Why Existential Coaching Could Help People at the End-of-Life

By Erick Messias, M.D., Ph.D., M.P.H.

With his place among history’s greatest writers cemented by War and Peace and Anna Karenina, Leo Tolstoy published a gem of a novella in 1886 titled The Death of Ivan Ilych. In the few pages of the novella, we follow the last days in the life of this member of the Court of Justice whose life had been “most simple, most ordinary, and therefore most terrible”.

Ivan Ilych was the second of three children of a mediocre official — for whom “posts are specially created” since he could not be dismissed. He followed his father’s footsteps into public service. Eventually, he met and married Praskovya Fedorovna who “came of a good family, was not bad looking, and had some property”. They lived seventeen years together and had two surviving children. By the time of his death, the girl was sixteen and the son “a young boy”. Tolstoy is quite brutal in describing their middle-class existence writing that their house “was just what is usually seen in houses of people of moderate means who want to appear rich, and therefore succeed only in resembling others like themselves”.

Their lives proceeded as scripted until the first signs of illness appear with “a queer taste in his mouth and some discomfort in his left side”. On the way back from the first doctor’s visit Ivan…