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Risk-taking Near the End of Life

I am basically a risk-taker. I think this is to some extent genetic; it’s in my blood. My very own father is a risk-taker– he spent most of his life driving high speeds for fun- he was first an amateur then a professional race car driver as I was growing up. At one point in my childhood, he quit his job in the coal mines to strike out on his own, to start his own business—to leave the safe and known world to enter the risky and unknown.

So, it came as no surprise to me when my now late-stage-COPD-home- oxygen-wearing-father called me up and said, “I’m leaving to drive to a high altitude area in New Mexico tomorrow to see some friends.” (Mind you, we live near sea level in Alabama and he gets short of breath just walking to the restroom.)

Without missing a beat, I said, “Well, OK.” The rest of the conversation was working out the details of how to do this. There was no hesitation, no pause. It was a moment of pure understanding between us- one risk-taker to another.

My sisters thought that we were both crazy- him for going and me for saying this was a fine idea. Most people would suggest that they were functioning from a more rational perspective than we were. I’m OK with that opinion, but I also want to give a plug for risk-taking near the end of life…for those of us who are more willing to live on the edge.

I have long begrudged the fear that often accompanies the frailty which develops near the end of life. I have seen fearless people become wimps, and I hate when this happens. In the years before my own mother-in-law’s death, she was transformed from a fearless-world-traveling-avenger-of-wrongs to a fearful-walker-clutching-kyphotic-elder. This bothered me. I wanted her to leave this world with the same sound and fury with which she roamed the earth for 80+ years.

So, in my father’s case, I was more than happy to see him off on his very risky journey. It felt like a triumph for us both- he was off on a grand adventure and I was happy for him… glad to see him go…to act in the face of his own fears. He was brave. This could very well have been his last trip…ever.

After he arrived back home from what proved to be a very arduous journey, I told him that in the days he was gone, I searched my heart about our decision to let him make this trip.

In my head, I had the same conversation that I have with my “end-stage” patients in the ER : “What is it you want to do with the time you have left? Do it now.”
And then, I told Dad that asked myself the “elephant in the room” question: “What if you died while in New Mexico? What if the journey itself killed you?”

The response, from my heart, was: “Then you would have died the way you lived-taking risks- but most importantly, you would have died doing what you wanted to do. What a way to go…”

My father simply replied, “That’s right.”

Written by Monica Williams-Murphy, MD for