What children, and teenagers, teach us about life and death

I work in pediatric palliative care, and I am often asked questions most people don’t know how to ask. Recently, a high school student reached out, wanting to understand why children die from cancer. He wasn’t asking from a place of shock or disbelief, he and his classmates wanted to help, through fundraising, awareness, advocacy, or maybe one day by becoming the kind of doctors who can change outcomes for children altogether. I agreed to meet in person with him and three of his classmates.

I told him the truth, which is that I don’t know why children die. No one does, not in a way that ever feels complete or satisfying. But I do know what we do when cure is no longer possible. I know how we care for children and families when the focus shifts from prolonging life to protecting its quality.

That answer didn’t end the conversation, it opened it.

They asked me questions many adults are too afraid to voice:

Is it different when a child dies compared to an adult?

Does it look different? Feel different?

Do children know they are dying?

Do they think about death the same way adults do?

From my experience, the answer to that last question is no.

Adults come to the end of life carrying a lifetime of memories, regrets, responsibilities, and an awareness of what they will miss and who they will leave behind. There is often a reckoning with a long story that suddenly feels unfinished.

The children we care for do not come to us carrying that same weight.

They don’t arrive burdened by decades of memories or regret for a future they never had the chance to imagine. Many of them cannot speak, so I cannot claim certainty, but from where I stand, they are profoundly rooted in this moment. In comfort. In presence. In what is happening right now.

Their world may be smaller, but it is also deeply honest.

What struck me just as much as the wisdom of the children in our care was the openness of these high school students. They were not guarded. They hadn’t yet been taught to look away from death or to soften their curiosity out of fear of discomfort. They asked boldly, and authentically, without armor.

One of them asked me if I think about dying.

I told him I do, every single day.

He asked if I was afraid to die. I said no, that I just don’t want it to happen anytime soon.

So I asked him the same question.

He thought for a moment and said, “No. Because when it’s time, it’ll happen.”

I asked if believing that changed how he planned to live his life.

He said no, that he isn’t going to waste time overthinking what he should or shouldn’t do, he’s just going to do what feels right in the moment that he is given.

Standing there, shaped by years of walking alongside those who are dying, I thought: This is what we forget as we age. Somewhere along the way, we learn to fear these conversations. We are taught that death is something to whisper about or avoid altogether. We build armor around grief, around love, around truth. And around death.

But children, and sometimes teenagers standing right at the edge of adulthood, remind us of something essential: talking about death does not steal life from us, it clarifies what matters, it sharpens our attention, and it teaches us how to love more honestly and grieve more openly.

Working in palliative care and hospice has taught me again and again, that meaning is not found in the length of a life, but in the depth of presence within it. That love does not require a lifetime to be real, and that being here, fully and courageously, matters.

Maybe the question isn’t why children die, maybe the deeper invitation is to notice how much they, and those brave enough to learn from them, can teach us about how to live.

xo

Gabby