In most cultures, there are a few numbers that are considered unlucky. One example is triskaidekaphobia, a long name for a common fear in the US – the fear of the number 13. There are hotels that skip the 13th floor and shooting ranges that have a 12, 12a, and 14th booth. I never understood why the number 13 was considered unlucky in America, even though I subscribe to the superstition myself. In the Chinese culture, however, 13 is a perfectly fine number. My parents, and their parents, are perfectly okay with staying on the 13th floor in the 13th room while I feel slightly unsteady. There is still one particular number, one even more commonplace than 13, that is avoided in hotel room numbers, floor numbers, even home addresses all over China. From a young age growing up, I knew it was bad luck to associate myself with the number four, 四, or sì in pinyin. When I went to China as a kid, even in some of the tallest, most affluent high rise towers in Beijing, there was no fourth floor. Neither was there a fortieth floor, nor a forty-first floor, nor a forty-second. I’ve known the reason for this fear since I learned how to speak Chinese and English as a little kid: 死, or sĭ in pinyin, means to die in Chinese.
It has always seemed natural to me to be afraid of dying. Just a month ago, my mom and I had a long winded argument about getting my wisdom teeth out after we went to the dentist over spring break. I couldn’t understand why she was so vehemently against the procedure, since to me, it seemed just like a normal medical procedure almost anyone my age got. It took a half hour, but I finally realized the reason my mom was so against it was because it meant me going under anesthesia and “dying” temporarily – a possibility she found unacceptable. She hated undergoing anesthesia for her past surgeries, and dreadfully fears the idea of losing consciousness. Death was something that she had recognized first hand, and something that remained a constant fear in the back of her head.
I myself never really recognized death until I joined the hospice program. I knew it existed, but it wasn’t something I really considered quantifiable or even real. No one I knew personally had ever passed away in my life, and my own death, and even my parents’, seemed like something stuck in the annals of the far future. The hospice unit, however, guaranteed that I was exposed to death. Looking from a perspective of fear, a perspective of avoiding death – it almost seemed self-harming, almost as if I was doing myself a disservice by exposing myself to death. That perspective could not be more erroneous. The hospice unit, the meetings, volunteering, talking to patients and other volunteers provided me one of the best opportunities to learn that I have ever had. The only way to get better at something is to practice it, and the only way to get better at interacting with patients, no matter how difficult the circumstances, is to practice it. Suffering is where we learn, learning to share in suffering is how we better understand how to help others.
On the hospice unit, there is a lot of suffering. That’s not to attack the patients who are almost always kind and thankful, or the always supportive staff that has helped me countless times. I’ve had plenty of great experiences playing games, going to ceramics, or simply chatting with the patients about their lives. Simply put though, the nature of the hospital environment is not where anyone is meant to stay long term, yet long hospital stays remain a necessary evil in modern healthcare. I remember talking to many patients about the physical pain they’re feeling and being unable to even comprehend their suffering. Even worse were the conversations about their emotional realizations as they come to terms with their death. “What makes a good person?” “My best friend killed himself more than fifty years ago. Why him?” “Why does God challenge us in such ways?” None of these conversations are easy for either me or the patient, but they’re not meant to be. Easy conversations don’t build relationships, they don’t instigate thought. Even the “mayor” of our wing, one of the nicest persons I have ever met, has had to deal with his friends passing on, has had to deal with the challenge of living surrounded by death. It will take a long lifetime for me to fully understand such suffering, to experience and truly empathize with them on as complete of a level as I can. And yet despite my lack of experience, my time spent volunteering on the hospice unit has been one of the greatest learning opportunities to learn about a key skill: suffering. I have a long way to go, but without the hospice experience, I would have a lot longer.
I believe now that four is a scary number, just because it’s meant to be a scary number. Its association with death has the same meaning that the very sound of words have on people. Meaning is ascribed by how we choose to interpret them. Death is scary if we avoid it. If we refuse to acknowledge its existence, and the suffering that comes with it. If we as future healthcare providers are afraid, unwilling to confront death, our patients can be no better. When we recognize life, with all its flaws and issues and great moments and happy days and sad days, we too have to recognize death as a part of that. Not something to be feared, but something that is an essential part of life itself.