What we can learn from people who are dying

The title might sound morbid, perhaps even unsettling. We are, after all, a culture that tends to turn away from the inevitable, to push thoughts of mortality into a dimly lit corner of our minds. But what if, in that turning away, we are missing some of life’s most profound and urgent lessons? What if the wisdom we seek—the keys to a more joyful, purposeful, and connected life—is being whispered by those who are approaching its final chapter?

This is the central, deeply moving premise of Diane Button’s new book, What Matters Most: Lessons the Dying Teach Us About Living. As an end-of-life doula for nearly two decades, Button has been a compassionate witness to countless transitions, guiding individuals and their families through the practical, emotional, and spiritual journey of dying. She has sat with people from all walks of life—from a six-year-old celebrating every day to a man confined to his bed who created a “joy counter.” In these intimate spaces, stripped of superficiality and distraction, she has discovered a powerful truth: that a good death is a direct reflection of a well-lived life, and that the lessons learned on the threshold of mortality are, in fact, the most vital guides for how we should live.

What Matters Most is not a guide to grief, but a roadmap to living. Through poignant, heartfelt stories, Button invites us into the sacred space of her work, allowing us to learn from her “wisdom keepers.” These are not simply case studies; they are glimpses into the human heart at its most vulnerable and honest. They reveal what truly matters when the noise of the world fades, leaving a raw, beautiful clarity.

The Stripping Away of the Superficial

As Button explains in an interview published in ‘Greater Good Magazine’ of the University of California, Berkeley, when people face the end of their lives, “everything that is superficial just gets stripped away.” The anxieties about taxes, politics, and the relentless to-do lists that consume our days simply vanish. What remains is a laser-like focus on love, connection, healing, and, for many, spirituality. The world becomes smaller, yet infinitely more profound. This is the first and perhaps most crucial lesson: much of what we spend our energy on is not, in the end, what we will remember. The time we have is precious, and we have a choice about where we invest it. Do we spend it on the things that will ultimately be stripped away, or on the things we can carry with us—the intangible, yet unbreakable bonds of love and meaning?

When people face the end of their lives, everything superficial is stripped away. The anxieties about taxes, politics, and the relentless to-do lists that consume our days simply vanish. What remains is a laser-like focus on love, connection, healing, and, for many, spirituality. 

The Pursuit of Joy

One of the most surprising insights Button offers is the prevalence of joy in the presence of death. “It’s amazing,” she says. “There’s often so much joy at the end of life.” This is not a denial of sadness or fear, but a conscious, deliberate choice to seek out and savor moments of happiness. As Button explains, the dying are not fixated on the past or the future; they are profoundly, exquisitely present. They find joy in a ray of sunlight on their face, a hand held, a shared memory. The freedom that comes with a shortened timeline and the absence of expectations allows for an appreciation of the simple, ordinary beauty that surrounds us every day.

This is a powerful lesson for us all. We don’t need a terminal diagnosis to learn to live in the moment. We can, as Button has started to do herself, practice pausing to notice something beautiful each day—a flower, the specific kindness of a grocery bagger, the loving gaze of a friend. By deliberately seeking joy, we train our minds to be present and cultivate gratitude in the small, everyday moments that make a meaningful life.

The story of Jacob, a client with a fast-moving brain tumor, perfectly illustrates this point. Confined to his bed, he created a “joy counter” to click every time he experienced a moment of happiness—a hug, a favorite food, a visit from a friend. It became his way of actively acknowledging the beauty that still existed in his life, and a powerful reminder that joy is not a grand event but a collection of ordinary moments, waiting to be counted.

Diane Button and her colleagues at the End of Life Doula Alliance in the Bay Area sit with people who are dying and their loved ones to help them through the practical, emotional, and spiritual aspects of dying. Diane has witnessed firsthand what people care about most and what brings them peace at the end of life. 

The Urgency of Unfinished Business

When time becomes a finite and visible resource, the things we have left unsaid or undone take on an urgent weight. Unfinished business, whether it’s a desire for forgiveness or a need to express love, becomes a top priority. Button shares the deeply moving story of Carrie, a woman who had abandoned her family years earlier and was holding onto a secret burden of regret. With Button’s patient and non-judgmental guidance, Carrie was able to confront this difficult truth, ultimately choosing to fly back to her family to seek their forgiveness.

This story, like many others in the book, is a profound reminder that the time to address these deep-seated issues is now. Holding on to grudges, silent resentments, or unspoken words of love creates an emotional debt that will eventually come due. The dying are forced to confront this debt, making calls, writing letters, and reaching out to people they haven’t spoken to in decades. This is a lesson we don’t need to wait for: “Do this work all along the way,” Button urges. Say “I’m sorry,” say “I love you,” and ask for forgiveness. The weight we carry is not worth the cost.

The Quest for Legacy

Ultimately, people who are dying want to know that their life mattered, that they will be remembered, and that their contributions will endure. This is the essence of legacy work, a crucial component of an end-of-life doula’s role. Legacy is both tangible and intangible. It can be a photo album, a recorded story, or a letter to a loved one. But it is also the intangible legacy—the way we made others feel, the kindness we extended, the love we shared.

The stories in What Matters Most reinforce that a meaningful life is not measured by wealth or status, but by the lasting impact we have on the hearts of others. As Button points out, creating a legacy project—a letter or recording for a grandchild, for example—not only brings comfort and a sense of purpose to the dying, but also becomes a beautiful, lasting gift for those they leave behind. It is a way of ensuring that their memory, their wisdom, and their love will continue to be a significant link in the generational chain.

“In What Matters Most, end-of-life doula Diane Button provides the same care and comfort to readers as she does with her clients. The insights she has learned from her clients will bring you peace and remind you that it is never too late to work towards a meaningful life.”

~ Maria Shriver, former First Lady of California, who invited Diane Button to write ‘What Matters Most’ for her Open Field imprint under Penguin.

A New Perspective on an Ancient Truth

At its core, What Matters Most is an invitation to reframe our relationship with death. We are a society that lives in fear of it, but Button’s work shows us that talking about death is really just talking about life. When we lean into this conversation and allow ourselves to consider what would be most important at the end of our lives, we are given a powerful new lens through which to live.

This is not a book to be feared; it is a profound and gentle roadmap for living a life filled with purpose, connection, and joy. It serves as a reminder that the great lessons of kindness, forgiveness, gratitude, and love are not abstract concepts, but rather the very things that will bring us peace and comfort in the end of our days. By listening to the wisdom of those who are dying, we can learn to live more fully, more honestly, and with a renewed sense of urgency and appreciation for the precious time we have been given.

‘What Matters Most: Lessons the Dying Teach Us About Living’ by Diane Button is published by Open Field/Penguin Life, and available on Amazon.