3 Ways For Dealing With Grief, From Someone Who Lost A Parent As A Teenager

“Death is natural — but that’s precisely why we should be open to talking about it.”

teen grief

By Susannah Keogh

Grief is all around us. It’s not something tangible, not something you can necessarily see or pinpoint. The tentacles of grief have no expiry point; no magic moment where it stops. It can subside, sure, but leave? Never.

One in every 1,500 secondary school pupils dies each year. One in seven Americans will lose a parent or sibling before the age of 20. So why aren’t we, as a society, talking about grief?

Perhaps it’s because, like anything new, we are scared. Scared of saying the wrong thing, of offending someone, or just of showing any signs of weakness in a society where being perfect is valued above all else.

Of course, it’s easy to argue that death is inevitable, a natural part of life and not something weneed to be made aware of. And to a certain extent, this is true. Death is natural — but that’s precisely why we should be open to talking about it, and the grief that comes with any bereavement. By not raising awareness of an issue that is a huge part of so many people’s lives and has a huge effect, especially in adolescence, society is doing everyone a disservice.

Grief can be neglected not out of malice, but simply out of how it’s perceived as being alien territory. But seriously, it’s OK not to know how to approach someone suffering the loss of a loved one. There are no magic words you can say to make their pain go away, no instant guidelines to follow. Every person’s grief is different, but with today being Children’s Grief Awareness Day, here is what to bear in mind, based on my own experiences:

1. Don’t ignore the elephant in the room.

If you or a friend is suffering from grief, acknowledge it. I don’t mean asking your friend 24/7 whether they need to talk, but it’s important to reach a happy medium point. You don’t want to push someone into talking if they’re not ready yet pretending nothing’s happened and carrying on as normal can be just as harmful.

Even now, eight years on from the death of my dad, there’s still that awkward silence whenever I mention him to people other than my closest friends. It’s that sense ofohgodIdon’tknowwhattosaysoI’llsaynothing. Check with your friend whether talking about their loss makes them feel uncomfortable. Above all else, if you’re not sure what to say, then say that. Explain that you are there for the person suffering, even if you might not have the words. As the old saying goes, actions speak louder than words. In the case of grief, they really do.

2. Grief is normal.

Think about it. You’ve lost someone who was a part of your life. Come on, what are you expected to do? Continue on as if nothing has happened? Dealing with the emotions associated with that lossis okay. You can cry, shout, throw yourself into work and should be able to do what feels normal to you without judgement. No one should be able to dictate to you what is grief and what isn’t. Grief just is.

3. Don’t be afraid to ask for help

My father died before I was a teenager. Looking back, if it had happened say now, when I’m in college or when I was in high school, I honestly don’t know whether I would have point blank refused the kind offer of counseling from the family support worker at the local hospice. Point is, there are so many different support networks out there. Take advantage of them — what have you got to lose?

Complete Article HERE!

Our Bodies, Ourselves

A funeral director wants to bring death back home.

 

BY

Caitlin Doughty
Caitlin Doughty, a funeral director, says, “Maybe we need to look and say, ‘Wow, let’s look at this beautiful, natural corpse.’ ”

Caitlin Doughty, who was about to open her first funeral parlor, in Los Angeles, gazed at a skull that she had put on display above the desk in her office. Although it was plaster, the skull was a provocative presence in a room where Doughty planned to receive grieving families. It was mid-June, and that afternoon John Gettys, a field representative of the California Cemetery and Funeral Bureau, was coming to give the business a final inspection. Doughty, who is thirty, said, “I want the office to look like me, but I don’t want it to look too Arty Death Hipster.” This was possibly a futile hope. She grabbed the skull and sat contemplating it; in her vintage wooden swivel chair, she looked like a noble in a memento-mori portrait. “I don’t want the state inspector to think I’m testing him,” she said. “Maybe I’ll put it on a lower shelf. That way, I will stay true to myself.” She checked her phone: Gettys was running late. “Maybe he died,” she said. “How funny would that be?”

Doughty’s office, which is in a medical building on the gritty end of Santa Monica Boulevard, has a view of the 101 from one window and a glimpse of the Scientology campus from the other. On one wall hangs a painting, by a high-school friend, of a coffin that has been bent in half and placed atop a chaise longue, in the manner of Magritte’s “Perspective: Madame Récamier by David.” The bookshelf bears volumes of poetry, including Whitman’s “Leaves of Grass,” as well as a compendium of nineteenth-century funeral practices titled “The Victorian Book of the Dead.”

When Gettys finally arrived, Doughty rose to shake his hand. She is six feet one in ballet flats, and has pale skin, long mahogany hair with bangs, and a penchant for vintage dresses with nipped-in waists. (Today’s outfit was emerald green, which matched her eyes.) Gettys read through her price list, which offered a biodegradable willow casket for thirteen hundred and seventy dollars and, for a hundred and twenty dollars, a newborn’s casket made from recycled paper embedded with pressed flowers. Doughty considered her business an “alternative funeral service” that would bring mourners into closer contact with the dead by helping people to tend to corpses at home. She did not plan to offer embalming services, although she was qualified to do so, having graduated in 2010 from the mortuary-science program at Cypress College. Regulations of funeral homes vary from state to state, and in California one can go into business without having taken a class in embalming, or even having learned how to securely close the eyes of a corpse. (A piece of cotton from the end of a Q-tip slipped under the eyelid usually does the trick.)

Doughty has a low, mellifluous voice and an ironical manner. “Are you going to give us a cool license number? Like, all the same digits?” she asked. Gettys, a middle-aged man whose pants and shirt were both of an olive hue, was not perceptibly amused, and replied that the number would be up to the bureau, in Sacramento. “We plan to be massively compliant,” Doughty told him. Her funeral parlor does not have its own crematory, so she and Gettys drove to examine the nearby facility that she planned to use. Gettys told her that, thirty years ago, he’d entered the business as an apprentice embalmer. “The funeral industry doesn’t change a lot—it’s been around for a long time,” he said. “Everybody tries to reinvent the wheel. Well, let me tell you something. The wheel has already been invented. O.K.—there are little permutations that can be done to the business model, but by and large the idea is to dispose of dead bodies.”

It was clear that Gettys was not aware of Doughty’s public profile—that he had not, for example, come across her popular series of online videos, “Ask a Mortician,” in which she fields such viewer questions as “Are these really my mother’s ashes?” and “What is the best way to write into my will that my children will receive no inheritance unless they have my dead body taxidermied and propped up in the corner of the living room?” In 2014, she published a best-selling memoir, “Smoke Gets in Your Eyes: And Other Lessons from the Crematory.” (“A girl always remembers the first corpse she shaves,” it begins.) And she is the founder of the Order of the Good Death, a mostly online meeting place for morticians and academics who are interested in exploring new ways to guide mourners through the experience of death.

A week after Gettys’s visit, Doughty posted on Twitter an image of an official letter that she had received from Sacramento. It began with a cheery “Congratulations!” Doughty tweeted, “I am a funeral home owner. There can be miracles, if you believe.”

Doughty grew up in Hawaii, on the island of Oahu. When she was a teen-ager, she fantasized about opening a funeral home that would combine retro charm with up-to-date service. As she writes in her memoir, she even came up with a name for her imaginary establishment: La Belle Mort. She saw herself creating tailored events that celebrated the life of the deceased in a highly personalized manner: sending cremated ashes into space, or shooting them out of a gun, or compressing them into a gemstone.

After graduating from the University of Chicago, she worked for about two years at Pacific Interment, a mortuary and crematory in an industrial district of Oakland. Without ceremony, she processed corpses through preparation and incineration. This work changed her vision of the ideal funeral practice. “When I first thought I wanted to get into the industry, I thought people needed a more friendly death—for death to be more accessible,” Doughty told me. “That changed very quickly. Now I think people need to get closer to it. It should be up in your face, not ‘Let’s turn Mom into a diamond.’ ”

Her new funeral parlor has a blunt name: Undertaking L.A. Along with Amber Carvaly, her business partner, Doughty intends to help people take care of their own dead, rather than outsource the task to professionals. “When I found myself in all these big industrial warehouses, alone with all these bodies, I thought, If Im doing all this, there are all these other people who arent doing this,” Doughty said. “That’s too much death for one person and not enough for all those other people.” Among the services offered by the fledgling company are help with home funerals, in which the body is bathed and dressed, then kept on ice for a few days, while the family grieves; natural burials, without casket or marker, at a green burial ground in Joshua Tree; and witness cremations, which permit family members to help load the body into the cremation machine and push the button that starts the fire.

Sherwin B. Nuland, in his 1994 best-seller, “How We Die,” wrote, “Modern dying takes place in the modern hospital, where it can be hidden, cleansed of its organic blight, and finally packaged for modern burial.” Doughty’s goal is to end our deliberate estrangement from the dead body. “There really are so many places in our culture where we demand something unnatural,” she told me. “As of right now, what most people find acceptable is either no body at all or something that has been highly mediated. Someone comes in, they take the body away, and, the next time you see it, it has been disinfected and treated and made safe and beautiful.” A dead body is not immediately dangerous, except in cases such as Ebola, and in those instances infectious-disease protocols apply. “And maybe a dead body doesn’t need to be pretty,” Doughty went on. “Maybe we need to look and say, ‘Wow, let’s look at this beautiful, natural corpse.’ ” The conventional funeral industry has given people the impression that death is an emergency. “But death is not an emergency,” Doughty said. “Death is the opposite of an emergency. Look at the person who died—all that stress and pain is gone from them. And now that stress and pain can be gone from you.”

The professionalization of death care in America didn’t get under way until the second half of the nineteenth century. Modern embalming—in which the bodily fluids inside a corpse are drained, through an incision in a vein, and replaced with a preservative solution, through an incision in an artery—was popularized during the Civil War, as a means of allowing the bodies of fallen soldiers to last long enough for them to be shipped home for burial. Embalming became the signature skill of the professional mortician, setting his services apart from those of people—usually women—who had previously been responsible for preparing a dead body for the grave, by bathing it, anointing it, and dressing it, often in a shroud. In 1863, Louisa May Alcott, who served as a nurse during the Civil War, wrote of an encounter with the body of a soldier whom she had tended until death. “The lovely expression which so often beautifies dead faces, soon replaced the marks of pain,” Alcott wrote. “I longed for those who loved him best to see him when half an hour’s acquaintance with Death had made them friends.”

As Gary Laderman, a professor of religion at Emory University, explains in his 2005 book, “Rest in Peace: A Cultural History of Death and the Funeral Home in Twentieth-Century America,” the first embalmers made house calls. Early techniques were sometimes primitive: in 1898, an article in the Journal of Medicine and Science complained that the arsenic used to preserve corpses had leached into the soil and the groundwater near cemeteries. The article cited a critic of the practice—“Gallons of poisonous solutions are squirted into bodies indiscriminately”—and called for the establishing of standards in the handling of corpses. Around this time, the first mortuary schools were established, and the National Funeral Directors Association, which is still the leading industry association, was founded.

The turn of the twentieth century saw the emergence of the first funeral homes—literally the homes of professional morticians, who lived over their shops. It became the norm to remove a body from a home or a hospital as quickly as possible. The death industry boomed: a survey published in 1928 revealed that between 1900 and 1920 the number of funeral directors grew by more than fifty per cent. (The annual number of deaths increased by only 2.3 per cent in the same period.) For most of the twentieth century, the majority of funeral homes were family businesses that were passed from father to son—and rarely to a daughter. In the seventies, ninety-five per cent of funeral directors were men, and even by 1995 there were still almost twice as many male mortuary-science students as female ones.

Today, sixty-five per cent of mortuary-school graduates are women. The gender shift reflects a significant change in funeral practices. Rates of burial—and, hence, of embalming—have undergone a drastic decline. In 1960, fewer than four per cent of corpses were cremated. Today, the cremation rate is forty-five per cent. (Industry projections estimate that it will reach seventy per cent by 2030.) The image of the funeral director has undergone a parallel evolution. Although undertakers are still often portrayed as black-suited men in possession of dour scientific expertise, the funeral director has emerged as a member of the caring professions.

Until recently, it was common to believe that women were not physically capable of doing removals. Though such sexist fictions have been upended—lifting a dead body is mostly a matter of technique—explanations for the recent rise in women’s “death work” are often no less dependent on restrictive stereotypes. Women in the industry often declare that they have an innate empathy for others, and that they excel at providing emotional support to the grieving. It’s also argued that women are especially skilled at dressing the dead—and at restoring the appearance of vitality through the tasteful application of cosmetics and styling of hair. “People are more comfortable about crying, about showing emotion, in front of a woman,” Erin Whitaker, a funeral director from South Carolina, told me. “And it’s easier, as a woman, to put your hand on their hand as a sign of comfort.”

With an increasing demand among baby boomers for customized funerals that reflect the individuality of the deceased, funeral directors are expanding into the business of event production. Today’s funeral director might stage a memorial service featuring the release of butterflies at the grave site, or with the deceased’s Harley parked ceremonially at the entrance to the chapel. In such instances, the skills of a funeral director can seem to fall somewhere between those of a nurse and a wedding planner.Mortuary Management, a trade magazine, offers articles about such innovations as the tribute blanket—an instant heirloom that incorporates photographs of the deceased into a custom-made tapestry—and urges funeral directors to be open-minded when faced with families who want pop songs played at a service. It’s a profitable strategy to, as a feeble witticism of the industry has it, “put the fun back into funerals.”

Since the nineteen-eighties, the National Funeral Directors Association has held an annual professional women’s conference. This year, it took place in Chicago, and it attracted more than two hundred women from across the country. They attended an embalming workshop and listened to speakers who delivered “Lean In”-style exhortations.

Many women at the conference were helping to run, or had taken over, their family’s funeral home, but there were also women who had been drawn to the work for other reasons. Patty Decker, of Woodstock, Georgia, who has been a funeral director for nearly thirty years, told me that she’d wanted to become one since she was eleven years old. “I just saw the respect that the funeral director in my home town had—how much he was admired,” Decker said. “You have to love this job. You are faced with your own mortality every day. We are like the directors of this show that no one wants to attend.” Maria Thomas, an apprentice embalmer in Virginia, had worked in the performing arts before starting her training. “The first time that a family threw their arms around me, thanking me for making their mom look so beautiful—that really touches something,” she said. Strangers were curious about her job, she said, and she welcomed it. “We worship youth and beauty—those are the things that are celebrated in our culture,” she said. “But we do have to accept that over here is the death corner, and you are not going to escape it. You might as well talk about it.”

Doughty didn’t attend the conference: she isn’t a member of the National Funeral Directors Association, and notes grandly in her book that the group “won’t comment on me.” But some of the funeral directors present were aware of her advocacy of alternative funeral practices. One afternoon, there was a roundtable discussion of ways that funeral homes might use social media.

“Who is going to follow a funeral home’s Twitter account, really?” one participant asked.

“Weirdos,” someone replied.

“Competitors,” added another.

Doughty’s online prowess came up, and one participant remarked that she thought it was healthy for the public to get a glimpse of a funeral director’s reality. But another participant expressed concern about Doughty’s perspective. “I feel like she’s the one who’s big on ‘You don’t need a funeral director,’ ” she said.

Affixed to the refrigerator in Doughty’s apartment is a photograph of the class of 1973 at the California College of Mortuary Science, which later became part of Cypress College. Forty-four men, nearly all of them white, are dressed in black tie; there are two women in the class. Hanging next to that image is a 2010 photo of Doughty’s class. Its thirty-one graduates form a racially diverse group, and twenty-two of them are women. At her new business, her colleagues are mostly female, too. “I don’t think it’s because we have some kind of helping gene—I don’t think it’s some deep need to nurture,” she told me. “For me, working with dead bodies is almost like a feminist act. I don’t want people to come in and say, ‘Oh, no, little lady, you don’t know what to do with this body,’ because they already say that about our reproductive systems. I know I am qualified to take care of this body.”

Many funeral directors like to say that they had a calling for the profession. Such statements are no doubt sincere, but it might also be convenient to characterize the career as having been thrust upon one: few people admit to being motivated by a deep interest in corpses and death. Doughty has no qualms in admitting to such a fascination. She says that she became “obsessed with death” in the nineties, while growing up as an only child in Kaneohe, on the east side of Oahu, where her father was a high-school teacher and her mother a real-estate agent. When Doughty was in grade school, she says, she witnessed a small girl tumbling from a height in a shopping mall. (Doughty presumes that the girl fell to her death, though she never found out for sure.) The incident made her conscious of her own mortality and that of everyone else. “Everybody has their moment when they realize that death is very real,” she says.

Doughty studied medieval history at the University of Chicago, and she eventually focussed on the cultural status of the corpse and the representation of dead bodies in art and religious iconography. “I was interested in how much they had a relationship with the dead,” she said. “If you went to a church in the Middle Ages, there would be bodies buried under the floor and in the wall and in pits outside the church, and absolutely everywhere. The church was the center of life, so you would go there and have sermons and plays and outdoor markets. Everything you did—you were surrounded by corpses. Of course, they feared Hell—it’s not like they were totally comfortable with death—but they were a lot more comfortable with the dead body than we are now.”

Upon graduation, in 2006, Doughty sought to convert her academic interest into real-world experience. At Pacific Interment, the Oakland crematory, she worked on bodies in the prep room and loaded them into the cremation machine. No special credentials were needed for the job, besides a tolerance for the brute facts of mortality. She gained intimate knowledge of the process of decomposition when it is unhindered by embalming: first comes a loosening of the skin, followed by bloating, putrefaction, and blackening. She chronicles her experiences in “Smoke Gets in Your Eyes,” which is filled with unflinching observations. (“The left side of her chest was caved in, giving the impression that someone had removed her heart in some elaborate ritual.”) Doughty learned that it is difficult to arrange the deceased’s facial features into a semblance of heavenly rest after rigor mortis sets in, a few hours postmortem. And she learned in what order corpses should be cremated when several must be processed in a single day. (Start with the heaviest decedent, when the cremation chamber is cold; if one waits until the chamber is hot, the body will burn too quickly, producing excessive smoke.)

For the most part, Doughty performed what is known as direct cremation, in which the body is removed from a hospital or a home, then incinerated without ceremony, the desiccated remains mechanically processed into unidentifiable fragments that are collected and given to a relative. This is the least expensive way of dealing with death: in the U.S., the cost of a direct cremation averages between seven hundred and twelve hundred dollars, whereas an in-ground burial typically costs about seven thousand dollars. Cremation gained in popularity in America largely in response to consumer groups that, starting in the nineteen-sixties, publicly questioned the expensive services of the funeral industry.

In 1963, Jessica Mitford published “The American Way of Death,” a scathing investigation into the practices of funeral directors. They were, she suggested, “merchants of a rather grubby order, preying on the grief, remorse, and guilt of survivors.” Funeral directors lined their pockets, in part, by promoting questionable psychological arguments, such as the claim that the viewing of an embalmed corpse was a necessary step in the grieving process. They recommended “eternal sealer” caskets to protect the corpse from even greater ravages than death. Mitford championed cremation as a sensible alternative to burial, and her book, which became a best-seller, helped set in motion an investigation of the industry by the Federal Trade Commission. When Mitford died, in 1996, she was cremated, at Pacific Interment, for a cost of four hundred and seventy-five dollars. A decade later, Doughty took considerable satisfaction from the fact that she was operating the same machine in which Mitford had been reduced to ash.

Like Mitford, Doughty reviled the excesses of the funeral industry. But the longer she worked at Pacific Interment the more she found her own attitude toward the dead body at odds with Mitford’s approach, which struck her as unsentimental to the point of callousness. Doughty began to think that Mitford’s effort to combat the commercial excesses of the traditional funeral industry had ended up reducing the dead body to something to be dispensed with as cheaply and efficiently as possible. This approach swept aside an important aspect of human experience: that of tending to loved ones in death, just as in life.

All Caring Cremations, the company that handles the burning of bodies for Undertaking L.A., is in a bleak industrial area in the San Fernando Valley. When Doughty took me there, she pointed out a building down the block that had served as the exterior of the Dunder Mifflin paper company, on the NBC show “The Office.” “In an ideal world, this is not the neighborhood I would choose if we had the option to go with a wooded-stream crematory,” Doughty said. “But that’s not an option we have.”

The lobby of All Caring was decorated with anonymous good taste: wingback chairs, a low table. There was an unplaceable unpleasant aroma. A small chapel was painted in institutional beige, with chairs and a lectern and, up front, space for a casket. “They have said we could do some décor stuff in here—not, like, a feminine touch, but we might put up different art, a different color on the walls, better lighting,” Doughty said. We heard a noise that I first took to be the loud rumble of the air-conditioning system; it was the sound of the cremation machine at work.

Doughty and Carvaly, her business partner, expect that many clients of Undertaking L.A. will seek out their services because of their advocacy of home funerals. For a fee of three hundred and forty dollars, Doughty and Carvaly will come to the home of a dying person and consult with the family about the best way to take care of the body in situ. (Opening windows can be useful, and so is planning to place the body on a bed or a couch that can be reached without climbing stairs.)

A person who helps families with a home funeral is often called a death midwife. (In most states, the services of a professional funeral director are not required by law.) Clients who like the idea of not handing off a loved one’s body might not have the space or the stomach for caring for a corpse at home, and so a visit to All Caring’s prep room—hidden behind a door marked “Employees Only”—is available. There they can help with bathing and dressing the body, then proceed to the chapel and sit with the deceased in valediction.

Carvaly, who is also thirty, was a women’s-studies major at college, and worked at a homeless shelter for women before enrolling at Cypress College’s mortuary program, where she began corresponding with Doughty. She had aspired to be an embalmer, which she thought would combine science and art. But she was disillusioned after working briefly at Forest Lawn, the vast L.A. funeral complex that inspired Evelyn Waugh to write “The Loved One,” his satirical 1948 novel. “Forest Lawn was very competitive,” Carvaly told me, over lunch at the SteamPunk Café, not far from the crematory. “How many bodies can you do in a day? How quick and efficient are you? It’s a business, and you should be able to do it quickly and efficiently. But I didn’t like it.” Undertaking L.A. is in the process of registering as a nonprofit.

Doughty and Carvaly do not expect their services to become mainstream choices. The notion that the dead body is a source of pollution is a deeply ingrained belief in many cultures. In Jewish law, a kohein, or priest, is not permitted to be under the same roof as a corpse (except in the case of close relatives). In Japanese tradition, undertakers belonged to the burakumin, society’s lowest and most reviled caste.

It would be more commercially viable to embrace the trend of selling the funeral as a kind of farewell party. I recently spoke with an entrepreneurial funeral director named Paula Staab-Polk, from Chatham, Illinois. Having grown up in her family’s funeral home, she struck out on her own a few years ago and decided to combine funeral and hospitality services. “The way I look at it is: our death is an event, and our life needs to be celebrated when we pass from this life to the next,” Staab-Polk told me. A few years ago, she added a reception center to her funeral home. She has given a funeral luncheon that featured the favorite recipes of a woman who died at ninety-eight; she has held a service for a ten-year-old girl who died of cancer, at which guests were invited to “adopt” one of the many stuffed animals that had been sent to the sick child’s bedside. Staab-Polk offers floral services and bagpipers, and she also hosts non-funerary events. “I’ve got three high-school proms coming up,” she told me.

Doughty understands the appeal of Staab-Polk’s model. “People are afraid of death,” she said. “Do you want to go sit with the corpse or do you want to party? If you put it like that, it’s not a very hard question.” She is not denying that people can find great comfort in a personalized funeral ceremony. “But I would still argue that it doesn’t give you the full engagement with death and grieving that you need,” she says.

She is particularly skeptical of funerals that offer the bereaved a very brief look at an embalmed corpse. “If you are one of those people who, when you were eight, walked by a hyper-embalmed, preserved corpse, with the makeup and the suit, that quick glimpse in the casket can be scary, because there is no time to process it, and it stays with you, and the fear stays with you,” she told me. Spending time with a dead body in its natural state may be more challenging, she says, but it “normalizes” the experience. “When you talk about families that have worked with their dead body, and sat with their dead body, first they come in and just kind of touch the hand gently, like they are going to break Uncle Bob. Then, three or four hours later, they are telling jokes about Uncle Bob and giving him a hug.”

Doughty contends that elements of Undertaking L.A.’s approach can be applied to the most traditional of funerals. Carvaly recently participated in the funeral preparations for a friend named Marea Balvaneda, who had died suddenly, of cardiac arrest, at the age of thirty-six. “She had a traditional Catholic funeral, and she was embalmed,” Carvaly said. “The only thing that was different was that, the day before she was buried, I went to the funeral home with her sisters, and we dressed her body.”

At first, one of Balvaneda’s sisters, Ashley Wodke, lingered outside the prep room while the others worked. Carvaly told me, “It was, like, super-intuitive—they didn’t even need me.” Wodke said, “I knew I needed to do it, too. And it wasn’t as disturbing or traumatic as I thought it was going to be.” Balvaneda was the oldest of five sisters and had always taken care of her younger siblings; Wodke said that she felt a responsibility to take care of her sister in return. “We made sure her last outfit, and her last application of makeup, was done right,” Wodke told me, her voice breaking. “We made sure she had the right red lipstick. She wore a very vibrant red—a stoplight red. If we hadn’t done it, it wouldn’t have been the right red.”

The death-care movement can be seen as echoing other attempts to celebrate the artisanal and reject the over-industrialized, over-sanitized, and over-medicalized way of life that prevailed in twentieth-century America. Home births, while still very much a minority choice, rose by more than fifty per cent between 2004 and 2012. The flourishing of farmers’ markets has supported local agriculture, and the eat-what-you-kill movement has emerged as an extreme critique of industrialized food. When Doughty adopts her exaggerated “Ask a Mortician” persona, it is so glibly morbid as to be almost a caricature of the Portland-Bushwick axis of cool. (In one episode, which explains that metal implants survive a cremation intact, she jokes, “My father has had to have both of his knees replaced, and if we decide to cremate him, guess what his beloved daughter will be keeping on her mantelpiece.”)

Doughty’s business is not, she insists, a hipster lark or a “vanity project.” She explained, “There’s no vanity in funeral service—you are in rooms with corpses all day. This is not to make ourselves look good. If you want to look good, you start a really rad Instagram account, or bake gluten-free cupcakes. You don’t cremate people.”

Undertaking L.A.’s support of home funerals is aligned with the death-with-dignity movement, which advocates for the right of the terminally ill to die at the time of their choosing. Doughty is on the advisory board of Compassion & Choices, a group that campaigns for right-to-die laws, and she believes that the way we treat the dead body in our culture has a great influence on the way we think about the care of an individual close to the end of life, be it our loved ones or ourselves.

Being afraid of the sight of a dead body is quite different from being afraid of dying, which is the province of the confessional, the therapy suite, or the insomniac bedroom. But Doughty has found that spending time around dead bodies has helped her accept her own mortality. Working at a crematory led her to a realization: “O.K., this is going to be me—so this body is, so I shall be one day.” She explained, “If you have that opportunity with your family or community to come around the body, it is not only good to honor the dead person—they probably don’t really care—but it’s for you, too.”

In late June, Doughty took a road trip with her boyfriend, Landis Blair, to Crestone, a former mining town in Colorado. Doughty met Blair, an illustrator whose pen-and-ink drawings evoke the work of Edward Gorey, in 2012, after giving a lecture in Chicago. When she posted an item to her blog titled “My Morbid Art Crush on Landis Blair,” they struck up a relationship. They have lived together for a year, in an apartment filled with macabre Victoriana and the odd taxidermy specimen. Blair owns a unicycle that is usually propped up in a corner of the living room.

Blair is illustrating Doughty’s next book, a globally informed look at the future of death care, and he was serving as navigator. Crestone is about four hours south of Denver, and it is eight thousand feet above sea level, at the edge of a plain surrounded by mountains. Over the past several decades, Crestone, which at its most recent count had a population of a hundred and thirty-seven, has become the site of a wide variety of religious retreats. The landscape is thought to have a spiritual aura like that of the Himalayas. It is also home to an open-air funeral pyre, which was built by the Crestone End-of-Life Project, a small but avid group that champions natural funerals. Doughty was visiting it for the first time.

After arriving in town, we met up with Stephanie Gaines, the End-of-Life Project’s founder, and Paul Kloppenburg, a rugged Dutch expatriate who holds the title of fire-master. Kloppenburg told Doughty that the first open-air cremations in Crestone, in the early nineties, were conducted on a mobile pyre—a hundred cinder blocks and a metal grate that could be set up on an individual’s property. “I would see the eagerness of the people,” he explained. “I would pull up with my truck and build the hearth, and let them have it.” But after the group received a letter of complaint from local residents it built a pyre four miles outside of town, on land belonging to a Buddhist center. To a metropolitan eye, the site is in the middle of nowhere, but Gaines reported that a neighbor a mile away was not happy about being downwind of it. “And people didn’t want the traffic,” she told Doughty. “Six cars is a lot of traffic around here.”

The plain was spectacular in its vastness, and snow-crested mountains rose craggily in the middle distance. The cremation site was strangely beautiful. There was a circular enclosure, about seventy-five feet in diameter, fenced with bamboo palings. Standing inside it, you had a sense of safety and intimacy, yet the grandeur of the wider landscape remained visible. Inside the fence were four teak benches; they were arranged around a ring of large stones that had been set into the dusty ground. At the center of the ring was the pyre: a structure, about as high as a workbench, consisting of an iron grate suspended between two thick walls of concrete. The grate sagged slightly in the middle, like a well-worn mattress.

Affixed to the pine posts that supported the bamboo enclosure were copper plaques with the names of the fifty or so people who had been cremated in Crestone. Some of them had moved there specifically to die; these included a woman with cervical cancer. Others had grown up in the area, among them a twenty-two-year-old man who’d died in a car accident.

The ceremonies take place around dawn, before the wind whips up. The body, wrapped in a shroud, is placed on the grate, and then family members with flaming torches ignite logs that have been placed underneath. The body is also overlaid with logs and fragrant juniper branches, so that onlookers see only flame, not the body as it incinerates. For the first quarter of an hour, there is usually silence among the onlookers as the flames roar; as the fire matures, people chant, pray, beat drums, sing songs. It takes about two and a half hours for the body to be reduced to ash—hardly longer than a conventional cremation, Doughty noted with surprise. Gaines told her that mourners “say they are never the same after this.”

That afternoon, we had tea at the mountainside cabin where Gaines lives. She explained to Doughty that in Crestone a body is given a three-day period of repose before it is burned on the pyre: chilled gel packs help keep the body fresh, and the corpse is placed on a wooden pallet, obviating the need to lift it from a bed or a couch several days after death. Doughty talked about a recent trip that she had taken to Japan, where she’d visited a corpse hotel, which allows families with apartments too tiny for a home funeral to participate in the ritual preparation of a body. She liked the idea of setting up something similar with Undertaking L.A. “What I am really interested in is asking whether it is possible to have a communal center,” she said. “Family comes from out of town and it’s, like, a three-day wonderland process.”

Gaines, who is in her seventies, had a radiant air of calm. She explained that she was a devout spiritual practitioner: a contemplative with a special interest in the Gnostic traditions. Many of the other members of the Crestone End-of-Life Project had similar inclinations, but, Gaines explained, anyone was welcome to participate in the community of care, which embraced both the deceased and their survivors. “You want everyone to have this opportunity, because it is so filled with grace, and such an opening,” she said. “It is so transformational for everybody—not just for the person who died.”

Doughty nodded. “I am pretty secular, but the transformation from body to ash is still incredibly meaningful to me,” she said. “I may not think the soul is necessarily going anywhere—but just the physical transformation and the transformation of the mourners are transitions. It is ritual, and it is very real, and it is important, no matter what ideas of the body and the soul and the spirit the family comes in with.” She petted Gaines’s cat, which was moving promiscuously from lap to lap, sparing nobody. “It’s an exciting time to be in death,” Doughty said. 

Complete Article HERE!

For Jewish Students, Field Trip Is Window on Death and Dying

By

Rochel Berman
Rochel Berman explained traditional Jewish burial shrouds to students from Yeshiva High School during a visit to the Gutterman Warheit Memorial Chapel in Boca Raton, Fla., on Tuesday.

 

Two yellow buses pulled away from Yeshiva High School here with a couple of class periods still left and the 77 seniors aboard giddy with the words “field trip.” They texted. They posed for selfies. They sent up clouds of chatter about weekend plans.

Then, less than a half-hour later, they walked into a cool, tiled room at the Gutterman Warheit Memorial Chapel and stared at the pine coffins and the inclined metal table used for cleaning a corpse.

“I thought I was cool about death,” one girl whispered to a classmate. “But this ——”

“This” meant more than the contents of the room, which is used at the Jewish funeral home for the body-washing ritual called tahara. It connoted the entire mini-course that she, along with the rest of Yeshiva High School’s graduating class, is taking about the Judaic practices and traditions surrounding death, dying and grief.

Few subjects run more powerfully counter to an American teenager’s innate sense of immortality than a confrontation with the reality of life’s end. The study of death became more common at the college level with the publication of Elisabeth Kubler-Ross’s influential book, “On Death and Dying,” in 1969. But it is rare that the subject is discussed at the high school level, particularly with an approach that includes fairly explicit instruction in caring for a cadaver.

Yeshiva High School
Yeshiva High School sent 77 senior students to the funeral home as part of a course teaching Judaic practices and traditions surrounding death, dying and grief.

 

“As a senior, you’re thinking about going to college, and as a teenager you have this feeling of invincibility,” Daniel Feldan, 17, said the morning after the visit to the funeral home on Tuesday. “I’ve never had that other feeling — of mortality, that life might end soon.”

Bailey Frohlich, also 17, nodded at hearing her classmate’s words. “It’s given us a reality check,” she said. “For us, it’s usually about college and friends and extracurriculars. You don’t focus on the grittier things. But even if you don’t have a personal connection to death, thank God, it affects the whole community.”

The 10-hour, eight-session course, titled “The Final Journey: How JudaismDignifies the Final Passage,” aims for sensitivity even as it provokes a certain degree of shock. Besides going to the funeral home, where they received detailed explanations of washing and dressing a corpse, the students have classroom lessons on topics including the history of the Jewish burial societies known as chevra kadisha, the Talmudic foundations of end-of-life practices, and issues involving autopsy and organ donation.

“When we started the program, there was a lot of hesitation and curiosity at the same time,” said Rabbi Jonathan Kroll, 45, the yeshiva’s head of school. “Jewish tradition for dealing with burial and the process of tahara is not that well known. Even for a lot of well-educated Jews, the chevra kadisha is like a secret society. But once you start talking about the values involved or the practical aspects, there’s a fascination.”

The program at Yeshiva High School began with Rochel U. Berman, a 79-year-old author and a former nursing home worker who moved near the school 13 years ago. Her well-regarded book on Jewish burial rituals, “Dignity Beyond Death,” was published in 2005. Over the years she lived in South Florida and the New York metropolitan area, and she served as a chevra kadisha volunteer in both places, preparing the bodies of about 1,000 women and girls, from centenarians who simply wore out to an 18-month-old baby felled by cancer.

In broad ways, Jewish rituals around death and dying trace back to antiquity, and they have been central to Jewish continuity in the diaspora. The system of chevra kadisha emerged in Central Europe in the 16th century. Initially almost a social institution composed of the elite, chevra kadisha groups transformed over the centuries into an example of communal or congregational voluntarism.

An unlikely adopter of religious tradition, Ms. Berman grew up in Winnipeg, Manitoba, as the child of secular socialists. Her Jewish language, rather than the Hebrew of worship and Zionism, was the Yiddish of the Old World shtetl and the New World slum.

By the time Ms. Berman’s father died in 1985, she had grown observant. Even so, between the final kiss she planted on his forehead in his deathbed and the lowering of the coffin into the ground the next day, she had no idea what had been done with her father’s body.

Jewish funeral process
From left: Sarina Solomon, Ariella Mamann and Jolie Davies, students at Yeshiva High School, practiced the Jewish funeral process that would be used to cleanse a body before burial.

 

“I didn’t know what I was missing, but I knew there was a hole there,” she recalled. “And the not-knowing made me even sadder.”

While living in New York, she and her husband, George Berman, both started volunteering in their Orthodox synagogue’s chevra kadisha, which has separate units for each gender. The processes of washing and purifying the body, of dressing it in a white linen shroud, of moving it into a plain wooden coffin filled her with a sense of communal purpose.

Not content with her own years as a volunteer or with her book, Ms. Berman resolved to reach young people as a way of imbuing the next generation with those Judaic values. “It’s a gift to give them, a part of the Jewish life cycle they didn’t know about,” she said. “And once they know it, they’ll be the ambassadors in sharing it.”

Rabbi Kroll assumed the leadership of Yeshiva High School in Boca Raton, Fla., three years ago. Coincidentally, it turned out that he, somewhat later than Ms. Berman, had belonged to the same synagogue and volunteered in the same chevra kadisha in New York’s Westchester County.

With $21,000 in grants from foundations and religious organizations, Ms. Berman devised a curriculum. Rabbi Kroll tested it last year with half of the seniors in the class of 2015.

“We had pushback,” he recalled, “but it wasn’t serious pushback. Several parents questioned the priority: ‘Why not use the time on something more pertinent, more relevant?’ My impression is that the pushback was about their own discomfort with mortality.”

As for the first batch of students, half of them reported on evaluation forms that, as a result of the course, they would consider being in a chevra kadisha. That response was more than sufficient for Rabbi Kroll to expand the program to this year’s entire senior class. Among the 78 students, he said, only three have had an immediate family member die. (One of those three was excused from the funeral home trip.)

Even those like Maya Borzak, 18, whose grandfather served in a chevra kadisha, found there was plenty to learn. In fact, the funeral home visit occurred just five days before the unveiling of that grandfather’s headstone, which in Jewish tradition takes place after a year of mourning.

“I always knew that, in general, it’s important to have a Jewish identity, that you’re born a Jew and you need to die a Jew,” Maya said. “You have a circumcision if you’re a boy, you have baby-naming if you’re a girl, and then, at the end, everyone is buried in the same way.”

“Now I know more than the sources for the processes and rituals,” she said. “I know the dignity that is supposed to be provided for everyone who dies. It’s the great equalizer. We’re all in this together.”

Complete Article HERE!

Death Is Way More Complicated When You’re Polyamorous

By Simon Davis

death become her
Screencap via ‘Death Becomes Her’

In February, Robert McGarey’s partner of 24 years died. It was the most devastating loss McGarey had ever encountered, and yet, there was a silver lining: “I had this profound sadness, but I don’t feel lonely,” McGarey told me. “I’m not without support, I’m not without companionship.”

That’s because he has other partners: Jane, who he’s been with for 16 years, and Mary, who he’s been with for eight. (Those are not their real names.) And while his grief for Pam, the girlfriend who died, was still immense, polyamory helped him deal with it.

There’s not a lot of research into how poly families cope with death—probably because there’s not a lot of research about how poly families choose to live. By rough estimates, there are several million poly people in the United States. And while polyamory can bring people tremendous benefits in life and in death, our social and legal systems weren’t designed to deal with people with more than one romantic partner—so when one person dies, it can usher in a slew of complicating legal and emotional problems.

“Whether people realize it or not, the partner to whom they are married will have more benefits and rights once a death happens,” explained Diana Adams, who runs a boutique law firm that practices “traditional and non-traditional family law with support for positive beginnings and endings of family relationships.”

Since married partners rights’ trump everyone else’s, the non-married partners don’t automatically have a say in end-of-life decisions, funeral arrangements, or inheritance. That’s true for non-married monogamous relationships, too, but the problem can be exacerbated in polyamorous relationships where partners are not disclosed or acknowledged by family members. In her work, Adams has seen poly partners get muscled out of hospital visits and hospice by family members who refused to recognize a poly partner as a legitimate partner.

McGarey and his girlfriend Pam weren’t married, so the decision to take her off life support had to go through Pam’s two sisters. The money Pam left behind—which McGarey would’ve inherited had they been married—went to her sisters too, who also organized Pam’s funeral.

This kind of power struggle can also happen among multiple partners who have all been romantically involved with the deceased. The only real way to ensure that everything is doled out evenly is to draft up a detailed prenuptial agreement and estate plan. Adams works with clients to employ “creative estate planning” to ensure that other partners are each acknowledged and taken care of.

Adams is a big proponent of structured mediation as a way of minimizing post-mortem surprises, like when families discover the existence of mysterious extra-marital partners in someone’s will. It’s much better to have those conversations in life than on someone’s deathbed, or after death.

But many poly people remain closeted in life and in death, according to sociologist Elisabeth Sheff, who has studied polyamorous families for 15 years and authored The Polyamorists Next Door: Inside Multiple-Partner Relationships and Families. A person might have a public primary partner—someone they’re married to, for example—plus other private relationships. That can make it harder to grieve when one of the non-primary partners dies, because others don’t recognize the relationship as “real” or legitimate in the way the death of a spouse might be.

Take, for example, something like an employee bereavement policy. Guidelines from the Society for Human Resource Management spell out the length of time off given in the event of the death of a loved one: a spouse, a parent, a child, a sibling, in-laws, aunts, uncles, grandparents. Unsurprisingly, extra-marital boyfriend or girlfriend is not on the list. (Actually, “boyfriend” and “girlfriend” aren’t on the list at all.) It’s possible for an employee to explain unique circumstances to an employer, but in her research, Sheff has found that some poly people prefer not to “out” themselves this way. People still disapprove of extra-marital affairs and some poly people, according to Sheff, have even lost their jobs from being outed, due to corporate “morality clauses.”

It’s similar, she says, to the experiences of same-sex couples who are closeted. “It’s much less so now because they’re more acknowledged and recognized, but 20 years ago, it was routine for [the family of the deceased] to muscle out the partner and ignore their wishes—even if [the deceased] hadn’t seen their family for years and years,” Sheff said. “They would come and descend on the funeral and take over. Or when the person was in the ICU. That same vulnerability that gays and lesbians have moved away from to some extent is still potentially very problematic for polyamorous people.”

Legal recognition of polyamorous unions could provide some relief. After the Supreme Court struck down the Defense of Marriage Act in 2013 and legalized same-sex marriage in 2015, calls for legalizing plural marriage have only become louder. Adams noted that an argument put forth in Chief Justice John Roberts’s 2015 dissent may provide a legal foothold for legalization advocates. “As Roberts points out, if there’s going to be a rejection of some of the traditional man-woman elements of marriage… those same arguments could easily be applied to three or four-person unions,” she said in an interview with US News & World Report earlier this year.

In 2006, Melissa Hall’s husband Paul died at the age of 52. Both were polyamorous, but Paul’s death presented “no special problems,” since they were legally married and Hall had all the rights of a spouse. Instead, she found unexpected benefits in dealing with her husband’s death: In particular, she told me that “being poly made it easier to love again.” Since they had both dated other people during their life together, Hall knew her husband’s death wouldn’t stop her from dating again.

In traditional relationships, it’s not uncommon for people to impose dating restrictions on themselves to honor the desires of their dead spouses, or to feel guilty when they start dating again. Of course, you don’t win if you don’t date either, as people eventually get on your case to “move on with your life.” All this goes out the window when you’re polyamorous, where dating doesn’t necessarily signal the end of an arbitrary acceptable period of mourning.

More partners in a relationship can certainly mean more support. It can also mean more people dying, and with that comes more grief. In an article about loss among polys published in the polyamory magazine Loving More, one man wrote: “Those of us who have practiced polyamory through our lifetime must be grateful for the abundance of love in our lives. But having those wonderful other loves means we must accept a little more grieving as well, when our times come.”

Is the trade off worth it? McGarey certainly seems to think so. “There is more grieving, but… we are held and cradled in the love of other people at the same time.”

He compares his relationship to the Disney movie Up, which starts with a guy falling in love and marrying his childhood sweetheart. “And then [she] dies, and he turns into this grumpy old man because he lost his love,” McGarey said. “I don’t see myself turning into a grumpy old man. I don’t know if I can attribute that to poly, but maybe that’s why.”

 Complete Article HERE!

Faced with tragic loss, families must face the difficult choice of organ donation

By Joe Smydo

Kelli Jo Lovich
Kelli Jo Lovich visits the grave of her 4-year-old son, Colbee, in mid-October in Butler. “I visit him twice a day, every day,” she said. Colbee was killed in an ATV accident in 2014. Mrs. Lovich decided to donate his organs to help preserve his memory.

“No.”

That’s what Kelli Jo Lovich said when she was asked to donate the organs of her 4-year-old son, Colbee, who died after suffering severe brain injuries last year in an ATV accident in Butler County.

But Mrs. Lovich recalled that Shannon Pribik, a procurement coordinator with the O’Hara-based Center for Organ Recovery and Education, persisted. Ms. Pribik answered questions, promised there would be minimal trauma to Colbee during organ recovery and agreed to stay by his side until the funeral director arrived for his body.

Mrs. Lovich relented. “He was only 4,” she said of Colbee, “but he loved to help.”

■     ■     ■

Procurement coordinators are on the front lines of the nation’s overwhelmed transplant system.

They approach families like the Loviches in the midst of a tragic loss and ask them — when their grief is raw and their spouse, child or sibling is tethered to machines in the intensive care unit — to donate their loved one’s organs so that others can live.

“When you do it for the first time, you feel like you’re invading their space,” said Linda Miller, who operates a University of Toledo graduate training program for coordinators. The program was founded in 2003 with CORE’s support.

The stakes are high.

With more than 122,000 people waiting for transplants, and an average of 22 of them dying each day, coordinators face great pressure to recover organs from the roughly 2 percent of Americans who end their lives in a way — usually of brain injuries while on a hospital ventilator — that makes donation possible. People who die outside of a hospital cannot be donors because their organs deteriorate too quickly.

Sometimes, a family will say, “It’s just not for us. Let the next person be the donor,” said Jonathan Coleman, a coordinator at CORE.

Because donation can occur only in limited situations, he said, coordinators stress a family’s “unique opportunity” to turn its tragedy into somebody else’s second chance at life. Often, advocates say, the decision to donate a loved one’s organs — to let that person live on through others — sustains a family for years.

Yet it can be a tough sell.transplant waiting list

While demand for organs is growing, donation rates have been stagnant, with deceased donors numbering about 8,000 annually for the past decade.

Overall, procurement organizations — CORE is one of 58 nationwide — recover organs from eligible donors 73.6 percent of the time. CORE’s recovery rate is 82.7 percent, according to the Scientific Registry of Transplant Recipients.

If a person had registered as a donor — the option is given at a driver’s license center, among other places — procurement organizations in Pennsylvania and most states have the authority to recover organs even if relatives object. If the person was not registered, coordinators try to persuade the family to donate the organs.

Some people balk at the prospect of organ donation because of fear that doctors will let the prospective donor die to save others waiting in the wings for transplants. While advocates insist that does not happen, procurement organizations have been sued at least twice by those who claim it did.

In 2009, Michael and Teresa Jacobs sued CORE, Hamot Medical Center in Erie, Pa., and several doctors, alleging that their 18-year-old-son, Gregory, who sustained brain injuries in a snowboarding accident, was “intentionally killed … so that his organs could be harvested.” The defendants settled for $1.2 million but contended that they provided proper care.

In 2012, Patrick McMahon, a former coordinator, sued the New York Organ Donor Network, now called LiveOnNY, alleging that the organization pressured him and a doctor to have patients declared brain dead — despite signs of brain activity — so that families could be persuaded to donate organs. In court papers, the donor network denied the allegations. The case is unresolved.

In 2012, Patrick McMahon, a former coordinator, sued the New York Organ Donor Network, now called LiveOnNY, alleging that the organization pressured him and a doctor to have patients declared brain dead — despite signs of brain activity — so that families could be persuaded to donate organs. In court papers, the donor network denied the allegations. The case is unresolved.

■     ■     ■

A former anesthesia tech, Mrs. Lovich once walked in on organ recovery surgery by mistake and blanched at the sight. Her reservations about organ donation were clear; Ms. Pribik recalled Mrs. Lovich’s silence and negative body language.

But Mrs. Lovich said Ms. Pribik’s promise that the cuts to Colbee’s body would be minimal — no greater than that required for regular surgery — softened her resistance to organ donation. Ms. Pribik’s promise to stay with Colbee until the funeral director arrived for his body — Mrs. Lovich didn’t want him “to just sit in a basement somewhere”— also helped. The thought of Colbee helping others moved her aching heart.

Coordinators are trained to address concerns and answer questions while guiding the family toward donation. Families often make special requests, and Ms. Pribik, who has held donor children in her arms, played their favorite songs in the operating room and kept treasured belongings near them, obliges when she can.

The job — with a starting base salary often in the low $60,000 range, Ms. Miller said — can be physically and emotionally grueling. Shifts of 24 hours or longer are common. Many coordinators, including Ms. Pribik, come from the nursing ranks and have experience with end-of-life care.

Ms. Miller said her training program was founded partly because high turnover signaled a need for better job preparation. Of the 84 who graduated from 2004 to 2014, about 78 percent are still in the field, she said, calling that a “very good” rate.

“I tell them every tough thing about this job,” she said.

Some coordinators are embedded in hospitals, but others travel as needed to hospitals in a procurement organization’s service area. CORE’s territory — encompassing five transplant centers, dozens of other hospitals and 46,177 square miles in Western Pennsylvania and parts of West Virginia and New York — is the 22nd largest in the nation.

Research and experience shape the strategies coordinators use. Ms. Miller said she speaks with her students about the “top 20 objections/​concerns families might have” and urges them to ask “probing questions” to get to the root of unspoken fears.


 
“Then I have a bazillion scenarios, and we role-play, and we role-play, and we role-play,” she said.

A study of Texas cases published last year in the Journal of Trauma and Acute Care Surgery suggested that female coordinators were more effective than males; that a family was more likely to consent to donation if approached by a coordinator of the same race; and that consent rates started to decline after midnight as families became fatigued.

Faced with the loss of a loved one, some families are dazed. Others are angry. “We are prepared for that,” Ms. Miller said.

■     ■     ■

The coordinator may start by reviewing patient data and huddling with the medical team to gain insight into family dynamics. Who are the decision makers? Is there conflict within the family? How are family members coping with the death?

“So far, I’ve never approached two families the same way,” CORE coordinator Wes Washington said.

One coordinator, interviewed for a 2011 article in the Journal of Health Communication, said gathering information about family members from a distance helps to provide important insights “long before they even know who I am.”

The article quoted another coordinator as saying he considers a lab coat a barrier to communication and takes his off before meeting with a family. If he senses that a necktie would create a “class barrier” with a family, he said, he removes that, too.

Families sometimes hesitate about donation because they don’t want further trauma to a loved one’s body. In those cases, coordinators explain that cuts will be as limited as possible and dignified and will not prevent an open-casket viewing. If the loved one died a tragic or unexpected death, the coordinator may point out that an autopsy is likely anyway.

Coordinators often suggest that donation would be a heroic act in keeping with the patient’s good character.

“We don’t ask the family. We offer them the opportunity. I really feel I’m giving them something good,” CORE coordinator Amy Weisgerber said.

Jenna LaSota, a Beaver County native who graduated from the Toledo program in July and works for Kentucky Organ Donor Affiliates, said she has found that families are receptive to the message and “want that good to happen.”

Ms. Pribik said donation also gives a measure of control to families who feel powerless after a tragic, unexpected death.

Some coordinators had used a “presumptive” approach and met a family with the expectation that it will donate after understanding the benefits. Ms. Miller said some in the field consider that approach “too strong” or “somewhat manipulative.” She said she teaches a “sensitive, effective family approach” that allows coordinators to better tailor their strategies to each family.

Some scholars and doctors have criticized coordinators for being too pushy. “Even seemingly caring and compassionate statements — like, ‘Would you like me to give you some time before you make your decision?’ — are discouraged in favor of language that rushes families along the preferred decisional pathway,” Robert Truog, a Harvard Medical School ethicist, wrote in 2012 in the American Journal of Bioethics.

Michael Grodin, a physician and ethicist at Boston University School of Public Health, agreed that coordinators sometimes are overzealous in their quest to keep organs from slipping through their grasp. Better for some organs to go unused than to undermine the public confidence that anchors the transplant system, Dr. Grodin added, calling for more transparent and verifiable standards for diagnosing death-by-brain criteria.

Coordinators say they are committed to ethical treatment of families. “I say, ‘That’s me in there. … What kind of person do I want talking to me and how do I want them talking to me?” CORE’s Mr. Coleman said.

Ms. LaSota said the coordinators she observed during her internships treated families with respect. “They didn’t try to push them or make it a big deal … .”

Some public education campaigns encourage family members to discuss donation so that, in the event of a tragedy, a loved one’s preferences are known and survivors have one fewer decision to make. A sudden death “is not the time to be thinking about organ donation for the first time,” said transplant advocate Kim Harbur of Kansas.

■     ■     ■

After consenting to donation and completing paperwork, family members are encouraged to go home.

But for the coordinator or coordinators — some work in teams — hours of work still are ahead. Organ systems must be evaluated, the data entered into a national database, prospective recipients identified and offers made to transplant centers.

The coordinator also must maintain the condition of a body that, without brain function, becomes unstable. Electrolytes go out of balance and body temperature and blood pressure drop — all changes that can damage the organs.

As soon as possible, procurement organizations give donor families welcome news. Mrs. Lovich learned that Colbee’s kidneys had gone to a man and a woman, both in their late 50s, and his heart valve to an 11-month-old baby.

She has continued to stay in touch with Ms. Pribik and has registered as a donor so that she has a chance to follow Colbee’s example.

“If my son can do it,” she said, “I can do it.”

Complete Article HERE!

Dogs now have bucket lists too

Charleston
Sarah Westcott and her boyfriend Vincent Bova trucked in 600 pounds of crushed ice so that Charleston could have one last snow day.

Last July, the doctor delivered news no pet owner ever wants to hear. Seven-year-old Tank’s cancer had spread. He likely had just two months to live.

So Diane Cosgrove, 37, set out to give her beloved Rottweiler as many memorable experiences as she could, making a bucket list that included going to a baseball game, getting Shake Shack treats and a pet-store shopping spree.

“I did everything to make his last month and a half special,” says Cosgrove, who lives in Pompton Plains, NJ.

The 2007 Jack Nicholson and Morgan Freeman movie “The Bucket List” brought the notion of a “things to do before you die” checklist into the mainstream, but the concept is no longer just for baby boomers. It’s also for pooches and pet owners, who are granting Fido’s every woof in his final days. A mutt’s dying wishes are even the plot of a current Subaru commercial.

“We’re afraid of death. The bucket list is just a way . . . of managing,” says Dr. Stephanie LaFarge, senior director of counseling services at the ASPCA. “Now that pets are part of the family, it’s natural that we extend this practice to them.”

When Lauren Fern Watt, 26, learned her 6-year-old English mastiff Gizelle had bone cancer last year, making an ambitious bucket list for the dog helped her to process her illness. The dog’s final adventures included canoeing, road trips and dockside ice-cream eating.

“It seemed like a good way to celebrate my dog’s life, rather than cry over it,” she says.

Gizelle
Lauren Fern Watt took Gizelle boating after her dog was diagnosed with cancer.

Last January, after Gizelle passed away, Watt, a freelance travel writer who lives in the East Village, put together a photo essay for Yahoo about the dog’s bucket list. It was so popular, it resulted in a book deal. “Gizelle’s Bucket List” is due out next fall from Simon & Schuster.

Sarah Westcott, a Brooklyn dog trainer, practically moved the sun and the stars when Charleston, her 5-year-old Labrador, was diagnosed with inoperable fibrosarcoma in the summer of 2008.

She and her boyfriend trucked in 600 pounds of crushed ice and dumped it on her grandmother’s lawn in Bensonhurst to give the snow-loving dog a final romp in fresh powder. Mini pints of Guinness, unlimited cheese and one last Hamptons jaunt rounded out Charleston’s adventures before he died three weeks later.

“It was good to know that I had done everything I could have for him,” says Westcott.

Vets say that bucket lists are fine, so long as the dying dog’s best interests are kept in mind.

“It should be something that the pet, not the human, is going to enjoy,” says Sonja Olson, a veterinarian with BluePearl Veterinary Partners. “Stressing an animal out can stress their immune system further. Talk about it with your veterinarian. It might need to be dialed back.”

In the end, Cosgrove had to modify Tank’s bucket list. Three items — going to the beach, riding in a convertible and eating at a restaurant — remained when he was euthanized in August.

But he did make it to a New Jersey Jackals baseball game.

“He wasn’t feeling that great,” remembers Cosgrove, “but for the couple hours he was there, he was really perky and alert and enjoyed being outside.”

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What You Say To Someone Who’s Grieving Vs. What They Hear

“This too shall pass.”

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1. What they say:

What they say:

What you hear:

What you hear:

When people say you need to move on, you can sometimes think, That’s easy for you to say. This isn’t your loss. Putting a timeline on grief is nearly impossible and unnecessary.

2. What they say:

What they say:

What you hear:

What you hear:

Someone who is grieving does not want to think about future spouses, or friends, etc., because that means thinking of a future that no longer includes their loved one.

3. What they say:

What they say:

What you hear:

What you hear:

You know in your heart there is no better place for your loved one than with you.

4. What they say:

What they say:

What you hear:

What you hear:

Losing a loved one is a HUGE part of someone’s life, and avoiding the subject will only make it worse. It’s OK to talk about it, and it’s OK to break down over it. It’s all part of the process.

5. What they say:

What they say:

What you hear:

What you hear:

Although this is meant to be comforting, every experience of loss is different, so no one truly knows how you feel.

6. What they say:

What they say:

What you hear:

What you hear:

Although we know no one would say this in a malicious way, it can come off as one of the worst things you could possibly say. While we’re glad you are appreciating your loved ones a little extra now, we just wish we still had our loved ones to appreciate.

7. What they say:

What they say:

What you hear:

What you hear:

In the aftermath of a loss, chances are we’re doing the best we can just to get out of bed most days, so hearing that we should be able to handle this with no problem will only make us feel like we’re handling it wrong.

8. What they say:

What they say:

What you hear:

What you hear:

No matter the situation surrounding a loss, knowing your loved one is no longer in pain is a very small comfort in a time of grief.

9. What they say:

What they say:

What you hear:

What you hear:

Evoking God and religion is a great comfort to many, but not all. Sometimes, even those who are deeply religious will feel anger toward God in the aftermath of a loss, and not want to hear it. NO reason is a good enough reason for your loved one to no longer be around.

10. What they say:

What they say:

What you hear:

What you hear:

If you want to help someone who is grieving, try doing something for them unprompted — like bringing over food, picking up their home, or taking their dog for a walk. It will mean a great deal.

11. What they say:

What they say:

What you hear:

What you hear:

Chances are, if you’ve lost a loved one, you’re already feeling guilt in some form. Letting someone know that their loved one wouldn’t want them to feel exactly what they are feeling could only make it worse.

12. What they say:

What they say:

What you hear:

What you hear:

Loss is a part of life, but not all losses are part of all lives. If you’ve lost a child, for example, hearing that what you’re experiencing is a “part of life” is especially upsetting.

13. What they say:

What they say:

What you hear:

What you hear:

Allowing yourself to feel emotion is strong.

14. What they say:

What they say:

What you hear:

What you hear:

Being told that you won’t always hurt so much for your loved one isn’t necessarily a comfort. You don’t want to hear you will move past them, even if you will.

15. What they say:

What they say:

What you hear:

What you hear:

You are, of course, thankful for the time you had with them, but you should be allowed to grieve for the time you’re going to miss — especially when so many others have time left with their loved ones.

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