Last night I happened upon a documentary about death on PBS. It included an introductory presentation by a woman who reports that she had found resolution to her fear of death by directly confronting it. She had made a point of viewing dead bodies at every opportunity and had even taken a job at a crematorium, which seemed like overkill to me. To complete her story, a vignette of that entire process was shown. I did not find watching the incineration of bodies as particularly entertaining, and Barb left the room saying she was repulsed. In spite of my interest, (I had always wondered how this procedure was done), I shared Barb’s feelings perhaps even more intensely for this is the method I had chosen for my disposal.

 

THE BIG QUESTION
Many years ago, I think it was the late 60s, Peggy Lee recorded a song titled: IS THAT ALL THERE IS? which has haunted me all these years for it expresses to me the most fundamental existential questions. What is life, where did it come from, why are we here, how did it happen, who or what caused it? When the answers to these questions seem almost within our reach, new questions arise and we end up confounded all over again. We humans are undoubtedly unique in our ability to even ponder such questions. As a matter of fact, we have no clear idea what life is let alone what it is all about. Our definitions of life are simplistic and do little to help us understand what it is. For example, for some time there have been efforts underway to actually synthesize a living cell, but those involved in such efforts cannot agree on the criteria for determining when something is alive.

 

WHAT IS DEATH?
Death on the other hand is defined as the absence of life, but is it? At this time of the year, one third of the world’s population is celebrating their belief that life is eternal. Muslims likewise hold strong beliefs in an afterlife as do many other religions. Freud described religion as a symptom of neurosis or in some cases psychosis. Karl Marx famously insisted that religion was the opiate of the masses. Both saw religious dogma as a defense against the vicissitudes of life: for Freud, defense from anxiety, and for Marx defense from the pain of domination. In spite of his atheistic beliefs Freud was reported to have said during a prolonged, and painful terminal illness that he envied those who had strong religious beliefs.
As our brains evolved to become huge cauliflower like globs of neurons, we developed the ability to not only perceive reality but to predict future events. This ability has served us well, but there is a down side in that we became aware of our mortality. Floyd, my dog who sleeps at my feet as I write this, is able to predict certain outcomes. For example, he has learned some of the routines of the house and knows when I put on a coat that he might be able to bum a ride. He will undoubtedly see dead animals during his lifetime, may even experience grief, but I feel fairly certain that he does not realize that in a few short years he will die.

 

RELIGION AND THE DEATH PROBLEM
Back in my younger days when as an academic I knew almost everything about everything, I found that death was one of those things even I did not understand. I was especially interested in how our awareness of mortality affected our thinking, values, behaviors, personality development, and even our mental health. My research on the subject of attitudes toward death indicated that certain diagnostic categories of psychiatric patients had attitudes significantly different from the norm. All very interesting, but I was left with the classic chicken egg dilemma, did their illness cause their unique attitudes or did those attitudes contribute to the illness? But that’s how it is with any scientific endeavor, to answer one question will only lead to more questions.
The study did tend to confirm what everyone already knew in that some people look forward to death while others fear it. In the former category is the late Billy Graham who on multiple occasions insisted that he was looking forward to his earthly death, and the beginning of a new (much better) life. Muslims are so convinced of an afterlife in paradise that they are willing to martyr themselves to ensure their admission. As a matter of fact, all religions seem to have in common the pursuit of a solution to the death problem. Those of strong faith have been shown to have less fear of dying, but in one study those adherents uncertain of an after-life were even more fearful than atheists who were convinced that there was nothing after death.

 

DEATH OR RELIEF?
Death may also be attractive to those suffering from extreme pain either physical or mental. Patients whom I have known to have suffered both serious physical and emotional distress at various times in their lives invariably report the emotional pain to be more difficult to endure. When combined with feeling there is no hope, for such people suicide may seem their only option.

On one occasion in the days before Google, I was approached by a patient asking what would be the lethal dose of phenobarbital. He reported that his mother had been ill for several years with several surgeries leaving her without ability to speak, a horribly disfigured face, and severe pain. She was on large doses of pain medications, and her illness was terminal. She had told her family that after careful consideration she had decided she wished to die sooner rather than later and wanted her family to be with her as she died. Had she been a family pet her assisted suicide would have been declared merciful, but in her case it was criminal. Go figure. On the other hand many agree that to countenance euthanasia is to start down a slippery slope.

 

CLINGING TO LIFE. FIGHTING DEATH.
There are others for whom life is so precious, or is it that death is so threatening, that they cling to life in spite of enormous pain or disability. Such was the case with my daughter who shortly before her death said: “I don’t want to die Daddy.” Was she afraid? I will never know for my response was to reassure her she was not dying rather than to address her feelings about the death she knew was imminent. Thus, her cry for support was brushed off and she was left to deal with the most difficult time of her life alone. I should have known better. Sometimes it is difficult to practice what you preach.

 

A recent example of one who chose to follow Dylan Thomas’s advice to “Rage, rage the dying of the light…….” Is exemplified by the late Stephen Hawking, who was diagnosed with Amyotrophic lateral sclerosis as a graduate student and told he could not be expected to live more than two years. In spite of total paralysis and the loss of his ability to speak, he went on to become a major contributor to the science of cosmology and was described by some as a modern day Isaac Newton. He was a prolific writer in both the scientific and lay literature in spite of limited ability to communicate. In his later years, he gave lectures all over the world with the use of a voice synthesizer operated by his only remaining functioning muscle group which was in his cheek.

 

LETTING GO
Sometimes death can be viewed as an opportunity to be reunited with a loved one. One very personal example of this was with the death of my Mother. My Father had been dead for a couple of years and Mother was staying with us. Her only known medical problem was a few episodes of cardiac arrhythmia one of which had resulted in hospitalization and successful treatment. I suspected she would be discharged the following day and stopped in to see her as I made morning rounds. I was surprised at her response when I asked her how she was feeling when she said: “I am feeling just fine, but I have been thinking a lot lately and have decided it is about time for me to be out there (the cemetery) beside your Father.” I thought little of her comment and went on to my office. A short time later I received a call from her nurse telling me she had died. We should all be so lucky as to go that way, in charge and at peace. This and similar stories have led me to believe that we have more control over our demise than is apparent.

 

SEX AND DEATH?
Perhaps the weirdest thanatophilic attitude toward death is in its libidinization which was not only observed in my research but in Greek mythology. In the story of “The Rape of Persephone,” Pluto, guardian of the underworld ascended from Hades to seduce the maiden Persephone. Throughout history this theme has been repeated many times in different iterations. You may be thinking: how can there be anything sexy about death? I told you it was weird. This brings me back to the young lady who was interviewed extensively on the PBS special. She not only presented her story of how she overcame her fear of death, but was filmed giving a lecture to a group of alleged thanatophobes. It occurred to me that she possibly could have gone overboard as she talked of the joys of death in a husky voice accompanied by a sexy smile. But in case you want to learn about even weirder stuff you might want to check on the necrophiles who enjoy sex with corpses. There is also John Wayne Gacy who admitted to having orgasms as he watched his victims die.

 

NEAR DEATH EXPERIENCES
None of those interviewed in the PBS documentary seemed more certain of life after death than those with histories of near death experiences. Their stories were consistent and the interviewees were very credible. Many others speak of witnessing from above the attempts made to resuscitate them, and report seeing a tunnel with a bright light in the distance. There have also been some who have reported very unpleasant experiences, and following their recoveries vowed to change their ways. There is one neurologist who suggested these experiences were simply the result of cerebral ischemia (diminished blood supply to the brain), but there is little doubt in the minds of these survivors that their experiences were real. One such survivor suffering from a terminal cancer reported she was looking forward to her death and we were told she died two months following the filming of the program. The others all said their lives had been changed since the experience, and that they had developed a kind of serenity they had never known previously. Although not mentioned in the broadcast, I am also aware of at least two books written about going to heaven and one describing a 20 minute visit to Hell, accounts which I found less credible.

 

CREATING YOUR OWN AFTERLIFE
Spookiest of all in my opinion was an in depth look at the so-called cryogenic procedure in which bodies are frozen in liquid nitrogen with the hope that in future years technology will allow their illnesses to be cured, and they will be able to do a secular version of the Lazarus trick. Cellular biologists believe it is impossible to do even a very quick freeze without doing permanent damage to the body’s cells. Nevertheless, there are people who are willing to pony up large sums of money to have their bodies frozen and stored in hopes of being brought back to life. One website reports they have over 100 such bodies stored in huge tanks of liquid nitrogen. As for me, I think I would prefer to take a shot at heading down that tunnel toward the bright light.

 

DEALING WITH OUR MORTALITY
There are many behaviors unique to humans for which one could make a good case to result from awareness of our mortality and even the concept of death. Denial is the most powerful tool that can be used to decrease anxiety, and typically the way most of us deal with the reality of death. Those things we don’t understand are the ones we find most frightening. Freud for all his foibles had much to say about death, although discounting religion, he presented some interesting comments about our denial. One which rang true to me was his statement: “It is indeed impossible to imagine our own death, because whenever we attempt to do so we can perceive that we are in fact still present as spectators.” I can’t help but wonder if he got this idea from Mark Twain’s story about Tom and Huck attending their own funeral. Nevertheless, he does make a point. We like to give instructions as to how our funeral or lack of should be conducted sometimes with great detail, and without consideration for the idea that such services should be for the benefit of those who grieve. Do we really believe we will be able to hear what hymns are played?
In spite of our knowledge of the inevitability of death we continue to seek token immortality. We select monuments, have portraits made, buy life insurance, establish charitable trusts, write wills, work hard in order to be able to leave something behind, and even write blogs in hopes we will be remembered; and continue to live in the minds of others. Not surprisingly there are often attempts to retain control after death. I recall one example of a friend who was noted to be an in control kind of guy who liked to keep his wife under his thumb. He wrote a will in which he specified that her inheritance would go to charity in the event she should remarry after his death. There are so many other questions which have gone unanswered. For example, to name a few: why do some enjoy the thrill of risking their life, why do some like to frighten others with the threat of death, why do some appear to actually enjoy killing. We seem to be unique among the animal kingdom in those behaviors.

ARE THERE ADVANTAGES TO THE REALIZATION OF OUR OWN MORTALITY?
Lest you think I am totally morbid in these thoughts, I should admit there are some obviously useful things surrounding this mortality thing. We tend in many ways to view death as punishment. We use terms like “he deserved to die,” and “the wages of sin are death.” Throughout history, assassinations have been carried out to punish those accused of misdeeds, and the most serious crimes are still punished by death. If we were convinced we would live forever, would we behave instinctively without regard to consequences, in other words would we have developed a super-ego? In like fashion what about creativity and the urge to complete projects if time were not limited? There would be no need for monuments or for offspring to mourn. Would we feel the need to band together with others? It sounds to me as if life would be boring.

MY STRATEGY
Well, enough of this death stuff. I hope the next PBS program will be about life. Meanwhile, I plan to adopt the “eat drink and be merry” strategy. Barb recently told me she had decided to concentrate on living each day to the fullest as long as she could. I suppose this would not leave much time for worrying about such mundane issues as dying. Maybe she will be willing to give me some lessons.

Addendum by retired eshrink editor:
My dad and I discussed the topic of this blog before he wrote it. I told him of a pivotal moment during college when a marketing professor posed the question, “What if this is all there is? Despite what you’ve been taught in church or by your parents, what if this life is all you get?”

It was if a light bulb went off! Religion uses “heaven” and “hell” (the “afterlife” in general) to relieve us of the anxiety of our own mortality and in some instances, to control us. You want to get to heaven. You don’t want to go to hell. Here’s what you need to do. As if, all chaos would ensue if we thought this was the one life we get to have.

Indeed, that was the point I got from this professor. The realization that this life is the one that is real and I better be a full participant because it’s the only one I know I have. Don’t use an “afterlife” idea to put off living this life fully. Don’t get me wrong, I hope there’s something really good after this life. My version of “heaven” is being able to use the heaven TV network to check in on all my people to see what’s going on because I don’t want to miss anything! Also, I would like to create my own weather, get to choose my own “age” during my time in heaven, visit with everyone else who is dead, and most of all, get all of those big questions answered. I freely admit that I’m afraid to die because I’m afraid of the unknown…I’m with Freud, I’m envious of those people who have no doubt in religion’s teaching of an afterlife. However, I must admit I have never understood why highly religious people who think their dead family member has gone home to Jesus to the next life, cry so much at the funeral. If you truly believe that without a doubt, wouldn’t you be happy for them?

However, I do believe there is something more and hope there is something more, but no proof to date.

So, I try to use mortality to make sure I live well in this moment that I have been so fortunate to be given and even more, to put life’s perceived “stresses” in perspective. “It’s not life and death” I’ll tell myself.

Since my husband died suddenly at a fairly young age , I also use “death” as a way to live my life double for those who don’t get to be here. I try very hard not to take one minute for granted. Life’s short. It’s not a dress rehearsal. Treasure the gift. Be present. Make every minute count.