friends is what means the most to all of us.

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