Assume you write for an audience consisting solely of
terminal patients. That is, after
all, the case.” Annie
Dillard, On Writing, p. 68
At age 41 I had an epiphany about my own mortality. I was
leaving my office, driving through a parking lot toward the main street. I had to stop the car as I had an
overwhelming sense of something that I can only call a revelation. It was as if the world opened up to say
“Here is something big. Pay
attention!” The message was this: “I
did not need to fear my own death.
It will come in its own due course. Others you have known have died and others you know and love
will also die but you are now free to live without any worry about when or how
you might die.” I sat there in
stunned silence wondering why me, why now, why here? The other question was all right, what am I to make of
that? Was this a classic mid-life
opportunity rather than a crisis? I
am now in my 79th year and living well, at least for now.
I was not aware that I had any deep concern about dying but in
there somewhere must have been a residue of wondering, even if out of simple curiosity. Part of my professional training had
included some work in pastoral care and helping others through various life
transitions, including dying and death. Being with those people and their
families gave me some insight into how we as a culture and society avoided the
topic most of the time. That in
itself was fascinating since it’s an experience everyone faces, usually more
than once. I have taken the
position that whatever you can’t talk about will come up and bite you in the
backside.
My interest in death and dying may stem from early
experiences, first with animals and then from watching the adults around me
deal with death. The first death I
recall in my own family was my paternal grandmother. When she died, rather suddenly, I was about 12 years old. I recall the farmhouse being prepared
for a “viewing.” I did not like
the term then and still don’t, but I understand that it may fulfill a need on
the part of the immediate family. My
thought then was that my grandmother, lying there, as if she were asleep, had
no interest in being stared at by all these people.
The casket was placed in the formal dining room, people came
to “pay their respects” and spoke softly in hushed voices as if a normal conversation
might be disrespectful. I couldn’t
figure that out. These practices
of viewing the dead vary from culture to culture, often depending on religious
traditions and practices. A
viewing (or wake as it is sometimes called) can be for one day or up to three
days. A visitation might just
include the immediate family without any public display of the dead body.
The morning of the funeral 40 to 50 people gathered in the
dining room and sat in chairs facing the casket. I remember my grandfather walking up to the casket and when
he was coming back to his seat, I could see that he was crying. It was the first and only time I saw
him with tears in his eyes except when he laughed so hard he cried. Then the entire group followed the
hearse to the church for the service, then to the little cemetery in the
country where both my parents and their families are buried. I have no interest in taking any real
estate for my remains and have made that known to my family.
There are enormous differences between a sudden death that
is unexpected and one that comes following some illness or disease. In either case the issues are loss and
grief for the “survivors” and coming to terms with living, not dying. Woody Allen is famous for saying “I am
not afraid of death. I just don’t
want to be there when it happens.” We know intellectually that life can change directions
quickly. We know that life is
unpredictable, uncertain, fragile and precious. We know death is certain, that every living person
experiences it and yet we go to extraordinary lengths to avoid it. We have, until more recently,
even avoided having open and honest conversations about death and dying.
Of the 2.5 million deaths in the U.S. in 2012, approximately
175,000 were in the “unnatural” category; 122,000 deaths by accident, 38,200 by
suicide and 14,600 by homicide.
Yet accidents ranked as the 5th leading cause of death and
suicide 10th. Numbers
can be misleading because over 1.4 million deaths ranked ahead of accidents as
a cause of death and these were from heart, cancer, and other diseases.
The point here is not to draw any conclusions from the
aggregated data but to understand that each one of these deaths is personal,
regardless of the cause. Every
person faces death, whether you are the dying person or you are among those
closest to that person. And
whether the death is anticipated or sudden, it must be dealt with one way or
another.
One of my favorite stories is “Appointment
in Samarra” as re-told by W. Somerset Maugham in 1933. It is an interesting
commentary on how some think they might
escape death, even if for awhile. Death is the speaker.
“There was a
merchant in Bagdad who sent his servant to market to buy provisions and in a
little while the servant came back, white and trembling, and said, Master, just
now when I was in the marketplace I was jostled by a woman in the crowd and
when I turned I saw it was Death that jostled me. She looked at me and
made a threatening gesture, now, lend me your horse, and I will ride away
from this city and avoid my fate. I will go to Samarra and there Death
will not find me. The merchant lent him his horse, and the servant
mounted it, and he dug his spurs in its flanks and as fast as the horse could
gallop he went. Then the merchant went down to the marketplace and he saw
me standing in the crowd and he came to me and said, 'Why did you make a
threatening gesture to my servant when you saw him this morning?’ That
was not a threatening gesture, I said, it was only a start of surprise. I
was astonished to see him in Bagdad, for I had an appointment with him tonight
in Samarra.”
There is a tremendous amount
of literature on death and dying, some from the medical community that deals
with death on a daily basis one way or another; other treatises from writers
and poets who try and soften the emotional traumas associated with the
inevitable end of life; and only recently have people begun to focus on the
choices available not only in the manner they wish to die but how they wish to
live.
The medical community seems to be shifting its attitude from
one of trying to keep people alive regardless of the physical, emotional and
economic costs toward a more humane approach. Hospice has made its positive presence felt among those
families trying to help loved ones live out their last days with more dignity
and comfort and several states, Oregon being a pioneer, have laws permitting
people to die with dignity.
How each family deals with the loss of a loved one varies
greatly. How we are prepared ahead of time will in some measure determine our
ability to plan for, accept and embrace the final chapter. There are now more resources available
than ever before. If you or a member of your family are in one of those
terminal but uncertain conditions, you can take control. With the help and support
from others who have the experience to walk through this valley of the shadow without
fear you can have the hope of as good an end as humanly possible.
