In the Slender Margin (6 page)

When my father-in-law died, we burned his favourite armchair, along with a gallon of Calona Red and his sharpest carving knife, so that he could feel at ease in his new home. I stood in the backyard of his house at the foot of the Chief Mountain and watched as the flames consumed the chair in minutes, leaving the blackened springs like the carcass of a beached whale. My father-in-law drank himself to death; I remember thinking how amazing it was that his wife put a gallon of rotgut wine on the burn pile for him. The ceremonies are non-judgmental: if the deceased drank himself to death with cheap wine, then cheap wine will be on the table.

I was drawn instinctively to many of these Salish rituals and practices. It made sense to light a candle in order to hold the spirit in the last days and hours; it made sense that someone should sit with the body from the time of death until burial or cremation so that the spirit would not feel frightened or abandoned; it seemed right to pick up a handful of dirt and throw it on the coffin before the plot was filled in—“a last handshake,” as the Coast Salish call it.

What I didn’t know, and was stunned to find out one afternoon, reading
Kaddish
by Leon Wieseltier on the steps of King’s College in London, Ontario, was that the Native
rituals that had resonated most deeply with me were also the rituals and beliefs of Jewish culture. Whereas the Salish light candles to hold the spirit of the dead, so Jewish tradition directs that a candle will burn for seven days to guide the soul from this earth to the next; whereas the mirrors are covered in Salish homes to protect the living from the gaze of the dead, mirrors are covered in Jewish homes to remind the mourners that this is a time to focus not on themselves but on the dead. In both traditions, from the moment of death, the body is not left alone until burial. Within the Jewish tradition, the people who sit with the dead body are called
shomrim
; within Salish culture, a watchman volunteers to sit the night through.

“Tradition is not reproduced. It is thrown and caught,” says Wieseltier. “It lives a long time in the air.”

From lighting candles and sitting with the body, to covering mirrors and throwing dirt in the grave—I had unwittingly been learning my own species song.

Test Pilots

I was regularly asked, by family members, to describe the dying process. I would tell them about how people often lapse into a coma in the days preceding death and how breath moves from the deep and regular to the shallow and intermittent. I would explain apnea and how people often hold
their breath for long periods of time, up to three minutes sometimes, and how everyone in the room also holds their breath until the gasping breath breaks the silence in the room. I would explain that people rarely die in the space between breaths, that they return to the body as if they’ve been on a practice run.

I would go over the possibility that phlegm would build up, resulting in what is known as a
death rattle,
a term that evokes a kind of dread, a term that conjures up scenes like the one Dostoevsky describes in
Crime and Punishment
: “She sank more and more into uneasy delirium. At times she shuddered, turned her eyes from side to side, recognized everyone for a minute, but at once sank into delirium again. Her breathing was hoarse and difficult; there was a sort of rattle in her throat.” I would talk about how the hands and feet get cold as blood leaves the extremities and pools around the heart and lungs in a last attempt to protect the vital organs, and how those hands and feet turn blue shortly before death. And I would talk about how the breath leaves the body, how it moves from the chest to the throat to the last little fish breaths.

The human embryonic heart starts beating approximately three weeks after conception: we are older than our hearts by twenty-one days. In the end, however, our hearts often outlive us, firing on for seconds, sometimes minutes, after our last breath. The moment of death is not always immediately evident; defining death has become a complicated business. In cases of brain death, ventilators, puffing like bike pumps, keep people alive after they have been declared legally dead, so that their organs can be harvested—not unlike a scene from the 1978 film
Coma
with Geneviève Bujold. In ICUs,
bodies are attached to machines that beep and chime with blue, green and red lines marking blood pressure, oxygen and heart rate on monitors that look like weather maps tracking massive storms.

“The proof that we don’t understand death,” says Jerry Seinfeld, “is that we give dead people a pillow.”

When writer Eleanor Vincent’s nineteen-year-old daughter was thrown from a horse and declared legally brain-dead twenty years ago, she was kept alive for a brief period so that her organs could be used. Eleanor remembers saying her final goodbye: “I learned that my daughter’s brainstem was actually gangrenous at the time she was declared legally dead. There was no chance she could ever live. Nonetheless, she appeared alive with rosy cheeks and a rising and falling chest when I stood before her for the last time.” In many ways, writes Vincent, “technology has fully outstripped our ability to comprehend what death is.”

With medical advances, we are faced with complex decisions about death—our own and those of our loved ones—in ICUs, hospital wards and hospices. When do we stop chemo, radiation, dialysis, surgery? At what point do we sign a do-not-resuscitate order letting people know that we do not want our ribs broken in an attempt to jump-start the heart? Keeping people alive in order to use their organs blurs the margin between life and death. Where is the demarcation line? In the words of bioethicist Stuart Youngner, “You could say, well, they’re almost dead, or they’re close to dead or they’re dead enough.”

That’s it, I think,
when they’re dead enough
and not a moment before.

At a recent dinner party, a friend talked about how, when the undertakers came shortly after her mother’s death to take the body away, her five-year-old daughter protested, saying, “It’s too soon, she needs time to rest from dying.” What’s the rush? We need time: the dead, the living, the nearly dead, the newly dead. Send the experts away; we all just need to think like five-year-olds. For a little while, anyway.

In his memoir
Patrimony,
Philip Roth writes about how, when his father was critically ill, he decided, along with the doctor, to forgo heroics and let his father die a natural death. The doctor, who was prepared to put Roth’s elderly father on life support, explained that once the ventilator was connected, it could not legally be disconnected. Roth leaned in close to his father and whispered, “Dad, I’m going to have to let you go.” A phrase he kept repeating until, as he says in the book, “I believed it myself.” Once, the Grim Reaper called the shots—and ultimately he still does—but death’s timetable has been co-opted by modern medicine.

Statistically, we are more likely to die at night when metabolic activity is at its lowest. The numbers also show we’re more likely to die of heart attacks on Monday mornings and, if we’re in hospital, weekends are a risky business. In my experience, people often died around five a.m. Once, when I was called around that time of the morning and told that a fifteen-year-old girl had died of lupus, I asked my ex-husband, as I headed out the door to meet the girl’s mother, what I could possibly say to her. I knew of her daughter; I knew that, after she was diagnosed at ten years old, she had slept in her mother’s bed every night and that they were inseparable. “Tell her that the heavens open at five a.m.,” he said. “Tell her that is when
the souls are gathered up and welcomed home with wide-open arms.” I was unsure about sharing this, not wanting to impose or make things “right” too easily, but as I sat with her and waited for the funeral home to come, I mentioned it and for the briefest of moments I thought I saw something like relief cross her face.

The idea of “home” is compelling. Pacific salmon are unique in that spawning is the last act of their life cycle. Hellbent for home, after years at sea, they return to lay their eggs and die in the streams and rivers where they were born. In Goldstream Park, not far from where I live, the salmon start appearing around mid-October. A few years ago, after a hot summer, I watched the fish thrash their way over dry rocks to reach a trickle of water, where they rested before jackknifing themselves into pools no deeper than two inches.

The instinct for home is a powerful one.

The dying, too, are often hell-bent for home. For the devout, it may mean going home to God; for the secular, it may have more to do with riverbeds and the urge to return to the original source. When they talk about wanting to go home, it is up to the living to decipher what this means. Sometimes it is a physical place: they want to leave the hospital and go home to die. Other times it is metaphorical. One man I met told his family on a Monday that he was going home at 3:18 p.m. on Thursday. Everyone, including me, waited to see what would happen. Thursday came and went, and we all felt a bit foolish for having thought we were witnessing an astonishing prediction. Who is to say the dying are punctual? He died the following day at precisely 3:18.

People want to know if the dying can hear at the end. I once listened to an ICU intensivist talk to a family whose mother was in a coma.

“Can she hear us?” they asked.

“Yes,” he replied. “She hears you the way a newborn hears the sound of its mother’s voice.”

I immediately liked that description. We hear our mother’s voices in utero; we hear them when we’re lying in our cradles and buggies. Before comprehension, there is comfort in the rise and fall of the familiar; words are less important than presence; meaning gives way to music and comfort.

My friend Lorna cites her love of Barry Manilow as a kind of proof of the subterranean existence of hearing—proof that the dying in a non-responsive state can hear us when we speak to them. When she comes home from a night shift at the hospital, she puts on her headphones and drifts off to the sounds of the local radio station. Nothing disturbs her: not the kids getting ready for school, the dog barking, not the garbage truck rumbling down the street. The only thing that can pull her out of sleep, she says, is if a Manilow song comes on the radio. She is unfazed by my clear ridicule of her musical tastes. Finishing off her tea, she smiles when she looks at me. “Proof,” is all she says.

“Music began,” says the British artist and writer John Berger, “with a howl lamenting a loss. The howl became a prayer and from the hope in the prayer started music, which can never forget its origin. In it, hope and loss are a pair.”

What, then, do the dying hear when we stand and wail at their bedsides? A sound more Wagnerian than Brahmsian? More Sturm und Drang than lullaby? In the longhouse each
winter, the new dancers can be heard crying from their makeshift tents on the bleachers above the dirt floor. Over a period of four days the dancers, known as babies, receive a song and a spirit helper during their initiation as spirit dancers. The drummers, listening carefully, circle the baby whose cry seems most urgent and begin to drum and sing in time with each cry. They know the beginnings of the dancers’ spirit songs are in their inconsolable wails. There are moments when I wonder if the dying might hear, in the cries of the grief-stricken, the first notes of their own songs.

In the early 1950s, child psychiatrist John Bowlby developed a theory of attachment. He believed the cries of a child served to reunite the infant with the mother; when the baby cries, the mom comes running. In grief, his theory holds: adults are all like children seeking reunion with the deceased. We wail to call them back. We wail so the bond won’t be broken. We wail with incomprehension at the separation. The truths are contradictory. When I first began working with the dying, I was struck by the resounding silence on the unit. In a place where people were dying every day, patients rarely cried and family members did not wail in corridors. Nobody tore their clothes or shook their fists at God. It was as if death itself was sleeping in the dimly lit rooms and nobody wanted to disturb it.

The polite silence wasn’t what I expected; but then, what did I expect? Something more Dionysian than Apollonian: more wine and drunkenness than cool marble and contemplation. Some sound to rise from the belly of grief. A howl and a respondent howl across a frozen lake. Something.

Go to the Health and Wellness section of most bookstores
and you will find titles such as
Dying Beautifully, Messages from the Light, Perfect Endings, Peaceful Dying
and
Deathing: An Intelligent Alternative for the Final Moments of Life.
Death is marketed as a teachable moment, a New Age journey for the enlightened. Take another look and you’ll often see the section right beside the one on death is stacked with books on sexuality.
La petite mort,
the French say for orgasm. Our ambivalence is clearly on display: we have one foot in the fire, the other in the grave. In North America it is easier to talk about sex than death. In the past, it was acceptable to talk to children about death but not sex; they were included at the deathbed at the same time as being told they were brought by the stork. Today, they receive sex education at school but might be told their loved ones are now stars twinkling in the heavens.

Sometimes we need help to break through our decorum. In many parts of the world, professionals are hired to cry at funerals. Wailers, usually women, stand by the grave and openly grieve; their high cries, a kind of ululation, spread amongst the mourners until they too break down. In Chile they were called
lloronas
; in Malaysia and Singapore in the 1960s it was said there were so many paid mourners at funerals it was hard to know if the families were actually there. In ancient Egypt, women were hired to cry and beat their breasts as it was believed the dead were ready to avenge the slightest sign of indifference on the part of those left behind. When I was ten, in grade five, I was assigned the role of grieving widow in a play we were performing about an Irish fisherman lost at sea. “You must keen,” said Mrs. Black, referring to the Irish word
caoinim,
meaning “to weep, wail, lament.”
Every day I stood on imaginary cliffs above the crashing waves and wailed as if my heart were breaking and my teacher had to gently suggest I tone it down just a little bit.