Death and last writes: Alternative ways of dealing with dying

THERE are some subjects around which it is impossible to cast a lasso of a thousand words and then draw tight into a point. One of them, it would seem, is death. Every time I think I have got a firm purchase, his scythe leaves me with strands.

The task seemed to much simpler on Tuesday, when I spotted four elements which I thought could be woven into a strong strand, but which, since then, has left me feeling confused, uneasy and nursing a sense of existential dread. Death, I suppose, will do that to you.

For Woody Allen, the thought of annihilation is so terrifying as to warrant taking a newspaper into a lift so as to better occupy his thoughts between floors. Philip Larkin, according to Martin Amis, suffered as a child from what he described as “premature death awareness” which coloured his life in shades of black and grey.

So, what has prompted so bleak a subject as we sit on the cusp of summer? Well, the first of the four frayed strands was the video released on YouTube of Philip Gould, the Labour peer and strategist who died of oesophageal cancer last November, and which is titled, like his posthumous book, When I Die. The film is eight minutes and 51 seconds long and was the last campaign of the man who helped secure three Labour governments. We, the living, are his “electorate” and his message is that while the process of dying is a journey into valleys of pain, intense fear and grave discomfort, it also leads into sunlit uplands of exquisite joy, resolution and a sublime unity with family, friends and the natural world.

As he sits on a yellow floral print armchair, wearing jeans, a blue shirt and light blue jumper, he explains to the camera: “In six weeks time, I will be dead, I will be cremated, I will face huge fear.” (I had encountered one of those moments of fear when reading his daughter’s account of his death. How he had been admitted into hospital and told he had just three days left. After sleeping, he awoke the next day and said you can do a lot in three days, only for his daughter to explain that was yesterday, today he was down to two. For some reason the fear rippled off the page and gripped my heart.)

In the film, we watch as he is photographed wearing a fetching tartan scarf on a grassy spot in Highgate Cemetery where his ashes will be interned. Like Mattie Ross in True Grit, he takes great comfort in “knowing where one will meet eternity”.

The second strand was Gould’s competition in terms of slim books on how to die, which has the title Until Further Notice, I Am Still Alive by Tom Lubbock, the chief art critic of the Independent who was diagnosed with a brain tumour in 2008. The tumour was located in the area of the brain associated with language, which slowly slipped from his grasp.

In a feat of stoic determination Lubbock, who married late and had a two-year-old son, Eugene, continued to write, discovering, mysteriously, that for a few hours after 10pm the fog cleared briefly and words were more easily reached. While admitting great sadness at his situation, he does not “rage against the dying of the light”.

At one point, he writes: “I know all the happiness and love I’ve felt I could know. My mind’s work has basically done what it can do. Love and work can of course be extended indefinitely, but, give or take, I don’t feel uncompleted, having missed out.”

Both books touch on the terrible fear of knowing that one is going to die, which leads me to the third strand. Lubbock writes: “In the past, when stoned, I’ve wondered what it would be like to be stoned and also in a knowingly fatal state. I imagined it would be monstrous, to be off my head like that, not to be in my perfect senses. Partly it seemed like an irresponsible dulling of myself. Partly I was terrified at the thought of where my mind might run, into free fall. I don’t get stoned now. I only get a little drunk. But I don’t feel such apprehension. Perhaps if I got drunker, stoned, and perhaps if I felt nearer death, I’d feel differently.”

As it happened, I had noticed an article in the New York Times magazine about a recent study by Charles Grob, a psychiatrist and researcher at Harbor UCLA Medical Centre who had administered psychedelic drugs to the terminally ill to see if it would reduce their fear of death.

Psilocybin, which is the active component in magic mushrooms and beloved by Timothy Leary, was given to patients in a room swathed with coloured fabrics and fresh flowers. Each patient wore eyeshades and listened to mystical music during a “trip” that lasted eight hours.

Pam Sakuda, who had terminal cancer, and having passed the estimated date of her demise was living in state of paralysed terror, said of the experience: “I left this lump of emotions welling up … Almost like an entity. I started to cry. Everything was concentrated and came welling up and then … it started to dissipate, and I started to look at it differently. I began to realise that all of this negative fear and guilt was such a hindrance to making the most of enjoying the healthy time that I’m having.”

Prior to taking the drugs each patient had undergone an assessment for depression and anxiety and afterwards, at intervals of one and three months, each of the 12 subjects was found to “demonstrate a sustained reduction in anxiety.”

The study, which was published last year in the Journal of Psychopharmacology, found that 94 per cent of the subjects said it was one of the top five meaningful experiences of their life, with 39 per cent saying it was the most meaningful experience.

If any of these three strands add up to single point it is that Bertolt Brecht was correct in saying: “Although the purely biological death of an individual is of no interest to society, dying ought nevertheless to be taught.”

The next question is: how? Well, for a start, those brave enough to wish to see how each of our own private movies will end could pick up a copy of Sherwin B Nuland’s book, How We Die, an unflinching and unsentimental account of the processes our bodies will undergo by a surgeon who has seen it all and wishes to be a sensitive guide.

So what about our minds? Both Gould and Lubbock, either wittingly or not, have reached back into the past and revived the ars moriendi: the art of dying, by attempting to find meaning and solace in their conditions, but there is no guarantee you or I will be so brave. One of the questions that has haunted me this week is whether it is better to experience a sudden death, or a brief , anguish-free illness in which we can be surrounded by our loved ones? Research has shown the majority of people prefer the latter, but I finally came to the conclusion that just as life rarely goes to plan, so, inevitably does death.

Which brings me, finally, to the fourth strand. When Claire Squires set out to run the London marathon her goal was to raise as much money as possible for charity and to cross the finishing line. She accomplished the former if not the latter, having collapsed and died toward the end of the 26-mile course.

The £500 in sponsorship she had secured prior to setting off has now soared to more than £650,000 as the public, in an astonishing display of generosity, has pledged funds for the Samaritans, her choice of charity. Why? Was it because she was young and beautiful which served only to remind us of the ancient ugliness of death, or, was it that for each pound people donated her final act, to raise funds, remained in motion?

As I said, I can’t write a ribbon of words round death’s cowl and tie it in a bow. After reading the books, watching the video and staring at the ceiling all I can conclude is that death is a grim, rapacious creditor who will, eventually, take all we have and, as Woody Allen said: “I don’t mind dying, I just don’t want to be there when it happens”.

So it seems only right that the last words on this subject are not mine but the last words of Lubbock, dictated with great difficulty just before his death:

“The final thing. The illiterate. The dumb.

Speech?

Quiet but still something?

Noises?

Nothing?

My body. My tree.

After that it becomes simply the world.”