What’s the most important and costly conversation Americans aren’t having?
According to a group of medical and wellness leaders, it’s how we want to die.
If 75% of Americans say they want to die at home, why do only 25% of them do?
As a consequence of the United States’ unique profit-first health care, religious taboos associated with death and the afterlife, and, I would contend, a general culture that shuns any sign of vulnerability, most of us aren’t prepared mentally, emotionally, spiritually, relationally or financially for our inevitable deaths.
[And, of course, Americans aren’t unique in their struggle to come to terms with death and dying, but as I live in the United States and these are the complexities and realities I and my community are navigating, I think it’s worth specifying.]
Enter: “Death over Dinner”
It all started with a 2013 University of Washington graduate course called “Let’s Have Dinner and Talk About Death.” Since that first course, they’ve facilitated and tracked over 500 Death Dinners in 20 countries. . . including one last Sunday in Salem.
Ever a sucker for highly organized experimental gatherings incorporating food, drink, and big ideas, I couldn’t resist the urge to start a shared google sheet and send an invitation to have dinner and talk about death. . .
Our evening would span essentially three parts.
We’d gather under the pergola to get to know each other. Of our twelve, some were family and some were strangers. All of our bodies were in different states of deterioration. Some of us were in the midst of loss, others could only imagine. Essentially we shared nothing, except our humanity.
One of our twelve signed up to bring a cocktail. I had suggested Painkillers, created on the island of Jost Van Dyke in the British Virgin Islands, an odd assortment of Pusser’s rum, pineapple, orange and cream of coconut. Another brought oysters we taught each other to shuck in situ, finding joy and sustenance in the sharing of knowledge and bearing witness to the window between life and death bivalves offer the industrious and adventurous.
On the kitchen island were arrayed an assortment of images related to death and dying. From Blake and Goya to the outsider artist Gregory Warmack and the Buddhist Wheel of Existence, we each selected one that spoke to us in some way, and then used that image as an invitation to introduce ourselves and our relationship to the evening’s topic.
We then moved into the darkened dining room, where our image cards also served as our place cards, arbitrarily but decidedly assigning each her place (oddly, we ended up segregated by gender).
Once settled, we were invited to remember those we love but see no more by lighting a candle in their honor. As the room grew brighter with the memory of family and friends, mentors we never met and beloveds we hardly knew, our host led us in the kaddish, the Jewish prayer for the dead.
In the kitchen, a buffet feast awaited: fresh spring vegetables bursting with life and a play on oyakodon, a traditional Japanese dish, literally parent and child, featuring chicken and eggs. Our version was a fricasee of young, organic, free-range chicken stained with turmeric, saffron and chili, served with hard boiled eggs marinated in a cilantro chimichurri, as well as a whole black sea bass served with caviar. Which came first. . . in life we are in death. . .
Back at the table, our cards had yet one more purpose. On the back of each was an invitation to ask a question, or pick a “Death” or “Life” reading.
Our questions came largely from the Death over Dinner folks: “Name the three person committee you would want consulted on any decisions about whether to continue life-prolonging treatments, like mechanical ventilation. Who would you want to chair that committee? Have you informed these people and put it in writing? If not, what’s stopping you?” and “If you could design your funeral, wake, or memorial, what it would be like?”
Our readings came from everywhere: The New Zealand Book of Common Prayer, the poetry of Rumi, scientific reports about cellular death and journalistic reports about trends in the funeral industry.
Be assured: we finalized no answers, drew no conclusions; we did not conquer death. . .
For one, our time was short.
Nevertheless, we did launch a conversation, identified tools to come back to, and broke through the fear that nearly all of us had identified at the beginning, not just of death itself but of talking about it.
We closed with a toast of eau de vie, the water of life, and broke into free-form conversation spilling into different rooms following different conversational threads. . .
The next day I circulated a workbook that offered practical guidance and resources for end of life decision making.
And yes, I’ve already started a google sheet collecting ideas for next time. . .
Jesus said, “Blessed are those who mourn, for they will be comforted.”
You may not know that I sit on the NSMC ethics advisory committee. almost every consult results from family members disagreeing on what the patient wanted at the end of their life. When I teach this topic to my nursing students, I use this tool: https://theconversationproject.org/about/ellen-goodman/ and this document I used when my mother was dying: https://www.compassionandchoices.org/5-questions-to-ask-about-end-of-life-care/
As always your Goat is spot on! Great piece.
So much of what people discuss in relation to death and dying is physical and relate to material issues while other issues must be dealt with, such as how we leave this world, what we have made of our lives, what makes us happy and content regarding what we leave behind.
Having said that, thank you so much for setting straight the “to do list”.
Jonathan, I found myself taking notes on philosophies and recipes. THAT’S a good blog post, every speck provocative. Thanks for sharing this night.
And also, coming to terms with death and dying is essential to our joy of life.
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