Broken survivors

Superb if gruelling documentary examining end of life issues from PBS.

One of the contributors is Judith E Nelson, professor of medicine at the Mount Sinai School of Medicine and associate director of Mount Sinai Hospital’s Intensive Care Unit:

The burdens of intensive care can be very, very heavy, and the outcomes are often not good. So we have to face this extraordinarily difficult challenge of knowing when to use this miraculous technology and for how long and knowing when to try to preserve for people a peaceful and dignified process of dying. Walking that line is the very hardest part of my job, and constantly recalibrating myself from one side of it to the other.

Although we can never be 100 percent certain until the moment of death that someone is dying, there are clinical situations where the odds are so overwhelming that someone can[‘t] survive the hospitalization in a condition that they would find acceptable, that we can see that outcome and compare that with the burden of the treatment. When it is virtually a foregone conclusion that that unacceptable outcome is going to occur, then using this technology to support the physiology of the patient doesn’t make sense. And it is invasive, and it’s burdensome.

It’s a situation in which a person is completely dependent for all of their care on a nurse and a physician; where the patient cannot even attend to their most personal care and has to be cleaned from head to toe and every buy cialis new york place in between by another individual; when they’re not even awake. And our nurses do that in the most unbelievably respectful way, but still, it’s a part of this experience. It is being attached to machines with constant noise from alarms and signals. It is being surrounded by electrical devices and monitors, with no control over any of your bodily functions, quite literally. And although we strive as hard as we possibly can to prevent discomfort, it’s probably impossible to prevent it at every moment. So there are discomforts, and one hopes rare but occasional pain and other kinds of distress, fear, delirium. All these things are occurring for people.

In addition to that, you’re in a bed that has side rails to protect you from falling, but also may make it more difficult for the people who love you to get close to you. Even if there’s open visiting in an ICU, which some ICUs have and some don’t, it is not a place where loved ones move about freely. They’re uncomfortable and unhappy and fearful. And all of that is part of the surrounding. So it’s a very disconnected, depersonalizing and occasionally even painful and frightening experience. I don’t think anybody wants to die that way. I think most of us, not everybody, but most of us would be willing to go through it for a good outcome, but nobody wants to be like that if nothing good is going to come of it.

Full interview transcript here.

Death in the community

This put a spring in my step. It is extracted from a letter to the Irish Times:

I never cease to be amazed at how we Irish continue to celebrate and embrace death so excellently.

The morgue is now giving way to families’ increasing desire to bring the body home for a wake, not just for a few hours but overnight, so that neighbours and friends can gather as a community for lashings of tea, cakes, sandwiches, etc, all prepared by the neighbours as genuine gestures of friendship and community.

The importance of the community wake is also to be seen in the new development of taking the body directly from home to church, not on the evening before burial but on the morning of the service, with the community present in full support to the bereaved.

We Irish celebrate and embrace death so well that a good funeral is still a more social event than a good wedding.

The whole letter is worth reading here. It is a response to this article here.

Monday shorts

Death Ref got there first

Time was when I could tuck a story away for a slow news day and not give a thought to any other death blogger getting there first. Can’t do that any more. The story I had been saving up for today has, I see, already been aired on the excellent Death Reference Desk blog, so I suggest you pop over and read it. It’s a very good blog, DRD, run by brainy people.

Find it here.

Having found it and enjoyed it, test your powers of enjoyment by reading their latest post. Here.

Time to remember

Yup, it’s a mixed bag today. You might like to go over to Dying Matters now and see what they’re saying about Brits and remembrancing:

A survey released today has revealed that three out of four (75%) people in England do not set aside time with friends and family around this time of year to remember loved ones who have died.

Commenting on this Professor Mayur Lakhani, GP, Chair of the Dying Matters Coalition and the National Council for Palliative Care (NCPC), said:

“It is shocking that the vast majority of people in England don’t take time to remember dead loved ones. This is further compelling evidence of the wall of silence our society’s built around dying and death.”

It’s an interesting point, if not well made. Of course Brits set time aside to remember their dead, they just don’t have rituals to accompany their remembrancing, that’s the point. Actually, I’m amazed that as many as one in four do something with friends and family. What do they do, I wonder? They can’t all be grave tenders.

Full survey results here.

Gail’s marathon

I hope you’re keeping up with Gail Rubin over at her blog as she covers 31 funerals in 31 days. I thought at the outset that it would amount to a fascinating and valuable social document and that’s just how it’s panning out. She’s on #10 already.

Start here.

Bear necessities

Here’s a story I’ve been sitting on for far too long. The aftermath of Russia’s long, hot summer has left bears very hungry, it seems. So hungry that they have started wandering into graveyards and eating the tenants. “In Karelia one bear learned how to do it [open a coffin]. He then taught the others,” she added, suggesting: “They are pretty quick learners.”

Find the full story here.

Dark art

Finally, over in Dublin the painter known as Rasher is holding an exhibition entitled Womb to Tomb.

Womb to Tomb shows his darker side, which emerged when his mother Sheila was diagnosed with cancer. She died two years ago at the age of 62. Watching his mother’s health deteriorate caused a shift in his world view. “It made me think about life in a way I hadn’t before. I remember saying to myself, before this, I can’t be a controversial painter because I don’t think that’s who I am but in some ways I’ve been pushed into this.”

The first painting visible in the cramped studio is a huge work called Dead Man’s Bells . The colours, brilliant blues and pinks, and the swirling endless sky is pure Rasher. The skeleton curled in a foetal position underneath the soaring foxglove or Dead Man’s Bells as they are known in America, is something of a departure. “I like the idea that when we go to our tomb we go back into the earth and when we decompose we feed new life, flowers bloom and then bees feed off the pollen and repollinate,” he says. “I find that cycle of life very comforting.”

Just to the right of this is an alarmingly authentic pig’s head with a bunch of flowers in a glass box, a work called Embalm and Calm . Another painting on the wall is a picture of his mother who used to tell him that self-praise was no praise, all the while quietly supporting her son’s dreams. “I probably wouldn’t have had the courage to do it if it wasn’t for my mother’s death because I’d have been afraid what people would think. I don’t care any more, it’s about expressing how I feel.”

Since she died, Rasher has been preoccupied with the ephemeral, the quicksand of life, the “here today, gone tomorrow” of existence. In this exhibition, the beautiful and the rancid sit side by side, like a disgusting perfume presented in exquisite packaging. “I just see beauty and tragedy hand in hand in everything I look at,” he says. “I see flowers and I just think in the next couple of weeks they are going to die. Everything I do now seems to be a reflection of that.”

Full story in the Irish Times here.

 

 

No going back

That modern death has failed to find its place on the continuum of ordinary life events is something we all recognise and more or less vehemently deplore. For most a funeral is a hermetically sealed, isolated (or devastated) worst-day-of-my-life episode rarely to be recalled, and only then with a shudder. We quarantine the bereaved and shoo them into the care of weird race of cool-blooded expatriates from another planet. Truly, a funeral is a para-normal and intensely private event with more than a touch of the hugger-mugger about it.

Feelings like this are echoed by a recently widowed blogger in Wales: “I found myself standing on stage introducing the Master of Ceremonies for the event – who was none other than the funeral director who buried R.

This situation was made all the more weird by the fact that he was wearing jeans and T-shirt, rather than his sombre funeral garb, sang in a rather excellent tenor voice and told a lot of slightly risqué jokes over the course of the evening. I am not sure what I expected a funeral director to do in his spare time, but it certainly wasn’t this.

But it didn’t end there. The other team performing this evening was led by the couple who own R’s burial field. They are lovely people, and made sure I was OK, but it was all very peculiar, standing there having a post-performance glass of wine with them.”

This being how it is, it was no surprise that there was so much media excitement yesterday about a brand new funeral photography enterprise, Funeography. The sub-text was Why on EARTH would anybody want a funeral commemorated with weepy snaps?

It’s a reasonable position, things being as they are, to take. I’ve just spoken to David at In Our Hearts Images in Lincolnshire. He and his partner Esther have been going for six months now and they’ve not exactly had the world beating a path to their door. For Esther this has been an insight into the Brit way of death. In Holland, where she comes from, they do it all the time. Until yesterday they were one of only three businesses in the UK offering the service.

If you’ve created something wonderful, that you’re proud of, you want to revisit it and share it. The only way to do that is to document it.

Laurel Catts in Sydney, Australia, is extremely proud of the send-off she gave for her son David. The funeral was filmed and posted on Vimeo. I posted it on this blog. Laurel emailed me this morning:  “David was the most incredible person and we wanted the funeral to reflect his wonderful personality and generosity of spirit.  Hence, I am so pleased that you thought the funeral service was a great and very moving send-off.” It was wonderful, wasn’t it? We wouldn’t have missed it for anything. Thank you, Laurel, for sharing it. You show us the way.

WARNING! This blog is about to transmigrate and inhabit a new server. The process of reincarnation may take a couple of days of suspended animation, but reborn we shall be. I can’t guarantee that the new flesh we put on will be incorruptible; indeed, it will probably look dispiritingly like the old. See you after the resurrection!

It’s what she would have wanted

Here’s a new poem by Wendy Cope published in the current Spectator. I hope she’ll forgive the flagrant breach of copyright and see this instead as a promo. Its sentiments are very contemporary.

My Funeral

I hope I can trust you, friends, not to use our relationship

As an excuse for an unsolicited ego-trip.

I have seen enough of them at funerals and they make me cross.

At this one, though deceased, I aim to be the boss.

If you are asked to talk about me for five minutes, please do not go on for eight

There is a strict timetable at the crematorium and nobody wants to be late

If invited to read a poem, just read the bloody poem. If requested

To sing a song, just sing it, as suggested,

And don’t say anything. Though I will not be there,

Glancing pointedly at my watch and fixing the speaker with a malevolent stare,

Remember that this was how I always reacted

When I felt that anybody’s speech, sermon or poetry reading was becoming too protracted.

Yes, I was intolerant, and not always polite

And if there aren’t many people at my funeral, it will serve me right.

Thirty funerals in thirty days

Over in Albuquerque, Gail Rubin has set herself the task of attending and writing up thirty funerals in thirty days. She got under way on Saturday. It’s going to make for a very interesting social document.

At this stage, of course, many of those whose funerals she will describe are as yet still alive…

Letting go

Rhoda Partridge took up painting when she was 70. Now 90 she’s still hard at it. Her spirited life has also embraced scuba diving, gliding and ceramics.

In an interview in this month’s Oldie magazine she is asked:

Do you find that after 70 years you live in the shadow of death?

She replies:

Oh pouf! Pocket full of crap! I think it could even be a good experience. We are beginning to be better about death, allowing people to die quietly, not to stick needles and drips in them. It’s important that the person who’s dying is allowed to die, that you hold their hand, tell them you love them and let them go. One of my sons has promised to look after me through my death. I would like all my children to come and talk to me one at a time. But I don’t want them all moaning around me.

Shovel-and-shoulder work

The words that follow are by Thomas Lynch, a hero to so many of us in the UK. (In the US there are those who reckon him paternalistic, but we don’t need to go into that. It’s complicated.)

Funerals are about the living and the dead — the talk and the traffic between them … in the face of mortality we need to stand and look, watch and wonder, listen and remember … This is what we do funerals for — not only to dispose of our dead, but to bear witness to their lives and times among us, to affirm the difference their living and dying makes among kin and community, and to provide a vehicle for the healthy expression of grief and faith, hope and wonder. The value of a funeral proceeds neither from how much we spend nor from how little. A death in the family is an existential event, not only or entirely a medical, emotional, religious or retail one.

“An act of sacred community theater,” Thomas Long calls the funeral — this “transporting” of the dead from this life to the next. “We move them to a further shore. Everyone has a part in this drama.” Long — theologian, writer, thinker and minister — speaks about the need for “a sacred text, sacred community and sacred space,” to process the deaths of “sacred persons.” The dead get to the grave or fire or tomb while the living get to the edge of a life they must learn to live without those loved ones. The transport is ritual, ceremonial, an amalgam of metaphor and reality, image and imagination, process and procession, text and scene set, script and silence, witness and participation — theater, “sacred theater,” indeed.

“Once you put a dead body in the room, you can talk about anything,” Alan Ball [creator of the HBO show Six Feet Under] wrote to me once in a note.

Source

Ghoul, calm and collected

For a death-averse people who shut their eyes tight to mortality, the Halloween look is not a good look. But children thrill to it; caring parents wickedly, gigglingly co-conspire.  Much of the imagery is so graphically horrifying I’d have thought it would reduce children (and some adults) to lasting gibbering mental breakdown. But it doesn’t. May we infer that most people do actually have a far more sophisticated and fully assimilated comprehension of death than  they are customarily credited with? And that Halloween teaches children more about death than we think?

If so, you will enjoy this delicious recipe for sugar skulls from the excellent Skull-A-Day.

Really getting real

When Americans decide to do things differently, it seems to me, they make a clean break. Brits, on the other hand, carry over a lot of familiar stuff from the past. I mean, how often does a natural burial ground witness a scene like this?

And which has the courage of its environmental convictions and buries at three feet?

Read the story in the Washington Post.

(Beautiful shrouds available from the UK here.)