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Skeletons in the Closet: Death as the Last Taboo

After you're able to envision your own death without breaking into a cold sweat, you're ready to make some choices so you can have as much control in dying as you have in living.
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Forward-thinker Dr. Timothy Leary first said, "[D]eath is the last taboo." He was right, but it doesn't have to be that way. Let's pick it up, spin it all around, look at all its facets, and then set it on the shelf right out there in the living room.

Fact One: Dying happens. It happens to everyone. To paraphrase Benjamin Franklin, it's the only guarantee in life besides taxes.

Fact Two: You have choices. While doctors and hospitals don't often discuss them with you, there are multiple courses of action when you or a loved one has a terminal disease or illness.

Fact Three: Death, whether it's your own or someone else's, can be easier if you think about it ahead of time and make a contingency plan. Those plans need to go way beyond pre-paid funeral arrangements or how you want the ashes scattered. We plan for every other eventuality in modern life, don't we? Why not plan for dying? We're Americans! We're pro-choice and have a right to have it on our own terms.

Easier said than done, perhaps. There are many reasons people don't think or talk about dying. Fear is high among them, but I think the bigger reason is that we don't have the words, the framework, the familiarity with the topic that helps us find a natural segue to start. How can you develop one?

The first step is to acknowledge on a visceral level that someday you will die. In our Western culture, we avoid that reality at all costs, which makes it much more shocking and traumatic when it inevitably occurs. You wouldn't pretend that you didn't have to eat or drink, would you? Yet dying is just another requirement of living.

People used to understand death. It was just another family event. Mothers died in childbirth. Fathers died in industrial accidents. Brothers died in wars. Children died of illness. It touched everyone from an early age, and people generally didn't live long enough to forget about it. It was sad but not frightening. Loved ones ate meals surrounding dead bodies. They lived with the dead for days before burial. Death wasn't a happy occasion but it was normal. Expected. OK.

I'm not suggesting that we stop using funeral homes, but we need to bring that kind of comfort zone into our modern thought process. Our focus has to be on the bigger picture, the continuum of mankind. It's not someone else's issue. It's yours. Be selfish about it; own it.

After you're able to envision your own death without breaking into a cold sweat, you're ready to make some choices so you can have as much control in dying as you have in living.

  • Do you want to be in the company of your family or friends, or do you want solitude?

  • Do you want familiar surroundings or doesn't that matter?
  • Do you want to know the truth about whether you're dying, or do you want the doctors to keep it from you?
  • Do you imagine yourself being peaceful? Afraid?
  • What role will your religious beliefs play, if any?
  • Will you try everything to stay alive, or do you think there comes a point when it will be O.K. to let your ending come at its own pace?
  • Do you believe in hastening death if you're terminally ill?
  • If your body is unable to perform basic functions, do you want technology to keep you alive?
  • How do you define quality of life, and is it important when making life-or-death decisions?
  • Taking a little time to imagine the most positive outcome, consistent with your own values and beliefs, will help you be prepared. Make some notes. They don't have to be fancy at first. Just the basics of what you've thought about so far. Put the notes aside for a week or two, then pick them up again. Do it over and over until the shock goes away, until it feels more normal. Until you're ready to talk about it.

    My next post will be about how to start the conversation once you're ready. In the meantime, keep thinking about it. Don't be superstitious. Thinking it won't make it happen any faster or slower, but like planning for your taxes, the clearer your picture, the more control you will have.


    Janice M. Van Dyck is an award-winning author and freelance writer. Her latest novel, "Finding Frances" (Winston-Higgins Press, April 2010), takes on the tough topic of end-of-life choices.