The Four Things That Matter Most (Book Review by Amy, Volunteer)

Byok, Ira.   

The FourThings That Matter Most: A Book About Living. 
 New York: Free Press, 2004.
Ira Byock, M.D. has devoted his career to improving thequality of care for those in the end-of-life season.   
He co-founded the Life’s End Institute:Missoula Demonstration Project, Inc., and has served as the president of theAcademy of Hospice and Palliative Medicine. He currently holds a faculty position at Dartmouth School of Medicineand is the director of palliative medicine at Dartmouth Hitchcock MedicalCenter. 
The thesis of this book is that “four simple statements arepowerful tools for improving your relationships and your life” (3).  These four statements are Please forgive me,I forgive you, Thank you, and I love you. Byock asserts that through saying the Four Things, people aretransformed and eperience healing and wholeness.  Through the stories presented in his book,Byock demonstrates how “The Four Things are powerful tools for reconciling therifts that divide us and restoring the closeness we innately desire” (7).  
Following the introductory overview of the Four Things,Byrock’s literary structure provides a section for each component of thesecritical words: (1) Forgiveness, (2) Gratitude, (3) I Love You and (4)Goodbye.  He further divides these broadsegments of four focus sections into detailed stories that illustrate thepowerful impact of the Four Things on various families.  Throughout the book, the stories capture thepowerful way in which transformation takes place as individuals utilized theFour Things to complete their relationships. 
From the outset, Byock clearly explains that his role as adoctor is not to heal the relationships himself: “As a doctor, I cannot healrelationships between other people any more than I can will the grass togrow.  I can prepare them for healing,plant some seeds, keep careful watch, and nurture any evidence of growth.  In the plowing and planting and tending ofthe emotional, spiritual healing process, words are my most valuable tool.”(14).  Through Byock’s wisdom regardingthe careful usage of words, I have been encouraged in my chaplaincy training,as I have seen how a prudent and thoughtful selection of words made an enormousimpact on the visits that I had with patients throughout the summer. 
I wasdeeply moved be each and every one of the sections included in The Four Things,but the most impaction section for my life as a chaplain-in-training thissummer was the first section on forgiveness. As Bryock notes, “Forgiveness is a passage to a sanctuary of wholeness,that nurturing place where we feel intimately connected to the people whomatter most to us.  It is a place ofhealing and transformation.  In it, wefeel the perfect fullness of the present” (40). I have experienced the gift of forgiveness even while meeting withpatients throughout the summer as I have traditionally been very hard on myselfand have learned over time how to forgive myself for not being perfect, and fornot always having the perfect response to everything.  Through slowing down to be with my patients,hear their stories and practice the ministry of presence this summer, I havelearned that there is truly a “perfect fullness” in the present, and the bestway to embrace that is through experiencing life from a place ofwholeness.   

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LINK TO BOOK ON AMAZON