Optimizing Until the Very End: Thoughts on Death and Living

Photo: BigStockPhoto.com, Copyright: AGCuesta

Despite being occasionally whiny about my genetic uphill battle when it comes to athletic performance and body composition, I enjoy a reasonable bill of health and my life in general. This, however, does not stop me from occasionally thinking about death and I think you should do so too.

Last week my wife and I bid farewell to her 12-year-old Labrador. Accompanying our canine family member during his last days motivated me to write this article.

So, let me dedicate this Life-Sparring Round to Happy, who cured me of a lifelong fear of large dogs and revealed the Cesar Millan in me.

Death, the Final Chapter of Life

Happy days with Happy the Labrador - Drawing: Sanjicka

All our lives, small and humble or grand and important, long or short, share one big certainty that neither of us will be able to escape. No matter how hard we try, until the singularity is upon us and we are all swallowed up by a botnet of artificial intelligence, we all will one day exhale our last breath of air and pass away.

Death is part of life, just like the ending of a movie is part of the film. If you are aiming at optimizing life, it would be a grave mistake to stop short of optimizing it till the very end.

The Best Recipe to die in Peace: Live Without Regrets

It is an open secret that hardly anyone on their death bed regretted not having worked more. We all know that we should live life as if we would have limited time left, because precisely that is the case. We just don’t know how much we have left and hence live as if our clock ticks indefinitely.

Unfortunately, we often get caught up in routine and our sense of duty. We soldier on with mindless jobs, even if we already lost the joy and purpose and fill the void with meaningless consumption of any kind.

While I don’t think that we all should storm out of our offices right away, we should avoid to put up with situations that possibly lead to regrets later. The challenging thing about regrets is though, that they most of the time reveal themselves only in the rear-view mirror.

It takes a conscious effort to check on yourself and avoid possible regret. Regular self-analysis and a mindfulness practice can help a lot. Mindfulness is a muscle that has to be trained and apps like calm or Headspace can be a good first step. Mindfulness as I definite it, is a state of heightened awareness for yourself and the world around you. An awareness that can help to overcome cognitive biases and escape automatisms like mindless consumption or wrong prioritization in life.

Even without mindfulness, you can improve your chances of regret-free living by following a few simple rules: take time for friends and family, never miss weddings and funerals, spend money on unique experiences instead of consumer goods, and never let being busy get in the way of helping anybody in need.

If you live without regrets, chances are good you also will die without them.

Practical Steps to Keep Your Freedom until the End

Mindfulness is important but there are other, very practical things that can be done to improve life till the very end.

One of the biggest dangers towards the end of the life is to lose your financial freedom due to increased expenses for medical treatment. In the US for example, medical costs are the biggest cause of private bankruptcies.

I believe this can be taken care of, with adequate insurance coverage. In Hong Kong we have practically no public insurance system. There is a cheap but fairly basic public medical system and additional private health insurance usually is provided as a benefit by the employer. 

Happy's way to say good bye - Photo: Life-Sparring.com

To maintain financial freedom towards the end of your life, you rely on your own initiative. In addition to my regular savings and the small compulsory mandatory provident fund, I have a private life insurance with a huge risk component and a so-called critical illness insurance.

The life insurance is part of my pension plan and the risk component is meant to support those members of my immediate family that survive me.

While most people have some form of life insurance or at least significant savings, I know multiple examples where this nest egg was spent in the desperate attempt to prolong the life of a terminal sick person, leaving the family nothing behind but grief and debts.

This above scenario is what I try to cover with the critical illness insurance. The critical illness insurance is an interesting, albeit slightly morbid concept. The insurance pays the sum insured in cash if I (before my 63rd birthday) am diagnosed with one of a catalog of severe conditions and survive the first 20 days after the diagnosis. 

What I like about the concept of a critical illness insurance, is that it pays the insured amount while I am still alive (different from the risk component of my life insurance) and independently from a treatment (different from a health insurance that (partially) refunds a treatment. 

This gives me in the case of a severe illness a choice: I could pursue expensive treatments or I could, for example, use the money to travel with family & friends before biting the dust, pay off a mortgage or add it to the inheritance. I strongly believe that having genuine choices towards the end if life can make a huge difference.

Dying as a Skill?

As crazy as it might sound to you, but I believe that dying is a skill that can and should be practiced. 

I don't mean that literally and ask you to crawl into different coffin styles to try which one is more comfortable. What I believe is, that it is important to talk with your family occasionally about the possible end of life.

Just like with sex education for children, not talking about death will not prevent it to happen, it will just leave you utterly unprepared. 

The Economist ran an interesting podcast in it’s “Ask” series on the topic of “Can we improve the way we die?” At the end (pun intended), too many people sacrifice the chance to maximize the quality of life, in a desperate attempt extend the lifespan. Not only are the costs often out of proportion to the benefits, patients that do not pursue aggressive treatments till the very end, often even live longer and experience less stress.

Just writing out your living will is not enough. I believe you have to cultivate and practice the ability to talk openly about the “what if” while you are in good health, to be able to do so when you are not. Otherwise the risk is huge that in the shock of severe diagnosis freeze, flight or fight reflexes take over and destroy all chances for rational decision-making.

I had seen it firsthand a few years ago, when my father in law died from a fast developing cancer. It is part of Chinese culture to not talk about death as it is seen as a bad omen, and on the surface staying optimistic and upbeat in the eye of the unavoidable seems a good thing to do. But for me it felt as it the forced optimism robbed the family of the chance to maximize the last months of his life.

After all, I only see one positive aspect about being diagnosed with a terminal illness, it gives you the chance to take control over your last months, weeks and days. You can say the things you still want to say, make peace with an old enemy or reach out to a lost friend, maybe have a special meal or travel to a place you always wanted to see. You do not have this opportunity when you die suddenly and you forfeit this chance if you hide behind