This award-winning true story shows an authentic and inspiring final journey -- from Diane Manahan's breast cancer diagnosis, to her conscious death at home, to a simple, deeply meaningful eco-friendly funeral to her extraordinary, life-changing after-death communications with loved ones.
People who seek a holistic approach to dying can learn from this extraordinary nurse's wisdom. Those who fear death can gain strength and confidence by having tools to help others—or themselves—complete their lives with dignity, purpose, and peace.
Diane's story embodies the wisdom of Tuesdays with Morrie, the humor of The Last Lecture, the holistic medical expertise of Andrew Weil, and the transcendent spirituality of Elisabeth Kübler-Ross.
Diane's husband, Bill Manahan, M.D., has written an insightful foreword regarding the cultural shift in how we are coming to view death as "a natural process rather than a defeat or a taboo."
Midwest Independent Publishers Association (MIPA) 18th Annual Midwest Book Awards 2008 attracted nominations from 78 publishers in twelve states. Living Consciously, Dying Gracefully: A Journey with Cancer and Beyond took top honors in the health category at the Midwest Book Awards ceremony, held at the Minnesota Humanities Center in St. Paul on May 14, 2008.
The Eric Hoffer Award, in honor of the American philosopher Eric Hoffer, recognizes independent books of exceptional merit, including books from small presses and academic presses. After the judging, books are donated to libraries, schools, and hospitals.
Living Consciously, Dying Gracefully: A Journey with Cancer and Beyond was first runner-up in the health category.
The Independent Publishers (IPPY) Book Awards, recognizing the best independently published books of the past year, awarded a silver medal to Living Consciously, Dying Gracefully: a Journey with Cancer and Beyond in category #29: Aging/Dying & Dying. The 2008 IPPYcontest attracted 3,175 entries from 49 US states and 16 other countries. The 12th Annual Independent Publishers Book Awards were presented in Los Angeles on May 31, 2008.
Reader Views, based in Austin, TX, was named by Fox News as one of the top five blog sites for health related books. In addition to appearing on the Reader Views website, reviews are placed in the Book Review Index, distributed to libraries and book sellers. Reader Views
Living Consciously, Dying Gracefully: A Journey with Cancer and Beyond placed second in the Women's Issues category. In her review, Vicki Landes says the book is "the most profound book on death I've ever read. Manahan and Bohan present a beautiful story of their loved one while offering hope to others facing similar circumstances. A life lesson for anyone wanting to leave a more powerful heritage behind, Living Consciously, Dying Gracefully tugs at the heartstrings, lifts the spirit, and pulls the conscious mind towards a more meaningful life and dignified ending.”
USA Book News, based in Los Angeles, CA, is an online publication providing coverage for books from mainstream and independent publishers to the world online community.
Winners of awards were from Simon & Schuster, Penguin-Putnam, HarperCollins, Random House, McGraw-Hill, as well as independent titles like Living Consciously, Dying Gracefully: a Journey with Cancer and Beyond, a finalist in the Health-Cancer Category.
"Diane’s story is a living example of an elegant spiritual life."
C. Norman Shealy, M.D., Ph.D., author of Life Beyond 100 and Soul Medicine
"A compelling and intimate story of a woman and her family’s journey with cancer and beyond. . . . It is raw, poignant, funny, and provocative but above all, inspirational and instructional."
Mary Jo Kreitzer, Ph.D., RN, FAAN, Director of the Center for Spirituality and Healing, U of Minnesota
"A great life is never extinguished, because compassion, love, and wisdom are eternal. That is why we believe Diane Manahan’s life and light will continue to shine through the ages."
Larry Dossey, M.D., author of Healing Beyond the Body, and Barbara Dossey, Ph.D., R.N., author of Holistic Nursing
"The most profound book on death I’ve ever read."
Vicki Landes, Reader Views/USA Today
"Living Consciously, Dying Gracefully not only is a tribute to a fabulous woman. It also holds her journey with illness and beyond as something we could all model. . . . The accounts of Diane's presence appearing after her death feel so natural, they will be validating to those who have experienced such things. They also hold out hope for those who might not have known about that possibility in their own loved ones' passing."
Penny George, PsyD, Co-founder, Penny George Institute for Health and Healing, Abbott Northwestern Hospital
"Diane teaches us how to live and how to made death an event to be shared by those we love."
Lee Lipsenthal, M.D., Past President American Board of Holistic Medicine
"I highly recommend it to those who care for people with cancer, as well as patients, friends, and families."
Victor S. Sierpina, M.D.. University of Texas Medical School
1. What is your book about?
Living Consciously, Dying Gracefully: A Journey with Cancer and Beyond is the riveting story of a professor of nursing who lived her values when faced with inoperable cancer and made it a teaching experience for others. It is also a primer on complementary therapies for cancer, a ground-breaking account of a home-death and cremation, and a glimpse of after-death-communication. It contains a supplemental guidebook for dealing with a serious illness or death.
It is like Tuesdays with Morrie, which people love because of the wonderful person at the heart of the book and because of the life lessons it offers. Given its emphasis on complementary therapies, it is also like Dr. Andrew Weil’s books on health and healing. And finally, Living Consciously, Dying Gracefully is similar to books by Elisabeth Kubler-Ross and Janis Amatuzio documenting extraordinary evidence of continuing consciousness after death.
2. Why did you write it?
We were inspired by Janis Amatuzio’s Forever Yours: Real Stories of Immortality and Living from a Forensic Pathologist, a book documenting the continuation of the spirit after death. We wanted to record the amazing experiences that we and others had after Diane’s death. As we began to read Diane’s journal, correspondence, and medical records, we realized that the story was much broader than her after-death communications. Diane’s integrity, her eloquence, and her mind/body/spirit approach to illness, had much to teach us and others. People are looking for meaning in their life and death, and this book offers an excellent model for living and dying.
3. How is this book different from other books about death and dying?
More people are looking at death not as a medical emergency or a tragedy, but as a natural family experience. As people choose to die at home or in hospice settings, they are looking for models of how to live fully while preparing for death. They hope to approach the dying process in ways that bring comfort, peace, and even joy. This book offers an inspiring story of a woman who shows us how.
Unique among books about illness and death, Living Consciously, Dying Gracefully—
* Introduces a remarkable couple: Diane Manahan, a professor of nursing, and Bill Manahan, a physician trained in both conventional and holistic medicine. They chart a course that enables them to enjoy a balanced and vibrant life together for over five years after Diane’s diagnosis of breast cancer.
* Explains Diane’s complementary therapies, including acupuncture, high-dose IV vitamin cocktails, Qigong and Healing Touch, and other modalities that could support other people going through cancer treatment.
* Contains Diane’s eloquent journal entries as she learns of her diagnosis, uses every resource available, eventually chooses quality of life over quantity, and makes plans for her last days.
* Describes in detail her remarkable death at home in the arms of her sister-in-law, one of the authors, and the family's crematorium experience.
* Describes after-death communications with Diane that comforted and changed the recipients.
* Provides a supplemental guidebook with practical information for dealing with a serious illness or death—everything from how to set up a support group and prepare legal documents to dealing with a seizure, washing a body, and holding a wake.
4. My friend has breast cancer. Would this be a good gift for her?
We recommend that you read the book first and then, based on your knowledge of your friend and her situation, determine what would be appropriate to offer her. Living Consciously, Dying Gracefully may not be the best book for those just diagnosed with breast cancer, or who are in the midst of treatment, unless they are researching holistic approaches, in which case, Part One of the book and the Appendices could be very helpful. The whole book, however, could be useful for families, friends, and caregivers.
Once your friend has completed treatment, she may be very interested in Diane’s journey. When our friend Susan Sobelson was going through chemo, she didn’t want to read anything about cancer. Two years later, however, Susan found the manuscript of our book so compelling she couldn’t put it down. Another long-term breast cancer survivor, Mary Treacy O’Keefe, loved reading the book and gave us an endorsement for the back cover.
We look forward to hearing how others dealing with cancer respond to Living Consciously, Dying Gracefully. Anyone whose illness is terminal will find the book extremely helpful and consoling.
5. Diane seems like such an unusually strong woman with an amazing support network. How can other people hope to emulate her?
Diane tried to live consciously and attentively, a path anyone can follow. Diane had a gift for friendships, and she put a lot of effort into developing her relationship skills. Her ability to listen deeply was one of the reasons people related to her so easily. When she knew her time was limited, she made choices that gave her enough physical and mental energy to nourish all her important relationships.
But Diane was not a saint—she could be judgmental and demanding. She sometimes struggled emotionally and spiritually. She shared some of these struggles in her journals and correspondence, accepting her feelings of sadness, resentment, or crabbiness. She grieved leaving Bill and missing their grandchildren growing up.
Although Diane and Bill were professionals, they had spent so many years working in poor countries and helping the underserved nationwide that they had only modest financial resources. When Diane's cancer metasticized, they withdrew a portion of her retirement account so they could spend time with their kids and grandkids, visit distant friends, and pay for complementary treatments that supported her physical and psychological health.
6. Why did the family choose to go to the crematorium?
The crematorium chapter is one of the most powerful in the book. After accompanying Diane on her journey with cancer, the book takes us along on the journey of her body.
Immediately after her death, intimate friends and family washed Diane’s body and prepared it for viewing. Later that day, after the mortician arrived at the house, two of Diane’s sons, their wives, and her sister-in-law Nancy decided to accompany the body to the end of its journey. They all felt that the experience gave them emotional closure and made Diane’s passing seem part of the natural cycle.
7. What was significant about Diane’s funeral?
First of all, she never called it a funeral. She always considered her memorial a celebration of her life. Once the cancer had metastasized to the point where Diane knew she had months rather than years, she began to plan how she wanted her life to be honored. She decided who she wanted to be involved in it and personally asked them to participate. She decided where the celebration would take place. She designated who would prepare the food, who would provide the music, and who would carry her ashes. She wanted everyone who attended to have a little present, so she made a bookmark with her message on it, which was distributed at the event.
8. Becky writes about seeing a portal above Diane when she died. Was this a glimpse of heaven? Were the three “beings” angels?
When Diane died, Becky sensed an opening in the ceiling directly above Diane's body with three beings looking down at the scene as though waiting for Diane’s soul to rise. Becky didn’t see anything beyond the immediate portal and she doesn’t name it as heaven, only a place on the other side. Neither does she name the three beings gathered around the portal as angels, although their presence was one of pure calm, patience, and serenity. Although she was tempted not to include this chapter in the book, she felt that Diane’s principles of showing up, paying attention, telling the truth, and letting go of outcomes bound her to share her powerful experience at Diane’s deathbed.
Lesson One: Take the wheel—it’s your journey!
Diane sought ways be an active agent in her journey with cancer, not just a passenger in a car driven by professionals. She did not accept medical advice passively—she and Bill researched widely, sought second opinions, and talked to those with alternative approaches. As Diane neared the end of her life, she and Bill explored ways to make dying at home possible. Not wanting to leave the care of her body solely in the hands of a mortician, she and Bill interviewed funeral homes until they found a mortician willing to accommodate her wishes. Likewise, she planned her memorial service carefully and creatively.
Lesson Two: A deliberate pace can be better than a rushed decision when choosing a path for medical treatment.
When cancer is diagnosed, the tendency of the medical establishment is to rush into surgery, start chemotherapy, and throw everything possible at the disease. Timeliness is, of course, an important consideration given that cancer eventually spreads. But you need not make your treatment decisions in haste. Indeed, taking the time to become informed can reap untold benefits.
There are a lot of statistics about cure rates and the efficacy of various treatments. Once you know the type of cancer you have, you can search the internet, consult with health care practitioners, and contact cancer support organizations for information. See “If You Are Diagnosed with a Serious Illness” in the Guidebook for more information.
Lesson Three: To thine own values be true, even in illness.
One of the things Diane modeled during her illness was being true to one’s beliefs. Diane believed in non-violence and had participated in anti-war marches as a young mother. When diagnosed with cancer, she refused to consider cancer her enemy against which to wage battle. She created a non-violent way to approach her illness, remaining true to her ideals.
Some people are warriors, though, and for them cancer is a call to arms. Considering cancer a battle may help them be active participants in their treatment.
Whatever one’s beliefs, a serious illness is a time to test them and perhaps to question them. However you choose to approach your illness, the strength of your integrity and resolve will help you.
Lesson Four: Sometimes an illness is just an illness.
Some popular literature promotes a concept of a “cancer personality.” Diane rebelled against that notion. Her personality did not fit the “cancer personality” mold, and she questioned the usefulness of an approach that “blamed the victim.”
There are many reasons why a person gets sick. Some may be rooted in psychology, but often, Diane believed, environmental toxins are at the root of illness. [According to Avoiding Cancer One Day at a Time by Lynn Eldridge, M.D. (Beaver’s Pond Press, 2007), eighty to ninety-five percent of all cancer is environmentally based.] You don’t have to turn an illness into a moral lesson. Some people may choose to do so, but it is not necessary and may not be helpful.
Lesson Five: Healing is a process, not necessarily a goal.
Healing doesn’t necessarily produce a cure—it can mean finding peace and acceptance, accepting the love and support of family and friends, and making oneself as comfortable as possible. Even when her cancer became inoperable and it was clear she would die from it, Diane continued healing treatments to support her immune system, calm her body and soul, and enrich her last years.
Lesson Six: All things in moderation, including moderation.
Diane enjoyed paradoxes, and one of her favorites was living with balance and, occasionally, throwing balance to the wind!
Diane used this phrase in a playful way, and when she was diagnosed with cancer, she followed this same maxim. For example, while she continued to eat healthy foods, especially those that strengthened the immune system, she did not begin a macrobiotic diet. She felt that her body and her psyche were under enough trauma without adding the stress of an unfamiliar diet.
Lesson Seven: All that matters are relationships!
Diane’s story shows us how important friends, family, and community are. Shortly before she died, Diane, who loved the finer things of life, told her friend Susie Symons, “I could live in a hut with a dirt floor and be happy. Relationships are the only things that matter!”
Lesson Eight: Don’t just die—complete your life!
Diane focused on living with cancer, not dying, and she had an amazing ability to include others in her journey. When her days were numbered, Diane was determined to complete her life’s work. A friend interviewed her for two days about growing up in Minnesota, her parents, her career, her family, her values, and her passions. Then he transcribed the tapes and presented a typed copy to her and Bill. Diane finished teaching spring semester, made time for her friends to say good-bye, planned her last days at home with her family, and made arrangements for the care of her body, her life celebration, and her bequests. By the time of her death, Diane’s life was complete.
Lesson Nine: “I deserve it!”
Near the end of her life, Diane confided to us that she felt a little embarrassed by the big production she was making for her Life Celebration. She had arranged the music, the food, the pall bearers, the rituals—including the release of doves at the end of the celebration. But after a pause, she said, “But you know, I’ve given a lot to this community. I deserve it!”
Indeed, all of us contribute in a multitude of ways. When the time comes to celebrate your life, give yourself permission to throw a bash. Your time on earth has been special. Celebrate it. You deserve it!
Lesson Ten: Death is the start of a new journey.
The after-death communications with Diane that several people experienced indicate that death is not the end, just the beginning of a new chapter. Indeed, in a dream in which Diane appeared, she comforted a friend and reassured her about death. “Dying is like moving to a different frequency. You don’t have to be afraid. It’s just like tuning to a different radio frequency.”
a) What was your reaction when you first heard about Living Consciously, Dying Gracefully: A Journey with Cancer and Beyond?
b) What are your own experiences with holistic/complementary medicine?
c) What do you think is most useful about the first section of the book, which focuses on Diane Manahan’s cancer treatments, both mainstream and complementary?
d) What are your experiences with breast cancer or other types of cancer, whether yourself, friends, or family members?
e) What are your experiences with people living with a terminal illness?
f) What do you think is most interesting about Diane’s approach to her illness?
g) In what ways, if any, can an illness be a learning experience? A teaching experience?
h) If you knew you had only one year to live, what would you do differently? What could you do to implement those changes now?
i) What do you think is most valuable about the second section of the book, which describes Diane’s death, the care of her body, the wake, and her life celebration?
j) What are your own experiences with people dying? With the care of their bodies and with visitations, memorial services, or funerals?
k) In what ways is the birthing process similar to the dying process?
l) What do you envision for a visitation, wake, memorial service, or life celebration for yourself?
m) What legacy would like to leave?
n) What do you think is most interesting about the third section of the book, which recounts several after-death experiences of Diane?
o) What are your own experiences with after-death communication, synchronicities, “thin places,” or similar phenomena?
p) Of the sixteen photographs in Living Consciously, Dying Gracefully, which do you like the most? Why?
q) Which of Diane’s journal entries or poems appeal to you the most? Why?
r) Which part of the Guidebook could be most helpful to you or your family and friends?
s) Which appendix did you find most informative?
t) Are their any actions you would like to take or any changes you would like to make as a result of reading Living Consciously, Dying Gracefully: A Journey with Cancer and Beyond?
Nancy Manahan and Diane Manahan in Sibley Park, 2001