Thursday, June 13, 2013

"The Good Death"

There is a humorous story told of a man who is dying at home. His daughter is sitting by his bedside offering care and comfort. She says to her father, "Daddy,I love you. Is there anything I can do for you? Her father whispers,"My daughter, you know how much I always loved your mothers ruggelah. I can smell them now baking in the kitchen Please go and bring me one." The daughter leaves and a few minutes later comes back to her father empty handed. She sits again next to the dying man and with a shrug says, "I am sorry Daddy. Mommy says they are for after!".

This week we find in the Torah too a story about dying, the death of Aharon, brother to Moshe and Kohen Gadol, High Priest. Only in our story the relevant word is "before" not "after". In the death story of Aharon, he, Moshe and Aharon's son Elazar ascend Hor haHor, the mountain on which Aharon is to die. At G-d's command, Moshe is told to remove the priestly clothes from Aharon just prior to his death and place them on Elazar. Then sorrounded by the two persons closest to him, Aharon lays down and dies. It is a beautiful death scene, and indeed a beautiful death. So much so that the Sages tell us that Moshe wished his death experience could be similar. And in concert with his request G-d told Moshe when his time came to die, later in the Torah, "...and you shall die as did Aharon your brother".

The story of Aharon's death also give rise to important Jewish laws concerning the dying. According to halacha,the dying are never to be left alone. The assumption is that it is a great comfort for the dying to spend their final moments around family and community.
The importance of a "good death" has given rise to the hospice movement, a movement that emphasizes the importance of being able to die at home sorrounded by one's loved ones.

Yet the matter may not be as simple as it first appears. Some years ago studies were done on the time patients tended to die in hospitals.
It was found that people seemed to die when no one was around. Even if they were attended by family they typically died at the times when attending family left. The family could be at the bedside 23 hours a day and the patient would die on the 24th hour, when they were left alone. Moreover it is often reported that Native Americans had quite a different idea about the "good death" than we find in hospice theory or halacha.When a Native American felt it was his time to die, he would go out from the camp into the woods, lay under a tree, and wait for his demise, alone!

And we might wonder about what seems an inconsistancy in the Torah itself. We mentioned above, that according to Tradition, Hashem promised Moshe the same death experience as Aharon. Yet in the story the Torah gives us no two experiences could be more different. Aharon died the "good death" sorrounded by those he loved and who loved him. Moshe died entirely alone. No one went with Moshe when he expired. He left the camp and simply walked away, very much like the Native American tradition. How could the Torah tell us the deaths were similar?

True we might argue that when Hashem told Moshe that his death would be like Aharon what He was referring to was the dying instant, that Moshe would know death as a "kiss" with the least possible pain. But that seems inadequate if Moshe really aspired to the "good death" experience Aharon had. If Moshe did not want to be alone when he died, true his moment of death may have been as easy as possible, but still he had no one with him, no companionship in his dying. That would be painful in and of itself!

I think what we are seeing from the Torah narrative is a great truth about dying and our responsibility to care for the dying. Yes, Aharon had the 'good death" in the classic sense. He had his loved ones by his side. But that death was good because that was the way Aharon lived. Aharon was a man of the people. He lived in community. He was invested in the personal lives of others. He was a peacemaker between husbands and wives. For him to die alone would be painful. He cherished his family, his friends and his community and invested in them. The "good death" for Aharon was exactly as the Torah describes it.

Moshe was different. He lived apart. He was separated even from his wife. He taught the People. He was their leader. But he was not of the community. His communion was with G-d. He had no friends, save perhaps Aharon his brother. And by the time Moshe died Aharon was already dead. For Moshe the "good death" , the death of Aharon, meant precisely to die alone, because that is how he lived.
Truth is there is no one model for the "good death". For some it means being enveloped in the web of family life. For others it means being left to solitude. I suspect our preference will be reflective of what we prefered when we were alive and well. Did we more prefer to be with others or more prefer our own space. The "good death" should be consistent with what we would have seen as the "good life".
And those of us who care for the dying as family and friends should make sure we understand what the "good death" will look like for the dying before we decide how to attend to them!

But I need to share one other very important point about the "good death". Even for those who lived amongst family and friends and want to die as they lived, its important that those who attend the dying know their role. When I quoted the study above that showed that patients in hospitals tended to die alone, when family was no in the room, it was not because those patients did not want family around them when they died. I am sure many of them would have preferred to have a "good death" with a son or daughter holding their hand as they died. The reason they 'chose' to die when no one was present was more often because the family made them feel it was not okay to die!
The dying person, in so many cases, even when they want loved ones with them, need those loved ones to give them permission to die, rather than encourage them to fight and live on when its clear their time has come.

Even when the "good death" that one wishes for includes being in the midst of loved ones. those loved ones need to know that their role is to facilitate death in the best way possible, not deny it or pretend it isn't happening!

The Torah gives us two stories of the "good death", this week of Aharon and at the end of the summer the story of Moshe. They were different deaths but they were both "good". We who live and love have our own obligation to make possible, as much as we can, the "good death" for the ones we love. To do that we need to know which story is most fitting. And if indeed it is the story of Aharon that fits, then to remember we are living with our loved one a story of death, and not to pretend or deny so that the one dying cannot feel it okay to play their part in the story and meet their end!

Shabbat Shalom

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