×

How Do We Want to Die?



Monday, December 28, 2015
There’s an old Woody Allen quip that neatly sums up our ambivalence toward our own mortality: “I’m not afraid of death; I just don’t want to be there when it happens.”

That may be a common viewpoint, but a recently released book, Let’s Talk About Death by Steve Gordon and Irene Kacandes (Prometheus Books), takes a radically different tack toward a subject about which youth-obsessed American culture is notably squeamish.

Over the course of a year, the authors probed the big existential questions about life and death through an exchange of emails now collected in book form. How do you want to die? What happens to you afterward? How can you continue to live well even when you know you are in the process of dying?

When people are asked how they’d like to die, the response is often at home, in bed, asleep and painlessly. But the odds of that happening have diminished as more Americans now die in hospitals or nursing homes. And while medical advances have extended people’s lives, they have also complicated dying, and how people think about it.

One of the premises of Let’s Talk About Death is that by talking more openly, and in a spirit of inquiry, about death in general, and our own death in particular, we can potentially lessen the fear and ignorance about what happens when we start to die, and acknowledge its inevitability with a measure of grace — or at least acceptance.

“Examining your feelings about how you want to die can really change how you want to live,” said Gordon, a massage therapist who founded The Hand to Heart Project in 2007 to offer massages at no charge to people in the Upper Valley who are living with, or dying from cancer. Gordon, who lives in Cornish, was also a reporter and editor for 25 years at this newspaper. He was interviewed at his practice at the Center for Integrative Health in Hanover.

In the past 15 years, Kacandes, a professor of comparative literature and German studies at Dartmouth College, has had to grapple with the fact that three family members were in the throes of terminal illnesses. “It’s very hard to talk about this stuff. If we don’t do it, though, it just is harder,” she said in an interview at her home in Lebanon.

This doesn’t mean only drawing up a living will and advance directives, which address how we would like medical treatment to proceed, or not, in the event of a life-threatening or terminal illness, but also engaging more honestly with the subject of death, rather than banishing it to the margins.

Let’s Talk About Death “highlights the need to be able to speak about these things,” said Dr. Kathryn Kirkland, a p alliative care specialist at Dartmouth-Hitchcock Medical Center who works with patients and their families on end-of-life care. Kirkland spends a lot of time talking both to patients who may have just months or weeks to live, and patients who are chronically or seriously ill but aren’t yet dying.

“As we get to know people, we help them think about decision-making and planning and creating the best possible life out of the options that are there,” Kirkland said.

“There are certain mysteries in life that happen, and happen in their own way at their own pace. Either you embrace those mysteries or you find them bothersome. It’s a little like birth: We don’t really know what’s before birth; we spend a huge amount of time preparing for a birth,” Kirkland added. “And maybe we should spending a little more time preparing for a death.”

For Kacandes, who divides her time between Germany, Switzerland (her husband is Swiss) and the U.S., there is a striking divide between the American way of death, and the German and Swiss way. On one hand, American society is reluctant to engage in substantive discussion about death; on the other, American pop culture makes huge sums of money peddling violent death in some of its films, television and music.

“We consume images of death all the time in TV and film,” Kacandes said, and yet it is in Germany, she said, that people are more willing to address what can be an uncomfortable topic. “In Germany those conversations happen much more frequently,” she added. In Switzerland, people meet informally at cafés mortels (death cafés) to talk about how death is affecting their families or how they would like to deal with the end of their own lives.

Let’s Talk About Death is an unusual project in a number of ways. It had its origin, in a sense, in violent death.

Kacandes was close friends with Susanne and Half Zantop, both professors at Dartmouth who were murdered at their home in Etna in January 2001 by two Vermont teenagers who didn’t know the couple. The shock and grief felt by the Zantops’ family, friends and colleagues was enormous, and was compounded not only by the manner of their death, but also by the relentless churn of the national media coverage.

To mark the year anniversary of the Zantops’ death, but most importantly, to remember the way they had lived, Kacandes approached Gordon, who was then the editor of the Sunday Valley News, with the idea of publishing more personal recollections of the couple by their friends and colleagues. Gordon agreed.

In the years afterward — Gordon left the paper in 2007 to concentrate on both his massage practice and The Hand to Heart Project — he and Kacandes had the occasional email exchange and realized they had points of connection beyond the reason for their original contact.

At the 10-year anniversary of the Zantops’ death, Gordon and Kacandes began to speak more often about death, and in the spring of 2011 they went for a long walk during which they exchanged their ideas about life and death. They then decided to collaborate and chose to continue corresponding via email while Kacandes spent a year in Switzerland and in Germany, where she ran an academic program for Dartmouth.

“It really became a flow of explore and respond. We did it frequently for a year, and at the end of the year we decided to evaluate,” Gordon said. “The fact that it happened when it did was something we were open to, or hungry for.”

It became clear eventually that their emails were not the jumping-off point for a book, but the book itself, Gordon said.

One of the strengths of their collaboration was that, although they were united by a mutual interest, they came, Gordon said, from very different family backgrounds. Kacandes, a Greek-American, was raised in the Eastern Orthodox Christian church, and Gordon in the Catholic church, although he no longer practices Catholicism; Kacandes works in the academic sphere and Gordon has worked as a journalist and now as a massage therapist who alleviates the pain and discomfort of chronically ill or dying patients through touch.

The fact they were not related and not intimate in the way of close friends was also an advantage, because they didn’t have a lot at stake personally, Kacandes said. The process of corresponding as a way of hashing out and articulating big questions elicited the kind of considered, thoughtful commentary that might not have happened over the phone, or even in person.

“It’s a valuable experience to write down what you think, and then the other person writes down what he thinks,” Gordon said.”If we’re not coming from the same place, we’re all headed to the same place.”

Kacandes was with her father when he died in 2014 after a long illness. “I was there sending love to my dad, stroking his hair and telling him I loved him,” she said. It’s very hard to really love someone, and it is hard to see that person die and to let him go, Kacandes added. “But it’s a heck of a lot easier when you get to say goodbye.”

After her father’s death and burial in a cemetery in White Plains, N.Y., the same cemetery where she used to play as a kid, Kacandes and her mother bought a plot together in the same cemetery. Her mother will, one day, be buried next to her father, while Kacandes envisions a small foot stone next to them.

“The day I bought a burial plot was one of the happiest days of my life,” Kacandes said.

People laugh when she makes that assertion, Kacandes said, but planning how you want medical treatments to proceed, and how you would like your remains disposed is not only pragmatic, but also a gift to those closest to you, she said.

“The point is not that your death is going to go that way but that certain steps are in place,” she said.

“People have the superficial idea that talking about (death) is depressing or macabre,” Gordon said. “But it’s the opposite of depressing: it’s liberating. It allows you to understand the incredible value of the life you’re living.”



Irene Kacandes and Steve Gordon will sign books, and give presentations and readings from Let’s Talk About Death at the following local venues.

Books A Million, West Lebanon. Sunday, Jan. 17. 1 p.m. Signing.

Norwich Bookstore. Wednesday, Jan. 27. 7 p.m. Reading and presentation. Reservations strongly recommended. Call 802-649-1114.

Howe Library, Hanover. Thursday, Feb. 25, 7 p.m. Reading and presentation.



Nicola Smith can be reached at nsmith@vnews.com.