As I listened to parts of a radio interview yesterday morning about new ways to think about the concept of death, I felt my mind adjusting itself to a new perspective. The interview, with an artist who created “death suits” impregnated with mushroom spores for corpses to wear for burial, dealt with an idea about death that is not foreign to me, but probably would be shocking to most people I know. Her idea is to “plant” people upon their death so that they would serve as nutrients for mushrooms, thereby accelerating their biodegradation. Mushrooms, she said, are extremely efficient converters of human remains into soil. The concept, in essence, is to celebrate the transition of the body from nutrient consumer to nutrient.
While I was contemplating her ideas, the radio program went on to address issues related to death and dying. One segment involved a conversation with an EMT who explained he had changed from liar to truth-teller when asked by mortally injured or ill patients whether they were going to die. At one point, he stopped giving them false hope and, instead, told them the truth. Without fail, he said, the patients became calm and seemed to be completely accepting of their impending death. Some asked, in one way or another, for forgiveness. Some expressed regrets about their lives. Others asked the EMT to pass along messages of love and encouragement to their families.
The next interview (the entire program was devoted to death and dying, in case you hadn’t guessed it) was with a doctor who had, before entering medical school, been electrocuted. He lost one arm and both legs; then, later, he went to medical school. He runs a hospice/ palliative care facility. He spoke of the need to educate doctors about what people who are dying (and their families) need in a patient’s waning days. They do not need the cold and efficient throughput of hyper-efficient hospitals; instead, they need the dignity and respect and genuine care of an institution designed with end-of-life in mind.
I was struck by the matter-of-fact manner in which death and dying was treated throughout the program. Each program segment emphasized that the natural course of life leads to death, regardless of the means of death—whether calmly slipping away due to illness or old age or, on the other hand, ending suddenly or violently through accident or suicide or whatever. A theme repeated during the program was that death is a normal transition—albeit one we never personally comprehend in a way that lets us share the experience—from life to its absence.
In spite of its universality and inevitability, humans tend to look at death as something to fear. And I guess it is, if one considers its effects on the ones left to suffer the emptiness created by the death of a loved one. But that perspective is biased toward the living, not the dead. If one looks at death analytically, or as close to analytically as one can do with such an emotional subject, I think the emotions we feel are not fears of death, but angst about what we might experience as it nears. In addition to that personal emotion related to our own experience, I suspect the prospect of one’s death coincides with compassion for those left with an empty hole to fill.
Quite aside from all the philosophical questions that arose during the radio program and my attempts, and the attempts by program guests and hosts, to answer them, the most meaningful thing for me about the program was this: it got me to think about what society does to smooth the transition from life to death. One person’s comments, in particular, struck a chord with me. He stressed that end-of-life care has evolved into a focus on prolonging life at all costs at the expense of enhancing and easing the transition from life to death.
The speaker described a common scene in a hospital in which a terminally ill patient is covered with tubes and wires, enduring the ceaseless beeps and chirps of electronic devices monitoring heart rate and respiration and brain activity and blood flow. When the body finally overcomes every heroic effort to prevent its transition to death, those devices continue to drone on, their incessant noise changing, perhaps, but not stopping. And then, a team of efficient people disconnect the wires and tubes and roll the patient away while another team cleans the room and readies it for the next terminally ill patient to be subjected to the same efforts to extend life for just a little longer, regardless of the quality of life, or lack thereof.
I wonder what those dying patients, those who can communicate, would say if given options about their last days. Would they ask for another four or five days, or even a week or a month, attached to tubes and wires, their bodily functions usurped by machinery and bags? Or would they prefer the quiet of a hospice, a place where the focus in not on extending life but easing the transition through palliative care?
I suspect relatively few of us actively want to die; we want to continue to experience what we have come to know as life. We want to remain in the company of loved ones and we want to be there for them. But don’t we also recognize that our choices eventually narrow to the point that our options (or those of our caregivers) are either to die as peacefully as possible in the company of caring people or to claw ferociously to life at the expense of our own comfort and dignity?
Thinking through the radio program, and following up with a flood of thoughts of my own, the importance of material possessions suddenly disappears.
I wonder, if given the choice between spending a week in a hospice with a dying person to help ease their transition and taking ownership of a new vehicle with leather seats and prime stereo, what percentage of us would eschew the car?
I am afraid to know the answer; I am afraid it would explain the tubes and wires and machinery. I am afraid the answer would explain the sterile efficiency of heroic end-of-life efforts.
Oh, I know about advanced directives; I have one that’s recorded with doctors, et al. And I sat by my father in his recliner at home during his last day. In fact, I administered the last injection of morphine to him on that last day to help him through the pain of dying from lung cancer. I wrote about that last year ( https://johnswinburn.com/a-gentleman-and-a-scholar/). I’m not at all sure we truly fear death; it’s the absence of life we think we’ll miss and the grief we know our death will cause in others that we fear.
Oh, you knew I’d have to weigh in on this one. It’s called an Advance Directive. And everyone should have one. Your doctor should have a copy of it and so should your significant other. And that way, your wishes will be followed when you get to this point.
Next, I have sat by a friends’ bed as they were dying. I sat by my father’s bed and I sat by my brother’s bed. And until you do something similar, any speculation is just that.
I have also dealt with hospice, who by the way, are angels walking around on earth.
As for dying, we are all dying – we just choose not to be aware of it. And as I’ve said before, it is not in death that we realize the importance of another human. It’s in life. Do your damnedest to show those you care about how you feel while they are alive.
As for dying, yes. I think the closer it gets, the more we fear it. But then we don’t actually know how close it is. It could be tomorrow, couldn’t it?