Our attitudes about food
influence how we live,
and how we die

But it's our relationship with food as a culture that fascinates me more than new restaurants opening or chefs creating the latest culinary fad.

Any mother who has been fortunate enough to breastfeed her child knows that the bond formed is about more than satisfying a screaming infant's seemingly insatiable appetite. Parents seem to spend all day trying to get their toddlers to eat -- and when they do, they feel vindicated somehow. No one needs to be told how our island hospitality is driven as much by the need to feed guests as it is to see them happy. Indeed the two are so intertwined that the wise guest dare not refuse food lest a host be insulted.

When I first came to Hawaii, I worked for six years as a registered nurse at St Francis Hospice.

It was there, through many days and nights of tears and trauma, that I was able to see clearly the unique connection between food and human relationships.

We equate feeding someone with loving them. When they eat, we feel better. When they are unable to eat, we are distressed. When they manage a mouthful of grandma's apple pie, we feel that hope reigns, no matter how poor their prognosis.

At hospice, family mealtimes would sometimes be unusual affairs as people brought gargantuan plates of food to loved ones who were unable to manage more than a morsel. Countless times as nurses, we'd sit with distraught relatives, explaining to them why auntie wouldn't or couldn't eat any more.

Protesters carrying giant spoons and pleading for judges to "feed" the unfortunate Terri Schiavo seem not to understand that body and soul need more than bread and water to survive.

And objectors probably don't want to hear that a patient in a vegetative state has no need for the extra fluids that place demands on ever-diminishing bodily resources; that kidneys can become overloaded, and that patients who are unable to respond to stimuli generally become bloated and uncomfortable from excessive fluids in their bodies.

The hardest thing we have to do in life is to let our loved ones go, but still we believe that if those who are terminally ill will just eat a bite, or taste a morsel, or drink a few sips, then all will be well. In reality, tales of people waking from comas and returning to normality are mostly apocryphal, and those who have expressed a desire not to be kept alive by artificial means usually mean what they have said.

The way we allow our friends and family members to die has as much to do with respect and love as how we let them live.

Children who live in war-torn Sudan are starving. Those who slip into persistent vegetative states, remaining unresponsive to stimuli, are not. Medical research has proved that patients who are comatose and have refused extraordinary measures to keep them alive slip naturally and comfortably into a pre-death state.

Those who are artificially fed stay alive often for years, usually contracting repeated infections that are then treated with more fluids and antibiotics.

Through all of my hospice years, and through all of the long nights spent with people about to take their last breath, I learned a lot of things -- the most important, perhaps, that the uneaten piece of apple pie on a bedside table means not that we're neglecting those we love, but rather that we realize it's time to say goodbye.