The four things that matter most

from The Forum of Fargo-Moorhead
Carol Bradley Bursack

Dear Readers: Please forgive me; I forgive you; thank you; I love you. After reading Ira Byock’s moving book “The Four Things That Matter Most: A Book About Living,” I found myself examining the deaths I’ve attended, as well as the relationships I am now a part of – close and otherwise – to see if those healing words have been at least implied, if not expressly said.

My answer to myself? Implied, but not always said. I’ve vowed to try harder to voice these feelings. I’m convinced that saying these words can heal.

Ira Byock, M.D., is director of palliative medicine at Dartmouth Hitchcock Medical Center and a faculty member of Dartmouth School of Medicine. Dr. Byock is devoted to improving end-of-life care.

Part of Byock’s care of the dying involves the emotional dynamics between dying people and their family members. No matter how close a family unit is, there will have been negative issues that were never addressed. No matter how flawed a family’s history has been, there is hope, according to Byock, for healing.

With powerful stories of fractured families healed through implementing “The Four Things,” Byock illustrates how these simple words can soften even the hardest hearts. Hearing and saying these phrases allows people to die in peace and survivors to move forward with their lives, often with a new perspective on their own history.

Dying people tend to look inward. Byock writes, “Most people who are dying still have the capacity to change in ways that are important to them. Their transformation can also make an enormous, and lasting, difference to the people around them.” Byock continues, “I look at these changes not as deathbed conversions, but as quantum leaps in personal development.”

Addressing legacy, Byock writes, “Painful legacies can arise from damaging emotional patterns that are perpetuated from generation to generation...Forgiveness is a courageous way of saying, ‘Enough is enough.’ ” Byock acknowledges the difference between forgiving and forgetting. They are not the same thing. Forgiveness is a choice. We can forgive, even if we can’t forget.

Lack of forgiveness hurts the person carrying the resentment. After reading some of Byock’s stories, the reader wonders how a person could say “I love you” and “I forgive you,” let alone “please forgive me,” to an abusive parent.

However, somehow, at least in Byock’s examples, when people were able to say the words, healing occurred. In one striking example the young man had to say to his father, “I love you?” as a question, in order to force out the words. Still, according to Byock, healing occurred – for both the young man and his father.

Reading “The Four Things” is an experience the reader will not forget. “The Four Things That Matter Most” is available at book stores and online. The hardcopy sells for $23.

Dr. Ira Byock will be appearing at a free and open event 7 p.m. April 11 at the Ramada Plaza Suites. The event is sponsored by Hospice of the Red River Valley.