This is a cross-post of an article that I wrote for the Africa edition of ehospice news reflecting on the lessons learnt from Hendri Coetzee’s book ‘Living the best day ever’.

Palliative care, by definition, is both a science and an art form that involves accepting the reality of death. What you have left when you accept this is what the profession calls ‘preserving or improving the quality of life’.
Never before though, have I been challenged to re-examine the concept of ‘quality of life’ than when reading Hendri Coetzee’s book: ‘Living the best day ever’.
Hendri Coetzee was a South African living in Uganda perpetually searching for the best day ever. This search led him to become a legend throughout the extreme sports and exploration world.
In 2004 Hendri led the first ever complete descent of River Nile from source (Lake Victoria) to sea (the Mediterranean). The 4,160 mile trip took four and a half months and crossed two war zones.
Coetzee was also the first person to run the rapids above the Nile’s Murchison Falls, a section of river filled with some of the biggest white water in the world, and holding one of the highest concentrations of crocodiles and hippos.
He would go on to complete this section of river a further seven times and he remains the only person ever to run the section by himself. He also ran large sections of the upper and lower Congo River, walked 1000 miles along the Tanzanian coast and was the first person ever to snowboard the glaciers in the Ruwenzori Mountains.
In short, his résumé was one of the most impressive in the business.
It was not, however, his outlandish adventures that makes Coetzee’s book such a challenge for anyone to read, but his burning passion for life. Deep within all of his adventures was an intertwined journey to accept the fullness of life – to be able to appreciate it to its full. Only by understanding and ultimately accepting one’s death, Coetzee believed, can we truly experience a ‘quality of life’.
Speaking to some, and by no means all, palliative care patients I have come across a stillness – a deeper happiness – that I have rarely seen elsewhere. It is a happiness that comes fundamentally from within, a spiritual or psychological wellbeing.
Does this come from an acceptance of one’s own death?
Early on in the book, when undertaking the Murchison Falls section of white water, Coetzee writes: “In our society we avoid the thought of death as if recognition alone could trigger the event. Thinking about your own death is seen as a sign that mentally, all is not well. Some people live their entire lives with the sole purpose of minimising the chances of it occurring to them, instead of preparing for the inevitable. After avoiding the issue for so long, it is almost soothing to invite death on my terms.”
Reflecting on this, I wonder how many palliative care practitioners spend their professional hours encouraging patients to think about their deaths, to make preparations and to become comfortable with the idea whilst then perpetuating the myth in their own lives that life is infinite?
I only speak for myself when I write that I am too often guilty of this self-delusion.
To live a truly high ‘quality of life’ do we have to be comfortable with the idea of our death? I don’t know.
For Coetzee though, this acceptance was clearly linked to the life he chose to lead. Writing about his desire to keep going on clearly dangerous expeditions he wrote: “Psychoanalysts may diagnose a death wish, but missions like these enhance the appreciation of life. It is no coincidence that death and rebirth are related in all forms of religion and spirituality. When you accept that you are going to die, and it will be sooner than you think, it becomes impossible to merely go through the motions.”
Even the acceptance of my own inevitable death cannot push me to actions that so invite the prospect of death earlier than it otherwise would arrive. There is too much to live for to put my life on the line in search of living just that one day to the extreme – in the search for the best day ever.
That said, it is imperative for the palliative care community to understand the full spectrum of thought that exists out there. Just as there are people who are terrified of the concept of their own passing so there are people like Coetzee that can write the following words:
“Death is coming for us all…the day we will have to face the crossing will come sooner than we think. I hope my day is many many years away, but… I don’t want to make the greatest leap in life in a vague dream. I want to have the chance to look it in the eye, to say: ‘You have had me in your sights all your life, but it’s on my terms that I come.’ Tibetans believe that one can find enlightenment at the moment of your death, as long as you prepared yourself for it during life…I have had the best day ever more times than I remember. So yes, I believe I am ready to die if that is what is needed to live as I want to.”
Hendri Coetzee was pulled from his kayak by a crocodile deep inside the Democratic Republic of the Congo and his body was never recovered.
At the end of his last ever blog entry though, after completing a section of river that many assumed impossible to kayak, he wrote: “We stood precariously on a unknown slope deep in the heart of Africa, for once my mind and heart agreed, I would never live a better day.”
I have no idea if – when it came – Hendri Coetzee was prepared for his death. It is clear though, that he lived life to the full and died in way he had to have expected.
Not many of us can say that and for that alone ‘Living the best day ever’ is worth reading. I think we can all learn something from Hendri Coetzee approach to both life and death.
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24 hours in the UK
Last year when my plane touched down at Heathrow coming back from Uganda I was met with a wonderful scene to welcome me back to old blighty. Queuing to enter the terminal building, what the British do best, an elegant determined woman pushed to the front of queue – sacrilege! One chap next to me notices that I have clocked this queue jumping outrage and chips in with the comment, “fucking French huh”.
What a welcome back to the UK – baseless xenophobic queue based hatred all performed to the backdrop tinny Christmas carols under a smattering of drizzle!
This year I was a smidgen disappointed to find no Christmas carols on repeat but delighted to make it out of the airport without witnessing any casual racism.
Once back in the hills and valleys of the ‘West Country’ though I took little time to head out for a walk. Thinking that this is what made the UK amazing I walked with uncharacteristic clear skies and meek winter sunshine hitting the frost covered ground. I was in a buoyed mood striding across farmer’s fields and down hidden valleys following bubbling brooks.
This mood was lifted further though with what truly makes the Great Britain great. With every dog walker passed a friendly ‘good morning’ was chirped followed by a compulsive observation of the uncharacteristically good weather: “wonderful day for it” or “you couldn’t ask for a better day” before then swiftly apologising for their dog who would be eagerly sniffing my trouser legs.
These small interactions last less than a few seconds but make up an integral part of the DNA of British culture.
Warmed by the simple pleasant jollity of rural British life I stopped in the open fire warmth of a local pub – the Woolpack in Slad – where I had arranged to meet family.
Sat sipping local real ales on slightly uncomfortable wooden furniture (why is that both pubs and churches consider it a virtue to have furniture that in other walks of life would be considered completely unfit for purpose?) I watched dogs curl up on the floor close to their owner muddy wellington boots. With a low warm afternoon winter sun breaking through the window I sat back with family around me and listened to the impromptu piano/saxophone performance that only added to the ambiance.
Outside, after a hearty pub lunch, we strode up Swift’s Hill which enjoys some of the finest views in the region down over the Slad Valley across the market town of Stroud and out to the Severn Valley and across to the Black Mountains in Wales. A few clouds clung to the horizon to exaggerate the sunset as wonderful pinks and oranges were thrown over the fields and footpaths.
It felt like the weather was welcoming me back to the UK, giving me 24 hours of pleasure before it inevitably resumed in the monotony of drizzle that everyone seems to perpetually believe might stop at any moment but so rarely does.
Walking back over the fields I make a decision to call into another pub on the way home. Instead of live piano/saxophone renditions, this pub instead has the unmistakable sound of football coming from the TV screens. Excited to be able to watch my national sport with my fellow countrymen I step in and order my pint of warm frothing ale.
Looking for a place to sit I approach a stranger with the prerequisite of “excuse me, I am terribly sorry, but would you mind if I possibly took a seat” motioning towards one of five empty seats surrounding him. Smiling warmly the man looks up from his Daily Telegraph with impeccable replicable manners and says, “Please, it would be an honour”.
How wonderful is that – being told it would be an honour for me to sit next to him.
Buoyed by these little interactions I sit happily watching Arsenal score four goals with the return of their star striker – Giroud. In an unspoken acknowledgment I suggest to the man next to me through nothing more than eye contact that I was happy, that I was delighted to be back in the UK and that in that moment I could think of nothing I would rather be doing.
Responding to this the man next to me commented in a perfect middle England accent, “Typical isn’t it”. “What’s that?” I responded. “The fucking French keeping such an English institution like Arsenal afloat” he sneered.
Sigh.
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Tagged as 24 hours in the UK, life in the UK, UK