A good death

Having recently participated in a Radio 4 documentary entitled “How to have a good death” and during preparations for yet another lecture about the media debate surrounding end of life care I’ve been pondering the somewhat abstract concept of a good death a great deal.

I was looking after a patient last week who was dying. His family were fully aware he was dying and when we came to discuss preferences regarding place of care they were very happy with the idea of him dying in the hospital “where he could be looked after properly”. I looked after a lady a few months ago who was also dying. Her husband had initially been adamant that he wanted to take her home to die and that had been her expressed preference when she had been able to communicate. However, her deterioration was fairly rapid and unfortunately it was not possible to facilitate her discharge in time. She went on to develop a problem with respiratory secretions which was identified early and treated effectively with a hyoscine syringe driver. Her husband commented that the care delivered in hospital was much more immediate and that he would have envisaged waiting a little while for that distressing symptom to be dealt with if they were at home. When I was doing my Palliative Care training I met many patients who had ambitions to die in the hospice. They felt this was the environment that appeared to offer the most support to both them and their families.

I do not want to die in either a hospital or a hospice. I would like to die at home in an environment that smells familiar, with familiar things around me and the ones I love nearby. But my experience as a clinician teaches me that we are not all the same and the concept of a good death means very different things to different people. We were having a lively debate in our Clinical Governance meeting this week regarding end of life care and the AMBER care bundle came up as a topic of conversation, especially with reference to Advance Care Planning. Some of the attendees could not grasp the fact that although many don’t, some patients and their families may want to be admitted to hospital with acute illnesses right up until their final illness. Are we as the healthcare professionals trying to impose our own views of what we feel a good death is onto our patients? I am very careful regarding this, knowing full well that I would be very agitated if someone tried to tell me what they thought my death should be like. I feel it is much more important to facilitate people to make decisions about their future by suggesting the possibilities and exploring their views without reference to our own beliefs.

So I’m clear in my own mind where I want to be and who I want to be there, but what else constitutes a good death for me? Symptom control is vital and perhaps my greatest fears regarding dying revolve around this and the possibility of me developing a bowel obstruction at the end of life. I remember vividly a patient when I was an F1 doctor who had a bowel cancer that caused an obstruction who died vomiting. It was horrendous. I cannot erase this memory, but I am going to have to do my best to push it to the back of my mind. I have confidence in the Specialist Palliative Care Team and their ability to treat my symptoms should I need them.

The good death concept has been researched quite extensively in the palliative care literature. Phrases such as “affirmation of the whole person” and “clear decisions and participation” come up time and again. Some of my most important ambitions for a good death are a little softer however. For example I have chosen which music I would like to listen to near the end of life; I’ve even made a few CDs of songs and pieces in preparation. I would like aromatherapy candles to be burning and I want Mum to read to me like she used to when we were kids. We have recently been picking out some books for this task including The Hobbit and The Darling Buds of May. These creature comforts in my vision for a good death create a homely, comforting, warm and peaceful environment that is not scary for either me or my family.

So what is your idea of a good death? It may be very different from the person sat next to you…

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30 thoughts on “A good death

  1. Kate, I’m so impressed by your thoroughness and consideration about this. Have to admit the thought of your mum reading to you fills my eyes with tears every time I read it – for her and for you. I hope it’s a long, long time coming, but that it is good for you all…

  2. I’m not sure what a good death is, but I thought your comment about big ambitions and small ambitions was very insightful. A few years ago, I nursed my father while he died at home, and music featured among the small ambitions. During my last few weeks with him, I bought a small stereo system for his room and made a selection of CDs that we could choose from. I introduced him to some music that I thought he and other members of the family would like. My father was European, but he was a scholar of Indian history and religion. Because he was a fusion of Western and Eastern cultures, I introduced him to the music of Sheila Chandra, who creates this fusion with her beautiful singing. It was a great choice because everyone loved it, but also because it seemed to create an impossible bridge—and not only between cultures.

    My father was aware he was dying, and we asked him what he wanted to do with the little time he had left. His answer was clear: he wanted to be at home with his family, and just continue doing the things he always did. So we shared meals and reminisced about the past. There were a lot of laughs during those final weeks, as well as a lot of sorrow. In fact, the atmosphere in the house was like two different weather systems colliding: the joy of being together and sorrow about the impending separation. You’d think the joy would help to offset the sorrow, but it wasn’t like that at all. The combination of two intense and very different emotions was difficult to endure. But somehow the music helped to make it endurable. Music occupied the impossible frontier where joy and sorrow collided, and it did so without taking sides. It did not function to create “cheer”, or to suppress it. It just created an impossible bridge.

    When I listen to the Sheila Chandra CD nowadays, it takes me back to my Father’s room, with the big windows and the leafy aspect, and him sitting up in bed, enjoying the view even though his world had shrunk down to that one space. I am grateful for the music’s ability to bring us together again, in the same way I am grateful when my dreams do the same.

    The small ambitions are less likely to disappoint us.

    Thank you for your blog.

  3. Kate, the way you describe your planning for your death reminds me very much of the planning I made for the birth of my first child; the choice of music, where I wanted to be, etc. Just like we welcome a new life into our world with a birth plan perhaps more of us should have our own ‘death plan’. As you described, this doesn’t have to be morbid. Rather it’s a kind of representation of the person you are and the things you like. Just as our birth is a momentous event for ourselves and those around us so is our death. For me, a ‘good’ death would involve great symptom control, some lucidity and lots of my favourite music and people. I would probably want life to go on around me and be involved in it as much as I possibly could be. I really wish you all the very best for the future.

  4. Kate,
    You are truly an inspirational and brave person, who possesses a beautiful humility and a wholesome approach to both life and death. Being a male with a low pain threshold I would ideally like a death free from pain and a mind freed of any guilt or regret and possessing a fervent hope that there is an afterlife where I again will see my beautiful departed Dad ( died of cancer of the transverse colon). Ideally death would be in an non hospital environment and with some loving company observing my passing.

  5. Agree Kate that as clinicians we can’t impose what we want on what our patients want , though sometimes things happen out with anyone’s control.
    My mum had a guid death. For the last few years life had not been good to her, with a pituitary tumour, and the gradual cognitive decline.
    In the end she did not die at home. She was brilliantly looked after by our DNs, her own GPs, and the staff at the local care centre. My sister and I sat with her for her final week, every day sharing old stories, knitting and chatting to her, as she lay dying. We listened to her favourite music, and she was listening to one of her favourite songs when she took her last breath, with us beside her. It was a time of great bonding too between us two sisters, and a time I look on strangely with a lot of fondness, where as the previous poster said
    Where joy and sorrow collide

  6. I was recently with my big sister at her premature death. Whilst she was in a coma, I sent her Monty Python CDs, hoping she might recover and wake up laughing with me. She was in ICU and I saw the benefits of the ‘hyacinth’ (as I thought it was then called). Her death seemed as good as it could have been.

    However, I hated standing and sitting around her bedside (apart from the time I told her my secrets) and I have made advanced decisions to forbid anyone from my bedside, if in a similar situation.

    A clean hospital, calm nurses and hyacinth. That’s all.

  7. I love your blog. In similar medical situation as you. Canadian woman. yours was the first books I read. Thank goodness! We all need a great death. But I’m scared each time I think of it. Only known 4 months. Dieing at home they will see everything which is good and bad. Worry about them…Love you. Thanks

  8. I’m a doctor specialising in haematology. A few years ago, a blood film from the community was given to me that showed Acute Myeloid Leukaemia from a gentleman in his late 80s in the community. Not having any further clinical information, I rang the only mobile we had on our computer which was his sons. I found out that the patient was recently discharged from another hospital with a pre-leukaemic condition and that he is now in a nursing home. I then rang the other hospital and there was no mention of leukaemia in the discharge summary. His son told me that his father (the patient) was gravely ill in the nursing home and have been visited by the community palliative care nurse earlier in the day. His father was currently with his sister (patient’s daughter) and was really agitated, in pain and was ‘begging’ and ‘clutching’ to her to ask to be re-admitted into hospital. I spoke to the nursing home and advised an urgent ambulance to take the patient into the original hospital he was discharged from.

    The next morning, I had a message from the Palliative Care consultant from that hospital asking me why I advised an emergency admission for a patient that was on the Care of the Dying Pathway in the nursing home. The Palliative care nurse had spent 3 hours the previous day teaching the nursing home nurses how to set up morphine infusions and look after the patient. I was not quite accused of recommending an ‘inappropriate admission’ but that was how it felt. Based on the limited information that I had and from the ‘dearth’ of information and inaccurate discharge summary I felt that I did the right thing.

    4 days later, the patients son rang me and thanked me for admitting his father to the hospital where he said that the staff were amazing in making his father more comfortable and that his father passed away, peacefully and free of suffering 3 days later in hospital.

    A ‘post-death’ debriefing meeting was called between myself, the palliative care nurse, consultant, GP and the nursing home manager several weeks later. This was a useful exercise. I could feel that the Palliative care nurse at that time felt, right or wrongly, that his efforts to trying to keep the patient out of hospital come to no avail. I explained that I was put in a difficult position with very little and inaccurate information, with the ‘story’ that the patient was begging to be re-admitted to hospital. All in all, however, the eventual outcome was positive, the patient and his family had a peaceful last few days in a controlled environment, in hospital.

    Lessons learnt:-
    1) Hospitals can be the ‘right place to die’ in some circumstances, and these circumstances can change very quickly.
    2) Written communication about a patient’s plan and current diagnosis esp. towards the end of life, should be accurate and checked by the patient, relative and more senior staff and not just left to the most junior member of the team to perform as an after-thought.
    3) It can be hard for nursing home staff to deal with the acutely unwell and difficult symptom management and if they cannot manage, even if the patient is on the care of the dying pathway, sometime, an emergency admission to hospital for emergency symptom relief is indicated.
    4) ‘Post-death’ debriefing meeting can be a very valuable learning experience for the health care professionals involved in a complex case like this.

  9. I love your headers, beautiful pictures reflecting something of you. I am full of admiration for you, your blog, your contribution to this world despite the harshness of it all. Wishing all good things for you and yours for many days to come. x

  10. I’ve just listened-again to the Radio 4 programme, How to have a Good Death, and I’m full of admiration for your thoughtful compassion both for yourself and for your loved ones, and for your knowledge that planning how you want to die is essential. I’m about to begin writing my third novel whose protagonist is a beneficent angel of death (who accidentally falls in love with the human being he has come to collect and spends the rest of the novel falling in love with life itself, through her. But she will, of course, die, eventually, and I’d like her to have a good death. I’ve called the novel For the Love of Life.) But I have no idea, yet, how the novel will develop. I’ve begun by researching how we die and, unless you would prefer that I did not, I’m planning to blog about you and your blog and your thoughts about a good death when next I blog on my website on 14 May. I will – obviously – link back from my blog to yours, but if you’d rather I didn’t write about you just let me know.

  11. Kate – really inspired by your post. I’m a UK GP (and DNUK member!) and I’ve increasingly noticed in our palliative care meetings and discussions that “hospital is not the place to die”. We have worked really hard to improve our palliative care, have great Mac nurses and DNs and are doing much better at having earlier conversations with patients and their families and acknowledging the non-cancer patients who benefit from this approach (two things I’m sure lots Drs will agree could be improved upon). However, I do feel uncomfortable with the idea that WE decide hospital isn’t the place to die. I don’t think it’s up to us to decide. The arguement is that the hospice is an alternative to home and that the acute hospital can’t stretch to good palliative care. You’ve strengthened my resolve to speak up next time this issue is mentioned. Thank you.

  12. Dear Kate, I have to ask you how you are?
    I am in awe of the way you conduct yourself while facing your struggles. Your grace , class and humor are refreshing.
    Thankyou for taking the time to blog, tweet and generally publicize your life . Just by reading the replies on this page it is amazing how many people you have helped with your precise,but thoughtful human take on issues most of us are unsure or frankly scared of.
    Thank you for sharing your thoughts and continuing to help others through your experience.
    You are appreciated….world wide!

    • Dear Clare,
      Thank you for your lovely message. It’s been quite a week for me emotionally. Gran died last Sunday and my cancer buddy Katie also passed away on Tuesday. In between all that happened I received unexpected news of stable scan results and have been under a fair bit of work stress as I started a new job and have a big end of year assessment coming up. I am hoping life will settle down a little in the coming weeks and I will have some time to reflect… Take care, K x

      • Dear kate
        Thankyou for your reply, I know you are busy so taking the time means alot Thankyou
        Firstly I am so sorry for the losses you have experienced , I can’t imagine the pain and sorrow. However what great news about your scans !!! I’m not a medical person but I’m assuming this is welcome and positive news
        Your positive attitude is definatly partly the reason I’m sure! Please continue to be positive and know that you are surrounded by support and love from people who admire you everywhere!!!

  13. Dear Kate,
    I listened to your talk at a conference and was so moved and full of admiration for your honesty and bravery. My lovely mum had been in a nursing home for some time with dementia and had reached the end stage where she refused all food and drink. She had been admitted to hospital with UTI and dehydration. The consultant was very sensitive and kind in the way he explained to myself and my daughter that this was her way of beginning the process of dying and that artificial feeding really wasnt an option. I agreed but wanted to get my mum back to the nursing home as my dad lives there as well and I wanted her to die with her husband and family by her side and not in the hospital. The consultant had already removed all cannulas so she was not getting any fluids by this time.
    As it was easter weekend approaching, on the thursday I visited my mum to be told that she could not return to the nursing home until atleast the following Tuesday as an HNA needed to be completed and all the social workers had gone home for the easter break!!!!
    The nursing home then said they would take her back without the paperwork as they realised how urgent it was. The hospital still said no. To cut a long story short, I had to refuse to leave the ward, and threaten to physically wrap my mum in a blanket and forcibly remove her from the hospital and take her back to her home to be with her husband. I was so upset at the seemingly callous and uncaring attitude of the hospital. Eventually they got a discharge planner to come and see me and after i lost my temper and asked him how he would feel if it was his mum lying dying in the hospital bed with only him to speak up for her and do what was the right thing. he did then arrange for transport on Good Friday to take her back to the nursing home. I and my husband and son wwent to the hospital that morning as we didnt trust the hospital to carry out their promises. Eventually in the late afternoon we got my mum back to the home. She died a week later with myself and my dad holding her hand. If only all doctors were as caring as you xx

    • I hear your frustrations icepop but find it intriguing that despite the consultant being the one who recognised that your mum was in a terminal phase, you still think he was not caring enough. I think the problem you describe here is one of the NHS bureaucracy we healthcare professionals are constantly fighting. It is what is ruining our amazing NHS and causing good doctors and nurses to leave the UK for greener pastures. So let us not turn against each other but let us all join forces to save our NHS and keep our lovely doctors and nurses!

      • Hi there,
        It wasn’t the consultant that wasn’t caring enough, rather the attitude of the hospital and the ward staff who basically told us that she couldn’t be returned to her nursing home to pass away with her husband by her side because of the paperwork that needed to be completed, even though the nursing home recognised the urgency and that she didn’t have long left and said they would take her back regardless of the paper work. However fast forward five months and here I am again at the hospital sitting with my dad for over 48 hours as he passed away. He was put in a side room for quiet and privacy which was appreciated but I was alone with him the entire night. No one even stuck their head round the door to see if I was okay or if I wanted a cup of tea. Yes there was a kitchen I was told I could use but I was too worried to leave my dad to go there incase I wasn’t there when he passed away. After he passed away the following morning, I and my husband and son were in total shock and grief, sitting with him and a care assistant came in and said Oh I need to put his headrest down, don’t want him going stiff in that position! I was shocked at this comment to say the least. Then a while later two doctors came to see him and asked us to wait outside the room. Then one of them came out and said oh did your dad have a pacemaker? To which I replied yes doctor then said oh it’s still ticking!!! I just feel these were two comments that shouldn’t have been made in the sad circumstances! 10 months on and I can laugh at the pacemaker comment, my dad always used to say his pacemaker would be going long after he had left this world! I would love to be able to tell him that he was right! He would’ve found it very amusing!

  14. You have basically written in words the thoughts that had been tumbling around and around in my head. I work in a hospital and come across these different ideas and beliefs of other staff, doctors, relatives and unfortunately least of all patients. We are a very busy surgical ward and emergency assessment unit, notoriously understaffed, doctors have their lists to work down, relatives are worried out of their minds and patients sit in their beds awaiting the day of doom. I rarely hear their actual thoughts on dying. The times I do, they have widened my horizon.
    I feel sad seeing patients die in hospital and often can’t understand that some relatives don’t want to take them home and rather let them die in such a public place. I suppose it does give scared relatives some sort of reassurance, without which they wouldn’t be able to cope alone at home. Some patients die alone on our ward because they don’t have anyone. For them, the hospital becomes their “last home”.
    It is an emotion that I’m still unsure of how to deal with and mostly override with a smile. For once we are supposed to be there for the patients and we are rarely able to express our own feelings. It can be difficult to accommodate everyone’s individual needs and include your own.
    Thank you for another insightful post Kate!
    Love
    Anna

  15. For days and days I have thought about this topic,having started to formulate a reply and dismissing it again.
    Too painful and emotional were the memories in my head of my fathers death 20 years ago.
    I could answer very easily what a bad death could look like, again my fathers passing serving me as a persistent reminder.
    Perhaps you would allow me to elaborate a little to clarify what I am trying to say.
    Father was diagnosed with lung cancer in early 1993 when he was 73 years old.
    By then I lived in the UK for some 6 years, having been born and raised in Germany until
    my move to Britain in 1987.
    So when I received news that my father wished to see me, I sprung into action and went to Germany .Due to circumstances I couldn’t spent more than a few days over there.
    When I walked into his hospital room I knew the end was near.No, I am not medically trained but common sense told me it wouldn’t be long.His Consultant told me that he could live for another 6 month….I tried to explain that I was only able to spend a few days with my Dad and needed to know the truth,still, the Consultant didn’t entertain my request.
    The same evening, a little Vietnamese Ward Doctor motioned me to him and told me that yes, my fathers life was coming to its conclusion and the end wouldn’t be very long.
    But please could I keep our conversation confidential as talking to me so openly could cause him problems with his job.
    At least I knew what was happening and could spend the remaining time with my Dad.
    He was too weak to even hold a spoon, let alone a cup so when I asked the nursing staff for a beaker my request was met with incredulous disbelief.
    Some huffing and puffing later a beaker materialised and I was able to give my father
    something to drink.
    Now imagine the very same nursing staff plonking a tray of food on his table, this was to be his dinner.Without even offering help the nurse just left the room to return a short while later moaning at my father for not having touched his food.
    His pain was all too visible and I knew that he was entitled to some better pain management which I made sure he got.Throughout all this my Dad was lucid and fully aware of what was happening.
    To say farewell knowing you never going to see this person again alive is at best traumatic and heartbreaking.Upon leaving for the last time I asked the nursing staff to take care of him which was met with ” anything else you want us to do,like read him a story or a fairy tale ?”
    The little Vietnamese Doctor who was on the ward, silently nodded to me before returning to his duties.I knew he understood.
    You would be forgiven for thinking that this may have been an isolated incident in a different culture.No,as I later found out.
    Whilst the German Health System may well be ultra modern and state-of-the- art I have encountered medical professionals and nursing staff behaving in a manner at contrast with their profession but more akin to being revered Demi Gods in pristine white coats.
    When I first arrived in the UK the NHS seemed like a dinosaur out of the dark ages but the longer I lived here the more I grew to love it.
    Yes, it has failings and room for improvements can always be found but in my 26 years of residence in this country I have encountered more good than bad.
    The relationship between a Doctor and his patient ought to be a partnership in which I as a patient know I can trust my Doctor or GP.
    It is this partnership which would enable me to plan my own death when the time comes because I can trust my GP to guide and support me as well as my loved ones when the need arises.
    As yet I have no particular preference of where I want to die,I would want good palliative care management surrounded by the people closest to me.
    My wish for myself would be that I would be met with openness, honesty and kindness even if I was to pass away in a hospital because my family may feel more secure knowing that help is close by.
    Hopefully my family will be able to turn to some caring and kind people,be they Doctors,Nurses or other staff.
    I would like to thank you for raising this topic although I never intended to write this much but there is a question still left….isn’t it extraordinary that we can have a birth plan for when a baby is born which we share with everyone we feel like but when it comes to what I call the
    ” exit ” plan things get hush hushed and all too often brushed under carpet until it is too late.
    Btw, my father died 4 days after my return to the UK.He was mentally alert and lucid to the very end. His death was noticed when a nurse came to tell him off for not having eaten his breakfast.
    Take care Dr Granger, thank you for your openness from the bottom of my heart.
    Sabine

  16. Hello Kate,
    I am a wise old geezer, 95 in July and I would like to tell you something about death which is not important for you, but is for your loving husband, who will soon be grieving for you.
    Death is the not the end, but is the door to the rest of your life, which is full of joyful activity and continued service to others which is what you are about here and now.

    You could be an enthusiastic materialist and that’s OK by me, but please give your husband the chance of lessening his grief by looking at my concise summary of the evidence for a different view. It is at http://www.afterlifeessays.org.uk . If you ever have time to potter, my Orchestra of the Bournemouth Philharmonic Society website is at http://www.baps-orch.co.uk and links to my other websites (I am an addicted website maker) are at the bottom of the Links Page. (I play viola and am secretary.)

    My relatives from all over the world are coming to my 95th birthday on 14 July, and I hope you have a few more birthdays to come yourself. I admire your courage and devotion to healing.

  17. Thank you for this. I have just discovered you in the last 24 hours. I am a 49 year old wife and mother. I was diagnosed with bony mets in March I I was given the all clear in December so a huge shock as you can imagine. I know my life is shortened but I feel hopeful for the time I have left. Lots of plans. I am less afraid of death than I ever imagined I would be. After the initial shock, like a kick to the stomach I felt weirdly calm. I never thought I would feel that way if faced with this prognosis. My husband, a surgeon, took it much worsen me. I would love it if you followed me on twitter. My friends and family don’t follow me on there so I am fairly candid. My twitter name is @poshlindy
    Your comments about waiting rooms full of people struck a chord with me. Because of my husband working at the hospital my consultant fits me in early so I miss the general hubbub of the clinic. I feel lucky and guilty about this at the same time. I don’t want to see really ill people, that is my future, I only want to see the next few months of future in front of me.
    Thanks again for this blog
    Lindy

  18. Pingback: Dying Matters | Angela Young

  19. I’ve just heard you on Radio 4 and have started to look at your blog. Thank you for taking the time to write it. I’m glad you can write it. My daughter is no longer able to write her blog, which had been her way of communicating with the world and trying to make sense of her diagnosis.

    I read to her (but struggle a bit when choosing books to read) but had never thought of reading those stories which I used to read to the family, a time we shared and loved so much.

    I look forward to spending more time with your blog.

  20. Dear Kate
    I read about you in the Telegraph today. I had to tell you that your approach to death and writing is a huge comfort to others.
    I lost my Dad, then Mum and my dear sister in the last year and still find it hard that if I want to occasionally talk about them or their death most people will change the subject or be very uncomfortable. It is helpful to be able to talk about approaching death, my sister and I had 2 months in which she planned her end of life and her funeral, we laughed, reminisced and told each other our secrets. Now it is only her husband and daughter who feel the same as me and want to talk occasionally.
    My sister had a few types of cancers over the last 12 years but also had Body Inclusion Myositis from which she became disabled in the last few years. She chose not to have further treatment when her liver cancer returned as her quality of life from the BIM was so bad by then.
    She would have thought you are a very brave and inspiring woman.
    I hope your future is happy and glad to hear you are able to live it to the full as much as possible at present.
    I am so sorry you have suffered bereavements.
    I am very lucky to be healthy but I know that whenever I die that my Mum, Dad and Sister will be there waiting for me.

  21. What a moving thread and touching comments. You are so brave, I hope I am not too inappropriate to ask you to have a look at my blog, and share it the best you can?

    Hi my name is Dan. Last year I got cancer, lost my job, lost my eye, sense of taste and smell, went bankrupt and had an amazing baby boy on Christmas Day, the same day as my birthday!
    I have made a blog for others to draw hope from. Please comment and share

    http://Www.igoggle.wordpress.com
    I hope you like it

    Best regards

    Dan

  22. A good death for me would be quick if I had the option. It is hard for me to be entirely sure because I keep changing but I would probably want a little of all my favourite things in no particular order. I would want to listen to my favourite music (which ranges from Rihanna’s unfaithful to TLC’s no scrubs to argentinian tango instrumentals to Nina Simone, to Jason Mraz, Coldplay and Seu Gorge the great Brazilian singer). I would want to watch my favourite disney movies (top 3 are Beauty and the Beast, the Lion King and Pocahontas), the Incredibles, Monsters Inc, Save the last dance, the drama Tess of Durberville. I would want to be surrounded by the smell of coffee or fresh-baked bread or my favourite traditional nigerian meal (tuwo da kuka). I would prefer for my mother to be in her grave because I would rather she not go through the pain of burying her baby. I would like to be near the sea, be able to see the ocean or hear the waves. And not be in too much pain or retching. Basically, I would like Mark Green’s death in the final ever episode of ER (down to Israel’s Kamakawiwo’ole over the rainbow playing) :D

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