How To Stay Famous After You Die.

AI Scientists Have An Answer

By Alex Zhavoronkov, PhD

If you are a young public figure, and will die an unnatural death, then I have good news for you! You will most likely be remembered for a long time after you die. Conversely, if you are older, are not a public figure, and will die of a natural cause, then the odds that you will be forgotten over time are strong.

Remembering those who have passed on from this life has been an important theme throughout human history. Our ancestors used to remember those who died by sharing their memories with the next generation in the form of stories and ballads. They would sit around a fire and exchange memories and hope they would be passed through generations after them. Later when the printing press was invented, humans began to store, collect and spread information on a massive scale. The printing press made it easier to collect and preserve memories of the deceased because it is easier to store written pieces of information. Today, the developments in communication technologies such as the internet have changed how we create, store and retain memories. The internet also allows us to analyze memory through large-scale data in a quantitative framework.

Being remembered after death has been such an important concern throughout history that civilizations such as the Romans considered damnatio memoriae, or being erased from the public’s memory, as one of the severest punishments imaginable. At some point, many of us might have wondered how we will be remembered after passing on from this life too.

The h-index, the number of research papers with the same number of citations is one of the common ways to evaluate academic performance. It is a very important number in academia. The mean and median H‐index for all peer reviewed papers at the time of promotion to Professor in the JHU School of Medicine is 25 and 23 respectively. In computer science and math, scientists do not cite each other as often as in biomedicine and there are very few young computer scientists with the H-index of 100. So it is natural to follow them on Google Scholar and learn about their research. One of the scholars I follow is Jure Leskovec (h-index = 117) the co-author of the famous node2vec and an authority on graph neural networks (GNNs).

So imagine my surprise, when I saw the paper by Robert West, Jure Leskovec, and Christopher Potts titled “Post-mortem memory of public figures in news and social media” in my Scholar feed. I don’t know any of the authors personally but based on their work, they are extremely credible, and productive. In this paper the authors identified trends and analyzed how people are remembered in news and social media one year before and after death. It technically answers a question how long will your name last in people’s memory after you die. We know what you needed to do in ancient Greece to make it last (hello, Achilles!) but what about today? So, if you ever wondered how you can stay famous after you die, then this paper is for you!

Robert is an assistant professor in the School of Computer and Communication Sciences at the Swiss Federal Institute of Technology Lausanne where he also leads the data science lab. Jure is an associate professor of computer science at Stanford University. He is also an investigator at nonprofit research organization Chan Zuckerberg Biohub. Meanwhile, Christopher is professor and chair of the linguistics department at Stanford University.

Despite their varying backgrounds, the trio have a few things in common: they are experts in the field of artificial intelligence and data analytics.

In this short but fascinating paper, the three scientists tracked mentions of 2,362 public figures in English-language online news and social media (Twitter) one year before and after death. The tracked people died between 2009 and 2014. They then looked at the spike and decay of attention after death and modeled the two as the interplay of communicative memory, which is “sustained by the oral transmission of information” and cultural memory, which is “sustained by the physical recording of information.”

In order to track mentions, they combined the Freebase knowledge base with online news and social media compiled through Spinn3r, an online media aggregation service that tracks mentions from a complete set of all 6,608 English-language web domains indexed by Google News as well as media posts from Twitter. For each of the 2,362 people, the scientists tracked the frequency with which they were remembered in the two medias on a daily basis during the year before and the year after death. This allowed them to quantify the spikes and decay of attention that follow the death of public figures. 

The analysis of mention frequencies revealed that for most public figures, a sharp increase of media attention followed immediately after death, whereby mention frequency increased by 9,400% in the news and by 28,000% on Twitter in the median. The average mention frequency then declined around one month after death and eventually decayed slowly to the pre-mortem level. These two stages are consistent with the two components of collective memory: communicative memory, which dominates early on and decays quickly, and cultural memory, which dominates starting around two weeks after death and decays slowly.

Based on the study, the researchers concluded that artists remain more present in the collective memory because they tend to leave a legacy that can long survive them, whereas leaders, athletes, etc who are noteworthy for the actions they take during their lifetime, are of decreased interest once they cannot replicate their actions anymore. This is most pronounced for leaders. Artists also stand out with respect to cultural memory, while no notability type stands out with respect to communicative memory. Ceteris paribus, an unnatural death, also increased the rank with respect to the short-term mention. The effect of age at death also was significant. For instance, on Twitter, the post-mortem boost was monotonically and negatively associated with age at death. Likewise, the increased short-term boost associated with unnatural deaths was more pronounced in the news than on Twitter.

Separately, the study also revealed that Twitter users pay less attention when an old public figure or leader died. Deaths of these poor souls were boosted more by the news both in the short and long-term. Additionally, the researchers noted that future studies may also add language, tone and attitude towards public figures one year before and after death to see if the study would come to a different conclusion.

To conclude, the researchers found that the largest post-mortem boost in English-language media attention can be described as an anglophone of any gender who was already well-known before death and died a young and unnatural death. So, try and get famous before you die if you want to be remembered for a long time!

And if you are interested in ways to avoid dying prematurely and gaining some time to become famous, consider finding more ways to live longer and attending the 8th Aging Research and Drug Discovery conference organized by University of Copenhagen and Columbia University. I am sure that one way to become famous in late life is to set a longevity record, currently held by Jeanne Calment (122.5).

Complete Article HERE!

Medicalizing My Grief


A classmate of mine committed suicide a few weeks ago. Though I’ve heard the harrowing statistics about physician and trainee suicide rates, to be honest, I never expected to personally encounter such a tragedy. The small classes at my medical school allow for a strong sense of community in which we all know each other, celebrate important life milestones, and happily reconnect when we’re together after clinical rotations scatter us throughout the hospital.

In some ways, I can’t help but wonder if the inevitable dispersion during rotations played a role in his distress. We spend much of our preclinical time leaning on our classmates as we collectively attempt to master the intricacies of medicine; oftentimes, they are the first to offer words of encouragement after exams don’t go our way, kindly explain concepts that weren’t clear the first time around, or simply provide companionship over an afternoon cup of coffee. However, during rotations, the medical school experience becomes much more isolating — joining teams often as the lone medical student, left to your own devices to navigate not only clinical challenges, but also the awkward and complicated hierarchies universally found in medical training. When considering the additional isolation that comes with social distancing due to the current pandemic, I can only begin to imagine the suffering my classmate must have been experiencing.

In the weeks since his passing, I’ve found it challenging to grieve. No tears have been shed, nor have I been able to reminisce over the warm memories of his kindness and joviality as we tackled cadaver dissection together. Instead, I’ve found myself wondering about the medical minutiae of his “case” — a word that, despite its omnipresence in our medical lexicon, takes on a cold, reductionist tone as it attempts to distill the life of a friend down to a history of present illness, physical exam, set of lab values, and assessment and plan. How long did it take for someone to find him? Was recovery even a possibility? Were his organs eligible for donation? Did his care team know he was one of their own?

When my thoughts of medicine abate, I’m left with more troubling questions about myself. Why can’t I ignore the medicine and simply grieve his loss? Has my ability to grieve morphed into a numb, medicalized replacement? Is this how I’ll “grieve” the losses of my family or other friends too?

In retrospect, these feelings shouldn’t come as a surprise. In medicine, we’re unconsciously taught to medicalize losses of all kinds as we care for patients. In the trauma bay, for example, I observed “a traumatic aortic injury with unsuccessful repair,” as opposed to a tragic car accident leaving behind a young widow with small children. The octogenarian I met on hospital service was no longer known as the life of the party at Bridge Club; instead, she was the frail elderly woman admitted for a change in mental status who would require skilled nursing placement at discharge and would have to miss her granddaughter’s birthday party. The disheveled gentleman I met in the acute care psychiatric unit wasn’t seen as the neighbor who shoveled snow off everyone else’s driveway, but rather the man with decompensated schizophrenia admitted under civil commitment for stabilization and medication optimization. In none of these instances was the impact of loss a component of the conversation; instead, we focused on the medicine.

To be clear, it is necessary that we view our patients through the lens of medicine; it is our job to address the medical issues that bring them to our doorsteps. However, when we overly medicalize our patients as they experience loss, we create an unnecessary distance, shielding ourselves from some of their grief. Based on my experience, I suspect we suffer from that distance as much as they do. I personally felt out of touch with grief because despite the losses occurring around me throughout my rotations, we seldom took time to acknowledge the elephant in the room. Grief is a normal human emotion, so why are we trying so hard to avoid it? What might hospital rounds or office visits look like if we took the time to discuss the losses our patients experience, not just with them but with each other too? How might that change the learning environment, or, more importantly, patient care?

Perhaps my feelings — or lack thereof — are simply a product of my training level that will fade as I become more comfortable with my clinical skills. Instead of worrying about interpreting lab data or performing physical exam maneuvers correctly, I hope someday to work through the medical aspects of care more efficiently, allowing me more time to sit with my patients, experience the weight of their sadness, walk through the pros and cons of difficult choices with them, and extend my condolences to loved ones. In the meantime, I can challenge myself to bring to light the grief experienced by the patients we encounter on rounds or in our outpatient clinics and encourage my peers and preceptors to pause in reverence of this emotion.

I hope as I encounter future losses, my fears about medicalizing grief are never realized, but I suspect that if I continue to acknowledge the presence of grief around me, I can safeguard myself from future hard-heartedness. I hope the same for others too.

Complete Article HERE!

Love, loss and pandemic puppies

Stephan Pastis’s tribute to his dog, Edee.

By Bonnie Jean Feldkamp

My daughter got Bella at her dad’s house shortly after the divorce. My ex even called the sweet yellow lab “the divorce dog.” Visits with dad also meant time with Bella, which was great when my daughter was 8 years old, but the teen years brought work, band practice and a social life. Visitation with dad became more sporadic. Then, my ex asked if we would dog sit. Bella was a senior dog by then, and we were all smitten. We asked if we could just keep her. He said yes.

Bella and I bonded in a way I hadn’t anticipated. I worked from home, and she was my constant companion. My daughter grew up and moved to an apartment of her own, but Bella stayed with me.

COVID-19 brought with it a puppy boom as people sought comfort and companionship during quarantine and isolation — but for me, Bella was there. We took walks in the woods and played in the yard with my son. Our circle got smaller as the pandemic began to rage. Schools closed, my husband was furloughed, and then, just as everything shut down, we had to say goodbye to Bella. That stacking of hardships is known as collective — or cumulative — grief, and I wasn’t sure I could take it.

One day in April, I woke up to find that Bella couldn’t even raise her head from her bed. Something was seriously wrong. I debated on rushing her to an emergency veterinarian but knew, due to COVID, I would have to watch her disappear into the building and not return. I knew this was her end. I made her comfortable and placed a video call to my daughter so she could say her goodbyes.

Every time we welcome a pet into our lives, we also welcome the inevitable heartbreak. We know how it ends, and yet we still open our homes and our hearts to four-footed companions.

Bella died at home in her bed while I sang her lullabies.

Anticipatory grief is the price we pay for unconditional love. Pets have seen us at our worst and our most embarrassing. They bear witness to everything in our lives without judgment. “That’s unprecedented emotional intimacy,” says Rachael Nolan Ph.D., MPH, CPH, public health educator and grief recovery specialist. Sure, pets can be moody sometimes (I’m looking at you, George the cat) but for the most part, their behavior is pretty predictable, which also provides us a source of stability. Nolan says stability is “one of the most important things in life for humans, particularly in regards to emotions.”

Isolation and quarantine during the pandemic deepened bonds and strengthened connections to our pets. Then, to have to say goodbye … it’s just devastating.

I began applying to adopt senior dogs. I’d fall in love with an online profile, only to be upset when the dog found a home with someone else. Pet adoptions soared last summer, making the high demand and the long wait heart wrenching. On one particular hot mess of a day, I sobbed over another dog I’d never met. I really missed my Bella. Adopting another dog wouldn’t fill that void. I withdrew my application from the local stray adoption program and gave myself time.

Then, one September day, my friend texted me about a litter of puppies needing homes. “I could pick up two and bring you one,” she wrote.

I said yes. She wasn’t an old Labrador like Bella — she was a mutt puppy who licked my face and chased my son while he squealed with delight. We named her Hamilton. I know I’ll have to say goodbye in a few years, but I’m grateful she’s here now, and I’m here for all the belly rubs she can handle.

Complete Article HERE!

The mourner’s Kaddish

— A prayer for the living

By Moshe Meirovich

In the words of Ben Sira, the second century B.C.E. Jewish apocryphal sage: “We are all destined to die. We share it with all who have ever lived and all who will ever be.”

This is a fact of life. Yet, with each death we enter a mourning period that Elisabeth Kubler-Ross (1926-2004) has so eloquently described as five stages of grief:

  • Denial;
  • Anger;
  • Bargaining;
  • Depression;
  • Acceptance.

Likewise, rabbinic scholars centuries ago comprehended the need to ‘concretize the abstract’ by embracing the grieving process even while standing at the grave of a loved one.

At the very moment when the heart is broken, Judaism mandates the public recitation of the Kaddish prayer thereby aiding the mourner to begin to move beyond denial by confronting death head-on.

The Kaddish, at this time of emotional upheaval, ever so slowly addresses the grieving process by encouraging the mourner to begin to accept a new reality with the ubiquitous reminder: “The Lord is close to the brokenhearted and helps those who are crushed in spirit.” (Psalm 34:19)

In the ancient Aramaic prayer, the Kaddish asserts: “Yitgadal V’yitkadash Shmei Rabbah.” Magnified and sanctified be the great name of God throughout the world created according to the divine will.

These words underscore the words of the prophet Isaiah: “For My plans are not your plans, nor are My ways your ways declares the Lord. But, as the heavens are high above the earth, so are My ways high above your ways and My plans above your plans.” (Isaiah 55: 8-9)

Poignantly, the psalmist reminds us that even though we may not comprehend God’s inscrutable will, “though I walk through the valley of the shadow of death, I fear no harm for Thou art with me.” (Psalm 23:4)

Hence, with the recitation of the Kaddish, the mourner publicly declares there is indeed hope and redemption beyond this moment of unbearable pain. Step by step, the Kaddish provides the mourner with a ritual to traverse the stages of grief that will surely follow while embraced by a community of family and friends who provide comfort in the house of Shiva (seven days) where Kaddish will be recited, thereby sustaining the mourners in their quest for healing.

Moreover, in the words of an anonymous author, we discover an additional purpose in reciting Kaddish: “… if there is one thing I beg you to take to heart, it is this: Say Kaddish after me, but not for me. Kaddish is the unique Jewish link that binds the generations of Israel. The grave hears not the Kaddish, but the speaker does, and the words will echo in your heart …” (“Jewish Reflections on Death” by Rabbi Jack Riemer)

Thus, the Kaddish not only connects one generation to another; it also ‘jump-starts’ the grieving process in the midst of a caring and loving community, so that the mourner can again begin to experience a measure of hope, even in moments of despair.

Complete Article HERE!

The Dancing Skeletons

By John Harvey Negru

One of the more enchanting costumed Tibetan Buddhist dances involves a couple of jovial skeletons (citipati) who perform a jig that is, to me, vaguely reminiscent of Abbot and Costello in a vaudeville routine. Their grins are ear-to-ear, one holds a skull cup full of blood and the other holds a wand comprising a child’s spine and skull. Charming.

There are many images of these two clowns; it’s not a particularly obscure bit of tantric exotica. They’re just part of the entourage. They come on between the multi-octave throat singers and the more elaborately gowned Black Hat re-enactment or Yamantaka dance.

Clearly this is not an image of death that was part of the zeitgeist when and where I grew up as a nice Jewish boy, down the street from Leonard Cohen in Westmount, the English enclave in Montreal, Québec, a Canadian province still in the fading grip of the Catholic Church after the Quiet Revolution.

And yet, as I and my generation have grown older and older, we find ourselves with a ticket to the Greatest Show on Earth: our demise, like it or not. Leonard has already made his own curtain call.

These days, we have a cornucopia of narratives about how our end of life will go. And as you can imagine, each of us is pretty darn committed to finding the one that will bring the greatest peace of mind and no regrets.

As we have learned over the past year and a half, dying is a much more difficult passage than being dead. Tragically, many of us have found ourselves unprepared to deal with the passing of a loved one or recognizing that we ourselves are leaving lots of loose ends for those we love.

Linda Hochstetler. Photo by Kristina Ruddick. Image courtesy of the author
Linda Hochstetler.

The end of life is not something folks like to talk about, but it is our ultimate mystery. On another plane, it is also a tricky logistical path across a gameboard, with pitfalls such as dealing with hospital bureaucracy, filling in forms, searching for hospice care, making advanced care plans, and so much more.

I know several Canadian Buddhists who have served as death doulas. A few months ago, I was approached by a Buddhist social worker from Toronto, Linda Hochstetler, who has specialized in death work for many years in a variety of capacities. She explained that she had written an end-of-life guide and asked if I would be interested in publishing it. The short answer was yes and the book will be out this autumn.

It seemed worth interviewing her because I wanted to learn more about her perspective on the end of life, and to explore some of the themes she raises in her book but which were subsumed to the need to keep it practical for its intended Canadian audience. Here is a portion of our conversation.

Buddhistdoor Global: When we talk about death and dying, reversing the order of things, we make death the focus of our attention at the expense of understanding and working with the process of dying. In the best of all possible worlds, how would you change that?

Linda Hochstetler: I would spend much more time teaching about the dying process. Everyone should know the death process intimately before they graduate high school. The dying process is not really understood or taught anywhere. Not to adults and certainly not to kids. I would love it to be a part of school curricula. It’s too often avoided at all ages. Switching the order within the phrase dying and death allows us to really look at dying up close and to spend much more time and interest here, understanding this before we try to move on to death.

BDG: The pandemic has transformed our awareness of the fragility of life, our interbeing, and our relationships with old and young. In offering spiritual care to frontline healthcare workers, what do you see and how do you respond?

LH: Frontline healthcare workers are called to do their work because it matters to them. They want to be a part of a system that they approve of and where they feel they can make a difference. The pandemic has been challenging because many of the policies in healthcare were not in line with healthcare workers’ priorities. Healthcare workers were asked to work without PPE initially, and there were often staff shortages when staff were sick themselves or just stressed out. These situations were unfortunate because they pitted the workers against families, and even when the healthcare workers wanted to work together with families to provide good care to sick family members, they were unable to do so. We have been hearing that we’re all in the pandemic together, but too often our needs have been competing and we have not been able to work together well. Under these conditions, spiritual support is often considered to be superfluous and the easiest part to cut out. This is unfortunate, because it is our spirituality that is the core of our common humanity.

BDG: What is “a good death” and is this a goal we need to strive toward?

LH: A good death will differ for everyone. It is one that is in line with one’s values. It is also one that is the best in those circumstances from the options available. It is helpful to aim for a good death but not to cling too tightly to the idea, because sometimes things come up that are a surprise. It’s easier to say what is not a good death than what is a good death. What is not a good death is hanging on and slowing down death with the idea that it can be prevented. Attached to this is the idea that resisting death increases interventions at the end. Interventions create activity and distraction from the dying process, and often require professionals and hospital rules to take precedence over the dying process, which belongs to the dying person and their loved ones.

BDG: How is death work different from grief work?

LH: Death work is the honest seeing of the process of dying. It is witnessing the changes in the body, understanding how this affects the mind and ultimately our conversations and interactions with those remaining. Grief work is both the work of the dying person, who is letting go of this lifetime, and the work of the loved ones, who are releasing the dying person, and imaging a life without their loved one even while they are still alive. Very basically, death work has a greater focus on the body, while grief work has a greater focus on the mind and feelings. And both can happen both before and after the final breath.

BDG: The use of self is one of the benchmarks by which neophyte chaplains are evaluated in their CPE training. Yet the role of a spiritual caregiver demands the abandonment of self for the benefit of the patient or client. Since Buddhism negates the idea of a self, is there some special advantage a Buddhist approach can offer here?

LH: The use of self in a therapeutic sense begins with an awareness of self and an awareness of other. Buddhism negates the idea of a self—not in the sense that it doesn’t exist but that it is not inherently different from the other. Awareness training helps to hold this seeming dichotomy together. In this way, a Buddhist chaplain has the experience and training to see the patient or client as themselves and can more easily offer help from this perspective. They can go between their needs and their client’s needs seamlessly without needing to drop either side. Buddhist chaplains are way more comfortable with “both/and” situations.

BDG: When a loved one is dying, it is often the nexus for family conflict that can leave lasting scars. Of course, preventing such conflict is important, but when it has been unavoidable, what is the best way to repair the damage?

LH: Preventing family conflict around the death bed is so much easier than repairing it afterwards, so whenever possible, resources and time should be spent here. Making room for all loved ones to share in the dying process is best, even if that means making a schedule and taking turns in the care. However, when damage has occurred, it is best to find a neutral person—a chaplain or social worker—to speak with all sides individually and invite them to consider the wishes of the dying person. The dying person’s wishes should be of greatest importance, and ideally this priority can guide the overall decision-making.

BDG: How do Western Buddhist views of dying and death differ from those of Asian Buddhists? How are they the same?

LH: Buddhism is always a combined product of the scriptures/teaching and the local culture. As such, it is often hard to know what is influenced by Buddhism and what is influenced by culture. In many ways, there are fewer differences between Western and Asian Buddhists, and more differences between traditional Buddhist interpretations and modern options. For example, 50 years ago if someone was close to dying, they would be doing so at home and tended by family members into a natural death. Today, modern medicine presents many options for extending life and often these extensions are what is considered controversial. These options, which involve feeding and breathing tubes, are offered around the world. Taking someone off of life support, medical assistance in dying, or organ donations are all options that have come up in the last 50 years and were not even imaginable in the Buddhist scriptures or teaching, so much must be extrapolated from the culture on the rightness and wrongness of these choices. I think Western Buddhists and Asian Buddhists have much more in common than is often assumed and would do well to look at their similarities rather than their differences.

BDG: Briefly, what is the difference between palliative and hospice care, from a Buddhist perspective?

LH: There is no difference between palliative care and hospice care from a Buddhist perspective. In actuality, palliative care can involve a greater resistance when it includes death hidden from the community, but this doesn’t have to be so. Hospice care often occurs in locations—home or residential hospice—that allow for fewer rules regarding spiritual practices, but this is not inherently so.

BDG: What is the difference between spiritual care and psycho-spiritual therapy?

LH: Spiritual care emphasizes both the individual and the community aspect of spiritual practice. This might include formal practices such as prayer and chanting, with the support of spiritual leaders or lay chaplains or sangha members. Psycho-spiritual therapy often involves a relationship that works on individual ego work, often throughout one’s life. It includes explorations of where spiritual practices and aspirations fit into an individual’s life. Ideally, therapy is done long before the dying process so as to clear away energy for dying without also having the weight of previous relationships unresolved.

BDG: Is it possible to celebrate dying?

LH: Absolutely. Just like there are many challenges in one’s life, dying is a final one. Celebration comes from training for death and then completing it according to the training. As with many challenges, the focus doesn’t have to be on the exact result, but more in the effort in a particular direction. And the celebration of dying includes the celebration of living. Look at the whole life and see that dying is one more step of the life, and celebrate when it all hangs together consistently and as a whole.

Complete Article HERE!

A Requiem, Derailed by the Pandemic

Arrives When It’s Needed Most

Courtney Bryan’s Requiem, premiering Thursday after its original date was canceled last year, now follows a time of loss and upheaval.

By Joshua Barone

You’ve probably heard a story like this before. Courtney Bryan’s Requiem was set to premiere with the Chicago Symphony Orchestra in late March 2020. In a time of incalculable loss, her music became part of another kind of casualty: the sounds that vanished from stages around the world.

Like many premieres originally planned for the past year, Bryan’s Requiem, written for the vocal quartet Quince Ensemble and members of the Chicago Symphony, was stranded in limbo. But through the orchestra’s turn to online programming and a season-ending series organized by Missy Mazzoli, its composer in residence, the piece was given a new date this week, when the latest episode of CSO Sessions lands on the streaming platform CSOtv.

Maybe it’s actually more fitting that the Requiem be released now, as the United States emerges from its worst days of the pandemic — over 600,000 deaths later — and the country celebrates its first federally recognized Juneteenth, a year after the emotional, nationwide peak of the Black Lives Matter movement following the murder of George Floyd.

“I think about the loss in my own life, but I know that a lot of people have had a lot of losses during this time, due to Covid and other situations,” Bryan said in a recent interview. “So I’m really happy that this is the actual premiere.”

Bryan, who is based in and from New Orleans, is a composer and performer who deals in collaboration, with an open ear to traditions like jazz and gospel — and, occasionally, to topics around racial justice like Black Lives Matter. In “Sanctum” (2015), she wove live orchestral playing in with sounds including the voices of demonstrators in Ferguson, Mo. Her oratorio “Yet Unheard” (2016) commemorated the life of Sandra Bland.

Edwin Outwater leads the Quince Ensemble and members of the Chicago Symphony Orchestra in the premiere performance of Bryan’s Requiem, now streaming.

Her Requiem was meant to be more abstract — haunted by contemporary tragedies, perhaps, but not explicitly tied to any one in particular. It draws from a broad range of inspirations, including death rituals from the Anglican Church, “The Tibetan Book of the Dead,” Neoshamanism’s death rite known as the “great death spiral” and New Orleans jazz funerals, as well as text from the Bible and the traditional Catholic Mass.

Its five movements — Bryan associates that number with life — begin with a gentle, a cappella harmony built from elemental “mmm” sounds before each of the four voices of the Quince singers begins to follow a unique line, with detours into half-sung Sprechstimme and percussive sibilance. The other instruments don’t enter until about seven and a half minutes in, when the clarinet and brasses offer a chorale-like interlude, mournful and dignified.

The Requiem is primarily a showcase for the Quince singers. They follow that instrumental passage with repetitions of the word “listen,” in different ways: The score instructs one to exclaim, and the others to plead, chant on pitch and whisper. A bass drum resounds, signaling the start of a dirge that includes a duet of simultaneous yet lonely melodies from the clarinet and trombone. By the end, after sadly beautiful word painting with the “Kyrie eleison” text and a clarinet solo of upward runs, Bryan arrives at a finale that is less restful and resolved than a traditional Requiem’s, but more cyclical, closing with the “mmm” vocalise that started the piece.

Bryan talked more about the work and its inspirations in the interview. Here are edited excerpts from the conversation.

Was this commission specifically for a Requiem, or was that your choice?

It actually goes back to when I met Quince. I was really taken not only with their music and their voices, but also how they talked about music and the things that they cared about. We bonded, and then a year after that — about four years ago — we were talking, and I told them I would like to write an a cappella Requiem.

I grew up in an Anglican church and was deciding between the Catholic Mass and the Anglican Mass, and thinking of writing a Requiem, but in my own style. As I got into it, I started reading about different dying rituals from traditions around the world, how people approach funerals and the celebration of life. Then I took a pause, because it got really big. There was a lot to learn, and it was changing the way I approached it — and because we didn’t have a specific deadline, I stepped down.

Later, I heard from Missy Mazzoli about a commission at the Chicago Symphony, and I knew that Quince was on the program. So I changed it. The first section is still a cappella, but then I added instruments.

Even with more musicians, it’s still far from the scale of something like Verdi’s Requiem.

It was already going to be chamber size. But yeah, I ended up going kind of minimal with the way I used the instruments. I checked out classic Requiems, definitely Verdi’s and Mozart’s, and the feeling I got — or even just from reading the Catholic Mass — was this feeling of rising up against death. It feels like there’s a battle or a triumph, and I found that I was most interested in thinking about death and the cyclical nature of life and death, and more, kind of, an acceptance. So all my text was Christian, but it’s my perspective on the Requiem.

I was about to say, there’s a tension at the end of your piece, between triumphant language like “Death will be no more” and music that’s more unsettled and mysterious.

It felt like a natural ending because it’s a life cycle; it wasn’t a triumph or an arrival point. And with the text, “The first things have passed away,” I thought it was something that was not an ending or a beginning.

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Performed by the Quince Ensemble with members of the Chicago Symphony Orchestra; Edwin Outwater, conductor.

When you were exploring traditions of mourning, what did you find yourself attracted to, conceptually and artistically?

The one that hit home the most is just thinking about New Orleans — the idea of the celebration of life and the jazz funeral. There’s the walking of the casket from the church to the burial ground, but there’s a whole ceremony in a jazz funeral that starts with the dirge, and then it goes up-tempo to a celebration of life. So that was a major influence on the instruments that I chose: the brass band or the New Orleans ensemble. I wasn’t trying to replicate the style, necessarily, but there are little symbolic things.

What do you make of the context of this Requiem’s premiere, as opposed to spring last year?

I know some commissions come in response to this historic thing, and you have your own take, but this was something that I just wanted to do. That’s why it’s interesting that it took its own time and that the actual premiere is after this really profound time of loss. I find these kinds of things mysterious, how they happen. So, I hear it differently. It sort of came out of some of the work I was already doing, where I was writing music about police brutality. I wouldn’t say this piece is about that; it was a chance for me to go in deeper into these ideas about life and death.

Quince asked, in the middle of the rougher parts of the pandemic, how I would feel if they just recorded the first, a cappella part and put it online for people — just something to share. The folks at the Chicago Symphony were very supportive of that, so we did. It felt good to have something like that to offer, and I feel the same way as it is being offered now. I hope it will be healing to people.

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‘Death Doulas’ Provide Aid at the End of Life

End-of-life doulas support people emotionally, physically, spiritually and practically: sitting vigil, giving hand massages, making snacks.

By Abby Ellin

As parents of a child with a progressive and potentially fatal illness, Maryanne and Nick O’Hara lived on hope. Hope that their daughter, Caitlin, who was diagnosed with cystic fibrosis at age 2, would prove the statistics wrong and live longer than the 46 years expected. Hope that she would receive the lung transplant she spent two and a half years waiting for in her early 30s. Hope that her body wouldn’t reject it.

That hope faded on Dec. 20, 2016, when Caitlin O’Hara died of a brain bleed at the University of Pittsburgh Medical Center, two days post-transplant. She was 33.

Shattered, her mother decided to try to give meaning to her grief. And so she signed up for a certificate program at the University of Vermont’s Larner College of Medicine to become an end-of-life doula, or “death doula,” working with individuals and families as they moved from this life into whatever is next. (The terms “end-of-life doula” and “death doula” are used interchangeably, though some find the latter a little too blunt.)

“In our culture, we go overboard preparing for birth, but ‘hope for the best’ at the end of life,” said Ms. O’Hara, 62, who lives in Boston and Ashland, Mass., and is the author of “Little Matches: A Memoir of Grief and Light,” published in April. “The training was really a way of going even deeper into my own grief and realizing how I could take my own experience and help other people have a better end of life.

“I saw for myself how horrifying it is during a medical crisis and then after a death, to realize that life keeps going and needs attending to,” she continued. “As soon as Caitlin passed, suddenly it’s over and the person is gone and you have to deal with the business of living. A good doula will support you with that.”

The word “doula” comes from the Greek word meaning “woman who serves,” though most people associate it with someone who helps during birth to usher in life. In recent years, however, more people have come to recognize the need for as much assistance at the end of life as the start, part of the so-called death positivity movement that is gaining momentum in the United States and other countries. The movement, popularized by the mortician and writer Caitlin Doughty, encourages open discussion on death and dying and people’s feelings on mortality.

“The beginning of life and the end are so similar,” said Francesca Arnoldy, the lead instructor at UVM’s End-of-Life Doula program. “The intensity of it, the mystery, all of the unknowns. You have to relinquish your sense of control and agenda and ride it out, and be super attentive in the moment.”

Unlike hospice workers, doulas don’t get involved in medical issues. Rather, they support clients emotionally, physically, spiritually and practically, stepping in whenever needed. That could be a few days before someone dies, sitting vigil with them in their last hours, giving hand massages, making snacks. Or it could be months or even years earlier, after someone receives a terminal diagnosis, keeping them company, listening to their life stories or helping them craft autobiographies, planning funerals. Prices range from $25 an hour on up, although many, like Ms. O’Hara, do it voluntarily. And like Ms. O’Hara, many have signed on to help give new meaning to their own grief while helping others in the process.

More than 1,400 people have graduated from the UVM program since its inception in 2017. Coursework, which costs $800 for eight weeks, includes writing farewell letters to loved ones, crafting their own obituaries, completing legacy work or a “Life Story Project” with a trained volunteer, and starting or updating their own advance care planning files. The program also recently started a “StoryListening” research project in which mourners across the country are invited to share their stories of loss during the pandemic with a trained doula. At the end of the hourlong session, participants are given a recording of their own conversation.

Since its founding in 2018, the National End-of-Life Doula Alliance, a professional organization of end-of-life practitioners and trainers, has grown to nearly 800 members; membership nearly doubled in the last year, said its president, Angela Shook. Interest has increased in training programs with the International End-of-Life Doula Association, Doulagivers, and the Doula Program to Accompany and Comfort, a nonprofit run by a hospice social worker, Amy L. Levine.

Much of the growing interest in these programs has come from artists, actors, young people and restaurant workers who found themselves unemployed during the pandemic and recognized that they could still be of service.

“People were reaching out from a variety of different ages, younger than we would normally see, because they realized that people were dying in their age category, which doesn’t usually happen,” said Diane Button, 62, of San Francisco, a doula facilitator at UVM and a member of the Bay Area End-of-Life Doula Alliance, a collective of death workers. “It made them more aware of their own mortality and really made them want to plan and get their documents and advance directives in order.”

Rebecca Ryskalczyk, 32, a singer in Vergennes, Vt., had always felt “kind of comfortable” with death. She lost two cousins in a plane crash when she was 12 and a friend to suicide four years later. When Covid put her performing schedule on pause, she enrolled at UVM. Her goal is to let people know that they don’t have to be afraid of death; nor do they have to do it alone. “Being able to help advocate for someone and to spend the last moments of their life with them and help them stick to their plan when they may not be able to express that is an honor,” she said.

Before the pandemic, Kate Primeau, 35, also worked in the music industry. Last June, after her grandfather died of Covid-19, she began researching how to host a Zoom memorial and came across the concept of a death doula. “I felt a huge gap between the amount of grief everyone was feeling and the resources available,” she said. She got certified as an end-of-life doula through Alua Arthur’s company, Going with Grace, and also volunteers in a hospice program. “I can’t believe how much I’m geeking out over all this death education.”

During the pandemic, of course, doulas had to shift the way they worked. That was one of the main challenges: They couldn’t interact in person. So like the rest of the world, they resorted to Zoom calls and FaceTime. Families often reached out for their own healing.

“A lot are coming to me for ritual and ceremony when they can’t be with their loved one physically and they’re alone in the hospital room,” said Ash Canty, 34, of Eugene, Ore., who refers to himself as a “death walker.” “There’s a curiosity that wasn’t there prior to Covid. They’re wanting to know, ‘How do I make sense of this spiritually? How do I be with this? Because I’m really struggling.’”

As for Ms. O’Hara, who is also a novelist, she is primarily helping people write their life stories. Her training at UVM was “humbling.” “I went into it thinking ‘I’ve been a volunteer with people who are dying, I’ve lost my daughter, I’m an expert in grief,’” she said. But the longer she studied, the more she realized that she was only an expert in her grief.

“You really can’t tell anyone else how to grieve,” she said. “You can offer advice, but there’s no timeline for grief. As soon as people get a diagnosis, they’re grieving. Their way of life is over. Everyone has suffered some kind of grief with the pandemic, even if they haven’t lost a person.”

She believes that grief and joy can coexist. “My grief is never going to go away,” she said. “I wouldn’t want it to. Grief and joy and love — it’s all part of the same spectrum. I’m grieving because I loved someone so much.”

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