What Matters?

It is a short question, ‘What matters to you?’. When it is asked within the context of a therapeutic relationship it is really a question about death hiding in plain sight.

The soft sell version is perhaps: ‘If you knew that you had a month left to live, what would you do with that time?’

So, what do people say?

If you take an average across various age groups, the young section being 25-40, the mid-group, 40-60, the next lot 70+, three distinct themes emerge. And yes, there is a gap in those groupings, the decade between 60-70. The general view is that during those years a lot of people are at their most contentedstill young enough to remember, and old enough to worry less about what really doesn’t matter. Then, at around 70, the fear of ageing creeps closer with every creaking joint and forgotten name and face.

For the first batch, the young, the idea of a dying within a few weeks is uncomplicated. The main reason for this is that it seems unimaginable for almost all of them, so the exercise is more of a game—a ‘bucket list’ experiment. It is assumed that, implicit in the question is that they will be in full health and good spirits during that month. Their looming death apparently will not impinge on their ability to have fabulous final flings with all the girls they fancied at high school, or snub all the boys who did not, to sky dive from a space rocket, take a lot of LSD, take over Google and create a logarithm for gender parity, the end of racism and poverty. This is not facetious but taken from the range of replies.

The middle years tend to have a theme of regret, of having ‘done those things which we ought not to have done, and left undone those things we ought to have done, and there is no health in us—’. There is often a morality swing towards a time of purging, reflection, confession, and the burning to desire to relive some of the big decision moments, and to choose differently.

And then there are the old, not those in the happy decade, but beyond. It takes longer to respond to the question, vast human weather passing over their faces as they confront that this is no longer just an idea. It is what is going to happen next. There is often great sadness. The opening line is a version of, ‘I want to live my life again knowing what I know now,’ or ‘I just don’t feel ready to be this old.’

One response that surprised me was a man in his early nineties. On paper his life was highly successful. He was in robust health, and he went on to live for nearly another decade after this conversation but, at that time his response was, ‘I have done nothing of any value, and I have failed at the only things that could have been of any use. I have been both a cruel boss and a dreadful father.’ When I asked him what he would do with that final month he said,’ ‘If I am as horribly healthy as I am now I would like to take a very long journey, find as many of those I have hurt as possible, and ask their forgiveness.’ I was very young when I asked the question, and I could not tell whether he was playing with me. Toying with the young was a habit of his. I like to hope that he was not.

There is a curious continuity between those close to that last month in years, those who find themselves in the same place as a result of a destructive illness, and those embarking on something life-threatening, say going to war, into space, or to Russia. The continuity is that these three groups of people have thought about death more than most—a great deal more. They are likely to have considered carefully what is important to them.

It is this squaring up to death that links them. George Orwell called it the ‘Power of Facing’, with the idea of confronting what is harsh in our own lives, all of it, the rough and the smooth. This is almost exactly opposite to a core aspect of human nature–the expending of huge amounts of human energy avoiding what we do not like and what we find hard to face about ourselves.

In this ‘facing’ three things emerge that stand above all others:

• Sorrow about those whom we love but have hurt.
• Regret about not spending enough time with those we love.
• Fear of dying in pain.

Perhaps what is important was summed up the most succinctly in this wish for the last month of one life.

This woman was at that point in old age when the number of years has become irrelevant. Her features had fallen back against the bone, her skin as delicate as fraying silk, marked with ‘les roses des cimetière’ as the French call age spots, the roses of the cemetery. Her posture was beautiful, up right in a velveteen chair, a porcelain brooch at the throat of her cardigan. She had been an academic, a history professor, her husband a politician, her father one of the very first fighter pilots during the First World War.

‘I wish I could teach my children and grandchildren one last thing. Actually, I would like to be able to teach everyone, but that makes me sound like a silly Miss World contestant, and that’s no good. But, the lesson would be knowing the difference between what matters and what does not. In the end not very many things matter and we do not take nearly enough care of those very few things that do. I am too old to cry but, if I could I would now.’ She then asked me not to ask her any more questions. We sat listening to the sound of cars passing outside her window, the wind moving the blind against the glass, the soft murmur of a radio in the next-door room.