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Death becomes us.

Can your final hours be your finest hours? Only if you're able to look death in, the eye and see your true self. Patrick McCormick discusses three new books that have the audacity to suggest that death can bring out the best in you.

In Scott McPherson's bittersweet film "Marvin's Room" (1996), Aunt Bessie (Diane Keaton), who has been taking care of her ailing father Marvin (Hume Cronyn) for most of her adult life, informs her doctor that "Dad's dying. He's been doing it for about 20 years now--so I don't miss anything." And neither do we--get to miss anything, that is. McPherson's small film offers us something one rarely sees in an American movie--a long, loving look at dying. A meditation on our mortality. There's no fast forward here, none of the flurry of rapid-fire deaths we're so accustomed to in our summer blockbusters, nor any of the high-tech trauma and adrenaline rush we get on "ER" or "Chicago Hope," with gurneys crashing into operating rooms and doctors racing to answer codes. Instead, death and dying are slowed down to real time, shown life-size without bombs or surgeons. We're treated to a steady, unblinking gaze that takes in all the creeping infirmities and insults of age and illness and never lets us forget death's ultimate inevitability.

Yet as frightening as this thought is to most of us, something rather magical occurs in the telling of this story. Seen through Bessie's eyes, the sickbed is not a medical battlefield or a place of exile or indignity. Rather it becomes something of a chapel, a chamber where the frail holiness of our humanity is gradually uncovered. Marvin's room, where a childlike father is entertained with prisms and fed creamed spinach, is in McPherson's film a sanctuary where we are stripped of all the armor and defenses of our powers and possessions, where we are rendered weak and dependent, and where all that remains is a touch of compassion and grace. It is our undressing room for this life, and perhaps our dressing room for the next.

This is a very different vision of death and dying than the one we are normally treated to at the movies. And different as well from the painful, high-tech, costly, and increasingly lonely one that haunts so many of our dreams and fuels our public appetite for an easy or assisted death. But it is a vision of what death might be, what it can be.

It is also a vision McPherson did not come by cheaply. In the program notes of the original New York play, the author, who died in 1991 of AIDS, wrote: "Now I am 31 and my lover has AIDS. Our friends have AIDS. And we all take care of each other, the less sick caring for the more sick. At times, an unbelievably harsh fate is transcended by a simple act of love, by caring for one another."

In his life and art the playwright found that the terror and loss of dying could be faced--sometimes even transcended--by keeping company and showing compassion, by offering and accepting a cup of water, a change of linens, a hand to the bathroom.

This article of faith is also the central argument of three recent books about death and dying--one by a popular psychiatrist and spiritual writer, another by a hospice physician, and the third by a hospital chaplain and long-term AIDS survivor. The authors of all three texts contend that instead of seeing death as the ultimate insult, defeat, or indignity, instead of repressing our terror of this monster that goes bump in the night, it is possible to come to grips with death, to face and move through our fears, suffering, and losses, and to open ourselves and our loved ones up to something redemptive.

In Denial of the Soul: Spiritual and Medical Perspectives on Euthanasia and Mortality (Harmony Books, 1997), M. Scott Peck takes on the question of assisted suicide, arguing that this may well be the central moral and spiritual question of our day. Acknowledging that far too many Americans continue to suffer unnecessarily prolonged and painful deaths (usually as a result of poor pain management and uncalled for "heroic" measures offering the patient little or no benefit), Peck nonetheless maintains that legalizing assisted suicide would be a grave mistake.

To begin with, as he asserts over and over again in the text, there is no need for any person to die in intractable physical pain, and thus no need to kill people to put them out of their misery. According to Peck (and here he strongly disagrees with supporters of assisted suicide like hospice physician Timothy Quill), palliative measures and treatments are currently available that would allow physicians in any U.S. hospital to control the physical sufferings of their patients. The only reason large numbers of persons continue to die in moderate to severe pain, Peck believes, is that for any number of reasons their doctors and nurses fail to recognize and respond to their cries for help. Instead of killing their patients, Peck suggests medical professionals simply need to learn to diagnose and manage their pain better.

Peck is also deeply concerned about the grave risk of injustice that would be associated with legalizing assisted suicide in the United States. In a society without universal health care, and at a time when the government and HMOs are increasingly concerned with cutting health-care costs to the bone, it would be surprising if those being "assisted" in their dying didn't turn out to include a disproportionate number of the poor and uneducated.

Peck's central objection to assisted suicide is that he sees both euthanasia and assisted suicide as "attempts to avoid the existential emotional suffering" associated with dying or a long debilitating disease. This "existential suffering," as Peck calls it, is the pain we experience in the face of all the losses and insults associated with dying.

Unlike physical pain that can, and should, be treated with morphine or other drugs, this existential pain must be faced. Indeed, as anyone familiar with Peck's other writings (especially The Road Less Traveled) can tell you, it is one of Peck's central convictions that the single source of all psychological and spiritual illness is our unwillingness to face or "do" our own existential (or authentic) suffering. Thus any attempt to end suffering is always a mistake, usually a very costly one.

In Peck's opinion, death offers us a profound opportunity to grow personally and spiritually. "We have an enormous amount to learn from the process of dying a natural death. To kill oneself in order to avoid the existential suffering of aging and dying is to shortchange oneself of that learning. It is also, I believe, to short-change the God who designed us for that learning."

By facing and moving through the existential suffering brought on by the losses of dying, we may, according to Peck, be able to resolve long-standing questions, become reconciled with our families, friends, selves, and our God, and experience profound spiritual growth. This suffering can even be redemptive, for if faced honestly it allows us to shed our secular illusions of self-sufficiency and abandon our idolatry of "autonomy" as the virtue of late-20th-century Americans. We discover that our real dignity as persons is not dependent on what we have or what we can do but on the graciousness of a God who calls us to be compassionate to one another.

Ira Byock makes a number of the same points in Dying Well: The Prospect for Growth at the End of Life (Riverhead Books, 1997). The president of the American Academy of Hospice and Palliative Medicine, Byock agrees with Peck's contention that far too many Americans die needlessly prolonged, painful, and expensive deaths, and he can certainly understand why so many of us would be afraid of dying in this way. Still, he is deeply critical of attempts to deal with the crises surrounding the care of the dying by introducing assisted suicide.

For him the challenges of "dying well" cannot be addressed by putting patients to death or by allowing them to put themselves to death. Dying well is a matter of coming to grips with the losses and suffering associated with dying, while helping others to die well is largely a question of learning to accompany and compassionately care for them in the dying process. And Byock believes that it is quite possible for more and more of us to die well.

In a passage that sounds very similar to Peck, Byock describes what he means by dying well and what characterizes those patients and families who manage to negotiate the pilgrimage of dying with some real grace.

"Patients who died most peacefully and families who felt enriched by the passing of a loved one tended to be particularly active in terms of their relationships and discussions of personal and spiritual matters. These families in particular also seemed to be involved in the person's physical care. In the broadest sense, it was as if dying from a progressive illness had provided them with opportunities to resolve and complete their relationships and to get their affairs in order."

Dying, then, at least when it involves an illness of some duration, offers us an opportunity--perhaps our best, certainly our last--for growth and reconciliation. And Byock believes that the way to take advantage of that opportunity is to face the suffering and challenges dying brings. He tells the stories of a dozen different persons and families facing death, and suggests that while for some the challenge is to learn to accept a growing dependence and let go of control, power, and prestige, for others it may be to acknowledge their fears and sadness, to learn to ask for help, or to bind up old wounds by asking for forgiveness or apologizing for past sins.

Again and again Byock reminds us that our dignity does not consist in our ability to control the events of our lives or go to the bathroom by ourselves, but in our capacity to face and accept the changes and losses that come to us and to learn from these experiences. Furthermore, he suggests our real dignity comes from coming to terms with our own sufferings and the sufferings of others--to offer and accept care.

Joseph Sharp has a very personal acquaintance with death and dying. A long-term survivor of AIDS, the author of Living Our Dying: A Way to the Sacred in Everyday Life (Hyperion, 1996) has served as a hospital chaplain and spent much of the past decade facing his own dying and learning to care for others as they die. As a result of these experiences Sharp has become convinced that dying is not merely a question for those in the end stages of life but a central mystery of the fabric of our whole lives. All of us,whether young and vibrant or sick and bedridden, are going to die, and we cannot postpone wrestling with the meaning and challenges of this question until a physician tells us we have cancer or AIDS. Instead, "you need to be waking up to the fact that you and everyone you love are going to die one day, and there must be more to life than you are currently experiencing."

According to Sharp, acknowledging and facing our dying, living consciously and honestly up against our mortality, is a path to the sacred that we need to follow all our lives. For every day has some dying in it. Every new place, job, friend, opportunity, and moment involves some bit of dying, some letting go of the one that preceded it. We are always moving on, losing our children as they become adolescents, our youth as we become middle-aged. Every change is a kind of death.

So our lives, if they are to be honest and conscious, must be lived in a present that is always giving up the past to move into the future. This calls for a kind of detachment, a sort of defenselessness, that allows us to travel lightly. We learn not to hold on to possessions, titles, power, or even the solace of absolutely certain answers but to live simply and consciously up against the mystery of our dying lives. We learn to sit for an hour with Jesus in the garden.

This sort of honesty, simplicity, consciousness, Sharp argues, teaches us compassion. Because we learn to look unflinchingly into the mystery of our own dying, we are not frightened by the dying of others, and we can keep them company. We can keep the dying company even when we no longer have the power to make them better, to offer cures, or to provide answers that make the pain go away.

Near the end of "Marvin's Room" Bessie (who is herself dying of leukemia) tells her sister Lee (Meryl Streep) that she is deeply grateful to have had so much love in her life, and Lee agrees that their father and aunt have loved Bessie a great deal. No, Bessie notes, she has been lucky to have been able to love them so much, to have had so much love in her heart.

Perhaps they are both correct, that our greatest blessing is that we love and are loved. Peck, Byock, and Sharp have each argued that death is not an enemy to be defeated or fled. Dying is an opportunity to live compassionately, to accept our own limits and creatureliness, and to reach out to our fellow pilgrims. Certainly it would be a mistake to flee before such an opportunity.

By Patrick McCormick, an assistant professor of ethics at Gonzaga University in Spokane, Washington.
COPYRIGHT 1997 Claretian Publications
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1997, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:motion picture Marvin's Room depicts spiritual side of death
Author:McCormick, Patrick
Publication:U.S. Catholic
Date:Nov 1, 1997
Words:2287
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