Modern burials and death practices are changing how we die and where our bodies go after we die.
Why it matters: Today, the funeral industry is worth $17 billion ($). Businesses are innovating on traditional practices, and more people are taking control of how they wish to die and be buried — in unconventional, surprising and even extraterrestrial ways.
It now ends with most of us getting turned into dust and obituaries posted online. Some new burial practices and places include:
Orbit in outer space. SpaceX recently launched the cremated remains of 152 people on its Falcon Heavy rocket. A company called Celestis facilitated these “funeral flights,” charging over $5,000 for 1 gram of “participant” ashes.
Transformation into a diamond. Engineers can turn the carbon from human ashes into diamonds that are physically and chemically identical to natural diamonds.
Green burial. Touted as an environmental and financially friendly option, green burials can be as simple as wrapping a body in a cotton shroud and lowering it to the ground — factoring out conventional vaults, coffins and embalming.
Green cremation. Instead of using flame, green cremation uses heated water and an alkali solution to accelerate the natural decomposition of the body.
Celebration of life ceremony. In lieu of a somber funeral, an end-of-life ceremony celebrates a person’s life and legacy, often with a dedicated event planner, a speaker and activity lineups.
Digital tombstones: One Slovenian cemetery is experimenting with digital tombstones that can show pictures and video, and potentially link to a smartphone application for interactivity.
Smart library. One Tokyo crematorium allows you to summon ashes with the swipe of a card: A machine transports the ashes from an underground vault through a conveyor belt to the right room.
Living wake. Some people are attending their own funerals ahead of death — by holding a “living wake,” offering family and friends a chance to say goodbye.
Live-streamed funerals. An estimated 20% of funeral homes offer livestreaming, allowing those who can’t make it to a funeral to share the experience — and those who’ve attended to look back on it.
Disney World. About once a month, Disney employees clean up scattered remains ($) in the park, where visitors sneak in ashes to disperse at Cinderella’s castle, on the Pirates of the Caribbean ride and throughout the Haunted Mansion.
On the last day of my grandmother’s life six years ago in fall 2014, I hugged her goodbye after an afternoon at my grandparents’ home in South Florida and expected to see her for lunch the following day. However, I woke up the next morning to the news that my grandmother had died suddenly in her sleep. Instead of meeting up for lunch, my family called to make funeral arrangements. I rescheduled my flight and figured out bereavement days with my job at the time. Because I was on vacation, I thankfully had time to spend with my grandmother during her last unexpected days. The shock from finding out she had died lasted through the week and well beyond her funeral.
After her death, I flew back to New York City to return to what remained of my old life. I’d wanted to leave everything I knew and loved behind and embark on an adventure to a place where I knew no one and recognized nothing. In winter 2015 I’d finally had enough courage and money saved up to visit Iceland on a solo trip for my grandmother’s belated deathiversary. I didn’t expect to find a group of Americans and road trip around the southern coast of Iceland and fall in love with traveling alone, a new part of my life my grandmother will never know.
Every year since my grandmother’s death, without fail, I panic around her deathiversary. How could I commemorate her and the impact she had on my life? In the years since Iceland, I’ve talked with family, went to yoga and stayed low-key. In 2018, four years after she died, I thought I’d go on another solo trip because I wasn’t working and had the time to travel.
However, instead of traveling, I did something different and more close to home. I attended a Death Cafe, where strangers gathered together to talk about death in a supportive environment, at a cemetery in Brooklyn on a cold autumn weeknight. I was intrigued about going to a cemetery where the topic of conversation revolved around death. It wasn’t like death was a hot topic of conversation for small talk, so I didn’t really have the opportunity to bring up death on a whim to friends and family, specifically my grandmother’s death, which happened years ago. I wasn’t sure what to expect or how much I would even talk about such an intimate part of my life with people I didn’t know. Once inside the crematory’s chapel, I noticed a small group of people gathered around trays of cookies and water bottles. The director introduced herself and the backstory of the Death Cafe and then separated us into smaller groups.
My group chose a private back room with urns lining the walls. We pulled our chairs together in a circle and introduced ourselves. The conversation started with why we were there and why we decided to attend a Death Cafe and then expanded to religion, stories of loved ones and friends and their passing and then to the beyond: What happens after we die? Is it good that we don’t know what happens? What would happen if we did? One girl asked how grief changes over time, and how grief changes people. We sat in reflective silence and I thought about the week after my grandmother died when I needed to be around only close friends and family. All of my senses had been muted. I lived life that week in quiet contemplation surrounded by familiarity, the exact opposite experience I was having at the Death Cafe: alone and surrounded by strangers.
After we rejoined the main group, the organizer shared two poems about death with us before concluding the Death Cafe. I felt a sense of peace at having talked about my grandmother to a group of strangers and keeping my memory of her alive. After my grandmother’s death, I was so angry at how she died. The director spoke of a good death and what that means, and my mom, after my grandmother died, had also mentioned that it was a good death. I’ve realized I was upset at the way my grandmother passed and, in a way, of our unfinished conversation. Never saying goodbye and never having that final lunch together.
In the years since my grandmother’s death, I needed to confront my ideas about life, death and everything in between and beyond. I needed the space to talk to people who hadn’t moved on because they didn’t have a starting point to move on from. I found myself opening up to these people and becoming more intimate the further our conversations progressed. After all, how do we talk about death when death is such a taboo topic to talk about?
My grandmother’s presence is still here, in the jewelry and pictures and memories left behind. Attending a Death Cafe provided a space of comfort and allowed me to talk openly and freely about my thoughts and feelings to strangers, and since then, family and friends, about all aspects of death in an open manner. My grandmother’s deathiversary, I’ve come to realize after leaving the Death Cafe, is another day that comes and goes with the passing of time. While my grandmother’s death came as a shock, the ending of her life came, as my mom said, as a mercy to her. A good death to a good person, and these realizations came from open conversations about death.
Initially, the cemetery in Rhinebeck, New York, appears conventional: businesslike granite squares placed in rows, flags and silk flowers sticking up here and there, grass mowed tight all around.
In one corner, however, a walking path roped off from vehicles invites visitors to stroll into the woods. The area looks wild, but it turns out to be part of the cemetery. A hardwood sign marks it the “Natural Burial Ground.” Cherry, beech, and locust trees stretch tall. Ferns cover the ground. The sweetness of phlox, a purple wildflower, wafts in the air. The lawn portion suddenly looks as contrived as a golf course.
“It’s stark, isn’t it?” Suzanne Kelly, the cemetery’s administrator, says of the contrast. On a spring day, she’s taking us on a tour of the natural section she helped establish in 2014. We step in and she starts describing the deer, wild turkeys, and songbirds that pass through (and also warns us about a poison ivy patch). About 100 yards in, we start to see mounds and a few small fieldstones, some engraved with simple words like “Dear Nature, Thank You, Evelyn.” These 10 acres have been permanently set aside for bodies to be buried without the chemical embalming, nonbiodegradable caskets, or concrete vaults that often accompany the modern American way of death.
Kelly is a thoughtful Gen X academic-turned-garlic-farmer-turned-green-burial-activist-and-expert. She remembers first feeling disconnected from standard funerals when her father died in 2000. She stared at the vinyl carpet covering his deep concrete vault and wondered what all the trappings of her dad’s Catholic service were for.
“The idea of ‘dust to dust’ seemed to be missing,” Kelly remembers. “Even though we were standing at the grave saying those words, we were not living those words.”
After moving back to the Hudson Valley in 2002, Kelly joined Rhinebeck’s cemetery advisory committee. She hoped to create options for people who wanted highly personal burials that connected to the earth. Since then, Kelly has positioned the Rhinebeck natural burial ground at the forefront of a growing international movement to reclaim death by bringing back burial traditions that are more environmentally friendly, more personalized, and more connected to place.
In 2015, Kelly wrote Greening Death, the definitive book on the grassroots efforts behind the movement. “The impetus has been to make death more environmentally minded, less resource-intensive, and less polluting,” she says. “And to tie us back to the land.”
While Stiles Najac buried her partner in March, she found that the Rhinebeck ground gave her an unexpected peace. Najac was nine months pregnant with their son when her partner, Souleymane Ouattara, died by suicide last fall. Six months of bureaucratic complications followed before Najac could lay him to rest. (A medical examiner stored Ouattara’s body in a cooler, a common preservation method before natural burials.) Ouattara was an Ivory Coast native, and his Muslim family wanted Islamic “dust to dust” burial traditions, which typically eschew vaults.
So on a crisp day, Ouattara’s friends and family traversed the burial ground’s muddy lane to a chosen spot in the sun. They lowered his body into the ground using straps.
“It added another level of connection,” Najac says. “People actually returned him to the earth.”
As sunlight flickered through the branches, each mourner had a chance to speak. Ouattara’s uncle had plainly felt the stigma of a family suicide. As the service went on, Najac watched his demeanor change. His nephew was still beloved.
Afterward, though lunch was waiting, everybody lingered. “We were nestled in the trees, which create warmth on even the coldest day,” Najac remembers. “I had that feeling of comfort and acceptance. This was nature’s home.” She plans to bring their exuberant baby son, Zana, to picnic in the woods with friends in the warmer months near his dad.
Since the Civil War, American death rituals have become increasingly elaborate, complete with artificial embalming, concrete vaults, and satin-lined metal caskets. But in 1963, writer Jessica Mitford’s witty exposé of the funeral industry, The American Way of Death, sold every copy the day it was published. (Spoiler: Plenty of material is wasted along the way, but lavishly buried bodies still decay, perhaps even more spectacularly than their pine-boxed counterparts.) The book changed the way Americans thought about funerals and contributed to the growth of cremation rates, from 2% then to more than 50% today.
Still, cremation has limitations in both cost and impact. In 2017, the median cost of an American funeral with viewing and vault was $8,755, according to the National Funeral Directors Association. The median cost of a comparable cremation wasn’t dramatically less, at $6,260.
In the age of climate change, environmental concerns have also prompted more people to cremate. For example, a conventional burial contributes to the production of about 230 pounds of CO2 equivalent, according to Sam Bar, quality assurance and manufacturing engineer at Green Burial Council, a California-based nonprofit that advocates for “environmentally sustainable, natural death care.” But burning isn’t as eco-friendly as many assume. Cremation relies on fossil fuels, produces about 150 pounds of CO2 per body, and releases mercury and other byproducts into the air. Burning one body is equivalent to driving 600 miles. And scattering “cremains” isn’t good for soil.
Then a couple decades ago, activists on both sides of the Atlantic came up with similar alternatives to the $20 billion funeral industry: What if we returned to burial practices that allowed bodies to decompose naturally? And what if lands could be preserved in the process? The author and social innovator Nicholas Albery helped establish “woodland burials” in the United Kingdom in 1994. The first similar but independently generated concept in the United States was Ramsey Creek Preserve, established in South Carolina in 1998. Billy and Kimberley Campbell are proud that it is now a dedicated Conservation Burial Ground, with a permanent land trust agreement. “Instead of wasting land, you’re actually protecting ecologically important land,” Billy says.
Whether next to a regular cemetery or on conserved land, there are now around 218 natural burial grounds in the U.S. , up from around 100 just five years ago. The Green Burial Council certifies about one-third of them. (New Hampshire Funeral Resources, Education & Advocacy keeps a longer list that includes grounds not certified by the Green Burial Council, while other burial sites remain unreported.)
The Green Burial Council holds dual nonprofit status: a 501(c)(6) that certifies grounds and a 501(c)(3) that conducts education and outreach. The organization formed in response to the growing green burial movement and has since become the standard bearer of, and leading authority in, the U.S. movement. That’s no mean feat, given the divisions of purpose that have fragmented the nascent industry in the past. Lee Webster, director of the Green Burial Council’s education and outreach arm, says parts of the early movement were “very elitist,” and there is still a lot of confusion around terminology and standards.
The Green Burial Council currently has three certification standards for green-burial grounds. Certified “hybrid cemeteries” are modern cemeteries that reserve space for burials without embalming or concrete vaults (each year, burials in the U.S. use more than 827,000 gallons of dangerous chemicals and 1.6 million tons of concrete, materials that can be toxic to produce and damaging to the environment). Certified “natural cemeteries” prohibit the use of vaults and toxic chemical embalming. And certified “conservation burial grounds” meet the other requirements of hybrid and natural cemeteries plus establish a land trust that holds a conservation easement, deed restriction, or other legally binding preservation of the land.
Webster spent three years on the Green Burial Council board through 2017 and returned earlier this year to help steer education and outreach. “Because of the myth people have been sold about vaults and caskets, we have to reeducate people on the safety of bodies being buried in the ground without all the furniture,” she says.
The Council updated its standards this spring to better align them with land trust and land management conservation practices. Establishing a land trust for a burial ground lends legitimacy to what’s still a niche movement, in addition to preserving the land and creating a potential revenue stream—crucial at a time when cemetery funding is short (in large part because increasing U.S. cremation rates have cut burial-plot revenues).
As private and municipal-run burial grounds fill up, they can’t keep adding bodies, which means they have to dip into endowments to fund operations, Webster says. It’s not uncommon for a private cemetery to be abandoned when it runs out of money, at which point a nearby municipality often takes over, stretching funds even thinner.
To advocates like Webster, land conversation is the future of green burial. “The way it’s been approached has been to see it from a cemeterian’s point of view rather than a conservation point of view,” she says. “We’re going back now to encourage more land trusts to participate in this and understand how burial can be a conservation strategy.”
Others are going even further. In May, Washington became the first state to legalize body composting as an alternative to cremation or casket burial, a process pioneered by the Seattle-based company Recompose. Other companies offer still more unusual methods of handling human remains: You can have your body mummified, dissolved in water and lye, buried in a pod and planted with a tree, “promessed” (frozen, vibrated into dust, dehydrated, and reintegrated into soil), or put into the ground with a burial suit embroidered with mushroom-spore thread.
Webster believes that body composting and other methods of reintegrating human remains into the environment are “the answer” for urban settings, where burial space is increasingly scarce. So why keep advocating for natural burial grounds like the one in Rhinebeck? It’s the potential they hold for land conservation that’s exciting, she says, and remembrance ceremonies can become new ways to engage with the land.
On the day we visited the Rhinebeck natural burial ground, two people bicycled on the pathway through the woods. Although they’d heard the site was a cemetery, they were using it as they’d use any public park.
“Conservation is about people needing and caring for land,” Webster says. “They’re going to conduct life-affirming activities: Getting married there, baptisms, confirmations, bird-watching, hiking, family picnics—all kinds of things are happening in these spaces because they’re conservation spaces first. That’s the value of it.
“It’s not just that we’re going to put people in the ground without concrete. It’s about the big picture and how it affects people, the way we relate to death but also the way we relate to each other in life.”
There is disagreement within the movement on how best to grow. The values driving green burial suggest there should be more conservation cemeteries, but to meet that standard usually requires starting a new cemetery rather than converting or hybridizing an existing one. That costs a lot of money and requires securing new land and going through a complicated zoning process. To date, the Green Burial Council has certified only six conservation cemeteries in the U.S., compared to 35 hybrid cemeteries.
Cynthia Beal, of the Natural Burial Company in Eugene, Oregon, is a vocal proponent for converting existing cemeteries to natural burial spaces. That averts the zoning issue and provides an educational opportunity for the community.
“If you’re coming into a situation where the cemetery has been abandoned or poorly cared for and you make natural burial its new focus, you’re likely to have neighbors as advocates, happy to see the grounds renewed and the place cared for again,” Beal says. “Every cemetery is unique, telling its own stories of a community’s establishment and growth, and that history is also worthy of stewardship.”
Webster, for her part, is pragmatic about the challenge: While it would be great for more conservation cemeteries to come online, practices at local cemeteries should be improved in the meantime. That would also increase education and access.
“A sense of place is critically important to this,” she says. “I’m not going to [be driven] 300 miles to be buried in a green cemetery. My family is going to associate me with here, where we lived.”
Even in places like Rhinebeck that build at least partly on existing cemetery infrastructure, establishing green-burial sites takes time. Ramsey Creek Preserve was easier, Kimberley Campbell says, because South Carolina didn’t bother regulating. “I called down to the funeral board and got a delightful secretary,” Kimberly remembers. “She said, ‘The cemetery board has shut down. … I think what you are doing sounds marvelous, and there is absolutely nothing to stop you.’”
For Rhinebeck administrator Kelly, using municipal land didn’t require raising the $50,000 in trust for upkeep that is standard in many places. Still, it had to be planned, bid, surveyed, plotted, and certified, which took around five years.
The payoff of a natural burial ground can be big for a community. Gina Walker Fox, a Rhinebeck real estate agent, says she feels more comfortable with death for having bought a plot. (At 61, she recently asked a local quilter to sew her a raw-linen shroud, which she plans to embroider with a symbolic river.) Fox’s plot is near a blackcap raspberry bush she knows her adult children will want to visit.
“That old way—where people pick berries, sit, visit, picnic—that speaks to me,” she says.
Kelly laughs when we ask where she’ll be buried. She hasn’t picked or purchased a spot yet. Even a green-burial activist can feel like she has plenty of time to live.
“Once in a while,” she says, “I come by here and think I should probably get around to getting a plot.”
With respect to end-of-life care, physicians’ likelihood of dying at home is similar to that of nonphysician patients, a Canadian study suggests.
“Overall, they did not consistently opt for less-aggressive care but instead used both intensive and palliative care more than nonphysicians,” Hannah Wunsch, MD, from the University of Toronto, Canada, and colleagues write in an article published online July 24 in JAMA Network Open.
Intensive end-of-life treatment is common in North America, often going against patients’ previously reported preferences. Previous studies have suggested that physicians in the United States are somewhat less likely to die in the hospital than other patients, suggesting they may be better able to match their care with their preferences.
To see if that pattern held true in a system with universal healthcare, Wunsch and colleagues compared the intensity of treatment received by physician and nonphysician patients at the end of life in Ontario, Canada.
“The primary outcome was location of death, with the hypothesis that physicians are more likely to receive less-intensive end-of-life care,” the authors write.
The researchers analyzed medical and death records of 2507 physicians and 7513 nonphysicians who died between 2004 and 2015.
They found that physicians were no more likely to die at home than nonphysicians (42.8% vs 39%; adjusted relative risk [aRR], 1.04; 95% confidence interval [CI], 0.99 – 1.09). However, physicians were more likely to die in an intensive care unit (ICU) (11.9% vs 10%; aRR, 1.22; 95% CI, 1.08 – 1.39).
The data also showed that, in the 6 months before death, physicians were less likely to visit an emergency department (73% vs 78.4%; aRR, 0.96; 95% CI, 0.94 – 0.98), but more likely to be admitted to an ICU (20.8% vs 19.1%; aRR, 1.14; 95% CI, 1.05 – 1.24), and to receive palliative care (52.9% vs 47.4%; aRR, 1.18; 95% CI, 1.13 – 1.23).
However, a subgroup analysis of patients with chronic conditions showed that physicians (n = 1375) were more likely to die at home than nonphysicians (n = 4117) (35.2% vs 30.7%; aRR, 1.12; 95% CI, 1.04 – 1.22). Among those with cancer in this subgroup, physicians were also more likely to die at home (37.6% vs 28.6%; aRR, 1.30; 95% CI, 1.13 – 1.50), and to receive chemotherapy in the last 6 months of life (37.9% vs 29.8%; aRR, 1.28; 95% CI, 1.13 – 1.46).
In an interview with Medscape Medical News, study coauthor Robert A. Fowler, MDCM, MS(Epi), also from the University of Toronto, was struck by how his group’s findings differed from the US studies.
“We wondered whether this might relate to differences in payment systems for healthcare services in the United States, in comparison to Canada where we have a theoretically universal healthcare system for in-hospital care, yet often have more limited options for home-based and palliative care at end of life.”
Overall, Fowler expressed surprise at the findings of both the US and Canadian studies — “chiefly, that many elements of end-of-life care are, despite some differences, remarkably similar among physicians and the general population.”
This was different from his group’s original hypothesis that physicians would opt for much less inpatient care.
“It was interesting that we did see that physicians were both more likely to receive treatment in an ICU, known for its use of technology-laden care,” he added, “and also more likely to receive palliative care at the end of life.”
According to Fowler, this offers a more nuanced perspective of what physicians may perceive to be optimal care at the end of life, as opposed to a simplistic notion of ‘more’ or ‘less’ being better: “Sometimes, more aggressive care is warranted,” he said, “yet, at other times, focusing more squarely on comfort is best.”
Rachel O’Neill knew her mother had terminal cancer, but there was never a timeline put on it
by Rachel O’Neill
I’ve six months to live.”
Five words that turned my life upside down.
I always knew that terminal cancer was something I would have to deal with. But because there was never a timeline put on it, it was something I didn’t have to think about. Sure, Mum had incurable cancer, but it wasn’t something that was going to affect me right this second.
And then suddenly it was there, affecting every part of my life.
In the time it took to say those five little words, my entire status changed. I was no longer someone whose mother was sick, I was someone whose mother was dying. Life as I knew it was officially on pause.
Suddenly, the “how’s your Mum doing?” questions become a lot harder to answer. I’m a very open person which means everyone tends to know everything that goes on in my life. I’m also a terrible liar. If someone asks me how Mum is doing, I will answer it very honestly. So honestly, that it can make people uncomfortable. I’ve had people squirm after I’ve told them that Mum is dying. I’ve had people shuffle awkwardly from foot to foot, desperately thinking of something to say that won’t upset me or them.
Now I’ve adopted a very simple tactic to counteract the awkwardness. I minimise what’s going on by joking about it instead.
Minimise, minimise, minimise.
Never let people see how badly you are struggling with it. I must never drop the facade that I’m managing to hold it together when in reality this is the worst thing I’ve ever had to face.
To make people comfortable, I tell them that my mother is dying and follow it with a quick “it’s fine”. I’ve joked about how I might finally be able to get on the property ladder with the inheritance. I quickly change the subject when I can feel people getting nervous, even if I’m bursting to talk about what’s happening. I’ve done everything I can to make people feel more comfortable around me because if I can joke about it, it means they can relax a little.
Nobody is truly comfortable with death.
Despite the fact that we “do death well” in Ireland, it’s still a subject that many of us won’t talk about. Confronting the fact that someday, we will cease to be here is something we’ll spend a lifetime trying to come to terms with. Many of us never do.
Knowing that myself and Mum have so little time left together is hard. I am terrified of regret, of saying the wrong thing, of not asking the right questions, of not making enough of our time together. It now feels like every conversation feels like it has to be meaningful in some way. I feel like if a moment with her isn’t memorable, I’ve wasted it. It’s a suffocating pressure to be under.
What has stood out to me is the endless kindness I’ve experienced from every corner of my life
The pressure manifests itself in many ways. For example, I’ve been in a perpetual state of anticipatory grief for the last few months. I’m grieving the life we won’t have together. I’m grieving that she won’t see me get married or meet her grandchildren. I’m grieving the advice she won’t be able to give me, the questions I won’t be able to ask her and the adventures she will never get to have.
That is a very painful process which your body does everything to protect yourself from. I’m constantly tense because I’m bracing myself for an impact that I know is coming, despite not being sure when it’ll hit. I feel like if I can process this pain now, it won’t be as painful when the inevitable comes. It’s the only way I know how to prepare for what’s coming.
Some people struggle to understand my approach. Some have even said to me that I need to move past the grief. They’ve said that my mum needs me to be upbeat and strong for her. To me, that feels fake. Anxiety and depression are in my DNA so worrying about the future and being down about it are things I’m very used to doing. It’s a coping mechanism that some people just don’t understand. They feel that I’m doing Mum a disservice, that I should pretend to be okay when in reality I am struggling badly with everything that’s happening. What I say to those people is that there’s no “right” way to grieve. It’s a uniquely personal process, best left to those undergoing it.
What has stood out to me over the past few months is the endless kindness I’ve experienced from every corner of my life. People offering food, time, shoulders to cry on and a kind ear to listen. People encouraging me to open up when I can and who treat me like a normal human being when I can’t. The empathy and kindness have been utterly overwhelming but serves as a reminder that people really do care. It gives me hope that when I come out the other side of this, I’ll have people who will help me build myself back up again.
Having discussed with Mum what happens when this is all over, she told me something that I’ll hold dear to my heart forever.
“Just let yourself be loved. It’s no more than you deserve and always carry with you that you are my beloved child. Always and forever.”
No matter what happens, a mother’s love lasts forever.
We Americans love to compete. We bet in March Madness office pools on who will win the annual college basketball championship. We pay a pretty penny for the best manicured lawn in the neighborhood or the biggest flat screen in the condo. Some of us will pay bribes to get our kids into the best colleges.
And, now it seems, there is a growing need to compete over who will have the best death. You know, the one where we are at home, pain-free but alert, surrounded by our loving families, singing our favorite songs, fully at ease with our last moments of mortal life.
For many of us, the reality will be quite different. Despite everyone’s best efforts, we may die in a hospital. The kids may not make it in time from their homes in LA or Chicago. The medications that relieve our pain may also slow our thinking. And we may not have resolved all those family issues that lingered inexplicably for decades.
What’s troubling about this drive for a good death (or, perhaps in our competitive world, the best death) is that many of us never will achieve it—often for reasons out of our control. And that may leave our surviving loved ones with an even bigger sense of guilt than they already have. And paradoxically, those who cared the most may end up feeling the most guilty and depressed.
Failing at some ideal of death may even make dying more difficult. Dr. Andreas Laupacis, a palliative care physician and professor of medicine at the University of Toronto, shared this concern in a wise 2018 essay about the idea of good death: “I worry that the term makes people who die with pain or psychological distress think that it is partially their fault…. They haven’t tried hard enough or aren’t tough enough.”
He even suggests it may add to the psychological burden of their doctors: “I worry that health care practitioners who have provided their best possible care will feel inadequate.”
A good life
Just as troubling: An excessive focus on the last hours of life shifts attention from the months or even years before that. Many older adults will die after living a long time with chronic conditions. It would be nice, as we focus on a good death, if we also think about a good life, especially during the time when it may include some level of disability.
The idea of competitive dying may be counterproductive in part because there is no true good death. Or rather, there are millions of them. For decades, clinicians have tried, and largely failed, to establish some agreed-upon norms. And researchers have no real idea how many people do in fact die a good death, by whatever measure.
Physicians and surviving family members, it turns out, often have different ideas of a good death than those who are doing the dying. For example, family members are much more likely than patients to say that maintaining dignity is important at the end of life.
But this uncertainty isn’t slowing us down. Google “good death” and you’ll get 1.97 million hits. Search Amazon, and you’ll find dozens of books. Bloggers blog on their own impending deaths or that of their relatives. A 2016 literature review turned about three dozen peer reviewed articles on what constitutes “successful dying.”
Better to watch a sunset
One Amazon reviewer wrote that she had read 60 books on a good death to prepare for her own passing. I don’t know if she was living with a terminal disease or just thinking way ahead. But I can’t help but wonder if her time would have been better spent watching a sunset, going to a concert, or having dinner with friends instead of being so focused on how to do death right.
This trend is by no means all bad. We are thinking—and talking—about a topic that for too long has been taboo in the US. But like those parents who were bribing college officials to get their children into the best schools, we may be going overboard. And we may be setting unrealistic, and counterproductive, expectations for ourselves and our families.
We absolutely should be proactive when it comes to preparing advanced directives, choosing health care proxies, and talking to one another about death. Especially talking. But we also need to recognize that, sometimes, circumstances mean that many of us will die alone, or in some pain, or with unresolved family issues. All we can do is our best. And nobody should be keeping score.
Toni Morrison is dead. So are D.A. Pennebaker and Aretha Franklin, and Philip Roth, Stephen Hawking, Ursula K. Le Guin, Milos Forman and too many others to name, even when limited to artists and writers who have perished in the past few years alone. By some accounts, two people die every second, thousands every hour, tens of millions every year. But at this moment in American life, the death of our best people has become a collective lifeline and refuge for our anxieties. It sometimes seems that the obituary is the only news that makes us feel whole.
Morrison was our essential conscience, a writer of narrative brilliance and moral clarity. The magnitude of her loss, at this moment in our descent into barbarism, is incalculable. But to spend time today with her work, with memories of her life and the testimony of those who knew her, is infinitely more rewarding than reading about all the other terrible things that have happened in the past few days. The deaths of artists and other creators make us reflective, and we live at a moment when looking back is much easier than looking forward.
We also crave the reassurance that we are not, as a species, entirely spent. Morrison died only days after two mass shootings, which are not only a regular fixture of American life, but also a recurring reminder of our political paralysis and the corruption of our democracy. We are in the midst of a trade war, markets have plunged, Greenland is hemorrhaging ice and our president tweets racism to inflame a hungry audience of white nationalists who dream of a world without people like Morrison in it.
Death and remembrance, at least, come with the customs and norms that have been shredded in most of the rest of public life. If nothing else, death still inspires a pause in ordinary life and, in the case of artists, a respectful consideration of their habitually ignored accomplishments. The reflective look back on a life and a body of work such as Morrison’s is ultimately celebratory, a chance to think the best of another person and, by extension, ourselves. Artists, performers, scientists, writers and other creators rarely “make news” in the same way politicians do, even though their influence on our culture is greater, deeper and more meaningful. The obituary is a belated observation and acknowledgment that people like Morrison, in fact, made news every day through their work. They formed the deeper part of the minds that our pollsters seek to measure and quantify in the frenzied haste of the news cycle. They are the atmosphere of American culture, while all else is merely weather.
Obituaries are a paradox of sorts, a distraction toward meaningfulness, a diversion to what really matters. The response to the rest of the news is often an impulse to escapism, a turning away. But while Morrison shares space with the usual firehouse of bad news, her passing offers at least one impulse to go deeper, to read more, dig in, think more critically and disconnect from the ephemera. Obituaries like the ones that have been written about her in the past day are even better than the usual “good” news, which is often little more than a reminder that somewhere, somehow, someone has done an unnecessary kindness; obituaries are redemptive on a grander scale.
We seem capable of only two modes of existence: panic and sadness, the former fast-paced and full of collateral damage to the world around us, the latter at least sometimes constructive and reflective. America has experienced periods of intense reflection around death in the past, as when the last remaining veterans of the Revolutionary War were dying in the middle of the 19th century, leaving people to wonder whether there were any steady voices and clear heads to steer us away from, or through, the accumulation of civil strife and political violence. The deaths of those who fought in World War II offered an occasion to think about the fraying of the old 20th-century social contract, the dissolution of the bond between the generations enshrined in key social-welfare programs, and the extinction of American optimism — that we might live in a society without poverty, without unnecessary suffering, with genuine opportunity and social mobility.
But the death of an artist is different from the loss of political leaders, no matter how wise or benevolent, or the larger passing of a generation, which has continued since the beginning of time. Morrison’s work remains with us, intractable, urgent and uncompromising, and it is no less effective today than it was on Monday. It is curious to listen to people on television debating the effectiveness of this policy or that plan, often arguing themselves into the absurdity that because nothing has yet worked, therefore nothing new should be attempted.
Meanwhile, the work of artists outlives them, operating on minds too young to be cynical. Politicians die and, if they’re lucky, are memorialized for having fixed something in the broken world they inherited. Artists die, and we flock to what they left behind, reanimating it, refreshing its meaning and reincorporating it into the body politic.
If you want to change the world, authentically and for the better, would you live your life like a politician, or a businessman, or a pharmaceutical executive or Donald Trump? Or would you live it like Toni Morrison?