“The other death,” a short story written by the Argentinian author Jorge Luis and published in English in the New Yorker in 1968 Borges (originally in 1949 as “La otra muerte”), opens with the narration of a fictional Borges, recounting a letter he received 2 years prior, from a friend named Gannon (Borges Reference Borges1968). Borges and Gannon live in Argentina, in the mid-1940s, and Gannon has written about a new translation he is working on, of “The Past,” a poem by Ralph Waldo Emerson.

In a postscript, Gannon notes that a mutual acquaintance, a man named Pedro Damián, has died of pulmonary congestion. Borges finds the news “predictable and even trite,” because Damián fought for the rebellious Aparicio Saravia in the Revolution of 1904 against the government of Uruguay. The former rebel was, in Borges’ view, a “common laborer” with no particular passions, swept into the uprising and “the occasional hand-to-hand skirmish” before the final battle at Masoller, when the revolutionary forces were defeated and Damián returned to his labors. The 2 met only once, in 1942, as Borges was passing through the small farm where Damián lived.

Borges is not surprised to learn that Damián had “relived that bloody day at Masoller” in a feverish delirium on his deathbed, thinking himself on the battlefield once again. But he is struck by a later conversation with Dionisio Tabares, the coronel who led the revolutionary side at Masoller in 1904, whom Borges seeks out after “the fever and agonizing death” of Damián suggests to him a new story. The coronel receives him and tells tales of gauchos, exhausted horses, and “sleepy men weaving labyrinths of marches.” Borges inquires about Damián, and Tabares informs him that the man from Entre Ríos behaved like a coward at Masoller; this information disturbs the narrator, but he continues with the story, and the following winter visits the coronel once more to collect some last details. He now finds Tabares in conversation with Dr. Juan Francisco Amaro, who also fought on the revolutionary side, and yet recalls that Damián died “as any man might wish to die”:

When the 3 men discuss Damián, the coronel no longer recalls his cowardly soldier. The others fail to remind him.

Back in Buenos Aires, Borges meets Gannon in an English bookshop and asks about his translation of “The Past.” Gannon denies any such endeavor. Borges tells Gannon that he had mentioned his translation in the same letter in which he noted the death of Damián, but Gannon now has no recollection of the man. Borges feels “the beginnings of a sense of terror” compounded, soon after, by a letter from Tabares, who writes that he is “no longer confused – now he remembered quite well the Entre Ríos boy who’d led the charge at Masoller and been buried that night at the foot of the hill” in 1904.

These discrepancies lead Borges through a labyrinthine series of hypotheses. There may have been 2 Damiáns – “the coward who died in Entre Ríos in 1946, and the brave man who died at Masoller in 1904,” but this would not explain the shifting recollections of Tabares and Gannon. There may be a supernatural explanation: Borges’ friend suggests that, “at the hour of his death,” Damián prayed for his return to Entre Ríos, but that God hesitated briefly, and Damián died; yet though God, who intended to grant this favor, cannot (according to this theory) change the past, he may change images of the past, and “a shade, a ghost” of Damián was thus returned to Entre Ríos, and it was this shade that “died” in 1946.

Borges’ final theory on the death of Damián is more similar to the second hypothesis, though it was finally inspired by 2 lines in Dante’s Paradiso. These lines lead him to Pier Damiani, the 11th-century Benedictine monk and Catholic Saint who writes, as Borges notes, “that God can make what once existed never to have been.” From this statement, the mystery unravels – or creates itself anew. Borges imagines Damián behaving like a coward in 1904, at Masoller, and returning to Entre Ríos in shame. This Damián yearns for another opportunity to prove himself and devotes himself to the possibility of such a moment. Forty years pass without another battle for Damián – until the moment of his death, in which fate answers his desire “in the form of a delirium”: tossing in his deathbed, a febrile Damián “relived his battle, and he acquitted himself like a man,” leading the final assault at Masoller and dying from a bullet in the chest.

Borges expounds on his theory by recalling that, in the Summa Theologica, Thomas Aquinas denies that God can “unmake what once existed” but is silent about “the entangled concatenation of causes and effects – which is so vast and so secret that it is possible that not a single remote event can be annulled, no matter how insignificant, without canceling the present.” God answered the yearning of Damián’s heart, but that answer required the creation of an alternative history not only of a death, but an entire life: a new history in which Damián died not in 1946, in Entre Ríos, but in 1904, at Masoller. The Borges who narrates “The other death” lives in the second history, but “the suppression of the former one was not immediate,” thus explaining the discrepancies of memory in Tabares, Gannon, and others.

With the rising public visibility of both palliative care and narrative medicine in recent years has come the intuitive recognition that much of palliative care is about stories and storytelling (Lanocha and Mahoney Reference Lanocha and Mahoney2023; Stanley and Hurst Reference Stanley and Hurst2011). Stories, in this context, teach clinicians something about empathy and also give patients, as well as families, opportunities to express and give new form to their suffering (Charon Reference Charon2001; DasGupta et al. Reference DasGupta, Irvine, Spiegel, Gunaratman and Oliviere2009). Borges would likely have supported such use of story, but in “The other death,” he also shows us that storytelling at the end of life is far from a conclusive process – it tends to infinity.

The challenge is that such narrative work, by its very nature, is an always-shifting effort. Dying patients, bereaved families, and clinicians are all faced with a kind of conclusion – death – but this conclusion does not preclude further creation. When we tell a story about a patient’s life, their death, or our involvement in either, we are, in effect, bound by the limits set by Aquinas: we cannot really change the past. But we are still like Pedro Damián, or witnesses to Pedro Damián: we can create, or help to create, new histories that will interact those that came before them. We may help an older man reconsider his lifelong regrets and accept that he need not suffer as a means of penitence; or we may find his bereaved daughter asking how she can look back on his absence in her childhood and feel anything but pain. Our responses to these situations, however open-ended or non-prescriptive, will often shift the interlocutor’s understanding of their past without actually changing that past; our words will, in effect, create new histories. Yet our participation in storytelling at the end of life is not suspicious or any less valid for this, nor does it suggest completion or the end of speculation. There are always more stories to be told. As Borges reminds us, “a man’s memory is not a summation; it is a chaos of vague possibilities” (Borges Reference Borges1998). The same is true death.

The palliative care clinician thus faces a worthy challenge in narrative medicine. To care for another human being is to place oneself squarely in the middle of a story, a story which one is called upon to help shape. In accepting this work, we involve ourselves not in a process of editing or even of recreation but of new creation, and this new creation can always give birth to yet other progeny. “The past is irrevocable,” W.H. Auden writes in an essay about tragedy, “but always redeemable now” (Auden Reference Auden1945). Irrevocable because what has happened cannot be deleted; redeemable because we can create fresh histories from an unalterable past. In this dialectic between the fixed and malleable, death becomes truly, wholly, Other.