Richard Smith: A jolly afternoon with Dying Matters

Richard SmithDying Matters is an organisation that aims to raise awareness of dying, death, and bereavement, and this is Dying Awareness Week.  The organisation exists because of the mass denial of death in our society that leaves people ill prepared for dying and death and contributes to so many people dying badly.

I’ve joined Dying Matters (anybody can, it’s free, and there are now 30 000 members), and I went to the launch of Dying Awareness Week. I arrived late, and the first thing that hit me was that the room was packed with perhaps 300 people. The event was sold out. As I expected the mood was jolly: I expected that because living well and dying well go together.

This year Dying Matters has five aims—get everybody to make a will, plan their funeral, make an advanced directive, register as an organ donor, and share their plans with your loved ones. (I can’t take the phrase “loved one” seriously since rereading Evelyn Waugh’s book with that title, but it’s hard to come up with an alternative: “partner,” “family,” or “family and friends,” don’t work as not everybody has a partner or family, “friends” on its own is insufficient, and “important others” is horrible.)

Only a third of Londoners have told their loved ones whether they want to be buried or cremated, which can leave the bereaved in something of a quandary. Suzanne Rich from Lewisham told us about Ronnie’s funeral. He and Lilian had been married for 60 years. He died suddenly, but he’d said what he wanted. There were big cars, the right music, a well informed, witty speech by the vicar, the right kind of clothes, and a great event afterwards in one of his favourite places. Everybody agreed the funeral was “so Ronnie.”

Six years later Lilian died, and the funeral was not so good. She was in a pink shroud she would have hated. Her name was spelt wrongly on the coffin. The vicar got several things wrong in his speech, and the wake was in a room in a pub, which she would not have wanted. Everybody agreed that the funeral was “so not Lilian.”

Rich then told us that Ronnie and Lilian were her parents. She’d become distant from her mother before her death.

To avoid a funeral that is “so not you” complete the form on your funeral wishes, post it to the National Association of Funeral Directors, and share it with your loved ones. I think of it as my chance to be on Desert Island Discs, although my brother tells me he’s not keen on three hours of experimental jazz and may have to make some adjustments.

Roger Kirkpatrick stunned the audience by telling us that he’d experienced dying without any pain. But first, pursuing his theme of life’s shocking unpredictability, he quoted from Graham Greene’s short story “A shocking accident.” A schoolboy, Jerome, is called to the headmaster’s study to hear some bad news. Jerome is an imaginative boy and has “recreated” his father from a “restless widowed author into a mysterious adventurer” who perhaps was a gunrunner or in the British Secret Service. Kirkpatrick read from the story:

“I’m afraid your father was very seriously hurt indeed.”

“Oh.”

“In fact, Jerome, he died yesterday. Quite without pain.”

“Did they shoot him through the heart?”

“I beg your pardon. What did you say, Jerome?”

“Did they shoot him through the heart?”

“Nobody shot him, Jerome. A pig fell on him.”

You can read the full story here.

Kirkpatrick experienced dying when he was 19, some 40 years ago. He was in a Lockheed plane flying south from the Canadian Arctic. The pilot explained that the wheels of the plane had become stuck, so they would have to crash land. Worse the fuel tanks were on the underside of the plane so that when the plane crash landed they would light and burn the passengers to death. To try and improve the chances the pilot flew around for five hours to burn off the petrol, but he said that it wouldn’t make much difference as the plane would simply explode.

“We were all convinced that we were going to die,” said Kirkpatrick, but oddly there was no fear. Time melted away, and he experienced “irritated regrets.” The fact that he wouldn’t be able to say goodbye to his family really upset him. He wanted to tell them that he loved them, was grateful for their care, and was sad that he wouldn’t see them again. The other thing that bothered him was that he was “going to die a virgin.” Anybody who has been a 19 year old, male virgin will understand this.

The plane did crash land but did not explode. Kirkpatrick and his colleagues ran from the plane. In the morning, concluded Kirkpatrick, I was alive and fine, most of the day I was dying, and in the evening I was alive and well again. Life is shockingly unpredictable.

During the interval a woman from Liverpool at my table told us how she wanted the full works at her funeral, black horses with feathered plumes, a glass coffin, and everybody in black. “Nobody will be admitted unless they’re in black, and I want everybody miserable and sad.” She’d seen a television programme about sky burials and been tempted, but she thought that Liverpool Council wouldn’t allow one; and, she bemoaned, “I’d probably have to bring my own vultures.”

This was an afternoon of well told stories about death, dying, and bereavement. And very effective it was. Why not join Dying Matters or enter the competition to come up with a final Tweet?

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