Death
“This is How We Die”: A Morning with a Hospice Nurse
Illustration Credit: Anna and Elena Balbusso
On Tuesday morning all I knew was that I was setting up an O’Connor table at the Heartland Hospice event that we were co-hosting. I got the table cloth & brochures all set out, greeted the attendees, and sat down in the back intending to “work” on my computer when the speaker, Barbara Karnes, a hospice nurse of 32 years, began speaking.
She said, “I don’t want to pretend that this is all Truth with a Capitol T.
This is MY experience.
Dying is the hardest thing we live through.”
(and you do live through it, that is, until you die)
That got my attention. I had the privilege of sitting for the next two hours hearing the stories and wisdom of this nurse. I typed out as much as I could of what she said, filling up 4 pages of notes and still not capturing all the information. –
Here are some of the incredible insights she gave me about death that Tuesday morning:
“We don’t die like the movies” – She mentioned scenes in movies where the dying person looks beautiful and radiant, perhaps they’re imparting some incredible words of wisdom that wrap up the whole story perfectly and then, they die . . . “This is not how people die,” she said. When people are dying of disease or cancer, the kind of people she gets to work with on hospice. “They don’t have the energy to speak, and if they are speaking, you probably can’t hear or understand what they are saying.”
“If they are a controlling person, they will control how and when they die” – She said that protective spouses or parents want to spare their loved ones from being there when they die. They will wait until they are alone to let go. She also said that if they want you there when they are going to die, then that is what will happen.
“No one dies alone” – Barbara said that all her years of experience have convinced her that we are ushered into the “other world” by the loved ones that have gone before them. She recounted the story of a 23 year old girl she was caring for whose brother died 3 weeks before she eventually would. The family chose not to tell her about his passing but shortly afterward all she could talk about was “Jim, Jim, Jim,” her brother. Her boyfriend thought she was confused, but then she looked at him and said, “No, I know who you are, Jim is here and says he’s going to take care of me.” Barbara recounted other stories like this, I’m pretty sure there wasn’t a dry eye in that room.
“Dying is always, always sad, it will never be ok. but it doesn’t have to be BAD.” – this is how you take something scary and negative and make it into a more normal and natural process that helps neutralize the fear.
Barbara inspired me and gave me truth and honesty about an element of life most of us know very little about. She changed how I see dying. She spoke about it with so much familiarity, knowledge, comfort and gentleness that it took out so much of the frightening mystery that dying is cloaked in. It will never be ok, but it doesn’t have to be bad or frightening.
To hear Barbara’s own words about dying, click here Gone From My Sight. To obtain a copy of her book,“Gone From My Sight” please contact Becky Lomaka.
What do you think of Barbara’s premises?’
In your experience, have you seen any of these played out?
*****
From today’s guest writer: Hello! My name is Molly and I am the Communications Director for O’Connor Mortuary in Orange County, California. I had my first exposure to a mortuary as a newborn when my parents took me home to their apartment above a mortuary in downtown Long Beach. Growing up as a mortician’s daughter it’s fair to say that mortuaries have had a profound role in my life; they have shaped my perspective, grown my compassion, and become an integral part of my identity. In 2011 I obtained my masters degree in English literature and was amazed to find a job at a mortuary that so beautifully fused my passion for writing and quality literature with my passion for those in grief. I am driven to provide bereaved people with valuable resources and to educate our community on the value of ceremony and personalization. I am proud to work for such a fine establishment that fits me so well and that gives value to what I do.
Cell Phone Funeral Etiquette
Cell phones often go off when we least want them to. In church. In school. During sex. And at a funeral. As other funeral directors can attest, the oddest thing about a cell phone ringing during funerals is how many people will actually answer.
“Hello. Yeah. I’m at a funeral service. Can I call you back?”
A funeral director friend once told me that the pastor’s cell phone rang while he was giving the funeral message. He answered it. Confirmed the time for his afternoon golf outing. Hung up and continued on with the service. The family – according to the funeral director – was “pissed.”
If you’re attending a funeral, the best piece of advice I can give you is this: Turn your phone off.
Simple.
But, they aren’t JUST phones. And it isn’t that simple. Funerals also double as family reunions. So, you pull you phone out. Show off your recent photos of your children and your relatives “oh” and “ah” about how much your children look like a young version of your great uncle Ned.
If you keep your phone on, turn it to — preferably — silent and — at least — buzzer.
Is it appropriate to text?
During a viewing and/or visitation, yes. During a funeral, probably not.
As with talking on your cell phone, if you’re going to text it would be polite to step outside or to a discreet area of the funeral home. Sexting, though, is off limits at any time during a funeral.
Can I take a photo of Aunt June laying in her casket?
That’s up to Aunt June’s next of kin. And when you ask, ask before the viewing starts. People aren’t always able to think straight during a viewing, so the polite thing to do is ask while they’re thinking straight … which is before and not during.
Don’t just take a photo like this guy:
I’m bringing the kids to the funeral. Can they play “Angry Birds”?
It’s common sense, but turn the sound off. Everyone else doesn’t need to hear screaming birds and snorting pigs. And, it’s probably NOT appropriate for them to play during the funeral.
“We’re gathered here today to remember the tragic loss of ______” At which time your kid yells “yes” as he overcomes a level that’s taken him a combined 1,000 birds to clear. Not cool.
Also, video. If your children want to watch video on your cell. Either find a separate place that’s out of the way for them to watch. Or, get them to wear headphones.
What do I do when somebody else is breaking funeral cell phone etiquette?
The biggest culprits for committing funeral cell crimes are old men and women who aren’t cell phone savvy. Their phone rings in the middle of the service and they frantically pull it out of their pocket or purse and start hitting buttons. After finding the “silence” button, they breath a sigh of releif ONLY to have their phone start ringing again a minute later.
At this point they start muttering. And it’s at this point someone should step in because if you don’t their next action will be to turn it off, which will only create another loud “turning off” noise and more muttering.
The difficulty isn’t with the cell phone newbies, it’s with the cell phone addicted. The young people. And when young people commit cell phone faux pas, and you can tell that it’s annoying people around them, you have to confront them.
“Excuse me. Can you please turn your cell phone off?” Then wait until they turn it off. That’s what I do.
And if they don’t turn it off, pray for cell phone karma (example of cell phone karma in the video below)
Embalming: The Religion of Funeral Service?
Death rites and rituals are hardly ever static. Change is the constant in both life in death. And so it is that change is here for the funeral business in the United States. We sit in liminality.
The “traditional funeral” (aka embalming and burial [as defined by the FTC]) in the US is becoming outdated for many reasons. It’s being replaced by cremation and (hopefully) a more natural orientation.
Yet, some (many?) funeral directors here in the United States and elsewhere are still preaching the Gospel that the presentation of an embalmed body is the foundation of the funeral business. Our preaching is so religious that when someone questions the value of embalming, some funeral directors kinda freak out like we’re questioning the very existence of God.
If embalming is the foundation of our practice, it’s a very shaky foundation. Here are ten reasons we probably shouldn’t deify embalming.
One. Embalming Will Slowly Die
Cremation is on the rise. Arizona has a 60% cremation rate. And the projections are that the rest of the country will eventually catch up.
Embalming and burial is “the traditional funeral” for a generation that is dying. And we should serve that generation and their needs. But, when that generation is dead, most will eventually opt for cremation. Embalming is more so a trend than an religion; and that’s an important distinction.
Two. Value Vs. Cost
There’s a difference between value and cost. People will pay for things that they see as valuable. And people are increasingly NOT seeing value in the traditional funeral to justify the cost of embalming, casket, vault and burial plots. Increasingly, people don’t have enough money for life, yet alone death. The lack of funds combined with a perceived lack of value is creating a smaller and smaller market for the “traditional funeral.”
Three. Botox
With the increasing rise of Botox, people are already embalmed and will look just as good in death. Have you seen Joan Rivers? Donatella Versace? Pete Burns? I’m just kidding. Botox has nothing to do with this conversation. Okay, bad attempt at humor. Moving on to the thesis of this post.
Four. The Gospel Isn’t True
I used to believe the Gospel of the “Traditional Funeral”. I was taught to believe the Gospel. That if you saw the body of the deceased you could repent of your death denial and place your faith in death acceptance.
Don’t get me wrong, I do see value in the traditional funeral. There is value in restoring the symbol of death. And, in many ways, the traditional funeral is a microcosm of the grief process. But the psychological value and sociological rites that come with embalming can be had from other types of disposition, especially when there’s more involvement from the friends and family of the deceased.
Five. Cremation Can be Converted
In funeral school, we were taught to fear this transition. We were taught that cremation and other alternative burial forms were THE ENEMY. They were the enemy to our bottom line (if people cremate, they wouldn’t need embalming, they won’t need a casket and they probably won’t need a vault). The ENEMY to our way of life.
AND, cremation and natural burial are the heresy to the Gospel. With cremation you just can’t repent and have faith. BUT, even cremation can be redeemed. We – at our funeral home – always give the family (and often encourage the family) the option to have a small private viewing before cremation. Allowing them the viewing helps their grief process AND allows them a more inexpensive funeral option.
Six. The Zombie Apocolypse
And there’s always THAT to worry about.
Seven. There’s Probably Better Psychological Benefits in Natural Burial
It just makes more sense that those who took care of the deceased in life should also do so in death. And when we (the so called funeral “professionals) are cut out, it may (probably) be a better aid in grief work to do it yourself.
Embalming helps confront death denial. But natural burial does it better because it often allows the true professionals to play their part.
Eight. Urbanization Creates Expensive Cemetery Space
One practical reason we can still bury casket, vault and body in the US is because we still have land. Where land is scarcer and urbanization is more of a reality, cremation is the pragmatic choice. As we become increasingly urbanized, and local cemetery space becomes more sparse, we will – by necessity – opt for cremation. For instance, in large towns in Europe the cremation rate is between 70 to 90% while a full burial is only reserved for the wealthy aristocracy who can afford grave plots.
Nine. We Live and Die in Transience
In times past, generation after generation lived and died in the same area, if not the same small town. Today our jobs, dreams and wanderlust have pulled our families and communities all through the US and the world.
In the past, you wanted to be buried with your people. And you see this in old cemeteries. Generation after generation of Suchandsuch family are all buried within a couple caskets lengths of each other. We live in transience and our desire to be buried with out people isn’t so easy anymore because our people are buried all … over … the country. And so we don’t bury with our people, we spread the ashes in an area that best represents the deceased.
Full burial just doesn’t have the same communal appeal that it did for older generations.
Ten. We Are Selling Ourselves Short
If we think embalming is the very best we have to offer the grieving masses, we’re missing out on our true potential. I think the value that funeral directors have to offer is much less “services provided” focused and much more rites and rituals focused, where we’re able to translate our experience with death and death rites into meaningful ritual. AND, if those meaningful rituals include embalming, then great.
In fact, I envision future funeral schools becoming much more focused on bereavement studies with the recognition that funeral directors are on the front line of the grief process. Our value, I believe, shouldn’t be solely in our ability to embalm (I still love you Jack Adams), but in our ability to help you through healthy rituals and aid in celebrating the life and death of your loved one.
I see a future where funeral directors — more than now — can stop serving our religion and start serving families. Because our religion is — and always should be — helping You.
The Disenfranchised Grief of Abortion
Disenfranchised grief is grief that is not recognized by society. One MAJOR type of disenfranchised grief that I often mention is the result of stillbirths and miscarriages.
A grief for one who had no connections in life. No schoolmates, no friends, no co-workers … all of which translates to no funeral. A grief that can’t be shared.
A grief to be borne solely by the ones who conceived. A grief that is carried by the one who may now feel guilt upon silent grief because she miscarried.
This is a grief that is often carried alone. A grief that is too often complicated by guilt. A grief that is private and difficult to share. A grief for a nameless soul.
Yet, there is a movement to recognize this grief. Mothers who have miscarried call us at the funeral home and request some public funeralization for their miscarried/stillborn child. Some even request a public viewing if the child is far enough along in it’s development. This movement to have funerals — whether through a funeral home or simply in a small private service — is a movement that provides a positive outlet for the grief of the parents and siblings. It recognizes a traditionally disenfranchised grief.
So, why isn’t there a movement to memorialize/remember abortions (The book, “Liquid Life: Abortion and Buddhism in Japan” explores abortion remembrance in Japanese culture)? Here’s some reasons why abortions might not be memorialized:
Obviously, the political contentiousness of the topic doesn’t help.
There’s the idea that the fetus is not a thing to be grieved.
There’s guilt factors,
there’s shame factors (one night stands, rape, incest),
and there’s trimester factors (the fetus could have been only a couple weeks old).
And, there’s the fact that abortions are VERY private decisions, that aren’t meant for public appraisal. How much would a woman / couple be shamed, guilted, chastised and questioned if there was a public funeral for an abortion?
And yet we have this from a discussion thread at Steady Health:
I am 31 and desperately wanted to have a child with my partner. Last month I found out that I was pregnant and I was surprised to feel absolutely nothing positive about the fact. After the initial shock wore off all I felt was indifference, fear and depression. The sight of women with babies etc. provoked feelings of nausea… I took this to mean that I didn’t actually want the baby and last week i had an abortion. Now that my body is returning to its normal state I feel exactly the way that i did before I found out that I was pregnant! I don’t understand how it’s possible to feel so emotionally estranged from myself during pregnancy. Is it possible that this happened because of pregnancy hormones? I feel like my body betrayed me. I wanted that baby. Has anyone else experienced anything similar to this? It’s very disturbing…
And this was one of the nearly 100 replies — most of similar nature — to the above post:
I too have recently had an abortion and am having those same feelings of regret and grief. i have always wanted a family more than anything, am in a committed loving relationship and would even go so far as to say that I disagree with abortion – and yet, i fell pregnant unplanned, got scared at the timing of it all and the consequences of it, and before i knew it, I’d done it.I cry a lot. I feel empty inside, like there is a big hole inside of me that won’t go away. I feel the desire to have another baby, soon, after my wedding, earlier than we had ever planned. I ache all the time and it’s as though my body misses being pregnant (even though I was so sick). I’ll be having a happy day and then suddenly i’ll break down into a flood of tears, racking sobs that shake my whole body and i feel an indescribable ache in my chest.
I worry that when i do have another baby that it won’t fix the real problem of the baby that I made the decision not to keep.
One of the problems with politicizing abortion is that when it becomes part of a platform we forget that there are REAL people involved, who are parting with a REAL part of themselves and who will likely experience some type of REAL grief.
I understand that just as some don’t experience grief over miscarriages so not everyone will experience grief over an abortion. I know some woman who have celebrated their abortions.
Yet, it IS important to recognize that abortions may likely cause a type of disenfranchised grief that if not recognized will cause psychological difficulty. And if the grief goes unexpressed, may cause intense, unintended emotional consequences.
It’s time to give talk about our abortions to people we can trust. And it’s okay to grieve apart of you that is no more.
Just Keep Swimming
Today’s guest post is from Jessica Charles. This from Jessica: I am Corporal Joshua Alexander Harton’s Big Sister. I am his sister and I protected him his whole life. That is until September 18th, 2010 when a bullet from Taliban’s rifle went through his neck, cutting his carotid artery, moving through his torso and destroying organs and finally leaving his body at the left hip and shattering his Kevlar armor. I am Josh’s sister and I need you to know that my little brother is dead and my epic life will never be the same again.
*****
What is living with PTSD like?
Uh, it is like….ummm well, you know.
And then people think Rambo:First Blood or some recent tragedy where a returning soldier kills his ex wife and her boyfriend.
It is NOT like that.
It is a lot like Finding Nemo, the kids’ movie where a father crosses an improbable ocean to save his son learning lessons on the way.
Try and remember the movie and I will outline it as I go. This explanation should be so simple that even civilians can follow.
The movie starts with Mommy fish and Daddy fish (Pearl and Marlin) admiring their new home and envisioning the future life of their many children. Then tragedy strikes. A big fish eats the babies and the mommy fish defends them, she also dies (And I thought Bambi was bad).
One egg survives, and Marlin (dad of the year) promises that from this moment on “Nothing will ever happen” to his baby Nemo.
Marlin has PTSD. Marlin spends the next few years (or however long it takes in fish time) protecting his son from EVERYTHING, because in truth, the world is a scary place and it will kill you. And it would seem paranoid and crazy except that Marlin is often proven right.
His son dares to leave the safety zone and is kidnapped. Marlin follows and is almost devoured by sharks, blown up, eaten by a monster fish with a flashlight, lost, shocked by jellyfish and lost again only to be eaten by a whale. Life is bad, and that is the only lesson Marlin can learn because it is the lesson he already knows.
Dory his adorably absent minded buddy doesn’t have any preconceived lessons. She “just keeps swimming”. To Marlin she is an imbecile because everywhere they turn there is obvious danger. Danger is all Marlin can see. And he isn’t wrong, but as Dory teaches him, he isn’t entirely right.
If Marlin hadn’t tried to force Dory away from the sharks, well there would have been no bloody nose to insight the hungry beasts. If Marlin hadn’t been so rude to the school of fish, he would have gotten directions earlier and more completely and would have avoided the jelly fish all together. In Marlin’s haste to protect himself from the world he makes it a more dangerous place. That is what living with PTSD is like.
I have always had PTSD. I have always lived in a world that was scary and dangerous and I have never been good at seeing the world as a place of both danger and joy. Someone once said, “The war is over.” And with the intensity of someone who feels threatened, I screamed, “No sir, it is still going on”.
It is true, I am still at war, still in war and still protecting myself from the enemy. The enemy is the world and as Marlin learns not only can you not protect yourself or your beloved child from the world, you shouldn’t because as Dory says, ” Well, you can’t never let anything happen to him. Then nothing would ever happen to him. Not much fun for little Harpo”.
Not much fun… yeah, fun, thriving versus surviving. Learning HOW to do that, instead of just over thinking every moment until you can plan for all foreseeable outcomes except the one where you may enjoy yourself.
So what is living with PTSD like? It is like Finding Nemo. And I hope everyone out there has a little blue buddy who can help them out, even if some days it is all you can do to just keep swimming.
*****
You can visit Jessica’s blog at “Always His Sister.” And you can follow her on Twitter.
