Death, dying &
end of life
I’m ready for the journey, but no one wants to say goodbye…
Copyright: Irene van Schagen, August 1979.
Nor dread nor hope attend
A dying animal;
A man awaits his end
Dreading and hoping all;
Many times he died
Many times rose again.
A great man in his pride,
Confronting murderous men,
Casts Derision upon
Supersession of breath;
He knows death to the bone,
Man has created death.
— William Butler Yeats, 1933
Death; a much discussed and often avoided subject;
Death; the inescapable fate of all;
Death; a scary and almost forbidden word;
Death; a necessary part of life;
Death; an elusive mystery, an elusive fact.
Death; ......... ???????????? !!!!!!!!!!!! ...............
Every life involves a confrontation with death. To begin with, through other people’s deaths and ultimately through our own. Incomprehensible and unthinkable: "the death of yourself." Is there life after death? Is there life without death? Do I get a golden chair in heaven, or is everything immaterial? Do I survive death? Does something of me survive or will my spirit disintegrate into its original building blocks? Nobody can answer these questions definitively, and no one ever will. Some people think they have an answer, but that answer will never satisfy everyone.
As long as we are so frightened of and struggling with death, we cling to life without seeing death as a part of it. Life is something we know and can do something with. We try to build a life without grief, pain, discomfort and uncertainties.
We have tranquillizers, relaxation techniques, etc. We have painkillers to deal with pain, we have all sorts of technical tricks that fulfil no other purpose than to comfort, and cushion us against uncertainties. We have high-brow theories, sciences and social services that serve us from cradle to grave. But the thing that causes us the greatest insecurity remains elusive, so we hide "death" away and want nothing to do with it. Those who are still “fully alive” distance themselves from those who "walk in the shadow of death". And so it is possible that in a densely populated country many people die in the greatest loneliness.
Death is inseparable from dying. Sometimes someone dies in a few minutes, or seconds. If someone is killed very suddenly, for example by accident, death strikes like lightning and leaves confusion and bewilderment: yesterday everything was still normal, and now everything is broken?! Often, dying is a stealthy process lasting months or years during which the person dying slowly but surely has to say goodbye to everything he or she has known and loved in their life.
Death takes us all. It creeps up or strikes like a thunderbolt; the moment in which our own death, which we have not yet been able to imagine, becomes a fact. But how do we deal with it before that time? How do we deal with people who are dying? Do we actually deal with it? That is what I want to talk about! Not about the question of how we should deal with someone who does not have long to live, because that is a personal matter, but about whether we actually deal with death and dying.
Death is so banished from life that people close to dying are excluded from social life. The confrontation with death strikes fear in our hearts. This threatens our peace and security, and so dying people are 'tucked away' in a nursing home or hospital. It may be hard, but it is a fact. This is how we end up in a vicious circle.
The person who is due to pass away parts ways with the outside world. The walk to the hospital is often the first step in this parting. In hospital the circle closes more and more, until at last only one person is left — the one that matters; the person who is going to die. He or she finds themselves increasingly isolated. Not only because of the process unfolding in their body, but also as a consequence of the way the outside world responds.
The dying persons resignation in the face of death is often matched by others unwillingness to accept it. The approaching death is denied, life has to be saved. How does it feel to accept your own death, while those around you insist you take medicines because they will ‘help’ you. How does it feel when you want to say goodbye and are told that it is not necessary because you are not yet dying? How will it feel if you can not even communicate that? How will it feel?
Yet there is a moment that the medical world must give in to fate; get rid of the matter. The treatment is limited to painkillers, artificial nutrition etc. etc .. But the circle around the dying person closes even tighter: a separate room is needed, because a dying person is a big burden to others. If the person about to die loses his or her ability to speak, their isolation is especially severe. In addition, we often overlook the fact that those people can still hear, that they are still people and that they are still alive. Is it not often the case that the dying are treated like breathing dead people?
How does it feel when someone enters your room, checks your infusion and then disappears as quickly as possible? How does it feel when two people are standing by your side, talking about your body and condition as if talking about someone else, not saying a word to you? How will it feel if you are hastily moved to another room, even as you feel the last bits of life slipping away?
I do not know; nobody knows. The moment you do know it is too late to share it with others. But do we have to wait for that moment to be able to say: "If I had known this before, I would have done things differently." Will the isolation of someone who is about to die not be compounded by the misunderstanding of those around them?
I now want to describe a part of my first confrontation with death because I think casts some light on the above, and I hope it might help others:
White uniforms surround the bed, all of them busy: "The drip is not running well", "Its coming to an end", "The pulse is getting weaker", "Someone has to stay here." An Increasing calm, more and more of those present find something else to do. Some try to show convincingly that this is a routine matter; for others it is a routine matter. Note: IT is a routine matter, and IT is the fact that someone is going to die.
Slowly everyone slips out and three people remain.
Nurse: "Do you want to stay here?"
I nod yes.
Nurse: "Is this your first time?"
I nod again.
Nurse: "It’s not necessary; I'm used to it and the first time is always scary."
Me: "I would like to stay with Mrs. X."
Nurse: "Well, you know what to do when the time comes?"
The nurse vanished. For her the lady had already died even before she had exhaled her last breath. I stayed behind trembling; afraid of what was going on, and sure that I did not want to leave, ashamed of what had just been said. I went to Mrs. X and took her hand. I talked to her a bit, and despite the fact that she could not talk we had contact. We both knew what was going to happen; we felt it approaching. Time and again when Mrs. X stopped breathing I was startled, as well as when she started again. Her breathing became more and more irregular and then a sigh, a few swallows, silence.
Suddenly I realized that the sigh I heard was her last. I am still alive, she no longer. We were there together and suddenly I am alone, she is no longer. Trembling I stood there, surprised, experiencing. The infinite calm that took hold in a few seconds. The necessity of life. Absolute silence. No breathing anymore. No more pulse. A body without a Soul. A breeze took her last thoughts, leaves rustled. The body stayed behind, with me; the body that was no longer hers.
I waited for a while and then called. From that moment on there was no room for any mystery. The same bustle as an hour ago returned. Someone mentions the fact that no one noted the time that Mrs. X died. But silence about the way in which she died.
Is this dealing with death? Is this dealing with a fellow human being in their last minutes? Or is it dodging and distancing, and do we not then disrupt many things that we can never talk about thereafter?
Questions, many unanswered questions. Would it not be a step in the right direction if everyone was more familiar with death rather than trying to avoid it this way?
And would acceptance of death as part of life not also bring more peace during life? I think so, because we avoid the subject of death while it is still far off, as well as when it is imminent, when we can no longer get around it, and the fear comes: because we are approaching something completely unknown, which we have never thought about, and because we realise that it is now our turn to be tucked away.
A large part of this fear would, in my opinion, disappear if we were more familiar with death. Because it can also be beautiful. The peace when it is finished; the mystery. After all, we can not avoid death, but is it not possible to overcome the fear of death?