We’re very willing to talk about and even interact with death on a fictional and fantasy level. Many of our current novels (e.g., The Fault is in our Stars, House for Sale, Bones Never Lie), TV shows (e.g., Game of Thrones, Grey’s Anatomy, Vampire Diaries), and video games deal with death, often very graphically. However, in reality, our cultures studiously avoid the subject. In the West, it’s all about being upbeat and the cult of the “survivor,” as Barbara Ehrenreich describes in her book Bright-sided: How Positive Thinking is Undermining America. You may expect a greater acceptance of death in the East—perhaps due to a more Zen-like perspective or belief in reincarnation—but here, again, philosophy is one thing, reality is another. Often people in their 70s who wish to speak about their impending death are hushed up with platitudes: “Oh, don’t think like that, you’re still young, you have many years left!” in other words “don’t worry, be happy.” But perhaps meaning, “Don’t bring me down!”
And if we the public are reticent to broach the subject, strangely so is the media. While the news itself is laced with the deaths of the famous or those who died in dramatic events (in fact such headlines are often amplified to draw eyes and ears), there’s little reportage or commentary on the field of regular dying.The New York Times “Lives” column says to prospective contributors of articles, “Do not make it about illness or death …” CS Monitor’s “Home Forum” column says it is looking for “upbeat, personal essays;” “we don’t deal with topics of death, aging and disease.”
Our public psyche quietly but consciously excludes death.
Much as we may try to ignore it though, the world’s population is aging. The number of people over 60 years of age is expected to double by 2050 to over two billion, with some 392 million over the age of 80. While the population in many developed countries is already aged, the aging trend in developing countries is just beginning. Furthermore, death does not strike only the elderly; in 2013, 6.3 million children under the age of five died.
Given such statistics and the simple truth that none of us will make it out of here alive, it behooves us to talk about death. I remember reading a short story long ago where Death comes as a handsome young man to coax a frightened old woman slowly out of her house and ultimately joyfully to her death. Likewise, we need a paradigm shift on Death. We need to see Death not as a frightening stranger but perhaps as a neighbor. We need to make death—if not a welcome then at least an expected—part of life.
The Institute of Medicine’s recent report Dying In America says “efforts are needed to normalize conversations about death and dying.” And indeed some people have already begun the conversation. The appropriately named Conversation Project, started in 2010, is a collaboration of doctors, social workers, clergy, health administration experts, and media to understand and facilitate end-of-life care wishes. Franchises of “death cafes” are cropping up all over the UK and America where people—often strangers—gather for an evening to “drink tea, eat cake, and discuss death;” more than a thousand such events have already happened in the past three years. While Dying in America and the Conversation Project encourage death conversations from a logistical perspective and focus on planning for end-of-life care, Death Cafes are open, informal, and diffused forums to discuss the process, realize we’re all on the same road, and hopefully come to a greater level of acceptance of the inevitable.
Just as we prepare for birth, we need to prepare to some extent for dying. To further the conversation, we could have self-help books (e.g., What to Expect When You’re Dying), courses (Pre-Death classes anyone?), and private counselors. In schools, like we have sex education, death education may not be out of place; like Morrie said, “Once you learn how to die, you learn how to live” (Tuesdays with Morrie by Mitch Albom). And death preparation could turn out to be a new and profitable service industry, while at the same time reduce healthcare costs.
Some may argue why waste time, effort, and money discussing or preparing for death; it’ll happen anyway. However, Peter Saul, an intensive care specialist, says we need to “try to reclaim this process … because how we die is important.” Many people—particularly in the West—die in ICUs with their families trying every intervention to keep them alive.
By talking about death before the fact, we may not only be more accepting of the event but get to have a say in how, where, and perhaps even when we die. Interestingly, as Ken Murray explains in his essay “Why Doctors Die Differently,” doctors themselves seem to be setting an example by opting for minimal care, opting out of life-extending methods, and making a graceful exit at home. We have brought back the concept of natural home births; maybe it’s now time once again for natural home deaths.
In a recent McKinsey Quarterly article, authors Eric Beinhocker and Nick Hanauer suggest that “the real measure of a society’s prosperity is the availability of solutions to human problems.” Impending death is certainly a very human problem and one we all face. And while it has no solutions, there are surely ways to make the process less frightening and more comfortable. Managing death better could be a measure of our society’s prosperity and progress.
We have taken Dylan Thomas’ poem “Do Not Go Gentle Into That Good Night” to heart and are still raging against the dying of the light. Perhaps it’s time to consider another poet’s perspective. Rabindranath Tagore said, “Death is not extinguishing the light; it is only putting out the lamp because the dawn has come.”
Ranjani Iyer Mohanty is a writer, editor, and commentator based in New Delhi. Her articles have appeared in several publications, including the International Herald Tribune, the New York Times, the WSJ, the Financial Times, and the Atlantic.