About Rationally Speaking

Rationally Speaking is a blog maintained by Prof. Massimo Pigliucci, a philosopher at the City University of New York. The blog reflects the Enlightenment figure Marquis de Condorcet's idea of what a public intellectual (yes, we know, that's such a bad word) ought to be: someone who devotes himself to "the tracking down of prejudices in the hiding places where priests, the schools, the government, and all long-established institutions had gathered and protected them." You're welcome. Please notice that the contents of this blog can be reprinted under the standard Creative Commons license.

Monday, June 20, 2011

The five top regrets of dying people

by Massimo Pigliucci
Bronnie Ware is the author (a bit too much on the mystical-touchy-feely side for my taste) of the blog “Inspiration and Chai” (QED). But she has also worked for years in palliative care, thereby having the life-altering experience of sharing people’s last few weeks and listening to what they regretted the most about their now about to end lives. The result is this list of “top five” things people wished they had done differently:
1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
2. I wish I didn’t work so hard.
3. I wish I’d had the courage to express my feelings.
4. I wish I had stayed in touch with my friends.
5. I wish that I had let myself be happier.
This is, of course, anecdotal evidence from a single source, and as such it needs to be taken with a rather large grain of salt. But it is hard to read the list and not begin reflecting on your own life — even if you are (hopefully!) very far from the end.
Ware’s list, of course, is precisely why Socrates famously said that “the unexamined life is not worth living” (in Apology 38a, Plato’s rendition of Socrates’ speech at his trial), and why Aristotle considered the quest for eudaimonia (flourishing) a life-long commitment the success of which can be assessed only at the very end.
Let’s then briefly consider the list and see what we can learn from it. Beginning with the first entry, I’m not sure what it means for someone to be true to oneself, but I take it that the notion attempts to get at the fact that too many of us cave to societal forces early on and do not actually follow our aspirations. The practicalities of life have a way of imposing themselves on us, beginning with parental pressure to enter a remunerative career path and continuing with the fact that no matter what your vocation is you still have to somehow pay the bills and put dinner on the table every evening. And yet, you wouldn’t believe the number of people I’ve met in recent years who — about midway through their expected lifespan — suddenly decided that what they had been doing with their lives during the previous couple of decades was somewhat empty and needed to change. Almost without exception, these friends in their late ‘30s or early ‘40s contemplated — and many actually followed through — going back to (graduate) school and preparing for a new career in areas that they felt augmented the meaningfulness of their lives (often, but not always, that meant teaching). One could argue that such self-examination should have occurred much earlier, but we are often badly equipped, in terms of both education and life experience, to ask ourselves that sort of question when we are entering college. Better midway than at the end, though...
The second entry in Ware’s list is more likely to make sense for Americans than for other people, particularly Europeans. There is much to admire in the work ethic of Americans, but it is also true that in this society people willingly forgo vacation time, weekends, and evenings just so that they can get more work done, even when their job is not helping to fulfill their lives but simply a means to an end. American workers are significantly more stressed than other people, and as a result they enjoy their lives much less. To add insult to injury, they are steeped in a society that actually makes fun of, say, France's short work week, or more in general, disdain the European “socialist” approach that allows people (God forbid!) to take sick leave without losing their pay, or to take care of their infant children while retaining their jobs.
The third point is also a bit puzzling from the point of view of a non-American. My European and South American friends seem to have little trouble expressing their feelings, and that goes for both men and women. But the US is, of course, the country where the quintessential icons are the tough silent guys with a gun (midwest and south) or the Woody Allen-type neurotic individual who spends a lifetime in therapy — neither of which seems a particularly appealing model to me. I suspect one’s ability to express feelings is greatly facilitated by the presence of the fourth ingredient of a happy life: friends.
Accordingly, the fourth entry — about friendship — follows the same pattern as the ones above. For Epicurus, friendship is a major way to ataraxia, or tranquillity in life: “Of all the things which wisdom provides to make life entirely happy, much the greatest is the possession of friendship.” Aristotle developed a sophisticated theory of friendship, recognizing three types: of pleasure, of utility, and of virtue. The first kind applies to situations in which one is a person’s friend because of the direct pleasure that friendship brings — for instance because you like people who are good conversationalists, or with whom you can go to concerts, and so on. Friendships of utility are those in which one gains a tangible benefit, either economic or political, from the relationship. The implication is not that one has utility friendships for the purpose of exploiting the other person, first because of course the advantage can be reciprocal, and second because a business or political relationship doesn’t preclude you having genuine feelings of affection for your partner or colleague. For Aristotle, though, the highest kind of friendship was one of virtue, where you are friends with someone because of the kind of person he is, because of her virtues. I suspect it is largely the latter — most precious and difficult to achieve — that Ware’s patients had in mind during the last few weeks of their lives.
Finally, we have this idea of letting oneself be happy. This, I think, is actually the result of what one does with the other four. Happiness in the sense of flourishing — Aristotle’s lifelong project — is the compound outcome of doing what one finds meaningful, of achieving a balance between work and other aspects of one’s life, of being able to engage our fellow human beings at both a rational and an emotional level, and of cultivating true friendships and other important relationships. It is therefore a bit misleading to think of “letting” oneself be happy. Eudaimonic happiness is actually hard and constant work, but it is the kind of work that allows you to get to your final few weeks of existence, look back, and think: wow, it really was a good life that I lived. And a bit more examination here and there will likely help you to arrive at that happy conclusion.


  1. #1 brings to my mind song lyrics (from "Angry Young Man" by Billy Joel): "I found that just surviving was a noble fight."

    Indeed, I believe that's the case for most working people, who do not have the luxury to entertain the elusive (and somewhat bourgeois) notion of a "true life", so much as a satisfactory or means-end-oriented one that affords them more modest joys in life.

    Perhaps that's why research shows that leisure is "unsurprisingly, linked with more happy moments than work."

  2. The first four items sound very plausible to me (setting aside the solecistic phrasing of no. 2, "I wish I didn't work so hard." I can't believe that many people on their deathbed are busy working and simultaneously regretting the fact. Presumably what Ms. Ware meant was "I wish I hadn't worked so hard"). But the fifth--"I wish that I had let myself be happier"--sounds like some New-Agey cant. While there may be people who think of happiness as something that you "let" yourself have, I can't believe that any large portion of people dying would say anything of the sort. Surely most people think of happiness either as something that is yours by luck (as the word itself implies) or as something for which you strive. Whatever Ms. Ware may have heard from her clients, in this instance she is plainly translating it into her particular psychobabble.

  3. MKR -

    I cannot agree with your assertion that a person must either "strive" or - God forbid - luck their way to happiness. It smacks of happiness merely through monetary means - though perhaps that is just an assumption on my part. It is not as difficult as you are making it sound to be happy. You can be the eye in the hurricane; perfectly happy despite the world falling about your ankles. It only requires the willingness to do so.

    "Happiness is not being pained in body or troubled in mind."
    ~Thomas Jefferson

    Believe it, my friend.

  4. I never bought the Stoic (or Buddhist) idea that happiness is entirely up to your self-imposed state of mind. Hard to be happy with a cancer growing inside you, or when you are starving to death, unless we mean something completely different by "happiness."

  5. You're probably right. It is harder. But could you imagine starving to death, and not being able to laugh? THAT would be a true Or at least, could you imagine the strength of the man or woman who was capable of laughing despite horrible circumstance? I believe humans are certainly capable of that.

  6. I don't get the priority that people often give to deathbed self-evaluations. A moment of lucidity? Hardly. By the time you're on your deathbed you're probably mentally clouded from sickness or injury, and if you're old, you're probably a lot less bright than you were before. You're faced with the specter of death, which is apt to bias one's judgments. So too is the phenomenon of old-fogeyism, in which one believes, for some reason, that it's bad to get drunk and have a good time, or bad to listen to rock music.

    I could go on and on, but I just don't see why people are supposed to be able to see things properly at the end.

  7. Thieves,

    > could you imagine the strength of the man or woman who was capable of laughing despite horrible circumstance? <

    Yes, but in what sense is that an indication of happiness? I don't equate that with the ability to laugh.

  8. Massimo,

    Great post. As a 38 year-old physician who stopped practicing medicine 2 months ago and is considering going back to grad school for a PhD in philosophy I quite fit the description above.

    I have no illusions, however, that however wonderful the life of a philosophy professor may be that it won't come with certain tradeoffs. I think part of living the examined life is examining these tradeoffs. I think a lot of people changing careers (and maybe I'm one of them) think that the change will serve as a magic bullet to ensure happiness (a psychologically complex topic in and of itself).
    In my opinion, this somewhat simplistic view is a setup for failure.

    The difference between the US and European weltaunshauungs falls into the same trap. I'd personally prefer to work in the US but live and retire in Europe. There are merits to both systems and also serious drawback. I think working toward a happy medium (that is often not discovered by measurements of centrality)given the imposed realities to which we are all subject is likely to be more fruitful than trying to determine the right path a priori.

  9. Replying to Thieves, June 20, 6:34 PM:

    I cannot agree with your assertion that a person must either "strive" or - God forbid - luck their way to happiness. It smacks of happiness merely through monetary means - though perhaps that is just an assumption on my part.

    (1) I never made the assertion that you attribute to me. I made an assertion about what most people say and think about happiness, not about what happiness is.

    (2) Your horror at the idea that happiness can be attained by luck suggests a lack of understanding of the origin and meaning of the very word. Perhaps you are unaware of the connection with such words as "happen" and "perhaps"? Here are the first two glosses in the OED entry for "happy" that are not marked as rare or obsolete (the very first entry, which is so marked, reads: "Coming or happening by chance; fortuitous; chance"):

    2. a. Having good ‘hap’ or fortune; lucky, fortunate; favoured by lot, position, or other external circumstance.

    3. Characterized by or involving good fortune; fortunate, lucky; prosperous; favourable, propitious.

    (3) Yes, your idea that "striving for happiness" implies that happiness is obtained by "merely monetary means" is just an assumption on your part.

    (4) You quote Thomas Jefferson to me as saying "Happiness is not being pained in body or troubled in mind," as if this countered the idea of happiness as an object of striving. It does nothing of the sort.

    (5) If you want to quote Jefferson, why not quote one of the most famous of all his phrases—"life, liberty, and the pursuit of happiness"? Even if he held the view that happiness is something that one "lets" oneself have, he plainly recognized that such is not the view of most people.

    (6) I will give you credit for making the suggestion that Ms. Ware's idea, which I dismissed as New-Age cant, has a basis in Stoicism. I failed to think of that.

  10. People who work too hard die in hospices. People who didn't work so hard die in Emergency Rooms and in their own home.

    I wonder if the same regret holds true in Japan.

    This post brings to mind one of my favorite slogans: "Live each day as if it was your last, and one of these days you'll be right."

    I'm relieved family isn't on the list. Mental illness runs in my family, and my friends have been my lifeline.

  11. MRK -

    You base your definition of happiness on what it says in the dictionary? I guess my feeling is that happiness is such a personal state of being - if you don't want to admit state of mind. What makes one person happy wouldn't make their neighbor happy.

    As far as my assumption - I readily admitted it. I was simply informing you of what your combination of words spoke to my mind. I didn't think you necessarily felt that way; and that assumption was more based on the connection of "luck" to happiness not "strive."

    Everyone's life is filled with great moments and terrible ones. It's up to us to sort through both and come out on the other side happy despite the bad. Sure there's a scale. A starving orphan child's bad days are probably worse by far than any of ours, and in that way we lucked out. And I agree that if that child wants to make his days a little less miserable it requires some hard work. But that requires a willingness to move, to do something about it. That is an incredibly difficult proposition for a depressed person to face. They'd rather wallow in self misery.

    Granted I am making broad generalizations, but as someone who had struggled for many years with near crippling depression, I can tell you that for me it was necessary for me to be happy to do anything. I was lucky - again. Yet, I made that luck myself. Honest truth, I woke up one day and realized I didn't need to be unhappy if I didn't want to be. Since then, I have lost my job, had a difficult time finding a new one, and lost one of my dearest friends. I've been sad. I've had hard days. But happiness and sadness are not opposites in my mind. They are two different emotions. It is possible to be both happy and sad at the same time. To relish the fact that your sadness comes directly from happiness, and despite whatever losses you may acquire, you've still been given (or lucked) into a life on this planet.

    That is enough for me to be happy.

    Oh and I probably shouldn't have used a quote at all. Though that means a great deal to me, clearly it doesn't to you. Anyone can take a sentence and make it whatever they want to. Look what people have done with Einstein and Hitler...

  12. As I read your blog, I thought about the movie, The Bucket List, Morgan Freeman and Jack Nicholson, and as I watched the movie,I thought technically we are all dying, I am unaware of a pill for immortality, so why do we wait until our mortality is confirmed to live. Truly an unexamined life is not worth living, yet I often wonder, is this why Socrates drunk the hemlock?

  13. Hmm, Socrates drunk the hemlock because he was forced to do so by the Athenian state...

  14. Massimo,

    Re: "Socrates drunk the hemlock because he was forced to do so by the Athenian state..."

    Not entirely true. As Crito explains, fleeing Athens and his death sentence would require little effort on Socrates' part (and little money on Crito's). In fact, I believe there is even historical evidence that suggests the Athenians preferred condemned criminals to flee rather than see through their penalties.

    No, Socrates wanted to die (why else would he instigate the sentencing jury by responding 'free meals in the Prytaneum' when asked what he thought his penalty should be for his crime?) and he provides a weak social contract argument in the Crito to defend his decision to stay. In the end, I think he wanted to die a martyr's death.

    While I am no admirer of Nietzsche, I will agree with him in that Socrates was too quick to give his life.

  15. I think saying the Athenian state forced Socrates to drink the hemlock is a fair assessment. Although they didn't PHYSICALLY pour it down his throat, that was the official punishment given by the state.

    Socrates did not flee for many reasons, and I do think the maxim "the unexamined life is not worth living" had something to do with it.

    If he were to flee, he would in essence invalidate much of his teachings. When it comes to his country, he would not only be breaking the social contract (which would be inconsistent because he surely followed the rule of law when he agreed with it), but he would also be doing a disservice to the Athenians he loved so well by reinforcing a bad precedent (that the state can force you to change your beliefs by coercion). By escaping his death-sentence he'd also be showing that he valued his life over the truth.

  16. Re: "I think saying the Athenian state forced Socrates to drink the hemlock is a fair assessment."

    That depends on how we are using the term 'forced'. It we use 'forced' to describe the fact that the State sentenced Socrates to death (and the fact that if he wishes to avoid his sentence, he must leave Athens), then the State certainly 'forced' Socrates to drink the hemlock.

    But if we so use 'forced' we will lose an important element in the Crito: (1) If it is not within Socrates' ability to avoid his death, then the pleas of Crito et al. are vacuous and Laws of Athens monologue is superfluous. But, as you note, Thomas, the monologue is not superfluous (it is rather important). Therefore, the State did not force Socrates to drink the hemlock.

    (This is to avoid the historical fact that Athenian officials rather preferred not to carry out a sentence and often "found" the cells of condemned men suddenly empty on the day of the execution.)

  17. Like living..dying may be considered, an art ..

  18. What does being an early bird or not (question No. 9 on the empathy quotient test) have to do with being empathetic? I stopped taking the test after that, Massimo.


    Massimo, agree with you on Buddhism/Stoicism, but agree with Paraconsistent on Socrates. He wanted to die a martyr. Beyond that, I agree with Izzy Stone, as I've said before - myths aside, Socrates was kind of an elitist.

  19. I find #3 (courage to express one's feelings) to be particularly culturally determined. In both Chinese and Japanese culture, being too direct in one's expressions can and often is viewed as an insult because one is not taking into consideration other people's feelings. Furthermore, sometimes being too direct in those culture is also insulting the other party because to be so direct is to suggest to the other party that they are insensitive to your feelings or that they are so socially inept such that you have to point out to them what's going on. Of course, sometimes we do need to be direct but I know that time and time again as I straddle between American and Asian culture I often notice how I'm "too" American in my Asian contexts and "too" Asian in my American contexts.

    We can't take this list of five things as being universally true for the entire human culture. We have to be very careful in considering the local and cultural basis for these comments.

    When my mother was in her dying months, I don't think she would have said she had hoped to speak more about her feelings. In fact, I think she found it appropriate that somethings (not everything, of course) was better left unsaid, let lying low, and left to one's own imagination.

    Basically, as an anthropologist I'm saying let's be careful of local context.