Going gently into that good night

THE author is a psychologist working in a unit dedicated to the dying in Paris

THE author is a psychologist working in a unit dedicated to the dying in Paris. Her testimony is that dying can be an intensification of life, a time of happy calm and resolving, of sated leave-taking beyond pain and sadness. This is one woman who will never have to put her hand in her pocket in any company.

But could it he true? Yes, although at first she herself appears impossible: she seems to imbibe life through an aura of inexhaustible tenderness. She scorns the understandable shrinks' emotional security measure of distance. She says touching is good language. She spends the same loving intuition on her patients as she does on her dying friends. Can anyone give so much to so many? Is such a dissemination of caring not like staring at the sun?

Not for such as here. She has navigated deaths that are near-life experiences and is not the defeated gardener extolling the beauty of the weeds. She is brave for the good and there are heroes still, despite the witterings of cretins forgiving themselves.

She convinces that what she gives is given back and tells how the reservoir of her attentiveness is refilled by the gratitude and very serviceable insights of people made profound by their proximity to death, who are driven to weigh all they know and did, quickly. Her regenerative process is similar to, and probably of, creativity, and her masterwork is calmness, high sentience and acceptance among the dying.

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Of course, don't look for this in the A&E of Portiuncula Hospital after your Hiace hits a cow. The Paris palliative unit was unique. Ten years ago it was France's first: there are 35 now and 80 mobile satellites. The Paris staff asked to be there. They are assiduous about the group solidarity and communication the work needs. Grief, confusion and achievement are shared.

They are united for the goal to enhance, not extend, the patients' days. The dying are "accompanied", a good death "accomplished". Brute medical imperialism is ditched. What is offered is intimacy, attentiveness, availability, an option on the blessed interregnum of a morphine coma (the length is agreed) and especially the solidarity of touch; for the tattered dignity of a ravaged body and for fear, an embrace is incomparable balm.

When it works, a space is made wherein a life can be recalled, even resolved, and a philosophy forged, tempered, discarded or reembraced, to carry the dying, with a sense of their own worth at the last, into death.

Francois Mitterrand, as he approached his death, wrote the book's vivid preface. No better man. He cut a figure in his going: big black coat, big black hat above the Gallic prow, startling amid the marble pillars and the honour guards, eyes to the horizon as he moved at the hero's grave pace, turning all about him into pilot fish, liberty, equality, mortality enfleshed. When Kohl wept it was probably from jealousy.

Cretins had always pegged Mitterrand as "morbid". You wonder how such people barrel on without appreciating that a daily relationship with death and the dead determines such matters as philosophical depth, a life's intensity, curiosity and its sister, creativity, ambition, and whether you're fun in the sack, et cetera ad nauseam.

Mitterrand's preface confirms that the haughtiest louser in the world (the prerequisite for the palace in the land of France) can embrace modest submission at the end. Before his sickness Mitterrand toured de Hennezel's unit (she was tapping him for the few bob) and met the patients. He was awed. "What was the source of peace in their eyes?"

When he himself accepted he was dying, he understood. "At the moment of utter solitude, when the body breaks down on the edge of infinity, a separate time begins to run that cannot be measured in any normal way. In the course of several days sometimes, with the help of another presence that allows despair and pain to declare themselves, the dying take hold of their lives, take possession of them, unlock their truth. . . It is as if, at the very culmination, everything managed to come free of the jumble of inner pains and illusions that prevent us from belonging to ourselves."

The book does its job through the spare telling of the stories of de Hennezel's patients in the unit as death develops them. The horrors are not evaded: depression, terror, denial, dependence, shit and shame, the deficiency of language.

She is patient as they resist and, made secure by the unit's amniotic devotion, finally allow the life left in them to tell them it is leaving. She is around when they embrace this. She skilfully promotes candour.

If they seize it, it liberates the dying and, just as dramatically, those who love them. The unthinkable is made thinkable, the unspeakable speakable, and the silence and repression shatter. Taboos explode, fear is shot down dead, the process of grief and sadness is begun but these are fundamentally recast and exchanged as tributes between those to part. And all hands earn the priceless chance to say goodbye.

A woman takes her grandchild in her arms. Will he never see her again after she dies? he asks. She tells him of a boat sailing away towards the horizon. It disappears. Because he can't see it anymore doesn't mean it doesn't exist.

This book will represent an unattainable idyll for so many who care for the dying here, in and out of institutions. We will never see our incipiently great hospice movement extended and properly funded, barring revolution or horrid scandals. Many who have taken someone with the bad luck to be old as well as dying to the devastating public health service here will know that economy has routed pity. You might as well get up on a termite hill on the Masai Mara and declaim to the elephants and the big tall giraffes. It is sorrowful that so many here will read with envy old the sweet deaths in sheltering calm the book reports.

We need help in the searing emotional commerce of last partings, and the dialogue beyond them. Ironically, de Hennezel herself shows dramatically that in the proving ground of loss even the most perceptive can be invisible to themselves and, like us all, are helpless alone. We perceive the seed of her heroism. It is a death. (Well, I never.) Early in the book she makes a glancing, constipated, angry reference to her father's "self-administered" and "cruel" death alone seven years before (melancholia, the tonnage of years, a pistol). You may cease to wonder why she marked last contact as the treasure it is. The famous duellist with distress tries to slip out the back door of the house of her own grief, the house of unforgiving mirrors.

Midway through the book and seven years to the day of her father's decision to leave she is levelled ("trapped") and fully-blinded by agonising conjunctivitis. The "work of grief" she confesses to evading ensues with volcanic sorrow.

She separates from the world. She is swept away "utterly alone" in a confluence of recollected sadness and affection and "all this fills my heart". She reviews what she hid from herself. In time, she uses the word that signals the early path to the other side of such affliction: "inheritance". She begins to recall and absorb the finest things from a finished life, her father's, and is fortified and grateful.

If she doesn't desert her grieving, a certain turning in its working may eventuate, when the knowledge gathered in the life and death of the life-giver she mourns has been so wholly inherited that it is hers to use and then bequeath in turn. It will be an enigmatic day. She may feel the seed has found the egg again and she has been remade.

Her focus on the work of her own grief is brisk. This is a pity. It may be our nearest intimation of the last moment.

De Hennezel is a paragon of spirituality without religion and a humanist of France: her solidarity with those hidden as unclean by materialism reclaims republicanism at the well it sprang from. She is using her gurudom (damn media) and exporting her subversion. I think she is on the job in America now.

Death is a severe democracy. It itself is probably the only immortal thing. Humility in the face of it is the way to go.