The Life Matters Media Connection, Part 2

I am delighted to announce that I will be contributing a second monthly column on the prestigious Life Matters Media website.

 

 

Life Matters

 

 

This column will be titled:  Relationships and Intimacy.  Here’s what I have to say about it:

 

The medicalization of dying, in hospitals, in extended care facilities and even in hospice, often leaves little room for the most human of experiences—intimacy. And yet being close to those we love—being able to touch and be touched, as well as having the privacy we need to express our feelings—are essential elements to living a good and wise death.

The sea change taking place in the popular culture, with regards to sexual minorities, people with disabilities, as well as seniors and elders, may not always be reflected in the way we care for those at the end of life. Conscious dying is virtually impossible if those around us are insensitive to our intimacy needs. And the truth is, this is just as pressing a concern for people in traditional relationships as it is for those in non-traditional relationships.

To find the inaugural column, titled — It Never Entered My Mind, look HERE!

The Good Death

By Robert Kastenbaum

What is the good life? Most people would prefer health to illness, affluence to poverty, and freedom to confinement. Nevertheless, different people might have significantly different priorities. Is the good life one that is devoted to family affection or individual achievement? To contemplation or action? To safeguarding tradition or discovering new possibilities? There is a parallel situation in regard to the good death. Not surprisingly, most people would prefer to end their lives with ease of body, mind, and spirit. This unanimity dissolves, however, when one moves beyond the desire to avoid suffering. Societies as well as individuals have differed markedly in their conception of the good death. The long and eventful history of the good death has taken some new turns at the turn of the millennium, although enduring links with the past are still evident.

Santa MuerteDying is a phase of living, and death is the outcome. This obvious distinction is not always preserved in language and thought. When people speak of “the good death,” they sometimes are thinking of the dying process, sometimes of death as an event that concludes the process, and sometimes of the status of “being dead.” Furthermore, it is not unusual for people to shift focus from one facet to another.

Consider, for example, a person whose life has ended suddenly in a motor vehicle accident. One might consider this to have been a bad death because a healthy and vibrant life was destroyed along with all its future possibilities. But one might also consider this to have been a good death in that there was no protracted period of suffering. The death was bad, having been premature, but the dying was merciful. Moreover, one might believe that the person, who is now “in death,” is either experiencing a joyous afterlife or simply no longer exists.

It is possible, then, to confuse oneself and others by shifting attention from process to event to status while using the same words. It is not only possible but also fairly common for these three aspects of death to be the subject of conflict. For example, the controversial practice of physician-assisted suicide advances the event of death to reduce suffering in the dying process. By contrast, some dying people have refrained from taking their own lives in the belief that suicide is a sin that will be punished when the soul has passed into the realm of death. It is therefore useful to keep in mind the distinction between death as process, event, and status. It is also important to consider perspective: who judges this death to be good or bad? Society and individual do not necessarily share the same view, nor do physician and patient.

Philosophers continue to disagree among themselves as to whether death can be either good or bad. The Greek philosopher Epicurus (341–270 B.C.E.) made the case that death means nothing to us one way or the other: When we are here, death is not. When death is here, we are not. So why worry? Subsequent philosophers, however, have come up with reasons to worry. For example, according to Walter Glannon, author of a 1993 article in the journal Monist, the Deprivation of Goods Principle holds that death is bad to the extent that it removes the opportunity to enjoy what life still might have offered. It can be seen that philosophers are talking past each other on this point. Epicurus argued that death is a matter of indifference because it is outside humans’ lived experience. This is a focus on process. Glannon and others argue that the “badness” of death is relative and quantitative—it depends on how much one has lost. This is a focus on death as event.Lucy

A World Perspective

From terminology and philosophy, one next turns to the rich heritage of world cultures as they have wrestled with the question of the good death within their own distinctive ways of life. Many of the world’s peoples have lived in fairly small groups. People knew each other well and were bonded to their territory by economic, social, and religious ties. These face-to-face societies often contended with hardships and external threats. Community survival was therefore vital to individual survival. Within this context, the good death was regarded as even more consequential for the community than for the individual.

The good death was one that did not expose the community to reprisals from angry spirits or stir up confusion and discontent among the survivors. Personal sorrow was experienced when a family member died, but the community as a whole responded with a sequence of rituals intended to avoid the disasters attendant on a bad death.

The Lugbara of Uganda and Zaire do not practice many rituals for birth, puberty, or marriage, but they become intensely involved in the funeral process. Death is regarded as an enemy, an alien force that raids the village. Nobody just dies. Much of Lugbara life is therefore devoted to controlling or placating evil spirits. The good death for the Lugbara encompasses the process, the event, and the state.

  • The Process: Dying right is a performance that should take place in the individual’s own hut with family gathered about to hear the last words. The dying person should be alert and capable of communicating, and the final hours should flow peacefully without physical discomfort or spiritual distress. The dying person has then prepared for the passage and has settled his or her affairs with family and community. It is especially desirable that a lineage successor has been appointed and confirmed to avoid rivalry and perhaps violence.
  • The Event: The death occurs on schedule—not too soon and not too much later than what was expected. The moment is marked by the lineage successor with the cre, a whooping cry, which signifies that the deceased is dead to the community both physically and socially, and that the people can now get back to their lives.
  • The State: The deceased and the community have performed their ritual obligations properly, so there is little danger of attack from discontented spirits. The spirit particular to the deceased may linger for a while, but it will soon continue its journey through the land of the dead.
  • A death can go bad when any of these components fails. For example, a person who dies suddenly or away from home is likely to become a confused and angry spirit who can become a menace to the community. A woman who dies in childbirth might return as an especially vengeful spirit because the sacred link between sexuality and fertility has been violated. The Lugbara deathbed scene shows compassion for the dying person and concern for the well-being of the community. Nevertheless, it is a tense occasion because a bad death can leave the survivors vulnerable to the forces of evil.

In many other world cultures the passage from life to death has also been regarded as a crucial transaction with the realm of gods and spirits. The community becomes especially vulnerable at such times. It is best, then, to support this passage with rules and rituals. These observances begin while the person is still alive and continue while the released spirit is exploring its new state of being. Dying people receive compassionate care because of close interpersonal relationships but also because a bad death is so risky for the community.

Google ChromeScreenSnapz012Other conceptions of the good death have also been around for a long time. Greek, Roman, Islamic, Viking, and early Christian cultures all valued heroic death in battle. Life was often difficult and brief in ancient times. Patriotic and religious beliefs extolled those who chose a glorious death instead of an increasingly burdensome and uncertain life. Norse mythology provides an example made famous in an opera by the nineteenth-century German composer Richard Wagner in which the Valkyrie—the spirits of formidable female warriors—bring fallen heroes to Valhalla where their mortal sacrifice is rewarded by the gods.

Images of the heroic death have not been limited to the remote past. Many subsequent commanders have sent their troops to almost certain death, urging them to die gloriously. The U.S. Civil War (1861–1865) provides numerous examples of men pressing forward into withering firepower, but similar episodes have also occurred repeatedly throughout the world. Critics of heroic death observe that the young men who think they are giving their lives for a noble cause are actually being manipulated by leaders interested only in their own power.

Some acts of suicide have also been considered heroic. The Roman commander who lost the battle could retain honor by falling on his sword, and the Roman senator who displeased the emperor was given the opportunity to have a good death by cutting his wrists and bleeding his life away. Japanese warriors and noblemen similarly could expiate mistakes or crimes by the ritualistic suicide known in the West as hara-kiri. Widows in India were expected to burn themselves alive on their husbands’ funeral pyres.

Other deaths through the centuries have earned admiration for the willingness of individuals to sacrifice their lives to help another person or affirm a core value. Martyrs, people who chose to die rather than renounce their faith, have been sources of inspiration in Christianity and Islam. There is also admiration for the courage of people who died at the hands of enemies instead of betraying their friends. History lauds physicians who succumbed to fatal illnesses while knowingly exposing themselves to the risk in order to find a cause or cure. These deaths are exemplary from society’s perspective, but they can be regarded as terrible misfortunes from the standpoint of the families and friends of the deceased.

The death of the Greek philosopher Socrates (c. 470–399 B.C.E.) shines through the centuries as an example of a person who remained true to his principles rather than take an available escape route. It is further distinguished as a death intended to be instruction to his followers. The good death, then, might be the one that strengthens and educates the living. The modern hospice/palliative care movement traces its origins to deaths of this kind.

With the advent of Christianity the stakes became higher for the dying person. The death and resurrection of Jesus led to the promise that true accepting deathbelievers would also find their way into heaven—but one might instead be condemned to eternal damnation. It was crucial, then, to end this life in a state of grace. A new purification ritual was developed to assist in this outcome, the ordo defunctorum. The last moments of life now took on extraordinary significance. Nothing less than the fate of the soul hung in the balance.

The mood as well as the practice of Christianity underwent changes through the centuries with the joyful messianic expectation of an imminent transformation giving way to anxiety and doubt. The fear of punishment as a sinner darkened the hope of a blissful eternity. Individual salvation became the most salient concern. By the fifteenth century, European society was deeply immersed in death anxiety. The Ars Moriendi (“art of dying”) movement advised people to prepare themselves for death every day of their lives—and to see that their children learned to focus on the perils of their
own deathbed scene rather than become attached to the amusements and temptations of earthly life. The good death was redemption and grace; everything else was of little value.

This heavy emphasis on lifelong contemplation of mortality and the crucial nature of the deathbed scene gradually lessened as the tempo of sociotechnological change accelerated. Hardships continued, but earthly life seemed to offer more attractions and possibilities, drawing attention away from meditations on death. And by the seventeenth century a familiar voice was speaking with a new ring of authority. Physicians were shedding their humble roles in society and proudly claiming enhanced powers and privileges. In consequence, the nobility were more likely to be tormented by aggressive, painful, and ineffective interventions before they could escape into death. The emerging medical profession was staking its claim to the deathbed scene. It was a good death now when physicians could assure each other, “We did everything that could be done and more.”

The Good Death in the Twenty-First Century

In the early twenty-first century, as in the past, humans seek order, security, and meaning when confronted with death. It is therefore clear that not everything has changed. Nevertheless, people’s views of the good death have been influenced by the altered conditions of life. To begin with, there are more people alive today than ever before, and, in technologically developed nations, they are more likely to remain alive into the later adult years. The most remarkable gains in average life expectancy have come from eliminating the contagious diseases that previously had killed many infants and children. The juvenile death rate had been so high that in various countries census takers did not bother to count young children. Parents mourned for their lost children then as they do now. The impact of this bad death was tempered to some extent by the knowledge that childhood was perilous and survival in God’s hands. The current expectation that children will certainly survive into adulthood makes their death even more devastating. Parental self-blame, anger at God, stress disorders, and marital separation are among the consequences that have been linked to the death of a child.

Childbirth was a hazardous experience that many women did not long survive. Graveyards around the world provide evidence in stone of young mothers who had soon joined their infants and children in death. Such deaths are much less expected in the twenty-first century and therefore create an even bigger impact when they do occur.

In the late twentieth and early twenty-first centuries, many Mexicans died while attempting to cross the desert to find employment in the United States in order to feed and shelter their families. Are these “good deaths” because of the heroism of those who risked—and lost—their lives, tragic deaths because of their consequences, or senseless deaths because society has allowed this situation to develop?

It is far more common to assume that one has the right to a long life and therefore to regard an earlier demise as unfair or tragic. Paradoxically, though, there is also more concern about not dying young. Many people remain vigorous and active through a long life. Nevertheless, gerontophobia (fear of growing old) has become a significant problem in part because more people, having lived long, now die old. Younger people often fear that age will bring them to a lonely, dependent, and helpless preterminal situation. The distinction between aging and dying has become blurred in the minds of many people, with aging viewed as a slow fading away in which a person becomes less useful to themselves and others. It is a singularly prolonged bad death, then, to slide gradually into terminal decline, in essence having outlived one’s authentic life. This pessimistic outlook has been linked to the rising rate of suicide for men in older age groups. In reality, many elders both contribute to society and receive loving support until the very end, but the image of dying too long and too late has become an anxious prospect since at least the middle of the twentieth century.

tumblr_min5gbpYVO1s11oe8o1_500Two other forms of the bad death came to prominence in the late twentieth century. The aggressive but mostly ineffective physicians of the seventeenth century have been replaced by a public health and medical establishment that has made remarkable strides in helping people through their crises. Unfortunately, some terminally ill people have experienced persistent and invasive medical procedures that produced suffering without either extending or restoring the quality of their lives. The international hospice movement arose as an alternative to what was seen as a futile overemphasis on treatment that added to the physical and emotional distress of the dying person. The hospice mission has been to provide effective symptom relief and help the dying person maintain a sense of security and worth by supporting the family’s own strength.

Being sustained indefinitely between life and death is the another image of the bad death that has been emerging from modern medical practice. The persistent vegetative state arouses anxieties once associated with fears of being buried alive. “Is this person alive, dead, or what?” is a question that adds the pangs of uncertainty to this form of the bad death.

The range of bad death has also expanded greatly from the perspective of those people who have not benefited from the general increase in life expectancy. The impoverished in technologically advanced societies and the larger part of the population in third world nations see others enjoy longer lives while their own kin die young. For example, once even the wealthy were vulnerable to high mortality rates in infancy, childhood, and childbirth. Many such deaths are now preventable, so when a child in a disadvantaged group dies for lack of basic care there is often a feeling of rage and despair.

A change in the configuration of society has made it more difficult to achieve consensus on the good death. Traditional societies usually were built upon shared residence, economic activity, and religious beliefs and practices. It was easier to judge what was good and what was bad. Many nations include substantial numbers of people from diverse backgrounds, practicing a variety of customs and rituals. There is an enriching effect with this cultural mix, but there is also the opportunity for misunderstandings and conflicts. One common example occurs when a large and loving family tries to gather around the bedside of a hospitalized family member. This custom is traditional within some ethnic groups, as is the open expression of feelings. Intense and demonstrative family gatherings can unnerve hospital personnel whose own roots are in a less expressive subculture. Such simple acts as touching and singing to a dying person can be vital within one ethnic tradition and mystifying or unsettling to another.

Current Conceptions of the Good Death

The most obvious way to discover people’s conceptions of the good death is to ask them. Most studies have focused on people who were not afflicted with a life-threatening condition at the time. There is a clear preference for an easy death. The process should be mercifully brief. Often people specify that death should occur in their sleep. Interestingly, students who are completing death education courses and experienced hospice care-givers tend toward a different view. When their turn comes, they would want to complete unfinished business, take leave of the people most important to them, and reflect upon their lives and their relationship to God. These actions require both time and awareness. Drifting off to sleep and death would be an easy ending, but only after they had enough opportunity to do what must be done during the dying process.

Women often describe their imagined deathbed scenes in consoling detail: wildflowers in an old milk jug; a favorite song being played; familiar faces gathered around; a grandchild skipping carefree in and out of the room; the woman, now aged and dying, easy in mind, leaving her full life without regrets. Conspicuous by their absence are the symptoms that often accompany the terminal phase—pain, respiratory difficulties, and so on. These good deaths require not only the positives of a familiar environment and interpersonal support but also a remarkably intact physical condition. (Men also seldom describe physical symptoms on their imagined deathbed.) Men usually give less detailed descriptions of their imagined final hours and are more likely than women to expect to die alone or suddenly in an accident. The imagined good death for some men and a few women takes place in a thrilling adventure, such as skydiving. This fantasy version of death is supposed to occur despite the ravages of a terminal illness.

What is the good death for people who know that they have only a short time to live? People dying of cancer in the National Hospice Demonstration study conducted in 1988, explained to their interviewers how they would like to experience the last three days of their lives. Among their wishes were the following:

  • I want certain people to be here with me.
  • I want to be physically able to do things.
  • I want to feel at peace.
  • I want to be free from pain.
  • I want the last three days of my life to be like any other days.

This vision of the good death does not rely on fantasy or miracles. It represents a continuation of the life they have known, and their chances of having these wishes fulfilled were well within the reality of their situation. Religion was seldom mentioned as such, most probably because these people were secure in their beliefs.

Society as a whole is still reconstructing its concepts of both the good life and the good death. Studies suggest that most people hope to be spared pain and suffering, and to end their days with supportive companionship in familiar surroundings. Dramatic endings such as heroic sacrifice or deathbed conversion are seldom mentioned. There are continuing differences of opinion in other areas, however. Should people fight for their lives until the last breath, or accept the inevitable with grace? Is the good death simply a no-fuss punctuation mark after a good life—or does the quality of the death depend on how well people have prepared themselves for the next phase of their spiritual journey? Questions such as these will continue to engage humankind as the conditions of life and death also continue to change over time.

Complete Article HERE!

The Life Matters Media Connection

I am delighted to announce that I will be contributing a monthly column on the prestigious Life Matters Media website.

 

 

Life Matters

 

 

This column will be titled:  Managing Our Mortality.  Here’s what I have to say about it:

 

We are notorious for ignoring and denying death; we keep death out of sight and out of mind, postponing any serious considerations until death comes knocking at our door. This inevitably leaves us unprepared and frightened as we face our own mortality. We seldom get around to asking ourselves; “Will my death be good? Will it be wise? Will it matter?”

Death is not only a universal fact of life, part of the round of nature; but it’s also a necessary part of what it means to be human. Everything that we value about life and living—its novelties, challenges, opportunities for development—would be impossible without death as the defining boundary of our lives. So planning for the inevitable, especially when death is not imminent, is important work for us all.

To find the inaugural column, titled — A Student Of Death, look HERE!

Live As If You Are Dying

I’m delighted to share with you a new review of The Amateur’s Guide To Death And Dying. It appears on the blog of Licensed Mental Health Counselor, Mandy Traut.

Mandy Traut

Just like the famous Tim McGraw song, I good friend of mine recently reminded me to “live like I was dying.” Many of you know that I was a recent guest on Dr. Dick’s Sex Advice: Sex Advice with an Edge (Sex Wisdom Show). Well, my association with “Dr. Dick” (AKA Dr. Richard Wagner) developed into a good friendship. I see him as a role model and mentor. So, I was quite privileged when he asked me to review his new book, “The Amateur’s Guide to Death & Dying: Enhancing the End of Life.”

Richard is, not only a renowned sexologist – Board Certified by the American College of Sexologists, The American Board of Sexology, and The American Association of Sex Educators, Counselors and Therapists, he is the founder and former Executive Director of the nonprofit organization, PARADIGM; “Enhancing Life Near Death — an outreach and resource for terminally ill, chronically ill, elder and dying people.”AGDD_front cover

His book, “The Amateur’s Guide to Death & Dying: Enhancing the End of Life,” is developed to be a workbook for terminally ill patients going through the process of dying. But, the reader realizes early on that one need not be terminally ill to follow the exercises. As Richard reminds us, we all die at some point. Richard introduces the concept of “proactive dying,” referring to an attitude whereby one addresses one’s mortality head-on. Richard illustrates how honest discussions, education and preparation, and support from family and friends, can really benefit all of us. Rather than present a typical workbook with a sequence of exercises, Richard has adapted his own workshop, associated with PARADIGM INC, into written form! You, the reader, become a participant in his workshop as you explore questions of mortality, loss, sickness, and isolation. Eventually, you and your fellow participants come to see death as a part of life.

Whether going through the group process of exploring various issues, listening to presentations on preparing Estates and Advanced Directives, or discussing the stigma of talking about death and dying in the first place, the reader gets to reflect on his/her own thoughts and feelings about death and learns how to be prepared for end-of-life concerns. Richard normalizes death in the most compassionate, authentic, and empathic way. I appreciated that he, as a facilitator, found a balance between professionalism and disclosing his own personal stories, fears, hopes, and dreams to the group. Additionally, reading his book, I, not only reflected on my own fears related to death, but I strangely began to relate and befriend the other participants in the group. I felt as if I were walking the journey with them. It was humbling and moving, as well as educational and informative.

As the group workshop was coming to an end one of the participants read a poem with the theme of “live as if you are dying.” As I read (imagining myself in the room with everyone else), tears welled up in my eyes. By now, I knew the group members pretty well. I empathized with their fears, their anger, and their sense of loss. Then, I thought of my own life and relationships. Inwardly, I thought, “How often do we go through life on automatic?” It is true: Like sleep-walkers, we miss the little moments that make life precious. It takes a terminal illness or a traumatic event to wake most of us up!

In the end, I completed “The Amateur’s Guide to Dying” with several take-aways: To my readers and clients alike, I hope that you can ponder these ideas and see how they fit in your own lives.

1) It is smart to explore your end-of-life wishes while you are healthy and can make these important decisions.

2) Live as if you are dying – do not take one breath – one hug – one smile – for granted. After all, sometimes death comes when we least expect it.

3) Honor and cultivate your relationships – our relationships are at the core of a meaningful, worthwhile life.

One last word: Thank you, Richard for sharing such a fresh, revolutionary perspective with the rest of us. This is not an easy subject for most of us to swallow.

Complete Article HERE!

Passing thoughts at L.A.’s first Death Cafe

Life’s end is a conversation-starter at Betsy Trapasso’s Topanga Canyon home, where there is no point of view beyond the broad notion that death deserves discourse.

BY NITA LELYVELD

If you’re going to talk about a subject most people don’t want to talk about, why not do so over tea and cake and cookies?

Why not gather in a sunny living room looking out on a lush tangle of green, where you can watch the breeze ruffle the leaves on the trees as you eat forkfuls of blueberry tart?

1393224_ME_deathcafe__Death comes to each of us, to everyone we love. Couldn’t talking about it in a safe, comfy setting make the prospect less frightening?

This is what Betsy Trapasso thinks. This is why she’s asked friends to come — why on a Sunday afternoon, they’ve braved Topanga Canyon’s twists and turns and climbed the dozens of wooden steps to her end-of-a-rural-road front door.

Together, they will make history at Los Angeles’ first Death Cafe.

Ever since a fellow named Jon Underwood held his first Death Cafe a year and a half ago in the basement of his London home, they’ve been popping up all over the globe.

His website lists numerous U.S. outcroppings — in Gig Harbor, Wash., and Searsport, Me.; in Ann Arbor, Mich., and Cleveland.

There’s no agenda. No profit motive. No point of view beyond broad notions: that death deserves discourse, and that facing it without angst can help people live their lives more fully.

“It’s not a support group. It’s not a grief group,” Trapasso says. “My whole thing is to get people talking about it so they’re not afraid when the time comes.”

To her house come an eclectic bunch, including a graphic artist, a psychologist, a film director, an LAPD sergeant and an actor/producer who wishes to remain anonymous and carries his white Maltese, Blossom, in his shoulder bag.

They gather in a loose circle — on a couch, in chairs, on the floor.

Trapasso is lithe, with flowing brown hair, a moon face and large, intense blue eyes. When she was a baby, those eyes won her the nickname “Spooky,” which stuck.

With those eyes, her friends say, the end-of-life guide is able to ease people’s last moments on Earth.

Because this is Topanga, Trapasso bangs a drum to begin the discussion. Then she passes around a vial of lavender oil and asks people to breathe it in deeply and relax.

Death makes people nervous. Trapasso understands this.

But death has been her life.

The first U.S. hospice, she tells her friends, came to her hometown of Branford, Conn., in 1974. Her grandfather, as mayor, pushed for it and took Trapasso to meetings.

She came west to USC to get her master’s in social work. After graduating, with a Thomas Guide in her lap, she learned Los Angeles — “every neighborhood and every culture and every race, the richest of the rich and the poorest of the poor”— by bringing comfort to the dying as a hospice social worker.

“The first person I ever saw dead was my grandmother,” says Dori Fisher. “She never wore makeup, but she was all made up and she was wearing something she would never wear. I said: ‘That’s not my grandmother.'” (Anne Cusack / Los Angeles Times) More photos

Now, she says, she wants to retrace that journey, carrying with her to venues all over L.A. a profound, floating conversation.

Trapasso says she also plans to make a documentary on how other cultures integrate death into life.

One of her partners, Leszek Burzynski, a British-born director, says America needs to learn to do this better.

“In a funny way, in our culture death is seen as a postscript, whereas in other cultures death is seen as a chapter in a continuation.”

That’s a problem, says Trapasso’s roommate, Jane Plotkin — a former marriage and family therapist who says she became a clairaudient, hearing voices from beyond, after a “major visionary experience.”

“There are so many people who live in fear of death, and that’s one of the reasons we have such a youth-obsessed culture and a culture that turns away from aging.”

The way we die is about to change, Burzynski says. He’s convinced of it.

Aging baby boomers will demand better options, and they know how to get things done.

His mother, he says, grew up in a village. As a girl, she helped wash and lay out the bodies of the dead.

Most deaths used to be at home, he says. Now that’s rare.

“We all want to make a good death. If you ask anybody, ‘How do you want to die?’ they’ll say, ‘In the bosom of my family, with my friends around.’ They don’t say, ‘In a hospital bed with tubes coming out of my nose and my ears, in a semi-coma — that’s my perfect death.'”

Plotkin describes her mother’s “grueling, grueling” end, on a respirator.

If one day she finds out she is dying, she says, she wants to choose when and “have some help to let go.”

Jane Plotkin says that if one day she finds out she is dying, she wants to choose when and “have some help to let go.”

“I’d like to have a few of my friends and be able to say all the things I’m grateful for in my life and thank everyone and end on a good note.”

Why are the odds stacked against getting to determine our own goodbyes?

Dori Fisher, the graphic artist, says seeing her first body terrified her.

Grandma never wore makeup or lipstick. That person in the satin-lined box looked like an over-decorated cake.

“I think that dying is as individual as living. And that’s what we don’t take into consideration,” she says. “Everybody should be able to die in the way that they want to, maybe as they lived.”

The volatility of grief, the way the young feel invincible, the heartbreaking loss of pets who loved unconditionally.

Life and death, death and life. The conversation slides easily back and forth between the two.

Live fully, says Trapasso. Why have regrets? She’s known many a dying person who felt smothered by them.

They gave her advice.

If you don’t like your job, quit. If you don’t like the person you’re with, leave that person.

Travel now. Don’t wait for later.

And don’t let anyone stop you from living the life you want.

For more than an hour, Fisher’s husband, Ron, stays silent — until someone addresses him directly.

As an LAPD sergeant, he must see death all the time. How was he trained to deal with it?

He wasn’t, he replies, unless you count learning “to fill out information in boxes” on a death report.

And then he starts talking — about death that comes violently, about wishing he knew how to help the ones left behind, how to console without internalizing the pain so much “that I start turning into a glob of goo.”

One day in East L.A., a big rig was waiting at a light. The light turned green. The truck moved forward.

The driver was too high up to see the lady crossing against the signal, pushing her grandson in a cart.

She tried to shove the boy out of the way. The cart fell under the truck’s front wheel.

She was unhurt. Her grandson was crushed.

Fisher and other officers held up sheets to shield the view from the public as the coroner removed what remained of the child.

“So there’s that image ingrained in your head forever,” he says. “How do you deal with that?”

“Well, I think you’re doing it right now,” says Richard Riemer, a psychologist, as other call out, “Yes,” “Yes, you are.”

Death can come suddenly. Dwelling on it can seem dark.

But it’s still bright out when L.A.’s first Death Cafe winds down after more than two hours.

There’s still cake, and people congregate near the kitchen counter — smiling, laughing.

Enough talk of endings.

They start to leave, making their way down the stairs.

The leaves rustle, the air feels fresh and there is life to be lived.

Complete Article HERE!