Natural Dying

In accepting death as natural, we confront more directly the limitations - and the mystery - of life

One of the articles in Birth, Sex & Death (IC#31)
Originally published in Spring 1992 on page 58
Copyright (c)1992, 1996 by Context Institute

Death. In death, as in birth, we touch the mystery of life. Where do we come from – and where do we go? And who and what are we, really, while we’re here?

When we look ahead to our death, our thoughts reflect back to us, in living color, Life. The universe, through eons of evolution, has brought into being this world, these creatures, this particular person, for an allotment of one lifetime.

Considering the magnificence of life, that allotment may seem all too short. We may, with Dylan Thomas, "rage against the dying of the light." Yet, at the same time, nothing is more natural than death. As Ernest Morgan reminds us in his gentle book, Dealing Creatively with Death:

Humankind is part of the ongoing community of nature, on a world scale, subject to the same cycle of birth and death which governs all other creatures and, like them, totally dependent on other life. Sometimes, in our high-rise apartments, our manicured suburbs and our chromium-plated institutions we tend to forget this.

Our need is not to reject nature but to live in harmony with it. This does not mean rejecting our technology, but it does mean controlling our numbers, quieting our egos, and simplifying lifestyles.

In the world of nature, death provides a service because it makes room in an ecological niche for a young one. People are part of nature, too, and when people die, they make room for more people. In a time of population explosion, it would be useful to be able to die without making too much of a fuss about it. But we humans, particularly in the affluent cultures of the first world, face the final journey of life with a load of weighty baggage. We avoid talk of death, and we dread the realities of the aging process.

We as individuals don’t necessarily create and lug around this excess baggage on our own. Something pervasive in our society molds our collective choices. Michael Ignatieff, writing in The New Republic, offers this explanation: "Cultures that live by the values of self-realization and self-mastery are not especially good at dying, at submitting to those experiences where freedom ends and biological fate begins. Why should they be? Their strong side is Promethean ambition: the defiance and transcendence of fate, the material and social limit. Their weak side is submitting to the inevitable."

This ambition of ours has borne fruit. Life expectancy has indeed increased. We can expect to live almost twice as long now as in the mid-1800s. Researchers now claim to be moving rapidly toward more extreme life extension – and even reversal of the aging process – through the use of human growth hormone. In tests conducted at Veterans Administration hospitals, elderly recipients of the experimental drugs have indeed become, by self-report and physical tests, many years "younger." What kind of sense does this "progress" make, considering the impact of population on a finite planet? Fear seems to be the primary motivator. One prominent researcher in the field admits, "I’m 65 and trying to save my ass."

In addition to the experimental leading edge of life extension, the ordinary, every day custom of keeping more people alive longer, through ever more costly medical interventions, persists. As medical ethicist Daniel Callahan writes about life, "The more we get, the more we want." The result is that more and more, old age is about illness, about surviving on a practical level with multiple disabilities, about living with a sense of vulnerability.

We have become victims of the health care system that our cultural values have created. The dying process has been transformed into a series of wrenching choices. A 94-year-old man who still "has his faculties" goes into heart failure. He has lived a long life, a good life. Perhaps with a trip to the hospital he can have a couple more good years. He just isn’t ready to die. So to the hospital he goes and, a few days later, into the nursing home. Three weeks after the first episode, he’s back into the hospital; the next day he’s dead. The cost? A miserable, prolonged dying for him, distress for his niece and nephew, bills adding up to tens of thousands of dollars. A woman, getting along pretty well after a stroke at age 80 – some confusion, but lots of independence and zest for life – develops increasing heart problems. She has no family support, just a few friends who do the best they can. The doctor recommends a pacemaker. She says no but he persuades her. There are complications during surgery. Now she’s totally disoriented and can barely walk even with assistance. Her pacemaker keeps her going.

Out of the apparently needless suffering of countless people has grown a strong movement toward patients’ rights and natural death – that is, death with a minimum of medical intervention. Advances are continually – albeit slowly – being made in legislation and public education. The Patient Self-Determination Act, which went into effect in December, 1991, requires health care facilities to inform patients of their rights to refuse treatment and to formulate advance directives such as a living will or health care proxy. Difficult moral dilemmas are also being debated on the topic of "aid-in-dying," or physician-assisted suicide. The goals of the broader "natural death movement" are to guarantee choice for individuals and to bring about a large-scale cultural shift. An article in The Economist of London describes such a large scale shift this way: "To civilize death, to bring it home and make it no longer a source of dread, is one of the great challenges of the age . . . Gradually, dying may come to hold again the place it used to occupy in the midst of life: not a terror but a mystery so deep that man would no more wish to cheat himself of it than to cheat himself of life."

People of other cultures have a lot to teach those of us who live in the industrialized North. Elizabeth Beverly writes in Commonweal about her experiences of death among Mandinka villagers in Senegal. She watched, and helped as best she could, as fathers and mothers, husbands and wives sat with the dying – young and old – bathing faces, giving drink.

In Mandinkakangho I can find no word for death, no big sturdy noun to embody both an instant and a permanent condition. Death slides into conversation as a verb: someone is dying, someone has died. In this way the fact of death seems to concern the act of dying. Death is not something you meet, dying is something you do. Each individual is the literal agent of his or her demise. That act is always a mystery for those of us who have not yet "done" it. Always a mystery for the living.

One must try to heal, but one must also hold; over the years, this is what I have learned about dying. . . . The last Mandinka child I held unto death was probably dying of meningitis; Vie wanted me to cradle his head in my lap. As I supported him so, and rubbed his silky back, I thought of my mother and the story she had told me of her mother’s long illness. How my mother filed her dying mother’s fingernails, trimmed the cuticles just so, buffed the nails to a high sheen. How her mother smiled at her pleasure, and in pain.

My grandmother was dying, and my mother was helping her. They both were using this "dying time" the best way they could.

Death happens to us, but dying is something we do. Death is a biological event, a moment in time, almost always painless. Dying most often extends through time, encompassing sensation, emotion, and process – and sometimes great pain. But dying is an opportunity unlike any other which life provides. Ken Wilbur’s story of his wife Treya’s dying time and his participation in that process, told in his book Grace and Grit, is a magnificent testament to the opportunity hidden within death.

At dying time we take a deeper look at what death represents to us. According to Robert J. Lifton, humans have a basic need to feel a sense of continuity and connection with the future – and that need is challenged in this time of uncertainty about the outcome of the human experiment on the planet. Will we indeed live on through our children – our own, or others to whom we offer guidance and love? Will our contributions to the greater good survive? Do we have, through either faith or experience, a belief in the existence of a life beyond the body?

For many, near-death experiences offer hope for the existence of life after death and for reconciliation with deceased loved ones. Timothy Ferris, writing in The New York Times Magazine, acknowledges that near-death experiences are often times of illumination and ecstasy. While these experiences may well reveal something about life after death – or about a life happening concurrently with physical life that we are only dimly aware of – Ferris believes that the teaching they offer is that the physical act of dying itself is a positive experience. And nature may have set it up that way. Death is painless – in fact, possibly downright pleasant – because it serves the species. Ferris quotes Lewis Thomas, who wrote in his book The Medusa and the Snail, "If I had to design an ecosystem in which creatures had to live off each other and in which dying was an indispensable part of living, I could not think of a better way to manage."

Ferris takes his thesis a step further. He suggests that our sense of resonance with the larger whole at the time of death may be a sign of our resonance with the cosmos, possibly revealing our place in the web of life that stretches back to the beginning of the universe.

Considering the discoveries of modern physics, Ferris may be right. But can we, in our own small lives, accept the naturalness of death? Can we look forward to our own dying – that moment when we make room in our ecological niche for a young one – with a sense of rightness and peace? It helps to know two things. First, that we have lived life fully, no matter how long or short our life has been. Second, that when we go, we are passing something on to others.

In Grace and Grit, during Treya’s dying, she kept asking her husband Ken, "You’ll find me?" He promised that he would. After her death, he reflects,

I don’t think any of us will ever meet Treya again. I don’t think it works that way. That’s much too concrete and literal. Rather, it is my own deepest feeling that every time you and I – and any who knew her – that every time we act from a position of integrity, and honesty, and strength, and compassion: every time we do that, now and forever, we unmistakenly meet again the mind and soul of Treya.

So my promise to Treya – the only promise that she made me repeat over and over – my promise that I would find her again really meant that I had promised to find my own enlightened Heart.

Death is simple. Dying may or may not be. Being with someone during their "dying time" deepens our sense of the miracle of living. Out of the encounter with death, we are pushed to choose life.

FOR MORE INFORMATION

Choice in Dying, 250 West 57th St., New York, NY 10107. Educates the general public, health care professionals, and lawmakers on the needs of dying people. Provides living wills and documents for appointment of a health care agent, specific to the requirements of each state.

Duda, Deborah. Coming Home: A Guide to Dying at Home with Dignity. Practical and inspiring. New York: Aurora Press, 1987.

Morgan, Ernest. Dealing Creatively with Death: A Manual of Death Education and Simple Burial. Celo Press, 1901 Hannah Branch Rd., Burnsville, NC 28614. Written by a Quaker whose "burial committee" provided simple burials for members of his Meeting. Includes basic information on the dying process, bereavement, creating simple death ceremonies, memorial societies, hospice care, etc.

National Hospice Organization, 1901 N. Fort Myer Drive, Suite 402, Arlington, VA 22209.

Scully, Dr. Thomas MD and Celia Scully. Playing God: The New World of Medical Choices. New York: Simon Schuster, 1987.

Wilbur, Ken. Grace and Grit: Spirituality and Healing in the Life and Death of Treya Killam Wilbur. Boston: Shambhala, 1991.


Breathing The Darkness In

You mother it. The light becomes your skin.
No tricks, no trouble, you take it deep and slow.
Light hushes light. You breathe the darkness in.

Time grows fat, cancerous. Your arms grow thin
until you cannot lift a finger or blow
a candle out. Its light becomes your skin.

"Change your life. Feed your soul vitamins,"
I joke. Inside, you know better. "No, no,
light must change. I’ll breathe the darkness in.

"Am I mother, father? Am I the true twin
of cancer? When will my growing cease to grow?
Bow your head. Your prayers become my skin."

What could I answer? Whatever words have been
they are not now. Let my fool’s words below
be silent. I’ll change, pray the darkness in.

Mother, just now we lay down both our sins.
I’ll pick them up. Your death is yours to know.
You’re gone. I’m here. The light becomes your skin.
You wrote. I’ll write. And breathe the darkness in.

– Lynn Shoemaker

 

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