BMJ Published 26 April 1997 Cite this as: BMJ 1997;314:1286

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In Ireland we have an ambivalent approach to death. Before it happens we are defensive and guarded, and denial is our most frequent coping mechanism; we don’t like to make a fuss or be any trouble.

But after death (especially if it’s somebody else’s) our attitude changes radically, and we have what is known as a wake, a triumphant ceremony, a celebration of life in the face of death, an acceptance that death is a fitting end to what was a good story and a tale well worth the telling. The death of a child or a young adult is never fair, never right, but for our older folk a wake can be a kind of posthumous This is Your Life, and merriment and devilment of all kinds can ensue as we trade stories through the night about the deceased and their exploits till the embers fade like ghosts. Sometimes, however, this laudable tradition can go too far.

A great old patient of mine was dying recently and I told his wife that he might not last till morning, promising that I would come back to put him down for the night. When I returned I had to park over a mile away up the boreen, such was the throng. Passing the kitchen I felt a blast of wild fiddle music, whiskey fumes, and boisterous laughter that nearly knocked me flat. There was even a Fat Lady singing, usually concrete evidence that death has occurred.

I prepared to pay my last respects to my old friend. Although I have no religious beliefs, when a patient of mine dies I like to touch their hands one last time, a final salute, a recognition of the end of our shared journey, but my sober mien was disturbed when, on entering his room, I found, not a coffin and a corpse, but a bed and a very-much-alive patient. I could tell he wasn’t dead; he looked too sick and old, the undertaker hadn’t had a chance to touch him up yet. I’ll not pretend he was chirpy or singing along, but he had definitely not yet joined the Choir Invisible.

I hate being a killjoy, but I felt that the festivities were a bit premature. His wife explained helplessly that it had not been planned, but had just … happened; one or two neighbours had heard a rumour and drifted in, then one or two more had seen them drifting in, and soon the rush had become unstoppable. This was not a sign of malign intent; it’s just what neighbours do in Ireland, especially if the local GAA team don’t have a game.

Using the full authority of my ancient profession, I shushed the crowd, smashed the fiddle, poured the whiskey down the sink, and stuffed a cream bun in the fat lady’s mouth, allowing my friend a few quiet moments alone with his family. When I returned to the kitchen some minutes later a respectful silence still prevailed.

“How is he, Doctor?” inquired a voice from the back.

“You thought it was all over,” I said, the words rising unbidden, “It is—now.”


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