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The Good Death: 10 Things I Want and Don’t Want When I Die

One.  I don’t want to prolong my life at the expense of quality.

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.”

Two.  I want to die at home.

I want to die at my home, surrounded by my family.

Three.  And if I die at home, I want hospice.

Atul Gawande writes in his New Yorker piece,

(Doctors) sacrifice the quality of your existence now—by performing surgery, providing chemotherapy, putting you in intensive care—for the chance of gaining time later. Hospice deploys nurses, doctors, and social workers to help people with a fatal illness have the fullest possible lives right now. That means focussing on objectives like freedom from pain and discomfort, or maintaining mental awareness for as long as possible, or getting out with family once in a while. Hospice and palliative-care specialists aren’t much concerned about whether that makes people’s lives longer or shorter.

Four  I don’t want to die in a nursing home.

I don’t like nursing homes. Let me qualify that statement: I understand that nursing homes are at times necessary and I understand that nursing homes provide invaluable care for those who need it; farther, I know that the nurses and their staff provide continuously care often at their own emotional expense.

But, I don’t likely the crowded loneliness inherent in these buildings, I don’t like the way nursing homes suck away money and I don’t like how some nursing homes are used to shelve away the weakest people in society.

Five.  If the chance presents itself, I’d like to die heroically.

Sacrificing my life while saving drowning orphans from a sinking boat.

Dying while defending the rights of unicorns.

Pulling a James and Lily Potter: Giving my life to save my son from Lord Voldemort.

Six.  I want the option of Death with Dignity.

If I find myself in a situation where I have a terminal illness that will cause great family distress or personal pain, I want to have this option available to me.

Seven.  I wouldn’t mind dying of cancer.

I know that’s a controversial statement, so let me qualify it: When cancer strikes the young and middle-aged, it’s always horrible per se.  But, when it strikes the aged — in terms of comparison and contrast — it’s not always the absolute worst way to reach the inevitable.  Sometimes it might be the best possible option.  It allows you to say your goodbyes, “get your house in order” and provides a set period of “quality time” to spend with your family and friends.  When I’m older, it’s a much better option than a sudden heart attack, dementia or a slow and methodical wasting away.

Eight.  I want total honesty from my doctor.

I have some skepticism when it comes to the medical community, especially when it comes to end of life care.  While I believe that most doctors are honest, there are ulterior motives when it comes to cancer treatment and the like.  While most doctors explicitly lay out the options for their patients, some will lay out the options that pad their pockets and suck the system.  I want to be socially responsible when I die.  I don’t want to suck hundreds of thousands of dollars out of the system so I can live a couple more months.   I want total honesty from my doctor.

Nine.  I want the least pain possible.

I’m not going to be prideful.  If I have the option to manage my pain, I’m going to take it.

Ten.  I want my family to know my advanced directives.

If I don’t die saving them from Voldemort, I want my family to know my advanced directives so that — if a situation ever presents itself — they can feel confident that they know what I wanted.  Although they might not agree with my advanced directives, or want them, at least they can know they honored my last wishes and so honored me in my death.

 

 

 

The Pain of Nursing Home Placement

Maybe it’s shame

Maybe it’s fear

Maybe it’s acknowledgement

That the end is near.

*****

Maybe it’s the halls

The impersonal room

That looks and feels

Like a living tomb.

*****

Maybe it’s the money

$500 a day

Eating retirement

And inheritance away.

*****

Maybe it’s the crowd

Of lonely souls

Who have death

As their only goal.

*****

Maybe it’s hurt

And maybe it’s the pain

That she doesn’t even

Remember your name.

*****

Maybe it’s the smell

Of those dying

That permeates the rooms

Of those left lying

*****

In beds so cold

While TVs fill

The hours and minutes

They’re trying to kill.

*****

Maybe it’s the inadequacy

You feel inside

That she cared for you

And now you can’t provide

*****

She birthed you

And nursed you

But you can’t reciprocate

And see this through.

*****

You tell yourself

“The staff is great”

And it’s true

There’s no debate.

*****

“This is for the best”

You have to say

Again it’s true

But it feels so grey.

*****

It’s hard and painful

And pricks the guilt syndrome

When you put a loved one

In a nursing home.

Six Good Things About Embalming and Restoration

Morticians have been taught that embalming is the foundation of the funeral business.  That without embalming … we’d be buried.  During the modernization of America and at the beginning of the “American way of death”, embalming was the foundation.  But we no longer exist in a modern paradigm, we exist in plurality and fragmentation with “American ways (!) of death”.

I don’t think the funeral profession’s survival depends on embalming nor do I think embalming is the pinnacle of a good funeral. England, Canada and Australia are examples of industries that exist without the centrality of embalming.  And it would be very neocolonialist of us to assume that our way of embalming represents the best and only way for healthy funeralization.

Despite this preface, I do believe embalming and restoration is valuable.  Here’s some short history of the practice as well as some possible benefits of embalming and restoration that I’ve observed.

One. Children.  

The fact that my wife and I are infertile has — for some reason — made me extra sensitive to the sight of dead children … or at least that’s the reason I give for the sickness I feel when seeing a child’s corpse.

He was three years old.  An all too young victim of cancer.  I returned from the Children’s Hospital with his withered corpse and found my grandfather — dressed in his embalming gear — awaiting me in the morgue.  That day we had a couple death calls and I had other work to do, so I left my grandfather alone to embalm this young body that had been emaciated by the cancer and the chemo.  In fact, I didn’t even offer to assist my grandfather because I knew the embalming experience would put me in a horrible mood for the rest of the week.

Two hours later I stuck my head in the morgue to peak at my grandfather’s results.  And what I saw was nothing like the boy I had brought back from the hospital.  His skin, which had been a greenish tone, was now a healthy looking flesh tone.  All the indentations on his face from the breathing machines, all the tube and machine imprints that had marked his body had been worked out by my grandfather’s expert work.  Even the boy’s weight looked more natural, as the embalming filled out the weight the cancer had taken.

Two.  Accidents, Cancer Emaciation and Tragedies.

For the most part, we’re able to restore various degrees of accidents, cancer emaciation and tragedies.  It helps.  It helps to see your loved one in a restored state.

Three.  It helps make the symbol of death look pretty.

Dr. Erich Lindemann (grief management pioneer) says that a defining characteristic of persons dealing with complicated bereavement is that they never saw the dead body of their loved one.  Although his observation isn’t based on any clinical studies, I think most funeral directors have recognized the weight of Dr. Lindemann’s statement.

An embalmed body helps the symbol look good.  There’s nothing wrong with that.  It’s a good thing.  In fact, at times it’s a beautiful thing.

Certainly, embalming isn’t necessary AT ALL to see the dead body.  But, it can help.

Four. War.

The emphasis on embalming the corpse for aesthetic purposes finds its popular beginning in the American Civil War.  As a humane token to the grieving families of soldiers who were killed in action, an attempt was made by the armies to return the bodies home for proper burial. To avoid the cruelty of shipping home (often by train) a decomposing body, “field embalmers”, comprised of civilian physicians and some undertakers, began offering families the option of having their sons embalmed. Those that had the “bodies of their relatives returned from the war theaters … could give testimony to the effectiveness and desirability of the chemical embalming by injection” (Habenstein and Lamers 1955: 336).

While refrigeration, etc. can keep persons KIA from decomposing, embalming and restoration can allow the family to see their son or daughter in a restored condition one last time.  In some circumstances, this makes embalming invaluable.

Five.  When the Body Has to Wait …

On the other side of the coin, maybe there’s a person deployed in the foreign field.  Or maybe one of the deceased’s sons lives in China.  And the quickest they can get home is in three weeks … and they feel they MUST see the deceased.  It’s possible to keep the deceased in refrigeration for three weeks unembalmed, but with a three weeks wait, embalming would be the much preferable option in this case.

Six.  Sometimes DIY Isn’t the Best

There’s a lot of “death hacks” and DIY options that all but eliminate the need for a funeral director.  But, this doesn’t mean funeral directors are outdated and unneeded.  Like taxes, wedding planning, buying a house or even giving birth, there’s a range of symbiotic DIY options and professional involvement.  While it’s usually possible to have a DIY funeral, funeral directors are beneficial during the death process.

And while it’s possible for a family to prepare a body for a home funeral, it’s not something everyone wants or can do.  We’re here, if you want us.  Some of us are VERY good at embalming and restoration and can help your loved look more like the person you remembered in life.

10 Reasons Why Embalming is Dying

1730

Michael Hall in HBO’s “Six Feet Under”

 

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.

If embalming is the foundation of our practice, it’s a very shaky foundation.  Here are ten reasons funeral directors 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 a 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.  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.

 

Death Positive

The metanarrative that we’ve been fed

Is that it’s always bad when someone’s dead

That death is public enemy number one

And that there’s nothing good when life is done.

*****

It’s true that death hurts me and you

And it’s true that death can be tragic too

It’s true that grief will never leave

And it’s never good to be bereaved.

*****

But the idea that death is all bad is a lie

It’s hard to see but let me help you try;

When your eyes adjust at night you can find

That this is the time for the stars to shine.

*****

We’re used to the day so it’s hard to see

But death’ darkness has its own kind of beauty

It’s not glamorous and it’s certainly not glorious

But caring for our dead is never ever worthless.

*****

For in the dead we see our future and our past

We see very clearly that some things don’t last

It helps us remember what’s valuable and real

It helps us remember that love is our ideal.

*****

Death is the friendly reminder that life is short

And it reminds us to only pursue things of import

And when our eyes see our own setting sun

If we lived with death in mind, we’ll hear “well done”

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