When I was nineteen and vacationing in Ft. Lauderdale, Florida I happened to be walking down a sidewalk when a homeless man fell down in front of me. I quickly ran to him and held his head up off the dirty concrete as people began to gather around. I had only been there on my knees helping him for about thirty seconds when he looked up into my eyes and let out his last breath and died. I held him until the ambulance came and vowed I would never forget him.
I was working in a small hospital in Texas as a nursing assistant many years ago. Part of my job included taking food to patients. I was taking a tray into the ICU to a gentleman. The moment I walked into the room he sat straight up in the bed and looked at me. He let out a groan and fell back dead. I ran to his bed, slammed a crash board under him and started CPR, but he never resuscitated. I remember he was vital, humorous, and entertaining. In one split second, he was dead.
I drove on to campus once as an undergraduate and a large crowd was gathered around a dormitory. After I parked, a few friends ran up to my car to inform me my best female friend had put a gun to her head and killed herself.
When I was in my late thirties, I was in a car accident. My dear grandmother came to see me. I couldn’t move anything and was bedridden. She walked with help and spoke with a device that she held to her throat. She was dying of cancer and I didn’t know how far along it was. Two days after visiting me and being her usual sweet self, she died. The last words she said to me were, “I love you.”
I wanted to add these stories to the mix, because I wanted to communicate that no matter how our culture glosses over it, how many times we may deny it, or what we use to keep it away, death will come and it will be definite and it may even be painful. That is reality. That is the truth.
The Greek word for death is Thanatos. The scientific study of this phenomenon is called Thanatology. Thanatology is the empirical, academic, scientific, logical, systemized study of death among human beings. This study of death is not concerned with the meaning of death so much as it is with the information the study can provide that will assist in the care of the dying. Thanatology seeks to increase the quality of care for hospice patients and enhance the quality of life as death approaches.
Death occurs physically when electrical impulses from the brain are nonexistent for a specified period of time. Higher cortical functions and lower brain stem functions must both be absent for death to be present and declared. It is important to state that the process of deterioration into death is a process. Death itself is not a process, as some would argue. Death is immediate, final, and complete.
Death is present legally when an individual has declared their wishes in legal instruments. The argument of passive and active euthanasia has received much press in this western culture. If the wishes of the patient have not been written in legal instruments or family members who have legal authority over the body do not declare their intentions, then death is legally pronounced by attending physicians.
The obvious and repetitive discussion of ethical reasoning around the phenomenon of death is always when death occurs. “When to pull the plug,” so to speak. I would argue that unless the patient has a legal document stating they don’t want to be resuscitated, they should be allowed to live as long as possible. When I come to that time and if I am in a hospital at the time, I want as many tubes, wires, and sophisticated electrical pieces of technology around me and in me as possible. Somebody might come up with a cure while I’m there in the bed. Don’t pull the plug on me until the last possible shot has been given and the last treatment tried!
OK, this is what I think legally, medically, and ethically. But I want to add a thought from the field of logotherapy. Dr. Frankl has stated in his theory of death in logotherapy that it is useful. The inevitability of death is what spurns us on to complete our destiny or our purpose for being here on the planet. Without the definite parameter of death at the end of our life, we would not be motivated to fulfill this destiny. We would languish in mediocrity all our lives without doing what we are intended to do. So, in this sense death is not an enemy. It is a kind friend reminding us to get on with whatever we need to get on with.
Tibetan Buddhism takes forty-nine days to actually get a physical body either in water, cremated, buried in dirt or in the sky. In the sky burial, the body is cut up and fed to vultures. In the water burial, the body is cut up and fed to a river. If a body is cremated, they will add sugar, butter, grains, and oils. Their rituals surrounding death are written in the Tibetan Book of the Dead. Grief is processed during this time and spiritual tasks are completed on behalf of the deceased.
Tibetans believe when a person dies, their soul must take a journey. The actual process of dying is divided into three sections; the moment of death, a trip through reality, and the seeking of rebirth. At some point in the first twenty-one days a person performs what is called the powa. This is a “transference of consciousness ritual” wherein the soul of the deceased is encouraged to let go of the yearning for this world and move on to the next.
Monks understand that when a person dies, the relatives or friends may have unfinished emotional business with the deceased. They provide rituals for the cleansing of the mind and heart so the deceased can continue to rise to the next life and the remaining alive can process their emotions and thoughts. The Heart Practice Meditation is especially interesting for grief therapy. The grieving are instructed to open their hearts to all the pain and experience it completely. They are instructed to ask for healing . They believe the Buddha will send streams of light out toward them that will become like nectar. This nectar fills the heart and transforms the suffering into bliss. They further understand that grief does not pass quickly, but if one focuses on the Three Jewels of Buddha, the Dharma, and the Community then solace will come.
And of course it must be stated that death is only physical. The “pneuma” or the life breath is what has existed before, exists now, and will exist later.