Death
“Death From Cancer is the Best”
© 2005 Steve Ganz, Flickr | CC-BY | via Wylio
Dr. Richard Smith, a former editor of the British Medical Journal, wrote recently, “death from cancer is the best.” And I think many of us, if not most of us, would disagree — to one extend or another — with Dr. Smith.
Cancer can create an embarrassment of dependence for it’s dying victim, causing the possibilities of:
Uncontrolled bowel movements,
Intense fatigue
Wasting away (cachexia)
Pain.
And, of course, there’s the equally horrible side effects of chemotherapy and various other cancer treatments:
Nausea and vomiting
Hair loss
And more pain.
So, what in the hell is Dr. Richard Smith talking about? Has he considered how many small caskets cancer has filled? The emotional stress, the exorbitant amount of money spent and the powerless insurance fights? How can an end-of-life that involves so much pain, money, dependence and cachexia be considered a “good death”?
He writes, with a bit of pithiness, about the good death of cancer:
“You can say goodbye, reflect on your life, leave last messages, perhaps visit special places for a last time, listen to favourite pieces of music, read loved poems, and prepare, according to your beliefs, to meet your maker or enjoy eternal oblivion,” he says.
“This is, I recognize, a romantic view of dying, but it is achievable with love, morphine, and whisky. But stay away from overambitious oncologists, and let’s stop wasting billions trying to cure cancer, potentially leaving us to die a much more horrible death.” — Via the BMJ Blog
There’s over 100 different types of cancer and not all cancers are equal; some are are much more deadly and others more painful. And I hope that Dr. Smith’s statement isn’t a blanket, meant to cover all types and forms. If he is making a blanket statement, he’s wrong.
Yet, I think the other metanarratives of “cancer sucks” and “cancer is the enemy” are equally wrong.
Luis Buñuel writes:
“An even more horrible death is one that’s kept at bay by the miracles of modern medicine, a death that never ends. In the name of Hippocrates, doctors have invented the most exquisite form of torture ever known to man: survival.”
We all know that the word “euthanasia” means “a good death”. The antonym of “euthanasia” is “dysthanasia” which means — you guessed it — “a bad death.” On a more practical level, “dysthanasia” is “generally used when a person is seen to be kept alive artificially in a condition where, otherwise, they cannot survive.” The bad death is a modern, medical induced phenomena where every attempt is made to hold back the inevitable; and yet, as Luis Buneul states, it ends up being an “exquisite form of torture.”
Part of the reason that cancer is often seen as bad death is because of the medical community’s attempt to use nearly every means possible to “cure”. Even when the prognosis is terminal, there seems to this held out hope in the miracle of modern medicine. And so, it’s not necessarily the cancer that is “dysthanasia”, but the treatment of it.
It also seems that our hatred towards cancer death is caused by framing cancer in a war narrative, where cancer is seen as “the enemy.” There are some problems when we frame cancer using a war narrative.
In earlier research, investigators found that war metaphors can lead to feelings of guilt and failure in patients who die of cancer, even though they have little control managing it.
…
Hauser says that medical professionals and media outlets should try to help expand the way that people think about the disease. He cites the “watchful waiting,” a passive method of treating prostate cancer, as one such example.
“What would be more beneficial would be changing the sorts of stories about cancer out there to expose aspects of the disease that don’t fit with this enemy conceptualization,” he says. “Blame is being put on the patient, and there’s almost a sense that, if you are dying, you must have given up and not have fought hard enough,” said the study’s author, Lancaster University professor Elena Semino, in a statement Via TIME
Sometimes — not all the time — cancer IS the good death. To start out with the assumption that cancer IS the enemy may rob us from enjoying the final days of our lives. Sure, there are times when cancer is a horrible death and times when it is the enemy, but not always. Cancer is what it is … it’s one way out of thousands that might pave your path to the inevitable. You will die. I will die. We will all die. And it’s very possible that cancer is a gracious way to end.
While we should hate the fact that cancer causes death (yes, cancer sucks), in terms of comparison and contrast, it’s not the absolute worst way to reach the inevitable. And while it mostly sucks, sometimes it might be the best possible option.
Why I Became a Mourning Doula
Today’s guest post is written by Laura Saba:
© 2003 Derrick Tyson, Flickr | CC-BY | via Wylio
I’ve been around death A LOT. When I was 4 one of my playmates, a 5 y/o, died of an asthma attack. They buried her and planted a tree at school in her memory. I couldn’t wrap my little brain around it – where did she go, and why did they plant a tree? Was she inside that tree?
A few years later, my grandmother’s tenant died, her body there on the apartment floor. Then when I was 11, my friend and I were about to deliver our newspaper route, when her mom was discovered. She’d had a stroke while leaning over to pull cookies out of the oven. Her face lying on the hot open oven door ’til found was not a pretty scene.
Flash forward to high school and you have the requisite schoolmate suicides, overdoses and car crashes. A few more years spin by and my best friend is murdered in a ”wrong place wrong time” incident, then a few years later my brother was KIA in Iraq (Semper Fi!). Then friends lost to cancer, as well as aging relatives and friends lost along the way.
My work as a birth doula also brought me into the realm of death at times. Soon I was volunteering as a loss doula, for women who would be induced due to a lost baby. There were the stillbirths. Then volunteering with Hospice, as I got really good at working with grief. Along the way I also co-owned a “Grief Gift Basket” business, where we created condolence baskets and our highly popular “Miscarriage Gift Baskets” which addressed the unspoken grief of so many women in a more honest and open way.
Along the way I often stepped in, helping others plan, assisting them as they went to make arrangements. Suddenly I knew the ins and outs of an industry I’d never been in. Too, I saw that supporting people through this process was, in so many ways, calling upon the skill-set of the birth doula, just channeled into a different high-stress time.
It became quickly obvious that people needed an advocate when dealing with this emotionally charged situation. That they needed a 3rd party, not emotionally attached to them or their dearly departed, to advocate for them, to hold their hand, to make necessary phone calls, to run clothing to the funeral home, or help figure out where that green cemetery plot is, precisely. Someone to help them hold it together as they navigate the minutiae in this complicated time – and to ensure they are fully informed, while ensuring they are also physically and emotionally supportive.
It amazed me to see that people responded to this support even more quickly and readily than they initially did to birth doula support. How was it that this Mourning Doula did not exist prior?
I realized it is because in other times we took care of our own dead. Family, friends, our villages rose up and assisted us. As with the birth industry, we need the support because these emotionally sensitive circumstances are no longer handled in the same way, but rather are almost under-the-rug-swept, as we as a culture work to dissociate ourselves from the messy realities of birth and death. Subsequently, there is the potential for someone to take advantage of our vulnerability – not even necessarily out of ill will or greed (though it too often is), but even out of good intentions.
It is simply a fact that no one knows what we would genuinely want if they don’t know us, and aren’t putting advocating for us first and foremost in their mind – especially when there is financial gain involved, it can be all too tempting to sway one in a particular direction over another. Had our culture not distanced itself emotionally and physically from birth and death, if these undertakings had remained undertakings rather than becoming a business, things would perhaps be very different at this time in history. However, as things are, this is how life is in the modern world. We have turned the very bookends that mark our lives into an industry, giving power over some of our most precious moments to others. With power comes at times corruption, and so it is we see the rise of the doula.
*****
Laura Saba is founder of Momdoulary, LLC, which provides training and certification in the Momdoulary Method of both Birth and End-of-life, Mourning, and Death Doula and Midwifery support, and Post-Loss Life Coaching, and Professional Organizing & Management of Material Artifacts Post-Loss.
Laura’s background in life & loss coaching, doula support, FEMA and Red Cross trainings, and experience providing support following natural and terror disasters, coupled with hospice volunteer support, led to a natural combination of her doula and coaching experience to provide end-of-life and post-loss support. This inclination was reinforced by extensive personal experience with loss, beginning at the age of 4 with the death of a playmate, and extending to the loss of a brother in Iraq, and numerous friends and former colleagues on 9/11.
If you’re interested in being trained to be a End-of-Life doula, Mourning doula, Death doula and/or Death Midwife, you can visit Laura’s website, Mourning Doula.
10 Marks of a Good Funeral Director
Over the past couple days I’ve been thinking about the question “what makes a good funeral director?” I wrote down 50 plus characteristics. Then I tried to find 10 that I thought were more essential than the others. Below are those 10.
But, these 10 “essentials” are very much opinion. In reality, the answers are quite relative … relative to a funeral director’s demographic, relative to funeral directors cultural expectations and relative to the funeral director’s personality.
With that in mind, let me be the first to say that this list is horribly inadequate. Nevertheless, here are 10 marks of a good funeral director.
1. Emotional Capital:
Funeral directors are paid to be the stable minds in the midst of unstable souls. We often dwell in the darkness and stare into the void. It takes emotional resiliency to bury a child. It takes emotional capital to bury the mother of three young children. If you don’t have that emotional capital, you’ll go bankrupt.
2. Altruism:
Most of us get our emotional capital by helping others. And although I’ve heard funeral directors say “I’m here to serve” a thousand times, the truth is this: If serving others is the core reason you’re in this industry, if service is your “calling”, you’re doing it right.
3. Continuing Education:
I’ve actually learned a thing or two at continuing education courses. But, I’m not talking about those mandated course hours here. I’m talking about the fact that a good funeral director (like in every field of life) always has a desire to expand their understanding. A good funeral director is alway considering new perspectives and challenging their mind to think outside the proverbial box.
4. Business Savvy (specifically for managers and owners):
The more money you can save the more of those savings can be passed back to the customer. Too often it is the mismanaged funeral homes that end up having to charge exorbitant amounts of money in order to support their bad business decisions.
5. Good Teachers
You don’t know everything. You will never know everything. You will always need teachers in your life.
6. Good co-workers/bosses/employees:
The funeral industry isn’t like the NBA where one player can take over and win the game nearly on their own. The funeral industry is more like the NFL. Sure, there are franchise players, but it’s much more of a team sport. And if you’re playing on a bad team, it’s really hard to do your job well. But, if you’re on the right team, your gifts can shine.
7. Internal Locus of control.
“Internal locus of control” is a more technical way of saying “a person with a high sense of personal responsibility.” This business moves too fast for us to always be dependent on our bosses. And at time, this business most so slow that you’ve got to look for things to be do. The blame game doesn’t work in this industry.
8. Empathy and sympathy.
Imagine being at the bottom of a deep, dark hole. Peer up to the top of the hole and you might see some of your friends and family waiting for you, offering words of support and encouragement. This is sympathy; they want to help you out of the pit you have found yourself in. This can assist, but not as much as the person who is standing beside you; the person who is in that hole with you and can see the world from your perspective; this is empathy. — Dr Nicola Davies
There are times (at funerals especially) when all we can give is sympathy. When it’s outside of our ability to fully empathize with a person’s situation. After all, the person laying in the casket isn’t my father. This isn’t my daughter. This isn’t my family.
And that’s our job. You pay us to be directors. And we couldn’t handle much more. We have to maintain a certain level of objectivity because there’s only so much pain, grief and heartache we can share until we too start to crash … burn out.
But, there’s other times when you can’t help but be drawn into the narrative, so that you enter the narrative and become a character in the story. Not just a director, but an actual character in the drama of life and death.
Knowing the difference between empathy and sympathy and having the ability of to use both is what can separate an average funeral director from a good one.
9. Integrity.
Integrity is doing the right thing when nobody is looking. The funeral industry is full of closed doors; and many of our jobs are performed behind closed doors. A good funeral directors is respectful in public and in private.
10. Honesty.
Honesty in the funeral industry looks something like this: admitting our mistakes when we’re wrong, doing our best to communicate truthfully to our customers and our co-workers and making sure we aren’t exploiting anyone.
*****
This “list” is missing something … your perspective. What do you think characterizes a “good funeral director”?
The Guardians of Death: A Short Story
© 2013 Scott Cresswell, Flickr | CC-BY | via Wylio
Lyle celebrated her twelfth birthday nearly a year after the end of The War. It was a long, oppressive war that left the world impoverished, broken and depressed. Like many children her age, Lyle’s father had died in The War, leaving Lyle, her mother and her grandfather together in their two room apartment.
Lyle’s family situation wasn’t unique, but she considered herself lucky. She didn’t have any memory of her father, any grief that plagued her soul during the bitter cold nights of winter. She was an infant when he died and all she had were photos of him in his Army uniform, holding her tight like he knew what his future held.
All the fatherly things that fathers do for their little girls had been assumed by her grandfather. Her mother worked when she could find it, and her grandfather stayed at home in their small apartment; he cooked (his potato casserole was Lyle’s favorite), did the cleaning when he felt able and tended to Lyle like a daughter, tucking her in bed and telling her bedtime stories when work keep Lyle’s mother late. They shared giggles, lots of hugs and both loved stargazing, especially in the winter months when the air was clear and the stars seemed brighter. “It’s in the darkness, “ her grandfather would say, “that you can see the stars. And it’s in the winter night that our eyes can see them most clearly.”
Lyle knew her grandfather was getting old. His cane became more of an aid with each passing day. And she know – from the stories told to her by her friends — that one day the Guardians would come unannounced and take grandfather away. The Guardians, she was told, were a group of people commissioned by society to shield us from the pain of dying and death. The War, they said, caused too much heart-ache and the state of the world was too depressed to confront the realities of death. “It’s just better”, Lyle was told, “that the Guardians deal with it. They’re professional. It’s their job.”
Lyle dreaded the day her grandfather would leave. And the older she became the more she feared it. Like a specter that grew longer with the setting sun, so her dread of grandfather’s death grew each passing day.
And then it happened. She came back from school and … gone.
Tears streaming down her face, she begged her mother,
“Where is he? Why can’t I see him? Is he dead? Is he in pain?”
The questions flowed as profusely as the tears.
And Lyle’s mother did the best she could …
“He’s very close to death … probably a couple hours … he’s with the Guardians at their home … they’ll take care of him …. that their job.”
Lyle ran to the bedroom. The answers didn’t satisfy. She slammed the door shut and devised a plan. As soon as the apartment had become quiet, Lyle jumped out of bed, grabbed her winter coat and tiptoed out the back door. The stars provided enough light for her to make her way to the Guardians’ home.
In and out of the back door came the Guardians, carrying dying bodies in and going out with the dead ones. Dressed in their black clothes, they moved effortlessly, methodically and solemnly. It didn’t take long for Lyle to find an opening in the rhythm to enter. She slipped inside and slowly made her way down the darkly lit hallways, peaking into the various crowded rooms, looking for her beloved grandfather. A lone, decrepit figure strode up and down the hallway, keeping watch over the hundreds of those dying and those already dead.
In the corner of a tightly packed large room she found him. His chest rising and falling at a slow pace. Eyes closed. Unresponsive. She grabbed his hand. And whether by miracle or reflex, he grabbed back. A grip that was at first tight, but as the night continued, slowly lost it’s strength.
She awoke in a daze, not knowing how long she had fallen asleep. Perhaps an hour or more. Lyle was so used to falling asleep next to her grandfather, that she must have crawled into his small cot at some point in the night. His body was cold. His lips a blueish gray. His face a ghostly white. He was dead.
Wiggling out of the cot and onto the floor, she knelt down beside him and — like he had done for her so many times — ran her fingers through the strands of silver that graced his familiar head. She began to cry, but these weren’t the empty tears of hopelessness and confusion she had cried a couple hours earlier. These were tears full of memory, of love; tears of grief.
Within seconds, the figure of that old, decrepit Guardian stood at the doorway. His keen eyes identified the source of the crying and he barked:
“Don’t you understand how dangerous this is?! Don’t you understand that once you touch death” he took a deep angry breath, “it will never, ever leave you?”
In as much defiance as a twelve year old could muster, she leaned over and kissed her grandfather’s cold face. Tears dripped from her nose.
And then words welled up from Lyle’s deep and out of her mouth:
“This is my grandfather. And this was my final act of love!”
The words came with such power from such a small person that the Guardian was momentarily shocked. The room Lyle was in was dark and the dim light from the hall outlined the Guardians frame, obscuring his face from her sight. He stood taller, gathered himself, puffed out his chest and replied,
“We are the Guardians. This is OUR job because you cannot and should not do it on your own.”
Lyle quickly retorted in a simplistic but honest statement, “I can do what my heart tells me I can I do.”
The Guardian stammered, “Leave now. You are not meant to see this. You are not meant to be here.”
She trotted out of the room, past the Guardian and quickly proceeded out the back door as the Guardian shouted, “You had better wash your face and your hands … !!!”
Lyle walked back home. It was still dark, but the stars seemed brighter than ever.
SURVIVING GRIEF AND THE HOLIDAYS
Today’s guest post is written by Pastor Dieter Reda:
© 2010 seyed mostafa zamani, Flickr | CC-BY | via Wylio
It was one day before Christmas Eve. The casket stood at the front of the decorated church, almost literally under the Christmas tree. In less than 24 hours the place would be packed to capacity and ringing with joyful carols and other festive music. But today it was the scene of the funeral of a prominent church member. In the casket was a 51 year old father of three: two teenagers and a twelve-year old. For them and their widowed mother this scene was surreal. The husband and father had died of cancer. The family had hoped he would at least make it to Christmas. A few days earlier, when I met with them in the home, the widow bitterly remarked, “some Christmas this is going to be.”
What does a young preacher in his twenties say in such a situation? Seminary had not prepared me for this (or a lot of other things still to unfold in my ministry). Fortunately – or not—there had been some preparations. I had been handed a piece of paper, on which were written, in the handwriting of the deceased, Scripture Readings, hymns, and a terse note: “I want you to preach on the following text which I have chosen.” That paper was indeed the framework for the service and it allowed us not to have to comment on the obvious by referring to Christmas.
That was more than 30 years ago. And while I never again had something quite that dramatic, I did have to again and again comfort people who were facing the first Christmas without a loved one, or the last Christmas with a terminally ill family member. And hence, these little pointers.
The first thing I would say is that there is no right or wrong way to handle grief at Christmas, or at any other time for that matter. What is helpful to some, will be useless for someone else. How you choose to handle the holidays will depend on your religious beliefs, your cultural customs, how you are emotionally “wired” and many other factors. What follows is intended only as some pointers to liberate you from the fear of the holidays.
- Don’t let anyone tell you what you should or should not do. It is possible that you will receive unsolicited advice from people who have good intentions, but are lacking in courtesy and tact. Listen if you must, but DO what you think is best and helpful to you.
- Should you “Skip” Christmas? It may surprise some to hear me as a minister say, “by all means—if that is your way of coping.” No one is under any obligation to “keep Christmas”. I reminded my congregation that the early Christian church got along quite fine without celebrating Jesus’s birth, and nobody knows the date on which he was born, except that it more probably than not wasn’t on December 25. If Christmas is just too much to handle emotionally one year, go easy on yourself and dispense with all of it…sending cards, buying gifts, going to parties, or even going to church. The family that I wrote about above did not attend the Christmas Eve service the day after the funeral, and nobody faulted them.
- If skipping Christmas is not for you, then consider a “different” Christmas. While some people take comfort in keeping old traditions alive, others find it more helpful to invent new traditions. Moving the venue of the celebrations can give a fresh perspective on things. I remember the first Christmas after my mother died, we moved the family celebration from my parents’ home to my home. For me the added work was a wonderful distraction and it acknowledged that Christmases would permanently be different.
- Try not to mask your grief. Some people do that by throwing themselves into as much activity and as much merriment as possible. Others avoid mentioning the name of their loved one thinking that will bring “bad luck” or make things worse. But the contrary might be true. Christmas is a nostalgic time and some have shared with me how helpful it was to remember the good Christmases past, even if that brings on tears. You might find yourself crying one minute and laughing the next, even as you remember some of the fun times with your loved one.
- Go Easy on yourself. Particularly if you are the caring and nurturing type who likes to take care of everyone else.
- Accept Gestures of Help and Support. This is a double edged sword. People who are bereaved often feel neglected and left out after the funeral. On the other hand, people have told me how they tried to reach out to bereaved friends only to be repeatedly rebuffed. Finally they gave up. If someone offers to do something for you like provide a meal, a gift, or help with a chore do accept it graciously…or ask for a rain check if the time just isn’t right.
And How Can You Be Helpful to Someone Who is Grieving Over the Holidays?
- Don’t Assume that because someone is in mourning, they want to be Excluded from Social Invitations. Let them make that decision. Perhaps being included, especially in things they used to do with a group of friends, is just what they need. Do invite them, but give them the freedom to decline if that is better for them.
- Don’t Pretend that the Deceased Never Existed. Friends are sometimes afraid to mention the name of someone who died, fearing it will upset the family. The truth is, they are thinking about their loved one a lot, and some have told me how hurtful it is when others behave as if the person was forgotten. Mention the deceased by name, when it would naturally come up in conversation, such as talking about memories – Christmas or otherwise.
- Should I send a Christmas card? There is no right or wrong answer to that. It would depend on what your usual custom is, how close to Christmas the death or funeral is etc. If you always exchanged cards, it might seem unusual to your friend if you suddenly stopped. In addition to the pre-printed prose that comes in the card, a hand-written note that you are thinking of them in a special way will probably by meaningful. As in other expressions of sympathy, avoid clichés, and unhelpful platitudes.
- Avoid saying, “If there is anything I can do, please call”. Most people will not take you up on it, thinking they are imposing or otherwise inconveniencing you. Also many people who say that, do it to ease their own conscience (at least we offered!) even if they have no intention of doing anything. It is much more thoughtful to find a need and meet it. Don’t ask if you can bring over a meal or shovel their snow or whatever. Just show up and do it. Or keep in touch with phone calls, emails, or visits, depending on your relationship. Perhaps you will become aware of something that “you can do”.
- Be Persistent but not overbearing. Be there when you are needed, but give your friends space when they need that. Be a ready and willing listener, but don’t ask prying questions.
- Invitations to small gatherings or perhaps a lunch with just the two of you might be more helpful than a large party (although consider # 1 above)
- Don’t Pretend that Everything is fine like it used to be. This Christmas will be different for your friends, and perhaps it will be difficult. The mirth and the joyful celebration of others may underscore the pain your friend is feeling. Don’t pretend by telling them to “get their mind off things” or say “you’ll feel better if you ….” Help your friend to make the best out of a difficult situation. They will remember your thoughtfulness…or your insensitivity for years to come.
Dieter Reda has been an ordained Minister for the past 34 years and served various churches in central and western Canada. Since 2003 he is senior pastor at Mission Baptist Church in Hamilton, Ontario (Canada). His blog of pastoral musings on various issues is at www.dieterreda.com and you can follow him on Twitter @Dieterreda.
