In thirty-one years of hospice and palliative care work, I have sat at the bedsides of over two thousand people in their final days and hours. I have held hands that trembled with fear and hands that were perfectly still with acceptance. I have listened to whispered confessions, belly laughs about long-ago adventures, and silences so profound they felt like prayers.
What I'm about to share isn't clinical research, though it aligns with much of it. These are the patterns I've witnessed firsthand -- the recurring themes that surface when human beings approach the threshold between living and dying. I share them not to be morbid, but because I believe the dying have an urgent message for the living.
The Five Regrets That Kept Appearing
After roughly my first thousand conversations, I began keeping an informal journal. Not of medical details, but of what people said when they were past the point of performing for anyone. When the social masks dissolve -- and they always dissolve -- what remains is startlingly honest.
Five regrets surfaced again and again:
1. "I wish I hadn't spent so much time being afraid."
This was the most common refrain, and it surprised me at first. Not afraid of death -- afraid of life. Afraid to speak up, to change careers, to admit love, to set boundaries, to be seen. A retired accountant named Margaret told me:
"I spent sixty years trying not to make anyone uncomfortable. Do you know what that costs? It costs you your entire life. Every single day, I chose someone else's comfort over my own truth."
Fear, my patients taught me, is the great thief. Not the dramatic fears -- not heights or spiders or public speaking. The quiet, insidious fear of what other people might think. That fear alone has stolen more life than any disease I've encountered.
2. "I wish I had let myself be loved properly."
Many people nearing death didn't regret failed relationships -- they regretted the love they deflected. They'd had partners, children, and friends who tried to reach them, and they'd held those people at arm's length.
A former surgeon named James, a man who had saved hundreds of lives, wept in his final week. Not over patients lost, but over the wife he'd kept at a professional distance for forty years.
"She would try to hold me, really hold me, and I would always find something to do. The dishes. A journal article. I was so busy saving strangers that I forgot to let the person closest to me save me."
Letting yourself be loved requires vulnerability. And vulnerability, my patients showed me, is not weakness -- it is the single bravest thing a person can do.
3. "I wish I hadn't waited for the perfect moment."
The trip to Portugal. The novel in the drawer. The conversation with an estranged sibling. Over and over, I heard about things that were always going to happen "next year" or "when the kids are grown" or "after retirement." The perfect moment, it turns out, was any moment at all.
A woman named Delia, a former schoolteacher dying of pancreatic cancer at sixty-seven, told me something I think about almost every day:
"The perfect moment is a lie we tell ourselves so we don't have to be brave today. Every single day I waited was a day I chose comfort over living."
4. "I wish I had forgiven sooner."
Grudges are extraordinarily heavy things to carry into the final stretch. I have watched people spend their last conscious hours trying to locate a phone number for a brother they haven't spoken to in twenty years. The urgency is heartbreaking.
Forgiveness, as my patients taught me, is not about the other person. It never was. It is about setting down a weight that has been slowly crushing you. One man, a Vietnam veteran named Robert, said it this way:
"I carried anger at my father for fifty-three years. Fifty-three years. And you know what? He died in 1994. I was just carrying it for myself at that point. What a waste of a good life."
5. "I wish I had known that ordinary days were the point."
This is the one that changed me most. We spend so much time chasing peak experiences -- the promotion, the vacation, the milestone birthday -- that we miss the actual texture of being alive. Morning coffee with someone you love. The sound of rain. A child's hand reaching for yours.
A grandmother named Inez, ninety-one years old, smiled at me from her hospice bed and said:
"Everyone asks me what my happiest memory is. They want me to say my wedding or the birth of my children. But honestly? It was Tuesday mornings. My husband and I would sit on the porch and drink coffee and say nothing at all. Twenty years of Tuesday mornings. That was the whole thing. That was everything."
What Gives People Peace
Not everyone dies with regret. Some of my patients arrived at their final days with a calm that was almost luminous. After three decades of observation, I can tell you what those people had in common.
They had said the important things out loud. Not in grand gestures, but in ordinary moments. "I love you." "I'm proud of you." "I'm sorry." "Thank you." These four phrases, spoken consistently and genuinely throughout a life, seemed to account for an enormous portion of end-of-life peace.
They had made peace with imperfection. The serene patients were not the ones who had lived perfect lives. They were the ones who had accepted their humanity -- their failures, their contradictions, their messy, incomplete attempts at goodness. Perfection is not required for peace. Honesty is.
They had invested in people, not achievements. I have sat with retired CEOs who were terrified and retired kindergarten teachers who were radiant. I do not say this to diminish professional accomplishment, but to observe a pattern: at the end, no one asks to see their resume. They ask to see photographs. They ask to hear voices. They ask if the people they loved know it.
They had practiced some form of presence. Whether it was prayer, meditation, gardening, fishing, or simply sitting quietly -- the people who died most peacefully had cultivated the ability to be where they were, fully, without constantly reaching for what was next.
What the Dying Want the Living to Know
If I could distill two thousand conversations into a single message, it would be this:
You are not preparing for your life. You are living it. Right now. Today.
The meeting you're dreading, the dishes in the sink, the mundane Wednesday evening -- this is not the preamble. This is the book itself. Every chapter is made of these ordinary hours.
My patients didn't ask me to tell the world to skydive more or quit their jobs to travel. That's not what the dying request. Their message is quieter and, I think, more revolutionary:
Pay attention. Forgive now. Say the thing. Hold the person. Stop waiting.
A Personal Confession
I want to be honest about something: knowing these lessons and living them are two very different things. I have spent thirty-one years learning from the most profound teachers imaginable -- people with nothing left to lose and therefore nothing left to hide -- and I still catch myself scrolling my phone instead of listening to my daughter. I still postpone the difficult conversation. I still choose efficiency over presence more often than I'd like to admit.
What my patients have given me is not perfection. They have given me awareness. When I catch myself drifting into autopilot, I hear Margaret's voice reminding me about the cost of constant comfort. When I want to postpone something important, Delia whispers that the perfect moment is today.
These two thousand people did not die so that I could write an inspirational article. They lived, each of them, a complete and unrepeatable life. But in their final hours, almost all of them wanted the same thing: for someone to listen, and for that listening to matter.
I am listening. I have always been listening.
And I am asking you, wherever you are reading this, to consider: what would you want to say if the luxury of time were taken from you tomorrow? Whatever that thing is -- say it today. Don't write it down for later. Don't save it for the right moment.
The right moment is the one you're in.
Ruth Abernathy has worked in hospice and palliative care for thirty-one years. She is a certified palliative care nurse practitioner and has served as clinical director of three hospice programs across the Pacific Northwest. She lives in Portland, Oregon, with her daughter and two deeply opinionated cats.