Dear Neil: My husband of 35 years has diabetes that he barely controls, his stents are completely collapsed, he smokes, does not exercise, and his physical condition is deteriorating badly. I have had a lot of death in my life already, so I am trying to build myself up so that I’m not completely devastated by his dying. So I am trying to create new friends, activities that draw me, maintaining my health, taking my medications, and so on. So far these things have have kept the stress from dragging me down.

The problem is it makes me feel a little like I am betraying my husband by separating my life from his in these ways. I am building a whole new life in preparation for his withdrawal from life, and also so I don’t get dragged down into his morbidity. I feel as if I’m sometimes trying to go through the steps of grieving before he dies, so it won’t hurt me so much after. Or is it normal to feel such a separation during a chronic, long-drawn-out illness that is terminal? I sometimes feel like I may be going nuts. He won’t see a doctor unless it’s an emergency, so we can’t know for sure what his progress is. Sometimes I wish it would all be over and done with, which makes me feel like I’m wishing he would be dead. And it really hurts to think that, but I don’t know anything else to do.

Lost Without Knowing What To Do

Dear Lost: First of all let me reassure you that you are not going nuts. I could see myself feeling similar to what you’re describing if I were in your shoes. It’s your job to stay alive and healthy and OK—you’re not the one with a terminal illness, and no good comes out of you giving up on life yourself. So continue doing what you’ve been doing to take care of yourself, and you have my respect and admiration for doing so.

I’m going to take you at your word—that your husband is terminal and has essentially given up on living—because that’s the implication of what you described in your email. So if this were my marriage, I would initiate an extremely open and honest conversation with him about what he’s doing, why, and how he expects you to respond to it.

You could , of course, tell him how you really feel—that he is letting himself die without even trying to put up a fight, and that leaves you feeling lonely and rejected—and it leaves you no choice but to separate from him and create a new identity for yourself so it won’t feel so devastating to you when he passes. And you can tell him that this upsets you, and that you are angry at him for how he is dealing with his diabetes, his smoking, his lack of exercise and so on.

You could tell him that you haven’t given up on living—and that you’re very angry he has. You could also invite him to look at what it would take for him to die with a sense of inner peace and contentment—for him to be more at peace with himself and his life.

If he were interested in that—sometimes called conscious dying—you could ask him with the following questions: Ask him who he was 40 (50) years ago—would he describe that person in detail? What would the “him” of then say to the “him” of today? That is, if the person he was 40 years ago could speak to him today, what would he think and feel about his accomplishments and experiences, what he did well, what he didn’t do, what he regrets, what battles he had to fight? What obstacles did he have to overcome? What triumphs did he have? What setbacks and disappointments? And how does the him of yesteryear feel about how he is choosing to live today?

What does he know about life—about people, about himself, about how things work—that he didn’t know then? What lessons has life taught him through the years? Likewise, who was he 30 years ago? 20 years ago? 10 years ago? If he could talk to the “him” of 10 years ago, what would the younger “him” have to say to the current him?

And there are more questions if he would be open to them. Which people has he had a profound influence on? Which people have had the most profound influence on him? What has their influence been, specifically? If he had his life to live all over again, what would he have done differently? Who has he loved, and how deeply has he allowed himself to love? Are there any amends or apologies he still needs to make with anybody, or any wrongs he has committed that he still needs to right?

What was fun about life? How did he express his creativity? Was he gifted in some way? What accomplishments, achievements, experiences and relationships have been most meaningful to him? What experiences has he had that he would call spiritual? Is there anyone he still needs to forgive? Anyone he still needs forgiveness from? Anything he still needs to forgive himself for? What is he most grateful, thankful or appreciative of about his life?

These questions will hopefully allow him to go through the process of making peace with his life—and to look more carefully as to why he is behaving the way he is right now. But you are doing the right thing to take care of yourself the best way you can. No use two people feeling bad about living.

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