I want to change how we talk about death, one conversation at a time.
Something I find fascinating is that we spend so much time, energy, and money focused on self-improvement. We are constantly seeking to be better, to do life better. We go to therapy and meditation courses. We go on diets, sign up for CrossFit, and make improvements to our spending. We’re a culture obsessed with transformation, and yet we fail to recognize that all transformation includes death and rebirth. The examples are endless, but at the simplest level, consider fall turning into winter and winter turning into spring. In all our striving, we fail to bring death into the conversation, and yet our mortality is the fulcrum of all personal transformation. We don’t think about improving our lives in the context of death, and we don’t talk about improving our deaths. Which is why the way we die in the modern age is broken.
Look no further than the language we use around death—or, rather, the language we avoid. Chyna Wu, a grief specialist/educator, talks about how her friends are constantly urging her not to use the word “death” in her communication materials but to use “passed away” or “went to heaven” instead. “I tell them, if I don’t use the words ‘death’ or ‘dying,’ who else is going to do it?” she says. She grew up in Hong Kong and feels that Westerners have a particular discomfort with talking about death. “I think it’s maybe because Western medicine tends to think it can beat death,” she says. “The language is very much about doing, things like ‘we won’t let that happen. We can do this, or do that.’” It’s as if we’re heroes in an action film, squaring off with an evil foe, and everyone knows the good guy wins in the end. We are doers. We are saviors. If it’s us versus death, we will come out victorious.
Of course, this narrative is a myth. And the more we perpetuate it, the more we lose. We’re a little messed up about death, to put it bluntly. On the one hand, it’s all around us. We flock to dark cable dramas and slow down our cars out of morbid fascination with traffic accidents. But to talk about it with one another? Honestly and openly? Forget it. When we live within this contradiction, we lose the chance for connection, communication, healing, and the richness and value that can come from facing our mortality head-on.
At the most tangible level our reluctance to have this conversation is costing us money every single day. A study from the Mt. Sinai School of Medicine found that 43 percent of Medicare recipients spend more than their total assets—out of pocket—on end-of-life care. Medical care is the number-one factor in American bankruptcies, with end-of-life care expenses—particularly hospital expenses—leading the charges. And although approximately 80 percent of Americans want to die at home, only 20 percent of them do. More than half of us are not getting what we want or what we’re entitled to—and we’re paying dearly for it. People are bankrupting their families, and for little good reason: most of them don’t even want expensive, extreme life-prolonging measures, but they haven’t talked to their families about their preferences, and no one has asked.
From where I sit, the writing is on the wall. It is time to face the inevitable, and we need a grassroots movement—we need to face our mortality as a village, not as isolated individuals. Funerals, law offices, and hospitals shouldn’t be the only places we confront the passing of loved ones. The proper depth of this conversation can’t happen when you feel intimidated, overwhelmed, and sad. It happens when you feel comfortable and are not staring down a crisis.
Given the right framing, a “difficult” conversation does not need to be difficult. It can be liberating. It can even be transformative.
Picture what you want your final days and the ones that follow to be like: Who is around you? Are you in a hospital? Will there be a funeral, and if so, what music is playing and who is speaking? What happens to your body? How do you want to be remembered? Telling your wishes to your friends and family will give them more than the ability to honor you; it will give them the peace of mind to properly grieve you without the weight of doubt and guilt. My friend Lucy Kalanithi, the widow who finished and published her husband’s memoir, When Breath Becomes Air, recently told me she viewed her conversations with Paul about his impending death as a second wedding vow—a sacred exchange, a vision, and an oath to follow and honor.
Elisabeth Kübler-Ross once said, “It is the denial of death that is partially responsible for people living empty, purposeless lives; for when you live as if you will live forever, it becomes too easy to postpone the things you know you must do.” To talk about our own mortality and the mortality of our loved ones is to talk about life. Death is the great mirror. Talking about it does not need to be fearsome or morbid. As my fellow northwesterner Michael Meade so poignantly states, “The role of a fully realized human being is to arrive at the door of death having become oneself.”
If we take ownership over our lives and eventual deaths, we can allow others to be powerfully present to our passing and not let it be lost in the chaos of indecision. If doctors and nurses had clear direction from each of us—advance-care directives, clear power of attorney, healthcare proxy—and if our families knew our wishes for the type of care we want at our life’s end, if they knew what we want to happen to our body and how we want to be celebrated, the emotional and financial burden would significantly reduce.
By transforming the planning process into an opportunity, a joyful and significant activity that allows us to honor ourselves and our loved ones, we can change the way we die—and the way we live. Death of a close family member or preparing for your own inevitable end can be one of the more daunting experiences we face. But by talking to one another, we can make the preparation and planning easier, even beautiful, whether it is an unexpected death or a slow waltz to the finish line.
Excerpted from Let’s Talk About Death (Over Dinner): An Invitation and Guide to Life’s Most Important Conversation by Michael Hebb. Copyright ©2018. Available from Da Capo Lifelong Books, an imprint of Perseus Books, LLC, a subsidiary of Hachette Book Group, Inc.