Top Quotes “Advice for Future Corpses” — Sallie Tisdale
Background: Tisdale is a palliative-care nurse and Buddhist who has spent a lot of time with dying people and shares her insights on topics like how to prepare for death, how to support someone with terminal illness, and what rights dying people should have. Death is actually my #1 fear and I would like to live forever like Hilda & Zelda on Sabrina the Teenage Witch if I could (although maybe not because of climate change) and this didn’t really calm my fears, but I feel now I understand the dying process a lot better now at least.
The Meaning of Death
“Buddhist practice requires one to confront the blunt facts of life: that we are constantly changing, that we are dissatisfied more or less all the time, that we try desperately to hang on to what we have. We will change and everything and everyone we love will change. An old Buddhist meditation is simply: I am of the nature to grow old. I am of the nature to be sick. I am of the nature to die. All that is dear to me and everyone I love are of the nature to change. There is no way to escape being separated from them.”
“One of the central ideas of our lives is that there will be a tomorrow. Tomorrow may be when I get the laundry done. Tomorrow may come after I retire. Tomorrow I start summer vacation. But if we are aware of our dangerous situation, there is no tomorrow. No next year. Only this. Of course we plan anyway; there’s no other way to live than to plant seeds and wait for the fruit. The trick comes in planning next summer’s vacation while knowing that next summer is not promised to anyone. The impermanence is the key to our pain and joy.”
“Most of us in the West will die on our old age of chronic illness and most of those illnesses cause a decline toward death over months or years.”
“Our lives as we live them day by day create the person we will be at the moment of death. You see this in the way a body rests or fights, in the lines of the face, in the faint shadow of a smile or scowl, worry or peace. With every passing day, we create the kind of death we will have.”
“The ancient Romans sometimes only said of a dead person, ‘Vixit’: ‘He has lived.’”
“Muslims are encouraged to contemplate death regularly. The Buddha sent many of his disciples to do corpse meditation. He outlined the specific kind of corpse a person should meditate upon, depending on their need. A person who lusts after a beautiful figure should meditate on a swollen corpse. A person who is vain about their complexion should meditate on a discolored corpse. One of the meditations goes like this: ‘Verily, exactly so is also my own body. It is of the same nature! Just so will this body become disgusting and it can never escape this fate!’ When he was himself dying, the Buddha lay on the ground in front of everyone, saying, ‘Don’t look away.’ Saying, ‘You, too, will be like this.’”
“Almost everyone who dies slowly from illness or age is unconscious in the last hours or days — or at least silent. Is a dying person who appears to be unconscious in the same state as a person who has fainted? Or as a person who is sleeping? Whatever their state is, many people are not responsive when they die. Their eyes are closed; they don’t seem to be aware of others. A person who does not seem to be awake may be conscious in a way we don’t grasp. They may be paying very close attention to what is happening. They may be whispering ‘I love you’ in a voice you cannot hear. No one knows.”
“For me, one of the marks of maturity is the willingness to be seen exactly as I am. As we grow more settled and mature, we become less hidden to others, more transparent to ourselves as well as to each other. With this growing authenticity comes a deepening of intimacy with each other.”
Being With a Dying Person
“When you are spending time with a dying person, listen. Say: ‘This sounds very difficult.’ Say: ‘I can tell how much thinking you’ve done about this.’ Say: ‘Mm-hmm, tell me more.’ Invite detail. Ask questions and make it clear you want to know. Anxiety makes it difficult to remember information, so repeat yourself if necessary. Speak in a calm and unhurried way. Reflect what you’ve heard, because you might have heard wrong: ‘It sounds like you’re saying you’re afraid.’ Clarify, because you might have heard wrong, ‘Let me make sure I understand. I think you are saying ___.’”
“If you are spending time with a dying person, you are the defender of modesty, privacy, silence, laughter, and many other things that can be lost in the daily tasks. You are a guardian of that person’s desires. You will become a gatekeeper. Be the one who can say with a smile, ‘Goodbye, Aunt Lucille.’ The one who can reach out a hand to a visitor and say, ‘Time to go. We’ll call you when we’re ready for another visit!’”
“Ask permission for everything. Be aware that you have the power here. Ask permission until your friend says, ‘Stop asking for permission.’ Ask if the person wants to talk before you plunge in with the news of the day. Would they rather listen to music, play checkers, or watch TV? Do they want to take a shower or eat something? If so, be clear: Vanilla or chocolate ice cream? Is easier to answer than Is there anything you want to eat? Give permission too. Permission to be sad, to be angry, to be sleepy or bored. To be something other than dying. To die.”
“Ask about privacy and confidentiality, favorite foods, how they want the room to be set up. Lights up, or down? Door open or closed? Music on or off? Agree on a signal for ending the visit. Know when to leave. Know when to be quiet.”
“A person who is ill may try to trigger your reactions. People may be testing whether you can handle talking about a difficult subject. Good listening goes a long way toward showing acceptance, and so does an open posture. Don’t stand over a person in bed or bustle around when they’re talking. Settle down, relax, keep your posture open, and try not to touch or brush away the difficulties. Don’t change the subject.”
“It’s not very helpful to say It’s going to be fine! People know when they are dying. They don’t need to be protected from the knowledge. Above all, if you are talking with a person who is dying, be aware of what you want and what you think the dying person should do and should feel, and keep it to yourself.”
“Only about 1 in 100 people has uncontrolled pain while dying.”
“About 40% of Americans have hospice services when they die. What that oft-cited stat actually means is that 40% of Americans have had at least three days of service. The median length of time in hospice is only 17 days. Home hospice accounts for 94% of hospice services in the U.S. Almost 1 in 5 people admitted to a hospice are discharged from hospice before dying, often with only 2 days’ notice. The hospices with the highest rates for doing this are the hospices with the highest profits. Federal regulators have raised the question of whether hospices are admitting people who really aren’t as sick as they are supposed to be.”
“A palliative care program may offer acupuncture, help solve financial issues, sort out family dynamics, and design an exercise program — all while the person is trying to get better.”
“People who haven’t been left alone for weeks will suddenly die in the one moment a caregiver or spouse goes to the bathroom. Why? They may be trying to spare a loved person; dying people can be just as polite, generous, and modest as people who are in good health — or as stubborn or profane or shy. A person may wait until the person they love most has enough help. So, be sure to give the person solitude for short periods, even if you’re just in the next room. Announce it: I’m going out for a few minutes. It may not even be enough to say, It’s okay to go now. Don’t worry about me. You may need to be more explicit: It’s fine to die now.”
“Dying people sometimes appear to have spiritual experiences. People gesture and wave, seem to hold invisible objects, or arrange items or mime doing something like cooking or knitting. Perhaps it is biochemistry, or memory, or dream. We cannot know. A person who has never done so before may begin to pray or sing religious songs. In various large studies as many as half of families interviewed said their dying relative appeared to talk to people who were not there, have visions, or describe visiting other worlds or seeing bright lights. A woman may appear to hold and cradle a baby; a man will reach to hug an invisible person. Mysteries. A dying person will occasionally predict the day or time of their death.”
Burial
“Most people stop speaking days or even weeks (or years) before death, and no one can remember their last words. But some people remain conscious until the last hours of life.”
“Sherwin Nuland described actual death as ‘a process in which every tissue of the body partakes, each by its own means and at its own pace.’ As each part fails a little, the homeostasis of the entire system begins to fail. Each system tumbles gently into the next like dominoes. By-products of metabolism break down in acidosis, and the room may suddenly smell sweet.”
“In many societies, the disposal of the body depends on the status of the dead person. Australian Aboriginals give the dead one a death name. Cannibalism is considered a sign of respect in certain societies. On the island of Sulawesi, families keep the body of a dead relative for several years while it slowly mummifies. The body is dressed, given a plate of food at the table, perhaps a cigar or glass of liquor now and then. Even after the mummy is entombed, the coffins are sometimes opened so the clothes can be changed.”
“The biggest funeral corporation by far is SCI (Service Corporation International, a deliberately meaningless name). SCI owns a huge fraction of the industry, including the brands National Cremation Service, Neptune Society, Dignity Memorial, and Advantage Funeral & Cremation Services. In the last few years, SCI bought its two largest competitors. Annual revenues are in the billions of dollars, with more than 2,000 funeral homes. SCI sometimes buys family-run mortuaries in order to trade on respected names.”
“Embalming was considered strange in the U.S. until the 20th century. In the Civil War, great numbers of people died away from home, and thousands of officers were experimentally embalmed. (Lincoln himself was famously embalmed to allow the long public mourning his death invoked.) But the odd practice didn’t catch on. The growing size of the country meant that funerals sometimes had to be delayed. Bodies that couldn’t be buried were packed in ice, and occasionally suspended in alcohol. Neither method was entirely reliable, and the occasional failure was spectacular.”
“Embalming is still uncommon in Europe. In many parts of the world, it’s so unusual that a special permit is required to do so. But over a very short period, starting in the 1930s, embalming became normal in the U.S. By the early 20th century, American society had changed. People were dying more often at hospitals than at home and families were more scattered. Religion had lost a little of its hold on daily life. The profession of ‘undertaker’ — a person who could handle all the complex details of a funeral — appeared.”
“I find embalming the most disturbing of all methods. It is not required by law unless a funeral is delayed for a long period, or when a body is being transported far. Embalming doesn’t protect public health by preventing the transmission of disease except in rare cases. Dead bodies are not particularly dangerous most of the time. The chemicals of embalming, principally formaldehyde, are toxic and dangerous, and they go into the ground with the body — hundreds of thousands of gallons of toxic chemicals every year.”
“Traditional Tibetans practice sky burial: the body is chopped into pieces and laid out for carrion eaters. The Zoroastrians place their dead bodies in a round raised structure known as a Tower of Silence. The thick, high walls are intended to protect the body from being degraded by water and fire. The bodies are laid on a rim inside, open to the air and the scavenger birds that perch on the walls. When they are reduced to a skeleton, attendants push the bones into the pit in the center.”
“The image of burial in the ground is terrifying for many people to be food for worms, a dreadful and seemingly unavoidable fate.”
“Walmart sells a casket ‘ designed for a woman’ with interior bedding in a light-pink velvet that is ‘soft to the touch.’ Or you can rent a coffin, and give it back after the funeral. You can be buried in a shroud. You can buy a coffin now that works as bookcase, a coffee table, or linen press until you don’t need a linen press anymore, and then your friends can put it together the other way. You can paint a coffin, decorate it, draw on it, invite your friends to draw on it. You can fill the coffin with leaves and vines. You can buy a wooden coffin kit that can be put together without tools. You can get a biodegradable bespoke coffin: a police ball box, a giant box of chocolates, a pile of autumn leaves. A golf bag. Leopard print. You don’t have to bury a body in anything, but the urge to do so seems nearly universal.”
“In 1786, the huge Les Innocents Cemetery of Paris was emptied, the bones and bodies and parts of bodies moved to the newly excavated cemetery. What an astonishing spectacle of death this must have been! For a long year Parisians were treated to nighttime caravans of rotting corpses carried through the city in carts. Enough fat was collected during the interment to make a good supply of candles and soap.”
“You can get a grave for free in Germany and Belgium, but only for 20 years or so. After that, your relatives will need to rent the space for you. If they don’t, the remains are buried deeper or moved to a mass grave, and the site is used again. Both the British government and the Church of England have warned people to expect graves to be reused after 75 years. At that point, there should be nothing left beyond a few bone fragments.”
“Graves last a long time in Egypt’s dry climate. Millions of people are buried here in tombs and mausoleums dating back to the 7th century. The graves are intact, but hundreds of thousands of people live among them and have for generations. Laundry hangs between the walls of tombs, children play inside the mausoleum, you can buy vegetables or get a shave next to a grave.”
“Nirvana Asia of Hong Kong offers enormous and elaborate cemeteries in several countries. Nirvana combines graveyards, columbaria (air-conditioned, with ‘advanced laser lighting system and sound effect’), memorial tablet halls (with ‘dedicated chanting of mantra at scheduled times’), a ‘Baby Paradise’ to help a child enter the afterlife freely, a burial ground carefully managed for maximum feng shui, and a cemetery for dogs and cats.”
“Hong Kong has been out of burial space for many years. Many people fulfill their responsibility to pay respects to dead ancestors by visiting a virtual grave; they can offer money or roast pig by emoji. A floating columbarium has been proposed to ‘offer serenity and breathtaking scenery with which island sites can’t compete.’”
“Space for graves is so scarce and expensive in Japan that large corporations may purchase a section of a cemetery and offer a site as an employee benefit. Japan also has webcams at several cemeteries. A multistory columbarium retrieves individual urns robotically with the insertion of a key card. The Ruriden columbarium in Tokyo has 2,046 small altar niches in the walls of a quiet, dark room. Each holds a crystal Buddha statue illuminated with LED lights in different colors, representing a different drawer of ashes. When a person swipes their ID card, the appropriate statue lights up and blinks. The box for 1 person costs more than $6,000.”
“Vertical cemeteries exist in several countries, the tallest being Brazil’s Memorial Necropoel Ecumenica in Santos: 14 stories tall, with 25,000 burial units. The Necropole is one of the Santos’ most popular tourist sites, with a snack bar on the roof and peacocks in the garden. Even a 3-year rental can cost tens of thousands of dollars here. The higher stories, with good views of the city, cost more. The 3-year period reflects the typical decomposition time, after which families often have the remains removed to a cheaper, less advantageous unit.”
“The word cemetery comes from a Greek word for sleeping place.”
“In time, the same thing happens to all bodies, no matter what we do. Embalmed bodies decompose, just more slowly and in a different pattern. Insects don’t seem to like formaldehyde much, and will focus on the parts of the body with the least chemical saturation. This is often the butt. Insects and animals usually make short work of things. A buried body may take years. Cremation is just a kind of very fast decomposition. The results are more or less the same. Maggots can reduce the weight of an exposed human body by 50% in just a few weeks.”
“There are several waves of insects in a decomposing body, colonizing in a strict sequence. The first wave is blowflies and houseflies; they begin to arrive within minutes of death. Their bodies are beautiful and glass-like, shimmering greens and blues with warm, deep-red eyes. They lay eggs in dark, warm corners, and the larvae quickly hatch and begin to eat. A dead body is alive in a new way, a busy place full of activity. At times the body seems to move of its own accord from their motion.”
“Eventually, other species of blowflies and horseflies arrive. The corpse begins to blacken and soften. The meat on which the maggots feed begins to liquefy and runs like melting butter. A third wave of flies arrives: fruit flies and drone flies, flies that prefer the liquid. Toward the end, the cheese skipper appears and carefully cleans the bones of the remnants of tendons and connective tissue.”
“In Seattle, a team is doing research into the ultimate natural burial, the eventual result of all burials made into a social choice: compost. A 2-year pilot project showed that in the proper mix of materials, oxygenation, and moisture, the bodies completely decomposed in 5 to 8 months. As the method is perfected, the organization will move toward creating legal language for legislation. The goal is a large-scale system where cities could receive and manage bodies in a formal way, and recover fertile soil for use in parks and landscapes.”
Cremation
“More than half of India’s population lives with a few hundred miles of the river Ganges. In Varanasi, a stretch of riverbank several miles long is divided into more than a hundred ghats, broad staircases that lead to the water, each ghat the plaza of a miniature neighborhood, catering to different needs. People bathe at dawn every day, reciting prayers. They come to do laundry, to visit, to make offerings, to flirt, to get a shave and haircut, commit crimes, gossip.”
“People come to the Ganges to die, because, in Hindu belief, to be cremated by the Ganges is to be released all at once from the cycle of suffering and reincarnation. (Certain people do not need to be cremated, such as unwed girls. They need merely to be sunk into the holy river.) The two burning ghats each have a fog of smoke hovering over them. Some people watch from boats because visitors are not entirely welcomed on the burning ghat itself, and photos are forbidden. There are always fires burning, perhaps a dozen or more at a time, each built on the ashes of previous fires so that the entire plaza has become a pillow of ash. Here a dying fire, there a body fully engulfed, a blackened skull facing the sky. Now and then, dry-eyed mourners carry a body down to the river, trailed by the eldest son. He steps awkwardly over the ash, wearing only a loincloth, his head newly shaved and looking like he’d really like to get back to work at the bank. The body is dipped into the water. While it dries, the family purchases firewood and the pyre is built. Then the body is laid on top and the flames begin to rise. The fire will burn for hours.”
“The government of India releases thousands of turtles into the Ganges every year to help eat the remains of all those bodies.”
“Cremation is one of the most common methods for disposing of a corpse in the world. Almost everyone in Japan is cremated. More than half of Americans who die are cremated. Cremation is cheaper than a traditional burial.”
“Don’t try this at home. A cremation oven runs as hot as 1,800 degrees F. The human body is wet, a loose collection of watery cells, about 85% moisture. The intense heat quickly evaporates the body’s water and the suddenly dry skin and hair ignite. Everything soft chars, shrivels, and burns away. On occasion, the chamber has to be opened to reposition the body for a more thorough burn. Gradually the skeleton is exposed, cooking until the bones are friable and begin to crumble. At the end, about 5% of the body is left.”
“Crematoria are considered incinerators, in the same category as municipal waste. The creamation of an average adult requires more than 2 million BTU an hour of energy. (To compare, a gallon of gas provides about 124,000 BTU.) The pyres of India and Nepal use up more than 50 million trees every year and create a significant fraction of the particulate pollution of this very polluted region. Cremation releases a number of dangerous compounds into the atmosphere along with greenhouse gases. The real environmental effects have been little studied, but a few limited surveys showed increased birth defects and stillbirths in the vicinity of crematoria.”
Ashes & Other Options
“You can also have Mom made into stained glass. Mail yourself to a good friend. Be made into a matched set of 240 pencils. Stuff a teddy bear. You can become an hourglass. Get added to an artificial coral reef. Be compressed into a diamond. Be mixed in with tattoo ink or paint. Be pressed into a vinyl record or mixed into fireworks. You can load your father into shotgun shells, which is advertised as ‘eco-friendly’ and allows your family to ‘honor you by shooting your ashes at sporting clays or live birds.’ You can ‘have the peace of mind of knowing that you can continue to protect your home and family even after you are gone.’ Nigel Barley reports that ‘a museum colleague has decreed that his ashes shall be flung in the eyes of the Trustees of the British Museum.’”
“In some states, an unclaimed body may be claimed for dissection and research. (This includes prisoners, historically the most common source of cadavers.)”
“You can opt to have your body displayed. The whole body or its parts can be preserved for a classroom or museum through plastification, which is controversial and has been banned in several places.”
Grief
“You know it will hurt and you know it will hurt for a long time. Grief lives in the body. MRI studies show a grieving brain has a pattern unlike other emotions. Most of the time, an emotion lights up parts of the brain, but grief is distributed everywhere, into areas associated with memory, metabolism, visual imagery, and more. Grief can make you sick; it can be deadly. One is coming to grips with what forever means. Grief is full of surprises. You may feel unreal, drugged.”
“What are the things to say [to a grieving person]? I love you. I’m so sorry. Do you want to talk? I’d be glad to listen to the story.
