Losing someone close is life changing. “How can you be a wife without a husband? A child without parents?" Writes the Harvard University School of Health to highlight that, although death is part of life, the grieving process can be very painful. Denying death or not talking about it is one of the ways to defend yourself from having to leave this world one day. Exactly the opposite is what Lola Aparicio has done, Doctor of Medicine since 1986, Master in Clinical Hypnosis and author of “The end is the beginning. A guide to cross to the other side” (Firefly).
Lola Aparicio gives in this book some advice on how we can accept death and accompany people who are nearing the end of their journey. The doctor, who is still active, has collected near-death experiences of patients she has treated or met for years to try to find patterns that repeat themselves, in the same way that doctors such as Sam Parnia, Pim van Lommel or Eben Alexander have done. Likewise, she has studied the grieving process, following in the footsteps of Elizabeth Kübler-Ross, the pioneer in this field, to find out what are the main stages that occur after the death of a loved one.
In this interview, Aparicio explains the conclusions he has reached during his career.
What is the best way to die, from what you have studied?
There are not many scientific studies on this topic. What there are are mystical treatises, such as "The Tibetan Book of the Dead." This work advises how to die, it is even recommended to do it in the lion's position, sideways, with one leg extended and placing the hand in a particular way. But in Western society we live with our backs to death, even though the only universal truth that has been revealed to us is that one day we are going to leave this world. But if you ask me what is the best way to die, I would say consciously, knowing that you are dying.
He cites Steve Jobs as an example to follow when dying. Because?
Death did not happen to Steve Jobs, but he worked on it in his last weeks, not leaving any detail without his strict supervision. Jobs, in his last moments, according to Mona Simpson, the sister of the founder of Apple, looked up over his shoulders and uttered what were his last words: “Oh, wow; oh wow oh wow." And, after those three "wow" (or "wow", as it would be written in Spanish), he expired, as if he had seen something wonderful that caused him the necessary astonishment to pronounce this word in triplicate.
Do you mean that he died enlightened?
Fairly. I quote Jobs in my book because it is surprising that a man of his culture died in a mystical way. And also because my great-grandfather, who lived in Guadix (Granada) and had a very different upbringing, died, according to what my mother has told me, in a very similar way. This has led me to think that perhaps there is a natural way of dying that makes us all equal, beyond factors such as age, race, gender, education, social class, and even time.
The only but that I would put is that many people have neither the time (by dying suddenly) nor the circumstances (by suffering from senile dementia or Alzheimer's) to prepare how they want to leave this world
That's how it is. According to my experience as a doctor, around 80% of people die unconscious, but a good part of the other 20% goes through the stages that I indicate: the notification phase, the visits, the customs effect and the farewell phase. In the same way that we are all born as we have designed (by dilation of the cervix or by caesarean section, because there is no other), we all die in a similar way, regardless of being European, Eskimo or Chinese. When the process of dying begins, there is no stopping it. It is all these experiences of those who are close to dying that I collect in the book: what they think, what they feel, what they see...
What do you see?
Many who have had near-death experiences claim to have had a vision of someone calling to them from a gate they have to cross or from the other bank of a river. It's like they're in transit. Those who enter the process of dying feel about two days before dying that their situation is irreversible. Another thing that we see in many hospitals is that some patients, when they are very close to death, call or experience visions of beings who have already died and who come to "visit" them. Above all it is the mother. As a curious fact, it is very rare to call or have a vision of the spouse.
How do and how should family members act when someone is dying?
Very good question. The relatives will be able to accompany the one who is going to where they have worked their own death.
Explain…
A person who has not dealt with their own death, when they see a loved one dying, has as their first impulse to refuse to accept it, to start feeding them, to urge the doctor, to call the ER to come and give them IV or something, etcetera. But that doesn't help. On the other hand, those who have faced the fact that one day we will all die, accompany the one who is leaving in a different way.
As?
What I see most in hospitals is that people panic. Instead of letting your loved one go home, you prefer to take them to the hospital. But many times, when the condition is irreversible, it is better to be in the family than surrounded by doctors. The best way to help someone close to you who is dying is to be by their side. No need to talk, no need to say anything, just be there, see what the other person wants and keep your body comfortable. And if the person who is dying wants to comment on something that apparently does not make sense or has a vision, do not scold him or tell him that this is impossible, because he or she is seeing it, for whatever reason. You have to let the process of dying flow, regardless of the form it presents, and not block the transit.
Some experts emphasize that mourning is never overcome, but simply moves on...
Indeed. And that is not only true for the loss of a loved one, but also for the loss of a relationship, even a job. Most of the time what we do is avoid pain. But the pain must be felt! If you don't face the pain you will never be able to get over it. It is clear that losing a loved one leaves a scar. But pain teaches that life has two faces and that you also have to know how to deal with the bitter one. The death of a child, for example, is one of the strongest duels that exists, but you can live with it. Life is joy and sadness, they are the two sides of the same coin, and you have to know how to live with both.
Does it mean that one of the keys to being able to rebuild life after the death of a loved one is to feel a lot of pain?
That's right: the day that has to hurt, well it hurts, and there's no more. You don't have to be afraid of pain. Pain often leads you down deeper paths or helps you de-dramatize and trivialize situations. Pain puts your feet on the ground and gives you a good measure of things.
Some research on bereaved parents and spouses indicates that they are almost twice as likely to die in the first three months as those who have not lost a loved one, and that after one year they are still 10% more likely. In the end, is it about mourning not taking a destructive form?
Sure, but it's still a very human reaction. When a spouse with whom you have been very close dies, it is very common for the other to die after a short time. Sometimes we need the energy of that person and, if that person has left, then you go behind. Many times you have to go through a phase of anger until you reach acceptance.
When does that moment come?
When you manage to integrate the loss of a loved one into your biography as if it were a chapter. And, from there, you continue to write other chapters in your life.
After six to twelve months, about 10% of bereaved people are still not functioning better. They get caught up in what is called “complicated grief”, anchored in persistent homesickness and social withdrawal. Is there a cure for this or can we just let time pass?
The passage of time heals many things, that's true. Now, these people who remain in a complicated duel, and this is something that I have seen many times as a doctor, tend to victimize themselves and turn the other, the one who has left, into their executioner. Someone who persecutes them and leads them to torture themselves with reproaches and questions: why didn't I do this, why didn't I do that, why did you leave... There are people I've known for a long time who are still bitter, for not being able to get over it. Perhaps the only cure that exists is the spiritual one: knowing that one day we will all die. There is a Clint Eastwood film called "Afterlife" that I recommend to those who are interested in this subject. But the problem is that nowadays society doesn't let you grieve.
What does it mean?
Well, they don't stop grieving! The neighbours, your friends and, in general, the whole world, tell you: "what you have to do is go out a little more". I have a friend whose mother died six or seven months ago who told me: "can you believe that a cousin of mine told me that, well, look, I'm not going to call you until you get a little better and then we'll talk!". But she would have to attend to her now that she is sick!
It's hard to know what to say to someone who has lost a loved one that might be helpful. What do you advise when giving condolences?
Be present. When giving condolences to someone, you have to look at how that person is. You have to look at her and see how she is: is she tired? Is she crying? If she's crying, she picks her up, hugs her and lets her cry. It is about not hindering her process. Is she overwhelmed, surrounded by people she doesn't even know what to say? Well, get her out of there, take her somewhere else, sit with her and ask her if she has eaten something or if she is thirsty. In the end, it's about caring about the person. And if you see her tired, allow her to rest from the chatter. There are times when the person needs to talk to vent and there are times when she needs to be quiet, and you have to respect that. In the end it is about making an appearance and transmitting: "I am here, what do you want, what do you need". And give it to him.
