Death: And Then What?

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Poets, essayists, researchers, and philosophers write often about death, but have rarely seen it. Physicians and nurses, who see it often, rarely write about it. Most people see it once or twice in a lifetime, in situations where they are too entangled in its emotional significance to retain dependable, useful memories of the ordeal. Survivors of mass destruction – plane crashes, hurricanes, terrorist bombings, building collapses – quickly develop such psychological defenses against the horror of what they have seen. Nightmarish images in their mind distort the actual events they have experienced. There are few reliable accounts regarding the ways in which we die.

Very few of us actually witness the deaths of those we love. For instance, not many people die at home anymore, and those who do are usually victims of  drawn-out diseases or chronic degenerative conditions in which drugging and narcosis effectively hide the biological processes that are occurring. Of the approximately 80 percent of Americans who die in a hospital, almost all are in large part concealed, or at least the details of the final conclusion of mortality are concealed, from those who have been closest to them in life. I was with my father when he took his last breath on December 9, 2014. Although I was glad to be with him as he passed away, it was a difficult experience.

An entire mythology has grown up around the process of dying. The mythologies of death are meant to combat fear on the one hand, and its opposite – wishes – on the other. They are meant to serve us by disarming our terror about what the reality may be. While many of us hope for a swift death or a death during sleep (so I won’t suffer), we at the same time cling to an image of our final moments that combines grace with a sense of closure; we need to believe in a clear-minded process in which the summation of a life takes place – either that or a perfect lapse into agony-free unconsciousness.

For many, death is a grim adversary to overcome, whether with the dramatic armaments of high-tech biomedicine or by a conscious acquiescence to its power, an acquiescence that evokes the serene style for which present usage has invented a term. Death With Dignity is our society’s expression of the universal yearning to achieve a graceful triumph over the stark and often repugnant finality of life’s last breath.

It is helpful to realize that death is not a confrontation.  It is simply an event in the sequence of nature’s ongoing rhythms. Not death but disease is the real enemy; it is disease that requires confrontation. Death is the give-over that comes when the exhausting battle has been lost. Even our confrontation with disease should be approached with the realization that many of the sicknesses that befall mankind are simply conveyances for the inevitable journey by which each of us is returned to the same state of physical non-existence from which we emerged at conception. Keeping in mind, of course, that I am speaking of physical death. In no manner to we cease to exist on a spiritual level at the time of our last breath.

Medical science has conferred on humanity the blessing of separating those pathological processes that are reversible from those that are not, constantly adding to the means by which the balance shifts ever in the favor of sustaining life. Unfortunately, modern medicine has also contributed to the misguided fancy by which each of us denies the certainty of our own individual mortality. The claims of too many laboratory-tested doctors to the contrary, medicine will always remain, as the ancient Greeks first dubbed it, an art. One of the most severe demands that its artistry makes of the physician is that he or she become familiar with the poorly delineated boundary zones between categories of treatment whose chances of success may be classified as certain, probable, possible, or unreasonable. Those uncharted spaces between what’s possible through medicine, and everything beyond its reach, are where the thoughtful physician must often wander, with only the accumulated judgment of a life’s experiences to guide the wisdom that must be shared with those who are sick.

Most people do not leave life in a manner they would choose. In previous centuries, men believed in the concept of ars moriendi, the art of dying. Those were times when the only possible attitude to impending death was to let it happen – once certain symptoms made their appearance, there was no choice but to die the best way possible, and hopefully at peace with God. But even then, most people went through a period of suffering that preceded the end; there was little but resignation, and the consolation of prayer and loved ones, to ease the final time.

We live today in an era not of the art of dying, but of the art of saving life. As recently as half a century ago, that other great art, the art of medicine, still prided itself on its ability to manage the process of death, making it as tranquil as professional kindness could make it. Except in the too-few programs in existence, such as hospice, that part of the art is now mostly lost, replaced by the brilliance of rescue and, unfortunately, the all-too-common abandonment when rescue proves to be impossible. The family of the afflicted grasps at a straw that comes in the form of a statistic; what is offered as objective clinical reality is often the subjectivity of a devout disciple of the philosophy that death is an implacable enemy. Once it is clear that someone is going to die – after all possible measures have been taken by the medical team – the crowd thins out. All that remains in the room is the dying and those that love them.

Though the hour of death itself is commonly tranquil, and often preceded by blissful unawareness, the serenity is typically bought at a fearful price – and the price is the effort and the process by which we reach that point. There are some who manage to achieve moments of nobility in which they somehow transcend the indignities being visited on them, and such moments are to be cherished. But such intervals do not lessen the distress over which they briefly triumph. Life is sprinkled throughout with periods of pain, and for some of us it is as if life decades have been bathed in pain and suffering, as we endure one illness or setback after another. In the course of ordinary living, pain is mitigated by periods of peace and times of joy. In dying, however, there is only the affliction. Its brief respites and ebbs are known always to be fleeting, and soon succeeded by a recurrence of the anguish. The peace, and sometimes the joy, comes with momentary relief from suffering.

The dignity we desire in dying, at least from a psychological standpoint, is often found in the dignity with which we have lived our lives. Honesty and grace over the years is frequently the real measure of how we die. This reminds me of the adage, “He who lives by the sword dies by the sword.” It is not in the last weeks or days of life that we compose the message which will form our legacy, but in all the decades that preceded them. Certainly, for the man who waits until the eleventh hour to try living a life worth being honored and celebrated, he will be frustrated, if not downright defeated. He who has lived in dignity, dies in dignity. Antithetically, he who has lived a shameful, selfish, evil life will die in abject fear of the ultimate judgment his is facing.

William Cullen Bryant wrote these words, which I think capture this sentiment well:

So live, that when thy summons comes to join
His chamber in the silent halls of death,
Thou go not, like the quarry-slave at night,
Scourged to his dungeon, but, sustained and soothed
By an unfaltering trust, approach thy grave,
Like one who wraps the drapery of his couch
About him, and lies down to pleasant dreams.

Death is the one great certainty in life. Some of us will die in ways out of our control. Amazingly, most of us will be unaware of the moment of death itself. As we live longer on average than ever before in human history, we develop an increasing cultural denial of aging and dying. I find it shocking that death attitudes of our elders have not been well integrated into the fields of gerontology and psychology. In addition, gerontologists have not investigated the unsuspected and differing effects of various world religions upon the personalities of older individuals. There have been no solid comparisons of the religious beliefs of various elderly patients who represent different faiths.

Death-related attitudes and death anxiety tell us that such proclivities have a cognitive component that connects death to our lives. Older persons are more likely to be anxious about death when they have lower levels of ego integrity – ego identity versus despair, the last life stage – a high number of physical problems, psychological problems, poor sense of spirituality, or have been institutionalized for the remaining months or years of their lives. Elders who fear death seem to do so because of the unknown, possible impending wrath or punishment from God, loss of self, or lost opportunities in life. Tomer and Eliason (1996) proposed a comprehensive model of the death and anxiety scale that relates death anxiety to three factors: past-related regret, future-related regret, and meaningfulness of death.

Though in the everyday sense, death is the end of life, spirituality makes death more meaningful and less frightening. Death is, after all, merely the separation of body and spirit. Death of the physical body does not put an end to the journey of the conscious, fully-aware spirit living inside it. Being present when a loved one takes his or her last breath is a very formidable event. While death is no longer an enemy for a believer in Jesus Christ, it remains difficult for the dying and their loved ones. Romans 14:7-9 says, “For none of us lives for ourselves alone, and none of us dies for ourselves alone. If we live, we live for the Lord, and if we die, we die for the Lord. So, whether we live or die, we belong to the Lord. For this very reason, Christ died and returned to life so that He might be the Lord of both the dead and the living.” (NIV)

The Bible compares death to sleep more than fifty times. After death, we are asleep; we are unconscious; we are not aware of the passage of time. Ecclesiastes 9:5 says, “For the living know that they will die, but the dead know nothing; they have no further reward, and even their name is forgotten.” (NIV) This brings to mind the idea of legacy. Psalm 145:4 says, “One generation shall commend your works to another, and shall declare your mighty acts.” (ESV) For the longest time, I gave no thought to what kind of legacy I would leave. It actually seemed arrogant to me that I should leave a legacy. What do I claim as my legacy? Our mind tends to run our stats and score board during the “final quarter.” My past is rather checkered, to say the least, containing many sinful acts and failures. What, exactly, will I be remembered for? I’ve come to understand that the greatest legacy I can leave is to show the importance of obedience. No matter who you are, or where you’ve been – regardless of your age – you can live in the same manner as Christ lived through allowing His presence to dwell in you.

Genesis 2:7 tells us, “God formed man out of dirt from the ground and blew into his nostrils the breath of life. The man came alive – a living soul.” (MSG) The New King James translation puts it this way: God did not put a soul into man, but a spirit. Your soul is that part of you that consists of your mind, character, thoughts and emotions. The Hebrew word for soul is nephesh, which translates to “living being.” The Greek synonym is psy. The human soul is central to the personhood of a human being. As God is triune (Father, Son, and Holy Spirit), man is spirit, soul and body. 1 Thessalonians 5:23 says, “May God Himself, the God of peace, sanctify you through and through. May your whole spirit, soul and body be kept blameless at the coming of our Lord Jesus Christ.” (NIV) Man is made up of physical material, the body, that can be seen and touched. But he is also made up of immaterial aspects, which are intangible – this includes the soul, spirit, intellect, will, emotions, conscience, and so forth. Man does not possess an immortal body. When we die, the breath of life leaves us.

We have a soul at the moment of conception, but God knew us even before we became living souls. At the moment of sperm and egg becoming one, our complete “code”  becomes set in stone, and our entire blueprint is created. From that moment forward, our cells carry out the work of making our physical body. We are spiritually created the instant our genetic code is formulated. According to Scripture, death is not really normal or natural even though it is a persistent fact of human history. Why? Because man was initially created by God to be a unity of body, soul and spirit to live forever with God in fellowship with Him. This is the natural, normal state that God planned for man. According to the Bible, death is an enemy; the last enemy to be conquered by the death and resurrection of Jesus Christ. Death is the result of sin and the fall of the human race. (See 1 Corinthians 15:25-26) At the moment of death, believers will be made perfect and cleansed from all sin.

Knowing that death ushers us directly into the reality of either heaven or hell should make us look up to Christ as our refuge and salvation, and should make us strive “…to have as our ambition, whether at home or absent, to be pleasing to Him.” (2 Corinthians 5:9) Even for believers, the prospect of death is sometimes a fearful thing because death is enshrouded in great mystery as the realm to which we have never gone. But we may take courage and lay aside our fears in the confidence that we have a God who time after time says to his people, “Do not be afraid.” God wants his people to be comforted in the face of death.

Romans 8:38-39. “For I am convinced that neither death, nor life, nor angels, nor principalities, nor things present, nor things to come, nor powers, nor height, nor death, nor any other created thing, will be able to separate us from the love of God, which is in Christ Jesus our Lord.” (NASB)

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