The honesty, candor and significance of conversations among the living can pale in comparison to those among the dying. I am repeatedly struck by my patients’ inclinations to communicate with their friends and loved ones in ways they never did before they got sick.


Steve was a gracious, genuine man in his late 50’s with an easy laugh and a peaceful demeanor. He had a full head of white hair with a neatly trimmed mustache that sat above an ever-emerging smile. He had a keen sense of humor and a gentle, yet persuasive quality that made Steve a natural leader. His daughters likened his compelling nature to the influence of the Jedi Mind Trick. Once, he walked the family dog into a 7-11, where the clerk told him that dogs were not allowed in the store. Steve quickly replied, “Oh, but he’s blind.” The clerk went along with it. Steve had something of a wild side that was complemented well by his deep spirituality – he would park his 1967 blue Corvette Stingray convertible in the synagogue parking lot during the years he served as president of the congregation.

After what was supposed to be routine gallbladder surgery, Steve was diagnosed with a particularly aggressive type of stomach cancer. He and I spent several afternoons at the hospital together, talking about his disease, his family, his future. He had always been a straight shooter, talking candidly to those closest to him about whatever was on his mind. But in the weeks and months after his diagnosis, the floodgates opened. Steve made open and honest communication a familiar theme with his family and friends. He called it “soul talk.”

He and his wife joined a support group of “really smart and loving people” who shared similar medical misfortunes. Right from the start, Steve described the love “emanating from the group” as “palpable.” He was quick to note that, “It’s a shame that it takes something like cancer for people to express what they are feeling a lot of the time.” From that moment on, Steve never wasted another word. About a month before he died, he wrote “I can tell people how much they have meant to my life over the years and people do the same with me. That in and of itself is a great gift.”

He kept a running commentary on a website for friends and family. He made a video about his life so that some day his grandchildren might watch it and get a glimpse of their grandfather. He told people how much they have meant to him and often heard those sentiments echoed right back. Not all of his honesty was about love; he was also ready to let the anger out when it surfaced. His dog, Zeke, who had been sick for two years, crossed Steve’s path one day. In a fit of understandable frustration, he cursed at the dog: “Zeke!” he exclaimed, “You’re going to outlive me!”

Steve’s “soul talk” came from deep inside him, and he expected the same kind of raw honesty from his family. Steve’s younger daughter had a habit of shying away from talking to her dad about his illness and approaching death. Steve was having none of it. One warm summer day he demanded, “Come in here. We’ve got to talk.” He let his candor set the example; he and his daughter spoke “soul talk” for hours.

His outspokenness was not lost on the other members of his family. In one of the last entries on the website, his older daughter wrote “He gave all of his close friends and family a wonderful gift by spending time with each of us before he died and telling us how much he loved us all.” Steve, too, realized he was leading by example. He wrote, “I guess there can be growth with almost anything. Maybe I was placed in this position for a reason. Not only for me to grow, but for me to show others one way to deal with this kind of diagnosis.” After Steve’s death, his wife noted that his openness gave his family the freedom to talk forthrightly and candidly, “without walking on eggshells.”

In what would be the last few weeks of his life, he accepted that he was nearing the end. Often he would say, “I lived fast and got done early.” During Steve’s final days, surrounded by family, the hospice program arranged for a harpist to play at the house. Steve smiled during the performance, relaxed and comforted. As the harpist finished, in a style that so embodies his humor and kindness, Steve turned to his daughter and, pointing at the musician, said “get her address and phone number, I want to send her a tip.”