Category: Spirituality

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It’s not un-Christian to support assisted dying

— Christian beliefs seem to underpin the views of many people opposed to assisted dying in the UK. As Prue Leith appears in an illuminating documentary about the practice for Channel 4, Kate Ng argues that allowing others to experience ‘good death’ is the most Christian thing you can do

Danny Kruger and Prue Leith in ‘Prue and Danny’s Death Road Trip’

My mother and I had a conversation about death recently. It wasn’t awkward or prolonged. In fact, it was a very brief exchange in the middle of a Christmas market in Germany while we waited for our bratwurst. “I think people live too long these days,” she told me. “I don’t want to live till I’m 100. And if I get sick, I don’t want to get to a point where it’s not worth living any more.” I agreed with her, we got our bratwurst, and went about our day.

I know many people will think this is morbid, but I’m glad that my mother and I are able to have casual conversations about death. Not because life isn’t precious, but because it’s too precious to dance around subjects like this. We all deserve a good death, just as we deserve good lives. Why not talk about it?

So when Prue Leith announced her new Channel 4 documentary about assisted dying, I was intrigued. Assisted dying, also known as assisted suicide, is defined by the NHS as the act of “deliberately assisting a person to kill themselves” and is illegal in the UK. The British Medical Journal says it is usually used in the context of “giving assistance to die to people with long-term progressive conditions and other people who are not dying, in addition to patients with a terminal illness”.

In short, if someone with a terminal illness or a condition that gets progressively worse wants to end their life, assisted dying would enable them to do so on their own terms. The alternative is to wait days, weeks, or even months to die. Leith argues that assisted dying is the most humane scenario here. I think she’s absolutely right about this.

However, Leith’s son Danny Kruger, the Tory MP for Devizes, strongly opposes his mother’s views. A staunch Christian, Kruger is the chair of the all-party parliamentary group (APPG) for dying well, which “promotes access to excellent care at end of life” and campaigns for better resources for hospice and palliative care services. This is an important and necessary cause. However, the group also “stands against the legalisation of doctor-assisted suicide in the UK”.

This puts Kruger head to head with his mother. Their documentary, Prue and Danny’s Death Road Trip, tackles this difficult discussion between mother and son, and sees them travelling across Canada – where assisted dying is legal – to speak to people who bolster both sides of their argument. At one point in the show, Leith hits the nail on the head when she asks her son if the root of his objection is because of his faith’s belief that “suffering is good for the soul”. Kruger replies: “I think suffering is part of life, but I don’t think we should suffer unnecessarily.” He doesn’t seem to grasp the irony of what he’s saying.

I would like the option to have a good death of my own choosing

Leith also points out that “a lot” of the APPG for dying well’s membership is made up of Christians, yet the individual members seem to avoid acknowledging the influence of their beliefs. They also seem to decline to admit that assisted dying goes against Christian beliefs. “Nobody would use that as their argument,” Kruger says in response. “We don’t go around saying, ‘God says don’t do this,’ I mean, that would be mad.”

But as long as assisted dying remains illegal in the UK, unnecessary suffering will continue. Perhaps he doesn’t want to believe it, but what Kruger is essentially saying – with all his religious bias – is that even if you’re already dying, you shouldn’t be given the choice to leave this mortal plane unless God decides it’s time for you to go.

As someone who grew up in a born-again Christian household, I know exactly how much Christians think suffering is crucial to the human experience. The idea is that the more you suffer in the name of God, the better your chances are of getting into heaven. So it’s hypocritical of Christians like Kruger to say they don’t think people should suffer unnecessarily.

The argument against assisted dying claims that legalising it would result in a “slippery slope that could lead to widespread abuse and distress” of vulnerable people. Members of the dying well group say that placing restrictions around who can access the service would not work, and the net would become wider and wider, even allowing people with no health conditions to qualify. Certainly, these are questions that need to be answered, and any policy drawn up should consider how vulnerable people will be protected. But, given that three-quarters of Britons support assisted dying for people who are terminally ill, MPs must begin having open and constructive conversations about changing the law.

I think about dying a lot. Not in a morbid or harmful way, but I think about how I want to die and what kind of memories I want to leave behind. And if it turns out that I should wind up with a terminal illness or a progressively chronic condition, then I would like the option to have a good death of my own choosing. I want my loved ones to remember me with joy, not with sadness or trauma at having watched me suffer till the end. It would be far more humane than any of “God’s work”.

Complete Article ↪HERE↩!

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Preparing Jewish bodies for burial, an artist finds inspiration

‘I could have painted landscapes,’ says Karen Benioff Friedman. Instead, she’s portraying the rituals around death.

Angels of Mercy Embrace the Dead, 2023, oil on canvasboard.© 2023 Karen Benioff Friedman.

By Stewart Ain

When a Berkeley rabbi in 2004 announced that he wanted to form a chevra kadisha, Hebrew for a group that cares for the dead before burial, an artist in his congregation signed herself up.

Karen Benioff Friedman had a mostly secular upbringing, and hadn’t known much about Jewish burial societies, but she knew she wanted to be a part of one.

“What I found compelling is the idea that we never leave the dead alone,” she said.

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Thresholds: Jewish Rituals of Death and Mourning – Placing the Metah into the Casket, 2019, oil on canvas. © 2023 Karen Benioff Friedman.

Ten years later, while Friedman was studying human anatomy and classical realism at an Oakland art school, she learned of 18th century paintings of Prague’s chevra kadisha. They depicted tahara, the rituals of the burial society.

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Thresholds – Jewish Rituals of Death and Mourning – Tying the Avnet, 2023, oil on canvas. © 2023 Karen Benioff Friedman.

As part of these rituals, bodies are placed in a white shroud before they are lowered into a casket. Coincidentally, Friedman had been painting images of shrouded figures. Seeing the Prague paintings made her think that tahara could be her subject too.

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Tahara, 2021, graphite on paper. © 2023 Karen Benioff Friedman.

“I could have painted landscapes or pets, but this is what really moved me,” said Friedman.

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Taharah: Pouring the Second Bucket, 2017, oil on canvas. © 2023 Karen Benioff Friedman.

Since then, Friedman, now 59, has drawn, painted and etched more than 150 images of tahara, each a window into a ritual so private that many Jews have little idea what it looks like. Those who perform tahara wash the body, and sit by it through the night, reciting prayers and psalms.

In her paintings, gauzy figures, some enveloped in light, attend lovingly to the dead, cradling their heads and pouring water over their bodies. The mood is somber, despite the daubs of bright blue she often uses for the aprons of the women of the chevra kadisha.

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Thresholds, Attending Grandmother’s Passing, 2020, charcoal on paper. © 2023 Karen Benioff Friedman.

Tahara calls for men to care for men and women for women, so Friedman’s subjects are mostly female, because, she said, that is what she knows from her own participation.

Respecting tahara, which means “purification,” Friedman would never try to draw or take photographs of the deceased. But she didn’t work solely from memory either. She hired models to impersonate both the living and the dead. One model did a “pretend tahara while another pretended to be a body that was dressed in a shroud,” she said. She worked from the photographs she took of them.

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Angels of Mercy Embrace The Dead, 2019, charcoal on paper. © 2023 Karen Benioff Friedman.

 

Friedman paints in oils and makes monotypes, a form of printmaking. All her drawings are in charcoal.

Many of her works depict angels. “One of the main pieces of liturgy we talk about is the one about the angels of mercy who embrace the metah — the female body,” Friedman said. “Angels come up a lot, including standing outside the gates of heaven. I love the concept of the angels.”

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Angel of Death Holding an Infant, 2022, monotype on silk. © 2023 Karen Benioff Friedman.

Ultimately, she said, she wants her works to teach about the mostly hidden work of the chevra kadisha, and its commitment to respect the dead, no matter who has died.

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Shmira (Guarding the Dead), 2019, oil on canvas. © 2023 Karen Benioff Friedman.

“We are all equal in death,” she said. “We all wear the same thing and are buried the same.”

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A Soul, 2023, monotype. © 2023 Karen Benioff Friedman.

An exhibit of Friedman’s work will open on Feb. 5 at  San Francisco’s Sinai Memorial Chapel and run through March 19.

Complete Article ↪HERE↩!

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‘I will reflect on my own death – and try to conquer my fears’

— The thing I’ll do differently in 2023

‘It is death that makes life meaningful’ … Monica Ali.

I don’t want to be mawkish or indulgent. But I want to consider my mortality in order to live well in the years I have left

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Have you ever spent time seriously contemplating your own death? I haven’t. I’m 55, in good health, exercise regularly, eat well and – barring the proverbial bus – have no reason to think death is imminent. Thoughts of my own mortality naturally arise from time to time but they’re easy to banish. After all, both my parents are still alive, forming a kind of metaphysical barrier. Not my turn yet! But one thing I will do differently in the coming years is to begin reflecting on my demise. Does that sound mawkish? Self-indulgent? Pointless?

Well, I won’t be picking out a coffin or selecting music for the funeral or tearfully imagining the mourners gathering. All that would be a waste of time and, like everyone else, I’m busy. With work, family, friends, travel, trips to the theatre, galleries, restaurants and so on. What I mean to say is that I have not lost my appetite for life. Why, then, do I wish to begin meditating on death?

For two reasons: in order to live well during whatever years I have left; and to begin to confront and maybe even conquer the fear that, thus far, has stopped me from having more than a fleeting engagement with the knowledge that death is the inevitable outcome of life.

There’s a well-worn trope about living each day as if it’s your last, or if you only had one year to live you wouldn’t choose to spend it at the office. That doesn’t quite chime with me. If I only had a year to live, I’d still choose to work. (I might try to write faster!) Nevertheless, it is death that makes life meaningful. In Howards End, EM Forster puts it like this: “Death destroys man: the idea of Death saves him.” The value of our days floats on the metaphysical stock market of ideas that we hold in our minds.

The idea of ceasing to exist isn’t easy to contemplate. But I don’t believe in reincarnation or an afterlife. I don’t believe that raging against the dying of the light is going to achieve anything. And ignoring the issue isn’t going to make it go away. In fact, it makes the prospect more, rather than less, frightening.

I first read The Complete Essays by Michel de Montaigne when I was at college, but it’s only now that I’m ready to take on this piece of sage advice: “To begin depriving death of its greatest advantage over us, let us deprive death of its strangeness, let us frequent it, let us get used to it; let us have nothing more often in mind than death.”

How will I go about it, then, this new contemplative practice? Place a skull or some other memento mori on the shelf above my desk? Fly to Thailand or Sri Lanka and visit the Theravāda Buddhist monasteries where photos of corpses are displayed as aids to the maranasati (mindfulness of death) meditation? Walk around graveyards?

I’ve recently rented an office where I go to write. There’s a huge picture window under which I’ve placed the desk. The window overlooks a Victorian graveyard that’s still in use. When I sit down, all I can see are the trees. But when I stand I have a view of the tombstones and, in the distance, the crematorium.

One day I’ll be gone, my body consigned to the earth or turned to ash. Sooner or later I’ll be forgotten. Truly accepting that revivifies life. It doesn’t make every moment wonderful, but knowing I will die is a source of strength to endure the difficulties, and a spur to be more present for all that is good and precious in life.

Complete Article ↪HERE↩!

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Most older adults are wary of mixing health care and religion or spirituality, poll finds

But majority see role for health care providers in finding meaning or hope in the face of illness, and are comfortable discussing their beliefs with their providers.

By Kara Gavin

When it comes to matters of personal beliefs, most older Americans prefer to keep their health care and their spiritual or religious lives separate, a University of Michigan poll finds.

But they do see a role for their health care providers in helping them cope with illness by looking for meaning or hope.

In all, 84% of people between the ages of 50 and 80 say that they have religious and/or spiritual beliefs that are somewhat or very important to them, including 71% who cited religious beliefs and 80% who cited spiritual beliefs, according to new data from the National Poll on Healthy Aging. About 40% of these older adults say those beliefs have gotten more important to them as they grow older.

Among older adults with religious or spiritual beliefs that are important to them, 19% say their beliefs have influenced their health care decisions, and 28% say they want health care providers to ask them about their beliefs.

Meanwhile, 77% of all older adults, regardless of beliefs, say health care providers should keep their own personal beliefs separate from how they deliver care.

The poll is based at the U-M Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine, U-M’s academic medical center.

For the report, the poll team worked with Adam Marks, M.D., M.P.H., a hospice and palliative care physician at Michigan Medicine, and L.J. Brazier, M.Div., a chaplain at Michigan Medicine’s Department of Spiritual Care.

“While 45% of older adults say their religious beliefs are very important to them, and 50% say that about their spiritual beliefs, even this group largely wants to keep this aspect of their lives separate from their health care,” said Marks, an associate professor of geriatric and palliative medicine. “But a sizable majority of all older adults – whether or not they say belief is important to them – reported that they’d turn to health care workers to help them find deeper meaning in their illness, and 78% believe health care workers will help them find hope when they’re having a health-related challenge.”

Brazier notes that many health care systems have a way to record the religious affiliation of patients in their electronic medical records, and that medical students and others training for health professions are told to ask their patients about any beliefs that might affect their future care.

“While 45% of older adults say their religious beliefs are very important to them, and 50% say that about their spiritual beliefs, even this group largely wants to keep this aspect of their lives separate from their health care.”

Having this information available can help providers ensure that patients with strongly held beliefs or specific religious affiliations receive everything from appropriate hospital food to visits with chaplains of a specific faith tradition when they’re having a health crisis or nearing the end of life.

But for those who do not follow a faith tradition or have strongly held beliefs, having that information available to health providers can also be helpful.

“Being a religious or spiritual person, or not following a faith tradition or spiritual practices, is a highly personal matter,” said poll director Jeffrey Kullgren, M.D., M.P.H., M.S., an associate professor of internal medicine at Michigan Medicine and physician and researcher at the VA Ann Arbor Healthcare System. “So perhaps it’s not surprising that only about a quarter of all people in this age range say they’ve talked about their beliefs with a health care provider, though this rose to about one-third of those who say their religious or spiritual beliefs are very important to them.”

In all, 70% of those who say their beliefs are somewhat or very important to them reported feeling comfortable discussing their beliefs with their health care providers.

Even if patients don’t want to discuss their beliefs with their health providers at a typical appointment, it’s important for providers to know if patients with significant health needs, or those experiencing a health crisis, are connected to a faith community that can help provide support.

In all, 65% of the older adults whose religious or spiritual beliefs are important to them said they belong to a community of people who share their beliefs.

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI and administered online and via phone in July 2022 among 2,163 adults aged 50 to 80. The sample was subsequently weighted to reflect the U.S. population. Read past National Poll on Healthy Aging reports and about the poll methodology

Complete Article ↪HERE↩!

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A modern witch celebrates the cycle of life and death at the confluence of cultures

— This time of year, a bruja, or witch, practices central Mexican Indigenous rituals and modern pagan ones, both honoring the Earth and “us as individuals as part of nature.” But the holidays of the Day of the Dead and Samhain are not the same.

The Rev. Laura Gonzalez poses after teaching about Day of the Dead at a bookstore in Chicago in 2019.

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As Americans of all faiths prepare for Halloween with costumes and candy or the Day of the Dead with food and flowers, the pagan community is also preparing for its holiday celebrating death and rebirth.

Samhain is the third and final harvest festival of the pagan Wheel of the Year, as the holiday calendar is known in many Earth-based religions.

“(Modern) Pagans have incorporated the seasonal concern with the dead in a holy day that celebrates the cyclicity of life, death, and rebirth,” writes folklorist and pagan scholar Sabina Magliocco in her book “Witching Culture.” 

Not unlike the Day of the Dead and Halloween, Samhain (a Gaelic word pronounced “Sow-en”) includes feasting and honoring one’s ancestors, though those celebrating Samhain are likely to add some divination. Based largely on Irish folk religion, it is a time when the divide between the physical and spiritual worlds are believed to be thin.

The Rev. Laura González, who is a practicing witch and a pagan educator and podcaster in Chicago, celebrates all three. “(My practice) is a hodgepodge,” she laughs.

The Rev. Laura Gonzalez celebrating Tlaxochimaco 2022 in Little Village, Chicago. Courtesy photo
The Rev. Laura Gonzalez celebrating Tlaxochimaco 2022 in Little Village, Chicago.

González merges modern paganism with Mexican traditions, including practices indigenous to central Mexico, where she is from. “At their core, modern paganism and these indigenous practices both honor the Earth,” she said. Nature reverence is essential, she said, to her spiritual path.

“Let me describe to you what happens in my life,” González said in a phone interview. On Oct. 1, the decorations go up for Halloween, a purely secular holiday for her. Then, around Oct. 27, she sets up a Day of the Dead altar to honor deceased relatives, as most Mexicans do about this time, she said. “My mother died on Oct. 27, 2011. I believe it was her last wink to me,” said González.

Since then, González has been honoring her mother with bread and coffee but has also made it her mission to teach others about the Day of the Dead and its origins. She teaches those traditions as well as modern paganism both locally and over the internet at the pagan distance-learning Fraternidad de la Diosa in Chihuahua, Mexico.

On Samhain, González always hosts a small ritual for her Pagan students and participates in Samhain celebrations, either as an attendee or organizer. Some years she travels to Wisconsin to be with fellow members of the Wiccan church Circle Sanctuary.

Samhain is traditionally honored on Oct. 31, but some pagans celebrate it Nov. 6 or 7, an astrologically calculated date. Regardless, group celebrations must often yield to modern schedules, and González said she will celebrate an early Samhain this year.

“My (Samhain) celebration is for the ancestors and for the Earth going into slumber — the Goddess goes to sleep,” González said. She likes to focus her ritual on modern pagan trailblazers, often referred to as “the mighty dead,” rather than on her relatives, which she honors on the Day of the Dead.

González’s central Mexican indigenous practice and her modern pagan practice, rooted in  northern Mexico and the United States, “are very similar,” she added, both honoring the Earth and “us as individuals as part of nature,” something she believes has been lost in modern Day of the Dead traditions. However, she quickly added, “Indigenous practices are not pagan.”

Growing up in Mexico City, González was surrounded by mainstream Mexican culture, with Day of the Dead festivals and altars. As she was exposed to the Indigenous traditions that are still woven through Mexican culture, she explained, she began to study folk magic and traditions, as well as “Native philosophies.”

The Day of the Dead, she said, “is the ultimate syncretic holiday,” a merger of the European-based Catholic traditions with Indigenous beliefs and celebrations. “The practices brought to Mexico by the Catholic colonizers were filled with pagan DNA,” she said. All Saints’ Day and All Souls’ Day contain remnants of traditional Samhain and other older beliefs, she noted.

“These colonizers came to a land filled — filled — with skulls and its imagery,” she said, which must have been frightening and somewhat of a culture shock, she added.

An altar during Tlaxochimaco 2022 commemorations in Little Village, Chicago. Courtesy photo
An altar during Tlaxochimaco 2022 commemorations in Chicago.

González is now actively participating in the revival of the Indigenous traditions as a teacher and celebrant. The Indigenous holiday, she said, is a 40-day celebration. The first 20 days is called Tlaxochimaco, or the birth of flowers, and the second is Xoco Huetzi, or the fall of the fruit.

“We all are flowers,” she explained. We grow, flower, bloom and then become fruit. Eventually falling and becoming seed, and the cycle continues. The Aztecs “used this mythology to describe life and life cycles,” she said.

“But there are people who do not make it to fruit. They die young,” González explained. These people are honored during Tlaxochimaco.

During Xoco Huetzi, celebrations are held to honor those who have made it to old age before passing. Both festivals traditionally involve dancing, she said, which is considered an offering to the dead. 

The 40-day celebration was eventually condensed into two days aligning with the colonizers’ Catholic traditions, she said, becoming the modern Day of the Dead celebration, a holiday that is quickly becoming as popular north of the Mexican border as Halloween is.

While González is not offended by purely secular Halloween celebrations, even with its classic depiction of witches, she struggles with the growing commercialization of the Day of the Dead. “I know what I am, and I know what I celebrate,” she said, speaking of Halloween. “I find it funny that the wise woman has been made into something scary.”

What does offend her is people dressed as sugar skulls. “It’s a double-edged sword,” González said. “It’s a source of pride knowing the world loves our culture,” she said. However, she added, “You love our culture, you love our music, you love our food, you love our traditions, you love our aesthetics, you love our parties and holidays, you love all of that, but you don’t love us.”

Complete Article ↪HERE↩!

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‘A Last Act of Intimate Kindness’

I had barely seen my brother in decades, but when time was short, he let me in.

By Michelle Friedman

The message I had dreaded for years appeared on my phone: “Looking to find the sister of my patient, Jay Friedman.”

My ensuing phone conversation with the doctor brought ominous news. My 65-year-old brother, Jay, had advanced pancreatic cancer. He and I grew up together in Divine Corners, N.Y., a hamlet in the Catskills, raised by secular Holocaust survivor parents who stumbled into raising chickens. Their histories, coupled with the isolation and poverty of the farm, rendered my father brutal, especially to his only son.

I am the only family member with whom Jay maintained contact for the last three decades. Over that time, we communicated exclusively through email and cards I sent to a post office box. Despite working a quarter century in I.T. for the local school system, my brother did not own a cellphone. His doctor found my number via Google.

Jay was admitted to a fancy Seattle hospital where I called him via the landline next to his bed. His voice sounded weak, plaintive.

“Jay, I’ll come,” I said. “Let me be with you.”

“I don’t know,” he said. “My house is a mess.”

“I can stay in a hotel.”

“I’ll let you know.”

I panicked. I knew the prognosis was dire, but my brother’s lonely life cast an even darker shadow.

The hospital discharged Jay with a bag hanging from his chest to drain bile from his tumor-blocked liver. A few days later the doctor called again. Jay wanted my help.

I caught a flight to Seattle, picked up a rental car and drove around Puget Sound to a town in Kitsap County. Before entering Jay’s house, I muttered an ad hoc prayer for strength. Following the sounds of his weak voice through the maze of papers, boxes and computer parts, I found my brother lying on the couch. The disease had consumed him, leaving his body whittled, skeletal. Only Jay’s voice sounded familiar, a gravelly baritone.

“Thank you for coming,” he said. “I’m sorry I was snappy over the phone.”

The blanket wrapping my brother was full of holes. A brown crust covered his kitchen floor and counters. Jay drank tea with lemon in the one glass he possessed. Not owning a kettle, he boiled water in an old pot.

I brewed tea and baked a piece of chicken. After a few sips of liquid and child-size bites of food, Jay felt full. He slowly climbed the stairs to the single bed in his bedroom. The sheets hadn’t been changed in months. All I found in the closet was a cotton duvet cover that I recognized from the farm where we grew up. The faint smell of the detergent and crisp lines from our mother’s iron told me Jay had never used it.

Retreating to a Best Western hotel two miles away gave me guilty relief. It was no palace, but it was clean and orderly.

In the morning, the doctor outlined my brother’s stark medical options. Surgery was out. Jay could pursue radiation or chemotherapy, but neither was likely to yield much in terms of quantity or quality of life.

Jay made his choice in seconds — no aggressive medical intervention. The focus shifted to palliative care at home.

He didn’t have much time, weeks. How was I to start a conversation with him about his death? I knew he took pride in his money management and had saved a lot (though I had no idea then how surprisingly much), so that’s where I started.

“Jay, have you thought about what you want to do with your money?”

“Yes, I’ve thought about this a lot. I want to give it to Planned Parenthood.”

“All of it?”

“Yes.”

His calm answer startled and pleased me. Throughout our decades of sparse contact, Jay stayed vague when it came to his personal opinions.

“Jay, that’s amazing! How did you come to this decision?”

“There are too many people in the world, and I believe that people should have autonomy over their own bodies.”

I sat in silence thinking about my brother’s autonomy, the little boy overwhelmed by our rageful father, the awkward teenager who wanted to join the Navy to get away but lacked nerve. My practical mind kicked in. “Jay, do you know a lawyer?”

Once again, he surprised me. “Yeah. One of the teachers I know went to law school at night. He’s a good guy.”

Jay had no contact information for the lawyer, but I found him through the school. He answered my text within minutes and got to work preparing the necessary papers.

By the next day, Jay could no longer crawl up and down the stairs and spent most of his time in his bedroom. We moved the mattress to the floor in case he rolled off during the night. I pleaded with hospice to fast-track Jay onto their service, and soon a nurse arrived and taught me how to dose the medication: morphine for pain, Haldol for nausea and Lorazepam for anxiety. Each floated in a medicine-dropper-topped bottle so that liquid relief could be applied to the inside of the patient’s cheek.

Jay’s condition deteriorated quickly, and I no longer retreated to the Best Western. My first night in Jay’s house, I slept downstairs on the sofa. The next night, I worried that I wouldn’t hear his whimpers, so I moved to the floor next to his mattress. My younger brother’s vulnerability pierced me; he was the innocent little boy on the farm who trusted me. I cried, silently.

When he no longer ate or drank, I repurposed a medicine dropper to drip orange juice and seltzer onto his parched lips.

The lawyer met privately with Jay and later told me of his firm wish to be cremated.

A clutch grabbed my heart. Jewish law, which I follow, prohibits cremation. “Can I at least get Jay’s ashes so that I can bury them according to our faith?”

“Yes. I think that will be OK.”

“We haven’t talked about this, but I’m wondering if you are part of a religious tradition?”

“I am. The Church of Jesus Christ of Latter-day Saints.”

His answer bolstered me, given what I was about to request.

“Can I ask you one more favor?”

“Sure.”

“When the time comes, I want to do a Jewish ritual washing for Jay. It’s called a tahara. It means purification. I’ll need help; it’s too hard to do alone.”

“Of course. Call me when you need me.”

The days passed in a kind of waking dream. Jay talked on and off, disclosing struggles of all kinds. He liked hearing stories about Divine Corners, how we played in the snow and explored the brook behind the coops. I emptied his drainage bag and changed his adult diapers.

“This is disgusting,” he said.

“I’m fine,” I said. “I’m here for you. There’s nothing else I want to do.”

As our mother did when we had fevers as children, I gave Jay a sponge bath and changed his worn pajamas to a clean set.

Jay quietly slipped away. He told me that his dream was to buy a house on a lake with a few acres of land.

“That’s such a nice idea, Jay,” I said. “I love you.”

“I love you too.”

And then I made a plea I knew people have uttered for millenniums. “Send me a sign, Jay. Please send me a sign from the other side.”

Early Thursday morning I woke up inches from my brother to find him gone. No labored breathing, no death rattle. His skin had cooled, his limbs stiffened.

When the sky was fully lit, I called his friend, and we performed the tahara. We removed Jay’s pajamas, removed the drain and bag, all the while using a clean sheet to keep his frame covered and dignified. I repurposed the battered teapot to pour water over his body, starting with his head and moving to his feet. We toweled him dry, dressed him in long underwear and wrapped him in the duvet cover from our childhood farm. The work felt tender, holy, a last act of intimate kindness.

The mortuary people came and removed Jay’s body. At 6 o’clock I boarded the van for the airport. Only one other person got on, a white-haired woman in a sweater set. I saw that she bid a sorrowful farewell to the man seeing her off. She sat a few rows behind me. Drizzle and traffic caused delays, but our elfin driver navigated the trip and asked us which terminals we needed.

“American,” she said, turning mournfully in my direction. “It’s a sad trip. My brother is dying of brain cancer in Florida.”

“United,” I said, and to her: “I just left after taking care of my brother, who died this morning. I hope you get there in time.”

We reached across the aisle and held hands. Jay had made good on his sign.

Complete Article ↪HERE↩!

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What Comes After Death?

— Clinicians can help young patients integrate existing belief systems to process grief

By Rebecca Morse, PhD, MA

I once attended a funeral during which the guests were invited to take a flower from atop a young mother’s casket as a memento. A little boy, her son, was being held by his father. He had been remarkably quiet throughout the funeral and interment process up to this point. Then, I began watching him, watch them. He was looking from the line of people to the casket, to his father, to the line of people, to the casket, to his father. He was starting to fidget. And suddenly, amid the silence, he asked his father “Daddy! Why are they taking mommy’s flowers? They are the lastest she’ll ever have?!”

The purpose of this story? To emphasize that this little boy, with only a handful of years on this earth, who couldn’t possibly have a full, contextual understanding of death, on some minute yet significant level got it. His mother would never get more flowers. At least, none she would be able to appreciate.

Last month, I wrote about how medical professionals should always provide honest and fact-based information when talking to pediatric patients about dying. Yet the question remains: What comes after death?

Children may not ask questions indicative of an existential crisis. They often ask very practical questions: What happens after we die? What will happen to me after I die? Is there a heaven? We must educate those who work with and around children: kids live in a world where death exists and we don’t help them if we don’t tell them, help scaffold their understanding, and better their ability to process difficult emotions.

Having established that children understand more than we recognize, how do we, as health professionals, discuss what comes next? First, the pragmatic recommendations: When discussing anything with a child, it’s best to ensure that the parents or legal guardians know what you will be sharing and why. Second, it’s critical to be mindful of culture. Depending on the family’s background there may be constraints or considerations integral to their belief system. And although the goal is transparency and honesty, to establish a trusting relationship with the child, it doesn’t help if the healthcare professionals and guardians are at odds with one another.

It can also be helpful to ask the child what they know already. What have they learned from their family? What does the child think? Children are remarkable observers. They “science” the world around them; correlation does imply causation to them. So, knowing and being able to understand their existing framework or cognitive schema(s) will help guide you in what to say. Even a child as young as 3 or 4 years old can make correlational connections, as did the young child in my story.

In my thanatology courses on children and death, I often require students to watch the movie “Ponette.” It’s a perfect example of what not to do. As each adult and older child gives Ponette different responses after her mother dies, she now must navigate conflicting narratives. And none of it makes sense to Ponette, who is engaging in a very healthy grief response: seeking proximity to her deceased mother and wanting to find ways to communicate with her spirit.

When discussing the afterlife and what comes next with kids, if you know the family’s belief or faith you can work with, not against, what the child has already internalized as their working model for their assumptive world. It’s not our place to undermine the child’s trust in their parents or guardians, or to question what the family has taught the child.

So, what might this look like in a clinical setting?

Step 1: Be honest about what you don’t know first-hand. Unless you are Frankenstein’s monster, it’s safe to assume you haven’t been dead yourself or returned from the grave. It’s okay to tell a child that you don’t know. In terms of sharing what you believe, there may be limitations on what you may or may not share based on professional ethical or legal guidelines, in addition to the need to respect the legal and moral rights of the parents.

Step 2: Ask. This is a good opportunity to ask the child what they believe. A child doesn’t need us to have all the answers. Children need a secure attachment base, and to know they can trust the adults in their world. Regardless of the child’s faith of origin (meaning their caregiver’s or cultural belief system that they are still internalizing), they need consistency in messaging, and their caregivers serve as a primary attachment figure. This can be challenging when the child or family has a different belief system than your own. This is where spiritual cultural humility is imperative; never undermine faith just because you don’t share it (e.g., thanatologists dealing with difference). By finding out what the client feels is salient, we can help them process their emotions around it.

Step 3: Help the child learn to label their emotions. Research has demonstrated that when parents have a more extensive vocabulary for emotion-related words, their children are more advanced in both their social and emotional development. Lev Vygotsky, an early developmentalist, was particularly interested in how we can structure learning in children; he posited that a child’s ability to learn and reach their potential is not limited as much by their own abilities, as it is by the ability of the “teacher” or more expert peer to “scaffold” learning. When children can have their emotion-related expressive language scaffolded (meaning built up or supported by a more experienced person), they show better emotional self-regulation. One final tip: children process through play, so don’t be surprised if they engage in imaginary playacting or games to practice what they are learning and to develop self-regulation. It’s perfectly normal if one moment they are crying or distressed and then minutes later they are laughing and silly. Children may also practice social scripts around loss through make-believe interactions with imaginary friends — this is healthy and adaptive as they are learning to adapt to their new world.

Talking with children about death is one of the most challenging things grown-ups must do. I know many parents who would much rather discuss sex than death and dying. Oftentimes, it may fall on healthcare professionals to provide support. Similar to discussing dying with a child, when discussing what comes after death it’s important to keep in mind the child’s cognitive ability, offer honesty titrated in language they can understand, and remember that grief may manifest itself in different ways such as upset tummies, headaches, irritability, and changes in eating and sleeping patterns.

Moral of the story? The best thing we can do to help children deal with death is to lean into those difficult discussions, work within their existing understanding, and allow them to process at their own pace.

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