We'll all shuffle off this mortal coil eventually, but how we feel about that is as individual as our Netflix queues. To help us navigate the grim reaper's inevitable visit, palliative care doctors and death doulas have shared their hard-won wisdom on the end - and how it shapes their daily existence. Spoiler: it's not about that corner office.
Dr Rachel Clarke, a palliative care doctor at an NHS hospital in Oxfordshire and author of The Story of a Heart, has seen enough to know what truly matters. "All the irrelevant stuff is stripped away," she says. "No one cares about how much power they had, how big their house is, how fancy their car is, how much status they had at work. What they care about is the people they love." In essence: "The way to live a life that is rich and deeply fulfilling is to build human connections."
Dr David Holland, a palliative care consultant in Norfolk, emphasizes the importance of mending fences before the final curtain. "People tend to have things they want to say, like 'I'm sorry', 'I forgive you', 'Forgive me', 'I love you' or 'Thank you'. Not addressing those unsaid feelings can lead to regrets." He also advises pursuing what matters: "If something is important to you, do as much of that as you can."
Ruby Love, an end-of-life doula in Bristol, warns against career obsession: "I've never met someone at the end of life who regretted not working more or not earning more money. If we can find a balance between what we need to live on and what we need to be happy, that is key."
Clarke differentiates pleasure from fulfillment: "Pleasure is a very superficial experience... it isn't going to give you a sense of fulfillment." Instead, seek "moments of joy, awe and wonder at the world around us."
Holland finds solace in nature: "I have always found great interest in wildlife and biodiversity. I really enjoy being out in nature and helping things to grow." He adds, "The richness of life comes from our relations with other living creatures, human and also non-human."
Tan Ming Li, an end-of-life doula in Singapore and founder of The Life Review, once focused on living without regrets. But a comment changed her perspective: "If you don't have any regrets, you are not living life enough, you're not daring to try things." Now she lives with intention, asking, "If tomorrow is my last day, how do I want to spend it?"
Tan finds meaning in small acts, like grooming her dog: "It's not easy and it takes a few hours. Could I have spent that time doing other things, which could be more productive in society's eyes? Of course." But she wouldn't trade it.
Love echoes this: "Value those small moments, like when the leaves first come back on the trees in the spring, or when you have a really good cup of tea."
Holland notes that legacy often comes up at the end. "I've had people who have wanted to hand over something important. This could be a business, memories or the building of a house." So finish that novel, sort those albums, get your affairs in order. Love even arranged an exhibition for a client who was a photographer: "It was very small and low-key, but that was something that she really wanted to do."
Clarke suggests asking if you've been part of something connecting you to others - through charity, teaching, family, art, or a craft. Holland values "running a kids' football team, having an input in village life and building relationships with neighbours."
On aging, Clarke flips the script: "The wrinkles, grey hairs and menopausal body that I now possess are all things that society wants us to feel distressed about... All of those stigmas associated with ageing are a blessing and a privilege." She adds, "Anybody who is old enough to feel anxious about those things should be saying: 'I am so lucky. I have lived long enough to creak when I get out of bed in the morning.'"
Holland balances health with living: "The doctor in me makes me want to look after myself. But... I see a lot of patients where medical issues happen for no reason that we can identify. Therefore, it is important not to get too hung up on things and remember that life is for living."
Clarke advises, "Try to be healthy, but don't beat yourself up for things that are often construed as minor sins of living, like eating delicious food and drinking beautiful wine." She sees health "in the broadest sense... embracing enjoying life, not just living it for as long as possible."
For those with a terminal diagnosis, Tan recommends a living funeral: "It doesn't have to have the word funeral in it; just have a party. I want balloons and wine and people I love to be with me." If that's too much, Love suggests smaller gatherings or one-on-one hangs.
Tan also advises celebrating birthdays, especially big ones, as you age. Love has clients who've had living funerals, but acknowledges it can be overwhelming: "If you can't face a big event, hanging out with people in smaller groups or one on one is a form of that."
Clarke has a bucket list of "about 100,000 things" she wants to do, including spotting otters in the wild. She recently saw "thousands of nesting puffins" in Northumberland, which was "almost as wonderful as I think seeing my first otter in the wild will be."
Holland dreams of Costa Rica with his son to see wildlife. Love wants "a baby, more time in nature, and to get really good at making focaccia." She recommends achievable goals: "That way, if you suddenly get hit with an accident or a terminal diagnosis, hopefully you won't have a long list of things that you've never done."
Clarke defines a good death: "A good death occurs when someone is at peace with the life they have lived... and they feel a sense of peace with the person they've been, the actions they've committed and, above everything, the relationships they have had with other people."
Her own fantasy: "To be a 90-year-old woman who is still engaged in and fiercely commenting on how she thinks the world should be, but also enjoying a glass of champagne with her grandchildren and doggedly going out at 5am trying to spot an otter."
Love stresses planning ahead: "If we plan now for all the potential scenarios, we can then put those plans away and focus on living." She's started her own plan in her early 30s, because "my work has taught me that you have to make the most of what you have, every day. So go to see your friend, do something fun - because life isn't infinite."