Tag: grief

We can’t really avoid each other on cruises.

We can ignore each other, and, frankly, that’s kind of a necessary skill at first. There’s an unspoken need to establish and recognize boundaries. Some passengers never try, and we all can tell. But in a short amount of time, we learn to live amongst each other—if not with each other. I’d be curious to hear a cruise director’s take on this, and how each voyage must develop its own social identity. Some cruises are likely more energetic and lively, others slower and more relaxed. Ours was a mixed bag, we had retirees, families, and college spring breakers. This made it helpful as you could see how people naturally gravitated to what felt right for them. I tend to prefer a simple vacation: a few choices a day are more than enough.

You’d find me by the pool.

But amid the sun and sea, I heard a Code Alpha over the cruise PA system. Anyone in public service—whether healthcare, school administration, or emergency response—knows that any code called over a public system means something serious is happening. My wife and I exchanged glances immediately (she’s a school administrator) as we both recognized that tone. Odds were, an older passenger had fallen ill—maybe a heart attack after a long walk along the pier. Maybe something else.

We didn’t know, and we likely never would.

Later, after dinner, another Code Alpha was called—this time for the deck we were on. As we stepped out of the restaurant, we saw a team of staff holding up tablecloths, shielding what was happening behind them. I caught a glimpse of IV bags being held up. But that was it.

I didn’t see what happened, and they didn’t want me to see.

The Art of Death and the Science of Dying

Maybe I was already thinking about death as I boarded the ship. I have personal reasons for that, and I’ll say more because I think it’s important.

I’m proud to be connected—albeit distantly—to the artist who designed the ship’s exterior. I never knew him personally, but someone I’ve known my entire life fell in love with him just as the world was discovering his work. It doesn’t help that the mermaid resembles my childhood friend (in my opinion), and I have a core memory of watching The Little Mermaid with her.

The artist, known as LeBO, was a Miami native like me. Even if I hadn’t known of him through personal connections, I would have known him as a hometown hero. His works bring joy, movement, and color to the world. You can learn more about his works here as well. His name was David Le Batard, and he is no longer with us.

He lived. He lived exceptionally well. And he was loved.

As I embarked on this ship adorned with his work, I was confronted by both the beauty of his life and the tragedy of his passing.

The American Healthcare System’s Problem With Death

The American healthcare system has always struggled with death. In many ways, it was built to defy and deny it from the very beginning. Yet, despite all its innovations, it loses that battle every day. Dr. Atul Gawande explores this tension in Being Mortal: the impossible expectation that medicine should beat death—until it doesn’t.

Patients are asked to fight death alongside their providers. We label cancer survivors as “survivors” and honor them as if they are soldiers returning from war. Our system doesn’t want you to look at death, but if you do, you’d better be prepared to fight it.

At some point, this is lunacy.

Anti-mortality is baked into our systems—not just healthcare but capitalism itself. The pursuit of something that outlasts its founder is foundational to many American institutions. But in healthcare, this obsession creates cruelty.

Telling a loved one, “We lost the patient” or “We lost the fight” implies that we could have won. That somehow, if we had just done something differently, the outcome would have changed. That’s not just cruel to families; it’s cruel to providers. Because the truth is—death is undefeated. Even on the Love Boat.

A Different Way Forward: The Quality of Death

In our recent paper, Transforming the American Experience of Death: What Dreams May Come?, my colleagues and I explored how the American healthcare system could approach death and bereavement differently. In the U.S., there is no standardized measure to assess the quality of death and dying experiences, yet in other countries, such assessments exist—and they make a difference.

Where such measures are in place, healthcare systems see higher levels of trust and better end-of-life care. These frameworks acknowledge that if a patient can live well in our care, they should also be able to die well. Families want to see their loved ones cared for, not in a battle, but guided gently toward a dignified end.

Right now, our system lacks the incentives or political will to track and improve death experiences. But it doesn’t have to stay that way. Imagine if we measured the quality of death the way we measure patient satisfaction. Imagine if hospitals were held accountable for how well they supported not just their living patients, but their dying ones.

We know that a bad death experience lingers. It changes how families perceive the care their loved one received. It alters trust in the system. But a good death—one that is dignified, peaceful, and guided by compassionate hands—also stays with those left behind.

If we’re willing to rethink the role of death in healthcare, we might just improve the way we care for both the living and the dying. And in doing so, we might create a system that sees death not as a failure, but as the inevitable—and meaningful—conclusion of life.

Sources:

Gawande, A. (2014). Being mortal: Medicine and what matters in the end. Metropolitan Books, Henry Holt and Company. 

Xu M, Silvera GA, Walton L, and Banaszak-Holl J. Transforming the American experience of death: What dreams may come?. Patient Experience Journal. 2023; 10(3):15-20. doi: 10.35680/2372-0247.1848.