Death is not Contagious (part 1 of 2)

August 9, 2010

by Jeanne Denney

When I tell people that I am a hospice worker I often get a standard response: “How do you do that?… Don’t you find that depressing?” The first question is actually quite deep and interesting. (“Yes how do I do that? With what part of myself do I do that?”) But the second one always stumps me. I get puzzled when people expect that I will be depressed in the face of a natural process. Why would I find being with dying any more depressing, I wonder, than attending a birth, watching leaves fall in the autumn, going to a wedding or taking off my youngest child’s training wheels? But somehow, somewhere the idea that contact with death is negative, even a possible contagion to be avoided, has spawned, even though (absent infectious disease) there is little direct evidence to support this. Perhaps because of this and the way that our healthcare system works to use exceptional means attempting to prolong life, more and more people die in hospitals each year rather than at home. This despite the fact that most people express wishes to die at home. Dr. Atule Gwande gives a good summary of how this comes about in this NPR interview: Making End of Life more humane.

Sometimes as a staff person in a Hospice I did feel tired or unsupported. Sometimes I feel sad at the trauma, shock and lack of support for dying people and their families. All of this has an effect on the experience of the people around dying, but rarely if ever do I feel depressed at the fact of death itself. Indeed, when I take good care of myself and have time to build relationship with a patient, the opposite is usually true. In a situation without trauma, once death is clearly coming and has been accepted, I am more likely to leave a deathbed with a kind of joyful, expanded energy as a depleted or depressed one. I continue to do this work because it enriches my life. On a good day, when I come from my deepest desire to connect to the full throb of life in all of its forms, it is extraordinarily uplifting and usually I can perceive that this response is mutual.

Experiencing contact with death as positive is admittedly not a common expectation. Talking of it this way can even be seen as a little subversive. Just yesterday I came across a Youtube video of a spiritual teacher Hindu Swami SivaBaba giving just this teaching. In a nutshell, he advised that to think of death or plan for it causes death: Don’t do it. I have worked with cancer patients that have this idea, and even the American Cancer Society often appears to advance this view in their aggressive stance in fighting death, the enemy. The assumption is common. As I was preparing to format a second class to support death planning (which I call “Planning on Dying: An Exhuberant Life Exploration”) I came upon a blog written by psychologist Wanda Horrell entited: I am Not Planning on Dying! Wanda’s article expressed important truths about mind/body health and the power of optimism and positive thinking on life and illness. I agree with her completely. I don’t wish to contradict anyone’s views or beliefs. Still, is it really a benefit NOT to plan on dying given that the death rate throughout history is still hovering at 100.00000000%?

Maybe it helps to explore the idea that illness and death are different things. Positive focus on principles of optimism is something that is healthy for people of all states and ages. It doesn’t follow that death thoughts are signs of pessimism or that avoiding them is the antidote to illness. What if deeply receiving the contractive principles of life is needed just as much as focus on expansive ones? I am betting my nickel that someday we will find that avoiding surrender to the facts and feelings of loss, aging, death and dying, is at the root of many illnesses and a source of lifelessness itself. At the very least it often brings unfortunate denial and resistance that ultimately increases pain, struggle, stress and suffering in processes around death. Studies like this one show that people who are supported in planning for their own dying, giving time and thought to their death wishes, have much better experiences in the life process we call death. To quote the article:

“Family members of patients who died had significantly less stress, anxiety, and depression than those of control patients. Patient and family satisfaction was also much higher in the intervention group.” (British Medical Journal Website)

Death avoidance sells a lot of products in the United States, and probably the rest of the world. Mania is in, depression is out. Expansion is in, contraction is out. Just as the Victorians suppressed and feared sexuality while they obsessed on death, so we do the opposite. Sex is in, death is out. But for me, being really alive is about the full monty.

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.

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9 Responses to “Death is not Contagious (part 1 of 2)”

  1. Susan said

    What a breath of fresh air on a topic typically skimmed past quickly or avoided altogether. Thank you for the honest disclosure about your experience and your assessment of our cultural attitude toward death.

    It is very supportive as I navigate a time of rapid aging in my mother’s life. She wrote today that she dreamed of a loud knocking at her door.

    Ah, that knock comes for us all. Is it a beginning or an end?

    I look forward to taking your online course when it is
    ready!

    Susan

  2. Being a practising doctor in an ICU, I can assure that we have to be humane and at the same time realistic. All of us are humans, and humans DIE. It is only the manner of dying that becomes painful sometimes. As a doctor, we have to be honest and yet sympathetic with the relatives of the dying patient.

    Nice article. I second most of the thoughts of the author.

  3. Jim Evers said

    Thanks, Jeanne, for re-reminding me of this important and valuable way of approaching death/dying. Your work, writings, and being have been most helpful to me.

  4. Thank you for this excellent post.

  5. Fran said

    Nice article. I work in a nursing home, and it seems to be an unspoken rule to keep suggestions of death out of the conversation in the rehab arena. I don’t mean discussions…I mean reference in any shape or form. In the long term care setting, people just disappear with twice yearly “celebrations of life” in memoriam to them. Death is abnormal in a place where everyone dies. Sounds like torture to me…We have to deny and ignore it because no one wants to deal with it (staff). It’s depressing. Call in the meds. Sedate even when there’s no pain. Have anything but a concious death, even if you want one! Thank you hospice. (not all hospices). I’m not saying this is a simple issue. I support your work Jeanne, even if the medical institution doesn’t want to take you on. It hasn’t been that long ago that doctors wouldn’t tell you if you had a terminal disease.

  6. Mark said

    I love this title: “Planning on Dying: An Exhuberant Life Exploration.”

    The ITP president died this past weekend after a two year battle with pancreatic cancer. Even being the chief transpersonalist isn’t enough to keep those 100% odds from hovering. Without meaning to, I probably contributed a bit to the stress that killed him. ;-(

  7. Great article, Jeanne!
    Having spent most of my professional life thus far doing end of life related work, your points strike home. I have long felt what a piece of what Becker was proposing (and quite possibly it was just my projection!) was that people who work in the health care field are really working with their own mortality issues. And that applies directly to hospice workers–some sort of magical thinking: maybe if I work in this field I’ll somehow be personally immune to suffering for myself and my family.

    Thanks for the great work you are doing–

  8. Mary Stoffel said

    I’ve been watching for part 2 of this to show up on the website. I’m at a point where my Mom’s health is failing more rapidly – so I look for a lot of information on this. I’m her only family so can use support. I do have a wonderful support network though.

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