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A View of Death

By Dr. Dick Wieder

     During my mid to late teens I became agnostic concerning the existence of any god. In all honesty it began with an interest in the evolution of man. For when I thought about it, it only seemed logical that if man evolved from lower forms then Genesis was wrong. Ergo, it is a myth and God does not exist.

     Atheism was merely a cop-out in my view. Because at that time I believed that whether God existed or not could not be known with the same certainty that the sun would rise tomorrow. No one could possibly know whether God existed; therefore, the honest approach was to think as an agnostic.

     However, there was a very major concern at that time. That being my concern with death. During those years of "not knowing" I had a morbid fascination with death. It seemed so wrong. It was ugly. It was an eternity of loneliness without any conscious knowledge. Though I would not admit it openly, my morbid obsession was merely a mask to cover the fear of my own death. A fear of one's death is in reality...Pride! It springs from a belief that the world cannot get along without you.

     I have seen death at close range. In fact the first major hurdle in the training of physicians is gross anatomy. For those who have never seen the anatomy room of a medical college, let me describe the one I knew. It was a large windowless room. Several stainless steel tables were arranged in an orderly fashion. Upon each table, wrapped in transparent plastic sheets, one can make out the gnarled remains of what once were human beings. Alive. Loving. Partakers of life now reduced to the ultimate visual aid.

       During class hours four to five medical students surround each cadaver. Carefully and with great attempts at precision, the cadavers are systematically dissected. Organs are identified. Nerve pathways are followed. Anatomical landmarks are noted. And when interesting pathology is found, all come to view. But the most remarkable aspect of the dissection room and the one memory that every physician will vividly carry with him to his own demise is the odor. Formalin is used to preserve these human remains. And its odor is simply overpowering. It is noxious and after long hours of close work, it is choking. It permeates everything. Not even after-class showers could erase the odor. Because of this, one keeps a set of clothes at the anatomy lockeroom. And the same clothes are worn every class, all semester long. At the end of the term, one must burn these clothes.

     And as has every physician, I have stood by the bedside and watched as a patient breathes for the last time. One in particular comes to mind. Near Enoree, S. C. on a neat, small farm lived a patient of mine. He was bedridden. Confused at times. And he was lovingly cared for by his wife and a Public Health Nurse who visited him once or twice a week. I inherited him as a patient from a doctor over in Union, S, C, who no longer could make house calls.

     As in many of the homes in this area and common to this socio-economic group, the room in which he rested was adorned with scores of photographs. Most of them old with the newest ones probably taken in the late 1950's. One picture caught my eye immediately. It was of a young soldier of World War I posing very stiffly in his uniform. It was my patient. Before he was shipped out to France in 1917.

     I was escorted to the biggest, most expensive looking chair in their home. His wife offered me coffee while she very precisely and expertly recounted her husband's previous medical history and his present condition. She had set out his medications for my review. As if the fates had smiled on him, he was having a good day and was not confused on that my first visit with him. He asked me various pointed questions regarding his condition. Even though be was thin, frail, and beset with disease, I knew be wanted no punches pulled. I very carefully related what I found in my examination. He accepted it quietly and with several nods of agreement. He had very advanced cardiopulmonary disease.

      After several minutes of discussion regarding his condition, and in an attempt to begin to marshall my exit, I inquired about the photograph of the soldier. He immediately made a mockery of everything I had said about his heart! He rolled back the covers of his hospital bed, swung his feet over the side of the bed--deftly moving his catheter out of the way. Smiling and in excited tones he started to tell me his "war stories." He had fought in the trenches in France. In great detail he described what it was like. The mud. The smells. The sounds. The death. The friends. Then he fell silent. Just staring at his feet with his hands resting on the edge of his bed. I made numerous trips to his home in caring for this patient. Since I, tool have an avid interest in American military history, I looked for ward to each visit with him. It was great. I grew to love this old guy a great deal.

     When the end came, it came quietly. At B. J. Workman Hospital in Woodruff, S, C. I admitted him there when he went into a mild congestive heart failure. But his renal system was failing him, I knew it would not be long. As it usually does, death came in the early hours before dawn. I was roused from sleep by the clanging of a phone. It was the nurse urging me to come quickly. I lived only fifteen minutes from the hospital . Yet, I knew it would be too late. No resuscitation was planned due to the severity of' his condition, but I did so want to see him one more time before he left.

     When I entered his room, it was lit only by a small soft light at the bedside. The only sounds were the furnace vent, and the quiet crying of his wife seated in the corner of the room. I looked down on his face. Lids closed. His cheeks sunken. Lips slightly parted. His chest was not moving. I felt for a carotid pulse. None. Placing the stethoscope in my ears, I searched his chest for heart sounds. There were none. Gently, I raised his upper eyelid. Staring blankly was the unresponsive pupil. Then, as now, I was struck by the appearence of the eye after death. Cloudy. Dry. Unmoving. Strange how so quickly the sparkle of life disappears from one's eyes after death. I closed his eye and whispered my good-by.

     For a long time I sat in the doctor's lounge. Drinking coffee. Smoking a cigarette. And wondering...Where do all the memories go. What happens to all the knowledge that one gains? All the laughter? Do they rot away with the neurons? For years there is a life. A thinking purposeful being with a brain that spends a 1ifetime gathering facts, memories, sharing, arguing, loving, and planning. Then in a matter of minutes--gone. No, death is not logical. It is a mockery of life. What is the sense in anything if death is the end! For the agnostic who searches for an answer, death is the most difficult event with which he must come to terms. For it is final. And cold. And inevitable.

     It has been said by Sigmund Freud that the rose is precious because in a few short days its petals wither and die. The blossom performs its function in the reproductive cycle and then gives up its life and beauty to death. A colleague had remarked to Dr. Freud how sad it was that such a beautiful form of life was lost so quickly. Freud answered him with the statement that the rose is precious and it beauty is so majestic only because it does die. If a blossom lived forever, man would not appreciate its beauty for it would be common place. I have often thought how different human life might be if man could view his fellows in the same vein as Dr. Freud viewed the rose. For death does make life precious. And so too it is with the universe. For it, too, is dying.

     Because this universe seems so huge, unchanging, eternal, its death is literally incomprehensible to man. And because of this, most humans do not give much thought to just what this grand explosion truly is. For in reality the universe is a grand cauldren for life. A latticework of atoms whose constituent parts are but pieces of energy and mass that arose out of a perfect order that was, and perhaps still is. And over the eons and in many corners of the universe, those chemicals came together (born in the hearts of stars that died billion of years ago to form life). Life now has an awareness of itself and its end. Man is the only known form of that system. As individuals and as a species, he must come to terms with his own demise as a step in the over all unfolding of cosmic evolution.

     And in that process of evolution, the individual becomes extremely precious indeed. I do not know why evolution allowed or placed into these chemicals the knowledge of death. For man knows he will die. It is not known and largely not believed that other life forms have the knowledge of death that mankind does. But because he dies, the moments of life take on new value, new meaning. Birth insures life. Death gives it meaning.

     And that patient of mine becomes more precious still. For in that brief span of friendship, his memories became my memories. His knowledge became my knowledge. He shared his laughter with me. And his pain. That inner quantum spark that was my patient has been passed to his friends, his loved ones, and to me. And he lives as long as my memory lives, and the memories of those to whom I pass the spark. For death is not cold..Nor ugly. Nor a defeat. It only appears so because man has a built-in fear--built in over the eons--of the unknown.

     And the words of Monica Furlong come to mind: "The terror of non-being is so fundamental to a human being that it takes exceptional courage and determination to undergo the contemplative experience, and it is one that is only possible in maturity. The cure for the panic is not to struggle and to clutch but to let go, actually to speed the descent into nothingness. The contemplative must let go not only of his fear and his corresponding attempt to control and manipulate his disturbing experience, but also of his own sick and regressed side. He must let go. He longs to let go. He is terrified of letting go. He dare not let go. He cannot escape unless he does let go."

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