Speaker 1: If we were at a party and everybody had two beers,
Speaker 1: and then I asked, what do you do for a living? Like,
Speaker 1: what do you actually say? In social setting? It depends
Speaker 1: how quickly I need to leave. If I need to
Speaker 1: leave soon, I'll usually say I teach sociology, which isn't
Speaker 1: really true, but I know it's really boring sounding, so
Speaker 1: then everyone's like, okay, bye. However, if it looks like
Speaker 1: I've got some time and I know the person will
Speaker 1: want to talk to me, I'll say I'm Director of
Speaker 1: the Center for Death and Society and I do research
Speaker 1: on death, dying, and the dead body, and interdisciplinary studies
Speaker 1: around everything to do with death and dying. That is
Speaker 1: Dr John Troyer, who lectures at the University of Bath
Speaker 1: in England and is the m v P of Every party.
Speaker 1: I am ess a host of Deeply Human and Deeply
Speaker 1: Human is the podcast you're listening to, And a podcast
Speaker 1: is like a balsamic reduction of pure knowledge drizzled in
Speaker 1: through your ears to season your brain. Today's episode is
Speaker 1: about dying and why you shouldn't put off talking about
Speaker 1: it until you're dead. So part your hair down the
Speaker 1: middle and your best Wednesday Adams and stretch out for
Speaker 1: rigorous conversation about death, activism, the guillotine, and the ferocity
Speaker 1: of human love. Love of mine, someday will die, but
Speaker 1: I'll be close behind. I'll follow you into the dark.
Speaker 1: You're blinding line. Okay, So back to the party scene.
Speaker 1: How does John introduce himself when he's off the clock
Speaker 1: in that scenario where you give him a long, interesting answer?
Speaker 1: Do you know what they're going to say next? Yeah?
Speaker 1: Usually this is actually almost always the way it happens.
Speaker 1: They'll say, oh God, wow, Okay, I have to ask
Speaker 1: you this question, and then it just goes into about
Speaker 1: thirty minutes to an hour or a couple of hours
Speaker 1: of just relentless questioning about everything and anyone's ever wanted
Speaker 1: to know about death and dying, which is normal. I
Speaker 1: expect that because people are genuinely interested in it, like
Speaker 1: it is a constant and if you can say anything
Speaker 1: about humans as a species, and this might strike some
Speaker 1: listeners is a bit grim, but I think it's completely accurate.
Speaker 1: Is that if there's anything we're good at, it's dying,
Speaker 1: that eventually it's going to happen. I met John a
Speaker 1: bunch of years ago before he'd moved to England and
Speaker 1: before he was a death rock star. We met in
Speaker 1: our twenties, both of us competing in the slam poetry
Speaker 1: scene in Minneapolis. He seemed funny and weird and smart,
Speaker 1: an assessment that still holds. And my delivery of a
Speaker 1: rhyming poem about metaphysics at one of our competitions must
Speaker 1: have passed mustard because he invited me to sit in
Speaker 1: on the defense of a PhD dissertation, and that seemed
Speaker 1: like a terribly adult way to spend an afternoon. So
Speaker 1: I went, and I was mesmerized listening to John talk
Speaker 1: about the science and culture of death. How the first
Speaker 1: embomed bodies were carted around the US like sideshow attractions,
Speaker 1: how people used to pose for pictures with their recently
Speaker 1: deceased relatives, and unless you look really closely at the photos,
Speaker 1: it's tough to tell who's warm and who's dead. Death,
Speaker 1: as it turns out, runs in John's family. So my
Speaker 1: dad was a funeral director for many years, owned a
Speaker 1: couple of funeral homes, worked at other couple of funeral homes,
Speaker 1: and you know, I just grew up watching him organized,
Speaker 1: run and do funerals. But He also taught cosmetology, so
Speaker 1: he taught the makeup classes. Apparently he was a very
Speaker 1: good at matching skin tone. His students would tell me,
Speaker 1: it's like Dan really good at the makeup, and I
Speaker 1: was like, well, it's good to know. For the record,
Speaker 1: John didn't want to follow in his dad's footsteps, and yes, dude,
Speaker 1: he has seen the HBO series six ft Under. John's
Speaker 1: interest was more intellectual. He wanted to investigate how technology
Speaker 1: affects the way that society treats death and dead bodies.
Speaker 1: For example, these days, we're living further apart from our families,
Speaker 1: which means that we're dying further apart. Two and so
Speaker 1: embalming services are in steady demand because by injecting a
Speaker 1: body with preservatives, we get a shelf stable corpse that
Speaker 1: allows the family time to gather. Because of this embalming technology,
Speaker 1: the dead body in your imagination might look sort of
Speaker 1: like a living person who's asleep, But before the Civil War,
Speaker 1: dead bodies looked really different than living bodies. They start
Speaker 1: to decompose, they turned black. Okay, quick extra credit fact.
Speaker 1: Abraham Lincoln played a really big part in popularizing embombing
Speaker 1: after his assassination. His body was taken across the country
Speaker 1: in a special train car for public viewing, and it
Speaker 1: was embombed more than once along the way. New technologies
Speaker 1: can shape the way that we handle are dead, and
Speaker 1: new political ideas can change the way that we die.
Speaker 1: For example, California becomes a first state to pass in
Speaker 1: what's called the Natural Death Act, and the Natural Death
Speaker 1: Act states you have a right to refuse treatment and
Speaker 1: to die naturally. And we think about that today is
Speaker 1: almost being given, But it wasn't. It wasn't. There had
Speaker 1: to be a law that was created and then passed
Speaker 1: along you could tell people both medically and ethically, but
Speaker 1: also philosophically and politically. And again I think the political
Speaker 1: side of this is very important. You have a right
Speaker 1: to die by refusing treatment if you no longer want it.
Speaker 1: And why is that political? Well, because it was a
Speaker 1: statement of autonomy. I will die as I choose. And
Speaker 1: there's a longer history here of a break than from
Speaker 1: religious tradition because of course, for many centuries you did
Speaker 1: not die the way you chose. You died the way
Speaker 1: God chose. Is well, if you say I die the
Speaker 1: way I choose, that means then that the state or
Speaker 1: whatever governing powers in place, no one will tell me
Speaker 1: how I can die. In the nineteen seventies, universities in
Speaker 1: the US and the UK taught sociology of death, courses
Speaker 1: and activists fought to change our approach to death with
Speaker 1: conversations about assisted suicide, end of life, rights and dignity
Speaker 1: and death, and the living Will was invented, a document
Speaker 1: that expresses a person's wishes for healthcare when they're no
Speaker 1: longer able to make those decisions. I thought that all
Speaker 1: these shifts in thinking and practice were designed to provide
Speaker 1: people with a good death. John not so much. There's
Speaker 1: been lots of conversations around this idea of a good death.
Speaker 1: I've never been big on that terminology because then it
Speaker 1: suggests there's a bad death. And I'm not saying you
Speaker 1: can't create qualitative judgments around these things, because I think
Speaker 1: we can talk about preferred ways of dying. But I
Speaker 1: think ultimately what we're talking about in terms of death is,
Speaker 1: you know, death is a phenomena you're, regardless of goodness
Speaker 1: or badness, is going to happen. But I'm see I'm confused.
Speaker 1: I mean, in some ways it feels like, oh, I
Speaker 1: don't know, like why shy from normative terms, because if
Speaker 1: I were to compare two ways of shark attack versus
Speaker 1: in the arms of my beloved, like one of those
Speaker 1: deaths is clearly sort of lousy and one is like
Speaker 1: why better? Right now, I understand that the concern you
Speaker 1: can come up with, and this is something that it's
Speaker 1: been discussed that because once you start to create expectations
Speaker 1: around dying, people can start to feel like they're doing
Speaker 1: it wrong. And that's always been one of my big
Speaker 1: concerns with a lot of the discussions around death and
Speaker 1: dying in all different kinds of facets society, which has
Speaker 1: been going on out for like the last twenty years.
Speaker 1: It's never not been a hot topic as it were.
Speaker 1: But I think that what happened is families, and usually
Speaker 1: families more than the dying, but sometimes the dying they
Speaker 1: can feel like they're doing it wrong. That fear that
Speaker 1: I'm somehow messing up at this basic biological function is
Speaker 1: one you might have also heard. In relation to childbirth,
Speaker 1: Moms can face a lot of pressures about how and
Speaker 1: where to deliver at home, at the hospital, in a
Speaker 1: birthing center, with or without pain meds in a tub
Speaker 1: of water, preferably on a weekday. A lot of parents
Speaker 1: hire birth doulas to help with their pregnancy and delivery.
Speaker 1: Doulas aren't part of the medical team, but there are
Speaker 1: a source of support and encouragement and they've got a
Speaker 1: lot of experience helping tykes into the world. There are
Speaker 1: also death doulas who help people to leave the world.
Speaker 1: I die with people. I say die with them because
Speaker 1: I feel like with every person I die with, I'm
Speaker 1: a little closer to understanding what death is. And that's
Speaker 1: just the last breath. There's nothing more magical about it.
Speaker 1: Denise Love has worked as a death duela for twenty
Speaker 1: eight years. She's also helped set up hospices and worked
Speaker 1: as a registered nurse, and part of her motivation in
Speaker 1: life is to help people talk about death, to be
Speaker 1: less afraid of the whole conversation. I think the fear
Speaker 1: is just too great. I could talk about it, you
Speaker 1: might drop dead. It's just terrified to use the word.
Speaker 1: Even most people don't ever use the word. In their eyes.
Speaker 1: We pass away or somebody's ill, we avoid the language
Speaker 1: of death. Denise has spent a lot of time working
Speaker 1: in the developing world with people in Nepal, Myanmar, Cambodia,
Speaker 1: and Thailand, which is where she was when I spoke
Speaker 1: with her. The death's Denise has witnessed and the developing
Speaker 1: world look really different than those she's been a part
Speaker 1: of in Western societies. Whatever this thing we're telling everybody
Speaker 1: is to fight, that's a lot of nonsense. There's nothing
Speaker 1: to fight. Surrendering to death means a comfortable death. That's
Speaker 1: my theory behind it. To die people often have to
Speaker 1: fight with their loved ones to die, absolutely, So come on, dad,
Speaker 1: you can do it. Fight it. You're going to be
Speaker 1: seventy six tomorrow, or you know. A young pregnant woman
Speaker 1: kept saying to her husband, could you just hold on
Speaker 1: and do I have the baby? And he looked at
Speaker 1: and he said, I can't. How do I tell her
Speaker 1: I'm done? I don't want to do this anymore? So
Speaker 1: I said, let's bring her in and tell her. And
Speaker 1: he just had terror in his eyes. And we had
Speaker 1: the most amazing hour of if you love me, you'll live,
Speaker 1: and if you love me, you'll let me die. And
Speaker 1: we had that beautiful, difficult conversation which was sort of
Speaker 1: a bit heated at times, but really negotiations, so a
Speaker 1: big death. Doller's job is getting a family talking in
Speaker 1: an honest and open way. But again there's a lot
Speaker 1: of disagreement, and one daughter wants this, and one daughter saying,
Speaker 1: come on, you can help you live. Let's give him
Speaker 1: vitamins and let's duce another twenty three thousand karat to
Speaker 1: be giving kale, and it's making drink his own urine.
Speaker 1: I mean, I've been through everything, and then I just say,
Speaker 1: let's all go inside and talk to them, and I say,
Speaker 1: do you want to live? What do you want to die?
Speaker 1: I mean, nobody answer that question because it seems selfish,
Speaker 1: and I've already told me they want to die usually,
Speaker 1: So you know, I feel really comfortable bringing the family
Speaker 1: and just saying can we let him go if you
Speaker 1: love him? Just saying about I've always thought a lot
Speaker 1: about death, even as a little kid, and you hope
Speaker 1: that when the time comes, you can spare the people
Speaker 1: you love pain or discomfort. But it hadn't occurred to
Speaker 1: me that I might help my loved ones by releasing
Speaker 1: them from any obligation they might feel to stick around
Speaker 1: when someone's really sick and maybe dying. I already know
Speaker 1: to ask, does it hurt? Okay, then let's talk to
Speaker 1: the morphine nurse. Now. I also know to ask, hey,
Speaker 1: do you just want to leave now? Because I don't
Speaker 1: want to keep you. This is your show, so don't
Speaker 1: stay late for me. That's a kindness, that question, and
Speaker 1: I'm grateful to Denis for handing it to me. Our
Speaker 1: next guest, Dr Sam Parnia deals in total totally different
Speaker 1: sorts of questions. Do you think that there might be
Speaker 1: a future where a good number of us died? Many times?
Speaker 1: I think what you're going to see is when resuscitation advances,
Speaker 1: then there'll be many people who can say, oh, I had,
Speaker 1: like you know, full cardiac rest in my life and
Speaker 1: nothing mattered. I was dead for twelve hours, sixteen hours
Speaker 1: they brought me back. If our body is still in
Speaker 1: good shape, we will be able to be revived and
Speaker 1: allowed to live another ten or twenty or thirty years.
Speaker 1: Dr Sam Parnia is the director of the Critical Care
Speaker 1: and Resuscitation Research Program at New York University. He specializes
Speaker 1: in bringing people back to life, and he thinks that
Speaker 1: his technology advances will have a lot more lazaruses and
Speaker 1: lazarettes amongst us, I asked him to start with a
Speaker 1: working definition of death in practice, How would a physician
Speaker 1: know if a patient is dead like dead dead dead.
Speaker 1: It's interesting because I think most people listening will think
Speaker 1: that they understand death and it's pretty simple. You're either
Speaker 1: dead or you're alive. And the reality is that was
Speaker 1: true because for thousands of years, whenever a person's heart stopped,
Speaker 1: they would essentially reach a point where they were irreversibly dead. So,
Speaker 1: to answer you a question, the way the physicians declass
Speaker 1: somebody dead is that their heart stops. When the person's
Speaker 1: heart stops, they also stop breathing, and because there's no
Speaker 1: blood flowing around the body, there's no energy, and the
Speaker 1: brain also shuts down almost immediately. So the three criteria
Speaker 1: that they look for are no heartbeat, no breathing, and
Speaker 1: absence of brain response. But as our tools and understanding
Speaker 1: have evolved, the heart, breath, and brain don't always stop
Speaker 1: on the same time. Ventilators can breathe for a body
Speaker 1: that's unable to respire on its own, for example, So
Speaker 1: what if machines performed the duties of the heart and
Speaker 1: lungs but the brain has stopped working. Is that person dead.
Speaker 1: To answer that question and others like it, a commission
Speaker 1: appointed by US President Jimmy Carter published a report called
Speaker 1: Defining Death. It said a person was dead if one
Speaker 1: of two criteria were met, either irreversible cessation of circulatory
Speaker 1: and respiratory functions, so like your heart stopped and you're
Speaker 1: not breathing, or irreversible cessation of all functions of the
Speaker 1: entire brain, including the brain stem. But not all the
Speaker 1: states adopted this definition in exactly the same way. New Jersey,
Speaker 1: for example, provides an exemption for patients whose religious views
Speaker 1: might be compromised by declaring brain death, so their families
Speaker 1: can ask that doctors use only the cardio pulmonary definition,
Speaker 1: the heart and long one, which means that a person
Speaker 1: would be considered dead in one state might not be
Speaker 1: dead in another. As definitions get more clinical, even our
Speaker 1: fundamental intuitions about death can start to give way. We
Speaker 1: socially have defined death as this irreversible moment where a
Speaker 1: person becomes lifeless, motionless, and they can never come back
Speaker 1: to life again. But it's important to understand that's just
Speaker 1: simple social and philosophical notions, and that as medicine and
Speaker 1: science have evolved have understood that actually death this far
Speaker 1: more complicated than we ever thought it could be. To
Speaker 1: further complicate the question, not all of the cells in
Speaker 1: your body die at the same time, So how long
Speaker 1: does it take for the human brain to go offline?
Speaker 1: If you were to be decapitated, would consciousness stop instantaneously?
Speaker 1: That question was not at all hypothetical when the guillotine
Speaker 1: was in vogue. The device was invented specifically to serve
Speaker 1: as a humane method of execution, which would hardly be
Speaker 1: true if a head severed from its body had the
Speaker 1: chance to appreciate its circumstance. In nineteen o five, a
Speaker 1: physician named Gabrielle Bourier conducted an experiment. He witnessed an
Speaker 1: execution of a criminal, approached the decapitated head and shouted
Speaker 1: the man's name. The doctor said that the man's eyelids
Speaker 1: lifted normally as they would in life, the pupils focused,
Speaker 1: and the eyes fixed on his own. Okay, trying to
Speaker 1: play the cool former goth kid over here holding steady
Speaker 1: in her combat boots, But I cannot fathom more chilling
Speaker 1: experience on all of the earth than commuting with a
Speaker 1: severed head. It may be difficult to demarcate the exact
Speaker 1: threshold where life ends, but of course all of us
Speaker 1: will die eventually, and we'll lose people we love too.
Speaker 1: The human animal is fully aware of our own impermanence
Speaker 1: and the fragility of our family and friends, but we
Speaker 1: go ahead and love them anyway. John Troyer, the expert
Speaker 1: and poet who we met at the beginning of the show,
Speaker 1: devoted his career to contemplating death and dying. But all
Speaker 1: those years of professional expertise didn't prepare him for a
Speaker 1: big personal loss. So on July, my younger sister, Julie,
Speaker 1: died from brain cancer at age a couple of young kids,
Speaker 1: husband lived in Italy, so she died in Italy. I
Speaker 1: was diagnosed in flight July, and then, you know, had
Speaker 1: a year of life and it was shocking, and I
Speaker 1: discovered a couple of blind spots that I had in
Speaker 1: the context of my sister's dying process, which is one
Speaker 1: it was clear at the end of April that she
Speaker 1: was dying, like there was no coming back from where
Speaker 1: she was the cancer of progress. And I knew it,
Speaker 1: My dad knew what, my mom knew it, and no
Speaker 1: one was saying anything about dying. Fast forward, I will
Speaker 1: then actually be the person who tells my sister she's dying.
Speaker 1: Used the word dying in July of twenty eighteen, so
Speaker 1: sixteen days before she dies, and she was already in
Speaker 1: the summer receiving outpatient hospice care from a wonderful hospice
Speaker 1: in Italy. So as to why I was actually talking
Speaker 1: about that, I don't know. Partly that's a cultural practice
Speaker 1: in Italy, but too because I think, you know, some
Speaker 1: of her friends just were they were unsure what to say,
Speaker 1: and my brother in law was being told by the
Speaker 1: counselor is like, well, you know, let her ask, And
Speaker 1: I mean, they're a whole lot of things going on involved,
Speaker 1: and it all in a way it makes sense. But
Speaker 1: I think it was also very important to tell Julie
Speaker 1: she was dying, because one I did, and she said, well, yeah,
Speaker 1: I mean I guess I knew, but thank you for
Speaker 1: saying this. And it changed then her end of life
Speaker 1: trajectory and care because suddenly then everyone was saying dying
Speaker 1: and it no longer meant that we had to pretend, right,
Speaker 1: how does it change it using that word? You know?
Speaker 1: How does that change care well, I think. And what
Speaker 1: I told my sister was, Julie, I can tell you
Speaker 1: you're dying. You're hearing me say dying. You have to
Speaker 1: be the one who says I'm dying because everyone needs
Speaker 1: to hear you saying it, because you saying it will
Speaker 1: make people take it more seriously. And she said, okay,
Speaker 1: I understand. Um, That'sai. Well I got choked up, but
Speaker 1: that's okay, Um, I'm happy to talk about because it's
Speaker 1: it's it's interesting to me that I've gone for so
Speaker 1: long without getting choked up about t story about the
Speaker 1: one thing she said to me that I has always
Speaker 1: stuck with me. You know, she says, I would do
Speaker 1: the same for you, and and she would and she
Speaker 1: would have done the same exact thing for me, and
Speaker 1: I the thing that I think this is why I
Speaker 1: always think about it, Like for everything I know about
Speaker 1: death and dying, which is perhaps a lot more could
Speaker 1: be learned than on the first to admit that for
Speaker 1: everything I know, when presented in this moment, I will
Speaker 1: always wonder why I didn't say what was clearly obvious.
Speaker 1: And and again it's not a moment of regret. I
Speaker 1: just won't I don't understand why, fellow immortals. Now would
Speaker 1: be a great time to pause this podcast and send
Speaker 1: a text to someone you love. I'm gonna h While
Speaker 1: Julie was dying, John was working on a book called
Speaker 1: Technologies of the Human Corpse. He included some poems about
Speaker 1: his sister, and at the end of the book he
Speaker 1: lists a bunch of questions that you can answer now
Speaker 1: to make choices about the way you'd like to die
Speaker 1: and be memorialized. I'm going to paraphrase a few of
Speaker 1: them here. Think about drotting down your responses and sharing
Speaker 1: them with someone you love, or maybe listen together and
Speaker 1: swap answer sheets. Number one, the price range I would
Speaker 1: like spent on my funeral is Number two? Does someone
Speaker 1: have all your passwords and log ins? If so, who?
Speaker 1: Number three are there's certain songs you'd like included on
Speaker 1: your funeral playlist? Number four? Do you want life support?
Speaker 1: Under what conditions would you like to be removed from it?
Speaker 1: Number five? Do you have an outfit you'd like to
Speaker 1: be dressed in? I really like that last one. There's
Speaker 1: this almost universal protocol that dead people should be dressed
Speaker 1: in their Sunday best, But I suck in high heels.
Speaker 1: I want to go out in my combat boots. I've
Speaker 1: walked the world in those, I've done my best work
Speaker 1: in them. I've fallen in and out of love in them.
Speaker 1: So lace them tight and double not them, please, I'm clumsy.
Speaker 1: Special thanks to Dr Troyer for his time and his
Speaker 1: candor John you aren't class act. And thank you, esteemed
Speaker 1: listener for hanging out. Our time is finite and ever fleeting,
Speaker 1: and so I'm very grateful you've spent some of yours
Speaker 1: with me. Deeply Human is a BBC World Service, an
Speaker 1: American public media co production with I Heart Media. Many
Speaker 1: humans of great depth have been involved in the making
Speaker 1: of Deeply Human, so credit where it's due to Senior
Speaker 1: commissioning editor Steve Titherington, editors Rich Knight and Hugh Levinson,
Speaker 1: series producers Ben Crighton, Sandra Canthal and Simon Mabn, producers
Speaker 1: Monica Whitlock, Jemma Nuby and Hannah Moore, researcher Beth and
Speaker 1: head production coordinators Janet Staples and Blaze Hesselgren, and for
Speaker 1: making it all sound beautiful. Our studio managers James Beard
Speaker 1: and Tom Bricknell, and the composer of the deeply human
Speaker 1: theme that is in your ears right now is Nick Thorburn.
Speaker 1: I think I said this already, but I'm Dessa. Thanks,
Speaker 1: see you next time.