Meet the inspiring doctor supporting Marie Curie’s mission to transform the way we think and talk about the end of life.
Over four decades, Dr Kathryn Mannix has supported thousands of dying patients and their families, encouraging them to understand the process, to hold each other’s hands and say those last farewells. Her experience has taught her some all-important truths about what happens at the end of our lives – and most importantly how to change that experience for ourselves and our loved ones for the better.
Now, as the author of a groundbreaking book called With the End in Mind, Kathryn wants to help others with her experiences to break the taboo around dying and encourage people to have important conversations about their last wishes.
Kathryn first became interested in thoughts around dying back at the start of her career when she witnessed a game-changing conversation between a consultant she was shadowing and his dying patient. “This lady was terminally ill and was terrified of dying in pain,” Kathryn reveals. “She was a French catholic and believed if she suffered pain, she would die in despair which would be a mortal sin and that would mean she wouldn’t be able to join her late husband in heaven.”
‘As so many people today die in hospital, instead of at home, we’ve lost the wisdom of what happens at the end of life’
As the consultant spoke to the lady, he asked if she’d like him to describe in exact detail what was going to happen to her as she died, something Kathryn was initially horrified by. When the lady said yes, the consultant began describing the pattern she would move through as her life ended, that she would become gradually more tired and weary as the days passed, dropping gently in and out of consciousness until eventually she’d sleep more than she was awake. Her breathing would gradually slow and ever so softly she’d then simply tip into a permanent slumber. No panic, no sudden rush of pain. And as the consultant described this largely universal process of dying to the lady, Kathryn saw her weep with relief, clutching the consultant’s hands in thanks.
Ever since that moment, Kathryn has told countless terminal patients about this very same pattern of dying and all have said that understanding what happens in death has brought them great comfort in the last stages of their life. “As so many people today die in hospital, instead of at home, we’ve lost the wisdom of what happens at the end of a life,” says Kathryn. “So because we don’t see it we often put into our heads what we think will happen, sometimes based on films or newspaper reports of horrid or unusual deaths, but in reality most deaths follow this pattern and that can be reassuring for the person who is dying and their family.”
In fact, over the years Kathryn says sharing information has stopped families from experiencing a lot of distress. “Many people worry their loved one is dying in pain because they make a moaning sound but once I explain this is because in death you start reflex breathing where you breathe unconsciously through your vocal chords this can really help families,” she says. “All this information won’t take away the fact a death is sad but it will stop it being scary – after all the more we know, the less there is to fear.”
‘You want to plan for both the best case scenarios and the worst-case ones so everyone feels that there is a plan in place’
The other thing Kathryn has found to bring enormous comfort to people and their nearest and dearest is having open and frank conversations. “Communication is so important and as you gather with your family, it’s a good time to start a conversation,” says Kathryn. “After all, if you’re the person the hospital are going to ask ‘what would this person like to do if they’re too unwell to speak?’ you’ll want to know. So often I see families very distressed because they haven’t had this conversation.”
Kathryn suggests making a plan, thinking about where people would like to be cared for at the end of their life, who you want to be around you and where you would like to draw the line with your care, for example, if you would prefer not to be resuscitated or taken to intensive care. “Tell a loved one and ideally write it down too and be prepared to revisit and adapt your plan as the time gets nearer,” says Kathryn. “You want to plan for both the best care you’d hope for and what to do in the worst-case scenarios, so everyone feels safe that there is a plan in place.”
Her biggest hope, though, is by encouraging these conversations and making people more aware of the reality of dying, is that at last the taboo around it will be lifted. “We need to think of dying not as a medical mistake but a universal human outcome and that giving people a good death is something we can be proud of in this country. We can’t prevent death but we can help make it peaceful and as positive as possible and that has to be a huge privilege."
Start a conversation today
Marie Curie know all too well what’s important when it comes to end of life. Opening up the conversation with loved ones earlier, talking about their wishes, plans and emotional concerns helps make life better in the end. That’s why they have launched Talkabout a new online magazine where you can find inspiration, useful checklists and personal stories. You can even request a deck of conversation cards to help you get started.
For more information visit mariecurie.org.uk/talkabout or call Marie Curie on 0800 716 146
Click here to purchase Dy Kathryn Mannix's book for RRP £9.99
Click to read Anneka Rice’s Talkabout article as she shares her thoughts on grief and making plans for end of life.