Read Knocking on Heaven's Door: The Path to a Better Way of Death Online
Authors: Katy Butler
Tags: #Non-Fiction
his hand. I was fifty-nine and had never before sat at a deathbed.
Once upon a time we knew how to die. We knew how to sit
at a deathbed. We knew how to sit and how to die because we
saw people we loved die all through infancy, childhood, youth,
middle age, and old age: deaths we could not make painless,
deaths no machine could postpone. The deaths of our ancestors
were not pretty. Some died roaring in pain. But through the cen-
turies we tutored ourselves in the art of dying by handing down
stories about how those we loved met their deaths.
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When St. Francis was in his forties in 1226, having suffered
years of illness and sensing his death was near, he “caused
himself to be stripped of all his clothing, and to be laid upon
the ground, that he might die in the arms of the Lady Poverty.”
Death did not come as quickly as he expected. He was taken
back into the house where he’d lain and lifted back to his bed.
He asked his monks to sing him his own “Canticle of the Sun.”
“Praised be my Lord for our sister the moon, and for the stars,
which He has set clear and lovely in heaven,” the monks sang,
and they added new lines that St. Francis had recently written.
“Praised be my Lord for our sister the death of the body, from
whom no man escapeth.” The next day, “when his pains were
some little abated,” St. Francis put his hand on the heads of
each of his monks, and gave his blessing “unto all the Order
present, absent, and to come, even unto the world’s end.
“Then as the sun was setting, there was a great silence,”
went one version of St. Francis’s death story, as recounted by a
Victorian essayist:
As the brethren were gazing on his face, desiring to see some
sign that he was still with them, behold a great multitude of
birds came about the house wherein he lay, and flying a little
way off did make a circle round the roof, and by their sweet
singing did seem to be praising the Lord with him.
Such holy deaths were not reserved for saints. In the fif-
teenth century, when Europe was so decimated by the Black
Death that there weren’t enough Catholic priests around to give
Last Rites, our ancestors created road maps for the deathbed.
The earliest Latin versions, written by priests, were called, sim-
ply,
Ars moriendi,
or
The Art of Dying.
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revised over time to fit Protestant theology, included
The Boke
of Crafte of Dyinge, The Art and Craft to Know Well to Die,
and
Rules and Exercises of Holy Dying.
The
Ars moriendi
did not sugarcoat the death agony, and they
described scenes foreign to us now. Relatives and friends gath-
ered at the bedside at home and followed the script of the
Ars
moriendi,
asking the right questions and saying the prescribed
prayers, giving the dying person reassurance and hope. The hall-
mark of a good death was not an absence of suffering but the
ability to meet it with faith, courage, and acceptance. Stoicism
was not required: in 1651, the Anglican theologian Jeremy Tay-
lor wrote in his
Rules and Exercises of Holy Dying
that it was
okay to groan on the deathbed.
The
Ars moriendi
texts did not pretend that dying was the
pinnacle of a lifetime of meaningful growth experiences. Their
authors lamented, even in 1491, that “men seek sooner and bus-
ier after medicine for the body than for the soul.” They portrayed
the deathbed not as a lowly place of helplessness and meaning-
less suffering but as a mighty, transcendent battleground where
angels and demons struggled for control of the soul. The dying
person, not the doctor, was the star of the show. Her anguish
was framed as a series of temptations to sin: wavering faith,
despair, impatience, regret for past misdeeds, reluctance to say
good-bye, and especially fear of death and hell. Dying was not
merely a physical agony; it was a spiritual ordeal. Its suffer-
ing had meaning. The brave person did not battle Death but
regarded dying as a test of one’s trust in God, an earthly puri-
fication to be followed by a heavenly reward, a sacred rite of
passage as profound and familial as a christening or a wedding.
The Good Death was marked by last words, treasured by the
survivors, expressing repentance for past misdeeds, acceptance
of God’s will, and confidence in his mercy.
My father did not die that way. He did not say three times,
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as the
Boke of the Crafte of Dyinge
recommended, “Into thine
hands, Lord, I commit my soul.” I did not ask him, as I would
later learn that the
Ars moriendi
recommended, if he asked for
God’s forgiveness, if he forgave those who’d harmed him, if he
forsook all the goods of the world, and if he thanked God for
Christ’s sacrifice. I held his hand and said almost nothing.
All I could see was his closed eyes and his labored breathing.
Dr. Elisabeth Kübler-Ross, in her 1969 best seller, theorized
that dying people moved through stages of denial, anger, bar-
gaining, depression, and acceptance, though not necessarily
in that order. If anything, my father had moved backward over
time, from acceptance to depression and anger.
He was doing the long, hard work of his dying in a small,
windowless, interior room within his own body, his once-boom-
ing and argumentative voice stopped by dementia, deafness,
stroke and brain damage, pneumonia and morphine. If he cried
out inside that small interior room, if he yearned for reconcili-
ation with his estranged son Michael, if he desired Jonathan’s
forgiveness for having been a neglectful father, if he forgave my
mother, if he saw white light or his dead brother Guy welcoming
him to paradise, I will never know.
The well-known hospice and palliative care doctor Ira Byock
counsels the dying and those they love to say to each other some
version of these words:
I love you. Thank you. Please forgive me. I
forgive you. good-bye.
My father and I said none of those things.
My father just breathed, a terrible loud, ever-louder breath-
ing, like someone working very hard at something, at something
like someone building a wall, like someone delivering a baby. As
he breathed day and night, as his lungs filled with fluid, he was
washed and changed and kept clean by kind paid strangers, and
my mother cried and pled for forgiveness, and I came and went
and held his hand. There was nothing left for us to do. In word-
less ways, over seven years, I had already said,
I love you. Thank
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you. Please forgive me. I forgive you.
I comforted myself with the memory of waking him on the last morning of my last trip home,
when I’d said, “Good-bye. I love you. Go back to sleep.”
As my mother and I made our passages to and fro through the
quiet streets of Middletown, we looked like anyone else there,
shopping for a roasted chicken or opening a car window or just
walking dully along. In the evenings at Pine Street, we found
messages from some of my father’s old colleagues on the answer-
ing machine—the outward and visible sign of a community
which still loved him and had wanted to connect throughout
his long illness but often had not known how. My mother, in her
agony and shame, or in her émigré self-reliance, or her reflexive
drawing-in to her core, discouraged them from coming to the
hospital. He was unconscious, she said. What was the point?
No all-night lighted square of window signaled to our neigh-
bors, who could not see my parents’ carefully sited house from
the street in any case, that our ancient vigil was under way. My
two brothers were still on the West Coast, throwing clothes into
their suitcases and shopping for funeral clothes. I dreaded their
arrival. Brian pleaded with me to let him fly in and support me,
but I still had not learned how to say, “I need you,” and I said no.
My father was a guest in a hotel for the dying. The hospice
nurses, practiced at filling the spiritual vacuums of contem-
porary life, would minister to us unobtrusively, the way priests
and family members once did. I was grateful. One calm nurse
explained to me that nobody could say exactly when my father’s
death would come, but that it
would
come: thus she gently dis-
abused me of my fantasy that maybe my father would get better
somehow and come home. To the hospice nurse, death was not
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an emergency. It was part of the plan. She told me that as the
time got closer, my father’s feet and hands would turn blue, and
her map of the coming of death calmed me.
She told me that thanks to the morphine, my father wasn’t
suffering, but I didn’t believe her. I knew that if we gave the word
he’d be gurneyed immediately to intensive care, where he’d be
shot full of antibiotics and hooked up to intravenous lines and
perhaps a respirator, and perhaps survive to die another day. I
wanted my father to die as quickly as possible. I wanted him not
to die until my brothers got there. I felt as if we were killing him.
I did not want him to die at all.
I had prayed for his death, awaited his death, and expected
his death. And now that it was nearly here, I was surprised it
had come.
My ancestors often did not know what they were dying
of,
but
knew when they were dying. Sometimes they saw their deaths
coming, and comforted those they loved ahead of time. When
hope was pointless, they fell back on the ancient technology of
acceptance. “I do want you not to fret about me,” my Quaker
great-grandfather James wrote in 1876 to his mother, Mary
Watts Butler, from the farm where he was staying in the Eng-
lish countryside, stricken by the tuberculosis that a generation
earlier had deformed his father’s backbone and killed his grand-
father and his aunt. James was only in his early twenties when
he wrote, He was in his early twenties. “We all know even if
we don’t often think about it that we all must pass away & that
our happy family circle must inevitably gradually dissolve.” His
younger sister Mary had died suddenly of typhoid at the age
of thirteen in a Quaker boarding school, and her death, James
went on, “spoke forcibly to all of us. It told us of the uncertainty
of life & of the necessity of preparing for death. I trust that I
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may join my dear sister, & that as we all one by one quit this
earth we may one by one re-form the family circle in Heaven.”
James’s doctors could do nothing for his health beyond suggest-
ing that he move to a sunny climate. Soon after he wrote his
mother the letter, he sailed for South Africa, settled in the des-
ert, and to everyone’s surprise, recovered enough to start the
Midland News and Karoo Farmer,
marry a farm girl named Lettie
Collett, and sire seven healthy sons and daughters, all of whom
lived long lives.
At my father’s bedside, I drew no comfort from the notion that
our family circle would ever be reconstituted in heaven and
even less from the notion, held by some of my fellow Buddhists,
that my father would be reborn in another form. I believed that
rebirth and heaven were myths, comforting stories for chil-
dren afraid of the dark. I believed that my father existed only
as long as the material conditions supporting his life existed,
and that when those conditions disappeared, he would disap-
pear too, leaving behind only memory traces in our minds, like a
trail of bubbles in a cloud chamber. The molecules of his body
would become part of cells in other bodies: plants, lizards, vinca
minor, figs. His love for me would live on inside me, just as my
brother Jonathan’s sense of abandonment would live on inside
him. That was the limit of my belief in eternal life.
All I could see was his closed eyes and his labored breathing.
The pacemaker kept delivering its tiny pulses.
His breathing grew ragged and his feet, as the nurse had
warned me, slowly started to turn blue. Sometimes yellow phlegm
dribbled out of his mouth onto the cloth the nurses had placed by
his pillow. In the presence of his extreme helplessness and suffer-
ing, I felt horror and disgust. But I had no prayers to say.
I left my mother and went alone to the Wesleyan library,
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