Monday, August 31, 2020

Book Review: "From Here To Eternity: Traveling the World to Find the Good Death" by Caitlin Doughty

by Jared Rubenstein (@DrJRubenstein)

Caitlin Doughty is a mortician, funeral home owner, author, and activist who strives to instill more death positivity into our classically death-avoidant culture. Through her writing, website caitlindoughty.com, podcast and numerous YouTube videos she utilizes her signature voice and style to both educate and entertain. In her book, From Here To Eternity: Traveling the World to Find the Good Death, Ms. Doughty treats the author to a whirlwind tour of different cultural practices around death throughout the world. In equal parts travelogue and ethnography, the reader gets to experience eight different and unique cultural practices related to how we care for each other after death.

In the Tana Toraja region of Indonesia, there is an annual event where families exhume their mummified loved ones to spend time with them and care for their bodies. They talk to the corpses, bring them gifts, and change their clothes prior to ultimately returning the body to the family crypts at the end of the festival. One man reported, “For us, we are used to it, this kind of thing. This life and death.” In Tokyo, Japan, we are taken to the Ruriden columbarium, a high-tech Buddhist facility for storing cremated remains. A room with two thousand glowing Buddhas that line the walls floor to ceiling serves as a means for technology to facilitate the way in which people connect with their deceased. Using an electronic card, visitors are able to locate which glowing Buddha holds the remains on their loved one which then glows a different color to draw the visitor’s focus and allow connection. In Colorado, we get a glimpse of an open air pyre where cremations occur with the engagement of the local community

Ms. Doughty’s style is both alternately serious and light-hearted. She masterfully navigates discussions of the diverse cultures while at all times maintaining cultural humility. The sum is a fascinating look at eight different ways people in this world conceptualize death. Two themes that intertwine throughout the book are the commercialization of post-mortem care and the relative lack of involvement with processes related to death that is becoming more common in American culture. Ms. Doughty makes no secret of her feeling that both of these are negative adaptations in our culture and through juxtaposition with the other cultures shared in the book, makes a convincing case for the benefits of a more “death positive” culture.

I would wholeheartedly recommend this book for anyone who likes learning about different cultures of the world, particularly as they relate to death. Any fans of the book Stiff, by Mary Roach, will likely enjoy this book for its similar series of short vignettes as well as its somewhat lighthearted take on what is otherwise potentially heavy subject matter.

Through the palliative care lens, it’s easy to see how the gradual, but relentless, distancing of life and death in our American culture affects the work we do. Increasingly, death becomes something that happens to other people rather than an indivisible counterpoint to life. In caring for people grappling with their own mortality and that of their loved ones, having taboos surrounding death makes navigating end-of-life conversations even more challenging than they inherently are. I would imagine that if we could achieve the type of death positive culture that Ms. Doughty and others advocate, people may be able to view discussing their death as simply another means of discussing their life. In this way, we could more effectively navigate conversations about goals of care and advance care planning, using the idea of death as a means to frame what it means for someone to feel alive.

Jared Rubenstein, MD is a pediatric palliative care physician and medical educator at Texas Children's Hospital. You may know him from his animated videos on palliative care topics. Check them out here. 

Monday, August 31, 2020 by Pallimed Editor ·

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