Month: March 2021

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Professor emeritus has last words on death and dying

Professor emeritus Ronald Bayne was one of Canada’s first geriatricians and a lifelong advocate for better care for older adults. Dr. Bayne, shown here receiving his honorary doctorate at McMaster in 2006, died on Friday after deciding to take advantage of the opportunity for medical assistance in dying.

Dr. Ronald Bayne was one of Canada’s first geriatricians and spent much of his long career as a passionate advocate for better care for the elderly, working to solve the problems in long-term care homes.

At 98, and racked with chronic pain, he turned his advocacy to another cause critical to the elderly: planning the end of life.

Bayne, who was a professor emeritus of McMaster University, died on Friday after deciding to take advantage of the opportunity for medical assistance in dying.

Before dying, he shared his story with the media and produced a compelling video urging seniors and their families to take control of the end of their lives.

The 12-minute video is a powerful demonstration of Bayne’s passion for the cause to the very end, part reflection on death and dying, part rallying cry for better health care and autonomy for the elderly.

“I’m 98 so I am near the end of my life. Fortunately, my mind is still clear though my body is exhausted,” he says in the video.

“I want the vast majority of the population, and seniors in particular, to realize that they have far more control at the end than they realize they do. Every Canadian has the right to control their own bodies. There’s no question about it. You are legally entitled, and you must insist that your voice is heard.”

In the video, Bayne is eloquent and passionate, referring to Dr. William Osler and Shakespeare and his long experience in health care.

“I had a long career as a physician and over these many years I’ve been struck by the fact that increasingly people are fearing death and dying. I think it’s become almost universal,” he says. “People themselves have become fearful about what may happen at the end of their lives, and if they’re going to be suffering great pain, if they’ll get relief.

“I want people to get over this fear of the unknown and make it known. Discuss it openly, realizing that death is inevitable.”

He says everyone has the right to end their life if it has become unbearable. “Some people say that’s promoting death. Of course it’s not promoting death. Death is inevitable, you don’t need to promote it. No, this is to reduce suffering and pain. And if you as a person are not likely to pass on soon, you should be able to control your own end of life.”

Trained at McGill University, Bayne was a professor of medicine at McMaster’s Michael G. DeGroote School of Medicine from 1970 until he retired as a professor emeritus in 1989.

He received an honorary degree from McMaster in 2006 for his advocacy and work raising awareness of the need for better care of the elderly and chronically ill people, and his initiation of programs that work to prevent the warehousing of often marginalized populations.

It is clear from the video that his passion for this work continued through the very end of his life.

“We must have our voices heard. That’s what I’m urging people to do in later life,” he says in the video. “Take that responsibility. Let us ensure that the health-care system for long-term care is properly organized and managed and supervised.

“We know, from recent experience with COVID, that these long-term institutions were very poorly managed, and in a way, the general public is justified in their fear of what will happen to seniors in those places,” Bayne says, suggesting the seniors need to realize they have more control than they think they do.

“We as seniors should be working with our families to discuss the end and how we wish it to occur and building up their [family’s] feeling of confidence that it will be peaceful for us and bearable for them. So instead of focusing on the end, build up great memories, happy memories that the family will treasure afterwards.”

Bayne had a close relationship with the university over the years, and 13 of his family members have McMaster degrees, including the honorary degree awarded his son-in-law, Michael Hayes, in 2017.

Bayne and his wife Barbara have made several donations to the university, establishing the Ronald Bayne Gerontology Award for a graduate student conducting aging research; and the Barbara and Ronald Bayne Award to provide support for senior students in the Department of Health, Aging and Society who are engaged in practical learning experience as part of their undergraduate studies.

“Dr. Bayne has been a wonderful teacher for all of us from his days at McMaster helping create geriatrics as its own discipline in Canada, to just before his death,” said Paul O’Byrne, dean and vice-president of the Faculty of Health Sciences. “I am very grateful for all of his lifelong contributions to improving the health of Canadians.”

Parminder Raina, scientific director of the McMaster Institute for Research on Aging, added: “One of Canada’s first geriatricians and a physician at Mac, Dr. Bayne founded the Hamilton-Wentworth Group on Aging, the Gerontology Research Council of Ontario (GRCO) and led the Canadian Association on Gerontology in the ‘80s. His tireless work in the area of geriatrics and gerontology drove the infusion of a lot of provincial funding into research and training in aging at a crucial time.

“His powerful messages around death and dying are inspiring and important.”

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Pandemic grief could become its own health crisis

By Hope Edelman

As the nation mourns more than 500,000 lives lost a year into the coronavirus pandemic, another pandemic wave is building — of grief. It poses a potential public health crisis of its own.

For the past century, Americans’ response to grief has been to minimize its impact and suppress the emotional pain. We treat grieving as an individual affair, with mourners responsible for “getting over” their losses, mostly in private. Social isolation during the pandemic has made grieving even more solitary.

But grief wasn’t always treated this way. For centuries, communities came together to mourn the passing of an individual as a loss to the polity. Victorian mourning practices were extravagant social affairs involving rituals that the bereaved and fellow citizens followed for months, sometimes years, after a death.

Then came the one-two punch of World War I and the 1918 influenza pandemic. With so many deaths occurring so fast, mourning rituals became prohibitively expensive and social mourning was effectively impossible to maintain. Like today, large public gatherings were prohibited and quarantines enforced. Funerals shrank in size, mourning periods contracted and families were left to grieve in isolation. By the 1920s, grief in America had largely gone underground.

A century later, grief is again a widespread issue. With each covid-19 death affecting an estimated nine survivors, more than 4.5 million Americans are grieving loved ones lost to the virus. Beyond deaths to other causes, there were additional U.S. fatalities last year: gatherings with family and friends, classroom learning, millions of jobs that won’t return. Collectively, we lost a way of life in 2020.

Yet there has been no sustained outpouring of public support for mourners, as happened after the devastation of 9/11. Instead of a broad acknowledgment of mass distress, our nation has been mute with grief. Pandemic skepticism has also disparaged the losses some have experienced.

This is a precarious state for a nation. Grief is cyclical, especially around anniversary dates. Even under optimal conditions, many mourners experience a dip in functioning at the one-year mark. We should expect this to happen, starting this month, with the one-year anniversaries of the first wave of pandemic deaths and lockdowns. One year isn’t far on the long arc of adjustment, but it’s well beyond the point that most people expect visible evidence of mourning to last. Collectively failing to grant each other permission to express distress beyond the first weeks after a loss can have profound health consequences.

In children and teens, unaddressed grief can manifest as trouble sleeping, depression, anxiety, behavior issues and lower self-esteem, a 2015 study found. Research from 2018 found it leads to aggression and academic or work struggles. In adults, unaddressed grief can manifest as depression, anger, anxiety, and substance use and abuse. Medical research has linked unaddressed and suppressed emotions to a host of physical ailments later in life, including hypertension and autoimmune disorders.

President Biden’s remarks on Monday, acknowledging not just the lives lost but also the loved ones mourning, are a good start. In addition to promoting professional help, there are steps that we citizens can take to address this siloed bereavement and help head off a looming public health crisis.

We can start by viewing grief support as part of our essential social contract. Those who are grieving need acknowledgment and understanding from family and friends. This starts with taking their losses seriously and accepting their reactions. Listening to their stories of a loved one’s life and death with compassion, instead of judgment, is key; so is confirming the coronavirus’s threat to human health if their loved one died of covid.

As in 1918, public health restrictions have affected the rituals people typically rely on for comfort and support. Funerals have again become stripped-down facsimiles, with some long-standing ethnic and religious traditions abbreviated or abandoned. Some families have postponed memorial services — and their own expressions of grief — in favor of planning to hold shows of respect when groups can again gather safely.

Today’s mourners should be helped to hold on to whatever rituals remain, even if that means attending a memorial service two years after a death. Rituals allow people to draw on the comforts of the past while projecting a loved one’s influence forward.

New rituals can be developed, too. Even repetitive, everyday acts such as drinking morning coffee from a mother’s favorite mug or touching a loved one’s framed photo when passing by can bring comfort if performed with intention. Folding the memory or values of a lost loved one into new traditions is a way to continue honoring the lives they lived.

Finally, participating in public acknowledgements of those who have died provides a larger meaning and context for the half-million deaths that otherwise risk being minimized or, worse, forgotten.

Everyone eventually loses someone dear, some of us sooner rather than later. Mourners’ unexpressed distress can manifest in them physically and in their interactions with others — in how they work, raise children and create policy. Validating and supporting the bereaved at the time of loss is not just the compassionate thing to do — it’s a necessary investment in the collective good.

Complete Article ↪HERE↩!

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How the world sends off its dead

And what that says about us

Tower of Silence in Yazd, Iran.

by

A great way to get under the skin of a living culture, especially a little-known one, is to learn about their thoughts, beliefs and rituals around death. Conversations about reincarnation, reunions with departed spirits, and the manner in which they send-off their loved ones might surprise you and lead to fascinating discoveries. While most rituals are rooted in ancient philosophies, modern science and technology is helping to develop sustainable options that can turn our lifeless barks into useful nuggets.

Whisperings of death are all around us. Statements of grief and love take form in flower bouquets and roadside memorials where a person might have lost their life in an instance. The names of loved ones are inscribed on park benches. They live on in academic scholarships, wings of hospitals, places of worship and most of all, in our memories. Their photographs are hung in our homes, shops and offices. While these may be familiar to us, in far-flung lands, other practices are thriving.

Wandering the lanes of the Old Quarter in Hanoi, Vietnam, my friend and I came upon Hang Ma street with shops selling things made from paper. The stalls were festooned with rather unique paper replicas of houses, cars, motorcycles, washing machines, refrigerators, clothes, cell-phones, shoes, wallets, eye-glasses and wads of cash. These, it turns out, are bought by relatives of the deceased and burned on Wandering Soul’s Day. People believe that on this day the gates to the afterlife are opened for spirits to come back to the earth, and their ancestors can accept and enjoy the offerings. From their vantage point, death is by no means a final departure and the next world bears a strong resemblance to the present one.

Gifts for the departed.

Driving through the countryside in Kyrgyzstan, the captivatingly beautiful hills reared up all around me and my guide Kuban. We stopped to explore curious clusters that looked like giant birdcages. Kuban explained that these airy domes housed tombs. Influenced by Islam and nomadic traditions, the Kyrgyz have uniquely adapted their grave coverings to look like yurts, with views of the open skies that are close to their hearts. While the Soviet occupation saw many mosques razed to the ground, the graves were left alone, and they continue to tell the story of the people held deep within their wombs.

High up in the folds of the Himalayas, several Tibetan Vajrayana Buddhists still opt for sky burials. In accordance with their beliefs, after a person’s passing, while the spirit is in transition, the body is a mere empty vessel to be given back to nature. In an extreme act of compassion, the naked body, often chopped into pieces, is left out in the open as food for scavenging vultures and predators. When full, they spare small creatures such as the mice, marmots, weasels and hares.

The respected priests, the Lamas, encourage people to confront death openly, and to feel the impermanence of life. Many a ritual object in the monasteries is made from human bones. The harsh, treeless landscape has also had a role to play in eliciting this practice, with the lack of wood for pyres or coffins and the earth being too hard to dig graves.

A sky burial site.

In Ladakh and the villages of the hinterland, if a baby dies before its teeth are cut, the dbon-po (astrologer) might recommend putting it in a small coffin and walling it up within the house to retain its g-yang, or good fortune and hoping its soul will re-enter the mother’s womb.

According to the ancient Zoroastrian faith, dead bodies must not defile the earth, water or air. Traditionally, they are cleansed in accordance with rituals and left in the ‘towers of silence’ to be consumed by vultures. The practice continues in a handful of places such as Yazd, Iran. In Mumbai and Hyderabad, the lack of vultures (many died from eating cow carcasses that contained the drug diclofenac) has made the community pivot to solar concentrators, where intense sunlight desiccates corpses as it passes through a fresnel lens.

In Longyearbyen, Svalbard, the northernmost town on the planet, it has been illegal to die since 1950. As the temperatures dip down to –43°C, there is constant permafrost in the ground. The archipelago belongs to Norwegians, who are mainly Christians, but they can’t bury their dead here, as the permafrost will preserve the bodies forever. Anyone expecting to die must fly to the mainland.

Over time, several polar explorers, whalers and scientists have lost their lives in Antarctica, where they might remain hidden forever, or make a macabre appearance as an iceberg calves and melts in the ocean. Similarly, as Everest melts, bodies of trekkers and Sherpas keep emerging from the ice.

On a trek through Mantadia Rainforest in Madagascar, as we looked out for creatures such as lemurs, indris and sifakas, our guide Eric Michel chatted with us about life on the island, describing the famadihana or ‘turning of the bones’ tradition. “We (Malagasy) believe that our dead ancestors influence our fortunes and fertility from the afterlife. Every 5-7 years, when enough money has been saved, our family plans a famadihana where the entire village comes together. Alcohol is passed around freely, food is served, and the festivities start. We make an opening in the family tomb to let out the bad smell, then begin pulling out one body after another. They’re re-wrapped in fresh fabric, even the crumbled ones. The band starts to play, people begin to dance, sing, and commune with the dead, rocking them, talking to them, filling them in on the latest news, introducing them to new family members, perhaps showing them a new bridge or house, and asking for specific blessings before placing them back. People are even more powerful once they die, so we must respect them.”

A famadihana in session.

Also believing in an afterlife, the San Bushmen of the Kalahari Desert add bows and arrows, pots and fabrics to the graves of their dead, whose bodies are anointed in ochre and fat and buried in foetal position, facing east. The spot is topped with a stone cairn to keep it from being dug up by any animals.

Death rites are not always achingly solemn. In Barbados, a driver commemorates his grandmother, who passed four years ago, by hanging her smiling picture on a badge on his rear-view mirror. In Ethiopia’s remote Omo Valley, the sudden loud gunshots turned out to be part of a funeral procession with a touch of gangsta-verve. Guns and bullets are a luxury, swapped with precious cows and goats, and so firing them is a way of lavishing honour on the departed. In Spanta, Romania, people believe that death leads to a better life, and so it must be celebrated. The notion is reflected in the Cimitriul Vesel, the ‘merry cemetery’, dense with colourful paintings on tombs illustrating the dead person’s life that are often topped with light-hearted epitaphs.

Our death is our swansong, and the manner in which we go also reflects who we are. The religious rites that are handed down to us over generations have a consolatory feel, but many of these were established millennia ago, when there were far fewer humans, rivers were pure and thick forests covered our planet. These traditions now need to be revisited. Our awareness of environmental issues has been heightened. Let’s look outside our windows today and think afresh. By 2050, there will be 10 billion humans. Does cutting down trees for pyres and coffins, putting masses of carbon in the air and choking our waters with ashes sound right?

Shedding our reticence and donating our bodies to science and allowing our organs as hearts, livers, eyes to be used by others upon our passing is modern-day compassion. Preserving, not depleting our planet is the new mantra. Fresh ideas abound. The US-based company Eternal Reefs compresses human remains into a sphere that is attached to a reef in the ocean providing habitat for sea life. Resomation is a technique where alkaline hydrolysis breaks down and liquifies the body with no carbon emission. Capsula Mundi, an Italian company, makes organic pods into which bodies are placed and put in the earth. Seeds or saplings are planted just above, and they become nourishment for the growing tree. A simple version of this practice requires a spot, a sack and a sapling. If we can allocate land and turn our bodies into forests, it could be our most considerate legacy for future generations. A human and a tree growing into each other. What better consolation.

Complete Article ↪HERE↩!