Death Together: Finding Hope in The Lost Art of Dying
A student chaplain looks back on his summer at a cancer hospital through the lens of L.S. Dugdale’s account of a culture that has lost sight of death in its mania for living well.
By Manato Jansen
During my first overnight on-call shift as a hospital chaplain, I witnessed the painful resuscitation of one of my patients. The man was in his sixties and was losing his battle with cancer. Weakened by his medication, his heart gave in to exhaustion that night. I’ll never forget his heartbreakingly slow demise as the night progressed, nor the panicked wailing of shock from his loved ones as we read the parting blessings early the next morning, the reality of his imminent departure more tangible than ever, despite the doctors’ intervention.
My patient was brought back from the brink of death that night, but at what cost? He was spared a few more hours to live, but with broken ribs, unconscious, intubated, and in a coma. The pain was palpable as the mechanical beeps and pumps of the ventilator filled the cold, sterile room—not only did the physical trauma of the resuscitation add to my patient’s suffering, but the family and friends who witnessed his debilitated state in his final hours were filled with remorse for having authorized the painful procedure. As I read an end-of-life blessing from my pocket prayer book the following morning and placed a comforting hand on the shoulder of the patient’s brother, who could no longer remain standing due to the intensity of his distress, I couldn’t help but feel that something was wrong with how all this was allowed to happen. Silently I told myself, no one should have to live into their death like this.
I read L. S. Dugdale’s book The Lost Art of Dying a couple of months after my first unit of chaplaincy came to a close, and her book has helped me process my concerns about the lives and deaths I witnessed that have been with me since I first walked the corridors of the hospital. Dr. Dugdale, a professor of medicine at Columbia University and founding co-director of the Program for Medicine, Spirituality, and Religion at Yale, opens her book with a similar story of resuscitation and remorse, when one of her patients was brought back three times in one night at the request of his daughters, who refused to let their father go. Using Dugdale’s study of the intersections of ethics, spirituality, and medicine, The Lost Art of Dying raises the question of what would mean for our modern world to reclaim the art of dying well, by looking at how people in the past addressed the fear of death and brought communities together to support and send off the dying in grace and peace.
Many of my patients were afraid and didn’t know how to start asking the questions they had about death.
Building on the ars moriendi, a text from medieval Europe dedicated to the art of dying well, Dugdale notes that although the fear of death has been present throughout human history, our modern American culture has, over the past century, developed an imbalanced focus solely on the art of living well. She argues that the economic growth of the Roaring Twenties and the luxuries and freedoms that came with it, paired with significant advancements in medicine, including the developments of vaccines and antibiotics and the ability to transplant organs, all fed into a general sense of control and invincibility over death.
Dugdale’s account resonated with me because it is true to my own experience as a chaplain at a cancer hospital. Most of my patients were in their seventies. Many described having lived a good life, having grown up in the church, but having walked away for the majority of their lives, never thinking much about death until the reality of their own deaths was inescapable.
One of my patients saw clearly enough to describe to me how the comforts and pleasures of her life distracted her from ever giving serious thought to the uncertainties of life after death, or what her own death might look like. Many of my patients were afraid and didn’t know how to start asking the questions they had about death. Along with fear, they most often expressed loneliness. Whether it be a lost spouse, severed ties with family, or loved ones simply living too far away, my patients shared with me their dread at the thought of facing the end of life alone. Clearly they weren’t the only ones in this predicament: Dugdale describes how she witnessed this same pattern play out far too many times, and often far too late to offer her patients much help.
As a chaplain, I’d like to help build a culture that doesn’t evade the reality of death, but instead embraces its certainties and uncertainties in community with others.
Dugdale doesn’t offer many concrete solutions for our culture, but she emphasizes the areas of our human experience that need healing and change: embracing our finitude and fear, building stronger communities, and acknowledging the body and spirit for what they are. Dugdale invites us to consider the importance of community, which she describes beautifully in the metaphor of drama—the dying as a protagonist, with their community members playing supporting roles. Many medieval communities would ring a bell at the time of someone’s pending death, Dugdale writes, and crowds of community members would flock to the scene, comforting, praying with, and supporting the departing as instructed by the ars moriendi. What might this kind of a community look like for us today?
I have a few ideas. Perhaps our churches could have a weekly team of on-call parishioners who answer the call when a dying community member requests fellowship and solidarity, even if they are complete strangers. I would also love to see us build living communities where young adults and the elderly live together, sharing wisdom, making meaning together, and combating loneliness on both sides. And as a chaplain, I’d like to help build a culture that doesn’t evade the reality of death, but instead embraces its certainties and uncertainties in community with others. In the Christian tradition, even Christ was terrified of his impending death—so terrified that he prayed for God to save him from his suffering (Luke 22:39–46). The unknown will always be naturally unsettling to us, but rather than ignoring the reality of my mortality, I’d like to try to move toward death with good company to help me bear the load—and to help my fellow travelers to do the same.
Manato Jansen was born and raised in Japan and now lives in Boston, where he is working toward his MDiv at Harvard Divinity School (’22). He pursued his undergraduate studies at Calvin University (’15), where he helped establish the college’s first interfaith dialogue student program. He currently serves as a ministerial intern at Old Cambridge Baptist Church and Addir intern with MIT’s Office of Religious, Spiritual, and Ethical Life.
The Lost Art of Dying: Reviving Ancient Wisdom is published by HarperOne, an imprint of HarperCollins Publishing. Fare Forward is grateful for their provision of a review copy for our writer. You can purchase the book on their website here.