Meanwhile, people come out of business meetings or the gym and return my calls. Bad news, I say, and begin to explain. They only hear “Kyogen” and “heart attack” before they yelp, What? No! and then, Okay, I’m coming, which hospital?
And I say, Wait.
And I say, He died.
No.
When I was in my thirties, I became afraid to fly. My life was complicated and demanding, but I was healthy. It was the kind of fear that had no rationale. Reading about the safety of flying didn’t help; studying the causes of turbulence didn’t make a difference. I talked to frequent flyers, to a counselor, and finally with a therapist who specialized in phobias. Nothing helped. I was simply very afraid whenever I was on a plane.
Fear of death begins in childhood. Children are sensitive to how adults talk about everything. With our hushed deflections and whispering, we can easily give children the message that death is not to be talked about at all, that silence is the only correct response. Funerals are not for children. Teenagers become acutely conscious of death, but they don’t grasp its permanence—thus the near-constant risking of life that accompanies those years. Only as we mature into middle age does one’s own death begin to seem real. My fear of flying was nothing more than a naked fear of dying—not in a plane crash, necessarily, but anywhere, ever. The Buddhist teacher Ken McLeod likes to ask his students to imagine all the ways they can die simply in going about their day. “Is there any circumstance that you can engage in in your life in which you’re absolutely guaranteed of not dying?” he asks. There is not a single moment, a single place, where we are not in danger.
I couldn’t articulate this for a while. I had come to the stark understanding that when I was flying I could not live without the airplane, that I was in a very dangerous situation. In time, I came to see that this danger was life’s danger, the death I couldn’t escape even on the ground. The safety of flying had nothing to do with it.
Now I can see that this fear appeared when it did precisely because this was a time when I was wielding strength and power. The fear was partly about being a parent and an adult in my own right—which is to say, I was afraid because I was growing and changing and time was passing. I had become aware of my own perishable nature—mine—which was nothing like anyone else’s. It was mine. I was aware of all that I could lose—of all that, somewhere in the back part of my mind, I knew I would lose. A bumpy flight just reminded me in a way I couldn’t avoid. It’s a dangerous situation up there, just as it is down here, just as it is when I am doing the laundry or lying in bed half-asleep. As it always is.
I recently filled out several questionnaires intended to determine one’s place on the actuarial tables. I’m doing okay. According to statistics, I have a less than 5 percent chance of dying within ten years. My blood pressure is excellent. My lipids and blood sugar are in a good range. My colonoscopy is clean. I’ve never smoked. I have about a 15 percent chance of developing breast cancer—almost double the normal rate, because of my mother’s disease, but still low. My odds of dying in a car accident are low. My odds of dying in a plane crash are minuscule. But. But. I will die. I could die tomorrow. Tonight. (No I won’t. Yes I will. No…)
The ancient Romans sometimes only said of a dead person, “Vixit”—“He has lived.” The Laymi people of Bolivia say that a dead person has “gone to cultivate chili pepper.” This could tell us, I suppose, that people have always avoided the subject. Most of the deaths in the program where I work come after a slow decline, telegraphed for weeks or months. In the last few weeks of life, the nurse often visits every day; she or he teaches the caregivers and the family what to expect, what symptoms mean, how to use medications, how to do everything possible to keep a person comfortable, and how to know when death is imminent. And yet that same nurse may chart that a person has passed away. She is deceased, she has expired. Sometimes the nurse cannot bring herself to write the bare, undeniable word.
All the fears we don’t say out loud. Never speaking about it at all, we come to believe that others don’t feel as we do. That somehow every other person in the world is at ease in their own skin, and I am the only imposter. But of course this is nonsense. Everyone has moments of feeling adult life is out of their reach: the responsibilities, the demands. The death at the end. How long will dying take? Will it hurt? What if I can’t breathe? Will I say something embarrassing? What if I’m alone? What if I’m with others? Will it hurt? What if no one notices? We fear what comes after the last moment. You have your own questions for that.
In her book Talking About Death Won’t Kill You, Virginia Morris, a journalist, has made a long list of fears collected from interviews. Fear of having an autopsy, having the body mutilated or taken apart—fairly common. People are afraid of being ignored when they are dying, or of being abandoned by their family. We are afraid that we will be ugly. We fear that there is no heaven. We fear there is a heaven and we won’t be allowed to enter. People worry about what it will be like to be weak and dependent. They fear having others make decisions for them, having no modesty, losing their privacy. We fear leaving something undone: work, a project, a story. (This book.) Many people fear becoming a burden to their family, that their lingering deaths will impoverish a spouse and ruin a child’s health. You may be afraid of dying in your sleep. You may be afraid of dying when you are awake. A person who has watched the long diminishing of a parent fears nothing more than his own diminishment.
Do you feel guilty about being afraid to die? Do you think you should have more equanimity? Perhaps you are a little superstitious. Don’t tell anyone—don’t ever admit it—but maybe you have just a little sense of being complicit, of making it come true. When my mother was dying and I said so, right out loud, my grandmother hissed at me like a snake. She believed that one could cause a person to die this way. You may be afraid of dying suddenly or afraid of dying slowly. People fear that they will lose control and cry or shout or curse. People fear that others will watch and judge them if they lose control. (People fear being watched all the time.) You may fear that no one will miss you. You may fear, more than anything, losing your hair. Or being on a ventilator. Or needles—a lot of people fear needles. Some people fear pain: pain, pain is what they think about, pain is what they dread. Another person can think only of struggling to breathe, and another of soiling the bed, anything but that. You may fear that you will wake up in the coffin; many people fear this. Perhaps you are afraid that the all-pervading quality of being dead is loneliness.
Morris’s particular fear is that she has no idea when it will happen and thus is always on edge. Always waiting. “Do you have thirty years left, or just a few days?” We may see death coming from far away, like a train while we stand at the platform and check our watches. We may see death all at once, in the flash of headlights or a stopped heart. We may wake up right in the middle of it, like a dream.
My friend, the poet Steve Tyler, has had a dodgy heart for years now: its beats are irregular, often too slow. He lives alone with his dog, and when he worries about dying, sometimes he worries that his dog will be trapped in the house. These are the things we worry about but rarely say aloud. In Steve’s lovely poem “Heart Fading,” he describes the feeling when his heart slows down and he grows faint, his mind fading like “the radio of a car / driving further and further away from the station.” When that happens, he goes outside and sits on the porch. That way, if he dies, if his heart leads him into the “white noise / Between stations,” his neighbors or the mail carrier will find him and rescue his dog.
The legal scholar Louise Harmon notes that we don’t really confront our own real deaths except “in the dark, in the dampness of Aristotelian sweat.” To accept death is to accept that this body belongs to the world. This body is subject to all the forces in the world. This body can be broken. This body will run down. “Golden lads and girls all must, / As chimney-sweepers, come to dust.” (Except, maybe, me.) I lean a little on the words of others, but I don’t want to forget
that quotes and poems are composed words, reflections formed beside the fire when nothing was breathing down Cicero’s neck. But what about that moment when you step firmly off the curb and hear the shrieking brakes behind you? When you are alone at home and a knife seems to shoot through your chest? What about that day in the exam room when your bare feet are dangling off the table and you’ve just heard the diagnosis and are trying not to cry? We may not sit down to discuss our wishes and fears until it is almost—and sometimes truly is—too late. I may believe it is true that contemplating death makes life ever sweeter. But I also believe you are not thinking this when the person you love is gasping for a final breath. Then all the world’s philosophy turns to vapor and the only prayer you can remember is Please. No words help and no one else’s death counts.
I am fond of a story I heard about Dainin Katagiri, the Buddhist teacher I quoted in the first chapter. When he was still a young man, his teacher, Shunryu Suzuki, was dying. All the major disciples were sitting around the deathbed in silence, meditating, when Katagiri arrived. He flung himself into the room, crying out, “Don’t die!” I don’t know if this story is true. We should never ask people not to die, but I am touched by this image of authenticity. Katagiri, the Zen priest, the model of decorum, couldn’t care less what others thought of him in that moment.
At some point, most of us shift from realizing that sooner or later some future self will die to realizing that this very self, me, precious and irreplaceable me, will die. It’s a terrible thing to grasp, and though this insight may last a mere second, it changes your life. To know that the physical body will cease to exist at some point—that this life will end—changes us. I’ve felt this knowledge like an electric shock and also as a kind of honeyed happiness. For an instant now and then, I’ve had the beauty of the china bowl right here in my hands.
Poor Elisabeth Kübler-Ross: so misunderstood. She is widely credited with identifying the five stages of grief. She didn’t. Kübler-Ross worked with dying people, not grieving people. She identified clear phases people go through when they are dying not as stages but as emotional experiences that come and go and may overlap. Decades after her research, I routinely come across references to the “five stages of grief.” People grieving a loss are surprised to find they are not traversing through the expected “five stages” in a straightforward way. It’s all more complicated than that.
In 1969, Kübler-Ross was working as a psychiatrist. She often encountered doctors who left orders not to tell a patient how sick they were. Doctors lied to patients about their prognosis or evaded the truth when asked. So she began to interview patients about what they knew and wanted.
Her book On Death and Dying is a plain summary of narrative research she did into the coping mechanisms of people with a terminal illness. The coping mechanisms of the dying person, she decided, could be described as denial and isolation, anger (which includes “rage, envy, and resentment”), bargaining (which means “entering into some sort of an agreement which may postpone the inevitable happening”), depression (“a sense of great loss”), and acceptance (in which the person is “neither depressed nor angry about his ‘fate’ ” but instead feels “a certain degree of quiet expectation” ). Kübler-Ross saw these states as “defense mechanisms in psychiatric terms, coping mechanisms to deal with extremely difficult situations. These means will last for different periods of time and will replace each other or exist at times side by side.” She was a psychiatrist, after all.
Kübler-Ross found that many doctors and nurses claimed the actively dying patient didn’t need their care, and withdrew from the bedside. Others resented the dying for wasting their time. “I am convinced,” she wrote, “that those doctors who need denial themselves will find it in their patients.” The most important task in taking care of the dying, she realized, is to deal with your own fears.
Experience helps: I have been forced to believe in my own death over and over again. And yet I get distracted. I resist. I forget. I am reminded again; I believe again. Of course people die. Everyone dies. Except (secretly, without the conscious thought) me. Such internal contradiction, these emotional and cognitive dissonances, are the complications that make us human and difficult and fascinating. I say yes and I say no; I am scared and I am curious; I refuse and I accept.
Epicurus, one of those philosophers we like to cite when we talk about death, was a Greek who founded a school of simple living and deep reflection. Epicurus thought the fundamental source of human anguish is the fear of death. He developed thought experiments to illustrate that the fear of annihilation is illogical: if you’re extinguished, you can’t regret extinction. There’s nothing to fear about nothing. In nothingness, there is no perception, no consciousness, no memory. “That most fearful of all bad things, death, is nothing to us, since when we are, death has not come, and when death is present, we are not.” (Many centuries later, Bernard de Fontenelle echoed him. He was a month short of a hundred years old when he died, saying, “I feel nothing except a certain difficulty in continuing to exist.”)
Epicurus died at the age of seventy-two from prostatitis, which he found a misery.
His attempt at comforting words fails to comfort many people. The idea that there will come a time when I am not is exactly what we fear. The Internet is a handy place to express and fuel our fears; there are many forums available for people who are afraid of dying. One woman writes of this particular ache: “I just think it’s such a horrible thought to completely cease to exist, everything we have ever known, every thought i have ever had, every person that i have ever loved or valued just gone, gone for all of eternity. I can barely think about it the thought is so distressing.” The psychiatrist Irvin Yalom describes the ego facing extinction as being “staggered by the enormity of eternity, of being dead forever and ever and ever and ever.” I like that repetition. Ever and ever and ever. Exactly.
I was interested to hear about a recent study in Psychological Science showing that contemplating one’s death makes you happier. The researchers asked people either to contemplate death or to contemplate dental pain. Then people were given combinations of letters and asked to fill in a word. For instance, an might become angry or angle; jo could be joy or job; and so on. The researchers found that those who had been contemplating death made significantly more positive choices of words than those contemplating a bad tooth.
That’s more like it, I thought. At last, a confirmation of a kind, that knowing we are going to die is not a terrible thing. But when I read more of the study, I saw the bias of the researchers, who didn’t think the results meant what I thought they meant. One said in an interview, “We are all walking around, unlike every other animal, thinking, ‘Oh, my God, eventually this all ends.’ ” Why would that make us happier? Because, they wrote, considering death evokes a psychological “immune response.” We cope with our distress by subconsciously invoking happier sensations, because otherwise we would be paralyzed by despair.
The researchers’ conclusion derives from the psychological idea known as terror management theory. I just love that phrase; talk about hubris. TMT is a complicated idea and not without controversy, but aspects of this idea have been the subject of hundreds of studies. TMT even has its own vocabulary: to be aware of our impending death is “mortality salience.”
Terror management theory has a deep pedigree. Our cultural shift to a scientific view was long and painful and part of a vast cultural change in how the world and human life and death was viewed. “The skull will grin in at the banquet,” in the words of William James, who wrote at length about the divided self: the stoic and the passionate, the aware and the repressed selves. He noted the type of personality he called “healthy-minded,” of which he was a bit suspicious, “with its strange power of living in the moment and ignoring and forgetting.” The rest, the “sick souls” (of whom he was one), can’t hide from the fact of mortality and all it implies. To secular thinkers like Darwin and Freud, death was a principle of life. How c
ould we reconcile the polarities of experience? Death was both unnatural—unbidden, undesired, caused by uncontrollable outside forces—and completely natural, because everything dies. “It was not life after death that Darwin and Freud speculated about, but life with death,” writes the psychotherapist Adam Phillips of the two. “What else could a life be now but a grief-stricken project?” How does the inquisitive human mind cope with its inevitable deconstruction? In this view, death is not natural even to the dying person. It is an assault.
The psychoanalyst Otto Rank paired “life anxiety” and “death anxiety.” He called the first that of realizing one’s self as an individual, one who is vulnerable, lonely, separate. The latter is the realization that the only way to overcome our loneliness is to merge with others and lose our precious individuality. We are left afraid of both life and death. In 1973, Ernest Becker, a cultural anthropologist, built on the ideas of Rank and others in an influential book called The Denial of Death. He believed that the “fear-of-death layer” is innermost in the human psyche, “the layer of our true and basic animal anxieties, the terror that we carry around in our secret heart.” The human, he wrote, “is a worm and food for worms…a terrifying dilemma to be in and to have to live with.”
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