An excerpt from the book Exhilarated Life: Discovering Inner Happiness
The Little Drama vs. the Big Picture.
Yesterday I made love to my home. I reclaimed her as my sanctuary. I got down on my hands and knees and actually reached under furniture, damp dusted the underside of things where the dog hair clung, carefully rewound the Christmas tree lights, dragged the tree outside, vacuumed the pine needles from under the carpet, and put the gasping poinsettias outside to “go to sleep.”
There are two significant aspects of this; one is that I normally mutter and spit through a perfunctory swiping of the floor—gathering the tumbleweeds of pet hair, and not quite reaching the corners. I usually make a joke that the maid will get the rest—but I am she…and well, you just can’t get good help these days. The second is that I am putting my home in order after the first Christmas and New Year since my beloved husband George’s death, last February.
Three weeks ago I was ready to bolt. I was going to take my sons to a beach somewhere and let the holiday roll right on past. It was my younger son who stopped me in my tracks. He said, “I don’t know why you have a problem with Christmas. Last year wasn’t our best Christmas, for sure, but this is our home and this is where we should be.” In those words and in his wise young eyes was the absolute spirit of George. It is just what he would have said. I hugged him in relief for his clarity and the three of us chose to celebrate the season by having a holiday much more joyful and healing than sad.
On Christmas Eve a year ago I knew that George was going to die. On Christmas Day at 11:00PM a 20lb turkey, stuffing and vegetables were dumped into a green garbage bag—no one could eat. At 3:00AM the day after Boxing Day, my older son, Nick, helped me maneuver George into the car, and I drove my husband to the hospital, where he stayed the week.
He wanted so much to be home for New Year’s that he was released that afternoon. We no sooner got home than we realized it was a mistake. As the clock ticked toward midnight, New Year’s Eve, George and I sat in the emergency room; George in a wheelchair, silent and still, enduring God knows what kind of pain, and me breathing and praying.
Our two sons, aged twenty and seventeen, were out at celebrations. I wouldn’t call them until after midnight to tell them I had brought their dad back to the hospital. They had been so relieved when he had been allowed to come home just that afternoon.
But wait, that isn’t the point of this story.
That part is the Little Drama as opposed to the Big Picture, as I havecome to view Life over the past several years. My good friend calls it the “Epic Story.” Like the Iliad. The one that is truly our path to God, which in my view is manifest in self-actualization, the path of love seeking love.
It is the divine blueprint of All That We Can Be. That path leads us right through the minefield of the small self with all its fears and rages, and life and death dramas, to our Greater Self—the poet, teacher or leader who resides in the heart of God or divine creation.
Here there is no death. Or rather death has no “sting.” There is only love—in its many and glorious forms. As we are birthed into this world, live and sooner or later die out of this world, we can be carried through our darkest nights on the grace of this knowing, or be badly bruised on the harshness of a “real” and physical world.
It actually becomes a conscious choice over which only we have control. I cannot trivialize the illness and death of my husband, the father of my sons, my business partner, mentor, lover, and soul mate. “George and Marilyn” was a phrase. For twenty-seven years we worked together, played together, had lunch together, shopped together, and on the way home in separate cars chatted on our cells to one another. We always had something to talk about. We rarely argued. We loved one another deeply and always wanted what was best for the other. We were only ever apart three or four times in more than a quarter century.
Was I afraid? Yes, I was terrified. I look back and realize I had bargained with God and offered to endure years of a million daily fears in exchange for the One Big One.
Was I sad? Yes, many nights I lay on our bedroom floor and wailed in the middle of the night, mindless in sorrow.
Was I angry? You bet. I hated the arrogance of doctors, the soullessness of CAT scans, the iniquity of the body. I was bloody outraged that my husband was to die. I wasn’t ready!
Did I suffer? In the sleepless nights and the numbed out days when I couldn’t fix what was broken, yes.
But so what? It all happened anyway—whether I liked it or not.
What emerged from the depths of my experience were a series of lessons about life and death. Really about life, mostly. They are a mere handful of truths that will help us live life more fully, prepare for our own death more objectively and accept the death of those we love.
Death is just the context for living our life. We are all going to die, one way or another, sooner or later. We all know this but continue to act surprised or betrayed when the end befalls us or one we love. There are no untimely deaths. Cancer, car accident, or crib death is merely part of the script. We all have an exit ticket.
There is a purpose to every single human life and how we express that to its fullest is our job on this planet. To the extent that we fulfill that mandate, the easier it will be for us to let go of the physical world and give ourselves over.
There is a saying that a good life means a good death. To my mind a “good” life does not mean one of perfection—pleasing God in our flawless following of rules, but of being real in all its darks and lights and striving. When we embrace this truth, we express our divinity in being God’s hands, eyes, mouth, ears, heart—healer, artist, teacher, counselor, lover—whatever.
The irony of all this is that I live in a world of healers—spiritual, energetic, natural. A world of miracles. In fact it is my business. After we sold our company and retired, George helped me realize my dream.
In July 2005, two weeks after I opened my boutique dedicated to the healing and creative arts, George collapsed and was rushed to hospital. He had a tumor from prostate cancer that had shut down his kidneys, he needed fourteen liters of blood, and he nearly died. The oncologist refused to take him on as a patient because she said there was nothing she could do. His urologist said he wouldn’t live until Christmas (2005), and he would spend the rest of his life dependent on dialysis.
George lived another eighteen months. He did it for me and our two sons, his family, and many others whose lives he touched during that time. I thought he was going to be my poster boy for miracles. How could the husband of one in the healing world die of the nastiest of illnesses—cancer?
But George did die. And in that passing emerged a profoundly beautiful love story. For in that final walk on Earth together, George, always my protector, led me through the fire of my greatest fears, and in return, I had the privilege of looking deeply into his eyes as he passed through the veil so he would not be afraid. From that moment the life and death drama of every day fell away and I witnessed my own soul’s journey.
I have lived my life in pursuit of the spiritual. I have prayed for clarity and understanding. I was certain that as I prayed for God’s Will to be done, that if I was really good and fulfilled my guidance in building this business around living life authentically and spiritually, I would be rewarded by my husband’s miraculous cure. How else could I really interpret his illness?
As it happened, something was lost in my interpretation. When I surrendered (small ‘s’) to God’s Will, I sensed this voice saying, “Are you sure?” and I answered, “Yep, yep, yep!” because, of course, I thought I knew what that meant. But what God really meant was that I would have to go where I dreaded more than anywhere on earth—and that was to the hospital. In this case, forty-two hours in the emergency section where George, awaiting medication, rocked back and forth on his gurney in pain and I sat on an overturned barf bowl for hours on end.
God’s Will also meant that I would ultimately have to give up my beloved when in my heart of hearts I knew he could have been “healed.” This is where I learned that healing does not always mean living.
To some I have shown strength or courage, but the truth is strength comes through surrender. In surrendering to what is, we can then look to what we need to lift us up and move us through a difficult passage.
This is where I can gratefully acknowledge the cast of hundreds who helped me—and George and family—by word or deed, practice, therapy or healing to take Life in hand and really live it…to death.This is the part I want to share.
The circumstances of the Little Drama are the tools for the Big Picture and serve only as the flash cards of greater meaning and purpose.
Yesterday, I plucked some faded roses from the Christmas centerpiece on the dining table. I was about to put them in the recycling bin, but instead to honor George (who never threw flowers in the garbage), I went out on the deck and, opening each dead rose one at a time, strewed them across the snow. The crisp brown outer petals fell away in my hands, and within the bud, deep pink silken petals unfurled.
Snowflakes and rose petals swirled in the air, then cascaded to the ground and rested there. As I looked out the window and saw the graceful pattern they left, it was a message that, like the roses, there is no death—just transformation and beauty when we look through the eyes of Love.
I hope you enjoyed this excerpt from my book, Exhilarated Life: Discovering Inner Happiness.
Today, December 8th, is George’s and my wedding anniversary.
The truth of a divine plan expressed in the chapter above is illustrated now in the diagnosis of prostate cancer in my life partner, Athan a year ago, October. Rather than being devastated by the news, we see it as destiny.
How can that be? There is a miracle unfolding for a new treatment and Athan is the sole volunteer to test it.
The irony? We have spent the past seven years involved in the testing and research of the cancer fighting properties proven in the phenolic compound oleocanthal only found in olive oil.
The adventure continues and finding the love, light and lessons in every moment is what happiness is all about.
Complete Article ↪HERE↩!
U.K. restaurateur Oliver Peyton’s newest project, a style-forward funeral home called Exit Here, aims to shake up a very traditional industry.
Oliver Peyton knows one thing about his death: Thin Lizzy will play at his funeral.
His Spotify playlist is already queued up. Peyton is Irish, and the ‘70s Dublin hard rockers behind “The Boys Are Back in Town” played the first concert he ever attended. He’s thinking that “Dancing in the Moonlight (It’s Caught Me in Its Spotlight),” off 1977’s Bad Reputation, might be the first song to kick things off.
Peyton’s funeral soundtrack doesn’t sound even slightly sepulchral. It also features ’90s groove tracks by Arrested Development, De La Soul, and A Tribe Called Quest, a nod to the first London establishment he ever opened (a hip-hop club). Peyton is nothing if not an entertainer: The longtime restaurateur is a judge on the BBC’s reality chef show, Great British Menu, and he earned an honorary British order of chivalry for his service as a caterer. When it all goes down, Peyton means for his funeral to be something special.
“I want every detail of my funeral to be choreographed,” Peyton says. “I don’t want my family or friends to think, ‘I wonder what Oliver would have liked.’ I think it’s so rude, in a way.”
Six years ago, when his father died, he came to realize that there isn’t enough choice in death. Since Victorian times, Peyton says, Great Britain’s death care industry has been served by a single prevailing model, a traditional means of commemorating life and ritualizing mortality—and it doesn’t suit him. So Peyton launched Exit Here, a funeral parlor, if that’s the word for it, in London’s Chiswick neighborhood.
“After my parents’ deaths, I just kept thinking, there’s no choice. You’re just on a conveyor belt,” Peyton says. “I didn’t achieve the things I know that certainly my father would have wanted. I was too traumatized.”
At first glance, Exit Here looks like a concept cafe, the sort of place where you might expect to order a flat white by day and a craft pour by night. The splashy, neon-backlit script over the entrance could be promoting a brasserie or raw bar (both of which Peyton has experience operating) instead of a funeral home. Nevertheless, Exit Here is a full-service provider of funerals and mortuary services, from traditional wakes to exotic possibilities.
“If you want a party on a beach in Goa, we’ll organize that for you,” Peyton says.
Style distinguishes Exit Here from the competition: It’s death, but hipper. The shop stands out for its considerable cheek (and chic). For example, Exit Here offers bright-colored urns shaped like capsules, a punny line called the “Bitter Pill” series. Bespoke caskets include a Día de los Muertos–inspired option and an English willow wicker coffin. Inside, teal and goldenrod hallways, blonde wood floors, and arched doorways (designed by Transit Studio) set Exit Here apart from traditional funeral-home interiors, with their dark woods and drab carpets.
There’s a growing movement to update the funeral business with offerings that reflect a wider range of customer choices. Los Angeles mortician and author Caitlin Doughty, who runs the Undertaking L.A. funeral service, also founded a collective of death care professionals and academics called the Order of the Good Death to help speed the adoption of more inclusive, less environmentally harmful, and more “death positive” practices within the industry. Other efforts, like the nonprofit Death Over Dinner and the Death Cafe initiative, encourage groups to talk openly about their demise, via public dinner events. Exit Here is entering an increasingly vibrant market for style-forward dying.
Since its opening a month ago, Exit Here has hosted four funerals. Peyton won’t talk about them in detail, but he says that the private services have ranged from the traditional to the extravagant. Everyone who has come through his doors has asked for something different. Funeral homes largely serve local neighborhoods and communities, and Exit Here is no different in this regard. Barry Pritchard, Peyton’s partner in the endeavor, is a third-generation funeral director who serves on the board of the U.K.’s National Association of Funeral Directors. All the services associated with a traditional funeral home, from collecting and preparing the body to hosting the reception, are available; the options simply go further.
When I ask him what an extravagant funeral might look like, he gives as an example the services for Aretha Franklin. Her televised 2018 funeral featured testimonials by the likes of Reverend Jesse L. Jackson and former President Bill Clinton, performances by Chaka Khan and Ariana Grande, and a procession of more than 100 pink Cadillacs. Peyton asks me whether I would describe the service as tasteful (I would). So why shouldn’t there be a category of funeral that falls somewhere between a faltering recitation of “Danny Boy” and a fantastic spectacle for the Queen of Soul?
Peyton outlines his philosophy on funerals this way: People plan their own birthdays, weddings, holidays, and vacations. Exit Here is for people who would like to plan their final departures as well. Plotting out the details, from the menu to the music, takes a burden off the shoulders of grieving loved ones and gives a person more control over the terms of their final departure. Peyton acknowledges the discomfort that some people might feel at the prospect of a trendy funeral home, but he says that’s ultimately discomfort with death itself. Convention does not ease a loved one’s passing, in the end.
So, what if I want to have a Star Wars-themed funeral? Somebody’s already asked him for a Star Wars casket, he replies, and he’s trying to figure out how to honor that request. Choice is the force behind Exit Here. In an increasingly secularized Britain, more people are searching for rituals that aren’t explicitly religious; other might like some extra flexibility within sacred traditions.
“Having spent most of my adult life in the restaurant business, you think you’re just helping people, and you are—you’re helping people to have a good time,” Peyton says. “But funerals are far more emotional. There’s far more attached to it. People’s grief manifests itself in different ways at different times. Being able to help people through that is a good thing.”
He adds, “It’s still, to me, a hospitality business. People say, ‘Oliver, why are you doing this?’ It’s about taking care of people.”
Costs for services at Exit Here run “a tiny bit above mid-market” for a traditional funeral, according to Peyton. The price point isn’t meant to be exclusionary. For services extending beyond traditional receptions, the prices run the gamut. “If you want a cheap funeral, you’re not going to come to us,” Peyton says, but “we’re definitely not out of reach.”
Peyton and his partner weren’t expecting to do any funerals before Christmas. But there’s clearly a lively market for Exit Here: About four weeks in, Peyton is already thinking ahead to opening as many as four similar establishments in the future. He says that he is fielding regular queries about franchise opportunities, something he hadn’t predicted (and isn’t considering for now). While Exit Here might look like an effort to disrupt the industry of death, there isn’t any private equity backing the venture. A service is still a service.
Peyton is willing to describe one funeral in detail: his own. It will begin with a lunch, he says. At about 3:00 p.m., when everyone’s thinking about heading home, they’ll bring out the really good wine. From there it’s DJs spinning his favorite music from different periods of his life—Patti Smith, Desmond Dekker, the Ramones—so that people will leave with a lasting memory.
Complete Article ↪HERE↩!
If I were to rank all of my fears, death — my own, and that of the people I love — would definitely be at the top of my list. It’s a pretty universal source of anxiety, whether we voice it or not. We cling to this fear, even if it won’t change the reality that all of us will die, eventually. The death positivity movement, however — which aims to shift this perception by encouraging a larger dialogue about death — is steadily growing.
Our anxiety surrounding death stems from how we tend to distance ourselves from the topic, explains Katherine Kortes-Miller, an assistant professor at Lakehead University and author of Talking About Death Won’t Kill You: The Essential Guide to End-of-Life Conversations. For many, “the only death and dying we see is on movies, where it’s heightened and traumatic, and not the death most of us are going to experience.”
The goal of death positivity is to “take death out of the closet,” Kortes-Miller says, so we no longer see it as a Big Scary Thing, but as an integral part of life. The nonprofit organization Death Cafe, for instance, has hosted thousands of loosely-structured events where people meet to “eat cake, drink tea, and discuss death,” according to its website.
Another group, Death Over Dinner, has a website that helps people plan dinners where they can discuss end-of-life issues, suggesting reading, audio, and video materials. Kortes-Miller co-organizes an event called Die-alogues, which hosts speakers and small-group discussions on topics like bucket lists, the use of social media to acknowledge death and dying, and animal companion death.
Popularized in a tweet by Caitlin Doughty, author of Smoke Gets in Your Eyes: And Other Lessons from the Crematory, death positivity is inspired by sex positivity, especially in its emphasis on choice. It advocates supporting people regardless of how they choose to die, whether it involves a green burial or aggressive medical treatments, explains Jillian Tullis, an associate professor at the University of San Diego whose research focuses on communicating about death in end-of-life settings. Creating space for the ways marginalized communities navigate death is another important part of death positivity — for instance, considering how much harder conversations about end-of life care might be for Black and Brown people, who have historically received worse healthcare than their white counterparts, Tullis says.
Millennials, ironically, seem especially interested in death positivity. (Doughty, for instance, is in her 30s.) Kortes-Miller notes that many young people have shared stories with her about family members who didn’t know how to deal with an aspect of a grandparent’s death, because no one talked about it. “They want to do more than the generation before,” she tells Mic. Tullis adds that many of her students have begun grappling with their mortality in the face of the climate crisis.
Death positivity sees normalizing death as crucial to wellness. Besides reducing anxiety around death, “it influences how we choose to live,” Tullis says. “When you have death and mortality as a guiding light, so to speak, it can help you understand what types of things are really important”— whether family, good food, or grand adventures — so we can prioritize them.
It can also help us prioritize who we spend our time with and how we spend it, and tease apart what’s really worth stressing over. Indeed, fully recognizing that life is finite can be freeing, Tullis says. She adds that talking about death also helps us make sense of it when it does touch our lives — and can better equip us to help others in our community make sense of it when it touches theirs, Kortes-Miller says.
By normalizing death, we can also begin learning more about what it’s like and talking to our loved ones about what we expect from them in the process, and vice-versa, Kortes-Miller says. This way, once we reach that point and can’t speak for ourselves, our loved ones can make important decisions — such as whether to pursue aggressive treatment or how to dispose of our bodies — based on what we actually want, not what they think we want, and we can do the same for them. “Nobody likes to think about dying and being sick,” Kortes-Miller says. But discussing these topics, however painful and difficult, can in fact be “a gift to the people we love.”
If you think death positivity could help you live your best life, here’s how to start embracing some of its tenets:
Take time to reflect
Figuring out your dying wishes may seem scary and depressing, but asking yourself the two questions Kortes-Miller suggests could help you ease into it: 1) What would you be willing to sacrifice in terms of quality of life for quantity of life? and 2) What are your non-negotiables — the important things about how you live now that you wouldn’t be willing to give up? Delicious food? Your memory? Your independence?
Start having conversations with the people closest to you
While self-reflection is important, the main goal of death positivity is to normalize death by having conversations about it, Kortes-Miller says. She suggests swapping stories about death with a good friend or partner. You could start by talking about the first time you learned about death and the message it conveyed to you. How do you want to use, and even disrupt, that message?
If that feels uncomfortable, starting with someone else’s story might be easier. A TV episode or a case you hear about on the news, like that of Brittany Maynard, who chose to end her life in 2014 after being diagnosed with terminal brain cancer, could act as a springboard, Tullis says.
Add some death-positive books to your reading list. Kortes-Miller suggests Atul Gawande’s Being Mortal: Medicine and What Matters in the End and Katherine Mannix’s With the End in Mind: Dying, Death, and Wisdom in an Age of Denial.
Attend a death positive event, or host your own
Check out a Death Cafe or other event in your area that encourages conversations about death. And just because it’s death-focused doesn’t necessarily mean the vibe will be all doom and gloom. Death Cafes, for instance, “often have cake and interesting people,” Tullis says, and Kortes-Millers notes that Die-algoues events are often abuzz with conversation and laughter.
You could also host your own death party. Some of Tullis’s friends get together to play Morbid Curiosity, a board game that features trivia and conversation cards about, well, death. One card, for instance, asks players, “If you could come back as a ghost, who would you haunt? What are the rules to haunting?” “You don’t’ have to go out and plan your funeral if you’re not there yet, but you can do little things that are fun and a little bit enjoyable,” Tullis says. In the end, death may really be only as scary as we make it out to be.
Complete Article ↪HERE↩!
Students reflect on planning own funerals
Each semester, a new classroom is filled with inquisitive students intrigued to uncover the perplexities behind the taboo topic of death. Taught by Chapman sociology professor Bernard McGrane, the “Sociology of Death” course takes students on an enlightening journey to confront the reality of mortality.
It takes a conscious effort to confront the idea of your life ending, McGrane said. On some level, every human being knows that they are going to die; but some others refuse to believe that death will happen to them.
“There’s a quote by Woody Allen that says, ‘I’m not afraid of death; I just don’t want to be there when it happens.’ That encapsulates Western attitudes toward death,” McGrane said. “Out of sight, out of mind; it’s not going to happen to me.”
McGrane’s interest in teaching “Sociology of Death” stemmed from his earliest experiences with Buddhist teachings, as death and impermanence is a component of Tibetan Buddhism.
“I had an interest in Eastern philosophy and meditative ways. I started connecting with it very early on – philosophically and personally – in terms of my own practices and spirituality,” he said. “Through readings, I discovered so many different avenues on the history of death and dying and how radically that’s changed over the years. Through all of this, it came together as a course.”
In the McGrane’s course, one specific assignment seems to stand out to students most – the task of visiting a funeral home and planning one’s own funeral. Students began to organize their own funeral in detail – from finances to whether they would prefer a coffin burial or cremation. McGrane told The Panther that this investigative experience gives students access to the funeral industry, the state laws and the practical skills of arranging a funeral.
One of the funeral homes in close proximity to Chapman that students visited for their funeral home assignment is the Shannon Family Mortuary on East Maple Avenue in Orange. The Shannon family declined to comment
“I’m not always the most outgoing. To go and talk to a stranger about death was difficult,” said Andreas Ter-Borch, a senior sociology major. “But I didn’t expect the funeral industry to be a money-making machine. Not everyone can afford to give their loved ones the funeral they think they deserve.”
Although Ter-Borch doesn’t always feel comfortable talking about death, the course has helped him recognize the significance in doing so. He didn’t expect to become so emotionally invested in the class, but McGrane’s required journal writing became therapeutic for him, helping him understand that humans can’t fully enjoy the quality of life without first accepting death.
“We strive for longevity, even if the quality of life is bad,” Ter-Borch said. “We are way too focused on avoiding death rather than improving the quality of our lives and living our lives to the fullest.”
McGrane’s first taught the course in 1980 at Colby College in Maine, when it was titled “The Sociology of Death and Medicine.” In 1983, McGrane moved to California where he began teaching at the University of California, Los Angeles, renaming the course “Sociology of Death,” which he eventually transferred to Chapman. “When things weren’t as legally restrictive as they are now, I would take my students to watch autopsies,” McGrane said.
“I wanted them to be exposed to dead bodies.” Lily Florczak, a senior screen acting major and current student in this course, said that if observing autopsies was a part of McGrane’s curriculum today, she would feel uncomfortable, but ready for the exposure.
“His class prepares you for something like this,” Florczak said. “But I do think it would only be a good idea if people had the choice to opt out.”
Florczak enrolled in the class because she didn’t know how to handle death well and thought it would help her own growth.
“I have learned that grief is not a handbook or a series of rules that you follow and then you’re OK,” Florczak said. “It’s different and unique and intimate for everyone. Understanding that death is a part of life is a personal process one must go through in order to heal.”
Complete Article ↪HERE↩!
By Gabrielle Elise Jimenez
For the past few months, when appropriate, I have asked some of my patients what it feels like to die. My reason for this is because I want to provide better care; I want to truly tap into all the ways that we can relieve someone of the struggles they experience when they are dying. I found it interesting that most people said that usually, no one asks that particular question. I explained my reason for wanting to know, and almost everyone had something to say.
I think we always assume pain is in the forefront, and that has proven to be true but it goes deeper than that. With the pain, comes the fear of never being free of the pain. The emotional exhaustion from having to constantly try something new, or increasing something that doesn’t work, or worse, not having it even touch the pain at all, is a heavy weight to bear. There is a very common thread amongst people who are experiencing pain; no one wants to die feeling that way, or worse, living that way until they die. While medications are effective most of the time, usually they just knock the patient out for an hour or two, and then are woken up by their pain once the medication wears off. Each person told me they do not want to die that way. One person said to me, “every day I lay here in this bed and I don’t move; not because I am paralyzed physically, but because I am paralyzed by the fear of making my pain worse if I move. Every time someone comes in here to reposition me, or check on me, I prepare myself for pain”. This resonated huge for me.
Death is hard enough, but death with pain is a constant debilitating struggle. I certainly can’t speak for anyone else, and I am in no position to tell you what to do, but after hearing this over and over again, and as a patient advocate, I can assure you anyone nearing the end of life, struggling with severe pain does not want to hold on and wait it out. They certainly do not want to feel this way until they take their last breath. My advice is if given the opportunity to ask them what they want or need, and they have a voice, listen to them and respect their wishes. It may not be something you approve of or agree with, but this isn’t about you. Imagine if you were able to be the difference between a painful or a peaceful death.
Emotional pain is a runner up to physical pain for those at the end of life. You would be surprised at how many people are actually not afraid to die. They are not as focused on the death itself, but more often, the amount of time it takes to get there. One person said to me, “every morning I wake up, I want to cry because I am still here”. Lying in a bed, day after day, knowing the inevitable is around the corner can be agonizing. I broke down and cried when a patient said to me, “I just want to die and I can’t. I am given a death sentence, of which I can no longer fight, but I am forced to just sit here and wait. There is no dignity in death. I have to die on someone else’s terms”. How do you respond to that?
They struggle with losing their independence, and having someone else clean and change them. This was repeated often. Having someone else move you from side to side, rolling you over as your head is pressing into the side rail, not even realizing that your shoulder is crunched down under you so hard you ache for hours after. And then, once you are cleaned up, re-positioned how someone else thinks you should be, you just lie there and cry inside. As death nears, they can’t help but think about their death; what it will be like, when it will happen and why the hell it isn’t happening sooner.
Meanwhile on the other side of this, is the family and loved ones crying at your bedside begging you not to leave them. So with everything else you are experiencing, guilt comes along and rears its ugly head. One person said to me, “I feel like I have let them down”. That is a heavy responsibility to carry. It is easy for us to think about how their death will effect us; but what most of us don’t think about, is how our feelings of their impending death effects them. So many have said to me how badly they wish they could tell their loved ones this isn’t their first choice, they didn’t want to get sick, they don’t want to die. They want to say they are sorry; sorry for getting sick, sorry for this long drawn out process, and most of all, sorry for the pain it causes everyone around them. Here they are dying and they want to apologize.
While I heard about the physical and emotional pain, I also heard the lovely things as well. Even people who were usually private and quiet and preferred to be left alone, welcomed the bedside visitors, the memories shared, the music played and the heartfelt goodbyes. They want to know how much they are loved, they want to know they made a contribution, and even though it is a hard pill to swallow, they want to know they will be missed. We think a lot about our own grief, and what saying goodbye to someone will feel like, but they have that too, in a very big way.
Some of the most beautiful conversations I have had are about the visions people see, the people standing next to the bed, or walking by a door or window… the ones that we can’t see. People tend to think they are delirious and afraid, but that is not what they have shared with me. In fact most feel safe and protected knowing there is someone watching over them, and perhaps waiting to guide them safely to wherever it is they will be going. I can’t help but wonder if it is our own fear that we are projecting onto them. What if instead, we asked about who or what they saw, encouraging them to trust us with their visions.
I cringe every time I see someone moving a patient without telling them first; repositioning them every two hours because that is what they were taught, not once thinking if this is truly in their best interest and certainly not thinking of the pain or discomfort this might cause. Whether or not they can verbalize, they should always be treated with kindness and respect. They should be offered a gentle warning before being touched, moved, or given medication. Lights should not be suddenly tuned on above their heads, after lying in a darkened room, covers should not be piled on heavily or quickly removed, and they definitely should NOT be lying naked for all to see when being changed. And please, if someone is actively dying, put the blood pressure cuff down, why are you taking their blood pressure? This irritates me like you can’t believe. Most vital signs can be assessed visually or by touch; at the end of life, please don’t put them through those tests. So many things we could do differently if we took the time to ask them what they need, or if we simply thought about their needs.
I remember awhile back, I walked in to visit a patient and said, “how are you doing today?” which seemed like a valid question. I had no idea the effect that question would have on someone until I received his response. “How do you think I feel, I am dying”. I never asked that question again. I start each visit now with, “it is really nice to see you”.
As I have said in many of my previous blogs, this is their experience not ours. The fact that we assume what they need, without asking, even when they have a voice, is selfish. As a society we have grown disrespectful on many levels and I am reminded of this most of all when talking to people who are at the end of their life. These are human beings who still have a voice and I think it is our responsibility to hear them. If we listen, if we truly take the time to ask them what they need, imagine the care we can provide not only to them, but also to those who do not have a voice, who can’t verbalize their needs. I only spoke to a handful of patients, so my findings do not speak on a global level, but I do think it is a good start to providing better care.
What does it feel like to die? It is emotional, it can be painful, it is usually sad, and it can sometimes be incredibly lonely. People do not die the same way and while there are similarities and common symptoms, each is still very unique. Therefore we need to take the time to listen, to observe, and assess what each person is experiencing, and what they might need when they are going through the dying process. We cannot treat everyone the same way. The only consistencies we should have when caring for someone at the end of their life, is that it is always done with kindness, compassion, respect, and honesty.
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No thanks, I’d rather learn not to fear death.
Herodotus, in the 5th century B.C., recorded an account of a race of people in northern Africa who, according to local lore, never seemed to age. Their secret, he wrote, was a fountain of youth in which they would bathe, emerging with “their flesh all glossy and sleek.” Legend has it that two millennia later, Spanish explorers searched for a similar restorative fountain off the coast of Florida.
We are still searching for the fountain of youth today. Instead of a fountain, however, it is a medical breakthrough, and instead of youth, we seek “transhumanism,” the secret to solving the problem of death by transcending ordinary physical and mental limitations. Many people believe this is possible. Observing a doubling of the average life span over the past century or so through science, people ask why another doubling is not possible. And if it is, whether there might be some “escape velocity” that could definitively end the aging of our cells while we also cure deadly diseases
Lest you think this concept is limited to snake-oil salesmen and science-fiction writers, the idea that aging is not inevitable is now in the mainstream of modern medical research at major institutions around the world. The journal Nature dubbed research from the University of California at Los Angeles a “hint that the body’s ‘biological age’ can be reversed.” According to reporting by Scientific American on research at the Salk Institute for Biological Studies: “Aging Is Reversible — at Least in Human Cells and Live Mice.”
The promise to end old age is exciting and mind-boggling, of course. But it raises a question: Why would we want to defeat old age and its lethal result? After all, as writer Susan Ertz wryly observed in her 1943 novel “Anger in the Sky,” “Millions long for immortality who don’t know what to do with themselves on a rainy Sunday afternoon.
Your boring Sundays notwithstanding, perhaps you think it’s obvious that getting old and dying are bad. “The idea of death, the fear of it, haunts the human animal like nothing else,” anthropologist Ernest Becker wrote in his 1973 book, “The Denial of Death.” Why else would we willingly put up with a medical system that seemingly will spend any sum to keep us alive for a few extra days or weeks?
It is strange that the most ordinary fact of life — its ending — would provoke such terror. Some chalk it up to what Cambridge University philosopher Stephen Cave calls the “mortality paradox” in his excellent 2012 book, “Immortality: The Quest to Live Forever and How It Drives Civilization.” While death is inevitable, it also seems impossible insofar as we cannot conceive of not existing. This creates an unresolvable, unbearable cognitive dissonance. Some have tried to resolve it with logic, such as the ancient Greek philosopher Epicurus’ observation that “death, the most terrifying of ills, is nothing to us, since so long as we exist, death is not with us; but when death comes, then we do not exist.”
Transhumanism responds, “Whatever, let’s just avoid that whole second scenario.”
Another argument for transhumanism is less philosophical and more humanitarian. We think avoidable deaths are a tragedy, don’t we? Well, if most of the 27 million annual worldwide deaths of people age 70 and over could be somehow avoided, wouldn’t that put them in the category of “tragedy”? Shouldn’t we fight like crazy to avoid them?
While the transhumanism movement is making progress, it isn’t without its skeptics. Some don’t think it will ever work the way we want it to, because it asks science to turn back a natural process of aging that has an uncountable number of manifestations. Critics of anti-aging research envision any number of dystopian futures, in which we defeat many of the causes of death before very old age, leaving only the most ghastly and intractable — but not directly lethal — maladies.
Imagine making it possible to cure or treat most communicable diseases and many conditions and cancers that were once a death sentence, but leaving the worst sort of dementias to ravage our brains and torment our loved ones. Wait, we don’t just have to imagine that, do we? As Cave puts it, we are “not so much living longer as dying slower.” Will transhumanism inadvertently bring us more of this?
No one can say conclusively where the transhumanist movement will go, or whether it will ultimately change the conception of living and dying in the coming decades. One way or another, however, I think we could productively use a parallel movement to transhumanism: one that seeks to transcend our limited understanding and acceptance of death, and the fact that without the reality of life’s absence, we cannot understand life in the first place. We might call this movement “transmortalism.”
Of course, a huge amount of work to understand death has gone on over the millennia and starts with the straightforward observation that confronting the reality of death is the best way to strip it of its terror. An example is maranasati, the Buddhist practice of meditating on the prospect of one’s own corpse in various states of decomposition. “This body, too,” the monks recite, “such is its nature, such is its future, such its unavoidable fate.”
Frightening? Far from it. Such exposure provokes what psychologists call “desensitization,” in which repeated contact makes something previously frightening or foreign seem quite ordinary. Think of the fear of death like a simple phobia. If you are afraid of heights, the solution might be, little by little, to look over the edge. As the 16th-century French essayist Michel de Montaigne wrote of death, “Let us disarm him of his novelty and strangeness, let us converse and be familiar with him, and have nothing so frequent in our thoughts as death.”
Perhaps while we wait for the promises of transhumanism, we should hedge our bets with a bit of transmortalism, which has the side benefit of costing us no money. Who knows? Maybe the solution to the problem of death comes not by pushing it further away but, ironically, by bringing it much closer.
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After loss, it’s a different path to ‘the new normal’ for those with depression
“Thank you for the intervention. Friends and family came to be with me. I agreed to be admitted to hospital. Am waiting for a bed. I had a horrible breakdown. I am sorry for worrying you.”
This was my message posted on Facebook to friends on October 19, 2014. It was over a year since my husband, Bob, passed away. Every day since he died on June 8, 2013 was like walking through thick, muddy water with a constant fog clouding my head.
I was a willing participant in the loss and grief cycle from day one. I had no interest in the future. The past was painful, the present bleak. Every day I woke up crying, for days, weeks, months, and soon a year passed. Depression is part of the initial journey. Many people feel like they can’t survive without their loved one. The agony is enormous, but the pain starts to diminish with time.
It is natural to experience intense grief after someone close dies, but complicated grief is different.
My story was different. The depression was pervasive and continued, even escalated. I journaled the experience, intermittently, in a blog. Posting my thoughts gave me temporary relief. Then I’d go down the rabbit hole again. What I didn’t realize was that I was experiencing something more than a normal grief journey. Though not diagnosed, researching my symptoms led me to what’s known as Complicated Grief.
The Intensity of Complicated Grief
According to The Center for Complicated Grief (CG) “[it] is a form of grief that takes hold of a person’s mind and won’t let go. It is natural to experience intense grief after someone close dies, but complicated grief is different. Troubling thoughts, dysfunctional behaviors or problems regulating emotions get a foothold and stall adaptation. Complicated grief is the condition that occurs when this happens.
“People with complicated grief don’t know what’s wrong. They assume that their lives have been irreparably damaged by their loss and cannot imagine how they can ever feel better. Grief dominates their thoughts and feelings with no respite in sight.”
According to the Mayo Clinic, CG can be determined “when the intensity of grief has not decreased in the months after your loved one’s death. Some mental health professionals diagnose CG when the grieving continues to be intense, persistent and debilitating beyond 12 months … Getting the correct diagnosis is essential for appropriate treatment, so a comprehensive medical and psychological exam is often done.”
The Diagnosis That Probably Saved My Life
I had seen several therapists. They tried to help, under the assumption that I was grieving as any woman would after the death of her husband. What I didn’t tell them was that my sadness had escalated to suicide ideation.
On the evening of Saturday October 18, 2014, I posted on Facebook: “Please take care of my cats.” My cry for help wasn’t a mystery to friends who were following my downward spiral. Phone calls went out from people in several cities to friends who lived near me who came to my house, then later family. Despite my uncharacteristic reaction screaming at everyone who entered the door and yelling at them to leave, I eventually calmed down and agreed to be taken to the hospital.
I was put in a room with no windows and a security guard. Some family members came in. The doctor followed and told me the medication I’d been taking for many years to control my clinical depression wasn’t working. When that happens, ironically, it can make you more depressed.
That diagnosis rocked me to the core and probably saved my life. Every day had been torture. And now I had someone who was telling me they could help me and life could actually get better.
I agreed to be admitted to hospital and new medication was prescribed by a hospital psychiatrist. I stayed there just over a week, eventually getting day passes, then a weekend pass. After my release, I was closely monitored to ensure my medication was doing what it should have done. I started seeking other ways to help me out of the dark pit and took part in several Cognitive Behavioral Therapy (CBT) programs, or what I refer to as retraining the brain to focus on the positive.
Live in the Moment
Today, I lead what those newly grieving are told is “the new normal life” because, when our loved ones die, life as we knew it is inevitably changed forever and will never go back to what we thought was our normal life. As Buddhist monk and peace activist, Nhat Hanh, said, “It is not impermanence that makes us suffer. What makes us suffer is wanting things to be permanent when they are not.”
The new life can be good if we come to terms with our losses; remember them with loving kindness; embrace our family, friends, and new people who come into our lives and accept that nothing is ever permanent in life. The biggest lesson I learned is to truly live in the moment and enjoy each precious day as a gift.
If you, or someone you know, has been suffering with extreme grief symptoms for over a year it might be time to seek help.
Coping with Grief and Loss
While grieving a loss is an inevitable part of life, there are ways to help cope with the pain, come to terms with your grief and eventually, find a way to pick up the pieces and move on with your life. Here are some suggestions from Help Guide:
1. Acknowledge your pain.
2. Accept that grief can trigger many different and unexpected emotions.
3. Understand that your grieving process will be unique to you.
4. Seek out face-to-face support from people who care about you.
5. Support yourself emotionally by taking care of yourself physically.
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