author Diane SolomonI’ve been fascinated by death as long as I remember.

Just before I turned eight, my Grampa Lewis died. The event left a lasting impression on me. He had gone to the hospital, puffy and deteriorating from kidney disease, at age 56. I remember that Dad parked the station wagon with faux wood paneling in the hospital lot and we all got out and stood there in cold December sunlight. Strict visiting hours prevailed then, and no kids were allowed, period. Dad pointed up to Grampa’s window, where he waved down at us through the glaring glass as we waved back. The youngest of four children, I was too embarrassed to admit I couldn’t locate him in the anonymous grid of windows.

At the funeral, I grappled with whether or not to look into the casket. Both available options seemed horrible—be forever haunted by a vision of dead Grampa, or guilt-ridden because I hadn’t respected him enough to look.

As a parent, I know no child should feel alone with that type of decision. But this was the 60s, when feelings weren’t discussed. Although neither an open casket or an embalmed body are traditionally Jewish, Granny must have decided she wanted it this way. At the last minute, as I hesitatingly advanced toward the casket, Dad intervened, calling me back to the comfort of his lap.

I grasped that death was permanent. Grampa was never coming back. Most of my life he’d lived two houses down, always there, smiling, opening warm arms. Shiva visitors thought they should distract me. “Have some strudel,” they urged, uncomfortable with my tears. “Show me how your Suzie Homemaker oven works.” I spurned them. Didn’t they know Grampa was dead? Forever? I had every right to be sad.

Right after Shiva, Mom sent me as proxy to nearby Los Angeles to visit family with Granny. Granny and I slept in the same seemingly giant bed. I often woke in the morning to her sobs as she read condolence cards.

“It’s okay, Granny,” I would tell her, snuggling up to her warm body, not knowing what else to do. It worked. She hugged me and smiled, soon able to get up and on with her morning routine. And my destiny as a caregiver was solidified forever. Age seven.

‘Death is just part of life.’

I ended up in Oregon for college and stayed. I voted for the nation’s first Death with Dignity Act in 1994, and again when it was challenged a couple years later. I was a nurse-midwife, passionate about women’s autonomy in reproductive health and pregnancy/birth. Choice and autonomy in dying was a no-brainer.

“Death is just part of life,” Mom always taught.

When I reached my early 50s and she was 78, she was diagnosed with ALS. “I’ve had a good life!” she insisted. When ready, she stopped eating and drinking, telling family and friends, “I have elected to die with dignity.” She stayed home with hospice, surrounded by Dad and her four children.

She died as she lived, making her own choices. Peaceful, and quietly stunning.

Frank talk in the shadow of death.

I had begun PhD studies in nursing. When I learned how few Americans die at home, even though the vast majority prefer to, I turned my focus to studying relationships between adult children and dying parents at home. I interviewed 10 dying mothers and their adult caregiving daughters in hospice at home about their relationships. They seemed comfortable—even relieved—to talk, appreciating the chance to vent, unburden, speak frankly about close bonds as they went through the taboo period of death and dying as practiced in America.

When I mentioned this research socially, people often rejected it as macabre, depressing. “It’s totally inspiring,” I’d counter. “People are getting the death they want, and family members—even if the relationship isn’t great—know they’re supporting them. Afterwards, the family heals with few regrets. It’s so much better than getting traumatized watching your loved one’s ribs and sternum crack in the ICU for no reason, when there’s no hope anyway.”

Readiness is all.

Most of us still try to avoid admitting the inevitability of death—avoid putting our affairs in order or even talking about it. I keep my papers and affairs in pretty good shape. And like my mom, I talk to my kids about death when it comes up. It’s not taboo.

“You can take care of the paperwork,” I tell one. “You’d throw up if you had to deal with body fluids.”

Or “You’re the one I want by my bed—nothing fazes you; you’ll be great. Thank you, in advance!”

I don’t think death is imminent—my work here isn’t done; I love and am grateful for my life. But when it happens, it’ll be okay.

And I practice dying.  At the end of yoga, for instance. Savasana, or corpse pose, is designed to help us practice death. Sure, it’s for total relaxation and soaking in the benefits of class; for taking a pause before the next thing in the day, yes. But it’s called “corpse pose” for a reason: To practice, to calmly prepare for, to dissolve the fear of, death.

So I lie there, tranquil, unmoving. Taking slow deep breaths in and out, extending my exhales, longer and longer.

By Diane N. Solomon, PhD, PMHNP-BC, CNM. The author has just closed her private practice as a psychiatric nurse practitioner in Portland, Oregon, to focus on writing and health policy. She serves on adjunct faculty at Oregon Health & Science University (OHSU), and on the boards of Nurse Practitioners of Oregon and the Oregon Wellness Program. She can be found at drsolomonconsulting.com and @DianeSolomonOR. Her last post for this blog was Practicing the ABCDEs of Self-Care in Pandemic Times.