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Mickey has seen his share of death and dying. In a span of four years, he watched his father and two close friends, Marsha and Richard, succumb to illness. A resident of Massachusetts, he says the experience of helping family and friends die has forced him to think more about the inevitability of his own death and heightened his desire to die with as much dignity as possible. Mickey says it has taught him that "as a culture we have not really done a good job of dealing with the issue of death."

His Father's Ordeal

Mickey's father was 75 when he had a coronary and died. In the preceding months, as his father's heart condition worsened, it became clear to Mickey that it was difficult for doctors to deliver bad news. "I don't think they did it out of any incompetence. But it is very hard for them to have to say, 'You've got a one-in-a-hundred chance of surviving.'"

Mickey says his father initially "was ready to face his own death" but his physicians kept pushing medical interventions to keep him alive, while downplaying the risk of those procedures. As a result, Mickey says, his father suffered a lot of pain to prolong his life for a relatively short period. "Their mandate is to deny death. While it is admirable, I think it does everyone a disservice. It puts physicians in an untenable position. They are constantly trying to present a scenario that is going to lead to life."

"We've got to incorporate the notion of failure into the conversation," Mickey says. "I think that would help doctors a lot and it would help patients and their families . . . As people become more willing to deal with issues of death and dying, then they can start dealing with decisions they have to face and questions of pain management and how to die."

Marsha: A Conspiracy of Denial

Marsha's unrelenting quest for miracle cures and distrust of traditional medicine got in the way of her facing the prospect of death. Marsha died of metastasized breast cancer. But as a mother with two young children, she resisted coming to terms with her illness until the very end of her life. Instead, Marsha zealously pursued questionable "alternative" therapies for her disease, hoping they would be the panacea.

Marsha's motivation was linked to the first encounter she had as a breast cancer patient. "It set up a sense of distrust," says Mickey. Marsha dealt with doctors who were unsympathetic to her disease and to her difficulty with having a mastectomy. "People are most vulnerable when they discover how ill they are . . . It took her weeks to recover" from that experience, he says. She eventually found a breast cancer clinic and had better relationships with her physicians. But when her cancer spread and it became evident that traditional treatment was no longer working, Marsha refused to accept her fate. "There was a conspiracy of denial. She was looking for a cure and a lot of New Age practitioners were invested in her being able to find some way out of her dilemma," explains Mickey.

Mickey and a physician friend were the ones to make her accept that she was dying and needed to say goodbye to her family and her friends. Marsha, exhausted at that point and in great physical pain, finally relented; when she died she was at home, surrounded by her friends and family.

Richard: Letting Go

Mickey's friend Richard also was consumed with finding a miracle cure for his terminal brain cancer. But he was more willing to face his situation. Like Marsha, Richard sought often futile alternative treatments. But unlike Marsha, he was willing to talk about his disease and express his fears about dying.

"Richard was most afraid of not having the people he loved around him," says Mickey. "He was most afraid of being alone." Richard's candor about his disease stemmed from watching Marsha suffer. He was "horrified by how painful her death was and how her denial sort of deprived her of a certain kind of resolution," says Mickey.

Mickey says Marsha's experience made Richard determined to talk about his situation. "He talked about everything... how he was feeling, what the disease did to him, how debilitating it was, and how sad it was to be dying." Richard had been an extraordinary athlete and his physique was important to him. He brooded about how difficult it was to lose control of his body and his independence.

Richard died the way he wanted because he took control. At 50, after nearly two years of suffering from brain cancer, Richard decided that he no longer wanted to live with such pain and used morphine he had acquired to help him die at home. Mickey, along with another of Richard's friends, helped him die. "He said goodbye with extraordinary dignity," says Mickey. He will always admire the grace Richard exhibited not only in struggling with his cancer "but in letting go."

A Great Gift

One of Mickey's happiest memories from right before Richard's death is having the opportunity to feed him ice cream, a pleasure Richard had denied himself for years. "He was obsessive about his diet. The last week I fed Richard hot dogs and we talked about being kids going to baseball games and I gave him the richest ice cream and he loved it." Sharing Richard's death, says Mickey, "was a great gift."

Mickey says these three experiences have forced him to consider how he would deal with a terminal disease. "I am determined not to spend my time looking for a cure . . . I watched my friends get caught up in fighting their disease. I want to spend the last days of my life doing what makes me happy."