One of the most compelling interviews I’ve done on A Good Goodbye Radio was the February 2014 conversation with Dr. Jeffrey Piehler. His New York Times essay about making his own casket while facing Stage 4 prostate cancer, titled “Ashes to Ashes, but First a Nice Pine Box” was incredibly powerful.
The process of hand-building his casket with a woodworker friend revealed important lessons about life, love and death.
Patient: A Surgeon’s Journey documents Dr. Piehler’s story and how he honestly faced his own end-of-life. This moving 72-minute documentary is now available on DVD, video on demand and for public screenings.
Dr. Piehler went into medicine partly to please his father, a pediatrician. He endured rigorous medical training and “barbaric hours” to become a surgeon at the Mayo Clinic. He operated on hearts and lungs as a thoracic surgeon, at one point handling over 1,000 cases a year. He moved to Kansas City with the hopes of slowing his pace of work.
When a prostate exam and follow-up tests revealed cancer, he had surgery and radiation treatment, yet he was still driven and work-obsessed. His cancer was treatable, but not curable.
“To be told you’re incurable, that takes some getting used to,” said Piehler. Becoming a cancer patient changes your perspective. “You see wisdom, you see a complete abandonment of trivia.”
When chemotherapy made his fingers numb, he finally accepted his life had changed and he retired from medicine. Piehler focused on finding joy and meaning in the time he had left – in art, photography, travel, and his family.
“It seems that when we’re born, we’re all given a knapsack that holds everything we need to be purposeful, joyful, happy – the ability to look at the world with wonder,” said Piehler. “That knapsack contains things like gratitude, kindness, and the ability to love people and empathize, the reluctance to judge people.”
“And then as we go through life, we pick up this other horrible stuff…. envy, materialism, judgmentalism, anger. And all those things just weight down the good stuff we were given….”
“It’s possible to empty the sack of all the bad things and get back to what we were given originally. And the world looks totally different when you do that.”
After it became apparent treatments weren’t working, he spoke to medical students, bringing his perspective as a cancer patient. He talked about communicating with patients as an empathetic physician, especially when delivering news about incurable disease and mortality.
“Isn’t compassion the first obligation of a physician?… All of this involves people. Just prolonging life for the sake of prolonging life is not what we owe our fellow human beings. We owe them a compassionate investigation of what their wishes are, and what is a compassionate use of the rest of their lives.”
Piehler got the idea to build his own coffin while attending a funeral that featured a very ornate mahogany casket. He decided he’d be happy with something simple and plain. He planned to have his body and casket present at his funeral, then cremated.
His woodworking artist friend Peter Warren took on the project with him after suggesting Piehler discuss it with his wife Jean. She was appalled.
Piehler said others perceived it as, “Wow, what a morose thing to do, it must mean you’ve given up the fight against cancer.” He perceived it as an opportunity to ground himself about dying, and putting it in perspective.
The casket was constructed of reclaimed pine lumber. On the inside of the lid was the phrase, “I have loved the stars too fondly to be fearful of the night.”
“The coffin is a reminder to me of what awaits all of us,” he said. “And it’s not a morose message. It’s a fact. And how are you going use that fact? I hope in a positive way. If you’ve just come from sanding your coffin, the trivia of everyday life really melts away.”
The response to his essay in The New York Times was overwhelming, with many respondents thanking him for bringing the issue out in the open. “No one wants to talk about dying, but everyone wants to talk about dying,” said Piehler. “Opening oneself to discussions of death … is fundamentally key to living more fully, and that is a conversation that people want to have.”
Jeffrey Piehler died on November 14, 2014, at home surrounded by family and friends.
Funeral homes could hold screenings of Patient, A Surgeon’s Journey as a thought- and conversation-provoking community outreach event. More information is available at www.PatientTheMovie.com.
You can listen to my interview with Jeffrey Piehler on A Good Goodbye Radio here:
About Jeffrey Piehler (from the website for Patient, a Surgeon’s Journey)
Jeffrey Piehler graduated from Cornell University Medical College in 1973, completed his general surgery training at Dartmouth-Hitchcock Medical Center, and completed his thoracic and cardiovascular surgery training at the Mayo Clinic. After joining the staff at Mayo in 1980, Jeff committed to a grueling work schedule, often running three operating rooms at a time. He performed thousands of surgeries, mentored residents, and published over 100 academic papers.
In 1986, Jeff moved to Kansas City, married his wife, Jean, and continued his pursuit of perfection in his field. But in 2005, Jeff retired from surgery. Treatments for an aggressive form of terminal prostate cancer had made his fingers numb.
Thrown into a new phase of his life and faced with his own mortality, Jeff’s life took a dramatic turn. His experience, his honesty, and his ultimate enlightenment are chronicled in Jeff’s own words in Patient, A Surgeon’s Journey.