With NPR host Scott Simon tweeting his mother’s deathbed vigil, more attention is thankfully being given to how Americans die. Twitter offers the real possibility of bringing death into the open as it once used to be, quite a wonderful thing given the sorry state of dying in America. It was back in the 1960s when some started to take notice that dying in Western culture was not what it used to be. “Once upon a time man knew how to die,” thought William Kitay, the deathbed vigil amongst family and friends at home a thing largely of the past. Now many died alone in hospitals, their minds clouded by drugs and bodies tethered to machines. “It seems that dying has become something to be ashamed of,” Kitay, writing in Today’s Health in 1966, “a sign of weakness and defeat.” Extending the process of dying not only created additional suffering but was degrading, he and a growing number of people thought, an affront to what it meant to be human.
Who or what had caused this cultural shift in how Americans died and, consequently, viewed death? Some felt that associations or societies dedicated to eradicating a particular disease were largely to blame, their fund raising campaigns instilling the idea that death was something that could be conquered or “solved.” Others, notably Jessica Mitford in her The American Way of Death, believed the funeral industry was largely at fault by making corpses as lifelike and beautiful as possible, an illusion that cloaked the reality of death. Physicians too were doing a disservice, it could be said, by preserving life at any cost and virtually ignoring the business of death and dying. It was true that medical schools in the mid-1960s did not offer courses in the care of the dying, choosing to focus exclusively on recovery. In short, a cured patient represented success while a dying patient signaled failure, a strange point of view given the inevitability and normalcy of death.
Physicians’ reluctance to inform patients they were dying was another important factor contributing to the denial of death in America. Relatives of the dying were complicit in this process, it need be said, their desire to protect loved ones only making the situation worse. There were moral, ethical, and practical reasons why the dying should be told they would not live much longer, those on the leading edge of an emerging “death with dignity” movement pointed out. Everyone had the right to “put their house in order,” it could be argued, that house being both financial and spiritual. The knowledge that one would soon be dead was an impetus to review wills and trust funds as well as provide final direction to business partners, lawyers, accountants, and secretaries. Many spouses and children had to spend years and large sums of money untangling Byzantine estates simply because the dying person was not told of his or her dire condition. Knowing that one’s days were numbered also encouraged the dying to find closure with their life and, perhaps, better prepare themselves for death. That the final stage of many people’s lives was not only wasted but experienced under false pretenses was simply wrong, more people were starting to think, the tide of death in America beginning to turn.
Simone de Beauvoir’s A Very Easy Death of 1966 vividly illustrated how little dignity there was in doctors’ attempts to keep alive a body that was obviously dying. Witnessing the end of a loved one’s life was never easy, de Beauvoir made clear in the memoir of her mother’s death from cancer, but modern medicine had seemed to make the experience even more difficult. More than that, however, de Beauvoir blamed society as a whole for turning death into such an agonizing event for all parties involved. In his review of the ironically titled book, Malcolm Muggeridge of Esquire suggested that it was our collective denial of death that was the bigger problem. "Death is…, from the mid-twentieth century point of view, life’s most appalling circumstance," he wrote. "We hide it away, pretend there’s no such thing; persuade ourselves that ‘science’ will soon ensure that it doesn’t happen; deck up our corpses to look as though they are still alive, scent them and curl them and dress them as for a date or a ball." That may all change as dying becomes part of the social media landscape, however, and as more of us share our experience with the death of a loved one in real time with hundreds or thousands of "followers."