Reflecting on death as a friend of life

 

Jenny Mackness wrote a beautiful blog post Death is a friend of life on her return from a 4 day course with Ian McGilchrist that explores the divided brain.

But Iain McGilchrist’s view is that life is literally on its way out in relation to the way in which we live our lives and behave as social animals in today’s society. Birth, sex, the body and death are all suffering.  Jenny’s post

Jenny’s own mother died recently and she says she hoped that this attendance on the course would provide some thinking space on this bereavement.

I have been profoundly moved by Jenny’s post and it got me thinking about my own experiences of death. My first significant bereavement experience was at 17 when my father died suddenly of a heart attack after returning from a walk. He was retired and when he died, I had been off school for four months with an illness that wasn’t life-threatening but required surgery (a few weeks after he died).  During this time we got know one another even better, talking about ‘adult’ topics like the General Election that was held that year. After his death, this time provided many precious memories. The way I became aware of his death was my mother coming downstairs and asking me to phone for the priest (to give my father the Last Rites). I was shocked by my mother’s request and asked if I shouldn’t call an ambulance first. She asked me to first phone the priest and then phone for the doctor. Knowing he was dead, she rejected the drama of the ambulance, and attended to his and her spiritual needs first.

Next, I thought of the only two deaths at which I have been present. In 1981, I found out, relatively late in my pregnancy, that I was expecting 2 babies, one of whom would die before or shortly after birth:  I have described the background in this post. I had 8 weeks to come to terms with the idea that I was carrying a baby I hadn’t known about and wouldn’t know for very long. I was very relieved that my baby Martin lived to be born so we could love him and say hello and goodbye to him. The unexpected event was the discovery that both twins had cleft lip and palates, and I spent the next four days coming to terms with what this meant practically in terms of feeding and in future surgery and treatment for the twin who lived. I very soon realised that Martin’s brief life and death really helped me to come to terms with his twin’s less serious condition. Martin had no aggressive medical intervention and I can honestly say that I regard being with him while he died to be a privilege. This was helped by the lovely agency nurse who cared for us all and allowed us to acknowledge his death when it happened.

I was also present at the death of one of my brothers a few years ago. He had a heart attack, was resuscitated and put on life support but tests revealed that he had suffered brain death. It was a terrible shock to his family and all of us, and I was privileged to be invited to be present when he died.

When I read what Jenny said about death, it chimed with my experience of my brother’s death surrounded by machines.  They can intrude, I think- tolerable when saving a life but out of place in a death that is inevitable.

Now death is often surrounded by machines. Unlike elephants and other animals who know how to mourn death (https://news.nationalgeographic.com/2016/08/elephants-mourning-video-animal-grief/), Iain McGilchrist believes that we no longer honour the reality of coming face-to-face with death, as we did in the past. Elephants seem to know and understand the reality of death.  Jenny’s post

We hear about the sad cases of decisions on babies’ life support when they come to court.  We don’t know how the medical staff and parents got to that point and it would be difficult to lay down rules I think.  In an earlier draft of the this post I wrote “The less said about the obstetrician the better” but on reflection, I want to say more about the role of medical professionals in my experiences of death. I was, I think, fortunate that at my 30 week hospital  check-up when the midwife detected more body parts than would be indicated by a single foetus, my double-barrelled name consultant was on holiday. The alternative consultant who supervised my scan gently helped me understand that though I would actually give birth to two babies, I would only go home with the one I had expected all along. In subsequent appointments , Mr double- barrelled name was reluctant to talk through the process of  Martin’s likely life and death – it seemed to make him uncomfortable.  He met me in the corridor after the twins were born, and spluttered something about ‘babies like that’ being put on ventilators in Liverpool, not something that I had ever requested.  I was fortunate in already knowing and trusting the paediatrician caring for my twins, from her care of my first son, whose life was saved with a ventilator. It must be very difficult for medical staff to predict outcomes when a baby is born with a disease that reveals itself later, and life support may be given then turn out not to be in the best interests of the child. Parents will naturally and rightly want their child to have the best life possible and it may be very difficult to relinquish hope.  Obviously, everyone wants to strive to heal a sick baby, but when healing is not possible, then quality of life becomes paramount.  I really believe that the dignified life and death that Martin and we experienced is a beautiful thing but it was fragile and depended on enough of the right people being around.

In the case of my father’s death, my mother chose to avoid the medicalisation of my father’s death by not calling for an ambulance.  Our GP arrived and certified my father’s death (though the Coroner’s office was later involved) without the need for him to be transported to hospital and medicalised in death.

How can death can be as good as it possibly can be in medical contexts?

There is a heroic narrative present in medical care that can get in the way of the humanity and trust needed for families and medical staff to act and make decisions on the care of the sick and disabled. Reading Jenny’s post, and reflecting on our experiences, it seems to me that not only can death be a friend to life but life can also be a friend to death.