A Good Death - Quareness Series 94th "Lecture".
It appears that for many (most?) of today's humanity our death more often than not tends to be attributed to a malicious intervention by some outside agent...something that in itself seems to cry out for retribution and punishment. Indeed this assumption can also lead us to believe that a grieving person may be attempting self-punishment in order to avoid or reduce the anticipated punishment for the blame s/he expects on the death of a loved one. And much as we may dislike admitting it, the process of grief may also (and often does) include some element of anger even at the deceased. But I can't help thinking we might be a lot better off within a culture where the norm would be for people to be allowed terminate their lives in a more familiar and beloved environment, with less stressful adjustment required of themselves and everybody else.
The more our society advances (in science, etc.) the more we seem to fear the reality of death. Dying nowadays is becoming a more and more dehumanised experience and is in many ways more lonely and mechanical for most of us...severely ill patients are often treated like persons with no right to an opinion, with someone else for example making the decision whether and when they should be hospitalised. We might wonder if this could be (at least in part) due to our own fear of discomfort with the dying and death as we concern ourselves mostly with mechanical monitoring and treatment of their physical condition whilst ignoring their psychological need to be treated as a person rather than a thing.
As a man's ability to defend himself physically (in modern warfare, etc.) gets smaller, his psychological defences may have to increase manifoldly. None can continuously and successfully pretend they are safe, and if we cannot deny death we may foolishly attempt to master it e.g. through using our group identity (class, gang, nation, race, etc.) to express our fear of being destroyed by attacking and destroying others. Maybe war itself is at base a perceived need to face death, to conquer and master it, to come out of it alive...a peculiar form of denying our own mortality? But if we all made an all-out effort to contemplate our own death, dealing with our anxieties about such and helping others to familiarise themselves with these thoughts, perhaps there could be less destructiveness around us.
Where a whole society suffers from fear and denial of death, it could appear necessary to use defences which can only be destructive. Wars, riots and increasing numbers of murders and other crimes may be indicators of our decreasing ability to face death with less irrationality and fear and more acceptance and dignity. In times past suffering was perhaps more bearable due to the strong influence of religion, where there was a purpose and future reward involved. Now we're more likely to sedate and try to avoid pain and agony when unnecessarily suffering doesn't seem to make any sense. But it seems that society's denial of suffering and death has only increased our anxiety and contributed to our destructiveness and aggressiveness. Our "civilisation" may become so petrified that it destroys itself!
Each of us must face the issue of our own death sooner or later, an unavoidable part of living likely greatly aided by caring inter-human relationships. If science and technology are not to be misused to increase destructiveness (including prolonging life rather than making it more human), if they could go hand-in-hand with freeing more time rather than less for individual person-to-person contacts, then we could really recognise a good society. And we may only achieve peace (our own inner peace as well as between groups and nations) by facing and accepting the reality of our own death.
Christopher...Christy...wasn't well, they said,
He's no longer able to look after himself
And needs proper care now, so they said,
And they would not listen, they did not know how.
Patient...it's an interesting word with an interesting meaning...
Like Job, a stoic one who suffers, and maybe we're all patients now,
Unwitting agents and clients of our badly designed systems
When they would not listen, they did not know how.
Necessary suffering, perhaps an essential part of the deal for humanity,
Seems to call us to adjust and grow, making room for proportionality
In recognising and realising something greater than ourselves,
Gaining perspective while magically turning anguish into a flower.
Necessary suffering can also be an enlightening doorway
Serving to combine caregiver and care receiver in unison,
Where the real healing of human beings happens
Joined in mutual compassion...suffering together.
Then again much of our suffering might be unnecessary,
Essentially invented and serving no good purpose,
And perhaps crying out for change in our thinking on palliative caring
More appropriately concerned with comfort and living well at any stage.
Spending our together-time thinking out loud about our lives
Might mean we could really grieve, and in this way
Keep up with our losses as they roll in,
So that we're ready to take in the next moment.
Loss is one thing but regret is another altogether,
Risking health and safety we could go for it anyway,
Revelling in that glorious world beyond our control
While still able to figure out what's best for us over time.
Maybe the most that Christy can hope for now is numbness,
Fruit of the anesthetic and the opposite of aesthetic,
In those places designed for acute trauma and treatable illness
Rather than refuges geared for optimal living and dying.
But for those closer to death, priorities change and little things aren't so little.
Comfort along with feeling unburdened and unburdening to those we love,
Existential peace, spirituality and a sense of wonderment are what's important,
And ultimately these things may matter more than whether we live or die.
Because so much of what we're about is simply loving our time
Sensuous aesthetic gratification is our reward for just being,
Embracing true dignity...by way of the senses...by way of the body...
The very thing doing the living and the dying.
Life playing itself all the way out asks for physical and psychic space,
And in that sense rather than just dropping out of sight
Our aging and dying can become a lively process of crescendo,
All the way through to the final curtain fall.
Part of us dies early on, and if we design our life around this fact
We become free to realise the beauty and meaning in what we have left,
In perfect present moments where past and future no longer dwell,
Where we learn to live well, not in spite of death but because of it.
Let death be what takes us, not lack of imagination,
In the final analysis this is what's best for Christy and for us,
And though they would not listen when they did not know how
Perhaps they could listen now.
Everybody at all capable enough of making their own decisions has a right to die in what they regard as peace and dignity, and should not be used to fulfill our own perceived needs. Patients for example should be listened to and consulted and their wishes and opinions respected. And if those wishes are contrary to our own beliefs or convictions, we could perhaps respectfully express this conflict openly but leave the decisions up to the patient in respect of further interventions or treatments. The vital aspect is to truly "put the patient first".
Indeed in a caring world, each generation has a need and a right to live their own lives, to have their own privacy, and their own needs fulfilled appropriate to their generation. Older folk seen as having outlived their usefulness in terms of our economic system, have nevertheless earned a right to live out their lives in dignity and peace. And difficult as this may be in practice for some cases (e.g. involving emotional or physical disablement) it still needs to be at the core of our care-giving thinking so as to offset the very real temptation of wishing (usually unspoken) for a quick and painless death, a situation which can bring about stressful feelings of guilt...hardly a helpful state of mind all round when anyone is preparing to "pass over".
A dying man who has found peace and acceptance in his death has to separate himself step by step from his environment. How could he ever be ready to die if he continued to hold onto his meaningful relationships? In requesting that fewer and fewer people visit (say a few friends, then his children and finally only his wife) it needs to be understood this is his way of separating himself gradually. It's likely only those who have worked through their dying that are able to detach themselves slowly and peacefully in this manner...realising this should be a source of comfort and solace and not one of grief and resentment for the family and friends. This would surely be a good death?
Sean.
Dean of Quareness.
August, 2018.