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What makes end-of-life care so interesting?

Many people have asked me why I wrote a book about end-of-life care. On the surface, the answer is simple: I've been passionate about this topic for decades.


But digging deeper, one wonders--what is it that makes end-of-life care so interesting? Now that question deserves additional reflection, and perhaps some priestly wisdom. And for that, I'd like to turn to none other than Ivan Illich.


For context, Ivan Illich (1926-2022) was a priest, philosopher, and social critic - quite the combination! But for me, he was an inspiration.


Back in 1976, I was fortunate enough to hear him deliver a special lecture at the University of Wisconsin-Madison, where I was a graduate student. At the time, Illich was an internationally recognized thought leader and was touring the US to lecture on his new book Medical Nemesis: The Expropriation of Health.


I remember the turnout for the lecture was extraordinary--perhaps one thousand were in attendance. The lecture was mesmerizing, and although his book was controversial, I knew I had to read it. This book has held a special place in my mind, and library, ever since.

It's a challenge to summarize any great thinker, but here is a representative example of Illich's thinking: “Technology can benefit many, yet, modern medicine has gone too far, launching into a godlike battle to eradicate death, pain, and sickness. In so doing, it turns people into risk-averse consuming objects, turning healing into mere science, turning medical healers into mere drug-surgical technicians.”


This is a profound observation about human nature and the limits of medical care. In many ways, this quote has been with me for 47 years. And while I could not have said it better myself, that did not stop me from trying with The Journey's End: An Investigation into Death and Dying in America. I can't promise it's as inspirational as Ivan Illich, but it will answer the question--what is it that makes end-of-life care so interesting?

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