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Death & life
5 min read

The lost art of dying well and what we can learn from it today

Living well in order to die well doesn’t simply happen. It takes work. It takes preparation. For All Souls Day, Lydia Dugdale asks if we are prepared for death.

Lydia Dugdale is the author of The Lost Art of Dying. She is Professor of Medicine at Columbia University and Director of the Center for Clinical Medical Ethics. She is a specialist in both medical ethics and the treatment of older patients. 

A medieval book illustration of a person dying in bed.
A 15th Century ars moriendi, or ‘art of dying’ image.
Basel University, via WikiCommons.

The first of November marks All Saints Day on many church calendars—a day when we Christians remember our martyrs together with all the faithful, both living and departed. On that day, we celebrate that our communion is not simply with one another on earth but is also with all saints of all time, including those who have died.  

For some people, the notion of fellowship with departed saints might be quite exciting. They may have pondered questions about the saints since school assemblies or RE lessons. What was racing through Abraham’s mind when he attempted to sacrifice his son Isaac? What would Mary say a sinless Jesus was like as a toddler? Did Jonah float around inside the great fish, or did he find something on which to perch himself?  

But others among us might wish to skip All Saints Day altogether. Talk of dead saints feels positively medieval, even a bit morbid. Some of us might wonder about our own saintliness—or lack thereof. Could we really experience ineffable joy in an afterlife? Moreover, the very suggestion of an afterlife implies that we ourselves must die—an uncomfortable prospect for most of us.   

Such divergent reactions to the day are revealing. On the one hand, the idea of having saints to remember is to inspire us to live well. They invite us to examine their lives and to grow ourselves in response. On the other hand, they remind us that our days are numbered. And because our days are numbered, we should attend carefully to what it means to live wisely. Saints teach us that if we want to die well, we must live well. 

But living well in order to die well doesn’t simply happen. It takes work. It takes preparation. Which is why this year on All Saints Day it’s worth asking the question: Am I prepared for death? 

Death exists as a paradox for Christians—as something at once lurking and vanquished. 

In the late Middle Ages, the ars moriendi, or ‘art of dying’ genre of literature developed in response to mass loss of life from a fourteenth-century outbreak of bubonic plague. The genre consisted of a number of handbooks on how to prepare for death. Although the earliest text was anonymous, historians believe that its authorship had a connection to the Western Church. After the Reformation, Protestant versions began to circulate, and later handbooks omitted religious particularity altogether. The handbooks grew in popularity throughout the West for more than 500 years. 

This notion of living well to die well lay at the core of the various iterations of the ars moriendi. Early texts warned readers that five temptations lead to dying poorly—temptations to doubt, despair, impatience, greed, and pride. If you don’t want to die a doubting, despairing, impatient, greedy, and proud person, you must cultivate the virtues of faith, hope, patience, generosity, and humility now. But the ars moriendi texts were very clear that virtue did not happen to a person all at once at the end of life. Rather, it required habituation. Cultivating virtues was the work of a lifetime. If you want to be remembered as a person of sound character, a generous person of hope and good will toward others, you cannot delay making such attributes a regular practice. If you are willing to be martyred for your faith—as some of those early saints were—you have got to be sure it is a faith worth dying for. 

I once met a man who had converted from the religion of radical self-centeredness to Christianity. When I asked him why, he told me that of all the world’s religions, Christianity had the best story. As with the martyred saints, it was for him a story worth dying for. And All Saints Day reminds us that in Christianity, death is stranger than you might think. 

Death exists as a paradox for Christians—as something at once lurking and vanquished. Death is the enemy that at long last will be destroyed, and death has already been swallowed up in victory. But you might ask: if death has already been defeated, what remains to be destroyed? And if death will be destroyed, how has it then been defeated? This enigma might partially explain why many regular church attenders are neither physically nor spiritually prepared for death. Researchers at Harvard University have shown that people who describe themselves as most supported by their religious communities are also most likely to reject hospice care and instead to elect aggressive life-extending technology. 

The story goes as follows. Death is an enemy because it suggests rejection of God. From the beginning, God tells our forebearer Adam that he can freely eat of any tree in the garden but one. If he eats from the tree of the knowledge of good and evil, he will die.  Thus, from the beginning, God equates the possibility of human disobedience with the actuality of death.  

Of course, Adam and Eve eat the proverbial apple. And when they do, they don’t immediately die, but they experience a sort of death. For the first time, they become filled with shame and fear. They hide themselves from God. They cast blame. God tells them that moving forward their life will be filled with great suffering. God says to Adam, ‘By the sweat of your face you shall eat bread until you return to the ground, for out of it you were taken. You are dust, and to dust you shall return.’ Disobedience is what Christians call ‘sin’—and it brings death. Sin severs that once harmonious relationship between God and people—a fact that also grieves God, which is why God does not let death have the final word. 

The story gets better. Since we humans cannot possibly undo the drastic results of our disobedience, God becomes fully human in Jesus Christ, so liable to death, while also retaining full, divinity which cannot die. Then, as a human on a cross, he dies as the ultimate sacrifice on behalf of humankind. But this God-Man does not stay dead. After three days in the tomb, Christ is resurrected, defeating death, on what has come to be known as Easter Sunday. Christ’s resurrection functions as a sort of guarantee that all God’s people will one day be resurrected and receive new bodies, that day on which the great enemy of death will be destroyed once and for all. If Adam and Eve brought death into the world, the resurrection hope is that death will be no more.  

This year on All Saints Day we have the opportunity to consider what it means to commune with ‘all saints’ extending back to Adam and forward to future generations. We have the opportunity to study the saints and then examine ourselves. What sort of people are we becoming? Are we living well to die well, as the ars moriendi handbooks teach? And of all the stories out there, which provides the greatest hope in life and in death? 

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Mapmaking our meaning in a modern world

Real ‘reasoning’ happens only when we have learned to trust one another.
A hand holds a pen over a map, at the side is closed journal and colour pencils.
Oxana v on Unsplash.

People first began to think about theology not because they were looking for intellectual stimulus or solutions to abstract problems, but because they found themselves living in an unsettling and vastly expanded ‘space’. They were conscious of new dimensions in their connection with each other, new dimensions in coping with their own fear, guilt, despair, a new sense of intimate access to the limitless reality of God. They connected these new experiences with the story of Jesus of Nazareth, executed by the Roman colonial government, reported by his closest friends as raised from death and present with them and their converts in the communication of divine ‘spirit.’ As we read Christian scripture, we are watching the first generations of Christian believers trying to construct a workable map of this unexpected territory. 

When I started writing the assorted pieces that make up the little book on Discovering Christianity (published earlier this year), my hope was above all to convey something of this sense of Christian thinking as a process of mapmaking in a new and bewildering landscape. That’s why one chapter – originally drafted for a Muslim audience – tried to list some of the things that an interested observer might spot in looking from outside at the habits of Christian believers: not first and foremost their spectacular and uniform embodiment of unconditional divine love (if only), but just the sorts of things they said and did, the sort of language used about Jesus, the rituals of induction and belonging. Indeed, if there is one biblical text I had in mind in virtually all the chapters, it is the simple phrase, ‘Come and see’ that Jesus uses in St John’s gospel when he is first followed by those who will become ‘disciples’, literally ‘learners.’ 

‘Come and see’. When we use language like that in everyday life, we’re encouraging others to share something that has excited or troubled us (or both). It’s not a proposal for solving a problem. It’s not even a recruitment campaign. It’s an invitation to stand where someone else is standing and look from there. In the rich symbolic context of John’s gospel, it’s about sharing Jesus’ ‘point of view’ – which is, as we’re told right at the start of the gospel, a point of view unimaginably close to the heart of eternal life and reality itself.  

We can only see in this way when we move away from our ordinary perceptions a bit. Just as we can only learn to swim when we have jumped into the water, so we shan’t learn what faith is all about until we have been prodded by whatever forces around us to take the risk of trusting that (so to speak) the ground is going to hold beneath us if we step forward (I like to speak sometimes about discovering what images, ideas, perspectives and relations are ‘load-bearing’ in our lives).  

So part of the invitation is also about telling the stories of those who have taken that kind of risk and what sort of lives they have shaped for themselves in the light of it. There is little point in summoning others just to share my individual set of feelings. But there is perhaps more weight is saying, ‘A lot of people have felt this shape beneath the surface, this grain running through things.’ Which is why – as the book seeks to explain – theology works with the ‘classical’ shared texts that most Christian communities found themselves reading together in the first hundred years after Jesus; and works also with the history of the arguments and diverse perceptions that reading brought into focus.  

We read and think in company; our theological reflection like the rest of our lives of faith is a shared, ‘conversational’ affair.

It's not unknown outside theology. We have become so much more interested over the last few decades in how to understand works of art not just in terms of what the artist ‘meant’, but in terms of what the actual work does or makes possible. What world does it create? So we read the Bible, obviously, but we also read the readers of the Bible (think of the Jewish Talmud, with the original text of its classical legal discussions literally surrounded on every page by the arguments that this text has generated). We read and think in company; our theological reflection like the rest of our lives of faith is a shared, ‘conversational’ affair. And so along with reading the Bible and immersing ourselves in the history of what sense others have made of the basic text and story, we also bring to bear the sorts of things that are part of our current conversations in society and culture – the habits of ‘reasoning’ that we have picked up.  

There is an important difference between talking about ‘reason’ as a sovereign, detached capacity and talking about ‘reasoning’, the range of processes and practices that carry forward a common life of intelligent learning (and that learning may be at any level of supposed ‘intellectual’ capacity; once more, it’s not about abstractions). Our society these days is fairly comprehensively confused about this: we have a mythological picture of some supremely obvious way of arguing that allows for no final dispute; we call it ‘science’; and then we expect the impossible of it and are disillusioned and sceptical when it can’t give us absolutely certain answers. One of the many ironies of our society is that we are besotted with ‘science’ and at the same time fascinated by the idea that there are many ‘truths’, or else suspicious that apparently objective sources are actually controlled by other interests. Real ‘reasoning’ happens only when we have learned to trust one another’: a long story, but an all-important element in our human discovery. 

Bible, tradition, human reasoning – those are the tools we bring to this job of mapmaking. The book is really just a meditation on those words, ‘Come and see’, as the basis of Christian thinking. At the centre of everything is a set of very ambitious claims about what God is like – and what we are like. Part of what we’re invited to ‘come and see’ is ourselves. Once again it’s not unlike what happens in a really good play or film, when we go away conscious that we have seen not just someone else’s story but something fresh about our own selves. 

And my greatest hope for the book is that it may prompt someone to look a bit harder, to listen in to how Christians talk – and in that moment find that they recognize what’s being said in some complicated and untidy way. One of the most vivid characters in the gospel I’ve been quoting says of Jesus that he has told her everything she has ever done. I hope that those who are moved to investigate a bit further will come to that same unsettling and exciting point where they see themselves freshly, and the new landscape begins to unfold.  

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