Birth and death are rites of passage for which preparation is important. In rich countries, information and support during pregnancy and childbirth are available in spades from a vast range of professional and lay sources. Choice of venue for the birth is often on offer too. The risk is not so much of entering uncharted territory unprepared as of entering it utterly bedraggled from a deluge of advice.

Are we equally well prepared for dying and death? Speaking for myself, the answer is no. I dodged the issue before life threatening surgery and floundered as I witnessed my father's slow decline from dementia. Practising medicine conferred familiarity but not understanding, competence, or even compassion. I learnt a lot through following his journey. Not from the half dozen doctors he was nominally under, but from his carers, who without exception came from poor countries. They tried, as we did, to bring meaning into a life that had been truncated by unexpected loss as well as disease.

During one midnight vigil two days before …