On My Life (Almost) Ending and Beginning Again
by Richard Riemer, Ph.D.
This essay originally appeared in the Los Angeles Psychologist , official publication of the Los Angeles County Psychological Association, in slightly edited form. Since the publication of this essay in 2006, my then wife and I have divorced.
I. The Descent: On My Life (Almost) Ending
On July 8, 2003, already unconscious in a hospital’s ICU and intubated (with what later would be diagnosed as Legionnaire’s pneumonia, the most virulent kind), I went into respiratory failure. My wife, upon returning home from visiting me that evening, received a terrifying telephone call: “Come at once. Your husband may not make it.” With a neighbor’s help, my wife gathered our children together to return to the hospital, all praying for my survival. When they arrived one - half hour later, my life had been saved by a dedicated pulmonologist and by...Divine intervention? My wife believes so. As for myself, I was unconscious...then.
I have since awakened, and my propensity is to understand experience with the deepest clarity and empathy possible. Therefore, in the last section I will attempt to distill the meaning of my near - death experience for me and, by extension, all of us living with the omnipresence of Death.
II. Facing Death: Fighting Back, Embracing Life
Although unconscious, I fought back in my encounter(s) with Death. I embodied both my mother’s fighting spirit and the words of Welsh poet Dylan Thomas on facing Death:
“Do not go gentle into that good night... Rage, rage against the dying of the light.”
And I did, surviving a pulmonary embolism and two potentially fatal, hospital - acquired infections. (The woman patient from whom I acquired one infection – because of cross - contamination from a healthcare worker’s unwashed hands – died from her infection.) While in my medically induced coma, at times I fought back like a frenzied beast: at one point, I chewed through my own intubation tube!
Hospitals are indeed dangerous to your health. Without my wife’s unflagging intervention as my effective patient advocate, I would not have survived my ordeal.
III. Beginning Again: Recovering
Awakening from my coma after 25 days, I experienced profound physical weakness because of severe muscle atrophy. (My muscles were so weakened, I could not walk initially, or even lower myself onto a toilet.) In addition, I felt groggy and mentally confused. Once I had regained consciousness in hospital, I began physical and occupational therapy. I progressed steadily. Upon discharge 12 days later I was able to hobble out of the hospital unassisted, blinking into the first direct sunlight I’d seen in 37 days.
I then spent five months on disability, rebuilding my atrophied muscles and emaciated body, and regaining my mental acuity. During all of 2004, I rebuilt my atrophied practice, ravaged by my sudden disappearance, protracted absence, and uncertain return. Part of the rebuilding process involved demonstrating to patients and referral sources alike that I “still had my wits,” i.e., that I could still master the complex thinking, rapid processing, attentive listening, and empathetic presence necessary for effective psychotherapy.
I did not feel fully recovered until the end of 2004, almost one and a half years after I had fallen ill.
IV. Meanings and Musings: How My Encounters With Death Profoundly Changed My Attitude Toward Life
In 2003, it was my turn: the good person to whom bad things happened. Prior to that, I had comforted and deluded myself with denial and rationalization: such catastrophic events somehow only befall the “other guy.” My paradigm has shifted as I experientially understand life’s precariousness: “Life [and death] is what happens when you’re making other plans.”
We’re all vulnerable.
With enough sustained loss, we all (commoner and King , layperson and Psychologist) are susceptible to decompensate. May that humbling awareness engender compassion for our susceptibility and admiration for those whose vulnerability inspires self - empowerment instead of foreshadowing collapse. By knowing death, we come to know life as well.
By knowing death, life becomes refined as we sort out priorities, and eliminate trivialities.
Life consists of changes, i.e., ongoing small deaths. Life teaches us the “truth of impermanence” and thus the futility of grasping. Accepting impermanence helps us know the wisdom of letting go in order to continue to transform.
Although we each face death alone, it is an integral part of our collective experience. Death is the great leveler. It infallibly mediates between all human differences.
Love and Will strengthened me in my confrontation with Death, and enabled me to survive. Expressed differently, I embraced Eros, and resisted mightily the downward pull of Thanatos... this time.
And yet I know, and now accept, that Death is as ubiquitous as Life. That’s hard to see, because we live in a culture that denies Death. My encounter with Death wrenched off my cultural blinders and shattered my denial; I now see death as the final stage of the life process, the natural outcome of life. As a result, I no longer fear death. Accepting that all living things (including relationships), have a life span allows me to accept the inevitability of death without anxiety. Consequently, I am more present, feel more calm, and think more clearly. That’s noticeable when I deal with patients’ separation anxiety.
From my transformed personal and clinical perspective, separation anxiety means death anxiety . It’s that simple and that profound. In the psyche, separation and loss of (or ab andonment by) one’s principal attachments can invoke the terror of annihilation and nothingness.
Accompanying patients where they are afraid to go with an attitude of calmness and acceptance both soothes and tacitly encourages them to face what previously seemed overwhelmingly threatening. Our willingness to bear witness in the face of Death makes the unbearable bearable.
Since Death will come ‘round again, when it’s our time (and we’ll know that if we’re not in denial), we can choose to practice the wis dom of letting go, and allow ourselves to continue to transform. Thus, how we confront Death lends meaning to life’s journey.
As one who survived my encounter with Death, I feel survivor awe and gratitude, not survivor guilt. In the eternal dance of Death and Life, endings give rise to new beginnings.
Seasoned by over thirty years of practice, Richard Riemer, Ph.D. continues to feel energized and fulfilled collaborating with patients. He does not aspire to retire.