I teach psychology to postgraduate students undertaking their PhD or Masters in clinical psychology. At some point, usually close to finishing, they invariably express their panic about a moment in the future when a patient will ask them about something about which they wouldn’t have a clue. One of this terrifying scenarios is seeing a patient dying from a terminal disease. And considering these young-about-to-be clinicians with little “life experience” let alone with “dying experience”; you can understand their alarm. In addition to my own idiosyncratic views, I normally rely on the traditional, somewhat mechanical, stages well espoused by many (e.g., those of Kubler-Ross’s); but I also tend to add some gems offered by Irving Yalom, “Staring at the Sun” in particular, which represents a very personable, yet professional and insightful work on the topic of helping people who are about to die.

I now feel the need to include Christopher Hitchens’ “Mortality” in the training; not only because Hitchens happens to be one of my intellectual heroes, but also because Mortality is a searingly honest and moving account of his last days. Indeed chapter VIII has a publisher’s note that reads ” These fragmentary jottings were left unfinished at the time of the author’s death”. To read such a clarification is a powerful and strange experience. I had the same feeling when I read the postscript to  the “Diving bell and the butterfly: A memoir of Life and Death” by Jean-Dominque Bauby which stated that the book was printed after the death of the author. In my eyes, irrespective of the actual chronology, , the author was alive, but when I finished the book he was dead. Hitchens was alive, although deeply unwell, as he narrated his views with such agonizing precision for the first chapters, and then at some time during those pages, somewhere in between a few lines, he left. This textual witnessing of his departure added an eerie and profoundly sad flavor to the reading.

Hitchens was a great writer, even when he was afflicted by an unforgiving illness; even when his health was cruelly and unavoidably battered by the treatment that briefly prolonged his life. He details his loss of hair, his weak body, the losing his voice, attention, concentration, and so on. He still managed to pertinently cite Nietzsche, Pascal, Elliot, Russell, Voltaire and others. His consistency is reflected in his approach to the questions many asked: Is Hitchens going to recant when facing the last minutes of his life and ask for forgiveness to secure a place somewhere in some  afterlife? Will he repudiate his atheism? He addresses this head-on and suggests he is not, and he didn’t (there was some morbid betting going on the net about this). Some even suggested, cancer was God’s revenge; “It’s [not] just a “coincidence” that out of any part of his body, Christopher Hitchens got cancer in the one part of his body he used for blasphemy?” The author of this quote goes on about Hitchens suffering in hell for his views (with, I must add, demonstrates an extraordinary level of cruelty on the part of  a so called believer). Hitchens addresses this and other questions with illuminating lucidity.

Pascal’s famous  gambit (which was put to Hitchens so many times in his last days) says something like:  since we don’t know what’s going to happen after death, it’s a better strategy to believe in god because if god does exist you go to heaven but if god doesn’t exist you don’t lose much. Hitchens replies to this saying that this belief assumes both a cynical god and an abjectly opportunistic human being. If he were to ditch the principles he held for a lifetime, “in the hope of gaining favor at the last minute? I hope and trust that no serious person would be at all impressed by such hucksterish choice. Meanwhile, the god who would reward cowardice and dishonesty and punish irreconcilable doubt is the many gods in which (who?) I do not believe”.

Another common therapy question touches on the apparent singling out the sufferer. All honest psychologists have the answer “why not” timidly floating in their minds when a terminal patient asks “Why me?”. Of course we find more humane ways of answering. Hitchens reflects on this: “To the dumb question ‘Why me?’ The cosmos barely bothers to return the reply: ‘Why not'”. A patient like Hitchens would make psychologist redundant.

Carol Blue, his wife, writes the afterword and confirms Hitchens’ stoic and consistent stance. After reading Mortality I will tell my students that reading it will provide them with a better and more honest strategy for dealing with death and “afterlife” issues. It was written by someone with an enviable intellectual prowess and moral courage. Yalom insists that fear of death is not really the core anxiety people feel in their last minutes, it’s the regrets they have about their lives, “you die well if you’ve lived well”.  And in this sense one can understand Hitchens’ last minute consistency and integrity.

© 2014 Rodrigo Becerra

Rodrigo Becerra is a Senior Lecturer in psychology at Edith Cowan University, WA, Australia and a private practitioner in West Perth, Australia