"Let's Talk About Death (over Dinner)": a book review (sort of)
First, I really appreciated the book "Let's Talk About Death (over Dinner): An Invitation & Guide to Life's Most Important Conversation" by Michael Hebb, founder of DeathOverDinner.org. It gave me some clarity on how to wrangle the words for the stuff I'm doing every day this time of year, and a bit of depth to my examples that didn't need to come from my own somewhat limited experience. It had about two dozen "prompts" and some stories about conversations that came up when those prompts were used. I think the idea is that you consider three or four prompts to use in a dinner party and then just let the conversation flow. I can't imagine doing it as a themed dinner party with my peers, but I *can* imagine doing it with my parents and children and siblings. For me, it was just getting better at my job.
I recommend the book for anyone who finds themselves needing to facilitate these conversations. But even if you don't read it, I think the *idea* of doing it hits you when you read the title, and that's 80% of the point. I'm almost past remembering this because it's so far in my rearview mirror, but I seem to recall that there are people who think death isn't an appropriate topic for conversations. No, that's politics and religion. But when you're discussing death, politics rolls off your back. (You may find it mentioned in an obituary from time to time, the way people mention their favorite sports team.) Religion gets similarly non-offensive treatment: we ask people what they wish for ceremonies, disposition of their bodies, clergy needing contacting... it's all really neutral. And I find that people are (dare I say) DYING to talk about this stuff with me.
The first time I discovered this was probably the second year I was doing taxes. A woman came to me and said she had terminal cancer and she wanted to get her affairs in order. I was distraught, gob-smacked, not sure what to say, but she taught me. She said, "I'm not allowed to talk to my kids about this stuff because they don't want to hear it. But I'm hiring you to help me with this because I need it done." Okay then. Do not make the terminal person be forced to comfort you about their impending death. Got it. So I take a clinical stance on these things and try to be as factual as I can, sort of like answering a kid's questions about where do babies come from. They ask the questions that they are ready to ask, you don't have to volunteer more.
This fall I'm speaking with all my clients about "getting your affairs in order". As they come in, I dive right in. I ask a series of questions about the location of things. Where will we find their actual wet-signature will? (Not a copy, I've just discovered, we need to find the original.) Where will we find their marriage certificate? Military discharge papers? (There are a bunch more questions like this.) Then I ask about people. Who's called on the first day? This leads to disposition of the body: if you don't want a big embalmed funeral with a casket and casket liner then perhaps the first call should NOT be to the funeral home. We have a direct-to-crematory service around here, and there are also services that will transport your body for medical donation, which I think I'd like to do. If you want a green burial you'd want your loved ones to have a chance to prepare your body themselves (also what I'd like). I tell them NOT to think they have to get a body moved immediately, that staying with the body, calling people over, washing and dressing the body: these are all reasonable things a person might do INSTEAD of calling 911 to cart the body away.
We talked about end of life choices. Don't want CPR as a frail elder? Say so. Say so loudly, and do it in your doctor's office while filling in a MOLST. (I want CPR as a healthy 54 year old, but I sure as hell wouldn't want it as a frail 94 year old!) We discussed "exit ramps", places where you do NOT call 911, but rather sit with your loved one crumpled on the kitchen floor and hold her hand. It's a wonderful thing to fall into the Maw of Big Medicine when it can cure you and give you forty more years of life. When it will medicalize your life and give you 30 days of torture, maybe skip it instead? We talked about what that would look like and agreed that severe pain would merit a 911 call, but merely being down and out wouldn't. I know someone who was terribly aggrieved that a hospital let her terribly ill octogenarian father die of pneumonia, which was basically the only disease he had that could be cured. I didn't have the language then to help her understand that "pneumonia is an old man's friend", that they were taking an exit ramp when one appeared, that her father was probably perfectly happy with that choice when it was presented to him. I think people are so caught up in the pattern of trying to stay or become healthy that they forget that the focus changes someday. Every time we click our seat belt it's not because we hope not to die, it's because we hope to die at 87 on morphine with your daughter holding your hand rather than in a car crash.
I bring up "life interrupted" issues: what would you need to tell your loved ones if you were suddenly not there? Any prepaid things we need to know about? Any automatic payments coming out of your bank account? Any collections worth more than you expect them to be?
I also bring up ethical wills: what stories do you want to pass down?
My prompts are substantially different from the prompts in the Michael Hebb book, but that's okay, I'm not serving any wine, either. On the contrary, I'm frantically scribbling notes about the artist's name of the art you bought that is NOT tag-sale junk. (Glad I asked!)
I wouldn't hesitate to talk about death over dinner, but if you would, I recommend reading this book. It's super important for you to learn to get better at this, because, well, just trust me on this one.
I recommend the book for anyone who finds themselves needing to facilitate these conversations. But even if you don't read it, I think the *idea* of doing it hits you when you read the title, and that's 80% of the point. I'm almost past remembering this because it's so far in my rearview mirror, but I seem to recall that there are people who think death isn't an appropriate topic for conversations. No, that's politics and religion. But when you're discussing death, politics rolls off your back. (You may find it mentioned in an obituary from time to time, the way people mention their favorite sports team.) Religion gets similarly non-offensive treatment: we ask people what they wish for ceremonies, disposition of their bodies, clergy needing contacting... it's all really neutral. And I find that people are (dare I say) DYING to talk about this stuff with me.
The first time I discovered this was probably the second year I was doing taxes. A woman came to me and said she had terminal cancer and she wanted to get her affairs in order. I was distraught, gob-smacked, not sure what to say, but she taught me. She said, "I'm not allowed to talk to my kids about this stuff because they don't want to hear it. But I'm hiring you to help me with this because I need it done." Okay then. Do not make the terminal person be forced to comfort you about their impending death. Got it. So I take a clinical stance on these things and try to be as factual as I can, sort of like answering a kid's questions about where do babies come from. They ask the questions that they are ready to ask, you don't have to volunteer more.
This fall I'm speaking with all my clients about "getting your affairs in order". As they come in, I dive right in. I ask a series of questions about the location of things. Where will we find their actual wet-signature will? (Not a copy, I've just discovered, we need to find the original.) Where will we find their marriage certificate? Military discharge papers? (There are a bunch more questions like this.) Then I ask about people. Who's called on the first day? This leads to disposition of the body: if you don't want a big embalmed funeral with a casket and casket liner then perhaps the first call should NOT be to the funeral home. We have a direct-to-crematory service around here, and there are also services that will transport your body for medical donation, which I think I'd like to do. If you want a green burial you'd want your loved ones to have a chance to prepare your body themselves (also what I'd like). I tell them NOT to think they have to get a body moved immediately, that staying with the body, calling people over, washing and dressing the body: these are all reasonable things a person might do INSTEAD of calling 911 to cart the body away.
We talked about end of life choices. Don't want CPR as a frail elder? Say so. Say so loudly, and do it in your doctor's office while filling in a MOLST. (I want CPR as a healthy 54 year old, but I sure as hell wouldn't want it as a frail 94 year old!) We discussed "exit ramps", places where you do NOT call 911, but rather sit with your loved one crumpled on the kitchen floor and hold her hand. It's a wonderful thing to fall into the Maw of Big Medicine when it can cure you and give you forty more years of life. When it will medicalize your life and give you 30 days of torture, maybe skip it instead? We talked about what that would look like and agreed that severe pain would merit a 911 call, but merely being down and out wouldn't. I know someone who was terribly aggrieved that a hospital let her terribly ill octogenarian father die of pneumonia, which was basically the only disease he had that could be cured. I didn't have the language then to help her understand that "pneumonia is an old man's friend", that they were taking an exit ramp when one appeared, that her father was probably perfectly happy with that choice when it was presented to him. I think people are so caught up in the pattern of trying to stay or become healthy that they forget that the focus changes someday. Every time we click our seat belt it's not because we hope not to die, it's because we hope to die at 87 on morphine with your daughter holding your hand rather than in a car crash.
I bring up "life interrupted" issues: what would you need to tell your loved ones if you were suddenly not there? Any prepaid things we need to know about? Any automatic payments coming out of your bank account? Any collections worth more than you expect them to be?
I also bring up ethical wills: what stories do you want to pass down?
My prompts are substantially different from the prompts in the Michael Hebb book, but that's okay, I'm not serving any wine, either. On the contrary, I'm frantically scribbling notes about the artist's name of the art you bought that is NOT tag-sale junk. (Glad I asked!)
I wouldn't hesitate to talk about death over dinner, but if you would, I recommend reading this book. It's super important for you to learn to get better at this, because, well, just trust me on this one.