A Handbook for Grieving

Go funeral dress shopping. When the saleswoman asks about the event, say: “Dressier than office, but not as fun as cocktail.”

By Caroline M. Grant

Before: Text your friends to tell them that your mother has entered hospice. Tell them that it’s just to get the equipment she needs (a hospital bed, a better wheelchair) and not a sign of her impending death. Pretend you believe it.

Brace yourself for the SWAT team of hospice services and providers that descends on you: the social worker, the nurse, the chaplain, the volunteer bearing a soft blanket, a stuffed bear and lavender-scented hand lotion. Give the bear away.

Answer every phone call from “Unknown Number” because usually it is some kindly person from hospice. Apologize to the Unknown Number who is not hospice when you tell her no, you can’t subscribe to the symphony because your mother is dying. Start to tell her that your mother used to subscribe to the symphony and you would like to someday, when she is … Trail off, hang up and feel guilty about the little bomb you dropped into her day.

A month before your mother’s death, read the draft of her obituary that your father has written, and start to offer edits like it’s any other piece of writing. Don’t cry until you come to the names of your children and nieces.

Nine days before her death, lean in close to your mom, sitting in her wheelchair at the dining table, and ask her to repeat herself until you hear her say, “I’m hurting.” Take her back to bed immediately and tell her you’re sorry, so sorry, you never want her to be in pain.

Cut up the back of all your mother’s nightgowns so that the caregivers can take them on and off easily. Cut off all the buttons to make the gowns more comfortable.

Talk and text with your siblings to help them figure out if and when they should fly out. Tell them not to feel guilty if they can’t; mean it. Feel relieved when they all book flights.

Sit at your mother’s bedside, holding her hand and begging her to please hang on, when your sister’s flight is delayed for six hours. Keep readjusting the sleeping arrangements in your house so that two guest rooms work for five extra family members. Put air mattresses on the floor of your bedroom for your kids and secretly wish it were a permanent arrangement.

Go funeral dress shopping with a friend. Meet her after work downtown and go to the mall like it’s a normal evening. Feel momentarily stumped when the young saleswoman asks brightly, “Shopping for an event?” Resist the urge to answer darkly; instead, try, “Dressier than office, but not as fun as cocktail.” Stare back at the saleswoman and feel some sympathy when she blinks.

Buy an entirely inappropriate, form-fitting, off-the-shoulder dress (which will hang in your closet, unworn, until you finally take it to a consignment store). Accept your tissue-wrapped purchase from the saleswoman who says, “Have fun at your event!”

Escape with your friend to a restaurant and down a glass of wine, very fast.

Seven days before her death, stand at your mother’s bedside while a priest gives her the Last Rites. Two days later try to control yourself, at church, when the same priest says that he is “bad at the Last Rites” because the recipients don’t actually die. Do not catch your sister’s eye, and definitely do not look at the woman the priest points to as proof; she is not your mother.

After church, race back to your mother’s bedside where your brothers have been keeping vigil. Lean in close and smile when she gestures toward your outfit and whispers, “I like this.”

Tell her you chose it with her in mind. Be so glad that “I’m hurting” won’t be the last thing she says to you.

Take turns with your father, sister and brothers, sitting with your mother and holding her hand. Notice when her tight grip, which you have had to peel off finger by finger, loosens, but don’t comment on it. Pass her hand gently to each family member in turn, like the baton in a terrible relay race.

Read to her and play music. Try not to flinch when the nurse nods approvingly and says, “Hearing is the last thing to go … well, nearly the last thing.” Wonder at how quickly you have become accustomed to your mother, your bright and opinionated mother, lying unconscious, mouth open and breathing heavily. Listen to her breathing and try to memorize the sound of it.

Three days before your mother’s death, start to sleep with the phone by your bedside. Be grateful on the two mornings you wake up without it having rung.
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After: Hang up the phone and lean into your husband’s arms. Tell him, “Now I have to learn how to live in this world.”

Wake your siblings. Drive through the darkness to your father’s apartment. Continue to call it your parents’ apartment.

Write “RINGS” on a piece of paper and set it on the floor by your mother’s bed so that you don’t forget to ask the undertaker to remove two of her rings. Ask him to please leave her wedding band on.

Go funeral dress shopping with your sister. Buy the only dress you try on. Notice ruefully that you actually kind of like it. Too bad; you will never be able to wear it again.

Dig out the darkest sunglasses you own and wear them even on gray and rainy days.

Drink so much water. Grief is dehydrating.

Be thankful for friends who make very specific offers: to do your laundry; to pick up family members at the airport; to deliver breakfast; to buy you waterproof mascara.

Look around during the funeral and realize how many of your friends have also buried their mothers. Wonder if you were supportive enough to them, realize you couldn’t possibly have been, know that you will be from now on.

Pause, during the final verse of the final hymn, and listen with tears and joy while your sister and niece float the descant high above all the other voices.

Add your voice and hope that the music somehow reaches your mother.

Complete Article ↪HERE↩!

October 26, 2018October 26, 2018

How close is your death?

New algorithm can tell patients how long they have to live

By Elizabeth Payne

Ottawa researchers are taking a page from Netflix and Google to help patients, their families and their doctors have informed conversations about death.

Researchers at Ottawa’s newly minted National Centre for Individualized Health have developed an algorithm that predicts how many months, or years, patients near the ends of their lives have to live.

It is information some people might not be comfortable with, acknowledged Dr. Peter Tanuseputro, an investigator at the Bruyère Research Institute and family doctor who offers house calls to his palliative patients. But he believes many elderly patients will want to know exactly how long they have to live, information not currently available for most. He also said everyone deserves access to the information, based on an individual’s health information and data collected across Ontario.

Among other things the end-of-life calculator can lead to is more appropriate care and more people benefitting from palliative care. Only 15 per cent of Canadians receive palliative care, according to recent data released from the Canadian Institute for Health Information. Even those who do often get it too late, said Tanuseputro.

“In Canada, we don’t like to talk about death and dying,” he said. “We think patients have the right to their own information to tell them about what is going to happen to them. We still live in a paternalistic society where we don’t think the patient can handle that information or don’t think they should have this information.”

The predictive algorithm, which goes by the acronym RESPECT (for Risk Evaluation for Support: Predictions for Elder-life in the Community Tool for the End of Life), calculates how long a person has to live based on 25 questions about what diseases they have and how difficult it is to care for themselves. The algorithm was developed using data collected through the province’s health system.

It is one of the digital health projects being developed by Bruyère aimed at addressing the health needs of people as they age (more info at bruyeredigitalhealth.ca/en/projects).

It is currently being pilot-tested in Windsor-Essex to help people who are frail understand whether they would benefit from palliative care. It is one of a series of algorithms using big data that is aimed at helping older people better understand their health risk factors in an effort to help them get better treatment.

When they are complete, the tools will be available to individuals and family members on the projectbiglife.ca website. In addition to calculating how close a person is to death, researchers are developing tools that will help calculate how long before an individual is likely to end up in a nursing home, and their risk of hospitalization.

Those tools can lead to preventative measures to help people stay in their homes longer, in some cases, or to get more appropriate care. Their development is part of the National Centre for Individualized Health, affiliated with Bruyère Research Institute, which was created with the help of donations totalling $1.25 million.

Tanuseputro said the use of big data to create predictive tools has the potential to change individual treatment and health care more generally. The health system is just catching up to what has been done elsewhere.

“If you watch Netflix, it will tell you what Netflix thinks you like based on your previous choices. In health care, we are just figuring this out,” he said.

“These tools are to help patients make informed decisions. Too often, you visit your doctor and your doctor has only limited amount of time and limited information.” While they might have a patient’s electronic medical data, that would not include what happened, for example, if the patient was in a hospital 100 kilometres away.

Among information patients are asked for in the 25 questions that feed into the predictive algorithm, are questions about activities of daily living, such as eating, bathing, personal hygiene and toiletting. Those, he said, are often a better indication that a patient does not have long to live, than a diagnosis of chronic illness.

He said physicians are sometimes hesitant to tell patients they are close to death — in part, because it is difficult to be accurate. This tool should change that, he said.

“We think patients have the right to know and seek out care that is appropriate to their needs. If a patient knows that they have a year to live, they should be receiving palliative care, supportive care, in order to stay at home. Clinicians don’t do it enough, partly because we live in a death-denying society and partly because it is hard, especially if you don’t have a terminal cancer diagnosis.”

Complete Article ↪HERE↩!

October 25, 2018October 25, 2018

More to dying than meets the eye

Those who work with dying people are familiar with patients seeing long deceased loved ones, angelic beings, even hearing music and comforting voices as the patient nears death. Deathbed phenomena have been documented in the days, weeks, and months before death since the 1500s. Often confused with hallucinations, deathbed phenomena can bring comfort to patients and caregivers if those involved know what they are experiencing. This talk will explain deathbed phenomena and present on-going research about the topic. Accounts from the dying and bedside witnesses will be shared.

October 24, 2018October 24, 2018

How to Grieve for Online Friends You Had Never Met in Person

We often use technology to form meaningful relationships with virtual strangers. But what happens when the person on the other side of the screen dies?

By Cindy Lamothe

Last November, Kristi Pahr felt both shock and denial after learning that her online friend of over four years, Amy, had died suddenly. She says she still cries remembering those initial days of grief. Amy, she said, “was a better, more ‘real’ friend to me than most people I know in person.”

Ms. Pahr, 41, a freelance writer from South Carolina, first met Amy through mutual friends in an online Star Wars game back in 2013. She fondly recalls a similar “geekiness” and love of fantasy novels quickly bonded the two. “We chatted every day, shared pictures of our kids,” complained about their spouses. And though she and Amy knew each other only virtually, their daily texts evolved into years of mutual support and understanding. “She encouraged me to start submitting my writing for publication,” Ms. Pahr said, “and was one of the only people I ever let read the things I wrote before I was published.”

Today around 70 percent of Americans connect over social media, according to the Pew Research Center. Although many of us are talking to people we know in real life, it’s easy to form connections with people we have never met in person.

More than ever before, we are using our smartphones and technology to form meaningful relationships with virtual strangers, both in romance and friendship; we celebrate one another’s successes, share our individual struggles, and despite geographical limitations, these bonds often span years. But what happens when the person on the other side of the screen dies?

Finding out about her friend’s death last fall was devastating, said Ms. Pahr, who recalls scrolling through her newsfeed one day and stumbling upon a post from someone outside of her contacts offering condolences to Amy’s family. “I was dumbstruck and thought it must’ve been a mistake.”

She remembers frantically messaging Amy soon after, and waiting for the “read” indicator to pop up next to the message — only to have it remain unanswered.

“Days passed and I still waited,” she said. “I kept expecting to find out it was a different person, or that someone had been wrong.” Not knowing what else to do, she eventually reached out to Amy’s husband by messenger, who confirmed her friend had passed away. “I was a disaster for a while, randomly crying throughout the day.”

Our ideas about which relationships are “real” have not caught up with the ways we actually live and connect, said Megan Devine, a Portland-based psychotherapist and author of “It’s OK That You’re Not OK.” She’s adamant that this deep sense of loss isn’t limited to in-person friendships.

One of the difficulties Ms. Pahr faced after Amy’s death was a lack of empathy from others. “Even well-meaning and compassionate people don’t place the same weight on your grief,” she noted, the way they would if you lost a friend you knew in person.

“Grief is often unacknowledged in western culture, no matter what the cause,” Ms. Devine said. In fact, the societal norms around grieving cyber relationships is still relatively new, and to this day, remains largely unexplored. “When you add in the non-corporeal relationship, the pain can be even more invisible.”

This can often lead people to experience what psychologists call “disenfranchised grief,” a term coined in 1985 by Dr. Kenneth J. Doka to describe a loss that isn’t acknowledged by others. As he explained in his book “Disenfranchised Grief: Recognizing Hidden Sorrow,” these losses can often deprive a person of the catharsis found in shared bereavement. “You don’t really have a socially sanctioned right to grieve,” said Dr. Doka, who teaches gerontology at the College of New Rochelle in New York. “But these relationships can be very profound.”

Understanding the unique challenges of cybergrief can validate how a person may be feeling. Here are five ways of coping with the loss of an online friend.

Don’t Dismiss It

“In many ways, the grief is twofold,” said Dr. Kathleen R. Gilbert, author of “Dying, Death, and Grief in an Online Universe,” because a person isn’t only grieving their loss, they’re also grieving for the loss of support they had hoped they would receive from other people. Often times, Ms. Devine explained, it’s our in-person friends or family who can be confused or dismissive of our grief. But, she emphasizes, the first step forward is to acknowledge that all relationships are important, whether we see someone physically or not.

Claim Your Grief

One of the things the internet does is expand our awareness of the world beyond the corporeal one we know. Social media allows us to develop a construct of another person, their hopes and dreams — and similarly, share our own. Many of us have spent years cultivating relationships based on words and images.

This has been true for Ms. Pahr: “Friendships and what it means to be friends has changed so much in the last 20 years,” she said. “The fact that you can be BFFs with someone without ever hearing their voice or touching their skin is mind-blowing to some people.”

Cyberloss isn’t any less genuine or deeply significant simply because the interactions took place online. As Ms. Devine explains, every grief is valid, and just because you aren’t in the same room, or connecting over tea in your home city, doesn’t mean you don’t rely on the person, or count them among your inner circle. “The only person who gets to decide what grief looks like is the person experiencing it.”

Gently Reach Out

Whether or not we should contact the person’s family with our condolences can be tricky. On the one hand, we want to express how much they meant to us, but we’re also wary of intruding.

Ms. Devine encourages gently reaching out to the family or friends of the person with a quick message or email sharing a favorite memory, and letting them know we join them in wishing things were different. Family members may not recognize your message in the initial days and weeks after the death, “but many people take great comfort in learning how vastly loved their person is.”

When it comes to attending the funeral, she cautioned that there are boundaries to keep in mind. While everyone has a right to grieve, if we aren’t in the epicenter of the loss — as in immediate relatives and loved ones — we might feel less recognized at in-person events like memorials or funerals. Even so, attending them shouldn’t be ruled out altogether. Go if it feels right, Ms. Devine suggested, but do not shove your way into the inner circle. “Your relationship is valid, but it’s different from the partner, parent, child, sibling, etc.,” she said.

Create a Ritual

The hardest task of mourning is to accept the reality of the loss, said Julia Samuel, a London-based psychotherapist and author of “Grief Works: Stories of Life, Death, and Surviving.” If someone is an online friend, she explained, there may be less concrete experiences or objects on which to focus one’s grief, which could make it hard to really believe the person has died. She advises the importance of creating a ritual that represents an ending, whether by lighting a candle and saying a prayer or poem, or going to a place of worship to do something similar. Dr. Gilbert likens this to a ritual of transformation: “The person is no longer available to me, but I can still have in my heart a connection with them.”

Find Your People

While the pain of grief may lessen over time, Dr. Doka noted that we never really get over a loss, we learn to live with it. That includes cybergrief. “Even years later, people can have surges of grief,” he said. Though it will feel difficult at times, finding support through a trusted counselor or online bereavement community can be an invaluable way of receiving the validation we need.

Of course, creating relationships — online and off — that are based on care, support, kindness and empathy are your best resource, adds Ms. Devine. Investing in all of those friendships is your best insurance, “that way, no matter what happens, you have a net to surround and support you.” As Ms. Samuel put it, “What we need most when someone we love has died is the love of others.”

Complete Article ↪HERE↩!

October 23, 2018October 23, 2018

‘I’m a friend at the end – why I became a death doula’

When a loved one dies, it is often medical staff, a hospice and an undertaker who deal with the final moments.

But families can now bring them back into the home, engaging an end-of-life doula to take care of the last wishes and arrangements for their loved ones.

Hilary Pepiette, a solicitor, is one of Scotland’s first end-of-life doulas.

She thinks there is a great need for her role as a “friend at the end”.

Hilary told BBC Radio Scotland’s Kaye Adams programme: “An end of life doula is someone who supports and walks alongside a dying person, the family and people close to that person, through the dying process, through the death and sometimes after that.

“The doula is your consistent flexible presence to fill in the gaps and give support emotionally, spiritually and practically in whatever way it is needed for each individual person and your family.”

Hilary believes we have handed over control to the professionals.

She said: “I have seen family members who have died and I think there is a feeling for me that I would love to do more and make sure that people can have the best possible death they can have, and to celebrate life.

“It is about making sure people live their life to the absolute fullest potential as long as they possibly can, and celebrate that, and then help them have the death that they want to have, give them come control over that.

“My mum died at home and while we did the best we could and it was a good death.”

Death is a taboo

But she added: “I wish I knew then what I do now about what was going on for her at that time.

“It’s only in the past 100 years or so that people have stopped caring for their dying family members at home and it all became about hospitals and the medical profession.

“Death has become a taboo and something that people have stopped talking about. But the more we are open about it the better. Being with someone and having those final conversations is so rewarding.”

Hilary thinks people can talk about their end of life wishes more easily with someone who is not family

As a solicitor in Edinburgh, Hilary processed wills and personal business. She decided to take her end-of-life services one step further.

She said: “It felt natural. I have been a private client solicitor for more than 20 years, and through that I have worked with a lot of people planning wills, powers of attorney and advanced medical directives to help them think about and plan for the end of their life.

“It seemed like a natural progression to me to take that one step further and think about what happens after the legal documents have been put in place.”

Hilary’s firm BTO, is the first to offer an end-of-life doula as part of its services.

What does an end-of-life doula do?

A doula will talk and listen to the patient’s wishes and hopes for the way they will die

According to Hilary: “I do things from washing dishes or making their dinner or cutting someone’s nails or feeding them at the end of their life. Also providing the personal care that might be provided in a hospice.

“Also talking. There is a big role for conversation here where it can be really hard within a family to have the difficult conversations about what you want the very end of your life to be like, where do you want to be when you die, who do you want to be there. Do you want music playing?

“It is establishing what the biggest hopes and fears are. What are you most afraid of? Is it pain or losing control of autonomy, of making decisions. Having those conversations is a big part a doula can play.

“Some people are never comfortable talking about it. But most people who are given that opportunity and a safe place to do that are happy to do that and have those conversations.”

Someone who agrees with Hilary is Prof Dame Sue Black, forensic anthropologist and vice chancellor for engagement at Lancaster University, wants death to be celebrated more.

She told Kaye Adams: “It is an inevitability, it is going to happen. What we can’t control is how it happens.

“In the past that would have often been done by family. I think we have become scared of death, we don’t want to admit it exists.”

Prof Black was awarded a Damehood in 2016

Prof Black thinks people have been conditioned to believe in a certain way of doing things.

She said: “People tend to accept there are rules we have to abide by but generally there aren’t. It’s important those left behind feel they have the autonomy to respect the person they have lost in a way that helps them with their grief.

“We think a funeral has to be very specific in that it has to have hymns and speaking, and it doesn’t. We need to have a confidence that those who are left behind have control over the celebration of the person who has been lost.”

She also thinks people should not be afraid of the last moments and to make the most of them.

She said: “I think we forget sometimes when patients are advancing towards the end of life that we think they are not listening and don’t communicate.

“There is some research that suggests the last sense to go may well be hearing so that’s the time we need to tell them how much we love them, how much we care, what a difference they’ve made.

“One of the last things we can do is communicate.”

Complete Article ↪HERE↩!

October 22, 2018October 22, 2018

The five stages of grief don’t come in fixed steps

– everyone feels differently

By Nick Haslam

Grief can seem desolate for those in the thick of it who often feel unable to imagine a way out of their suffering. But, as time passes, the pain usually dampens or becomes more fleeting.

Understanding the normal trajectory of grief matters for the person experiencing the grief and those treating them. Attempts to provide a map of the bereavement process have typically proposed a sequence of stages. The “five stages” model is the best known, with the stages being denial, anger, bargaining, depression and acceptance.

While there is some evidence for these stages, the experience of grief is highly individualised and not well captured by their fixed sequence. Some of the five stages may be absent, their order may be jumbled, certain experiences may rise to prominence more than once and the progression of stages may stall. The age of the bereaved person and the cause of death may also shape the grief process.

Stages of grief

The first major attempt to outline the stages of grief was made by British psychiatrist John Bowlby, father of attachment theory, an influential account of how infants and children form close bonds to their care-givers. Bowlby and his colleague Colin Parkes proposed four stages of grieving.

The first is of numbness and shock, when the loss is not accepted or seen as not real. The second stage of yearning and searching is marked by a sense of emptiness. The mourner is preoccupied with the person who has been lost, seeking reminders and reliving memories.

In the third stage, despair and disorganisation set in. This is a sense of hopelessness and sometimes anger where the bereaved person may withdraw into depression. Finally, in the re-organisation and recovery stage, hope rekindles and there is a gradual return to the rhythms of daily life.

Bowlby and Parkes’s model, first proposed in the early 1960s, may have been the first. However, it’s Swiss-American psychiatrist Elisabeth Kübler-Ross’s model coined in 1969 that has become the most widely known. Her five stages of grief – originally developed to map patient responses to terminal illness – have become famous. They have been applied not only to responses to death but also to a variety of other losses.

Kübler-Ross’s first stage, denial, resembles what Bowlby and Parkes labelled numbness and shock, but her second, anger, departs from their scheme. The affected person demands to understand why the loss or illness has taken place, and why it has happened to them. In the third stage, bargaining, the person may be consumed with “if only”, guiltily wishing they could go back in time and undo whatever may have led to the illness, or death.

Stages four and five involve depression and acceptance. Despair and withdrawal gradually give way to a sense of fully acknowledging and making peace with the loss.

Evidence for the five stages

Kübler-Ross’s stages emerged from her clinical work with dying patients rather than systematic research. Empirical support for the existence of the proposed sequence of stages has been scant but intriguing.

One study followed 233 older adults over a 24-month period after the death of a loved one from natural causes. It assessed them on experiences associated with a modified version of Kübler-Ross’s stages. In accord with her theory, each of the five experiences peaked in the predicted order.

Disbelief was highest immediately after the loss and declined gradually thereafter. Yearning, anger and depression peaked at four, five and six months respectively before declining. Acceptance of the loss rose steadily over the two-year period.

Seeking reminders and reliving memories are often part of the grieving process

Problems with the stage model

Although the sequence of peaks matched Kübler-Ross’s model, some aspects of this research also challenged it.

First, although disbelief was at its highest immediately after the loss, it was always less prominent than acceptance. Acceptance is not a late stage of resolution for people who are grieving, but an experience that prevails from the start and continues to grow.

Second, yearning was the most prominent negative experience, despite being omitted from the most well-known version of Kübler-Ross’s five stages. This points to the limitations of framing grief in the clinical terms of depression, which study participants experienced less frequently than longing.

But the study’s findings can’t necessarily be generalised as it looked only at older adults and natural causes of death. Another major study found the typical pattern of grieving among young adults was substantially different.

Yearning peaked before disbelief, and depression remained constant without resolving over two years. In addition, yearning, anger and disbelief returned with a second peak near the two-year mark, when acceptance also declined.

Moreover, young adults whose loved ones died by violent causes differed from the typical pattern. For them, disbelief dominated their first months, and depression initially declined but then rose again as the second anniversary of the death approached.

The way a person has died may shape the process of grief for their loved ones.

All these findings represent the average responses of a sample rather than the trajectories of individual participants. Even if the Kübler-Ross’s stages partially reflect the statistical tendencies of the whole sample, they might fail to capture how individuals’ experiences of grief unfold.

That is the conclusion of a study that followed 205 adults over an 18-month period following the loss of a spouse. These adults had been interviewed for a related study prior to the loss.

The researchers found evidence of five distinct trajectories, with some people being depressed before the loss, and recovering afterwards. Some fell into a long-lasting depression, while others were fairly resilient and had experienced low levels of depression throughout.

States of grief

Kübler-Ross came to acknowledge the reality that her stages compose an appealing narrative of recovery rather than an accurate sequencing of grief. Experts now place less emphasis on her stages as a series of steps on the bereavement journey, much as they have tended to lose faith in other stage theories of human behaviour.

For all its limitations, Kübler-Ross’s analysis still has value. The supposed stages of grief may be better understood as states of grief: recognisable experiences that rise to the surface in distinctive ways in each person’s sorrowful passage through loss.

Complete Article ↪HERE↩!

October 21, 2018October 21, 2018

The Four Words Nobody Likes to Hear

You’re Going to Die

By Emma Silvers

About two months ago, seated on a small airplane that was descending through a lightning storm on its way to land in Florence, Italy, I was 90 percent certain I was going to die.

My terror only lasted about 10 minutes—from the moment I saw the first flash in the dark outside the tiny window, through a half-dozen weightless-feeling, heart-stopping lurches, until the wheels touched down on the runway.

Which is to say, it was nothing compared to what the residents of Hawaii felt earlier this year when one click of the wrong button at a local government office sent warning of an imminent ballistic missile in an all-caps text message to everyone within state limits.

The mistake went uncorrected for 38 minutes—minutes in which, as a close friend who happened to be there for a wedding later told me, people did what anyone would do: panic and try to take shelter, yes, but also attempt to make peace with the inconceivable notion that there, on a previously unremarkable Saturday in January, they were about to die. Unable to assess the legitimacy of the threat, my friend called her parents and told them she loved them, then she and a few other wedding attendees headed for the beach. At the very least, they decided, they would die somewhere beautiful.

I can’t be alone in hitting a wall of cognitive dissonance when I try to think about death: it’s universal, an equalizer, one of the few absolute inevitabilities about the experience of being human (along with taxes, har har). And yet it’s also so personal, and unknowable: especially for those of us who don’t practice a religion with a sure-footed concept of the afterlife, what actually happens when we leave this mortal coil is the ultimate in unavoidable question marks. All of which makes it fantastically appealing to try to avoid the topic entirely—particularly if you live somewhere, like, say, America, that worships youth and the young.

But if the uptick in death-themed workshops and events geared toward young people is any indication, avoiding the topic of death is no longer working for a vast number of people.

“It’s a really a whole movement we’re seeing, in which people are asking different questions, having new conversations, saying they’re not satisfied with how death has been treated in our culture—which is, of course, to push it aside until you can’t anymore,” says Chelsea Coleman, a singer-songwriter and co-host of You’re Going to Die, an ongoing performance series in which participants are invited to share stories and songs about grief and loss. Coleman hosts the series’ first Oakland event this Wednesday, Sept. 26, at the Starline Social Club.

Founded in San Francisco in March 2009 by the writer Ned Buskirk, “YG2D” began as a monthly community open mic at the intimate, now-defunct venue Viracocha; it didn’t take long for the event to start regularly selling out. Buskirk soon restructured the night to highlight featured musicians at each event, eventually asking Coleman to join him as co-host.

Ned Buskirk founded You’re Going To Die in 2009.

Coleman attended her first event in 2012, shortly after the death of her grandfather, with whom she was very close. “I was with him when he died, and I wrote songs about it, so I was looking for an outlet to perform some heavy stuff,” says Coleman. “Often when you play at a bar, it’s like—sure, you can play songs about heartbreak, but ‘Here’s a song about my grandpa dying’ is really not the vibe most places.”

She was hooked after one show. “It was such a powerful space,” says Coleman. “Hearing other people speak and perform is always moving, but I also felt like what I was offering had more power there. In the past I had sometimes felt like what I was doing was a burden.”

“But people show up [at YG2D] because they want to have an emotional experience,” she says. “That changes everything.”

A selection from the You’re Going To Die Instagram feed, which offers regular reminders of the inevitable.

You’re Going To Die became a registered nonprofit in 2017. The organization has expanded swiftly in the last two years, forging new partnerships with prisons—including workshops and shows at San Quentin—and with hospice programs, in which volunteers visit with people who are dying to hear stories, and to write or play music with them. The events are spreading geographically as well, with workshops or shows planned for San Diego, Ohio and New York in the coming months.

In doing so, the nonprofit joins organizations like The Dinner Party, a grief support network for 20- and 30-somethings that began as a series of informal potlucks in LA; the network now includes meetups in the Bay Area, Washington, D.C. and New York. Death Salon, meanwhile, hosts pop-up events of academic discussion and performance organized by a group of medical historians, artists and funeral industry professionals who’ve positioned themselves at the forefront of the Death Positive Movement.

It’s tough, as an American, not to wonder if there’s some correlation between the growing call for such conversations and the events of the past two years—when macabre jokes about our president’s access to nuclear buttons have become part of daily life: one part gallows humor, two parts very real fear.

But for a vast number of Americans, of course, the reality of death is perhaps no closer than it ever felt before: black men and women contend with the reality that they might be killed every time they step out the door, for actions as simple as walking, driving or taking BART. When a former coworker of mine, an activist and health care worker who was also a trans woman, died earlier this year, I felt (along with sadness for her family and close friends) a small sting of resignation: the numbers don’t lie.

Coleman has a sense, however, that those not previously accustomed to considering death may have been moved in that direction by the “heightened” state of U.S. politics since 2016.

“I think a lot of people who have had the privilege of being in denial for a long time are starting to ask questions,” she says, as I flash on my brief lightning storm-induced terror. “A lot of communities haven’t had that privilege.”

Regardless of the timing, “I think things feel heavy right now for pretty much everyone, and it’s very clear to me that people are hungry for these kinds of conversations,” says Coleman, recalling the first YG2D event she hosted solo, without Buskirk. “I was nervous people weren’t going to want to talk, but from the moment we started, everyone wanted to tell stories.”

Oh, and keep that in mind if you’re heading to your first YG2D, as well. Coleman says some of the most powerful performances come from people who weren’t planning on performing. While the event has morphed over the years, the open-mic portion still makes up its bones. Audience members who’ve never sung or told stories publicly before quite frequently take the stage.

In other words, there’s perhaps something universal happening there as well. What would I do if I had 38 minutes to live? For a topic so commonplace, so obvious and so inevitable, people surprise themselves all the damn time.

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