Cramming for your finals

...I know the kind of person I would like to become, but I have no assurance I will succeed...

...As I tried to think about these deaths, however, something else occurred to me...

...For some there will be: out of the struggle, the sacrifice, the suffering, there will be individual redemption and the possibility of transcendence...

...in each case, as far as I could see, was what they made of their situation...

...It is our human condition that is the problem, of which death is the great token...

...CRAMMING FOR YOUR FINALS MAKE DEATH A PART OF LIFE DANIEL CALLAHAN lthough I did not understand it at the time, when my longtime friend asked me to visit him at his farm during my summer vacation his purpose was almost surely to pull together the strands of our relationship over the years and, without directly letting me know it, to say good-by...

...I had not seen him for a few years, and his altered appearance was unsettling--a thin and wasted body, and a face that showed pain as his constant companion...

...I will try to offer some suggestions of a possible direction in which to look...

...One point stands out: Their peaceful death did not seem a matter of good fortune only...

...I can see, by the living and dying of others, the truth of that perception...

...We cannot have everything we want in life...

...Copyright 9 1993 by Daniel Callahan...

...We learn to talk and think about them...

...Actions or events will have meaning for us if they make a kind of sense: they are coherent with other things in life that we already understand, and we can see how they came about, even if not fully...

...Where can that shared meaning be found...

...If there was pain, they endured it...

...That means medicine must abandon the modern cultic myth that, in the cure of disease lies the cure of death...

...From the forthcoming book The Troubled Dream of Life by Daniel CalIahan to be published by Simon & Schuster, Inc...

...We make of them symbols of good or evil, order or chaos, threat or reassurance, and, equally, we make them patterns of order and explanation...

...Now what was to be done...

...Instead, I mean some agreement on what it is we need to think together about, and how we ought to express together the communal solidarity that is broken by death, best expressed by public symbols and open grieving...

...We can smile with pleasure at the sound of a newborn child because that sound betokens renewal, hope, rejuvenation, continuance into the future...

...I can envy those who have such hope, even if I cannot share it...

...If they required a bedpan and the humiliation of a public display of their wastes, they just put up with that...

...Some were in pain and some were not...

...This is a hard truth to accept...

...We are as individuals the living sacrifices that human existence as such requires, our own as well as every other form of life...

...They sought to put those around them at ease, anxious not to carry others down with them...

...So too, when we encounter on occasion someone for whom a new child is a burden, a threat to some other sense of order, we can understand how a birth can have a very dif12:16 July 1993 Commonwealferent, threatening, meaning...

...Most of all, I sensed, they put death in its place, downplaying its importance and drama...

...It offers us no easy way out...

...A self obsessed with control--either to remedy the failures of medicine to give us a biological domination of death, or to express a commitment to the value of self-determinationwill be a deficient and defective self, less flexible and protean in the face of mortality than it ought to be...

...Those who die peacefully seem to find ways to throw off those garments, and see death for what it is, our fate...

...We sent him along with aching love and blessing on his journey, and he left us, quietly and peacefully-as beautiful and noble and spiritual in death as he was in life...

...It cannot, and will not, last...

...They had always been the kind of people who drew others to them, in bad times as well as good...

...I wish there could be more, a better direction...

...There are two directions our conversation can take--not necessarily the only directions, but I believe the most fruitful...

...I recount these observations to make two points...

...Gustavo Gutierrez, Instituto Bartolom~ de Las Casas-Rimac, Lima, Peru Dr...

...He was, I could see in retrospect, vague about his plans...

...I suppose they were lucky in having a circle of family and friends who remained with them all the way, who visited and talked and watched...

...They may be found, but not necessarily, within particular religious and ethnic groups, at least for those members who have remained close to their traditions and rituals...

...Why not just put death out of sight, take the sick bodies out of houses and put them in hospitals, and take the dead bodies out of living rooms and put them in funeral parlors...

...It is the way we renew the species, create our families, and bring into the world new possibilities...

...As the historian James J. Farrell nicely reminds us in Inventing the American Way of Death, 1830-1920 (Temple University Press): The middle-class funeral reformers promoted death control as a fight against the fear of death...

...But it is increasingly hard in modem society to live only in such communities, probably impossible...

...A more general question also came to mind...

...The religious or philosophical meaning of death was pushed aside as a question...

...We see death at the end of the road in our lives, but it is forever foreshadowed in living our daily lives...

...I find it reassuring to know that the kind of person ! am can and will make a difference in tile way I die, in my capacity to adapt and endure...

...We looked to science, that great modem faith, for relief, and then to the art of psychological management as skillfully deployed by grief therapists and funeral directors, and then, as a last hope, to law and regulation...

...Was there no luck in all of this...

...Yet all we have left now is the need to find a way to talk together as people about death...

...I wait and watch...

...It is not there to be found, at least not in our common life together, by which I mean to encompass our relationships with strangers as well as intimates...

...Here we come to what may be our most important deficit: we do not have the shared sense of destiny that Philippe Ari6s identified as central to the possibility of a tame death in an earlier time...

...It is the question to which we all want an answer, and the question we find most difficult to talk with one another about...

...For science, he argues persuasively, the answer is as "equally emphatic" as it is in religion--no...

...I am not certain, and it will have to be left as an open question, the answer to which will make a great difference in the years to come...

...We surely need before death to reconsider the self and the way it situates itself...

...By securing the ritual of the funeral in a web of social conventions under the supervision of a funeral director, they allowed bereaved people to pay their final respects with a minimum of pain and involvement...

...They did not die differently from the way they had lived...

...RELI61ON: SOURCE OF CONFLICT.SOUE[ OF HOPI Sunday, September 19, 1993 Speakers and panelists include: The Rev...

...In the idea of sacrifice, Bowker sees religion and science coming together...

...I do not know with any certainty...

...In The Meanings I 14:16 July 1993 Commonwealof Death (Cambridge University Press), the theologian John Bowker captures well this direction when, concluding his exploration of the meanings of death in the great world religions, he writes: "The religious affirmation of value includes the reality of death, maybe as the last enemy, but also as the necessary condition of life...

...Yet, because they had been the kind of people who accepted the good and bad in life, I suspect they might well have endured more terrible deaths with the same grace...

...But increasingly, I suspect, the emptiness about death that marks our common life infects even those groups, if only because they cannot easily remain isolated...

...Could we bear death better if life were perfect...

...They had reconciled them"Turns eighty, and right away it's 'odes to autumn.'" Commonweal 16 July 1993:11selves to their end but knew this would be harder for others...

...I have suggested that it must encompass at least a view of the self and a picture of nature...

...I am fearful that I may fail, or may have the kind of bad luck that would overwhelm even someone otherwise ready for, and able to accept, death...

...t is worth recollecting what those substitutes have been...

...This may have been a skill that other generations mastered better than ours, even if, lacking much choice, they were driven to it by necessity...

...Paley' s death...

...We would do well to hope those strangers will have a sensitivity to death, that they will know how to talk with and to comfort us, and that they will see in our dying their own eventual fate and thus our common lot...

...They could have had a condition that choked them to death...

...We need something more general, for all of us together, not only so that the smaller religious communities will not be entirely bereft of some larger societal support, but also so that those without the benefit of such communities will not be left empty-handed at the time of their dying...

...We hate death, I believe, because it means the end of that life which has given us what we have, and what we can become...

...If there was sorrow, they did not pour it on themselves...

...We have tried, to be sure, to find substitutes, but in each case they turn out to be ways of better mastering and controlling death, not of finding a common way to seek and share its meaning and accept its inevitability...

...Frank Chikane, General Secretary of the South Africa Council of Churches Bishop Francisco Claver, Institute on Church and Social Issues, Manila, Philippines Virginia West Davidson, Elder, Downtown United Presbyterian Church, Rochester, New York Dr...

...I only know that it is one of the great and necessary cultural tasks before us, just as important as the more generally accepted need to find some shared way of understanding the human relationship to nature, to deal with our environmental problems...

...By assigning the care of the / body to specialists, they liberated people from death's bodily gruesomeness...

...But, then, medical science and the funeral industry have provided us some benefits also...

...The goal of a peaceful death should be as much a part of the purpose of medicine as that of the promotion of good health...

...Such a tactic is not going to work either, though surely it will have some benefits...

...sometimes kindly and forgiving, if we are lucky-will be better able to meet the demands of death...

...How could someone in such pain die that way, I had to ask myself...

...But was that really chance...

...When I tried to do that, he changed the subject--not by way of evasion, I came to realize, but out of a fear felt by many who have been ill a long time, that they will seem caught in self-pity, soon wearing out our solicitude...

...That is surely helpful, and there is no doubt that many people die, and well, with the embrace of a particular community, usually religious...

...They accepted their death, bowing without complaint to its coming, some for religious reasons and some for reasons of other kinds...

...Can my children's children live unless I die...

...Those who die peacefully seem to have understood that, and thus sought to find ways to make death less, not more, important...

...It was as if they gathered into one culminating moment all those personal traits and virtues that had served them well in life...

...We can, therefore, talk with others about the joy that the newborn child brings and understand the place that the new life, and the meaning it carries, fits into our understanding of the order of things...

...We no less hate death because it is the final, the crowning, reminder once and for all that we are finite, bounded creatures...

...William Paley, the founder of CBS and a man used to power and control and glamour, supposedly asked on his deathbed...

...My death, that is, can make sense even if I find that sense intolerable...

...Science could thus pick up most triumphantly on an ancient theme, that of death as an accident, the result of trivial incidents or choices, each of which could have been otherwise...

...One of them expresses the great profundity and contradiction at the heart of human life: that death itself is necessary for life, and, that life cannot be understood without seeing the place, and the necessary place, of death...

...Some will feel that is not enough, though for now it seems enough for me...

...A self that is, by contrast, willing to bend and shape itself to the contours of mortality--sometimes harsh and demanding, if we are unfortunate...

...We need the help of others, of a cormnunity whose meaning we can share, making it our own with the same strength as if we had discovered it for ourselves...

...We come to feel part of a community because we find its system of symbols, of interpretation, and of meaning plausible and satisfying...

...Because of an increasingly extended old age, there is a good chance that many of us will die in the company of strangers, our spouses and friends dead before us, and perhaps even our children...

...Of course...

...Without that, the other measures will continue to fail, and the nakedness of their evasions will stand out even more...

...But it does offer us reason to bear with one another, and bear one another, in working through the ways and cycles of nature...

...The answer was soon forthcoming and is still in the process of refinement...

...We can scarcely hope to find on our own the answer to a question that has troubled and puzzled the human species for thousands of years...

...and we know how to share with others the language of that community...

...The continuation of biological life in general requires in particular the death of each and every creature that appears...

...Printed by permission...

...Here, then, we can see why, in a certain view of religion and science, death is and must always remain both friend and enemy, as much the one as the other...

...No answer was forthcoming, of course...

...Rosemary R. Ruether, Garrett Theological Seminary, Evanston, illinois Gustav Niebuhr, Washington Post Walter Brueggemann, Columbia Theological Seminary, Decatur, Georgia In honor of the inauguration of Glenn R. Bucher, 5th President of the Graduate Theological Union...

...They were conscious and lucid almost until the end, in part because they had asked that their medical treatment be stopped earlier than it might have been...

...It is unlikely but perhaps not impossible...

...At its best, however, medicine can only work within the boundaries of nature, moving the furniture and fittings of our mortality about with some great skill, but never changing the inexorability of that mortality...

...I also find it terrifying to know that I should even now, with death not immediately in sight, be working to become that kind of person, and the sooner the better...

...Yet it is precisely when we try to discover the meaning death has in our society that we run into trouble...

...In some cases their death was premature, in some cases not...

...Can we, he asks, have human life on any other terms than death...

...They were the kind of people who had always known when to hold their tongue, to conceal their pain, understanding full well that such a discipline is part of a tolerable life with others, both the living and the dying parts of it...

...Just not enough, never enough, and, even worse, giving us more than a hint that we may be even worse off in dealing with death than In celebration of 30 years of distinguished, denominational, ecumenical, and interfaith theological education at the Graduate Theological Union -an International Conference and Interfaith Service...

...But that would still not be enough...

...If medicine has failed to control death, and funeral ceremonies cannot altogether manage the way people feel and think about death--cannot, that is, take away the anxiety its prospect inspires--there was still one other maneuver to be tried...

...We need to see whether a civic conversation can be developed that would blend the insights of the great religions of the world-for they have animated particular communities over the centuries, providing a road map for them--and our secular understanding of philosophy and human biology...

...The test is not the death of my known neighbor or family member but of the stranger...

...The great events of life and death come to have a meaning, I believe, in a similar way...

...Motivated by an obsession for order and by a humane compassion for suffering people, funeral directors met with some success in controlling the effects of death...

...We cannot have our dreams live on forever, even if we can achieve them for a time...

...But ours is still the same necessity, just dressed up in fine clothes to disguise the underlying reality...

...possibly, beneath the surface, were fear, dread, anxiety, and perhaps even more pain than we thought...

...In the fight, they attempted to assassinate both fear and death....By redefining death, they spared many people from an incapacitating fear of death, and from the public expression of their private emotions...

...What, I wondered, have been the common traits of those people whose peaceful deaths I have seen or heard about...

...In its place was put the scientific effort to understand the causes of death...

...I stumble at this point...

...Nature has not been banished, and it is one of the more egregious of contemporary conceits to think it has been...

...It requires of us a view of the human condition broader than that of our own fate and gives us a common stake in the ongoing enterprises of human life----even if, inescapably, that enterprise must grind us down as individuals...

...That is the task before me, with the outcome in doubt until I am put to the test...

...What mattered DANIEL CALLAHAN is director of the Hastings Center...

...They saw that it would be a greater blow to others than to themselves...

...One of the great harms done by the modern, and particularly medical, ambivalence about death has been to magnify its damage and significance in our lives, creating excess fear and uncertainty...

...A medicine that embodied an acceptance of death within it would represent a great change in the common conception of medicine, and might then set the stage for seeing the care of the dying not as an afterthought when all else has failed but as itself one of the ends of medicine...

...All men must die: but for every man his death is an accident, and, even if he knows it and consents to it, an unjustifiable violation...

...What should we talk about...

...To this sense of violation, science had a response: get rid of the causes of death, dcrasez l'infgm~ e. Yet death continued to exist despite the scientific wars against it, its timing and circumstances changed but not its final and still-dominating reality...

...They did not think a loss of control of their bodies and their lives meant a loss of dignity and selfrespect...

...We cannot, or are unlikely to, find a meaning in death entirely on our own, even if this seems the demand placed upon us...

...All good health eventually comes to an end, and nowhere is our human fragility more manifest than when we are fit and healthy...

...We need no tess to reconsider the place of nature, and particularly the human relationship to nature, to find the line between human actions leading to death, and the independent actions of nature...

...This is the bent of the great Western religions, and it is only the superstitions Of modernism that would, with the back of the hand, dismiss that possibility...

...N WHAT IS AT STANE...

...I cannot say for certain that they were not suffering...

...There is, in that fuller sense, no common response to death, no shared ritual, no clear conventions of succor, sorrow, and grief...

...They grieved for those who would have to bear their loss...

...Why do I have to die...

...That move, of course, is our present emphasis upon rights and choices: empower people to sign documents specifying how they want to die, to appoint surrogates to speak in their behalf, and in that way death will be pacified...

...I do not see this for myself, but I hope to live the remainder of my days in a way that at least puts me in a position to be (as Wordsworth put it) "surprised by joy...

...Is there a way out of this dilemma...

...Not everything that has meaning need be acceptable...

...But not enough success...

...Attempts to evade death, or to pretend that it is not serious, or to deny its necessary place in the ordering of life, have almost always been regarded by the major religious traditions as false or dangerous or subversive of truth...

...They took their leave, making it a point to see their friends, even if they did not always say why...

...Contact: Graduate Theological Union 2400 Ridge Rd., Berkeley, CA 94709 510-649-2420 3TL Commonweal 16 July 1993:13we were in supposedly more primitive, backward, and innocent times...

...We must find our own meaning in death, and yet we cannot easily, if at all, do it alone...

...To say we need a "shared communal meaning" is to deny the sufficiency of membership in a religious or ethnic group that itself offers an interpetation of death and a way of understanding it...

...By such a shared meaning I have in mind not necessarily a precisely agreed-upon common interpretation of death...

...We might well begin by speculating that a sense of common meaning may be more of a mosaic of elements than some single, decisive insight...

...It is an awkward question to put before the public, yet also an arresting one, which is no doubt why the media underscored it in the story of Mr...

...Medical science could in its own way agree with the plaintive lament of Simone de Beauvoir in A Very Easy Death (Weidenfeld): "There is no such thing as a natural death: nothing that ever happens to a man is ever natural, since his presence calls the world into question...

...People die that way, even though, we may rightly remind ourselves, the odds are against it...

...I can only offer some suggestive pointers, working outward from some insights already part of our common patrimony...

...They did not treat their dying as bad luck, but simply the way things were...

...Alexander Morgan Commonweal 16 July 1993:15...

...It is even better, to be sure, if I can find some justification for the way things are, but that may not be possible...

...Or brought them to unconsciousness long before they died...

...We talked instead the way we had always talked, about what we were thinking and feeling and about our plans for the future...

...his was the kind of death I have recently been working to understand and describe...

...Can death, and the life in which it is embedded, be transcended...

...At least I can understand what is happening...

...The first, and still the most fateful, was to make of death a medical problem, a matter of understanding the diseases and pathologies that kill human bodies and then taking arms against them...

...If their deaths were, from the inside, far more terrible than I could know, they hid this well and thereby made it easier for those of us who survived to face our own deaths better...

...By "meaning," first of all, I comprehend especially the notion of coherence and explanation...

...fthose parts of the mosaic of the meaning of death could be put in place, a start would have been made...

...He looked older than his seventy years...

...But only the token...

...I need not be a mere victim, whatever my dying may have in store for me...

...Disease and death will have their day...

...For all that, we still lack the foundation for a peaceful death--a foundation that can only be of one kind, a shared communal meaning of death, one that has some depth and richness...

...Science makes clear to us that death is a necessary condition of life...

...By "meaning" I also want to convey, however, the way we as human beings create communities of meaning...

...We cannot stop things from going wrong, however much we dedicate ourselves to control...

...We talked, but not about his illness, much less his coming death...

...For all their skills--now extended to that even more distancing ceremony, the memorial servicethe funeral directors have no control over the dying that brings people to them...

...We have come to understand birth, for instance, not simply as a particular biological phenomenon, the way we all come into the world, but also as a social event...

...We need to see that these deaths matter to us as well...

...Why do I say we cannot find our own meaning...

...A consideration of nature leads directly to medicine, which attempts to understand and control nature in the name of health and the preservation of life...

...Yet I came to see why I would never know the truth about this...

...Words have meanings for us because we have come, as people living and talking together, to share through language and symbols our understanding of things, the external objects and events in the world and the internal feelings, thoughts, and yearnings within ourselves...

...Or financially ruined their families...

...My second point, therefore, seems to contradict my first...

...By curtailing the lengthy formality of mourning customs, they prevented death from overshadowing the lives of relatives and friends of the deceased...

...I might come to understand the biological inevitability of death without thereby accepting the natural order that made it inevitable...

...A few months later, he died...

...As his wife wrote afterward, "On the day that turned out to be his last, he told us it was time to die, asked us not to prolong his life but to let him go...

...The pain of separation from life would be all the greater...

...The first is simply to articulate a perception I find both reassuring and terrifying: we must find our own meaning for death and die our own deaths...

...Probably not...