Dr. Talbon was struck by another very important thing. It all hung together. The stories Cheryl told — even though it was upsetting to think people could do stuff like that — they were not disjointed They were not repetitive in terms of "I've heard this before". It was not just she'd someone trying consciously or unconsciously to get attention. really processed them out and was done with them. She didn't come up with them again [after telling the story once and dealing with it]. Once it was done, it was done. And I think that was probably the biggest factor for me in her believability. I got no sense that she was using these stories to make herself a really interesting person to me so I'd really want to work with her, or something. Or that she was just living in this stuff like it was her life. Once she dealt with it and processed it, it was gone. We just went on to other things. 'Throughout the whole thing, emotionally Cheryl was getting her life together. Parts of her were integrating where she could say,"I have a sense that some particular alter has folded in with some basic alter", and she didn't bring it up again. She didn't say that this alter has reappeared to cause more problems. That just didn't happen. The therapist had learned from training and experience that when real integration occurs, it is permanent and the patient moves on.

In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions. And, six months after their death, their caregivers were three times as likely to suffer major depression. Spending one’s final days in an I.C.U. because of terminal illness is for most people a kind of failure. You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place. The end comes with no chance for you to have said goodbye or “It’s O.K.” or “I’m sorry” or “I love you.”People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives.