My Kenyan friend thinks that Americans are mad. He worked for a while in an American hospital, and one day a colleague disappeared for a few hours. When he came back in the afternoon he said that he’d been to his father’s funeral. “He didn’t even seem sad,” said my friend. “In Kenya when a father dies there is a big funeral lasting days. Everybody comes.”

Two weeks later my Kenyan friend saw his colleague weeping. When he asked why, his colleague told him that his dog had died. “Fancy crying over a dog,” said my friend. “In Kenya dogs are never allowed into the house. They live with the other dogs. They are dogs. They work. How can you cry over a dog and not over your father? These Americans are crazy. They have everything upside down.”

I was remembering this as I was walking my dog—Henry the miniature schnauzer—on Clapham Common. Henry will be 11 this year, and I was wondering how long he would last. Death, as you might know, is my thing. I can’t help but think that I’ll be very sad when Henry dies. I cried when our rabbit was killed by a fox, and I didn’t have much of a relationship with the rabbit.

Henry, in contrast, is central to my life. Sitting beside me when I read and between me and my wife when we are watching the television. When I come back from a trip Henry is hugely pleased to see me, whereas my human family are so used to me coming and going that both are non-events. I’m going to miss him a lot when he dies.

But I didn’t cry when my father died. I loved him very much, have a picture of him above my desk, and his memoirs on my hard drive, and think of him almost every day seven years after he died. “His death,” said a good friend who is scared of death and dying, “showed how death is normal.” Syd, my father, was 81. He fought at the El Alamein, spent three years in prisoner of war camps, weighed just 7 stone on his 21st birthday, and smoked all his life. He never thought he’d get to 81, and he died magnificently—at home, without any pain killers, still in his right mind, and five weeks after he first began to cough up blood. He didn’t even seem old. What was there to be sad about? It would have been much sadder to see him become demented and disabled.

So why did I cry when my rabbit died and why do I think that I’ll cry when Henry dies? It’s something to do, I suspect, with consciousness, rationality, and consent. The rabbit didn’t have any of that triad and died suddenly and brutally with his neck broken by a fox in a pointless piece of vandalism. Henry doesn’t have any of the triad either, although he looks at me as if he understands more about me than I do about myself. (We think that he was a dermatologist in a former life.) And perhaps if he grows old, slow, arthritic, and blind I’ll see that death is the best option for him—as it is for all of us if we live long enough—and I’ll not be sad.

But I already qualify as crazy by the standards of my Kenyan friend—perhaps even crazier than the American, crying over a rabbit and not my father. How did we get to this point in Western culture? And does it matter? I’m not confident of the answer to either question. Can you help?

RS was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.