Smoke Gets in Your Eyes and Other Lessons from the Crematory

There is a mid-fifteenth-century German woodcut entitled Triumph over Temptation that depicts a man lying on his deathbed. The denizens of heaven and hell surround him, fighting over his mortal soul. Demons with twisted porcine faces, claws, and hooves reach toward the bed to drag him down to the fiery underworld; above him, a horde of angels and a floating crucified Jesus pull a tiny version of the man (presumably his soul) upward to heaven. In the midst of all this commotion, the dying man looks positively blissed-out, filled with inner Zen. The little smirk on his face tells the viewer what he is thinking: “Ah yes, death. I’ve got this.”

The question is: how do we get to be that guy? The one who is facing his own death with complete calm, ready to get on with the moving-on.

The woodcut represents a popular genre in the late Middle Ages: the Ars Moriendi, or the Art of Dying. Ars Moriendi were instruction manuals that taught Christians how to die the good death, repenting mortal sins and allowing the soul to ascend to heaven. This view of death as an “art” or “practice,” rather than an emotionless biological process, can be tremendously empowering.

There is no Art of Dying manual available in our society, so I decided to write my own. It is intended not only for the religious, but also for the growing number of atheists, agnostics, and vaguely “spiritual” among us. For me, the good death includes being prepared to die, with my affairs in order, the good and bad messages delivered that need delivering. The good death means dying while I still have my mind sharp and aware; it also means dying without having to endure large amounts of suffering and pain. The good death means accepting death as inevitable, and not fighting it when the time comes. This is my good death, but as legendary psychotherapist Carl Jung said, “It won’t help to hear what I think about death.” Your relationship to mortality is your own.

I recently sat next to a middle-aged Japanese man on a flight from L.A. to Reno. He was reading a professional magazine called Topics in Hemorrhoids, complete with a large-scale photographic cross-section of the anal canal on the cover. Magazines for gastroenterologists do not mess around with metaphorical cover images of sunsets or mountainscapes. I, on the other hand, was reading a professional magazine that proclaimed “Decay Issue!” on the cover. We looked at each other and smiled, sharing a tacit understanding that our respective publications weren’t for popular consumption.

He introduced himself as a doctor and medical-school professor, and I introduced myself as a mortician trying to engage the wider public in a conversation about death. When he found out what I was working on, he said, “Well, good, I’m glad you’re talking about this. By 2020 there will be a huge shortage of physicians and caretakers, but no one wants to talk about it.”

We know that media vita in morte sumus or, “in the midst of life we are in death.” We begin dying the day we are born, after all. But because of advances in medical science, the majority of Americans will spend the later years of their life actively dying. The fastest-growing segment of the US population is over eighty-five, what I would call the aggressively elderly. If you reach eighty-five, not only is there a strong chance you are living with some form of dementia or terminal disease, but statistics show that you have a 50-50 chance of ending up in a nursing home, raising the question of whether a good life is measured in quality or quantity. This slow decline differs sharply from times past, when people tended to die quickly, often in a single day. Postmortem daguerreotypes from the 1800s picture fresh, young, almost lifelike corpses, many of them victims of scarlet fever or diphtheria. In 1899, a mere 4 percent of the US population was over sixty-five—forget making it to eighty-five. Now, many will know that death is coming during months or years of deterioration. Medicine has given us the “opportunity”—loosely defined—to sit at our own wakes.