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Stephen, the death coach

Author: Dr Jamie Zhou and Dr Noreen Chan, National University Health System, Singapore
04 October 2016

Stephen was not the easiest patient to care for. The youngest child of a single mother, he dropped out of school at age 15 and joined a gang (insisted that he was the ‘intelligence unit’).

He later decided that he didn’t want a life of delinquency, so he worked hard and acquired two Diplomas, an MBA, and professional success as a company director.

A diagnosis of advanced bile duct cancer at the prime of his life felt like another unfair challenge that fate had thrown at him.

He reacted in the only way he knew how, by exerting control. This resulted in a few fractious encounters with the healthcare teams, but as we got to know one another, it was clear that behind the prickly and bluff exterior was someone who valued love and friendship, and who found joy and meaning by helping others.

While he was often ‘in your face’, brash and provocative, and his language colourful, he could also be charming, humorous and even sensitive. He appreciated candour, hated “bulls#*t” and was always ready with an opinion or piece of advice.

For example, on how to improve public awareness of palliative care, he had this to say: “When I worked in the tobacco company, I learnt about ‘dark marketing’. I think palliative care is something like tobacco because people associate it with death and dying. Perhaps you need to rebrand yourself, like tell people you’re a life coach for the dying… a death coach?”

He had always wanted to leave a legacy, and had planned to write a book which he would call, in typical Stephen fashion: ‘I am dying, so are you’.

But it was not to be. His cancer was worsening rapidly, and he probably had just weeks left. When told the bad news, he joked: “Oh great, now my book will have to become just a booklet.”

Not one to give up easily, Stephen decided to film a series of videos on his smartphone, from his hospital bed, in which he would share his personal journey and the perspectives he gained from his experiences.

In the few weeks before he died, he would cover a variety of topics including coping with cancer, palliative care, and preparing for the final journey.

He hoped the videos would be widely shared, not just to remember him, but more to help fellow patients, their family and friends, and healthcare workers.

The videos were edited and uploaded to YouTube as the ‘Stephen Says’ Series. Here, Stephen tackled topics such as: 

  • How you can support sick patients’ (“What I like you to do (when I have low energy) is to just hold my hand, tell me I’m here with you…”)
  • How I cope with cancer’ (“Another way to cope is to focus on other people … by helping others, the energy returned … is double or triple, and it is usually very happy or rewarding”); and 
  • Make Death your slave: use your dying moments to help others’ (“We must understand ourselves first, then we can understand how to help other people”).

Stephen died on 26 September 2016, three months shy of his 52nd birthday. As it turned out, he was the better death coach. In his dying, he taught us about living. 

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