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    ‘Best’ ways to die?


    “The fear of death follows from the fear of life. A man who lives fully is prepared to die at any time.” —Mark Twain

    Dr. McDonnell

    A recent article in The New York Times1 suggests that physicians—because we understand the implications of a serious illness diagnosis and the implications of treatment and the associated morbidity—die “better” than do non-physicians.

    Also, a study of graduates of my medical school showed that these doctors were much more likely to have advanced directives (“living wills”) than other American adults.

    Perhaps reading that article put me in the frame of mind to contemplate my own mortality while taking a walk for exercise with another ophthalmologist. Although my ophthalmologist friend practices in a city literally on the other side of the world from my own, we shared the same concerns:

    Will our children be okay? Will our savings be adequate to provide for the needs of our loved ones? How should we make investments today so that—if something bad happens to us tomorrow—people who count on us and may not have much financial sophistication will understand what to do?

    We discussed different ways to allocate our investments and prepare for the small chance that—despite our both being healthy today and at the youngest end of the baby boomer generation—some sort of catastrophic injury or illness might lurk around the corner.

    “This is what fathers like us have to do,” said my friend.

    “If something bad happens to me, will you help my family understand what to do?” I asked my friend.

    “Certainly,” he replied. “And will you do the same for mine?”

    “Of course,” I said.

    Is there a good or bad way?

    We then contemplated that if doctors really do die better than other people, what would be the better and worse ways to get our proverbial tickets punched. Our list of good and bad ways to “buy the farm” included:

    • Being bored to death listening to billing and coding experts (bad way to die)
    • Being annoyed to death by the transition to ICD-10 (even worse)
    • Death from laughing (this has been documented to occur, and strikes me as a relatively good way to go).
    • Death from embarrassment (although I frequently hear people say they were so embarrassed they nearly died, I am not aware of this having actually occurred).
    • Death on the toilet (like Elvis Presley). We agreed this is not a great way to go, but definitely not the worst.
    • Death in a whirlpool bath (like Orville Redenbacher). Respect for the dead prevents me from making a joke about this, but I assume the whirlpool bath was more comfortable and pleasant than Elvis’ toilet seat.

    “Death from laughter has been known to occur since the time of ancient Greece,” I told my friend. “People who write about the phenomenon suggest it may result in either a heart attack or asphyxiation.”

    “I see now why you studiously avoid any semblance of humor in your editorials,” he replied.

    “Everyone says the best way to pass on is probably quietly in one’s sleep. So that is probably going to be my preference,” I told my friend.

    “Nonsense,” was his reply. “The best way to die is to follow the example of Nelson Rockefeller.”



    1. How doctors die. The New York Times, Nov. 20, 2013







    Peter J. McDonnell, MD
    He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of ...

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