On the art of dying

By Gary Moore

I’m reading this excellent book by the author Katy Butler entitled “The Art Of Dying Well.”

Put down those phones, no emergency call needed! I’m not going anywhere for awhile. I just want to be prepared.

George Harrison, one of my musical idols also spoke a lot about preparing for death, so when you finally die, you can do so peacefully and transition seamlessly into the next stage of your life. In fact, he wrote a song entitled “The Art of Dying,” which appeared on his first solo album “All Things Must Pass.” In that song, he wrote:

“There’ll come a time when all your hopes are fading

When things that seemed so very plain become an awful pain

Searching for the truth among the lying

And answered when you’ve learned the art of dying”

George’s wife, Olivia, said that when he passed, you didn’t need a candle to light the room. By that, I assume she meant his lighted spirit left his body. Selfishly, I wish George hadn’t left so soon, and I doubt I will encounter him if he returns (because he may not, having died peacefully). But, one never knows.

George’s wife, Olivia, said that when he passed, you didn’t need a candle to light the room. By that, I assume she meant his lighted spirit left his body. Selfishly, I wish George hadn’t left so soon, and I doubt I will encounter him if he returns (because he may not, having died peacefully). But, one never knows.

In the book, Ms. Butler outlines chapter by chapter what elders can do as they reach the end of their life cycle and how to prepare for each stage. She thoughtfully begins each chapter by stating “If you are experiencing…” and lists several conditions, going from mildly annoying to life-threatening, that people our age will experience as they reach the end. It’s done matter of factly, clinically, but with great warmth and compassion, because she then expounds in each chapter on what you should be doing at each particular stage.

One of her suggestions that I found very helpful was transitioning from a general practitioner to a doctor that specializes in elder medicine. In this kind of practice, the doctor asks “What is it that you want to do?” rather then tells you how she or he is going to save you from dying.

Let’s face it: death is a phase we all must go through. There may be a way to delay it, preventative practices you can use to slow it down, but, in the end, it’s the end.

A reader recently responded to one of my articles that discussed death with a quote from the film director and gay rights activist Derek Jarman, who is quoted to have said “I am not afraid of death, but, I am afraid of dying.”

This is because, we know death is coming, but we don’t know how or when it will come. We are unsure of the process by which we transition from life to death and what waits on “the other side.” We have books on faith and religion and spirituality to suggest, in some way, what we might expect, but we don’t know for sure and that uncertainty breeds fear.

On the other hand, another of my heroes, Mark Twain, is quoted as saying “The fear of death follows from the fear of life. A man who lives fully is prepared to die at anytime.”

A story told about St. Francis of Assisi has a man asking everybody in town what they would do if they knew they were going to die tomorrow. Various people offer various versions of tying up loose ends. When the man reaches Francis, Francis is hoeing the garden of the monastery. The man asks Francis what he would do. Francis looks up and around, smiles and replies “I would keep hoeing.”

I doubt that I possess Francis’ courage, strength of faith or ease with mortality. In fact, I might add, this column seems to verify that. Dylan Thomas urges us to “rage / rage / against the dying of the light.”

Katy Butler urges us to accept it and prepare for it as best we can.

I find myself somewhere in the middle. As my younger friend expressed it “I have so much more I have to do.” I think many people in my generation feel that way. Places to go. People to visit. Grandchildren to watch grow. Alas and alack.

But, in conclusion, this quote from Lord Beaverbrook, who was a newspaper tycoon and member of Churchill’s cabinet, struck me:

“This is my final word. It is time for me to become an apprentice once more. I have not settled in which direction. But, somewhere, sometime, soon.”

The idea of becoming an apprentice, of starting over, of beginning a new, different phase of “life” appeals to me. And, maybe, that’s exactly what happens.

Or, to quote Oscar Wilde’s dying words: “Either that wallpaper goes, or I do.”

He did.

Hold those grey heads up!

Complete Article HERE!

The Meaning of Life is That It Ends

How Horror Movies Prepare Us to Talk About Death

by

“Most things will be okay eventually, but not everything will be. Sometimes you’ll put up a good fight and lose. Sometimes you’ll hold on really hard and realize there is no choice but to let go. Acceptance is a small, quiet room.”
–Cheryl Strayed

“That it will never come again makes life so sweet.”Emily Dickinson

There are a lot of uncertainties in life, but the only constant and known fact is that we all die. Despite this collective, inevitable experience that will eventually happen to everyone on the  planet, we tend to avoid this fact altogether. It’s a painful topic, death. A fickle, unfair shadow that situates itself deep in the recesses of our minds; and when brought to the forefront, it usually initiates debilitating emotions and forces actions that the majority of us are not prepared to deal with. Our affairs are not in order; our options for burials are limited and at the mercy of a funeral director; and we are forced to make finite decisions while experiencing agonizing grief. Despite our culture’s adoration for Halloween and horror films, death is still a subject that many prefer to view as an abstract concept. It’s cathartic and safe to embrace the grim reaper within a holiday or cinematic context, but when it comes to our own mortality we recoil at the thought.

Over the past few years, thoughts about burial practices, death preparation, and the acceptance of the horror genre have been progressively evolving. 2018 was the first time that more Americans decided to choose cremation over more expensive burials. Alternative death options are becoming more widely accepted and advanced to not only alleviate the pain for loved ones, but to help reduce damage to the planet while nourishing the growth of new life through one’s passing. Additionally, the horror genre is thriving. Jordan Peele’s Get Out won an Oscar for best original screenplay in 2018; there are continuous remakes of classic genre films like IT and Pet Sematary; and numerous children’s films that lean into the spooky fascination with death such as Goosebumps and most recently Scary Stories to Tell in the Dark are all becoming more mainstream.

In his book Scary Stories to Tell in the Dark, author Alvin Schwartz wrote “don’t you ever laugh as the hearse goes by, for you may be the next to die”, a line that is part of “The Hearse Song”. His trilogy of terror aimed at children was filled with creepy folklore tales and grim illustrations courtesy of artist Stephen Gammell. Straight-forward and blunt, Schwartz was revolutionary in his approach to conveying curiosities revolving around death for those at a young age. Through lore that spanned cultures across the world, he was able to shine light on a dark subject that many parents censor their children from entirely. However, this type of censorship ultimately does not help children. Just like Disney fairytales of a happy ending where the good guy always wins and true love is everlasting, it isn’t reality.

And yet, our society as a whole refuses to address the inevitable truths of life, death, heartbreak, and loss which inadequately and falsely prepare us for the day that we meet these experiences. In the film adaptation of Schwartz’s classic books, there’s a familiar storyline that accompanies haunted locations—the misinterpretation of the past and inflamed legacy of an individual who has passed away. Scary Stories features a character by the name of Sarah Bellows depicted as a sinister spirit who wreaks havoc on a group of friends once her book of self-written stories is stolen. In the end, young protagonist Stella addresses Sarah’s ghost and tells her that she will write her story the way it really was and let everyone know what really happened to her. This is a prime example of reclaiming one’s death (and life) in a manner they choose – a concept that is becoming more commonplace in the funeral industry and is a staple within the Death Positive Movement.

The average American funeral costs $8,000-$10,000, not including the burial and cemetery price tags. Many of the decisions around funeral preparation are made after a loved one dies. As a result, individuals are more easily taken advantage of and choose the most expensive and standard options not knowing for sure what their loved ones preferred to do with their remains, or if there are even alternatives. HBO’s new insightful and tender documentary Alternate Endings: Six New Ways To Die In America aims to introduce viewers to options that may be a better financial, emotional, and environmental fit for their death and the death of their loved ones. The documentary opens with scenes from the National Funeral Directors Association’s (NFDA) annual convention where hundreds gather to display and learn about the latest advancements or trends in the funeral industry. Companies offer the service of decorating personalized caskets, hologram eulogies, and even submerging one’s ashes in the dirt of their native homeland.

The six alternate endings mentioned in the documentary include: a memorial reef burial, living wake, green burial, space burial, “medical aid in dying” (MAID), and a celebration of life. The memorial reef, green, and space burials are all alternate options within the realm of a standard cremation or grave burial. Memorial Reef International builds artificial coral reefs to enhance coral generation, increase marine biomass, and provide eco-friendly alternatives that sustain life for hundreds of years. Another eco-friendly option is the green burial which skips the casket entirely as the body is wrapped in a shroud and placed directly into the earth. This method also bypasses the expensive cost of cement vaults in a standard cemetery which are just meant to keep the grounds even and easier for the landscapers to mow the grass.

As the effects of climate change grow increasingly dire, more and more people seek ways to give their bodies back to the earth to sustain new growth. Water cremation or aquamation is a form of green cremation which does not emit toxic chemicals nor does it contribute to greenhouse gases. Its carbon footprint is one-tenth of what fire-based cremations produce. In an article by National Geographic, it states “American funerals are responsible each year for the felling of 30 million board feet of casket wood (some of which comes from tropical hardwoods), 90,000 tons of steel, 1.6 million tons of concrete for burial vaults, and 800,000 gallons of embalming fluid. Even cremation is an environmental horror story, with the incineration process emitting many a noxious substance, including dioxin, hydrochloric acid, sulfur dioxide, and climate-changing carbon dioxide.” 

The traditional ritualistic aspect of funerals is also evolving. A terminally ill couple in Alternate Endings chooses to have a living wake, a celebration where loved ones and friends are able to say goodbye in person. By embracing their mortality, they’re allowing those close to them to say their final words and experience the appreciation of their life that they may not have realized had they kept their death at a distance. It’s a way to say how much you love someone to their face before you no longer have the chance. Living wakes are performed while the person is still alive and celebrations of life occur after someone has passed. After losing their five-year-old son, two parents in the documentary decide to fulfill their child’s wishes by throwing a party in his honor complete with five bounce houses, painting stations, and an appearance from Batman himself. Even at five, their son realized how sad funerals can be and facing his own death, he specifically requested he not have one. 

Now, if someone as young as five years old can embrace their mortality and make a decision about his passing, then why is it so hard for adults? There’s a stigma around death and it is easier to just ignore it as long as possible, but in the end, doing so can be detrimental. In fact, thinking about death can be a positive and productive practice. Mortician Caitlin Doughty understands this and set out to change the way we view death by creating the Death Positive Movement through her work with The Order of the Good Death. “The Order is about making death a part of your life. Staring down your death fears—whether it be your own death, the death of those you love, the pain of dying, the afterlife (or lack thereof), grief, corpses, bodily decomposition, or all of the above. Accepting that death itself is natural, but the death anxiety of modern culture is not.” This is achieved through various resources and advocacy. The name may sound like a cult, but I assure you it’s not.

In her book, Smoke Gets in Your Eyes, she describes her idea of a “good death” as being prepared to die, with affairs in order, the good and bad messages delivered, dying while the mind is sharp, and dying without large amounts of suffering and pain. It means accepting death as inevitable as opposed to fighting it when the time comes. Therefore, she has collaborated with an array of funeral industry professionals, academics, and artists to provide the best resources possible including information on end of life planning, green burial technology, as well as methods on how to alter our innate fear of death that has only been enhanced through recent (and unfortunately perpetual) devastating events in the news. 

While the horror genre provides viewers the chance to vicariously experience our fear of death in a safe, dissociative capacity, there are now more resources and options than ever before to help us face the inevitable. Instead of solely harnessing terror and sadness, there are ways to find beauty and inspiration in death. As Kafka said, “The meaning of life is that it ends.” Welcoming our mortality allows us to cherish people more because we don’t know how much time we’ll have with them. It is the driving force behind learning, loving, creating, and achieving what we want out of life. While death can be its own scary story, at least there’s comfort in knowing that it is something we will all face one day and there is some control you can have over the process as well as one’s legacy. And when that fateful day comes, let it be the good death you’d want for yourself and those you love, with plenty of peace and the least amount of pain and regret as possible.

Complete Article HERE!

Who Will Wear My Dead Husband’s Clothes?

It took me a long time to find a new home for the belongings he left behind.

By

My husband and I shared a narrow, shoebox-shaped closet in our home here, his clothes facing mine from double-hanging wardrobes mounted on the walls. After he died of pancreatic cancer on Nov. 1, 2017, a month after his diagnosis, I’d often wander into the closet to search for his smell on his shirts. My mother caught me one day sniffing his shirts and crying, and said, “You can’t keep doing this forever.”

“What should I do?” I asked.

“You need to find the right people to give his clothes to,” she replied.

I packed his shirts, slacks, shoes, belts and ties into the gunpowder-gray suitcases we’d bought for our trip through western Ireland years earlier. That same day, a Federal District Court judge in San Francisco ordered the Trump administration to keep on renewing the permits that gave young undocumented immigrants permission to temporarily live and work in the United States, as prescribed by the Obama-era program known as Deferred Action for Childhood Arrivals, or DACA.

I noted the events in my journal in short, unemotional sentences: “Cleaned closet, packed Mike’s stuff away;” “Good news of the day: DACA still alive.”

I parked the suitcases in a corner of my garage, where they stayed for 16 months, gathering dust as the president made a mess out of the country’s already messy immigration system.

In these months, my daughter’s nanny, a naturalized citizen, lost her brother in Mexico, where he had been deported last year after living illegally for 26 years in Phoenix. (His wife and three children still live here.) The nanny said that he’d died of a broken heart.

Also in these months, accounts of Central Americans released from immigration detention and dumped at the Greyhound bus station in town began showing up in my news feeds, followed by reports about Central Americans lost in the punishing desert that straddles the Arizona-Mexico border, or about children falling ill and dying in overcrowded Border Patrol stations.

I had written articles of my own about the conditions inside these stations during my stint as Phoenix bureau chief for The Times. I’d also written a report in 2014 from inside a makeshift shelter that the Border Patrol had set up for migrant children in the border city of Nogales, Ariz. Then, as now, despair had led thousands of people to leave their home countries in search of what so many of us in America take for granted: the right to live without fear of being kidnapped, tortured, killed.

What I saw at that shelter stayed with me. The children sleeping shoulder-to-shoulder on the floor, in dirty clothes, under blankets that looked like sheets of aluminum foil. These memories, and the new crop of migrant stories on my news feeds, only added to the grief of losing my husband at the relatively young age of 44 — and to the anguish of raising our daughter alone and far away from my family, in a country that is legally my own but that has made it tough for me at times to feel that this is the country where I belong.

My husband was a proud American, the son of a nurse and a gas-meter reader born and bred in a blue-collar mill town in Central Massachusetts, where, like him, almost everyone was white. He was curious enough about the world to marry me, an immigrant from Brazil. When our daughter was born, he spoke proudly about the jumble of heritages coursing through her veins — Scots-Irish and French Canadian from his side, and indigenous, Portuguese and African from mine. I sometimes called her “a mutt.” He called her “the perfect American.”

He was an optimist and in the days right after Mr. Trump’s election, he kept his glass-half-full attitude, telling me that the unorthodox president-elect might be just what was needed to get things going in Washington. But that didn’t last long. I remember the glum expression on his face as he checked the new president’s Twitter feed while silently sipping his coffee. I urged him to find another morning routine, to check out of social media for a while.

He told me, “I wished Trump knew the immigrants we know, all these good, honest people.”

One morning this spring, I logged onto his email for only the second time since his death. I typed my name in the search field, watched the results populate the screen and scrolled through the messages, contemplating the simplicity of our life, the tenderness of his words, the intimacy we shared, all of it contained in subject lines: “cool summer camp ideas,” “add to nanny to-do list,” “miss you while you’re away.”

One such line caught my eye — “The toll it’s taken,” it read. The message, dated Nov. 16, 2016, was in the drafts folder. I clicked it open.

I haven’t been sleeping well since last Tuesday. I’m really upset about the election. Was in denial there for a few days and tried to put a good face on it. But I just need to express how angry, frightened and disgusted I am. You know me — I don’t like to emote — but I am really crushed by this. So deeply disappointed in my country and in many people that I know.
I’m sorry. I love you.

Just that week, I had received a text message from a friend, asking if I might be willing to volunteer as a Spanish-English interpreter when the next group of Central American migrants seeking asylum arrived at her church. The church is one of dozens to have banded together to offer a safety net of sorts for these migrants, giving them basic health checks, some toiletries and clothes, and making travel arrangements so that they can reunite with relatives already settled in the United States. I was on the fence about it, in part because I was afraid to face the migrants’ sadness.

I found the courage I needed in my husband’s unsent message to me.

By then, the migrants at the church had come and gone. But I knew that another group would be around soon.

The next day, I got a text from my friend: “It looks like 11 a.m. Please don’t tell anyone.”

I put the suitcases in my car and waited for instructions.

“When you get here, ask for me directly,” she wrote.

I drove south and west from my house. On the way, I listened to Bruce Springsteen’s “The River,” the album that my husband played for me on our first date. I cried. I talked to him.

I got off in a part of the city full of warehouses and big, empty lots. I walked into the church. Just as my mother suggested, I had found the right people to give his clothes to.

Complete Article HERE!

We’re looking at death all wrong. Here’s why.

Can a shift in the way we treat death and dying improve our lives while we’re still here?

A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death

  • These days, for the most part, the concept of death is consumed by health care and medicine.
  • However, as humans we need to view death as more than just a medical event. It takes into account our psychology, spirituality, philosophy, social worlds, and personal lives.
  • This reconsideration should also apply to the way we treat people who are dying. Life is in the senses, not just our physical capabilities.

BJ Miller: Health care, medicine in our country is a giant, colossal thing. And it’s got a ton of momentum. And medicine has become– the domain of death is more or less ruled these days by health care. In times past, it’s been the church, or the family was the sort of center of all this.

These days, it’s mostly medicine. But what’s really important in all this is that we people, we humans, we patients, loved ones, we need to kind of take back the subject on some level– that dying is not just a medical event. It’s way bigger than that. It is all-encompassing. It’s where everything comes to account– our psychology, our philosophy, our spirituality, our social world, our intrapersonal lives– all of it. The medical piece is a little itty bitty piece. It just gets too much attention.

So I’ll just think about the emotions for a second. For one thing, to remind ourselves– for me, the difference between emotion and a thought is you can control your thoughts. You can’t really control your emotions. Emotions are much more slippery. They’re going to have their way with you. So you ignore them at your own peril.

That’s one thing to get across. But I also say that to let us off the hook. The way you’re feeling, on some level, isn’t your fault. And one of the things I see that happens a lot around this subject– again, we’ve talked about how one can be made to feel ashamed to be sick, ashamed to be dying, like we’re failing, somehow.

I want to make sure that we all understand, there are certain things that are way beyond our control. And that means– that may be hard to swallow, but it also means we’re off the hook. It’s not my fault, the way I feel. I shouldn’t have to hate myself or be embarrassed about it. So let’s set some ground rules.

And there’s this other layer that is particularly vexing, which is how others start treating you. And it’s very common, under the banner of sanctity or wanting to protect someone, to– I watch people, they stop telling jokes. Maybe they think it’s sort of sacrilegious to try to be funny around someone who’s sick. Or maybe they don’t talk about their own joys that they happen to have in their day while their colleague is meanwhile miserable with a fever or something. They don’t feel like they should talk about their own joys. Or I don’t know, whatever it is– pick anything.

But one of the things that ends up happening is we end up accidentally making life even harder for each other by keeping the truth of the situation at bay. All right? So these are the ways we die before we have to die. We die before we have to die because no one tells jokes to us anymore because they don’t think we’re going to want to laugh, or that sounds perverse.

Or maybe our partner stops the intimacy. Physical intimacy might dry up, or sexuality. The idea that a disabled person can be sexual, that’s still a novel concept. Just look at most exam rooms in a doctor’s office or in a hospital. Most of them are not even wheelchair-accessible.

My mother uses a wheelchair. They used to just assume she wasn’t having sex, so they wouldn’t offer her a pap smear.
And so one of the things you want to avoid if you plan for your death is you want to– ideally, we come to our death without piles and piles of regret. So when I’m working with patients, especially upstream of their death, I’m always encouraging them to feel things, enjoy the body they have while they have it, appreciate their body while they have it, because it’s someday going to go, and you’re going to miss it.

So touch is just profound. It’s elemental. It is, even if you think about, I think, the scourge of dementia, for example– and a lot of us are terrified of this eventuality. We’re going to lose our minds. Yeah. And it’s hard. And that is a very difficult prospect. And I’m also pretty convinced that there’s a life on the far side of our intellect.

And for me, that life is in the senses. As long as I can feel something, I’m interested in being alive. I’m even more interested in that than a thought.

Complete Article HERE!

Judy Chicago contemplates death, and all it means, in this powerful exhibition

Artist Judy Chicago

By Angela Haupt

Judy Chicago is well-aware she’s going to die one day — and she’s coming to terms with it. In her newest body of work, the 80-year-old feminist artist reckons with her own mortality, as well as the untimely death she fears for the planet’s threatened species and ecosystems.

“The End: A Meditation on Death and Extinction,” at the National Museum of Women in the Arts, consists of nearly 40 works of painted porcelain and glass, plus two large sculptures. It’s divided into three sequential sections: “Stages of Dying,” “Mortality” and “Extinction.” Chicago’s new series is “luminous,” according to exhibition curator Virginia Treanor. “I think it’s going to be a really contemplative experience. People will be moved by it, for sure.”

Here’s a closer look at five of the pieces on display.

“Stages of Dying 5/6: Depression.”

Stages of Dying 5/6: Depression

An aged, bald woman cradles her face in her hands in this white porcelain piece, which is part of the “Stages of Dying” section of the exhibition. The figure personifies one of the five stages of grief: denial, anger, bargaining, depression and acceptance. These stages can apply both to those who are grieving the loss of someone and to those grappling with their own end. The older woman Chicago depicts is intended to represent an Everywoman, as well as the indiscriminate inevitability of death. “For so much of human history, the male figure has been the archetype of humanity,” says Treanor. “We say, ‘mankind.’ She wanted to shift that paradigm and make an Everywoman rather than an Everyman.”

Mortality Relief

A woman’s eyes are closed, her head resting on a pillow, hands clasped around a bouquet of lilies. The bronze sculpture is a self-portrait of the artist, who in the “Mortality” section of the show imagines different scenarios in which she might die. “Mortality Relief” pays homage to traditional death masks, which were used from the Middle Ages until the 19th century — before the advent of photography — to preserve someone’s likeness after death. Treanor describes the sculpture as “peaceful and serene.”

“Mortality Relief.”

In the Shadow of Death

Thirty of the pieces in “The End” — including this one from the “Mortality” section — are kiln-fired paintings on black glass: a laborious process that requires multiple firings. Each time something’s put into the kiln, there’s a risk that it’s going to break, which means that the artist needs to be exacting. “In the Shadow of Death” is engraved with a quote from philosopher Todd May, reading, in part: “To forge our lives under the haunting shadow of death is both our reality and our opportunity,” with an emphasis on the word “opportunity.” It’s Chicago’s way of noting that there’s no need to fear death. “We have this opportunity in life because we know it’s finite,” Treanor says. “It’s going to end at some point.”

“How Will I Die? #2.”

How Will I Die? #2

A woman, once again a self-portrait of Chicago, is curled into the fetal position, text wrapped around her body — “Will I leave as I arrived?” — in this kiln-fired painting on black glass. “Linking the experience of birth and death is powerful in a visual way, but also in an existential way,” Treanor says. She particularly lauds Chicago’s use of a wrinkled, aged figure. “This is classic Judy Chicago, and it’s one of the reasons I love her and her work so much,” she says. “She’s constantly pushing the boundaries. Nude women in art are a dime a dozen, right? But very rarely do we see an older nude woman. Very rarely do we see older women at all.”

“Stranded.”

Stranded

In “Extinction,” the final section of the exhibit, Chicago turns from pondering individual death to the obliteration of entire ecosystems and species. A gaunt polar bear clings to a melting iceberg in the black-glass painting “Stranded.” Other works depict elephants killed for their tusks and trees flayed of their bark. Capturing that kind of destruction requires extensive research, which Chicago has described as an emotionally draining experience. “It was interesting to hear her speak about these works, and equating the physical exertion that went into them — like multiple [kiln] firings — with the emotional toll it took on her,” Treanor says. “She said it was really gut-wrenching.”

If you go/

Judy Chicago — The End: A Meditation on Death and Extinction

National Museum of Women in the Arts, 1250 New York Ave. NW. nmwa.org .

Dates: Through Jan. 20.

Admission: $10; $8 for seniors and students; free for members and visitors 18 and under.

Complete Article HERE!

What’s a ‘good death’?

It’s not quite the peaceful drifting off I’d imagined for my dad.

By Harriet Brown

At age 86, my father had survived both colon cancer and a stroke that left him with aphasia. His mind was sharp, though, and he wasn’t depressed. A crack bridge player with a passion for Italian restaurants, he was popular at his assisted living facility even though he couldn’t speak much. He told me he’d lived a good life and wasn’t afraid of dying, and he didn’t want to go through any more medical trauma. No chemo, no radiation, no surgeries, no treatment.

His advance directive read DNR and DNI — do not resuscitate, do not intubate. No one would break his ribs doing CPR or make bruises bloom along his arms trying to find a vein. As his health-care proxy, I was completely on board. I’d read Sherwin Nuland’s “How We Die,” Atul Gawande’s “Being Mortal,” Elisabeth Kubler-Ross’s “On Death and Dying.” Comfort would be the priority and any pain would be “managed,” which I assumed meant erased.

Up to 80 percent of Americans die in hospitals or nursing homes, and a third spend at least 10 days in an intensive care unit before they die, many of them comatose or on a ventilator. A week after his sudden diagnosis of widespread metastatic disease, my father was lucky enough to get a bed in our town’s only hospice, a homey facility staffed with attentive and experienced caregivers. The alternative would have been a hospital bed in my living room, so it was a relief to know that my father was in the hands of professionals. They would know what to do.

And they did. The nurses and caregivers were gentle as they repositioned my father in bed, explaining each move even when it seemed he couldn’t hear or follow. When he could no longer swallow they squirted morphine into his cheek and rubbed it so the medicine would be absorbed. “This will make you feel better,” they would say, and my father would turn his head and open his chapped lips like a baby bird.

But his death was not the peaceful drifting away I’d always imagined, where you floated into a calm, morphine-induced sleep, your breath came slower and slower and then simply stopped. He vomited blood over and over. A lifelong stoic who never complained of pain — even when he’d broken a hip the year before — he twitched restlessly in bed, eyes closed, his brow furrowed and his skin clammy.

The magical “managing” of pain and nausea I’d anticipated turned out to be more aspirational than real. The hospice nurse prescribed one anti-nausea medication, then another, without success. Eventually, Ativan and Haldol settled the nausea, and morphine helped the pain. My father was lucky it helped; about 25 percent of people die in pain. One caregiver confided to me, “There are people whose pain we never get under control.”

For days we watched my father’s cheeks hollow, watched him pluck at the thin blanket that was all he could bear on his body. His kind brown eyes glazed over, and some trick of the light made them look blue under his half-closed lids. Sometimes he sat up suddenly, reaching forward, and then fell back on the pillows. I knew there was a name for this behavior, terminal restlessness, that it’s common during the dying process. I knew the gurgling sounds he made as he breathed came from his body’s inability to clear secretions, and that — according to hospice — it probably wasn’t uncomfortable for him.

Leaving the hospice facility one night, I told my 81-year-old aunt that I wished I had the nerve to put a pillow over his face. “I’ll stand guard at the door while you do,” she replied. Dying is hard work. And it’s hard to watch.

On the last night, I sat with my father until the summer sky began to darken. Then I gathered my belongings and leaned over the bed where he lay unresponsive, his eyes closed, his mouth half-open. I kissed his stubbled cheek. “Dad, I’m going now,” I told him. “It’s time for you to go too.” He died a few hours later. He was alone, as most people are when they die, so I don’t know if it was peaceful, if he made a sound or opened his eyes or just stopped breathing.

After he died, I was haunted by scenes of his suffering. I remembered looking out a hospital window nearly 30 years earlier with my newborn daughter in my arms, realizing that every one of the people I saw on the street had been born. For every person walking down Seventh Avenue, a woman had borne pain that tore her body open. It was a horrifying thought.

Drugs help with the pain of childbirth, but they can’t take it away completely. It’s the same with dying.

“Suffering is an ineradicable part of life, [like] fate and death,” wrote psychologist Viktor E. Frankl in his bestseller “Man’s Search for Meaning.” He was something of an expert, having survived nearly three years in a variety of Nazi camps.

Of course, my father’s suffering was nothing like the kind Frankl witnessed. But still, death, like birth, is a creaturely process, a force that wrenches us onward without consulting our preferences or respecting our sensibilities.

In the weeks after my father’s death, I began to understand in a deeper way the meaning of a good death. No drugs took away all my father’s physical pain and nausea. But in the care he was given, the morphine, the quiet words, the repositioning and cool cloths on his forehead, his suffering was addressed even if it couldn’t be “managed.”

And that, I think, is what we all want. Not just freedom from beeping machines and needles and the cold lighting of an ICU, though that matters, too. Not just the absence of pain, which isn’t possible for everyone. But the solace of being seen and heard and acknowledged brings comfort even in the face of deep suffering.

I hope it’s something we can remember as we move toward a society where more of us can have a truly good death.

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I will never forget my grandma’s last days, surrounded by people who were half shaman, half scientist, and all good

We expected Nana to die years ago. When she finally went, it was both sadder and sweeter than we were prepared for

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I knew it was coming; I had known it was coming for years. I had seen my friends go through it, and I had spent many hours thinking deeply about what would happen. Comforted by theories on the nature of consciousness, seduced by feasible rationales for an afterlife, sobered by the practical science of what was really going to happen, I was prepared. And then she died.

My nana had been ill for a long time. Her final diagnosis, chronic obstructive pulmonary disease, came 12 years before she died, although the prognosis was no more than four. She had come close so many times that we had started calling her “the boomerang”. But when she went into hospital for the last time, although in our heads we constructed logical expectations of her coming back to us, in our hearts we knew she wasn’t coming home.

Losing someone close to you is something you can only really talk about once it has happened. All the cliches about grief that I had heard over the years became my reality. Half an hour after she died, my cousin Elliot and I sat in the hospital coffee shop, exhausted, paralysed, silently delirious, while a tiny white butterfly fluttered around our heads, flew a full circle above us and disappeared. Over the next week, the appearance of white butterflies comforted each member of my family at different times in some ineffable way. Despite our wildly varying degrees of faith, that delicate symbol soothed us with an understanding that she was OK: whether she was on a cloud with her brothers and parents, united on an unknown spiritual plane with a greater force as part of a universal consciousness, or just gone, she was no longer in pain.

It was very sad, of course, and that is the best it was ever going to be. The reason I say “the best” is that, if it were not for the acutely careful preparations of us all, including Nana, it could have been far worse.

Palliative care should not be as taboo or scary as it is to many of us. I would go as far as to say that it is the ultimate in wellbeing practices, when a person’s health has failed and all that can be done is care. The word “palliative” comes from the Latin pallium, a cloak, and in many ways this metaphor is apt. In the last days, a “syringe driver” delivered her a steady flow of morphine and anti-anxiety drugs that concealed the worst of her symptoms, shielded her from their effects, protected her from the pain, and even hid her from death for a few more hours or days. If she had not had that, she would have died of hypoxia on the Thursday, gasping violently for breath as she drowned in carbon dioxide that her lungs were too weak to exhale. Instead, she went on until the following Tuesday, my auntie’s birthday, not before she had me write in her card: “Life is worth living because you’re my daughter.” When she finally passed, it was a moment of peace.

(Note to doctors: if it could be called anything other than a “syringe driver”, I think everyone would be much happier. My bampy (grandfather) in particular was unnerved by the name and was initially convinced that it was going to speed up her death.)

On the Saturday, when we all first expected her to go, we played her favourite songs at her bedside: lots of Maria Callas and Ella Fitzgerald, and (who knew?!) Hot Chocolate’s No Doubt About It, a song that recounts Errol Brown’s alien visitation. We were gifted the time to rejoice with her in what made her joyful, emotional and eccentric. As she appeared to slip away, our tear-stained faces fixed around her in uncontainable smiles, sure that the hour had come, she boomeranged back again, just in time for The Chase.

Memories of moments in her final days are precious and I am gratefully aware of how lucky my family and I are to have had them. They exist because of palliative-care specialists. What a mystically unique role: part scientist, part shaman; half doctor, half priest; with careful words held equally as important as the careful drugs. Never hard-heartedly functional, and never “compulsively positive”, it is as if they are of the same station as midwives, just on the other end. I am profoundly moved by this practice. The UK is reportedly the best in the world at end-of-life care, which is cause to be proud, and there are calls from both the International Association of Research in Cancer and the World Health Organization to declare palliative care a human right.

As someone whose first close bereavement was sort-of-sweet-sad but without regret, I support these proposals wholeheartedly. I wish that all people could be treated with such deep compassion and humanity. I sincerely hope that, when it is my time to die, my family and I will be helped to prepare in the same caring, tender way that my grandmother and family were in Llandough on a long weekend in July.

Complete Article HERE!