Last weekend, on the train ride home from New York City, B and I spent a good hour talking about end-of-life issues.

     We'd gone to New York to see Wit, starring Cynthia Nixon, about a woman dying of cancer. You may have heard of it, since the play, written by Margaret Edson, was originally produced off-Broadway in the late 1990s and won the Pulitzer prize for drama in 1999. Then in 2001 HBO produced a TV movie of the play starring Emma Thompson.

Cynthia Nixon as Dr. Vivian Bearing

    I'm not a true Cynthia Nixon fan. I saw a few episodes of "Sex and the City" and I've seen her in "The Big C" -- but I'm mesmerized by Laura Linney, not Cynthia Nixon.

     Nevertheless, Nixon does an amazing job as Vivian Bearing, a woman with a PhD in English who specializes in John Donne (1572-1631), the poet famous for his lines: "Death, be not proud ..." The play chronicles Dr. Bearing's story, from a diagnosis of stage IV ovarian cancer ("there is no stage five") to her death. She embarks on her journey with no friends and no family, just her uncompromising academic standards. Along the way she meets her match in an equally impersonal and disinterested medical student, and in the end only finds some measure of solace in an unlikely companion.

     The final moment of the play presents the audience with a brief nude scene, as Cynthia Nixon completely disrobes. But by that time, she has exposed such raw emotions, with such complete abandon, that the idea of nudity seems almost ... anticlimactic.

    After the play was over, it was impossible not to discuss some of those end-of-life issues, including the "Do Not Resuscitate" option, and that's what B and I were talking about on the way home. B is all in favor of the DNR order and other health directives aimed at dying with dignity. She also has long-term-care insurance, a power of attorney, and some other health documents as well.

     I'm not quite so organized. Nor am I quite so ready to look death square in the eye. Perhaps it's because B is more religious than I am, and a little more comfortable with the notion of death. I guess I would opt for a DNR order, if I really and truly knew I only had a few days to live, and I was in excruciating pain, and I knew there was no hope at all of recovery. In other words, I'll sign those papers when I get to be 90.

     Coincidentally, author Ken Murray, a retired doctor, wrote an article appearing in The Wall Street Journal, "Why Doctors Die Differently." He reported that many doctors, who know all about the treatment options and have access to top medical care, often decide against undergoing cutting-edge medical procedures. They accept death, and instead go home to live out their lives as best they can and spend their last days with their loved ones.

     "It's not something we like to talk about, but doctors die too," writes Dr. Murray. "What's unusual about them is not how much treatment they get compared with most Americans, but how little."

     He cites the case of an orthopedist who found out he had pancreatic cancer. Instead of opting for aggressive treatment that would give him, at best, a 15% chance of surviving, with a poor quality of life, he focused on spending time with his family. And Murray cites the case of his own cousin, diagnosed with lung cancer. The cousin decided against radiation or chemotherapy, and instead spent the next eight months going to Disneyland and hanging out at home watching his favorite sports teams -- then dying peacefully in his sleep.

     I remember by own dad, who died ten years ago at the age of 91. He'd developed shingles, and when he didn't get better the doctors found he had cancer in his bones, his lungs and everywhere else as well. The doctors were ready to give up on him -- after all, he was 90. But he wasn't ready to go. He wanted treatment. We got him to the hospital where he received some radiation therapy. No one ever said it would be a cure. But it did arrest the tumors for a while, and gave my dad an extra couple of months of relatively pain-free life -- which we all appreciated, my dad most of all.

     There's no easy way to get out of this world. And if you think there is, go see Wit. The play will cure you of any illusions you have on that score. But I'm sure it would help if you have some control over the process, if there's a way to make death less painful and desperate.

     I should go make out some health directives ... I really should.

     So ... here's the John Donne sonnet which features prominently in Wit:

Death, be not proud

by John Donne

Death, be not proud, though some have called thee

Mighty and dreadful, for thou art not so;

For those whom thou think'st thou dost overthrow

Die not, poor Death, nor yet canst thou kill me.

From rest and sleep, which but thy pictures be,

Much pleasure; then from thee much more must flow,

And soonest our best men with thee do go,

Rest of their bones, and soul's delivery.

Thou art slave to fate, chance, kings, and desperate men,

And dost with poison, war, and sickness dwell,

And poppy or charms can make us sleep as well

And better than thy stroke; why swell'st thou then?

One short sleep past, we wake eternally

And death shall be no more; Death, thou shalt die.