Saying goodbye forever is always difficult both for the voyager and for those who stay. But worse still is leaving with no communication. I have always appreciated the good friends who let me know of their serious diagnosis or their move to hospice, and for the chance to exchange loving reminiscences, thoughts, and adieus. Often, when that is not possible, things are left unsaid with a poignant emptiness.
So I was particularly interested in a recent article by VJ Periyakoil, a geriatric and palliative care doctor, who has developed a format for thinking through and writing farewell letters. The idea grew out of the treatment of a stoic, silent patient with terminal cancer who was unable to discuss his feelings with family but could with the doctor. Together, they recorded a letter which expressed his loving memories and pride for his family. When his wife and son heard the taped letter, they were amazed and moved to tears.
This experience was very comforting for both the patient and the family. It led to a project to encourage patients to put their often unexpressed feelings into words and to write letters to important family members and friends which acknowledge their importance in one’s life, recall treasured moments, apologize for possible hurts, forgive those who had been hurtful, and say good-by with love. The project created, tested and revised templates for these last letters, expanded the audience from terminal patients to sick ones and then, since death is often unexpected, to healthy people. Currently, free templates for those with serious illness and those in good health are available in eight languages; along with instructions, examples and videos they are available on line. The mechanical process is relatively simple since the templates can be filled out, revised, and printed easily from one’s computer.
Some may find a farewell letter template overly rigid, but it need not be followed exactly; innovation and personalization are encouraged and people should include only with what they are comfortable. Some find the template is too simplistic for complex, sensitive feelings but it offers an important starting point and wide map of issues to consider. To those who feel a template and a review of memories is unnecessary since a farewell letter is intuitive and natural, the only question one might ask is “have you written your messages yet?”
It is not always easy to carve out a letter of love; it takes time, thought, and sometimes courage to review and express emotional bonds, but it can be a healing summary for the writer and a loving legacy for the reader.
(Go to med.standfor.edu/letter to review the suggested process, obtain the template, and write your letters.)