On death, dying, pain, and the silence of modernity

A friend of my mother's, a man she worked with years ago, died very recently from cancer. My mum was saddened by his passing, although, given the nature of his disease, not especially shocked. She did, however, express a deal of frustration with the palliative care he received, which she described as medically competent but emotionally inadequate. All that could be done to relieve his pain and make him physically comfortable had been done, but his fear, his anger, his sense of loss at the ending of his life - that had no real outlet. Nurses were incredibly kind, doctors soothing, his sisters conscientious and grieving, but he was encouraged - subtly, but surely - to die "peacefully", by which she meant to die QUIETLY, stoically, silently.

I witnessed this with the death of my friend from a brain tumour last year also. Her bravery, cheerfulness and the indomitability of her spirit was cited over and over again by friends and acquaintances, and so many people who visited her ended up being comforted by her rather than the other way around. My friend was lucky to have an awesome family around her who gave her space to express the full gamut of her fear, pain and outrage at this dreadful thing that was stealing her years. Her sister, speaking at her funeral, expressed this best when she said that the hardest thing a person can be called on to do is to stand with another in their pain - pain that can't be fixed or cured, but must be ridden to into the long dark, with no abatement or surcease.

Learning on Twitter this week of the death of Australian fantasy author Sara Douglass in September brought these musings sharply to mind, as I read her powerful post on her blog about this very point, The Silence of the Dying. Being ten times the writer that I'll ever be, and having the awful authority of terminal ovarian cancer to inform her words, Douglass's post captured everything I'd been struggling to express as I've sat by several terminal bedsides over the past years.

Douglass talks about the modern discomfort with death and disease. She speaks doubly powerfully - in the voice of a medieval historian, with the perspective of time (her other professional life, as Sara Warnecke, and where I first came across her, as I am myself a trained historian and it's a small incestuous world in Australian historical scholarship); and, of course, in the voice of a dying woman. Writing about the pre-modern experience of illness, dying and death, she wrote:

"Suffering, if not quite celebrated, was at least something to which everyone could relate, and with which everyone was at ease. People were comfortable with death and with the dying. Death was not shunted away out of sight. Grief was not subdued. Emotions were not repressed... Death and dying was familiar, and its journey’s milestones well marked and recognizable. People prepared from an early age to die, they were always prepared, for none knew when death would strike."

My grandmothers, both of them, told stories of family deathbeds not unlike this - relatives coming and going, open wailing, vast oceans of grief being voiced (including, oftentimes, by the dying themselves). My Irish grandmother told me about the release of an old-style wake - celebration and mourning in one, remembrance and acknowledgement.

It seems to me that this kind of integration of death and dying into life and living is something that we miss in modern Western society. Even illness - chronic, severe, painful illness - is something verboten for us; something we're supposed to talk about in whispers, if at all; something we're meant to endure without complaint (and, preferably, without talking about it). Pain, fear, death, is not to be cried against, for us, but to be suppressed, to be denied, to be papered over with a brave smile, because we wouldn't want other people to be made uncomfortable, would we?

Would we?

Sara Douglass expressed it thus:

"Now we ignore death. We shunt it away. Children are protected from it (and adults wish they could be protected from it). The dying are often not allowed to express what they are really feeling, but are expected (by many pressures) to be positive, bright and cheerful as ‘this will make them feel better’ (actually, it doesn’t make the dying feel better at all, it just makes them feel worse, but it does make their dying more bearable for those who have to be with them).

When it comes to death and dying, we impose a dreadful silence on the dying lest they discomfort the living too greatly."

I think this silence is suffocating and unnatural and inhuman, and I think it makes all of our passings more traumatic than nature would have them. Why must we go silently into the night? Why should we be rendered mute with embarrassment at the pain and anger of others as they die? Why is death seen as something separate to life instead of its inevitable, terrible, but rightful end?

Dylan Thomas had it when he wrote:

"Do not go gentle into that good night,
Old age should burn and rage at close of day;
Rage, rage against the dying of the light...

And you, my father, there on the sad height,
Curse, bless me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light."

To my friends who are suffering, and to the one who is dying (although, we believe and hope, slowly), I say: Do NOT feel pressured to go gentle into that good night. I will rage with you and grieve with you and wail for myself and for you.

No more silence.

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I'm taking an online holiday this week, barring email. Comments will still be approved but I won't be on Twitter or posting here until the weekend. I hope you all have a good week and for those going to pbevent, I look forward to hearing about it when I'm "back".