An article written by Conner, 2017 highlights that people in the olden days would buy a skull and place it on their desks, to keep their thoughts focused. One can say that they would deliberately scare themselves to make most of every opportunity and to accomplish the important everyday tasks. I have noticed that working at hospitals and clinics is making me so aware of my impending death. I really enjoy working with geriatric patients, and talking to them has left me with a realization of how life and time so quickly goes by. I recently had a patient who was once a gym instructor (for over twenty years). They practiced a healthy lifestyle, never smoked cigarettes or drank alcohol, would go mountain climbing, ran marathons and participated in triathlons but now were diagnosed with a terminal disease rendering them in a sense, powerless. This encounter with them had me thinking about my death for a greater part of that whole month. How would I die?
First, the good news. I probably will not be murdered, eaten by a shark or crash with an airplane. Nearly 10% of deaths in South Africa are due to non-natural causes e.g. transport accidents, assault, etc. (Africa, 2017) which is quite reassuring. Now, the less good news. Most people including myself would like to die quietly, without prior warning and in our sleep. But the reality is that my death will possibly be drawn out and with plenty of forewarning. National cause-of-death statistics released by Statistics South Africa in 2005 revealed that 20% of deaths in the 35–64 year age group were a result of chronic lifestyle diseases (Van Zyl et al. 2012). According to the journal, 55% of deaths in the developing world are caused by non-infectious diseases and the percentage is on the rise, reducing the ability of the individual to live a full life. This then means that I will most likely die in a hospital. Bradshaw et al., 2010 reported that 43.9% of deaths occurred in hospital according to Statistics South Africa. Of those people who die in hospitals, an astonishing 20% is reported to have been there for a month or more. Only just 3.8% of people die in their homes according to Africa, 2017, comforted by the sight of familiar surroundings and possessions and loved ones. On the plus side, I will most definitely not die in physical pain. Pain is fully controlled in 60-70% of chronic disease cases (Brand et al., 2013), though dying involves some neurological and emotional pain that is hard to relieve. That is most probably, how I will die.
But what exactly will kill me? According to Steyn, 2007, my heart will be the cause. The Heart and Stroke Foundation of South Africa, 2007 observed that people living in South Africa in an urban setting have 1 in 3 chances of dying from cardiovascular disease. The single biggest risk factor is something I can do little to prevent which is high blood pressure. A piece written by Health 24, 2017 reported that in over 90% of high blood pressure cases, the cause is unknown. My father also having suffered from hypertension places me at an even greater risk of developing the condition. This does not look good for me. The next thing most likely to kill me is cancer. This is caused when a mutation develops in the cells and reproduces uncontrollably. Cancer is responsible for 21% of deaths in the developing world (Siegel, 2017). There are variations due to gender; ethnicity and some cancers can be reduced through changes in lifestyle. According to Cancer statistics released in January 2017, 22% of some cancers can be prevented by not smoking but 2/3 of cancers are non-preventable. Which means no change in diet or lifestyle will help and the biggest risk factor is the least preventable of all, age.
What I found out is that when I die, I will be old according to Statistics South Africa, 2017 which predicts that by 2030, people over the age of 65 years will make up 64.3% of the population. Although I can never predict the future, these factors and figures cannot change the fact that we all will die. This is about our life and how useful it might be to dwell on the idea that we will die which helped me get a better perspective on death. From the people who had skulls on their desks to my geriatric patients, I learnt that I should use the thought of death not to make me live in despair but to shake me into pursuing more committedly the life I want to live.
Africa, S. (2017). What are South Africans dying of? | Statistics South Africa. Statssa.gov.za. Retrieved 7 April 2017, from http://www.statssa.gov.za/?p=1023
Bradshaw, D., Pillay-Van Wyk, V., Laubscher, R., Nojilana, B., Groenewald, P., Nannan, N., & Metcalf, C. (2010). Cause of death statistics for South Africa: Challenges and possibilities for improvement (1st ed., pp. 3-7). Retrieved from http://www.mrc.ac.za/bod/cause_death_statsSA.pdf
Brand, M., Woodiwiss, A., Michel, F., Booysens, H., Majane, O., & Maseko, M. et al. (2013). Chronic diseases are not being managed effectively in either high-risk or low-risk populations in South Africa. South African Medical Journal, 103(12), 938. http://dx.doi.org/10.7196/samj.6018
Conner, M. (2017). Anthony Horowitz: ‘The human skull on my desk reminds me how short time is’. the Guardian. Retrieved 8 April 2017, from https://www.theguardian.com/books/2013/sep/14/anthony-horowitz-author-screenwriter
More Die of Heart Disease in SA Every Day than are Murdered. (2017). Health24. Retrieved 9 April 2017, from http://www.health24.com/Medical/Heart/About-heart/Iin-SA-more-die-of-heart-disease-every-day-than-are-murdered-20150929
Morens, D., Folkers, G., & Fauci, A. (2009). What Is a Pandemic?. The Journal Of Infectious Diseases, 200(7), 1018-1021. http://dx.doi.org/10.1086/644537
Siegel, R., Miller, K., & Jemal, A. (2017). Cancer statistics, 2017. CA: A Cancer Journal For Clinicians, 67(1), 7-30. http://dx.doi.org/10.3322/caac.21387
Steyn, K. (2007). The heart and stroke foundation South Africa heart disease in South Africa. Retrieved 9 April 2017, from http://www.heartfoundation.co.za/sites/default/files/Heart%20Disease%20in%20SA%20MRC%20Report.pdf
Van Zyl, S., Van der Merwe, L., Walsh, C., Groenewald, A., & Van Rooyen, F. (2012). Risk-factor profiles for chronic diseases of lifestyle and metabolic syndrome in an urban and rural setting in South Africa. African Journal Of Primary Health Care & Family Medicine, 4(1). http://dx.doi.org/10.4102/phcfm.v4i1.346