Death

Death has always fascinated me. I don’t know why; it just has. So, of course I had to stop and listen the other day, when I stumbled upon an NPR Radio Lab podcast called “11 Meditations on the Moment of Death and What Happens After.”

The first “meditation” involved a doctor named Duncan McDougall, who, in 1907 set out to see if he could prove the soul exited the body after death. Dr. McDougall treated tuberculosis patients, many of whom died. So, he rigged a set of scales which he put patients on when they were about to die.

Back then, the moment of death was considered to be when the last breath was taken, so Dr. McDougall would check the scales just before and right after that. And, he found, on average, patients lost 21 grams the instant they died. He published his research, and The New York Times ran a front page headline that year stating, “Soul has Weight Physician Thinks.”

In 1907 scales were crude, so a weight change of ¾ ounce could’ve been caused by a lot of different things, and 21 grams is statistically insignificant, when factored into a person’s entire body weight, but still…Why the consistent average of 21 grams?

Another of the “meditations” was about changing perceptions in when the time of death is. In Dr. McDougall’s day, and before that, death was considered to be when a person stopped breathing. In the 1960’s, with the advent of CPR (cardiopulmonary resuscitation) the time of death changed to when the heart stopped – for good. A little later, after breathing machines (ventilators) became common, the definition of death became sometime after the brain stopped functioning or when the person was declared “brain dead.” Tricky concept, that…leading to all kinds of difficult decisions about when to “pull the plug,” whether or not to put the person “on the vent”, etc. etc. Tough stuff…

A third NPR podcast “meditation” was a short story about the “final time of death” being “that moment sometime in the future when your name is spoke for the last time.” What a sobering concept – the notion that there will come a time when no one will ever speak my name again…no wonder the thought of a headstone comforts me.

I have worked on the ambulance (as an EMT) and in the emergency room (as a social worker) for the past six years. And, during that time I have seen a lot of deaths. A “good death” is one that comes to a very elderly person, suddenly and silently, without pain or suffering. An example would be having a stroke while sleeping. “He just slipped away,” is what those families say…What a nice way to die.

A “bad death” can take many forms, but it is always unexpected and traumatic, for the person and their loved ones. One of my jobs is to be with people and/or their loved ones while they die. Sometimes this happens quickly; other times it takes what seems like a very long time. During this time and afterward, while “the body is readied for transport” and the paperwork is completed, there is more time spent with the dead. I usually say a prayer, tell the person goodbye, and wish them Godspeed to whatever comes next for them.

Maybe because I’ve been around a lot of deaths (or maybe because I have an active imagination), in a lot of cases it feels like I can sense what the soul is doing, in relationship to the body during these final times. Sometimes, like in the case of a bad trauma, the soul seems to be gone already - nowhere near that body the paramedics roll in, CPR in progress. I sort of wonder, in the case of something like a bad wreck, if the soul is still back there at the scene, wondering what the heck just happened…

In other cases, the soul fights to stay in the body and on this earth. These are probably people who have been strong willed their whole life. Often they have large families gathered at the bedside. They have to be given permission, by the doctors and their loved ones, to go ahead and let go.

“It’s okay, Daddy,” a son or daughter will say. “We know how tired you are. It’s okay to stop fighting and just go home now…”

Sometimes, the soul seems to linger for awhile, and then just sort of fade away, either before or a short while after the time of death has been declared. In a lot of cases, it’s pretty obvious when the vitality, or light, or essence of what made that person that person is gone…Interesting, strange, humbling…

No matter what your thoughts on death are, there is one thing you can do to make a huge positive difference to your family and the doctors who treat you when your time comes – have an Advanced Directive and be sure the people who matter to you most know what it says and where it is.

The only thing worse than facing death or losing someone you love, is to do that without any kind of map showing the route. And, part of that map involves deciding how you want to die with regard to the many medical interventions that can, but don’t have to be, administered when your time comes.

There are a variety of websites that provide information on Advance Directives. Here are a few: www.legacywriter.com, www.caringinfo.org, www.liv-will1.uslivingwillregistry.com. So, please, check them out. It’s heartbreaking to watch a family try to make those difficult decisions at an already really difficult, sad time.