Death Dynamics

             Death is the destination we all share. No one has ever escaped it. 

          And that is as it should be, because Death is very likely the single 

          best invention of Life. It is Life's change agent. 

          It clears out the old to make way for the new. 

                    Steve Jobs

Death is “the termination of all biological functions in a living organism”, according to Wikipedia. The most common cause of human deaths in the world is heart disease, followed by stroke and other cerebrovascular diseases, and lower respiratory infections. ⁽¹⁾

Death is commonly considered sad or unpleasant, and is accompanied by anxiety, sorrow, grief, emotional pain, depression, sympathy, compassion, and solitude. The natural tendency is to avoid the thought of death because it makes people uncomfortable and even causes fear. Many consider the subject morbid. ⁽²⁾

For most people, their own life experience seems open ended. There seems to be no reason why normal experiences cannot continue indefinitely. With this view death, no matter how inevitable, is the cancellation of an indefinitely extendible good life.

The value of life is not mere organic survival. Surviving in a coma is not appealing to anyone. Many consider premature death dreadful. Objectively, it is recognized that humans cannot live much more than about 100 years. So, one can only feel deprived of those years that one does not live long enough to enjoy.  ⁽³⁾

Life after death

Ideas of the after-life and immortality are human constructs. Most religions teach that the immortal soul survives the body after physical death, which is comforting for many. Some say that the soul will live forever in either heaven or hell. Others suppose that after death the soul will reanimate in other life forms in an endless cycle of reincarnation. Atheists dispute the idea of a soul and are convinced that after death there is only nothingness.

Because understanding of life after death runs the gamut of human experience and cultural values, anthropologists conclude that man invented religion to explain life’s experiences and to offer solace from life’s troubles.

Longevity

Since 1900, life expectancy in America has jumped from age 47 to 80. This derives mostly from improved hygiene and nutrition; everything from heart surgery to antibiotics and drugs that combat most diseases. ⁽⁴⁾

The primary construct of most modern cultures is to prolong life, and rapid medical advancements are extending human lifetimes. Even without new high-tech advances, the UN estimates that human life expectancy will approach 100 years over the next century.

The cover story of the February 23, 2015 issue of Time Magazine was, "This baby could live to be 142 years old". ⁽⁵⁾

The question arises: would anyone want to live that long? The same question could have been asked in 1880, when life expectancy was only 40, about living to 75. And the same answers would be given: "Is it a good idea?" and  "Why would anyone want to live that long?" 

After about 60 many ailments come into play: Diabetes, arthritis, heart-disease, depression, Alzheimer's & dementia, Parkinson’s, hearing loss, incontinence, osteoporosis – the list goes on.

In the US, health care costs have grown faster than the economy as a whole – now 16% of GDP, compared to 9% in 1980. Consider this: 5% of the US population accounted for 50% of overall health care spending. 65% of medical expenses are for the elderly.

Most people are not philosophically, morally and socially ready to accept prolonged life. What will life be like when life is prolonged for those who can choose? People with a life expectancy of over 100 years are unlikely to retire at 65. If people knew they could live comfortably to 125, they’d likely have several careers.

Die at 75

Ezekiel J. Emanuel, an oncologist and bioethicist, wrote an article in The Atlantic, October 2014, headlined "Why I Hope to Die at 75".  Says Emanuel, when he reaches 75, he won’t actively end his life. But he will stop seeking medical treatments to actively prolong it: no cancer screenings or treatments after 75, no pacemaker or bypass surgery, no flu shots or antibiotics. ⁽⁶⁾ 

Emanuel is a vociferous opponent of euthanasia and assisted suicide. His essay is personal, about what he wants in his own life, how he wants to be remembered by his family and friends. He is 57; one wonders whether his views will change as he nears 75.

  

One must admire the blunt, unsentimental humanity with which Emanuel presents his case. Aging and death are realities in every life. No insurance policy, gym membership, or super food can fully protect us against a frightening, sad, depressing, or burdensome trajectory in our final days. These issues need to be discussed lovingly but plainly, long before these become immediately pressing.

At 77, I am in good health; I feel energetic and productive and still have places to visit on my “bucket-list”. But, as I watch friends and family grow old, with increasing aches and pains, debilitating ailments and memory loss, I sometimes wonder how I’ll fare as I approach my own end of life.

Death Cafe

According to a Pew survey, more than a quarter of American adults have given little or no thought to how they want doctors to handle medical treatment at the end of their lives. Another survey, found that 90% of Americans said it was important to talk about their own and their loved ones end-of-life wishes, but only 30 % have actually done that.

It seems that the emergence of Death Café fills the need. These have been taking place for several years, modeled on similar gatherings in European cities. People, mostly strangers, gather to snack, drink tea and have frank, open conversations about death. The objective is “to increase awareness of death with a view to helping people make the most of their (finite) lives”. ⁽⁷⁾

I’ve attended a Death Café meeting near my home. There were about 50 people present, ranging from college students to recent retirees, with no preponderance of any age group. It was a group-directed discussion of death with no agenda, objectives or themes.  There were a couple of speakers and organizers who got us started, and then we split into smaller groups to facilitate personal discussions.

Death Café has spread throughout the world. Take a look at the web link I’ve provided; there is likely a regular meeting not far from where you live.

Death Over Dinner

Here’s another similar concept that is gaining momentum: Death over Dinner. The website says, “How we want to die – represents the most important and costly conversation America isn’t having. We have gathered dozens of medical and wellness leaders to cast an unflinching eye at end of life, and we have created an uplifting interactive adventure that transforms this seemingly difficult conversation into one of deep engagement, insight and empowerment. We invite you to gather friends and family and fill a table.” ⁽⁸⁾

The first Death Over Dinner event took place January 2014, with 20,000 people downloading the starter kit and more than 1,500 registering their dinner parties.

“A lot of people (were) reluctant to talk about it beforehand,” says Ellen Goodman, who started her “Conversation Project” in 2010. “By the end of the dinners they’ve had some of the richest conversations they’d ever had.”

Dinner hosts can download a “Conversational Starter Kit” from the website, which includes questions like: Do you want to live as long as possible, no matter what; or is quality of life more important than quantity? Where do you want to receive end-of-life care, at home, at a nursing facility or a hospital? And what kinds of aggressive treatment would you want, or not want, such as resuscitation if your heart stops, breathing machines or feeding tubes? Most often, families confront these questions when it’s too late, in hospital emergency rooms or intensive-care units.

eDeath

Most of us probably have hundreds, maybe thousands of e-mails stored in computers, or on in the cloud. We likely have a Facebook page, or a Twitter account, and countless photos in a Dropbox album. All that information amounts to a digital profile of sorts.

This raises many questions: What happens to your online material after you die? What happens to your email, passwords, website, text messages? What will happen to your cyber presence after you’ve exited and your e-presence still lingers? It’s helpful to create an inventory of online accounts, to ensure your heirs know what's most important and where to find things.

In the early days of computers, people died with passwords in their heads and no one could access their files. When access to these files was critical, businesses would sometimes stop while they tried to figure it out. This is why programmers invented “death switches”. ⁽⁹⁾

With a death switch, the computer prompts you for passwords once a week to make sure you are still alive. When you don't enter your password for some period of time, the computer deduces you are dead, and your passwords are automatically e-mailed to the second-in-command.

People have started to use death switches to reveal their bank account numbers to their heirs, to get the last word in arguments, to confess secrets that were unspeakable during their lifetime.

Death switches provide a good opportunity to say goodbye electronically. People program their computers to send e-mails announcing their own death. Imagine receiving an email like this, from a friend: "I'm dead now and I’d like to tell you things I've always wanted to say..." ⁽¹⁰⁾

What happens to your online presence after your death is important. With Facebook, family members can choose one of two options: close the account, or convert it into a memorial profile. Facebook's policy states the company will never release login information to anyone other than the account holder, even after death. ⁽¹¹⁾

The Internet provides a place for people to express thoughts and feelings as they grieve a loss. Your social networking profile could become a spot where your friends and family can share memories of you. People who might not otherwise hear of your passing may learn of it through your profile page.

Let’s Engage

For this blog, I’m asking you to engage! Don’t just read passively.

This is an exercise that has helped me to consider my own feelings about death. You are in good health, but are informed that you have one week to live; you will die next Sunday, at noon. Answer the following questions – for yourself, or directly via the blog.

1. What will you do immediately? Will you quit your job? Will you tell your family?
2. Will you stay home? Or, will you travel to see loved ones?
3. Will you get your affairs in order? Or leave that for your family to do?
4. What will you do on your last Saturday? Will you sleep well that night?
5. Who will you choose to be with on Sunday morning, a few hours before noon?
6. What will you do in the hours or minutes before noon? Walk on the beach? Lie in bed and wait?
7. Do these reflections bother you? Or help you to understand yourself? 

Please express your views on your own “death dynamics” directly via the blog.

Reflection

Finally, here is a very simple question: How long do YOU yourself expect and want to live? ⁽¹²⁾

References

  

1. Wikipedia on “Death”: http://goo.gl/BiaB3o
2. Why Do We Avoid The Subject Of Death? http://goo.gl/wWaLUp
3. New Scientist – Death topics: http://goo.gl/FXQIHC
4. Life expectancy in the USA hits a record high: http://goo.gl/FWq3f0
5. Responses to Time, “Baby will live to be 142”: http://goo.gl/emTEht
6. Why I Hope to Die at 75: http://goo.gl/vbubA8
7. Death Café: http://goo.gl/IiTxEL
8. Death Over Dinner: http://goo.gl/OqM105
9. A brief history of death switches: http://goo.gl/KQPtos
10. Wired – Communicate From Beyond the Grave: http://goo.gl/6anIuk
11. Facebook rolls out feature for users when they die: http://goo.gl/4EwByL
12. How Long Do You Want to Live? http://goo.gl/G1GZOQ 

Jim Pinto

Carlsbad, CA.

USA

26 March 2015