June 25th, 2019

Recently, I’ve been thinking quite a bit about death and dying. I am guessing that I have just lost a great deal of my readership right then and there; but for those who persist, I urge you to hang on. Too often we postpone these conversations until they are absolutely necessary: when we are faced with our own imminent death or the death of a loved one. But I suspect that opening the dialogue before we are enveloped by impending grief may make decisions and conversations less intimidating when the time does come. And come it will.

Death is both essentially philosophical and deeply personal. As such, there are a seemingly endless number of questions that swirl within its domain: Why does death feel fundamentally negative to us? Is death something to be feared? Is it possible to have a “good” death? What does it look like for me? And what about the afterlife? As I gear up to enter the health profession, I’ve been thinking about how our healthcare system grapples with death.

For the sake of full disclosure, I can’t say that I arrived at this topic by a chance pondering on a sunny day. I just returned from a trip in which I helped moved my grandmother, who has been ailing with cancer for the last several years, into hospice care. It was a dizzying week – we were swept up into a typhoon of paperwork and thrust into the middle of an unsettling standoff between her oncology team, hospital physicians, and the hospice care workers. All the while, my grandmother, suspended between the false hope given by her oncologists and utter exhaustion from the treatment that has ravished her body, suffered from debilitating pain.

Sociologists use the term “medicalization” to describe the creeping influence of the profession of medicine on all areas of human life and society – generally to negative effect. If we reflect on the way our society grapples with death in the modern age, it is difficult to deflect these charges of medicalization. Death has lost its status as an essential and meaningful aspect of life. Instead, the language that we use suggests that we are “at war” with death – cancer must be “conquered,” a physician’s foretelling of how much time a terminal patient has left is something to be “proven wrong.” We have eschewed rituals around caring for those near the end – there is no mainstream equivalent for maternity leave when caring for a dying relative. Instead, we place our loved ones in the hands of medical institutions: hospitals, nursing homes, and hospice care centers.

In my musings I don’t intend to place blame on any patients, their family members, or even their physicians. Rather, I get the sense that well-intentioned individuals have been swept up in a health system that has lost self-awareness of its own boundaries. Medicine does not hold the sum total of the human experience within its domain, and is too often motivated by metrics more easily quantifiable than quality of life.

Healthcare must instead distinguish between the process of illness and the process of dying. This is no easy task, as death essentially involves the breakdown of the physical body. But perhaps all cannot simply be reduced to our physical form. Medicine can combat illness by providing curative or comforting treatment that increases one’s quality of life. But when a patient embarks on the process of dying, Medicine must humbly retract its slick, synthetic tubing, its needled fingers, its cytotoxic chemicals, to allow space for the non-physical – for meaning.
It’s been a couple years at this point, but Japanese Breakfast’s breakout album Soft Sounds from Another Planet (2017) (SpotifyYouTubeBandcamp) still pops up in my regular listening rotation. The sound of Soft Sounds is cosmic and abstract, even distant; nevertheless, it reads as intensely raw and intimate. Luckily, Japanese Breakfast has satiated my appetite for the time being with a couple singles recorded at the W Hotels Sound Suite in Bali: “Essentially” (SpotifyYouTube), along with a stirring cover of the Tears for Fears hit, “Head Over Heels” (SpotifyYouTube), which tickles my soft spot for New Wave.
Enjoy these images from Corso Zundert, a parade of giant, colorful floats carpeted in dahlia flowers (!). Every year since 1936 the floats (constructed entirely by volunteers) have traversed the streets of the tiny town of Zundert, Netherlands.
For those who already nurse a bit of aerophobia (fear of flying), this may not be the best recommendation for you. For the rest of us, I found this investigative piece from the Atlantic on the missing Malaysian Airlines flight to be a study in longform journalism. Part mystery, part psychological thriller, part political drama, with some technical stuff thrown in the for the nerds out there, it is well worth your time.
Ukiyo-e is a genre of Japanese art popular during the Edo period depicting scenes of ukiyo, a term literally meaning “floating world” which refers to the hedonistic lifestyle characteristic of the time (think sumo wrestling, kabuki, and courtesans). Ukiyoemon Mitomoya has adapted the ukiyo-e style to the modern day, satirizing everything from the banality of white-collar life in Japan to Western politics.
That’s all for this week folks! Please send in original work, cultural recommendations, responses to the stuff here, or stray thoughts to butterforthebrain@gmail.com. Older newsletters are archived at butterforthebrain.blog. Share with your pals. Feedback in all forms is always appreciated. If you or your friends aren’t on the listserv already, please use this form to sign up!

Much love,

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