The most difficult deaths seem to me to be those of the warriors. These are people whose tenaciousness of spirit dominate and drive the will to live well beyond what should be physically possible. These often are the folks who have spent a lifetime overcoming threats to their existence. They are survivors. They have defined everyday life as a challenge and they have often developed extraordinary skills to be present in the moment. Sometimes they are enormously curious about what life will bring next and know how to savor experience. They rely on a value of “keeping on” or doing what needs to be done next. It has worked millions of times in the past. They can ignore physical reality, particularly if they have endured pain or injury. They focus their energy on meeting and overcoming obstacles.
Parents of young children often have no intention of leaving their young ones. They are warriors. They can generate anger and persistence that dominates. To die with any acceptance, readiness or even resignation would somehow betray not only their children but their definition as a protective parent.
They fight. They experience pain and often derive energy for the next moments from this pain. They resist sleep and medication for the threat these represent. With rest they sense they will succumb to weakness.
One of my AIDS patients chose to discontinue his medications and refused numerous interventions offered for comfort. His death resulted from the experience of 15 hours of chosen grand mal seizures. He lived hard and died hard.
Terror, unresolved business, and spiritual crisis can be parts of this. Those with PTSD and wartime memories can revisit this trauma experience as can those who sustained abuse as children.