What is your life’s purpose?
To increasingly model integrity, compassion, and justice as I work to decrease suffering for people nearing the end of life by encouraging and empowering them to honestly face their mortality.
How are you living your purpose?
I put much of the insights I gained in a career caring for seriously and terminally ill people into a book titled Dying with Ease: A Compassionate Guide to Making Wiser Decisions at the End of Life. In this volume I provide factual information about how death and dying happen in America and offer practical advice in navigating through this unfamiliar territory; my primary message, though, is to challenge readers to honestly encounter their own dying, an encounter that by necessity involves all parts of one’s being: physical, emotional, social, and spiritual. My blog is primarily dedicated to this topic also, as topics as diverse as Monty Python, baseball, and Black Lives Matter are informed by the universal human experience of mortality.
How did you find your purpose?
After completing medical school, internal medicine residency, and a fellowship in hematology and medical oncology, I emerged as an enthusiastic but wet-behind-the-ears physician, ready to take on blood diseases, cancer, and just about anything else. I joined one other oncologist in a multi-specialty group practice in the delightful Ohio college town of Wooster. Initially the thrill of finally being the doctor-in-charge, the novelty of “great cases” coming through the door, and the chance to build a reputation were all that I needed.
But working with patients with cancer, far too many of whom die of their disease, can be a draining enterprise. Every cancer specialist finds their own path to meaning; I found it in two separate but related activities. The first was my interest in my patients and their families as individuals with fascinating life experiences and coping strategies they were often eager to share. The other nudge toward my purpose came from serving as a volunteer part-time co-medical director for the local hospice agency. This seemed a logical area of involvement since so many of my patients eventually availed themselves of the service, but I was surprised to find a deep sense of confirmation as I learned the tremendous value of hospice care. My own care of and interaction with the dying and their anxious and grieving families generated a deep resonance and affirmation.
I toyed with possibilities of how I could expand and deepen my work with the dying, and in 2001, a confluence of coincidences gave me the opportunity to re-enter the academic world at the University of Iowa where I served as oncologist, teacher, and director of the inpatient palliative care service. While I valued my opportunities and my colleagues and learned to love Iowa City (and the Hawkeyes), my naïveté as to the inner workings and politics of an academic department and medical center generated enough frustration for me to decide to leave. I was fortunate to find that Hospice of the Western Reserve, a large and nationally recognized agency in the Cleveland area, was actively recruiting a new physician. I joined them in 2005 and from then until my retirement from active practice in 2015, I focused my clinical practice totally on the care of the dying.
A confirmation that this was my purpose in the world was the community I found, not only in our agency, but also in the national hospice and palliative care family. I had attended my first national assembly in the early 1990s, and at that point I knew I was home. I reveled in how each day’s opening session began with a chanted invocation from members of the First Nations people living in the Vancouver area. I saw that everybody else there had followed their own unique but often similarly winding path to this world. I have remained active in that community, which has grown exponentially and evolved into a specialty much more incorporated into the mainstream of healthcare in America while maintaining some of that spark of soul and whole person care, not only care of the patient but care of ourselves.
A tragedy in the way too many people reach the end of their lives in America is the amount of unnecessary pain and suffering that they endure: physical symptoms, emotional distress, family discord, and spiritual pain. Part of this is the nature of the cosmos; death is often not pretty. A huge contributor is unwise decision-making caused by poor understanding of reality, especially prognosis, and this stems from couched, vague, or even well-meaning but dishonest communication with their health care providers, especially their doctors. I believe that there is an avoidance of honesty in these vital conversations because we, patients, family members, and medical professionals, are not comfortable talking about death and dying because we avoid facing our own mortality. I am convinced that if we choose to honestly encounter the reality that we will die, we will make wiser choices for our health care in the last part of our lives, we will die with less distress, and, as so many dying patients have told me, we will refocus our priorities and live more full and authentic lives. Since my retirement from active practice, I have taken communication of this truth, as well as many other lessons I have learned from the dying, as a focus of my life.
What advice do you have for purpose seekers?
Remember that a door that closes, a choice that doesn’t work out well, is of tremendous value and the sooner you recognize that this is not your purpose and head in a different direction, the sooner you will near your goal.
Advice from others can be helpful but weigh every option by paying attention to your inner voice; cultivate some type of contemplative or spiritual practice that helps you hear it.
What resources do you recommend?
The book that has most influenced me in discerning my purpose is Let Your Life Speak by Parker Palmer, founder of the Center for Courage & Renewal. I first encountered his message of discovery of and listening to my true self while serving on a discernment committee for a candidate for the Episcopal Diaconate, but the book impacted my personal discernment far more than it affected the committee deliberations.
I wrote Dying with Ease as a guide and resource for everyone facing death, and that is everyone. Terminally ill individuals told me over and over that dying taught them how to live. So, I recommend an honest encounter with your mortality as an informative exercise, and, of course, I believe my book does just that.
Connect with Dr. Jeff Spiess
Book: Dying with Ease: A Compassionate Guide to Making Wiser Decisions at the End of Life
Dr. Jeff Spiess has spent his medical career with people facing serious illness and death, first as an oncologist, then as a hospice physician. He has lectured extensively and has been recognized as a leader in the field of end-of-life care. He has observed, through extensive clinical experience and innumerable conversations with the dying and those caring for and about them, the burden of unnecessary or avoidable suffering and distress engendered by the American tendency to avoid facing death as an inevitable personal reality. His medical practice and writing are informed by his interest in philosophy and theology, and he finds additional insights in depictions of dying in literature, including sacred texts, music, and popular culture. His writing provides information and inspiration, challenging readers to honestly encounter their own mortality to both die better and live more fully.