Carol was a 50 year old wife, mother, and grandmother.  She was a business executive and a registered nurse.  Carol had leiomyosarcoma, a fatal cancer that grew tumors in her chest.  For the last 14 months of her life she kept a journal to record her thoughts and feelings as she fought for her life and prepared to die.  Her experience of learning to live and learning to die can be an example for many that come after her.  It was her wish that through her experience other might find a light in a time of darkness.

"Tuesday, August 27, 1985: (11 months before she died)

Well, the damn things have grown.  Dr. C told me very matter of factly that nothing can be done - there is no cure - I am chasing rainbows and not dealing with reality.  I am very upset about the news.  It is the first time that cancer has seemed like a reality to me.  I can feel it in my chest.  The reality is that I am going to die.  I have moments when I want to end it now and get it over with as it is so hard to live with but then I want to enjoy each day to the fullest.  If I can just forget about it and not dwell on it.  It is very hard to do.

Even Milt (her husband) had difficulty being his usual  supportive self.  He managed to say, 'You have good days left.'  I guess that is what I am down to ... days.  I cried on the phone to my mother and I know it upset her.  Mark (her youngest son) called from college.  Holly (her second daughter) called.  They are very supportive and want me to get on with my medication.  I cried at everything I thought of - I won't get to see Mark graduate.  I won't attend his wedding or see his babies.  The Tyler (her baby grandson) issue... deserting my beloved Milt and abandoning all of our plans.  It is a tough one to handle. Why????????"

Death is a subject that many people have difficulty discussing or considering.  It is an event that will impact every human's life, at least once.  Every human will experience the reality of his or her own death, through actually dying, and perhaps through the observation of the death of family members and friends.

In this paper I will primarily discuss the western Judeo-Christian cultural perspective of death and dying and:

  1. Define what it means to learn to die.
  2. Discuss what it means to understand that dying is a natural, inevitable process.
  3. Discuss the process of dying and death.
  4. Discuss how the acceptance of death leads to an ability to live a more enriched life and die peacefully.

The ability to face the reality of death and its impact on our life and each other's lives and the ability to discuss our fears, anticipations, fantasies, etc., will better prepare us to fully live our lives.  To fully live our lives we should "stop and smell the roses" and live our lives as if we knew we only had days to live.  Carol overcame her fear of dying and was able to make the remainder of her life fruitful both to her and her family and friends by living each day to its fullest.  Carol came to an understanding of death, the process of dying, and the acceptance of her mortality in this life.  The understanding and acceptance of her pending death provided Carol, her family, and friends a peaceful transition from life to death.
 
 

Learning To Die:

Dying is the final stage of growth in the life cycle.  To achieve the maximum experience from this stage the dying person and his or her significant other(s) should be educated on the final stage of life.  The educating of people about death, the processes of dying and grieving, and how to prepare to die, can ease the actual dying period by preparing all participants for the final moments of life.

Learning to die is directly associated with learning to live.  By understanding the process of dying, accepting the physical finality of death, and the development of an understanding of the psychological and spiritual self, individuals can free him or her self from the fear of dying.  The fear of dying can be a possible underlying deterrent for being able to living a fruitful life.   Michael Landon, the actor, director and producer, recently announced that he was dying of inoperable cancer.  His assessment of life is that he "notices more" and "doesn't want to miss anything."  Through the attainment of an understanding and acceptance of death, life can be lived more fully and death can come more peacefully.

Many humans have difficulty conceptualizing the end of their own existence.  The conscious mind has never knowingly experienced its own non-existence.  It has no reference to what not being part of life is like.  The human has no learned experiences of not being alive.  It continuously attempts to rationalize, reason, or find purpose in death.  As the dying person nears his or her death, the permanence of death becomes more real.  He or she begins to realize that he or she is really going to cease to exist and that his or her memory in this life will not be under his or her control but in the minds and memories of others.  Proof of his or her existence, in this life, will be the memories that others have of him or her, the artifacts that he or she leaves, and the children that are a result of his or her life.

Guiding the dying person through what the dying process is going to be like, and helping him or her to prepare for the physiological and psychological effects of dying, can be beneficial for both the dying person and the support people.  Helping the dying person not be frightened about embarking on the  solo journey of death, is one of the primary responsibilities of a death guide.  A death guide is an individual who teaches people how to die.  The guide teaches how to prepare to die and what to expect, physically, cognitively, and emotionally as one dies.  The guide is there to serve the dying person and his or her needs.

Social opinions of death and the dying process can directly influence an individual's ability to accept the reality of death and the acceptance or rejection of the position that death is natural part of life and the final stage of physical growth.  The following parable provides an illustration of a common human social response of not being comfortable to discuss the ever presence of death in life.

"When the guest came in for dinner, there it was, quietly  sitting and munching.  The host, not wishing to upset his guests, made no reference to the horse; the guests, not wishing to upset the host, made no reference to the horse.  Consequently, he or she ate his or her dinner in silence - so overwhelmed by the presence of the horse that he or she could neither carry on a conversation nor enjoy the dinner and so imbued with his or her notion of politeness that he     or she dared not mention the horse.  The horse, of course, was death." (Kalish, 1981).

By educating people about death, prior to having to deal with death, can ease the actual death experience and provide a calm, cohesive environment throughout this stage of human life.  It is an important life skill to learn to notice more and attempt to appreciate and experience everything throughout life instead of waiting until death is eminent.

During our lives we are taught about dying and the death process through the media of literature and dramatic interpretations, religion and philosophy, and by the experiences of others.  The use of literature and audio-visual media, to depict an event that is final and permanent for an individual, can be helpful in developing the knowledge to prepare the human for his or her own death or the death of others.  It is also an opportunity for the individual to learn to appreciate and experience life vicariously.  By seeing, hearing, or reading about the process of dying, the human can be detached from the process but can voyeuristically participate and learn about the process and act of dying.

Acceptance of death involves the growth of knowledge of self through psychological and spiritual development.  Anxiety and fear of death can be alleviated by understanding death is the final stage of life and that it can be an enlightening experience for both the dying individual and his or her family and friends.  The acceptance of human mortality can be achieved by learning to prepare for death by taking care of personal business and gaining understanding that death and the dying process is a natural process that should not be feared.

Understanding Death:

Philosophical beliefs, religious beliefs, and cultural practices help to provide the human with a sense of understanding about death.  Philosophical and religious beliefs provide a basis for the dying individual to psychologically and spiritually prepare for the inevitable of death.  Cultural practices provide the foundation for the way individuals, who are touched by death, to react and grieve.

Psychologically it is a lonely realization that our existence in this life and our continued memory is directly related to other people keeping our memories alive.  Regardless of religious or philosophical beliefs, when we die we are no longer part of the reality of the life we know now, but a memory in someone's mind.  As the dying person prepares to die, he or she begins to realize that he or she will only remain a part of reality and the living world as long as his or her memory is kept alive by the memories of others.  They realize that there existence will ultimately be forgotten and lost as those people that have memories of him or her die and that eventually, unless he or she has left a permanent imprint on this life's history, he or she will be forgotten and will permanently cease to exist.  During life, the dying person keeps his or her own existence alive, in part, by the acts and events he or she is involved with and shares with others.  While we are alive we are part of reality.

Each human has his or her own relationship with his or her religion and his or her perspective of death.  It is through the belief in hope that most dying people deal with the loneliness and finality of his or her death.  Hope is the desire for some good, accompanied with at least a slight expectation of obtaining it, and the belief that good is obtainable.  It is the confidence in a future event and/or the highest degree of well-founded expectation of good.  It is in the hope of life after death that the individual is able to accept the end of this life and the beginning of another life.

Religious beliefs and social customs influence the dying person's attitude towards the transition from life into death and the grief process the family and friends that are left behind.  Most religious teachings reflect upon preparing the individual to die and examining perspectives of life after death.

Much art, literature, and religion support the hope that humans have that there is life after death.  There are numerous artistic renderings of scenes of life after death, literary interpretations of death and life after death, and volumes of religious studies of life after death.  Each individual authors interpretation of death and life after death are shared through his or her art form.  The artifacts of art, literature, and science provide monuments to individuals and human society.

Human cultures accept and deal with the dying person and death differently.  The individual who is dying also has a sense of loss for this life but dependent on his or her cultural and religious foundation, a sense of hope and/or expectation for the future.  Universally there is a sense of personal loss when a family member, friend, or associate dies.  Grieving practices are personal and cultural activities.  "The differences in deaths depends upon the difference between disciplined and undisciplined living, between pure and impure mind or between 'carefulness' and 'carelessness.'" (Kubler-Ross, 1975).

Practitioners of Hinduism and Buddhism believe that death should be considered an "ever present companion" in life.  They feel the loss of their loved one, friend, or associate but they are confident in the dying person's afterlife.  They believe that a person is continuously reborn to a new life until the person's spirit reaches the point of enlightenment and all knowing.  The Hindus and Buddhist believe there are differences in the quality of deaths just as there are differences in the quality of births and lives.  Dying is taught as part of his or her religion and culture so that when it is his or her time to die, he or she will die peacefully.

Judeo-Christian culture and religion view death as a part of life, but as described in the parable of "The horse on the dining-room table", usually do not openly discuss death and dying.  It is a subject that the general population places in its own time and place and do not make it an "ever present companion".  Many Judeo-Christians accept that there is an afterlife to their present existence.  Judeo-Christian religions teach hope for the afterlife.  It is based on the belief that there is one lifetime and after death the good shall exist with God forever.  The Bible teaches the individual how to live properly and to prepare to spend eternity with God.

Through understanding death from a philosophical, religious, and cultural perspective, the individual can psychologically begin to accept the inevitability and finality of death.  Understanding and learning the process of dying and what to expect as one dies, provides the individual with a level of knowledge that can alleviate some of the fear of the unknown.

The Process Of Dying:

The individual who learns that he or she is going to die in a short period of time, psychologically, may go through the five steps defined by Dr. Kubler-Ross.  She has identified five general stages the person goes through when he or she learns that he or she is going to die.  These stages are denial & isolation, anger, bargaining, depression, and acceptance.

The dying person does not necessarily go through all these stages in this order.  Sometimes he or she may move from one stage to another and then back to a former stage.  Other times the dying person may move rapidly through the various stages and then settle into one stage for a significant period of time.  It is the role of the guide, therapist, and support people to help the dying person to reach the final stage of acceptance in order to achieve a peaceful transition from life into death.

There are also practical needs that the dying person needs to attend to before he or she dies.  The completion of these needs will give the person a feeling of some control of his or her life and a sense of accomplishment and completion.  Some of these needs may be to complete any unfinished business, deal with any medical requirements to be comfortable, allocate personal time and energy, and make arrangements for after his or her death.

As death approaches, the dying individual may begin to lose strength, mental acuity, and the ability to care for him or her self.  It is during this time that there is the greatest need for a support person.  The dying person may become anxious and fearful if he or she is not prepared emotionally, psychologically, and spiritually to die.

By providing a calm, cohesive environment, during the final period of life and having the knowledge of what to expect physically and psychologically, the dying person will have a more peaceful, smooth, and fearless transition from this life into death.  By providing a peaceful transition for the dying person, the family and friends that are associated with the dying process will have an easier grief process.

The process of dying is similar to the process of birthing.  The dying person, very often, demonstrates similar breathing patterns as the expectant mother who is undergoing labor contractions.  As death approaches, the dying person's breathing becomes more labored and the fear of the unknown becomes more prominent.  The expectant mother and her coach are taught breathing rhythms and mental exercises to easy the birthing process.  Similar breathing and mental exercises can be taught to the dying person and his or her coach to ease the dying process.

Acceptance: