Friday, December 21, 2018

ACCEPTING MORTALITY - ON DEATH AND DYING



“The darkness of death is like an evening twilight. It makes all objects more lovely to the dying.”

            These beautifully perceptive words were recorded by the 18th century German poet and author, Johan Paul Richter (Jean Paul) in his masterpiece The Invisible Lodge, which detailed his own personal spiritual crisis. It describes an experience that most people who have worked with the dying will readily confirm; that at the final moment of life, there is a peace of acceptance as the spirit moves on.      Death is the single, most certain event in the life of every single living creature on this earth. While some of us will die in ways beyond our control, most of us will be aware of our final moments, and contrary to the prevailing beliefs, only a very few unfortunate ones will not be able to surrender control, and depart this life in a state of true submission.

         In my own personal professional life I have witnessed the peace of mind and calm that comes from the acceptance of the inevitable, and the subsequent joy and celebration of the life of the departed which followed. Above all, I appreciated the good memories that will remain with me long after, and cherished the good feelings they imparted. And even more gratifying have been those few instances along the way when I also witnessed the overnight metamorphosis that took place where an angry, aggressive, antagonistic patient was abruptly transformed into a peaceful, caring and accepting person, sometimes after he reported having experienced a “spiritual” visit. The feelings of joy and relief that resulted, and radiated throughout the family after such an occurrence was truly indescribable. But I have also shared the deep excruciating pain and torment of a few unfortunate ones who could not, and would not accept the truth, and who fought to the very end, cursing their lot, their luck, their life and their God. That pain lingers on forever, and I and the family, are robbed of all the good memories of a life that could have been, but were buried by the unrequited resentments.

         Our general attitude to the concept of death and dying has never been honest or realistic. Although we all readily accept and recognize that death is inevitable, yet we all seem to behave that this is not really the case, or at least hope in some way, that it does not apply to us. Most of us are so concerned in spending our lives in the pursuit of living and in satisfying our needs and our desires, that we seem totally oblivious of the fact that it will someday come to an end. In fact, we actually spend a great deal of our time actively trying to avoid thinking about dying, and when we do so, it will invariably be about someone else. We steadfastly resist thinking or projecting about our own mortality, almost as if at a subconscious level at least, we are hoping for immortality. We all seem to have a deep-seated fear of dying and that colors our thinking and goes a long way to preventing us from facing the truth. We show this in our daily living by our unmistakable tendency to banish any thought or reference to dying and hope by so  doing, to eliminate the possibility of it affecting us. We are of course, sadly mistaken, for whether or not we believe in the inevitability of death, each and every one of us will face that moment whenever the appointed time arrives. This is precisely what the great Roman-Syrian orator Publilius Syrus was alluding to when he advised:

“The fear of death is worse than death itself.”

         Unfortunately, the attitudes to death and dying by most of the modern societies have undergone very drastic changes over the last few centuries of civilization. In the past, and to some extent, still existing in many of the Eastern cultures, the dying individual will be kept at home, surrounded by family and friends tending to their comfort and listening to everything said. Children were brought in and encouraged to be actively involved. Death was therefore familiar to all and was calmly accepted as a common destiny of all of mankind. The experience that results for all in attendance, although intense and conclusive, achieved acceptance for them, and provided them with opportunities for personal reflection on their own mortality.

But in the last two centuries, the rapid economic and scientific changes brought about by the industrial revolution forced a rethinking on many of the familiar ways of life, including the attitudes toward death and dying. Instead of death being seen as a common destiny of all the species, the scientific advances have encouraged a desire to preserve life at all cost and by all means. At the same time, there has been a shift in society’s attitude to death from one of sharing the experience with the individual, to one of protecting all those around from experiencing the disturbing and painful exposure to dying and death. The result is that, instead of dying at home, fully surrounded by familiar faces, death occurred in sterile impersonal places like hospitals or nursing homes; usually alone and unsupported. This has resulted in a gradual loss of the dignity for death and an increasing alienation of people from the idea of the acceptance of mortality.

            Sigmund Freud, the renowned German psychiatrist who is considered to be the father of modern psychoanalysis, in 1918 quoted in a paper on death, the ancient popular Latin proverb, “Si vis vitam, para mortem,” which loosely translates to:

“If you want to experience life, prepare for death.”

He was making the point that to truly experience and respect life, one cannot ignore the reality of death being an integral part of life. But more and more, this original concept of the dignity in death is being assaulted, and instead, an attitude of resentment to dying has taken hold. The feeling that death should never be allowed to take place, if at all possible, is rapidly gaining credence among scientists and other leaders. This serves only to extend the suffering and alienate and confuse others with wrong expectations. We are at risk of losing that noble dignity that once dominated our expectations; that dying was a natural extension of living and that life continues beyond. This attitude is clearly reflected by the very sensitive observation of Albert Einstein, the outstanding theoretical physicist and a genuine philosopher in his own right, when he noted:

“Our death is not an end if we can live in our children and the younger generation. For they are us; our bodies are only wilted leaves on the tree of life.”

In 1969, Dr. Elizabeth Kubler-Ross, a Swiss-American psychiatrist and pioneer in death and dying studies, published a book on this subject  in which she detailed the five stages of grief an individual will generally go through during the period of dying. It has become a gold standard in the understanding of death and dying and is being used all over the world. The five stages are denial, anger, bargaining, anticipatory grief/depression and withdrawal, then leading ultimately to acceptance and coming to terms with death as a natural part of the life cycle. Although the order and the duration of each stage may be different, there appears to be a consistency in their occurring. If these stages are allowed to take place with the presence and support of friends and family, then the transition from life to death will be made easier and the subsequent remorse will be much lighter. But, if, as often happens in the current settings of hospital or nursing home isolation, they take effect without support, the experience is invariably much less acceptable to all.

In 2009, an Australian nurse, Bronnie Ware, published a brief internet essay based on her 10 years of experience as a Hospice nurse entitled “The Top Regrets of the Dying,” in which she recorded the five most common regrets expressed by her patients as they approached death. This was so well received that two years later she expanded her presentation into publishing a book under the same title. In a simple, very personal way, she identified the most common regrets expressed by her patients and their need and desire to have them addressed before the final event occurs. She also spent some time reminding us that with some effort, it was possible to avoid these unfortunate situations and die with peace of mind and dignity by taking care to make the right choices during our lifetime. She further reaffirmed the truth, which anyone working in the field will readily confirm, that even in dying, with some effort, it was possible to help the person to achieve peace and acceptance. In a very personal and deeply sensitive way, she recorded the following reassuring observation in her essay: 

“I learnt never to underestimate someone's capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually true acceptance. Every single patient found their peace before they departed though, every one of them.”

Professor James L. Hallenbeck,  a leading authority in palliative care and the study of end-of-life issues, noted that people tend to lose their senses in a certain predictable order. They will lose hunger and thirst first, followed by speech then vision, but the sensations of hearing and touch will usually linger on to the very end. This clearly underlines the very real need for all concerned to understand that even to the very last moment of life when awareness appears to have ebbed away, the dying person is still able to feel and hear. So rather then standing by in silence, the need to continue to express feelings of love and comfort, and engage in personal touching and support are paramount in making the transition easier. This finding completely contradicts the present-day attitudes of placing our dying in the ‘sterile’ isolation of the hospital or nursing home under the care of trained personnel. For although we have succeeded in optimizing the physical care of the individual, we are sacrificing the all-important last words and feelings that may mean so much to the individual and the family at this stage.

       There is a growing tendency in these days with so much amazing and wonderful discoveries are being made on a daily basis, and where there appears to be increasing optimism that we will be able to replace and restore destroyed and dying organs at will, that perhaps ultimately, one day in the future, we will be able to defeat death itself. Already we increasingly try to cover up the signs of aging with cosmetics and surgery, and we have no hesitation to reverse some of nature’s fundamental changes with the ambitious use of powerful hormones in a concerted attempt to stay young. This might well serve to prolong the inevitable moment and improve the quality of life, which obviously are desirable goals for us all to achieve, but it will not change the outcome. We must never lose sight of this fact, nor should we ever abandon our responsibility to prepare ourselves and those around us to the basic inevitability of our destiny in God’s ultimate plan. 

In the end however, few will ever be bold enough to deny the inevitability of death as part of the cycle of life, and it is left entirely to each person to come to his own decision with regard to the events that will happens afterwards. I personally, like so many others,  prefer to share the view of Michelangelo of Lodovico, the Italian born grand-master, whose name is synonymous with the Renaissance Period and whose sculptures, paintings, architecture and poetry are treasured all over the world. Before he died he recorded one of the finest descriptions of the deeply spiritual relationship of life and death I have ever seen or heard: 

“If we have been pleased with life, we should not be displeased with death, since it comes from the hand of the same master.”

-No one who believes in God should need any further proof or explanation, and no God-fearing person should ever be afraid to cross over when his name is called!



<        >


KINDLY SHARE THIS, AND THE OTHER 2 ESSAYS
ON THIS SUBJECT, WITH ALL YOUR FRIENDS AND FAMILY. 
ALSO IF POSSIBLE, BEGIN A DISCUSSION ON THEM. THIS MAY BE THE BEST THING YOU WILL DO, FOR YOURSELF AND FOR THEM.

No comments:

Post a Comment