Dead bodies do not seem to have a place in the modern world. Death, dying, the dead—if they can be so unceremoniously bundled together—lie in our culture somewhere between the unmentionable, the ineffable, and the simply ill-mannered. (Shades here of La Rochefoucauld: neither death nor the sun can be looked at directly, both presumably having a tendency to harm, or at least disturb, the one who looks.)

There has been much discussion in the BMJ over the years about the need for a “good death” and the linked need for death and an awareness of death to take its rightful place in our understanding of the narrative arc of human life. Although medicine has much more to do with dying than with death, with the process rather than the terminus, the difficulty of looking at death directly has played its part in our collective denial.

What cannot be looked at directly can sometimes be approached indirectly, by way of ritual—which calls to mind Nietzsche’s dictum that some truths are better approached obliquely, out of the corner of the eye. And talking of ritual I recently watched Yôjirô Takita’s Departures. Having spent 18 million yen on a cello, Daigo Kobayahsi loses his job in a Tokyo orchestra. Full of self doubt he returns to his home town with his wife, moving back to the old coffee shop he has inherited from his mother where they live among the remains of his childhood. He answers a newspaper ad for what he thinks is a job with a travel business, but it turns out to be preparing the bodies of the dead for their funerals—hence Departures. Initially less than delighted by the idea, watching his boss gracefully, tenderly preparing a body (his boss, Mr Sasaki, played by the wonderful Tsutomu Yamazaki may not be the film’s hero, but he is certainly its centre of gravity.) he begins to change his mind, taken by the solace that it brings to the grieving.

What Daigo and Mr Sasaki do is ritually prepare the body for the coffin: they are, in the terms of the trade “encoffineers.” Before the gathered, kneeling family they slowly wash the draped body, dress it, bring its hands together, and with makeup remove the traces of death from its face. As they go from house to house, performing their quiet ritual, we see families respond differently to the different deaths: with grief of course but also with rage, even with humour. Although the film is strung on its own loose thread—Daigo’s lost father—the ritual of preparation is at the heart of it.

Departures is not a perfect film. It is menaced at times by coyness and sentimentality. Death is sanitised as much as ritualised: the one grim death—an elderly woman who has lain undiscovered for two weeks—remains firmly off-camera, with only the flies, the rotting food, and Daigo’s overplayed reactions to insinuate the horror. Too many of the dead are beautiful. But where it does work is in its gentle reminder that the trouble we have in living with death might be linked to the decay of ritual. Ritual, it hints, is not so much a way of looking at death as a way of understanding how to co-exist with it; not knowledge, but response to knowledge.

Death may no longer be a biological mystery, but it remains a human one. Medicine can help understand the process of dying, it can sometimes help defer it; fortunately for all of us it can ameliorate the physical pain of it. But I am not sure it can help us live better in the knowledge of it. For that we need thought, we need courage (as Nietzsche said, if you look into the void, the void has a habit of looking back into you) we need ritual and, some of us at least, need art. And Departures is a small but lovely contribution.

Julian Sheather is ethics manager, BMA. The views he expresses in his blog posts are entirely his own.