Beginning with the end in mind: Why thinking about death can make you “Highly Effective” by Monica Williams-Murphy, MD

Wednesday, 18 Sep 2013 08:14

About Dr. Monica Williams-Murphy (120 Posts)

Dr. Monica Williams-Murphy is a Board Certified Emergency Medicine Physician, who practices in one of the largest emergency departments in the United States at Huntsville Hospital. Through her writing and speaking, she is devoted to transforming the end of life into a time of peace, closure and healing. Media Page


According to Steven Covey, in his book the “7 Habits of Highly Effective People,” the second habit that one should have or develop is to “begin with the end in mind.” Now, I’m pretty sure that Covey’s intention was not to have you wake up every day and think about your death, but maybe he should consider adding this to his description of the principle. You see there is something very powerful about entertaining thoughts of your end…somehow, it clarifies and magnifies the present.  Many other “Highly Effective” and brilliant people throughout the ages have practiced this same principle.

Take Shakespeare for example, he was a pretty smart guy. By all accounts, he had a “highly effective” life, and he penned these words, “Be still prepared for death- and death or life shall thereby be the sweeter.” (Measure for Measure, Act III, Scene I)

Hmmm… sounds like he was on to something.

Centuries later, Steve Jobs, another “Highly Effective” and brilliant guy said, “Remembering that I’ll be dead soon is the most important tool I’ve ever encountered to help me make the big choices in life. Because almost everything – all external expectations, all pride, all fear of embarrassment or failure – these things just fall away in the face of death, leaving only what is truly important.”

Yep, there’s a whole lotta truth to this.

 I recently spoke at a Church who is actively seeking to look death in the face as a way of deepening the experience of daily life, a practice known as Momentum Mori, first initiated in 5th Century Benedictine spiritual practice. The congregation has devoted a whole month of sessions to this principle. Wow! Similarly, many Buddhist spend hours meditating on death. A Buddhist friend of mine spent extensive amounts of time sitting in grave yards meditating on the reality of her own death.

Anyone involved in any such bold spiritual practice is bound to find his or her daily life transformed. Living in the present with the knowledge that each moment might be your last (and preparing for it)– reorients you to what is most important in your daily living.

Personally, I came by this practice not by spiritual discipline, but by the nature of my work. I am one of the lucky ones who has the privilege of witness dying on a regular basis. Yes, I said “lucky”. You read that right.

You see, rather than choosing to add “facing death” to my spiritual practice, I am forced to look death in the face on a daily and weekly basis. I come home after most shifts recognizing that this day, this hour, this moment, could be my last. And then, I ask myself some variation of the following questions: “Is this the life I long to lead?” “Are these things the best use of my time?” “Can I sleep tonight with a clear conscience?” “Do my children know that I love them?”

And what about those questions…how do you answer them?

If your answers to any of these questions are “No,” then I challenge you to “begin with your end in mind”…it really makes everything better. Just ask Steven Covey.


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10 thoughts on “Beginning with the end in mind: Why thinking about death can make you “Highly Effective” by Monica Williams-Murphy, MD

  1. Rea

    A gem! Living life to the fullest – even more than that if we keep the end in mind. Looking death in the face forces us to look LIFE in the face. That can be equally difficult. What really matters in life? Each of us must answer for ourselves, and the answers don’t always come easily. Practice! It’s important now, and it’s important for later. What matters? Am I guilt-free? Do the most important people in my life know their tremendous importance? Do they know I love them? — All good. All life-giving. That is sharpened awareness of living life to the fullest…thanks to looking death in the face. That is highly effective, enlightened living.

    Beautiful. Looks so simple — in actuality, so complex! Beautiful.

  2. Alex Sheehan

    What an interesting way to achieve the ‘live in the moment’ mindset. Some really great information about achieving mental clarity. Who knew death could be so positive? Thanks for sharing this perspective!

  3. Pingback: Beginning With The End in Mind | OK To Die | It’s OK to Die | All Things Palliative - Article Feed

  4. Debbie Weaver

    This is one of the reasons I started asking students in my End of Life online course for nursing students to write their own obituary, visit cemeteries, and complete their own Advanced Directive. Wow, what I have seen then in their journals related to this journey they are forced to take. I pray they will be more effective in their nursing care because of these exercises.

  5. Rea

    THE BOOK!!! The book!!! I knew I saw Shakespeare recently. THE END, the quote, p. 275!! Ah, at last! — What am I talking about? The last page of Dr. Murphy’s book, IT’S OK TO DIE, last chapter titled “The END.” There’s the very same Shakespeare quote at the end of The END, p. 275. Perfect pick from the playwright/poet!! Nice!

  6. Lani Leary, Ph.D.

    Thank you Monica…well said! When I taught a Death & Dying course at George Mason University I asked my graduate students to identify their greatest fear surround death, and the answer usually had nothing to do with “being dead” but the regrets they had related to loved ones’ deaths. Their final project was to address the fear/regret with a project that might resolve it. Over the years I have received so many letters from students thanking me for asking them to address their fears because their action made a difference in the ways they lived their lives. When we face death and our fears about dying, we are raising our death competency and lowering death anxiety…and lo and behold, we end up living a fuller, richer life. Thanks for the work you do and the hearts you open.

  7. Joe Blythe, MD, FCCP

    Reading these comments has spurred me to include covering this topic with fourth year medical students during the time they spend on our palliative medicine rotation. I think I’ll suggest that they write their obituaries and present them for discussion. Any other suggestions?

  8. Rob Webb

    A wonderful blog indeed. The Dalai Lama said something similar to Shakespeare, in his book “Advice on Dying”: “You need to accept that death is part of life, then when it actually does come, you may face it more easily.”
    My dad just died and that brought home to me the importance of this life on earth.
    Thanks again for your continued mission in this area. It is much appreaciated and needed.
    Dr. Rob Webb [Florence, AL]

  9. Robert Jones

    In another sense, what the world needs is people who have come alive. Many things spell death, for example a good pilot friend once said ” tail spin spells death”.

    Get into work and people that make you feel most alive, and your aliveness will over come the tail spins of life. Your aliveness will get you through the many forms of death that try to drag us down daily. Your aliveness will also encourage the world to come alive.

    In that sense we can all strive to be a part of doctor Monica Murphy’s team for life! Death will have to take a back seat. Even when it comes it is brief. Our spirit of aliveness goes on forever.


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