Transcript for Let's Talk About Death

Anne Strainchamps: It is time to talk about death.

Therese Morrisey: But before I leave for an overnight, I clean the house, because I always think if something happens to me, and my family comes to the house, I don't want to have rotten food in the refrigerator, and I don't want to have a moment. My names Therese Morrisey, and I've always been aware of death, I had a brother who died when I was three months old, and it was something that we were not allowed to talk about. I think in society people feel uncomfortable and want to change the topic, and death is morbid.

Strainchamps: We've been avoiding death for a long time now. We don't want to think about people we love dying, and we don't want to contemplate our own death. That's kind of a taboo subject, but now something's changing.

This is a death cafe, a group of people who've come together to share tasty treats and talk about the one thing supposedly no one wants to talk about.

Detin Dachima: My name is Detin Dachima [sic], but I go by Chima. I think death is such an integral part of life, and the concept of not talking about it as a morbid issue, but having a little lightness to it, like a cafe atmosphere, the whole idea, you get together, have tea and talk about it, was attractive to me. 

Strainchamps: These conversations are happening all over the country at death cafes, death dinners, death salons, and for the next five episodes we'll be bringing the conversation to you. So to start out, let's talk about, talking about death. Because even though we think we don't like to talk about death, in fact it's possible that we are all actually dying to talk about it. Kaitlin Doughty is the woman behind Ask a Mortician, a series of cheerfully morbid YouTube videos.

Doughty: 'Where have all the corpses gone? Until I was 23 years old, I didn't see too many dead bodies, even though 2.5 million people die every year in the US, I just didn't see them. Then I got a job at a crematory, and there they were, they had been hiding. Well, to be more accurate, they had been hidden by the living.'

Strainchamps: Kaitlin, is something changing, is something happening in the way we thing about, deal with death?

Doughty: It absolutely is. I started speaking publicly, having things on the internet, having this larger conversation, I guess almost four years ago now, and the first year or so it was kind of like speaking into the canyon, you know, and then just hearing nothing back, and really in the past two years there's just been an explosion of people who want to be involved, just saying that hey, maybe hiding all of these things behind closed doors isn't the best policy for us as a culture. 

'This is episode one of Ask A Mortician. You ask a question about death, dying, decomposition, mourning, funeral customs, and I will answer it.'

I'm one of those people who really likes to know what's happening, and with death the fear comes from that lack of knowledge, and once you're given that information in a very practical, straightforward, even humorous way, it makes you feel better.

Strainchamps: So for instance, when you were doing the Ask A Mortician series, what did people ask?

Doughty: Oh, they asked a, they asked everything from more simple, straightforward things like, how, what happens to the bones after a cremation, or what are the chemicals used in the embalming process? It's surprising, almost universally, when I tell somebody what I do, I'm the most popular person at the party, in the sense that they'll say, Oh, so you cremate a body? Oh, that's, tell me more. You know, they'll just, they can't, they can't help themselves because there's a lot about the funeral industry, and death and dying that's still behind the scenes.

'Funeral home workers drive their unmarked vans up to hospital loading docks to retrieve and make off with their secret cargo. Bodies are sent to centralized facilities to be embalmed or cremated, disposed of, so as not to disturb our first world, corpse free privilege.'

Strainchamps: So what do you think happens to us, I mean, what's the cost of living in a culture that doesn't talk about or even want to see death, and from what you're saying is largely ignorant of death, too?

Doughty: It leads to you being terrified of death, it leaves you to live out your life in deep fear of what's going to happen to you, what's going to happen to your body, is dying going to hurt, am I going to go to heaven or hell. Talking about death is important for you, and it's important for your family.

Strainchamps: So people are having conversations about death in cafes and online, but what about in the doctor's office? Michael Bernhagen and Terry Kaldhusdal have made two films about how many heath professionals avoid talking about this stuff, even with their patients. When Michael and Terry started filming, they weren't actually sure anyone would want to talk about this, let alone see their films.

Michael Bernhagen: At our theatrical premier, which was in a small town, Oconomowoc, Wisconsin, a freezing cold Saturday night, the night before the Packers played the Super Bowl, we were scared to death that nobody was going to show. And it sold out, which we still find that shocking, and we knew we hit a chord when at the end of the film, it's usually silent and everybody slowly walks out, it was loud, it was really loud. People wanted to tell their stories, and people wanted to talk.
 
Strainchamps: What kind of conversations did you want us to consider having? 

Bernhagen: Where here's the deal, I think it's really important that people recognize that American medicine's success at fighting disease and extending life has created a new problem. Where we die has fundamentally changed. Where did most people die 100 years ago? They died at home. Today, most of us can expect to die in a hospital or a nursing home.

Strainchamps: Yeah, one of the figures is something like 90% of us want to die at home. I'm not getting the numbers right, but only 20% of us will be able to do that.

Bernhagen: I call it the 80-20 rule. The majority of us do want to die at home, and we do want to talk about it. But guess what?  50% of them are going to die in a hospital, 20% of them hooked up to a whole bunch of tubes and machines in an intensive care unit, another 25% in a skilled nursing facility, so we got this big disconnect. In my particular case, my mother died in a nursing home from congestive heart failure and vascular dementia, and it was a dear nursing friend of mine who managed to pull out of me, in some detail, the story of my mother's dying experience. And as I'm telling her this story she gets this bewildered look on her face and she asked me this simple question that literally haunts me to this day, 'Didn't anybody mention hospice as an option to your family?' I said, no, nobody mentioned hospice as an option, you know, her family practitioner that she knew for 20 years and is still my dad's doctor, never mentioned it, the cardiologists never mentioned it, none of the nurses or social workers in the hospital or the nursing home mentioned it. And I was embarrassed because I had been this big shot, so I thought Business Development guy, I didn't know anything about hospice or end of life care.

Strainchamps: So what needs to happen?

Terry Kaldhusdal:  Yeah, so a couple of things need to happen. One is, the training of having these conversations should be part of the medical curriculum. That whole idea that death is now optional is one that we're fighting, because the reality is, death is as natural as birth, but dying a natural death has become unnatural.

Strainchamps: You helped start a lot of conversations, personal, but also community conversations, what have you notice happening and what do people want to talk about?

Kaldhusdal: People want to talk about that they value that time at the end of their life, they want to be surrounded by their loved ones, they wanted to know that their life had meaning. The problem is, if all we do is, I have this proceedure I can do, I can do this procedure, I mean, we can keep the human body alive way past the expiration date, right? And what's really gotten difficult is where do you draw the line? Too many times in medicine we don't give people that opportunity to say goodbye.

Bernhagen: People really do want to talk about this because everybody has a story. They've seen a friend or a relative pass away, and pass away poorly, and sometimes pass away well, and so that's the taboo we're breaking through.

Kaldhusdal: You know, it's this crossroads where we are, historically, it's a new world that we live in, and if we don't change, then somebody's going to make those decisions for us and that may not end well.

Strainchamps: We're inventing a new conversation for new situations.

Kaldhusdal: That's exactly right.

Bernhagen: Yeah, this in new.

Strainchamps: Filmmakers Michael Bernhagen and Terry Kaldhusdal, their films are called Consider the Conversation 1 & 2. We'll hear both of them again, later in the series.

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