Two books I highly recommend from my recent forays: The Spirit Catches You and You Fall Down by Anne Fadiman (which all of my friends are probably tired of hearing me evangelize at this point) and How We Die by Sherwin Nuland. They are both non-fiction books about healthcare, quality of life, culture clash, and (unsurprisingly) death.
Death has been on my mind recently, for a number of reasons. 1) People close to my loved ones have died - some suddenly, some expectedly, but all tragically. Death, as Nuland teaches us, is inescapably tragic. The "good death" is not very much a realistic expectation. Death is messy, undignified, hard to watch, full of emotions, for those who live on. Regardless of the circumstances, despite the fact we know- the one thing we know with absolute certainty - that death will come to each of us, without exception, irrespective of our outlook on the afterlife - despite all of these things, it is still a change, an ending - and that makes it a hard pill to swallow.
Per one of my dear friend's Facebook: "But that cryogenics man said 'Wait:/It's a funny, fickle thing is fate." How we get to the end of our life is a funny, fickle thing.
2) [There is indeed a second reason, I hadn't forgotten about it in my rambles.] It's getting on towards Halloween [1] and the season is changing in my corner of the world. The leave are falling, turning yellow and orange and brown. The days are getting shorter and colder - the world is sinking in on itself, much as a dying person will. So ye, autumn's melancholy is a good time to contemplate mortality.
But back too the books. They are written from very different viewpoints: Spirit by an ethnographically-minded journalist and How We Die by a long-practicing cardiac surgeon. They also have seeming very different goals, or at least endpoints: Spirit ends with the famaily caring for and preserving their vegetative, epileptic daughter's life, for an improbable 26 years, long after the Western doctors had deemed the case futile and washed their hands of it. How We Die discusses at length the need to let people die when it is there time to go - that it is a fallacy for Western medical discourse to think of doctors as as conquerors: because there will come a time that a disease cannot be conquered, or a vital organ damaged cannot be repaired.
Both books scrutinize current (or current as of the mid-1990s) Western medical practice, and draw attention to the fact that our doctors are not saviors or conquerors of death: it is unfair for the layman and the doctors themselves to expect that. Sometimes, as in the case of Lia Lee, the saving grace can be found in the home and the care of family. Fadiman's book leaves us to wonder that had there been more mutual understanding between the doctors and Lia's parents if she might not have lived the last 26 years of her life in a vegetative state - there was misunderstanding and lack of cooperation on both sides of the medical divide, with the western doctors on one side and the animistic parents on the other, and Fadiman is even-handed and objective in telling with compassion both sides of the story. But what we do not wonder about is that Lia's parents loved her, and that while the doctors tried to do what they thought best, it was not the doctors who kept her alive for more than two decades. It was the love and care of her family.
Her eventual death, though, was nevertheless inevitable. Like all of us, despite the lovingcare of our family and friends, Lia died. And this is where How We Die picks up the thread. Nuland writes about America's expectation of death as a dignified thing: we long for "the good death." But that good death, he writes, is not the reality of most people. People die after greuling sickness and sometimes even more harrowing treatments. People die with their minds barely lucid from medicines. People die with their arms pocked with IVs and their throats crammed with feeding tubes and with doctors rushing to and fro. Above all, Nuland reminds us, people die. No matter how much we wish to prevent it, no matter how many treatments doctors dole out, no matter how many resuscitations succeed, eventually everybody dies.
Nuland discusses the various types of death in clinical, though not dry, language - the theory being that the more you know about something, the less scary. Some may find this sort of description off-putting, but I felt enlightened and comforted by this doctor's calm but still empathetic description of dying. Per the Time quote on the cover of my copy: "Eloquent and uncommonly moving...Nuland writes with unsentimental passion." Cardiac arrest, cancer cells taking over, oxygen-deprived brains - the paths of life vary widely, he writes, but death comes by relatively few roads.
How We Die teaches that the good death is really the good life. Lia's death was dignified not because she made any grand pronouncements from her deathbed (indeed, she could not, being comatose for many years), not because she made all sorts of pre-death arrangements to ease her family's burden, but because her life was full of love. Lia's parents loved her, and her family cared for her, from the time she fell into a seizure-induced coma to the day she died. Their love lent her death dignity.
Spirit is essentially about love that prolongs life, and How about love that allows death. But the overarching theme of them both, perhaps obviously, is love. Love of family, dignity of life and choice, making a good life out of the time and circumstance that one has been given or carved out.
xo,
Devo
[1] I started writing this post before Halloween, so just roll with it.
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