When do we die?
The legal and medical answer is when we experience loss of all brain function, or when cardiopulmonary activity stops. The biological answer, however, is when we lose our ability for integrated function— enough parts have ceased to function so that we cannot be put back together. The moment we call “death” is quite arbitrary.
I am now in the second half of the academic quarter, teaching the course Death & Dying. Students have learned about the causes of death, diagnosing death, the biological process of bodily decay and autopsy. We have discussed advance directives, palliative care, hospice, funeral practices, grief and cross-cultural perspectives on these subjects. The most interesting idea that I have learned through leading this course is that “death” and “dying” are distinct things.
Yes, “death” is about biology. But “dying” is about the social process of preparing to leave this world and enter another (real or imagined). In
The Social History of Dying, sociologist Allan Kellehear presents the relationship between death and dying throughout history. He begins in the Stone Age, a time when death was common at all ages. Most rituals, taking place after a death, were intended to ensure that the soul traveled to the afterlife, a journey requiring assistance from the living.
Currently, however, dying starts before death— we create wills and living trusts, for example. We move the old or sick to hospitals and long-term care facilities. Kellehear quotes those in these facilities, and though they may be in fair health– they say they feel as if they were supposed to have begun the journey toward death. Death is viewed as something to get through, a stigma about which to be embarrassed. We set it aside where people do not have to view it.
The moment we call “death” is quite arbitrary.
I read the recently published Women in Late Life: Critical Perspectives on Gender and Aging by Martha Holstein. The author argues that traditional social roles of older females are ageist and sexist— viewed either as (1) young women trapped in old bodies or (2) frail and needing protection and coddling. According to Holstein, our society has made efforts to demonize the notion of “old.”
A new program on Showtime, Happyish, follows a 44-year-old who suddenly finds himself outdated when 20-something hipsters shake things up at his advertising agency. The hipsters want to retire long-held icons and choose clients by work they feel like doing, rather than work for which companies will pay. In Happyish, newer is better, younger is more innovative, and anyone older than 40 needs to get out of the way.
As a long-time improviser, I was recently surprised by a show in which request suggestions were for things from ancient history— the 1990s. Those on stage were young children during that decade. Though I was in graduate school and likely missed a great deal of pop culture, the bands, shows and nostalgic references were like a foreign language. Have I become “old”? I first felt that way at 35, when I presented students the classic deontology thought exercise, “The KGB is knocking on your door…” When I asked if there were any questions, a student asked, “Yeah, what’s the KGB?”
Even in the few years since Kellehear published his book, “dying” has come to resemble a period like our own late 30s- when cultural references become outdated, when advertisers no longer crave our business, when we realize that hip fashions now look terrible on us.
In a society so focused on youth, aging comes quickly– even when life is not yet half-done. What are we to do when we are no longer the apple of marketers’ eyes? We start dying. We notice that our bodies do not allow us to be active in the same ways. We eat less, move more and still gain weight. We hold on tightly to our jobs because some younger person is moving up the ranks fast. We complete advance directives, write a will, and spend Friday nights at home exhausted, rather than at the latest fashionable restaurant.
Watching my parents in their golden years, I see them as healthy- but they have decided certain things are no longer for them. Each trip overseas is the “last one.” They look for a smaller place to live and beg their children to unload them of their possessions. They purchase pre-paid funeral plans and live in a “forever condo.” Even when there is seemingly nothing wrong, they travel from doctor to doctor every week– just to be sure.
In an evolutionary sense, “dying” has moved from what the community once did for us after biological death, to what we individually spend half our lives doing– often forced by a society that values only the young.
I teach my students that we learn about death so that we know how to live. This week, they wrote their own obituaries. In their narratives, they could choose any age and reason for death. This exercise, they said, made them realize how they want to spend their time.
The creeping of dying to an earlier and earlier age is not productive, it simply ignores those of us still active, productive and wise. Studying death and dying helps us to embrace life. But living in a culture of dying means that those in middle age and older are viewed as irrelevant.
As Holstein suggests, the project we face is how to re-envision age: “The task is nothing short of reconstructing old age.” Being old means living a different kind of “good life,” not sitting around waiting for death.