A few generations ago, most people in North America either lived on a farm or they knew someone who did. The farm animals were born, got sick or injured, and died with short life cycles that were easy for all to see. People generally lived a short life then, too, and people were generally sick or disabled only a short time before they either recovered or died at home. People usually didn’t go to hospitals. Doctors, midwives, and neighbors came to the house and helped the family care for them.
So it's likely that your grandparents and your ancestors before them grew up seeing the natural cycle of birth, infirmity, and death as part of daily life. They often saw death happen to people they knew well, touching their dead bodies and taking part in community grieving.
Since then, because four trends have changed everything, we've forgotten that illness and death are as normal as conception and birth. If you look at the table below, you will see some illustrations of this.
The Way We Deal with Illness and Death in North America Has Changed
Medicare began in 1965 and was with the purpose of providing healthcare to people age 65 and older. Since then, increasingly powerful medical, surgical, and radiological treatment research have been funded by government and private foundations to the tune of billions of dollars over the past 45 years. People have been able to afford the treatments from expensive technologies largely because of an increase in the health insurance industry, including Medicare for people 65 years and older in the United States. In most cases, in order to get these treatments, people have had to be in the hospitals.
Another important trend is the enormous increase in leisure time and money to spend on entertainment that has created powerful entertainment and communications media that sensationalize some types of death and ignore others. These factors influence us to expect to live into our 80s and beyond, and be angry when we do not.
Newspapers, TV, and movies often portray death without showing us anything realistic about how it was meaningful to the dying person, their family, or their community. This leaves us feeling empty and denies us an opportunity to experience the profound grief, gratitude, healing, and soul growth that birth, illness, and death can provide.
A third trend is that most adults in North America have scheduled our lives in ways that give us very little flexibility to care for our sick and dying loved ones, so it fits our busy lives much more conveniently when the people we love die in hospitals or nursing homes. And it's more than inconvenience. It's also that we don't know how to support a person through their illness and death.
When faced with illness or death, most of us are frightened because our awareness of our own mortality is stirred, and we do not see the gift in that. We're also frightened because of the images we've taken in from the media. And we're frightened because the dying process seems to be painful, messy, and unpredictable, and we do not have mentors to show us how it can be navigated.
The fourth trend is that a funeral industry has legalized and commercialized unnatural ways of treating dead bodies. Embalming was originally created by cultures that believed the spirit would need the physical body in its next life. It was introduced in the United States during the civil war, when men were dying far from home and it was impossible to get their bodies home before they were rotten.
With the commercialization of embalming dead bodies soon came additional products like metal caskets, vaults, and cremation. All of these prevent the body from returning to the earth to feed and fertilize life. And all of them require polluting chemicals, nonbiodegradable materials, or fossil fuel depletion and air pollution. Fortunately there is a Green Burial movement that brings awareness to this growing misuse of resources and offers cleaner alternatives.
The funeral industry has boomed along with the hospitals and nursing homes for the same reasons. People have found it easier to leave their family's deaths in the hands of “professionals” instead of learning ceremonial and burial skills and passing them on to the next generation.
Together, these four trends have had enormous impact on the way we perceive death now. The result is that, as a people, we've forgotten the lessons, gifts, and wisdom that come only from a lifetime of seeing, smelling, touching, celebrating, supporting, and grieving the people we love and receiving these gifts when it's our turn.
To paraphrase Stephen Jenkinson, we have massive technological sophistication for managing illness and death and a serious poverty for knowing dying, so that at the end of our lives we often find a hole where our skills should have grown.