Why Cancer Patients Should Write a Life Review Letter


The title of a New York Times piece written by a palliative physician, Dr. VJ Periyakoil—“Writing a ‘Last Letter’ When You’re Healthy”—caught my eye.

Dr. Periyakoil tells the story of one of his patients, a Marine combat veteran, who, when he learned he was dying, expressed his regrets and his love for his wife and pride in his son.

“When I mentioned these comments to his wife and son,” said Dr. Periyakoil, “they looked incredulously at each other and then disbelievingly at me. They thanked me for being kind but stated that my patient was incapable of expressing such sentiments.”

Suspecting the stoic ex-Marine wouldn’t say those words directly to his wife and son, the doctor lugged his over-sized family camcorder to work the next day, and with consent, recorded his patient’s words. The wife and son were moved to tears when they later viewed the tape.

Photo Credit: Pixabay

This experience inspired the Stanford Friends and Family Letter Project, designed to encourage people to write a last letter to their loved ones.

There are 3 free letter templates at the Stanford Friends and Family Letter Project website, developed with guidance from seriously ill patients and their family members:

  1. What Matters Most Letter. This is a letter template that allows anyone to document what matters most to them and what treatments they want in the future.
  1. Letter Project Advance Directive. This tool allows anyone to complete an advance directive document and a supplemental letter to their doctor describing their preferences for medical care at the end of life.

It’s this third template at the Letter Project site that I’d like to focus on:

  1. Friends and Family Letter. This letter template helps adults address what is referred to as the 7 life review tasks:
  • Acknowledging important people in our lives
  • Remembering treasured moments in our lives
  • Apologizing to those we may have hurt
  • Forgiving those who have hurt us
  • Saying thank you
  • Saying I love you
  • Saying goodbye

One of the things that helped me in accepting and coping with the death of my husband was the gift of time. Hubby lived much longer, much longer, than the experts originally projected and we had time to say everything we wanted to say to each other.

We had time to create adventure and make more fun and dollop more memories onto our tower of memories, like a fifty-scoop ice cream cone. There were no regrets.

But not everyone is allowed this sacred invaluable gift.

Since there is the guarantee that we’ll all eventually die—I know, pretty encouraging stuff right there—but no guarantee we’ll get to say good-bye to the most precious people in our lives, then why not capture our thoughts in writing now? While we have time?

Acknowledging their contribution to our lives. It would come to me quite frequently—while on top of a mountain with backpacks; on a road trip; or while sitting in front of our fireplace with snow falling and sipping Chai tea—how much I loved our life together. And so I said it to him often: “I love the life you’ve given me.”

And he’d grin his cute grin, the one where he’s trying not to grin but it looks like a smirk. Yes, we made this life together, but I have always acknowledged Hubby’s contribution as being the kind gentle thoughtful considerate unconditionally-loving would-do-anything-for-me husband.

Smiling over fabulous memories. In the last week of Hubby’s life, three of our adult children were present. We poured over old photos featuring chubby-cheeked toddlers and Hubby’s beard from his younger years and ridiculously amazing hair styles from the 80s and graduations and weddings and births of grandbabies. Holding the photos up for Hubby to see: “Remember this, Dad?” Acknowledged by a faint smile. Priceless epic memories.

Apologizing and forgiving. Hubby and I kept the apology-forgiveness pipeline open between us, but how immense to be set free from binding hurtful limiting paralyzing things. Now, and not on our death beds.

Saying thank you, I love you, good-bye. “Did we do everything?” Hubby asked weakly after the Hospice Field Nurse left after she said 24-48 hours due to renal failure after Hubby’s remaining nephrostomy tube fell out.

“We did,” I reassured him. “We made memories and took adventures, we lived well, we loved each other, we loved our kids, our grandkids, our family. We did everything that’s most important.” Thank you, my love.

And he was at peace.

So … letter-writing time? Yes?

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