Sue Wootton
But things are changing. Perhaps it’s because the baby boomers are getting old, and waking up to the fact that there’s no special dispensation for anyone: the petals of even the most beautiful former flower children eventually wither and die. Whatever the reason, people are beginning to talk, seriously talk, about death.
Two of many recent publications that tackle the subject are We’re all going to die: a Joyful book about Death by Dr Leah Kaminsky, and Death’s Summer Coat: What the History of Death and Dying Teaches us about Life and Living by historian Brandy Schillace.
How can we accept our vulnerability—the truth that our days are numbered and our deaths inevitable?
Leah Kaminsky is an Australian GP and writer. She deals with the reality of death every day, as doctors do. Yet, paradoxically (but almost certainly commonly), she has, since childhood, “harboured a profound fear of death”. Her book explores this fear, looking into her own family history, and looking outward too, to the bigger picture of acculturated attitudes to death in contemporary Western society, and in the medical profession.
Kaminsky grew up safely in a 1960s leafy Melbourne suburb, the daughter of refugees from postwar Europe. Her parents, who had both suffered traumatically during the war, were determined to protect their child from the pain of grief—so determined, in fact, that Kaminsky couldn’t have a pet “because they didn’t want me to have to face a beloved animal dying one day.” On the one hand, medicine is an odd career choice for someone who grew up “scared of becoming ill, of dying”, but on the other hand, as Kaminsky notes:
Death has become the Enemy for doctors too… The medical profession takes a militant stand against death, which is reflected in the very language of illness—we fight infection, wage an ongoing battle against cancer and help patients defy a poor prognosis.”
Several pivotal encounters with patients challenge Kaminsky to reappraise her personal and professional attitudes to death. Far from turning away from their mortality, these people turn towards it, weaving a tolerance for the fact of death into their understanding of life itself. And while these patients remain deeply saddened and pained by death—they do not particularly want to die and do not want their loved ones to die—they surprise Kaminsky by also being deeply connected to life, often joyfully so. Kaminsky finds this same response in others who have developed their capacity to bear the fact of death. It seems that acknowledging the reality of death can be a key that opens the door to gratitude and happiness. Being death-conscious (or as Heideggar has it, ‘being-towards-death’) is a life-enhancing position.
Realising that both her upbringing and her medical training have taught her to view death and dying through a narrow lens, Kaminsky sets aside her stethoscope and picks up her pen. We’re All Going to Die has chapters on children and death, terminal illness, near-death experiences, health anxiety, honouring the dead, and the concept of a ‘good death’. Kaminsky interviews patients, doctors, undertakers, extreme sport adrenaline junkies, the curator of a death museum, and the convenors of death salons and death cafes. She looks too at medical training, and asks hard questions about the effect of the dissection-based educational model on doctors’ attitudes to death and dying. She explores the way that modern medicine’s pharmaceutical, surgical and technological successes have both cemented and undermined trust in medical practice—people expect medicine to cure and save, yet harbour a deep fear of enduring a medically over-prolonged life. Patients want doctors to ‘know the answers’, yet fear losing control, especially through being reduced to biological data and no longer being seen or heard as a person. For Kaminsky, this is a pressing issue for the medical profession:
Gadgetry might have improved diagnostics but it also helps the medical profession hide from the patient behind bells, whistles and screens. This disconnect objectifies those who are ill to become a set of readings and numbers to be interpreted clinically, rather than a real person with a life story and individual narrative about their own health and wellbeing. And all this encourages us to not talk to our patients about that huge elephant in the room—death.
We die. We know this, in principle, and yet in the Western world we don’t live with the idea of death. We refrain from thinking about it, we avoid reflecting on it, and death is something most of us simply don’t talk about.”
Kaminsky has to write her way out of her medicalised viewpoint just to ‘see’ death more clearly, but Schillace already has the historian’s advantage of the long view. She puts customs into perspective and context, and so our own practices emerge as peculiar: culturally specific, bound to time and place. Schillace describes the history of the West’s journey towards the medicalisation of death. Like Kaminsky, she exposes the cracks in this way of thinking and challenges traditional ideas about medical training.
Through Schillace’s eyes we come to understand why we do things the way we do, and what behaviours and beliefs we have adopted, adapted or discarded along the way. “Remember,” she writes, “that death, for much of the world and for much of human history, was not a singular, individual moment but a community event. And remember, grief and ritual exist for the living as much as for the dying…” But, asks Schillace:
Has something happened to our rituals for death? For dying and for grieving?
Grief and ritual: these two words are always partners in Death’s Summer Coat. Schillace reveals ‘death denial’ as not just a fear of dying, but also a deeply embedded fear of grief. The sorrow and immense loneliness of bereavement are terrible to contemplate and hard to endure. To face grief without falling apart we need to be held, actually and metaphorically. Throughout human history, mourning rituals have provided a community-sanctioned ‘holding’ for anguish and sorrow. Yet, now, we have few public rituals which validate our feelings, signal our pain to others, and guide our passage. Schillace writes:
The modern westerner has lost loss; death as a community event, and mourning as a communal practice, has been steadily killed off.”
Grief is a journey: turbulent, disobedient, rude, unpredictable. Ritual is also a process, but it progresses in steady, predictable steps according to a known plan, courteously, respectfully. Schillace surveys a rich array of responses to death, and in doing so casts light on our depleted death customs.
Both books give much food for thought. How can we become healthier about death? What rituals surrounding death do we want to develop in our communities? How can we hold and be held as we travel in anguish and grief?
Sue Wootton is co-editor of Corpus.