Cambridge University Press, 2007, 297 pp., $21.99
A few days after my father died, in that interim between afternoon and evening prayers when a brief lesson is sometimes given, the rabbi chose as his subject the preparations for burial. How, I wondered, would the rabbi refer to my father’s body: Would he speak of the “deceased” or of my father’s “earthly remains?” Would he be less sensitive and refer to “the corpse”, or more clinical and refer to the “cadaver?” But nothing prepared me, when the moment finally arrived, for the rabbi’s reference to my father as “the carcass.” To their everlasting credit, my mother and sister had the good grace to burst out laughing.
Whether as comedy or as tragedy, the meaning of what surrounds the moment of death must somehow be taken into account. Death is a physical event, but dying almost invariably absorbs the engagement of others, whether directly as relatives and attendants, or indirectly, as companions in mortality. All cultures, therefore, have evolved ways to cope with death, and all socialize the young to behave properly in the face of death. It is Allan Kellehear’s thesis in A Social History of Dying that this concept of dying, as a social and cultural rather than a merely physical phenomenon, has changed markedly over the course of human history.
Kellehear divides the social history of dying into four periods. In the first, “The Stone Age”, he argues that social death actually occurred after physical death. Since hunter-gatherers lived lives that were often cut short by disease or accident, little concern was given to social preparations for death. Instead, attention was focused mainly on that “lengthy otherworldly journey” for which the burial or exposure of the body, and the contribution of grave goods, were aimed at assisting the deceased in the progress from live human to ancestor, specter, non-entity or god. “Death was not the opposite of life but its continuation”, writes Kellehear. Social death only took place after the deceased was sent on his or her journey, days or longer after physical death. Building on the claim that many other creatures besides human beings are conscious of their mortality, Kellehear sees this cultural response as an evolutionary development for situations in which the opportunity to prepare for death is limited.
In Kellehear’s second period, “The Pastoral Age”, sedentary agriculturalists could see death coming. Part of that earlier aspect of dying as an otherworldly journey was now reversed, so that dying became to a greater extent an activity of and within this world. The idea developed of the “Good Death”, one which was the proper culmination of the “Good Life.” Indeed, the good death was “a moral dying, a dying that can be done well or badly as a social performance.” What was previously an individual act of being toyed with by the fates now became a partnership with people in this world, particularly engagement with soon-to-be survivors, who began to participate directly in preparing for one’s absence. And because, as George Herbert Mead argued, the interests of the dying and those of the community may not fully coincide at such a moment, a nagging sense of ambivalence toward others’ interests in one’s death begins to crop up throughout the whole of life itself.
[credit: Ed Kashi/Corbis]
Kellehear attributes the shift to the third period, that of the “Managed Death”, to the rise of cities. A managed death is one that is controlled by professionals, one where “the adulteration of identity”, as University of Maryland psychologist Kenneth Sharoff calls it, is, in Kellehear’s words, “made ‘good’ by having the right people [clergy, lawyers, doctors] attend to you during dying and at the right time.” As the dying man or woman’s identity was parceled out to the care of professionals, it may now have seemed to family members, to borrow the words of the poet Roy Fisher, that “as he came near death things grew shallower for us.” In an age of ever-increasing attempts to control nature, dying was transformed from a “wild” thing into something that had to be, and for the first time could be, “tamed” by those who knew how to do so.
In the current “Cosmopolitan Age”, there has been an enormous erosion of the “awareness of dying.” Dying has become a trial, a stigma and an embarrassment. The preparations for death have been severed from dying, and after millennia of social involvement, dying as a collective act seems to be disintegrating. Citing disturbing figures about nursing-home deaths and very high rates of elderly suicide, Kellehear argues that the lingering process of dying has itself “become a form of social death, a living without supports and a dying frequently unrecognised.”
The de-socializing of death, notes Kellehear, shows up in the bland way death is now officially described. While observing that a number of death certificates in Britain simply list the cause of death as “old age”, he does not refer to the American practice of inscribing the rather accusatory phrase “failure to flourish.” (He would probably not be surprised that the local newspaper turned down my request to list my father’s cause of death as “murdered by God.”) His point strikes home, however. The poignancy of our having lost a clear sense of the social process of dying is strikingly captured in the words of a mortally ill student nurse anthologized in D.J. Enright’s The Oxford Book of Death (1985). She says to the fellow nurses caring for her: “The dying patient is not yet seen as a person and thus cannot be communicated with as such. . . . If you really care, would you lose so much of your valuable professionalism if you even cried with me?”
Although Kellehear initially suggests that the defining features of all four periods of the social history of dying may be found in each of the others, that assertion is quickly overwhelmed by his evolutionary approach to the subject. The “handful of simple styles” of dying to which he refers in describing the four periods is presented as an ineluctable process of the displacement of each by its successor. This process begins at the very beginning, in the evolution of life on earth to fully human consciousness, for the author insists that animals also know death. But recognizing a dead fellow creature or covering it from predators is not the same as contemplating one’s dying when one is not in extremis. Perhaps Vladimir Nabokov was right when he cited the old philosophy saw: “A syllogism: other men die; but I/ Am not another: therefore I’ll not die.” Citing beavers and platypuses or the social life of insects may be required by Kellehear’s evolutionism, but it is unnecessary as a vehicle for justifying his insights, and it is ruinous to his opening claim that different styles of dying may be mixed among historic periods. Unlike the new breed of geographic determinists such as Jared Diamond and Harm de Blij, Kellehear does take culture seriously. But he does not make a strong case for why it is only by understanding this developmental cultural history that we can “understand the development of contemporary priorities around death”, and his invoking the animal kingdom does not help.
Kellehear’s evolutionism becomes especially problematic when, in referring to the present period, religion totally drops out of his consideration. Even George Orwell, who did not seek the return of ideas about life after death, acknowledged that “its disappearance has left a big hole.” On the other side of the equation, as Miguel de Unamuno wrote in The Tragic Sense of Life, “in some recess of the soul of the true believer who has faith in a future life, a muffled voice, the voice of uncertainty, murmurs in his spirit’s ear: ‘Who knows?’” Perhaps in Britain, Australia and the Continent, where few people attend religious services, the Cosmopolitan Age debars real connections between religion and dying, but in the United States, where more than 40 percent attend services regularly, it is difficult to justify ignoring the role of religion altogether.
Questions of faith not only still matter in defining social death; they are essential in distinguishing certain forms of expression from others. Among Muslims, the idea of a good death can take a very different form. Those who die as pilgrims, martyrs or in an unpleasant manner, for example, require no prayers on their behalf, their earthly misdeeds having been erased by the manner of their deaths. Are we to speak of Muslim societies as “stuck” at some earlier stage of development? It is because he has banished religion from his analysis that Kellehear can convey such a chilling sense that in some countries the absence of an agreed, definable period of dying places people in a position of not knowing quite how they should act at death’s door—whether concerned family members or the soon-to-be departed. But is it true, or true to the extent he claims?
Kellehear’s rejection of religion as relevant to current social dying is also matched by his largely negative reaction to psychological theories of dying, even though at moments he allows such considerations to creep into his analysis. Just as he finds the historical work of Phillipe Ariès and others to be too selective in their portrayal of death in early modern Europe, so too he finds Freud’s ideas about the denial of death to be insupportable. If, as Kellehear asserts, Freud was wrong to argue that “it is indeed impossible to imagine our own death [such that] in the unconscious every one of us is convinced of his own immortality”, then why allow a place for psychology to return by claiming, as he does, that guilt, shame and conscience have played key roles in shaping our universal responses to dying?
Perhaps both we and the author need a more nuanced sense of how each of Kellehear’s four styles of dying—whether correlated to specific moments in social evolution or existing as part of a repertoire transcending periodization—are used (or not used) as a people’s sense of how to act before death becomes as problematic as other aspects of their collective identity.
It may be, then, that not knowing how to proceed with dying, rather than a loss of social identity as such, is at the heart of the matter. Recent surveys by Findlaw and by Harris Interactive for Martindale-Hubbell show that 55 percent of Americans do not have a will—many giving as their reason that they don’t know how to go about it, or don’t want to face the idea of dying. Nevertheless, 41 percent have living wills and 38 percent have assigned power of attorney for decisions affecting their health and mortality, acts that clearly suggest some consciousness of a dying process. Are these figures low or high? Do they portend realism, denial, obstinacy or a lack of established social conventions for dying? The uncertainty is real enough, as illustrated by a colleague who told me she wanted to tell her children to shoot her when the time comes; but she realizes that in her dotage she may forget to tell them when the hour is nigh, or worse, she might remember, only to have them do it too soon.
Whatever the reasons for the modern blurring of the line between living and dying, there can be little doubt, as Kellehear insists, that dying in a nursing home can be a desperate and anonymizing act—a good deal like Beckett’s view of hell as involving “small chat to the babbling of Lethe about the good old days when we wished we were dead.” On the other hand, if the tender ministrations of hospice care are any indication, the sociology of dying may be more varied and even more creative than the limited examples that Kellehear’s bleak view suggests. Those ministrations vary widely, from silent morphine at the ready to highly idiosyncratic rituals such as, in the recent case of a friend’s parent, a chorus of caretakers overpowering the death rattle with the singing of German hymns.
Ultimately, the strength and weakness of A Social History of Dying lies in its typological claims. A crisp typology of forms of social dying usefully focuses our wandering attentions, but at the same time clear categories do not always run true to form, and comparative instances from multiple cultures suggest not evolutionary necessity but alternative ways of coping with living identity (and not just dying identity). There appears to be a wide range of creative possibilities—many more than Kellehear’s four in number—presented by history and changing social forms in the ongoing quest for a form of expression that feels right.
As far as we in the West are concerned, in the absence of ritual acts and phrasing, we can conceive of or discuss dying no more than we can many other emotions. The rabbi who could not find a comfortable term for my father’s body may therefore be forgiven for feeling, as did Jacques-Bénigne Bossuet in the 17th century, that on death
our flesh soon changes in nature, our body takes another name. . . . It becomes a je ne sais quoi which no longer has a name in any language; so true is it that everything dies in it, even to those funereal terms by which its miserable remains were known!
Whatever other social forces may be at work, perhaps the thought of being a “carcass” will be enough to stimulate a new and comparatively desirable vision of the process of dying itself.