The edge of death: Unraveling the mysteries of human resilience

Produced and written by Andrea Brody

“So much that's happening to us when we're sick is well beyond our control and I try to emphasize this with my patients — that who you are is not changed by the illness. Who you are is so much bigger than your body.” Graphics courtesy of Darius Johari

In a recent article in The Atlantic, writer and palliative care doctor Sunita Puri explores why some people's will to live defies the odds. 

Puri reflects on how former US President Jimmy Carter wanted to live long enough to vote for Kamala Harris. Despite being in hospice care for well over a year, she asked whether the former President had any control — conscious or not — over when to die? 

“[There’s] this idea of a final act. What it means to still have hope to do something personal, and meaningful, and leave a final legacy — even when you may be in the very final stretch of life.” 

Puri explores the hope that compels people nearing death to hold on until they can achieve a personal or meaningful milestone; whether it's a birthday, the arrival of a grandchild, or casting a vote.

What it means to, “grapple with the greater spiritual mysteries of what determines the time of death, how we are all connected, and how death is still generative… even though we think it's the very end. It still holds the possibility for a final act of dignity, or love, or meaning.”  

Puri reflects on how she has had to “wrestle with the uncertainty” in palliative care, noting that there are times when (despite all odds) a patient's will to live remains mysteriously and miraculously strong.


Sunita Puri, pictured here, says that: “Death is generative in that it forces us to ask big questions about ourselves — a reevaluation of who we are, who we want to be, [and] what we want our days to look like.”  Photo courtesy of David Zaugh.


That Good Night: Life and Medicine in the Eleventh Hour
by Sunita Puri.

Alex Hutchison, a writer and journalist who covers the science of endurance, explains how athletes (especially endurance athletes) are able to push themselves to their limits. Hutchinson is the author of  Endure; Mind, Body, and the Curiously Elastic Limits of Human Performance and The Explorer’s Gene

“Effort is the master switch that determines whether you've reached your limits or not,” Hutchinson tells us. “But that master switch is negotiable, it’s not just something that you can measure with a, you know, a rectal thermometer or something like that. It's something that involves psychology, as well as physiology.” 

Hutchinson explains that we often overanalyze our feelings, especially when facing challenges. While it's important to understand how our body and mind respond to stress, he emphasizes that we shouldn't dwell on it — particularly when tackling something difficult. “Sometimes you have to just accept it. Right now, I'm doing a hard thing. I'll check in and make sure I'm okay periodically, but I'm going to try and think about something else for large swaths of this time.” 


Alex Hutchinson says: “Doing something that's hard for one minute can [make someone] go a little bit farther and [extend] their limits. And so I think this is one of the crucial processes that athletic training teaches us, and that we can apply to other aspects of life.” Photo by Lauren King


Book cover for Explorers Gene:Why We Seek Big Challenges, New Flavors, and the Blank Spots on the Map by Alex Hutchinson. 

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Credits

Guests:

  • Sunita Puri - Associate professor of medicine and Program Director for the Hospice and Palliative Medicine Fellowship at the UMass Chan School of Medicine. Author of That Good Night: Life and Medicine in the Eleventh Hour - @sunitapurimd
  • Alex Hutchison - Writer; journalist; author

Producer:

Andrea Brody