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Death Without Duality: Three Both/Ands at the End of Life

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[D]ying, like living, is not an either/or affair. It’s a both/and. Which is part of what makes it all so maddening for the floundering human who craves the comfort of dualities, of right and wrong, of fail-proof instructions.

I was reminded of this by some of the masters this month when I had the honor of hosting the End Well symposium in San Francisco. Twenty-eight speakers took the stage and talked about their experiences of almost dying, or treating the dying, or mourning someone who has died, or caring for the caregivers, or trying to shape policy or redesign systems or teach people about dying and/or do some of these simultaneously. There was some anger, and no small amount of sadness of course, but also a surprising amount of laughter. It turns out that we are funny right to the end.

Here are three both/and axioms that I heard echoed most often from people with a hugely wide range of professional backgrounds:

1) Reckoning with one’s life at the time of death is both the simplest thing in the world and the most complex.

Buddhist teacher and co-founder of the Zen Hospice Project, Frank Ostaseski, put it beautifully:

“At the end of life, it gets really simple: Am I loved? Did I love well?”

He’s right. Those questions are incredibly simple. As are the “four things” one can say — “Please forgive me,” “I forgive you,” “Thank you,” and “I love you” — at the time of death, popularized by Ira Byock. One of the huge, unique gifts of facing the end of life — whether your own or someone you love — is that the urgency for healing is undeniable.

But the dynamics that spark and rot and flow and flutter underneath those questions are anything but simple. They are as complex as human relationships as a whole, which is to say very fucking complex. The answer to the question of whether I am loved may seem obvious to an outsider, but if I’ve never felt loved in the right way by the one person I needed it most from, I may not be capable of a “yes.” Even at the time of death, especially at the time of death, we are not logical creatures.

And to answer whether we have loved well is perhaps an even more charged and challenged task. We carry our regrets and sense of relational inadequacy around for decades and then, in the end, are asked to lay them down and surrender to our own imperfection. A tall order. The tallest perhaps. Dr. B.J. Miller, former executive director of the Zen Hospice Project and a clinician, teaches:

“If there is any enemy at the end of life it is shame.”

If we can’t shed our shame, it makes it hard to go. The power in the dying process, from what I gather from these wise souls, is acknowledging the complexity underneath or behind the simplicity and still managing to grace one another with the forgiveness and recognition that we all so desperately crave. It is the kind of emotional courage that transcends death.

2) Our job, when caring for the dying, is to ease suffering, but also recognize that it is a source of meaning for many people.

B.J. also said, “I wouldn’t wish a lack of suffering on my worst enemy. There’s no way to learn.”

He knows a bit about it, having had three limbs amputated and survived near-lethal burns on much of his body after an accident in college. His own time in hell was incredible preparation for a lifetime of treating patients and talking with people about facing death.

Some of us have an inclination to romanticize death. It’s the peak of drama, no doubt — the final scene. But of course it is not all buzzer beater catharsis and mystical visitations. It is sometimes choking and seizing and terrible, ugly, unbearable pain. In a word, suffering.

Now the role of palliative care, but all health care really, is to ease suffering. This is true and important and so often lost in our current system, which too often feeds the wrong motivations in otherwise decent and smart humans. We have to redesign the system so that easing suffering is the heart of everything we do, or as designer Ivor Williams puts it, “Death involves everyone. Design accordingly.”

And yet, B.J. Miller would not be B.J. Miller without his suffering. None of would be any of us without our suffering. It is what erodes our delusions and softens our hubris and strengthens our capacity to resist duality and blame. It is the fires in which we are all forged.

So that, too, we must remember. Which doesn’t mean easing off on pain meds, but it does mean witnessing suffering as a sacred and necessary part of being human, even as we try to work with its ferocity and sit with the one being visited at this particular moment. Or as Dr. Lucy Kalanithi, a clinician, beautiful speaker, and widow to Paul Kalanithi, author of When Breath Becomes Air, put it:

“A gift we get to have in medicine is to be witnesses. It’s a front row seat to the human condition.”

3) When you die, you are the most alone you will ever be, and yet you cannot do it well without the gift of others.

Think about it: There is no journey more solitary, by definition, than that of dying — unless you Thelma-and-Louise it. Just as you have lived in your body alone all your life — experienced its holy and wholly specific alchemy of aches and pains and pleasures — you and only you leave that body at some unpredictable moment. (As I write this, I’m reminded how otherworldly pregnancy is, a moment when women actually do, in a sense, share their solitary experience for 10 strange months.)

In any case, accepting the solitude of it is probably key to surrendering to it. You have to go it alone, at least from a purely physical sense.

And yet, to die well is to die together. Or at least surrounded by people who care for you in your time of exquisite vulnerability. Hopefully these are people who have known you at your most robust, people that you have cared for, people you have eaten and drunk too much with and laughed beside and tickled and fought with and repaired again. Hopefully these are people who know your wishes and will fight like momma bears to see them through.

In one study, 66 percent of people said that the thing they feared most at the moment of death was pain. Understandable. And not particularly surprising. Do you know what topped that fear? The fear that they would be a burden to their family members — logistically, psychologically, financially.

Dr. Aditi Mallick says, “The things that scare us the most about death are at the core of what it means to be human.” Indeed, we fear being dependent on others, being inconvenient and messy and powerless, our whole lives long. And when we die, this fear becomes epic. Our power lies in making peace with it. If we live like we will one day die, then we can’t help but create relationships that are loving and strong and imperfect and they can weather even this, the final test of the human condition.

As B.J. puts it, “The end of life is a call to learn how to be loved. The hardest thing of all.”

Complete Article ↪HERE↩!

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Keeping the Peace While Settling a Family Estate

Yes, you can settle a family estate without fighting. Here’s how.

 

[I]f a family member has passed away and his or her will or trust is in the midst of being settled, emotions and tensions within your clan may be high. Relatives are grieving, but at the same time, decisions regarding the fate of the estate must be made. 

Siblings may squabble over their “fair share” of the estate, a surviving spouse may face resistance from the deceased’s children from an earlier marriage, estranged family members may come out of the woodwork, and more. It may seem unlikely to maintain family harmony during such a challenging time.

Fortunately, a few key interpersonal tactics, as well as some practical solutions, can help keep arguments to a minimum, says Susan Lill, Senior Regional Fiduciary Manager with Wells Fargo Wealth Management. “Managing conflict generally boils down to good communication among family members, and perhaps some smart mediation-type skills,” she says. 

“A sense of transparency can help allay concerns for beneficiaries. Many misunderstandings arise when family members don’t understand the timeframes for settling an estate, or feel that they have not been kept in the loop,” she says. 

The following are a few of the most common estate-settlement conflicts and some potential solutions to bring harmony to all those involved.

1. Squabbling over personal items
“You’d be amazed at how often siblings are fine about splitting millions of dollars in stock shares, but practically get into fist fights about one family vase,” says Lill. Because dividing personal property is often the most difficult part of settling an estate, Wells Fargo Wealth Management has specialized tangible property experts. They can help families when the bank serves as executor, trustee, or agent for the executor.

Peacekeeping tactics: It may feel a bit extreme, but Lill suggests having the personal representative/trustee change the locks on family and vacation homes while the estate is being settled. “Tell family members you’re just trying to make sure no one removes favorite items before anyone else, in an effort to avoid major arguments,” she says.

Next, decide on a reasonable way for family members to split items not clearly delineated in the will or trust — from vehicles to pocketbooks, suggests Lill. One option: Have family members write down 10 items from the estate they would most like. If someone wants an item that no one else lists, it’s theirs. 

For overlapping items — and any other physical items left in the estate — consider taking a round-robin approach, allowing family members to take turns selecting items. Depending on the will/trust language, or the decision of the personal representative, McDermott says you could deduct the value of tangible items from each family members’ share of the estate. That way, no one feels they’ve gotten less than “their share.”

2. Impatient beneficiaries
Maybe you have a cousin who is tight on money and wants his inheritance well before the estate can be settled. Or perhaps two siblings inherit a vacation home; one wants to sell it immediately even if the market isn’t great, while the other wants to wait and sell later at a potentially higher price.

Peacekeeping tactics: A modest “advance on an inheritance” can help calm antsy relatives. “Keep in mind that the estate account will need to cover expected taxes, medical bills, and other fees, so leave enough in the account to cover that — and be sure to document the advance as part of paying out the estate,” says Lill.

3. Unequal distribution of assets
One beneficiary might be left a smaller share of the estate for a variety of reasons. For instance, maybe one adult child is financially successful and the parents didn’t think they needed as much help. 

Peacekeeping tactics: “In some situations, it’s helpful if benefactors talk to family members while they (benefactors) are still alive or leave a side letter with their will or trust that explains their reasons for treating beneficiaries unequally,” says McDermott. If that wasn’t done, consider bringing in a trust professional — either formally, as a co-fiduciary if the estate allows it, or informally, as a family advisor. This person may be able to objectively explain and help manage the disparity, rather than pitting family members against each other.

Overall, remember that settling a family estate can be emotionally challenging. A reasonable goal is to get through the process without unnecessarily damaging relationships — and without incurring a lot of expenses settling disagreements.

“Give family members a little extra grace and understanding during this process, since everyone grieves differently,” Lill suggests. Also, when an estate settlement proves particularly challenging for a family, Lill suggests bringing in professionals to take on settlement tasks and help resolve disputes. “That can be a great way to preserve family harmony.”

Complete Article ↪HERE↩!

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Things I Wish I Had Known When My Dog Died

By JEN A. MILLER

[O]n Jan. 4, 11 years and 26 days after I walked out of an animal shelter in New Jersey with a little white and brown dog attached to the end of a brand-new leash, she died. On this day, an undiagnosed tumor pressed down on Emily’s brain and told her that she needed to escape, which made her usually soft, cuddly and often napping body go wild, endangering herself and me. The humane thing to do was put her down.

I don’t think anything could have prepared me for that moment, or the searing grief that followed. But if I could go back in time to console myself, I would tell myself these six things:

Most people will say the wrong thing. They will talk about dogs they knew and loved and put down, too, or, if they haven’t walked through this long, lonely tunnel yet, about how they can’t possibly imagine losing their very alive pet, which reminds you that yours is dead. They will also ask how old she was, and when you say 15, they will say, “Well, it was a good long life,” as if the ending of it would be less painful because of how long you were together.

They may tell you other dog death stories, too, like the one about the dog who was so excited to be home from vacation that he bolted out of the car and was immediately run over while the whole family watched — stories that imply it could have been worse. They will shove shelter listings for other Jack Russell terriers at you, as if another dog could slip into that perfect little spot left by your beloved one-of-a-kind pet.

Guilt overwhelms. I still tell myself that I killed Emily, despite the veterinarian telling me, after her body had been taken away, while I gripped both a counter and a vet tech to keep from collapsing, that all four of her paws had been bloodied as she had clawed at the floor, the door and the ground during her manic and desperate attempt to get away from my home. There is guilt, too, over the relief of no longer having to take care of a dog who was on multiple medications and who had arthritis, two defective heart valves and pulmonary hypertension.

You will become unmoored. I adopted Emily soon after I became a freelance writer, and I wrote three books with her by my side. She was the metronome to my life. With her gone, I floated through a space she no longer occupied but haunted with every little white hair found on my blankets, on the floor, in my shoes. Once, in the first week following her death, I came up from the basement and looked at the spot where she would usually be waiting. I called for her with the foolish notion that she’d appear at the top of the stairs. But of course, no: just another sledgehammer reminder that she was really gone.

Grief is exhausting. Last fall, I ran two marathons and an ultramarathon. After Emily died, I couldn’t drag myself through three miles, not to mention find the energy to get out of bed, put on clothes that were not my pajamas and shower at regular intervals. I pushed off assignments because the idea of putting my fingers to the keyboard was inconceivable when Emily wasn’t sleeping on her bed in the corner of my office. These were wretched, grief-stained days, surrounded by a deafening silence.

I went back into therapy after she died and was told I was depressed, which wasn’t surprising, as I had started to slip into bed at 8:30 p.m. and not get up until half a day later. Losing a companion and your routine all at once, especially if you’re single like me, could throw anyone into a tailspin.

It will get better. You won’t want to hear it, or believe it, because the pain is so suffocating. It does ease, though, almost without you noticing it.

But still, it slaps back. This may happen at predictable moments, such as when you decide to sell her crate, and sometimes not. Soon after Emily died, I got on a plane and went to Florida to bake out the pain with all-day poolside sessions punctuated by midday drinks. It worked, somewhat, but on my last night there, my face cracked open at the World of Disney store when I saw a mug with the character Stitch that said “brave” on one side and “loyal” on the other. Only the cashier noticed that I paid with tears and snot running down my face. I then ran out of the store to stare at a lake.

These days, I get up, I brush my teeth, I write, I run. I smile now and laugh sometimes. The pain still catches me, though, and I can now more clearly see why: I loved that dog, and in giving a scared, abused, imperfect Emily a home, she loved me back, and together our lives both bloomed. The loss of that joy is why the pain is so acute — and why, at some point in the maybe not so distant future, I’ll go back to that animal shelter with a brand-new leash, and do it all over again.

Complete Article ↪HERE↩!

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The Drift Called the Infinite: Emily Dickinson on Making Sense of Loss

Reflections on silence and eternity from the poet laureate of death.

By Maria Popova

“The people we most love do become a physical part of us, ingrained in our synapses, in the pathways where memories are created,” poet Meghan O’Rourke wrote in her stirring memoir of losing her mother. More than a century earlier, another poet with a rare gift for philosophical prose reflected on mortality in the wake of her own mother’s death.

Emily Dickinson (December 10, 1830–May 15, 1886) was about to turn fifty-two when her mother, after whom she was named, died. A stroke had left her paralyzed and almost entirely disabled eight years earlier. Despite her lifelong infirm health, her disinterest in the life of the mind, and the surges of unhappiness in the Dickinson home, Emily Norcross Dickinson had been attentive and affectionate to her daughter, igniting the poet’s little-known but ardent passion for botany and prompting her to write that “home is a holy thing.”

Although a contemplation of mortality haunts nearly all of Dickinson’s 1775 surviving poems in varying degrees of directness, her mother’s death forced a confrontation with mortality of a wholly different order — loss as an acute immediacy rather than a symbolic and speculative abstraction.

In a letter to her cousins penned shortly after her mother’s death in November of 1882 and found in The Letters of Emily Dickinson (public library), the poet writes:

Mother’s dying almost stunned my spirit… She slipped from our fingers like a flake gathered by the wind, and is now part of the drift called “the infinite.”

We don’t know where she is, though so many tell us.

Emily Dickinson, daguerreotype, circa 1847.

Even as a child, Emily had come to doubt the immortality so resolutely promised by the Calvinist dogma of her elders. “Sermons on unbelief ever did attract me,” she wrote in her twenties to Susan Gilbert — her first great love and lifelong closest friend. Dickinson went on to reject the prescriptive traditional religion of her era, never joined a church, and adopted a view of spirituality kindred to astronomer Maria Mitchell’s. It is with this mindset that she adds in the letter to her cousins:

I believe we shall in some manner be cherished by our Maker — that the One who gave us this remarkable earth has the power still farther to surprise that which He has caused. Beyond that all is silence…

Writing less than four years before her own untimely death, she ends the letter with these words:

I cannot tell how Eternity seems. It sweeps around me like a sea… Thank you for remembering me. Remembrance — mighty word.

In another letter from the following spring, penned after receiving news of a friend’s death, Dickinson stills her swirling sorrow the best way she knew how — in a poem:

Each that we lose takes part of us;
A crescent still abides,
Which like the moon, some turbid night,
Is summoned by the tides.

She adds a sobering reflection on the shock each of us experiences the first time we lose a loved one:

Till the first friend dies, we think ecstasy impersonal, but then discover that he was the cup from which we drank it, itself as yet unknown.

Complement with a collection of moving consolation letters by great artists, writers, and scientists ranging from Lincoln to Einstein to Turing, psychoanalyst Adam Phillips on how Darwin and Freud shaped our relationship to mortality, Seneca on the key to resilience in the face of loss, and this unusual Danish picture-book about death, then revisit Cynthia Nixon’s beautiful reading of Dickinson’s “While I was fearing it, it came” and Dickinson’s forgotten herbarium — an elegy for time and mortality at the intersection of poetry and science.

Complete Article ↪HERE↩!

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People are hiring doulas to help them die

By Molly Shea

Chad Lewis charges $20 to $25 an hour to assist the gravely ill and their families.

[W]hen Chad Lewis’ mother passed away seven years ago from complications from diabetes, he couldn’t stop thinking about her death. “It wasn’t loving and sweet,” he says. “It was chaotic and angry and scary.”

So Lewis, a 39-year-old who lives in Astoria, set out to find a better way to process the end of life, ultimately making a career shift from Broadway stage manager to death doula.

Doulas who aid women in giving birth have been trendy for years, but now a different type of support person is helping people navigate life’s other major passage. Dying people and their loved ones are hiring death doulas to help them coordinate end-of-life care and vigils, plan funerals and provide a sympathetic but unattached ear.

The profession first came into being in the early aughts and is growing increasingly popular. In 2014, Suzanne O’Brien launched the New York City-based Doulagivers, an online training program for death doulas.

“I can hardly keep up with demand,” says O’Brien, who also holds monthly seminars at an Upper West Side branch of the New York Public Library.

The process usually starts with a patient deciding how they want to die and outlining that with the doulas.

“It’s similar to a birthing plan … Where [do] you want to die? What kind of room you want to die in? What [do] you want to be looking at? What [do] you want it to smell like?” says Shelby Kirillin, 41, a Richmond, Va.-based death doula. She charges between $1,000 and $3,000 as a retainer fee, and asks for payment upfront to avoid chasing down money posthumously. She’ll also work pro bono if a situation merits it.

The “scary” death of Chad Lewis’ mother led him to become a doula.

“I had one young girl say she wanted to die in a yurt,” says Kirillin of a client who’s currently planning her own death. The girl’s cancer condition makes a yurt too impractical, so Kirillin is getting creative. “We decided on mosquito netting over her bed, and twinkle lights to look like stars.” After she takes her last breath, her loved ones will put wildflowers in her hair.

Death doulas also help out after someone passes. Lewis, who charges $20 to $25 per hour, likes to create a basic plan to take care of issues such as child care, grocery shopping and bill payment, to clear up mental space for grieving families.

And more than anything, the professionals help patients process what they’re going through.

“Families buffer pain — you hate to see people you love in pain. And doulas aren’t buffers,” says Kirillin. “Instead of saying, ‘OK, let’s see if we can give you meds,’ I’ll say, yeah, ‘I bet you are in pain. Tell me about it — what does it feel like?’”

When Richmond resident Mel Titus’ best friend of 31 years, Kim, was entering the final stages of her battle with cervical and breast cancers last year, they were introduced to Kirillin.

They were skeptical at first, but Kim (whose last name is being withheld for personal reasons) decided on a death doula so she could manage her death the way she did her life. “She was a processor,” says Titus. “She really liked that she could come up with a plan and do things a certain way.”

And for Titus, Kirillin provided emotional support during an impossible time. “I would have tough days, and I’d call Shelby, and she’d walk me through it,” she says.

Kirillin helped the duo plan Kim’s visitor schedule, and what music they’d play and books they’d read in the final days. Taking care of logistics freed them up to reminisce about Kim’s life, and even laugh about how things were going. “We actually had some funny moments, believe it or not,” says Titus. “It’s sad, but it can be a happy thing, too.”

Complete Article ↪HERE↩!

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“Please Read This Before You Post Another RIP On Social Media.”

by InspireMore Staff

There is nothing more painful than the death of a loved one. Aside from sadness that comes with the loss, there’s also the task managing that comes with sudden tragedies. Calling the family, talking to the police if necessary, and– yes– posting on Facebook.

As silly as that last point may sound, it’s become a very real part of the grieving process in this social media age. So much so that, a woman named Taya Dunn Johnson, wrote the following open letter after her husband’s death, titled “Please read this before you post another RIP on social media.”

It’s a powerful reminder to put people first– to honor what Taya calls “the hierarchy of grief”– even in our social media obsessed world.

Grieving in the technology age is uncharted territory.

I’ll take you back to Saturday, June 9, 2012. At 8:20 a.m., my 36-year-old husband was pronounced dead at a hospital just outside Washington, D.C.

By 9:20 a.m., my cellphone would not stop ringing or text-alerting me long enough for me to make the necessary calls that I needed to make: people like immediate family, primary-care doctors to discuss death certificates and autopsies, funeral homes to discuss picking him up, and so on. Real things, important things, time-sensitive, urgent things.

At 9:47 a.m., while speaking to a police officer (because yes, when your spouse dies, you must be questioned by the police immediately), one call did make it through. I didn’t recognize the number. But in those moments, I knew I should break my normal rule and answer all calls. “He’s dead??? Oh my God. Who’s with you? Are you OK? Why am I reading this on Facebook? Taya, what the heck is going on?”

Facebook? I was confused. I hadn’t been on Facebook since the day before, so I certainly hadn’t taken the time in the last 90 minutes to peek at the site.

“I’ll call you back”, I screamed and hung up. I called my best friend and asked her to search for anything someone might have written and to contact them immediately and demand they delete it. I still hadn’t spoken to his best friend, or his godsister, or our godchild’s parents, or a million other people!

Why would someone post it to Facebook SO FAST?

While I can in no way speak for the entire planet, I certainly feel qualified to propose some suggestions — or, dare I say, rules — for social media grieving.

How many RIPs have you seen floating through your social media stream over the last month? Probably a few. Death is a fate that we will each meet at some point. The Information Age has changed the ways in which we live and communicate daily, yet there are still large voids in universally accepted norms.

This next statement is something that is impossible to understand unless you’ve been through it:

There is a hierarchy of grief.

Yes, a hierarchy. It’s something people either don’t understand or understand but don’t want to think or talk about — yet we must.

There is a hierarchy of grief.

Hierarchy is defined as:

1. a system or organization in which people or groups are ranked one above the other according to status or authority, and

2. an arrangement or classification of things according to relative importance or inclusiveness.

What does this mean as it relates to grief? Let me explain. When someone dies  — whether suddenly or after a prolonged illness, via natural causes or an unnatural fate, a young person in their prime or an elderly person with more memories behind them than ahead — there is one universal truth : The ripples of people who are affected is vast and, at times, largely unknown to all other parties.

A death is always a gut punch with varying degrees of force and a reminder of our own mortality. Most people are moved to express their love for the deceased by showing their support to the family and friends left behind.

In the days before social media, these expressions came in the form of phone calls, voicemail messages, and floral deliveries.

If you were lucky enough to be in close proximity to the family of the newly deceased, there were visits that came wrapped with hugs and tears, and deliveries of food and beverages to feed all the weary souls.

Insert social media. All of those courtesies still occur, but there is a new layer of grief expression — the online tribute in the form of Facebook posts, Instagram photo collages, and short tweets.

What’s the problem with that? Shouldn’t people be allowed to express their love, care, concern, support, and prayers for the soul of the recently deceased and for their family?

Yes.

And no.

Why? Because there are no established “rules,” and people have adopted their own. This isn’t breaking news, and you’re not trying to scoop TMZ. Listen, I know you’re hurt. Guess what? Me too. I know you’re shocked. Guess what? Me too. Your social media is an extension of who you are. I get it. You “need” to express your pain, acknowledge your relationship with the deceased, and pray for the family.

Yes.

However…

Please give us a minute.

We are shocked.

We are heartbroken.

Give the immediate family or circle a little time to handle the immediate and time-sensitive “business” related to death. In the minutes and early hours after someone passes away, social media is most likely the last thing on their minds. And even if it does cross their mind, my earlier statement comes into play here.

There is a hierarchy of grief.

Please pause and consider your role and relationship to the newly deceased. Remember, hierarchy refers to your status and your relative importance to the deceased. I caution you to wait and then wait a little longer before posting anything. This may seem trivial, silly, and not worth talking about, but I promise you it isn’t.

If the person is married, let the spouse post first.

If the person is “young” and single, let the partner, parents, or siblings post first.

If the person is “old” and single, let the children post first.

If you can’t identify the family/inner circle of the person, you probably shouldn’t be posting at all.

Do you get where I’m going with this?

In theory, we should never compare grief levels, cast the grief-stricken survivors into roles, or use words like status and importance. But maybe we need to at this moment (and for the next few weeks and months).

The “RIP” posts started hitting my timeline about an hour after my husband’s death, and I certainly didn’t start them. This created a sense of confusion, fear, anxiety, panic, dread, and shock for the people who knew me, too. What’s wrong? Who are we praying for? Did something happen? Did someone pass? Why are there RIPs on your wall and I can’t reach you? Call me please! What’s going on?

That’s a small sample of messages on my voicemail and text inbox. I had to take a minute in the midst of it all to ask a friend to post a status to my Facebook page on my behalf.

Your love and expressions of support are appreciated and needed, but they can also be ill-timed and create unintended additional stress.

The person is no less dead and your sympathy no less heartfelt if your post, photo, or tweet is delayed by a few hours. Honestly, the first couple of hours are shocking, and many things are a blur. Most bereaved people will be able to truly appreciate your love, concern, prayers, and gestures after the first 24 hours.

I’ve learned this from the inside — twice within the last four years. And I assure you that if we each adopted a little patience and restraint in this area, we would help those who are in the darkest hours of their lives by not adding an unnecessary layer of stress.

A few extra hours could make all the difference.

Complete Article ↪HERE↩!

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The Difficult Business of Dying

The U.S. funeral industry is the most expensive and corporate in the world. Can Americans find a better way to grieve?

By Jess Bergman

[I]n the six years since my father died, I’ve visited the cemetery where his ashes are interred exactly twice—the second time only because of the Jewish tradition of unveiling, where the initial graveside funeral service is followed within a year by a ceremony to uncover and dedicate the headstone. It’s not that returning would be too difficult. It’s more like the reverse: I fear an inability to perform the sadness and solemnity the pilgrimage seems to require. I miss my dad, but the cemetery, nestled alongside the highways and strip malls of suburban South Jersey, fails to evoke him in any meaningful way. It’s a site associated with him only retroactively, for the worst of all possible reasons. Where I’m supposed to feel his presence, there’s only a void.

FROM HERE TO ETERNITY: TRAVELING THE WORLD TO FIND THE GOOD DEATH by Caitlin Doughty

Los Angeles-based mortician and writer Caitlin Doughty argues that such feelings result from the failures of America’s death industry, which has become “more expensive, more corporate, and more bureaucratic than any other on Earth.” According to the National Funeral Directors’ association, the median cost of traditional funeral with a viewing and burial was $7,181 in 2014; Doughty cites the current average at $8,000 to $10,000. 14 percent of US funeral homes are run by publicly traded firms. Service Corporation International, the largest funeral services provider in the US, operates over 2,000 funeral homes employing more than 24,000 people. The $20-billion industry often pushes grief to the margins by pressuring families to make a series of high-stakes decisions on a very short timeline—most funeral homes come to pick up a body within an hour of being contacted.

In some cases, funeral homes deliberately exploit families for financial gain at a time of profound vulnerability. A 2013 undercover investigation conducted by the Federal Trade Commission revealed that up to one in five American funeral homes engage in “deceptive and manipulative practices.” The offenders violated the 1984 Funeral Rule, which stipulates that funeral homes must provide itemized price lists. The compulsory bundling of products and services is prohibited: They can’t require that you buy a traditional varnished casket when all you want is a cremation; an inexpensive, unfinished wooden box must be made available. And the law bans the aggressive sale of products that are not required by law, like the use of a hearse to transport remains to a cemetery. Though most funeral homes keep dedicated websites, few display their prices online, which makes it challenging to compare costs.

With its focus on profits, the industry has also changed the way we treat dead bodies. As recently as a hundred years ago, “no one would have questioned a wife washing and dressing the body of her husband,” Doughty writes, “or a father carrying his son to the grave in a homemade coffin.” The Civil War is often identified as the point at which practices began to shift. Embalming became more common as soldiers’ bodies were transported from the South to the North. It gained even more popularity after Abraham Lincoln’s funeral train tour, which took his embalmed corpse to 180 cities between Washington D.C. and Springfield, Illinois. Now, the United States is the only country in the world in which chemical conservation of the dead is common practice—a process that can cost anything from $495 to over $1,000. What was once a practical solution with a historically specific context has become a profitable norm, despite, according to the CDC, providing no public health benefit.

In her book From Here to Eternity: Traveling the World to Find the Good Death, Doughty tries to find a better way to die and to grieve, seeking out death rituals from the Western United States to Japan, Spain, Indonesia, and beyond. It sounds a bit like Eat, Pray, Die, but her project is much larger than its premise first implies. She is searching not for personal spiritual enlightenment or the morbid titillation of thana-tourism, but for practical, radical alternatives to our corporatized death industry. Her travels illuminate a host of compelling possibilities for better funerals and a less fraught relationship with our dead. But the book also reveals a larger failure of our culture to allow for mourning and grieving after the last goodbye. If it is hard to navigate the death care industry, it is harder still to work out how to live with grief.

On her travels, Doughty finds many rituals that involve prolonged contact with corpses—prolonged, at least, by American standards. All around the world, she meets people less troubled by the physical reality of dead bodies, whether those bodies are burned to ash, mummified, “decomposting,” or lying under glass in their natural, un-embalmed state. In Japan she visits a corpse hotel where families may rent a suite that looks like an ordinary condo and “just be with the body, free from the performance required at a formal viewing.” And at the Rinkai crematory, Doughty learns about the practice of kotsuage. According to this custom, families are escorted into a room called a shūkotsu-shitsu after a cremation, where they pick up their loved one’s remaining bone fragments and place them gently into an urn.

In North Carolina, Doughty spends time at Western Carolina University’s Forensic Osteology Research Station (FOREST), where corpses donated to science are turned into compost. The bodies are laid to rest in a wooded research facility, blanketed with alfalfa and woodchips, covered in a silver shroud, and in the hot sun to turn into dark, nutrient-rich soil after a period of weeks. The project is still in its experimental phase, but the FOREST researchers hope it will become a green solution with a therapeutic arc. Families will ultimately be invited to collect the soil made from the body of their loved one and with it, cultivate new life.

Doughty finds her most extreme example of dead body positivity in Tana Toraja in Indonesia. For Torajans, the border between the living and the dead is porous. Corpses frequently remain in the home for a period of weeks, months, or even years, and are cared for like any other member of the family—bathed, fed, dressed, and spoken to. After they are finally buried, following elaborate community funerals, bodies are periodically exhumed during what is called the ma’nene’. Families have the opportunity to reunite, and even picnic, with their dead; they can make animal sacrifices they may not have been able to afford at the time of the original burial. What sounds grisly to some is, to the Torajans, both tender and sacred: “Hauling someone out of their grave years after their death is not only respectful,” Doughty writes, “but it provides a meaningful way to stay connected to their dead.”

Doughty’s chatty calm in the presence of dead bodies and her arguments against American squeamishness are admirable. But it feels, at times, like From Here to Eternity’s focus on death comes at the expense of grief. This is not a failure of the project so much as its shape; the nature of Doughty’s inquiry makes grief a secondary concern. It does appear sporadically: In the chapter on the Day of the Dead, she travels to Mexico with her friend Sarah to visit a mummy museum, as well as the altars families erect to honor the people they’ve lost that year. Sarah is still reeling from the decision to obtain a late-term abortion when her fetus was diagnosed with trisomy 13, and Doughty writes about the isolation of Sarah’s grief, her feeling that the inability to move on from the loss had made her “radioactive” to her friends and coworkers. Her loss, and the future she had imagined, is devastatingly rendered. There is a digression, too, on the Western funeral industry’s fixation on “dignity,” by which they really mean silence, composure, and repression—this, too, is a moment of genuine feeling, and Doughty shows that though her tone is often light, she has the capacity to move and enrage.

But just as often, Doughty fails to engage with the realities of mourning. At an open-air cremation she attends in Crestone, Colorado, she professes to witness the “pall of grief [lifting] from the circle.” I don’t doubt the power of this ceremony. But the implication that it was able to dispel sadness—that such a thing is possible, or even desirable, at a funeral—gives me pause. Worse, in the book’s epilogue, she writes, “A sense of purpose helps the mourner grieve. Grieving helps the mourner begin to heal.” This is a neat, linear progression; in other words, it’s exactly what the experience of grief is not.

There is more to death and dying than funerals. From Here to Eternity is in some ways a missed opportunity to explore how the profit motive has distorted our experience of death—not just burial, but all the feeling that comes after a body is buried. In The Last Word, Julia Cooper writes of the difficulty of grieving under late capitalism. The amorphous, endless, and unpredictable nature of grief puts it fundamentally at odds with pressures “to be efficient, to progress, to—most of all—get back to work.” But, she writes, “mourning doesn’t work that way. There is no timeline because the work of grieving is never done. There is nothing efficient or productive about loss, but there it is all the same.” Grieving is the enemy of work, and we’re expected to suppress the former in the interest of the latter.

Minimizing the pain of personal loss, Cooper argues, is in service of “maintaining productivity for the benefit of a capitalist system.” Public displays of grief are shunned in part because they undermine the relentless positivity our economic system feeds on. The isolation of those who are unable to successfully curb their mourning is “a socially enforced strategy of our neoliberal era.” The repression of grief is also materially enforced: The standard paid bereavement leave, where it does exist, is three days. At Facebook, COO and Lean In author Sheryl Sandberg changed the company’s bereavement policy following the sudden death of her husband in 2015; the company now offers employees a comparatively generous 20 days paid leave following the loss of an immediate family member.

In the op-ed Sandberg wrote for The New York Times about her children’s experience of bereavement, she talks about grief in the language of business. The death of a parent is “adversity”; the word “resilience” is used six times, while “grieving” makes one appearance. Sandberg writes of her son and daughter’s loss (and her own) alongside the story of a friend’s child who was bullied at summer camp, with the implication that both experiences can be “overcome” with the same set of therapeutic tools. Sandberg’s approach isn’t insincere; original or not, the idea that “there is no wrong way to grieve” is an important one. But for those who don’t find this way of thinking helpful, our culture offers few other ways to address grief and work.

Caitlin Doughty’s mission to reimagine the death industry—to cast out our shame and fear of the dead—is an important one, for which she makes the case well and with good humor. More humane and meaningful rituals around death would doubtless ease the transition into the new reality that awaits the living after a traumatic loss. For my part, I look forward to one day spreading what I’ve kept of my father’s ashes, at a site less dour than a New Jersey tomb. But reforming our funeral industrial complex is only the beginning of the work ahead of us.

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