Death has always felt close at hand. My dad died when I was 13 from his fourth heart attack. This has haunted me as I reached the age of his bout with heart disease. My aunt died by suicide, so did a friend from college, and eventually my mom. This haunts me as I deal with trauma-induced anxiety (the cousin of depression) after my mom’s death. I still remember that last conversation with my grandfather (who lived with us for over 20 years) before he died, asking my wife and I to stay longer the next time we visited. I am one of those that Dr. Lydia S. Dugdale writes about in The Lost Art of Dying who is hyper aware of human finitude. What Dugdale tackles in this book, however, is both how to not only die well, but how to live well in recognition of our unavoidable end.
Dugdale is a physician who has seen plenty of death. Her stories of patients paint powerful pictures, particularly of not dying well. Of clinging to a rapidly declining quality of life. The book is easy to read, sometimes lingering longer than necessary on points, but generally quickly paced. Dugdale’s primary inspiration for this book, beyond her own career, is the Ars Moriendi, a medieval collection of literature that taught people how to die well. I read this with a Christian faculty book group that we have on campus and we chose it in light of the current pandemic. The Ars Moriendi emerged after the Black Death claimed millions of lives in Europe during the 14th century. The book took on new meaning as we reached over half a million COVID-19 deaths in the United States.
Dugdale draws from this literature to place in stark relief the drawbacks of our modern approach to dying. Namely, we push death away, into a hospital and away from community. This helps us ignore the inevitability of death and increases the likelihood that we will not cope with it well when it comes. Death is no longer as visibly a part of life in modern America as it was for much of human history. Both patients and doctors seek increasingly heroic interventions that can themselves exacerbate the horror of death. Dugdale argues that trying to ignore death, and all of the subsequently poor practices that then accompany our death, results in our not fully living life.
I will share one passage that illustrates these points. It comes from the final chapter titled Life:
In the end, these virtues – patience, hope, humility, faith, and “letting go” – lead to flourishing through life as through death. In reflecting on the themes of this book, the habit of letting go makes possible the acknowledgement of human finitude, and the habit of humility makes space for community – recognizing finitude and embracing community being the foundational elements of an art of dying. Exercising faith together with hope helps to mitigate fear of death, suggests answers to our deepest existential anxieties, and promotes the cultivation of peace. And nearly all of us could do with more patience – every day of our living and our dying.
I will agree with the endorsement of the front cover that this book is recommended for all who are mortal. If you want an overview of the book before reading it, see Dr. Dugdale’s interview at the Trinity Forum from Good Friday 2021: https://www.ttf.org/portfolios/online-conversation-lydia-dugdale/.
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