Quotes on death and dying collected by the Lancet Commission on the Value of Death

“Death is not the opposite of life, but a part of it”. Haruki Murakami.

“Life is pleasant. Death is peaceful. It´s the transition that is troublesome”. Isaac Asimov.

“People living deeply have no fear of death”. Anais Nin

It is our knowledge that we have to die that makes us human…” Alexander Smith, Dreamthorp

“Is it not for us to confess that in our civilized attitude towards death we are once more living psychologically beyond our means, and must reform and give truth its due?  Would it not be better to give death the place in actuality and in our thoughts which properly belongs to it, and to yield a little more prominence to that unconscious attitude towards death which we have hitherto so carefully suppressed?  This hardly seems indeed a greater achievement, but rather a backward step…but it has the merit of taking somewhat more into account the true state of affairs….” Sigmund Freud, Thoughts for the Times on War and Death

“…it has always seemed to me that the only painless death must be that which takes the intelligence by violent surprise and from the rear so to speak since if death be anything at all beyond a brief and peculiar emotional state of the bereaved it must be a brief and likewise peculiar state of the subject as well and if aught can be more painful to any intelligence above that of a child or an idiot than a slow and gradual confronting with that which over a long period of bewilderment and dread it has been taught to regard as an irrevocable and unplumbable finality, I do not know it.” William Faulkner, Absalom, Absalom

“Back of everything is the great specter of universal death, the all-encompassing blackness. . . . We need a life not correlated with death . . . a good that will not perish, a good in fact that flies beyond the Goods of nature. . . . And so with most of us: . . . a little irritable weakness will bring the worm at the core of all our usual springs of delight into full view, and turn us into melancholy metaphysicians.” William James, The Varieties of Religious Experience

“…the idea of death, the fear of it, haunts the human animal like nothing else; it is a mainspring of human activity—activity designed largely to avoid the fatality of death, to overcome it by denying in some way that it is the final destiny for man.” Ernest Becker, The Denial of Death

 “Come to terms with death. Thereafter anything is possible.” Albert Camus, Notebooks

“The only two certainties in life are death and taxes.” Wrongly attributed to Mark Twain

“A medical revolution has extended the life of our elder citizens without providing the dignity and security those later years deserve.” J.F. Kennedy, speech 1960

“Facing the development of modern medicine, a central question arises: How many floors has dying?” Jean Paul Sartre

“Die Würde des Menschen liegt in der Wahl.“ (Human dignity lies in choice) Max Frisch:

“The fear of death follows from the fear of life. A man who lives fully is prepared to die at any time”. Mark Twain.

 “I don´t want to die without any scars”. Chuck Palahniuk.

“Life is for the living.

      Death is for the dead.

      Let life be like music.

      And death a note unsaid”

       Langston Hughes.

“You only live twice:

 Once when you are born

 And once when you look death in the face”. Ian Fleming

“It is nothing to die. It is frightful not to live”.

     Victor Hugo.

“The dead can survive as part of the lives of those that still live.” Kenzaburo Oe

“Dying

 Is an art, like everything else.

 I do it exceptionally well.

 I do it so it feels like hell.

I do it so it feels real.

I guess you could say I have a call.”

       Sylvia Plath

“Mr S [in India] told us with outward calm, “I shall come again next Wednesday. I will bring a piece of rope with me. If the tablets [opiates] are still not here, I am going to hang myself from that tree”. He pointed to the window. I believed he meant what he said.” Indian physician

“I ended up in an isolation room in the antechamber of the intensive care department. You’re tired, so you’re resigned to your fate. You completely surrender to the nursing staff. You live in a routine from syringe to infusion and you hope you make it. I am usually quite proactive in the way I operate, but here I was 100% patient.  Peter Piot, dean of the London School of Hygiene and Tropical Medicine and discover of the Ebola virus https://www.sciencemag.org/news/2020/05/finally-virus-got-me-scientist-who-fought-ebola-and-hiv-reflects-facing-death-covid-19

‘Gogol died screaming and Diaghilev died laughing, but Ravel died gradually. That is the worst.’ Igor Stravinsky

“I think my sense of death– which appears exaggerated to some of my friends – is quite proportionate. For me, death is the one appalling fact which defines life; unless you are constantly aware of it, you cannot begin to understand what life is about; unless you know and feel that the days of wine and roses are limited, that the wine will madeirize and the roses turn brown in their stinking water before all are thrown out for ever – including the jug – there is no context to such pleasures and interests as come your way on the road to the grave.” Julian Barnes

“Life is a predicament before death.” Henry James

“We live but an afternoon and strike but one note.” Henry James (probably misquoted)

“The most interesting part of life is death.” Turgenev

“We may always choose knowledge over ignorance; we may wish to be conscious of our dying; we may hope for a best-case scenario in which a calm mind observes a gradual decline, perhaps with a Voltairean finger on the ebbing pulse.

We may get all this; but even so, we should consider the evidence of Arthur Koestler. In Dialogue with Death he recorded his experiences in the Francoist prisons of Malaga and Seville during the Spanish Civil War. Admittedly, there is a difference between young men facing immediate execution by political opponents, and older men and women, most of their lives behind them, contemplating quieter extinctions. But Koestler observed many of those about to die – including, as he was assured, himself – and came to the following conclusions.

First, that no one, even in the condemned cell, even hearing the sound of their friends and comrades being shot, can ever truly believe in his own death; indeed, Koestler thought this fact could be expressed quasi-mathematically – ‘One’s disbelief in death grows in proportion to its approach.’

Secondly, the mind has recourse to various tricks when it finds itself in the presence of death: it produces ‘merciful narcotics or ecstatic stimulants’ to deceive us. In particular, Koestler thought, it is capable of splitting consciousness in two, so that one half is examining coolly what the other half is experiencing. In this way, ‘the consciousness sees to it that its complete annihilation is never experienced’.

Two decades previously, in ‘Thoughts for the Times on War and Death’, Freud had written: ‘It is indeed impossible to imagine our own death; and whenever we attempt to do so, we can perceive that we are in fact still present as spectators.’” Julian Barnes

“‘Death is not an artist.’ Its virtues are at best artisanal: diligence, stubborn application and a sense of contradictoriness which at times rises to the level of irony; but it doesn’t have enough subtlety, or ambiguity, and is more repetitive than a Bruckner symphony. True, it has complete flexibility of location, and a pretty array of encircling customs and superstitions.” Julian Barnes

“God might be dead, but death is well alive.” Julian Barnes

‘Good writers, like good soldiers, know how to die, whereas politicians and doctors are afraid of death. Everyone can corroborate this remark by looking around them. Though there are, of course, exceptions.’ Alphonse Daudet on the death of Jules Renard

“Speak only of that which you truly know.” Wittgenstein. [How then can I, or indeed anybody, write of death.] Julian Barnes

“If you don’t know how to die, don’t worry; Nature will tell you what to do on the spot, fully and adequately. She will do this job perfectly for you; don’t bother your head about it.” Montaigne

“If I had my life over again I should form the habit of nightly composing myself to thoughts of death. I would practise, as it were, the remembrance of death. There is no other practice which so intensifies life. Death, when it approaches, ought not to take one by surprise. It should be part of the full experience of life. Without an ever-present sense of death life is insipid. You might as well live on the whites of eggs.” Muriel Spark, Momento Mori

Fear of death sells the pharmaceutical, political, financial, film, and food product promising to make good the wish to live forever. Lewis Lapham

I was born without knowing why. I have lived with knowing why, and I am dying without either knowing why or how. Pierre Gassendi, 1655

Death is a punishment to some, to some a gift, and to many a favour. Seneca

Perhaps even the happiest of mankind would not, if it were offered, accept the privilege of being immortal. What he would ask in lieu of it is not to die until he chose. J S Mill

Books are a real magic, or rather necromancy—a person speaking from the dead, and speaking his most earnest feelings and gravest and most recondite thoughts. J S Mill

Words, words, words, that’s the only medicine. Anatole Broyard

An even more horrible death is one that’s kept at bay by the miracles of modern medicine, a death that never ends. In the name of Hippocrates, doctors have invented the most exquisite form of torture ever known to man: survival. Luis Buñuel

To desire immortality for the individual is really the same as wanting to perpetuate an error for ever. Arthur Schopenhauer

How pathetic it was to try to relegate death to the periphery of life when death was at the centre of everything. Elif Shafak

The experiment of making mortality a medical experience is just decades old. It is young. And the evidence is it is failing. Atul Gawande

Scientific advances have turned the processes of aging and dying into medical experiences, matters to be managed by health care professionals. And we in the medical world have proved alarmingly unprepared for it. Atul Gawande

When the prevailing fantasy is that we can be ageless, the geriatrician’s uncomfortable demand is that we accept we are not. Atul Gawande

Whether we admit it or not, a lot of doctors don’t like taking care of the elderly. Atul Gawande

This is the consequence of a society that faces the final phase of the human life cycle by trying not to think about it. We end up with institutions that address any number of societal goals—from freeing up hospital beds to taking burdens off families’ hands to coping with poverty among the elderly—but never the goal that matters to people who reside in them: how to make life worth living when we’re weak and frail and can’t fend for ourselves anymore.

The battle of being mortal is the battle to maintain the integrity of one’s life—to avoid becoming so diminished or dissipated or subjugated that who you are becomes disconnected from who you were or who you want to be. Atul Gawande

If end of life discussions were an experimental drug, the FDA would approve it. Atul Gawande

Learning about the end of life: The lesson seems almost Zen: you live longer only when you stop trying to live longer. Atul Gawande

More than 40% of oncologists admit to offering treatments that they believe are unlikely to work. Atul Gawande

Arriving at an acceptance of one’s mortality and a clear understanding of the limits and the possibilities of medicine is a process, not an epiphany.

About two thirds of patients are willing to undergo therapies they don’t want if that is what their loved ones want.Atul Gawande

The only mistake that physicians seem to fear is doing too little. Atul Gawande

When doctors forget the larger aims of people’s lives the suffering they inflict can be barbaric. Atul Gawande

Over and over we in medicine inflict deep gouges at the end of people’s lives and then stand oblivious of the harm done. Atul Gawande

To me, the story of medicine is the story of how we deal with the incompleteness of our knowledge and the fallibility of our skills. Atul Gawande

A review of “Death” by Todd May and “The Book of Dead Philosophers” by Simon Critchley

Richard Smith

The fact that we die, argues the American philosopher Todd May, is the most important fact about us. Death is tragic, arbitrary, and meaningless, but at the same time opens us to a fullness of life that would not exist without it. That it can negate every other element of our lives, including love and wisdom, is what makes it the most important fact about us. So how should we live in the face of complete negation? How should we think about death? And should doctors, who are sometimes accused of being charlatan salesmen of immortality, pay more attention to the philosophy of death?

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Sallekhana: how Jains may voluntarily fast to death

Sallekhana (IAST: sallekhanā), also known as samlehna, santhara, samadhi-marana or sanyasana-marana,[1] is a supplementary vow to the ethical code of conduct of Jainism. It is the religious practice of voluntarily fasting to death by gradually reducing the intake of food and liquids. It is viewed in Jainism as the thinning of human passions and the body,[3] and another means of destroying rebirth-influencing karma by withdrawing all physical and mental activities.It is not considered as a suicide by Jain scholars because it is not an act of passion, nor does it deploy poisons or weapons. After the sallekhana vow, the ritual preparation and practice can extend into years.[1]

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The struggle to create a new craft of dying: what is medicine’s role?

Richard Smith

“Lyn Lofland’s The Craft of Dying (1978) is one of the most important books on post-WWII death and dying practices that almost no one has read,” writes John Troyer, director of the Centre for Death and Society at Bath University. He thinks that everybody interested in death and dying should read the book. I agree. Potentially that means that every human being should read the book—because who cannot be interested in death, arguably the most important thing about us. Plus The Craft of Dying is short, easily read, full of compelling stories, and constructs a clear argument.

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Quotes from The Denial of Death by Ernest Becker

Foreword

The bitter medicine he prescribes — contemplation of the horror of our inevitable death — is , paradoxically , the tincture that adds sweetness to mortality .

 “ This is the terror : to have emerged from nothing , to have a name , consciousness of self , deep inner feelings , an excruciating inner yearning for life and self – expression — and with all this yet to die . ”

We achieve ersatz immortality by sacrificing ourselves to conquer an empire , to build a temple , to write a book , to establish a family , to accumulate a fortune , to further progress and prosperity , to create an information – society and global free market .

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Death festival day three

Richard Smith

This death festival was held in London in 2012.

I’m up early and off to the death festival for the third day with a very light heart, and we are straight into practicalities.

Affordable funerals

A funeral, says Rosie Inman-Cook, director of the Natural Death Centre,  is the “ultimate stress purchase.” People are often stunned and wholly unprepared—and vulnerable to being fleeced. The cheapest British funeral is £2600, which can be unaffordable to many people—and the pressure is on to provide “nothing but the best” for the dead person. People do not bargain in these circumstances, and people may find themselves with huge bills. A grave in Lewisham, which is not famous for its tourists, can cost £18 000.

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Day two of a death festival

The three-day death festival took place on London’s Southbank in 2012.

The second day of the festival began with Jude Kelly, the artistic director of the Southbank Centre, explaining that the festival is about “reshaping our ability to look death in the eye, and to have a relaxed way of talking about death.” In a secular age, she says, we don’t have ways of congregating to talk about important things like death.

She explains as well how the idea for the festival has grown directly out of her own experience. Two couples she knows have had children who killed themselves and both couples were driven apart by the experience. Perhaps if there was more conversation about death those splits could have been avoided.

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A death festival: day one

Richard Smith

In 2012 the Southbank Centre, London’s art centre on the South Bank of the Thames, held a three-day festival on death. The aim was “to look death in the eye…to confront mortality head-on through music, theatre, literature, and debate.”

I attended every minute of every day of the festival, which was crowded and joyous, and wrote a blog about each day. This is my account of the first day.

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Holbein’s Dance of Death: the perfect Christmas present

Richard Smith

Hans Holbein produced his Dance of Death in Basle in 1526, mainly because he needed the money. Pictures of the dance of death were fashionable, featuring on the walls of cemeteries, and people wanted their own pictures. The pictures have been reproduced many times in many forms since then, and the latest version is a book by Penguin published this month. It makes a perfect Christmas present. https://www.penguin.co.uk/books/273024/the-dance-of-death/

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