The Way We Die Now (22 page)

Johann Wolfgang von Goethe (1749–1832), widely acclaimed as the wisest man of his age, lived to eighty-two, productive almost to the end. His friend, the poet Johann Peter Eckermann, wrote in
Conversations of Goethe
: ‘The morning after Goethe’s death, a deep desire seized me to look once again upon his earthly garment. His faithful servant, Frederick, opened for me the chamber in which he was laid out. Stretched upon his back, he reposed as if asleep; profound peace and security reigned in the features of his sublimely noble countenance.’ His doctor’s diary, however, revealed that Goethe, at the end, was ‘in the grip of a terrible fear and agitation’. Goethe’s last words were famously: ‘
mehr Licht
’ (‘more light’). The Austrian novelist Thomas Bernhard wrote a short story, ‘Claim’, about a man who claimed at every opportunity that Goethe’s last words, were, in fact, ‘
mehr nicht
’ (‘no more’). For his persistence, this man was eventually incarcerated in a lunatic asylum. Goethe’s close friend, Friedrich Schiller (1759–1805), fell ill with pneumonia and died. Goethe had been sick at the same time, but recovered. Schiller’s last words, in the throes of pre-terminal delirium were: ‘
Ist das euer Himmel, ist das euer Hölle?’
(‘Is that your heaven, is that your hell?’) Goethe and Schiller were buried alongside each other in Weimar.

Philip Larkin dismissed the claims of both religion and philosophy:

This is a special way of being afraid

No trick dispels. Religion used to try,

That vast moth-eaten musical brocade

Created to pretend we never die,

And specious stuff that says
No rational being

Can fear a thing it will not feel
...

Larkin died in hospital in Hull. Like Christopher Hitchens, he had oesophageal cancer and was in his early sixties (sixty-three). A friend visiting him the day before he died said: ‘If Philip hadn’t been drugged, he would have been raving. He was that frightened.’

The novelist Elizabeth Jane Howard once told Julian Barnes that the three most death-haunted people she had known were Larkin, Kingsley Amis and John Betjeman. In his poem ‘Late-Flowering Lust’, the cuddly Poet Laureate chillingly confessed that a love affair in middle age merely served to remind him of the inevitable:

I cling to you inflamed with fear

As now you cling to me,

I feel how frail you are my dear

And wonder what will be –

A week? or twenty years remain?

And then – what kind of death?

A losing fight with frightful pain

Or a gasping fight for breath?

But the death-haunted Betjeman, in the end, was luckier than he had anticipated. He died peacefully in Treen, the house in Trebetherick, Cornwall, which he had loved so much. Betjeman’s long-time lover, Elizabeth Cavendish, wrote to a friend:

...he died on the most beautiful sunny morning with the sun streaming into the room & the French windows open & the lovely smell of the garden everywhere & Carole [Betjeman’s nurse] was holding one of his hands & me the other & he had old Archy [his teddy-bear] & Jumbo in each arm & Stanley the cat asleep on his tummy.

A. N. Wilson, in his biography of Betjeman, observed: ‘There was a perfection in his dying where he had spent so many childhood hours of happiness.’

Somerset Maugham (1874–1965) learned much about death and suffering during his five years as a medical student at St Thomas’s Hospital in London. On the hospital wards and in the slums of Lambeth (where he worked as an obstetric clerk), he witnessed many deaths, and found nothing noble about it:

I set down in my note-books, not once or twice, but in a dozen places, the facts that I had seen. I knew that suffering did not ennoble; it degraded. It made men selfish, mean, petty and suspicious. It absorbed them in small things. It did not make them more than men; it made them less than men; and I wrote ferociously that we learn resignation not by our own suffering, but by the suffering of others.

Although he never practised as a doctor, Maugham’s experience as a medical student formed his world-view, which was that people weren’t much good, and life was meaningless. Maugham’s own end was messy, protracted and undignified. He lived to ninety-one, but his final years were scarred by dementia and violent mood swings. Interviewed by the
Daily Express
on the occasion of his ninetieth birthday, he said he longed for death: ‘I am drunk with the thought of it. It seems to me to offer the final and absolute freedom.’ The story is told (it may be apocryphal) that Maugham, nearing the end, summoned the philosopher A. J. Ayer to his home on the Riviera, the Villa Mauresque. He asked Ayer, a resolute atheist, to reassure him that there was no afterlife. Ayer was happy to oblige. More than twenty years later, Ayer had a near-death experience after choking on a piece of salmon. He admitted that this experience provided ‘rather strong evidence that death does not put an end to consciousness’. Ayer’s wife, Dee, told Jonathan Miller: ‘Freddie has got so much nicer since he died.’

Tolstoy (1828–1910) showed unique psychological and spiritual understanding of dying in his fiction, but his own death was undignified and unedifying. At the age of eighty-two, he finally summoned the courage to leave his wife, Sonia. Their relationship had been deteriorating for several years, not helped latterly by the constant presence at his country estate, Yasnaya Polyana, of Tolstoy’s ‘disciples’. The great novelist crept out in the dead of night, but quickly fell ill with pneumonia, and died a few days later in the station-master’s house in the railway station of the rural town of Astapovo. A swarm of journalists and cameramen descended on the little town in a media scrum; at least six doctors kept separate records of his final illness, and Tsarist spies reported back to St Petersburg.

George Orwell (1903–50) described the horrors of hospital death in his essay ‘How the Poor Die’ (1946), after a spell as a patient in the Hôpital Cochin in Paris in 1929. He died in 1950 in University College Hospital in London, having suffered from pulmonary tuberculosis for many years. In his biography of Orwell, Bernard Crick wrote that he was not aware that he was dying. At the time of his death, he was making plans to travel to a Swiss sanatorium and his main concern was the quality of the tea he might be offered there: ‘They have that filthy Chinese stuff, you know. I like Ceylon tea, very strong.’ Orwell died at night, alone, following a lung haemorrhage.

Sigmund Freud died in London in 1939, having fled Vienna the year before. Over a period of sixteen years, he had undergone over thirty operations and several courses of radiation. He was seeing patients up to two months before his death. Towards the end, Freud’s dog, a chow called Lün, could not bear to be in the same room as his master because of the stink from Freud’s necrotic tumour. His physician, Max Schur, had followed Freud to London, and kept his promise: ‘When he was again in agony, I gave him a hypodermic of two centigrams of morphine. The expression of pain and suffering was gone. I repeated the dose after about 12 hours. Freud was obviously so close to the end of his reserves that he lapsed into a coma and did not wake up again.’ At the end, Schur, as he had promised, was Freud’s
amicus mortis.

The combination of virtues shown by Hume and Wittgenstein – courage, nobility, intellect and an unflinching acceptance of the truth – are rare indeed. Seneca, Goethe, Maugham and Tolstoy, for all their insight into death and dying, died themselves no better than the unlettered vulgarians. There have doubtless been many anonymous and uncelebrated folk throughout history (such as Montaigne’s peasant neighbours) who died as bravely and as nobly as Hume and Wittgenstein. Being a philosopher or a thanatologist clearly confers no special advantage. Sarah Bakewell concluded of Montaigne: ‘Philosophers find it hard to leave the world because they try to maintain control. So much for “To philosophise is to learn how to die.” Philosophy looked more like a way of teaching people to
un
learn the natural skill that every peasant had as a birthright.’

So, is philosophy a waste of time, impotent to temper the terror of death? Some writers less exalted than Montaigne and Seneca may have more relevant things to say to us about death. Montaigne did not conduct interviews with the dying, but Bronnie Ware, an Australian palliative care worker, did, and wrote a bestselling book called
The Top Five Regrets of the Dying: A Life Transformed by the Dearly Departing
(2012). These top five are: (1) I wish I’d had the courage to live a life true to myself, not the life others expected of me; (2) I wish I hadn’t worked so hard; (3) I wish I’d had the courage to express my feelings; (4) I wish I’d stayed in touch with my friends; (5) I wish I’d let myself be happier. Ware argues that our denial of death causes us to lead inauthentic lives: ‘we carry on trying to validate ourselves through our material life and associated fearful behaviour instead. If we are able to face our own inevitable death with honest acceptance, before we have reached that time, then we shift our priorities well before it is too late.’

The French psychologist Marie de Hennezel also worked for many years in palliative care, and also wrote a bestseller, called
Seize the Day
(2012), with the same message: ‘Death can be a door that opens to a greater awareness and a more meaningful life.’ The trick, of course, is to come to this conclusion when you are still healthy.

Julian Barnes wrote about the ‘lemon table’ at the Kämp restaurant in Helsinki, where, in the 1920s, local intellectuals, including the composer Sibelius, would gather to discuss death. The lemon was the ancient Chinese symbol of death, and those seated at this particular table were obliged to discuss this – and no other – topic.

I have my own version of the lemon table. The largest cemetery in Cork, St Finbarr’s, is a short walk from the hospital where I work. I regularly visit St Finbarr’s, usually at lunchtime, particularly when the weather is good. I started visiting the cemetery not because of any Montaignian intention to contemplate death, but because it is a restful, quiet place, ideal for a short walk in the middle of the working day. St Finbarr’s is so large that I walk only a small section at a time. There is a long, wide, tree-lined avenue, flanked by two Romanesque chapels, with several smaller, numbered, paths leading off it. The Republican plot is situated just inside the main entrance gate, and contains the graves of the local heroes, such as Tomás MacCurtain and Terence MacSwiney, who died in the War of Independence. The cemetery was built in the mid-nineteenth century and initially accommodated mainly the professional and merchant classes. Many headstones proudly list the degrees and professional qualifications of the deceased. Nearly all famous Corkonians are buried in St Finbarr’s; the only notable exceptions being Michael Collins (buried in Glasnevin in Dublin) and the blues guitarist Rory Gallagher, whose plot is in the new cemetery, St Oliver’s, where my father is also buried.

My interest, however, is in the unknown, the unheroic and the neglected. Each row of headstones tells a few brief stories of heartbreak: here, the young surgeon, dead at thirty – what happened? There, the child dead at fifteen, his father joining him less than two years later. Next, the girl I knew at school, who died of leukaemia aged just seventeen. (Her mother had been to see me as a patient, and I told her that I had known his long-dead daughter. Her eyes filled with tears as I told her.) Most of the plots are tidy and well maintained; a few are neglected and overgrown, the lettering on the headstones now indecipherable. One well-kept plot commemorates a woman who died aged forty-three in 1884, ‘To the inexpressible grief of her husband and children’. Wittgenstein would have understood. The plot containing the remains of the local Franciscan monks has a headstone on which is engraved a phrase of St Francis’s: ‘Welcome, Sister Death’.

When I last visited St Finbarr’s, on a fine, windy autumn day, I heard my name called from the other side of the cemetery wall. It was K., a classmate from primary school. He was standing on a ladder, thinning a tree in a garden adjoining the cemetery. K. had started working as a landscape gardener when he was made redundant, after twenty-eight years, from his job at a local factory. I retrieved for him some of the branches that had fallen on the plots below; we talked amiably about getting older, children leaving home, and how it all went by so fast. A visit to St Finbarr’s is a reliable antidote to work-related worry; half an hour spent in the company of the dead is surprisingly soothing.

Philippe Ariès observed how, in medieval Europe, death was seen as a transition to another life. Religion, not medicine, was the guiding force: nobody expected medicine, as we do now, to cure them when they fell mortally ill. Much of our contemporary fear of death is attributable to the prevailing certainty, for most people, that death means extinction, oblivion. One would think, intuitively, that death and dying would be less terrifying for those with a strong religious faith. But I do not believe that this is so. The US, ostensibly the most God-fearing nation on earth, is also the most death-fearing. A palliative care colleague told me how commonly priests experience profound spiritual crises when they are dying. The story is told of a cardinal who, when diagnosed with terminal cancer, confided in a saintly fellow priest. The priest congratulated the cardinal and expressed some envy that he would soon be with God and his angels. This priest is presented to us as a sort of holy fool, but isn’t this exactly how a true believer should react to such news? J. G. Ballard wrote of Francis Bacon’s series of ‘pope’ paintings (inspired by Velásquez’s portrait of Pope Innocent X): ‘His popes screamed because they knew there was no God.’

Unlike Bacon’s popes, my uncle – the priest – truly believed. Did his faith sustain him when he was dying? I think so. Although he was ninety and had endured a miserable year or more, he was frightened of dying. He did not fear death but, rather, dying alone. Although his supple mind was well acquainted with theology and philosophy, he had the simple, unshakeable faith of country people. He firmly believed that physical death was the portal that opened into eternal life. When it became clear that he was dying, family members took it in turns to sit with him. For the last twenty-four hours, he was semi-conscious, anaesthetized by the syringe-driver. In his final agony, he called out: ‘I want to go home.’ Home, for him, was always Dromore, the place he had left more than seventy years before. Dromore had always held for him a mystical, almost religious, fascination. Honour thy father and thy mother: he revered his parents and prayed daily that he would rejoin them in Heaven.