There is a strong tendency, especially on the intertoobs, to set everything up as an either/or, the better to be belligerently defensive about your position. Mea culpa, mea culpa, mea maxima culpa. But this quote from Laurie Anderson made me want to re-examine the question of death, with perhaps less strenuousness on my part:
One of the interesting parts of the film was about your decision not to euthanize Lolabelle when she gets sick, because Buddhist teacshings say that dying is a process that involves approaching death and then withdrawing from it, and you didn’t want to deny Lolabelle that cathartic experience. But could you also argue that it wasn’t empathetic to keep her alive through her illness?The point being: death is informed by our philosophy (which includes, by most tellings, Buddhism); or by our theology; or, if you prefer, by our spirituality. How we approach death, what we even think death is, is a matter of our own expectations. Take Ivan Ilyich, for example:
Of course you could. I try to be really light-handed with that because there are animals that get so sick that you kind of have to do that. The trouble is, the American way of death is really about that. There’s this fear of pain and fear of suffering. So I’ll just clonk you on the back of the head with a brick, put you out so you won’t be there. And I think being there is a really important thing now. Of course you might ask me that [question] when I’m on my deathbed, begging for morphine and you’ll go, “Remember what you said! I just want to see it through. We’ll take you home. There’s no equipment at all. “ I’m not trying to tell people what to do. I’m just trying to say what we did.
And suddenly it grew clear to him that what had been oppressing him and would not leave him was all dropping away at once from two sides, from ten sides, and from all sides. He was sorry for them, he must act so as not to hurt them: release them and free himself from these sufferings. "How good and how simple!" he thought. "And the pain?" he asked himself. "What has become of it? Where are you, pain?"Throughout the story, since he injured his hip, Ilyich has suffered from his fear of death; but there is nothing in 19th century Russia available to relieve his suffering; certainly no physician assisted suicide (Tolstoy's mocking of the medical establishment is one of the highlights of the story). There are contextual reasons for the relief that releases Ilyich from his suffering, that allows him to embrace death and stop struggling against being forced into the black sack (Tolstoy's imagery). And certainly this is a very internal view; his wife tells a visitor at the beginning of the tale that Ilyich screamed "incessantly for three days" before he finally died. But internally? He doesn't suffer at all at the very end. Why? Because he frees himself from his sufferings, something he has been able to do all along. And what is the cause of his suffering? In Tolstoy's telling, it is spiritual, not physical; but in Tolstoy's telling the spiritual and the physical are at odds with each other; and one is real, and one is, ultimately, false.
He turned his attention to it.
"Yes, here it is. Well, what of it? Let the pain be."
"And death...where is it?"
He sought his former accustomed fear of death and did not find it. "Where is it? What death?" There was no fear because there was no death.
In place of death there was light.
"So that's what it is!" he suddenly exclaimed aloud. "What joy!"
To him all this happened in a single instant, and the meaning of that instant did not change. For those present his agony continued for another two hours. Something rattled in his throat, his emaciated body twitched, then the gasping and rattle became less and less frequent.
"It is finished!" said someone near him.
He heard these words and repeated them in his soul.
"Death is finished," he said to himself. "It is no more!"
He drew in a breath, stopped in the midst of a sigh, stretched out, and died.
Maybe this is what we have lost. It is dualism, to be sure; but it is a reality, too. Suffering is a matter of apprehension as well as perception. The contemporary fear of suffering seems to rest almost entirely on the fear of loss of control; the same fear Samuel Johnson suffered most of his life, as he worried again and again that he would lose his reason (it was his personal hell).
Modernity has deep roots.
This is not to compare the suffering that can be relieved with drugs to the suffering that is psychological. Hospice care is about palliative care, and I am one of its biggest proponents. I have been at the deathbed of people in hospice care, and I cannot recommend it strongly enough; especially since death took place at home, not in some building no one goes to but the sick and dying. We should not part with the dead so easily when we have the choice. We should recover the sense that even the corpse is our family member, our beloved father or grandmother, and they should not be left alone until the burial.
Our sense of the rightness of things has deep roots, too; but we keep uprooting them, thinking what is new is better, because it is new.
But about suffering: there is chronic pain, and I have known people to suffer from that, and find little relief despite the best efforts of medicine; and I have known people so afraid of death it paralyzes life. And we seem so prone to that we praise the courage of someone so afraid of dying they die on their own terms; so afraid of the suffering they have yet to feel, that the fear of it alone is too great to suffer.
I pity such people; but I will not praise them.