Is Death an Orderly Process? (Part 1 of 2): Probing the Womb of the Next World

By Jeanne Denney

In this column and the next one I am offering a few musings on the regularity of life’s messiest process, and the role of chaos and surrender to the order of things.

Last fall I spent four days learning about the development of the human embryo. Embryology is a stunning field of science. I am still in awe of the intricacy and profoundly regular process of any beings trip from nothingness (or chaos) to the organized life of a body. Its processes unfold with precision and remarkably few problems, yet what lies in our developmental variations shape us for the duration of our lifetime. I took this class looking for clues to the processes of dying. I reasoned that in utero development must give a clue about how we leave the body as well as come into it. Could death also be such an orderly process?

Since death is notoriously messy it seems hard to imagine that the breakdown of the physical body and our relationships is orderly. Yet Eldercare workers can’t avoid seeing a certain systematic regression in aging and dying. In aging, we walk backward through the events of our life and relationships, interpreting and integrating their meanings. We lose abilities we proudly gained as children (walking, toileting, speaking and the ability to stay in a consensual reality) most often in a reverse sequence. As we claimed our independence in early life, so we return to dependence in later life. Finally we arrive in a nonverbal state in a fetal position in a bed. I have often called this state “The Womb of the Next World”.

I like to sit at bedsides with my many questions about this “pregnancy” a little like a scientist with a micro camera in utero. Clearly there is more here than pure loss. As skills and capacities are disappearing, there seems to be something just as surely opening in their wake. Patients pulling into their deeply interior states seem to be involved with an intimate but highly focused process, something hardwired into our unconscious minds, our cellular memory, perhaps even our genetic code. Kathleen Dowling Singh writes beautifully about this in her book Grace in Dying as “Nearing Death Awareness”. As Kathleen notes, death is both a variable and predictable transformation. Just as no one has to be taught how to form an arm or a leg, how to speak or how to walk, no one has to be taught how to go through the transformations of birth and death. We may struggle and thrash, we may go in peace or in wrath, but we will eventually follow the much stronger flow of the outgoing tide that brought us to body in the first place. Some sooner, some later. Some tidier, some messier.

Sitting with Nellie

As a hospice worker it is common to experience rooms where someone has just died or is just about to. The majority of my experiences at bedside in this state have been ones of bliss and joy as waves of energy wash over the room and everyone in it, especially if the death is peaceful. It is, in fact, much like birth, yet the quality of energy is different. There seem to be factors of personal history and variables of support which affect this transformation. Death might be seen as a culmination of a lifetime of habituated practice with self and others. But though the base skill seems to be innate, the relational environment can have profound effects on the unfolding. How can we ultimately learn about this stage of development, support it, accept it and trust it without interfering or imagining that we control it? These are constant questions for any hospice worker.

Just these questions were opening up for a family I was with a couple of weeks ago for a mother/daughter pair as their elderly matriarch, Nellie, was dying. The family had been faithfully waiting for death at bedside for several days and were exhausted. Nellie’s daughter was agonized about leaving for the night. She worried that her mother was suffering because her eyes were open slightly and her breath was labored. At the same time she worried that her presence was keeping her from dying. “We have waited for days. I have done everything…we have told her over and over that we are fine and that she can go. Am I keeping her here?“ She had begun to see dying as a performance that could be failed, and looked for someone to correct what had gone wrong. “Why isn’t she dying? Maybe she can’t do it. What are we missing?” They were in an emotional state of fragility and despair that reminded me of a birth mother in late labor just before the point of useful surrender. In their words I heard the ubiquitous “I (we) can’t do it” that comes with regularity.

When the nurse and I arrived to support, we confirmed that Nellie was not suffering and was certainly in a process that would end. We talked about how people die, what they probably experience and how often they need to do it alone when there is a lot of attachment. With knowledge that Nellie wasn’t suffering and that nothing had gone wrong, Ann began to relax and recount a few stories about her mother. Good will, ease and humor entered the room. Within a few minutes, before they could reconsider leaving for the night, Nellie took her last breaths and died. The joy and radiance of release were palpable in the room for some time. As anxiety left, Grace arrived on cue.

Perhaps there are predictable and orderly processes for all of us in these passages, and ones that we can get better at if we recognize that death, like birth, works in unique but also highly regular ways. While in birthing processes we must learn to attach and effectively respond over and over again, in death we must master the skills of detachment, calm witness and a tough allegiance to love and truth. It does seem possible that we can get stuck in these processes for awhile, something I will muse more about in my next column, but it never fails. In this, nature bats 100.00000000000%. Maybe that is a fact we can take strange comfort in.

Jeanne Denney is a therapist and hospice worker in Rockland County, NY and the author of The Effects of Compassionate Presence on the Dying. She directs the Rockland Institute for Mind/Body Education and Kairos, an organization for helping professionals. (See http://www.rocklandmindbody.com)

If you are interested in subscribing to this blog, contributing to the Kairos Network or participating in a process of “Planning on Dying” contact jeannedenney@gmail.com. You can also just hit the subscription icon above.