We’re All Going To Die
“We’re all gonna die! I want to know how!”
Jennifer Lawrence’s character screamed it at her interviewers for downplaying a comet headed towards Earth in Netflix’s Don’t Look Up. Raja said it with wonder in her eyes during a commencement speech for the queens of All Stars 7. It’s one of Homer’s favorite sayings on The Simpsons, as well as a running gag. Sufjan Stevens, during a live performance of “Fourth of July” at Outside Lands, got his audience to chant it with him: “We’re all going to die.”
I’m inclined to agree with their worldview. Lately I’ve been dwelling on the subject of death and how birth counts as automatic entry into a game of Plinko that erratically funnels one towards their demise. Every kind of chemical exposure; a smoking habit here, a toxic household there, matters. Living is a conundrum, tenacious and fragile, grievous and exciting, all at the same time. Subtle changes to its course can yield quite a consequential shift in how your story ends.
“We’re all going to die” is a sentence only half thought-out. The rest of it should tell us how. Like most experiences, death exists on a spectrum, and we’re not the only ones within its reach. Entire galaxies can perish in gargantuan cosmic collisions. The last immortal force will be time itself.
If you’re a fan of Six Feet Under or the Final Destination films, you know good and well that death can strike whenever, in any fashion. Generally speaking however, there are four main ways we depart this realm.
Frailty
It’s what they mean by “dying of old age.” This is not supposed to mean dying in obscurity. It’s not the same as dying in your sleep. This is arguably the most social death in that everyone shapes the outcome. The youth-obsessed culture of the United States differs dramatically from those that value their elders. Our collective indifference and even hostility towards them manifests in their mistreatment and abuse in care facilities nationwide. In close quarters with depleted immune systems, senior citizens were among the first to die en masse when COVID-19 appeared.
To die of frailty is to suffer an uninspiring end. I do not want to age here if things keep going the way they are. Many otherwise healthy adults die every year in accidental falls. The age-adjusted fall death rate is 64 deaths per 100,000 seniors according to the CDC. From 2009 to 2018, “Fall death rates among adults age 65 and older increased about 30%.”
At some point, living alone is no longer practical. You become a living liability. For the price of your agency, you can enter into palliative care, where physicians focus on treating your pain without the objective of a “cure.” The better-known hospice care facility however isn’t open to just anyone. A doctor must first declare your case “beyond hope.” Old age alone won’t cut it. For your drip to be morphine, you’ll need to be certified done-zo. Get something like terminal cancer. That oughta show your autonomy who’s boss.
Cancer
Cancer is an industrious disease. Its catalysts are everywhere—except “chemtrails,” 5G, or COVID-19 vaccines, all distractions from genuine carcinogens like pesticides, chemical spills, ionizing radiation. Half of American males will likely develop cancer. One in five will die from it. The risk is marginally lower for females, with one in every three diagnosed and one in six dying.
A terminal cancer prognosis is highly predictable. That’s because we have so much data available from the millions of people who’ve died from it. The decline is slight at first, almost too broad to follow until that infamous turn for the worst. It’s often in hospital settings that such precipitous dips take place. Cancer is among the most medically expensive causes of death, not only for its often long duration. American hospitals overall are more likely to respond with aggressive, costly measures.
Death doesn’t stop price gougers. Even after a patient draws their last breath. Individualizing and dividing up the labor of death is deeply capitalist. It’s a compulsion that asks, how can we squeeze profit from a corpse? The total lack of government-funded healthcare reinforces norms of passive, hospitalized death. Who should finance end-of-life care? Who else but those involved should be “responsible?”
Everyone. That’s right, all of us. Death and grieving were community events until recently. Colonization and religious repression changed that. Lakota people would gather at the tipi of a deceased tribal member and weep over the body with their relatives. Learning this, armed forces distributed smallpox blankets accordingly.
Whether you’re aging healthily or not, if you’re admitted to the hospital for any type of malady, please take a few minutes and fill out an Advanced Directive (not the same as a DNR). We are not special, unique, or safe just because we’re young. You don’t have to be old to write one, because anybody can die. It takes no talent at all.
Organ Failure
If a lifespan is the x-axis and the y-axis is one’s quality of life, the line rises, then falls when one dies from organ failure. The bounceback crests at a lower point each time, and the dive is usually steeper. The descent looks gradual to the observer, taking months or even years. One by one, the lights go out.
Though people of any age can succumb to organ failure, it primarily affects the elderly. What does society expect from us as we age? America is not youth-obsessed for the sake of aesthetics alone. Armed forces and corporations value the young for their vast reserves of energy, as sources of dirt-cheap labor, for being as replaceable as shark’s teeth. The elderly on the other hand can’t produce nearly enough to remain economically competitive. Moreover, as their medical needs grow more demanding with time, the cost of continued care clashes with profits. Remember: in our capitalist reality, “time is money.” Slave-owner and Founding Father Benjamin Franklin said that. My money-laundering stepdad believed it. Health insurance companies live by it.
Multiple organ system failure is not a pleasant demise. The painful, sometimes drawn-out prognosis is implicitly why the DNR, or do-not-resuscitate order, exists. No, it’s not a form of suicide. We need to remove “suicide” from the language surrounding end-of-life care. It detracts from the point, which is quality of life and agency unto death. Dying might be less terrifying if we had a say in how we go.
Did you know EMTs legally have to attempt resuscitation in the ambulance on the way to the hospital? Similarly, doctors must try to revive their patients in the absence of a DNR. If a patient does have a DNR though, the revived patient can sue that doctor even if they weren’t aware of it. DNRs must be included in your medical chart. If you signed one, make sure it’s in your files on your next doctor’s visit.
A Sudden Death
It’s the one we think of first, a primary subject of art, literature, and music. It’s an accident, a murder, an undetected aneurism. My great-aunt died when hers burst. This path promises the most chaos of all, especially for unprepared survivors. Off the top of your head, do you know the best time to harvest organs? How might higher brain death complicate that? Issues like organ donation present a moral dilemma. Family can legally decide to donate your organs for you if you didn’t first stipulate otherwise. Currently, a cadaver has more autonomy than any living woman.
This fate is feared most uniformly. Virtually every horror and suspense plot revolves around it. Because accidents happen (death-by-accident is the fourth leading cause of death overall), it’s great to have a will lying around. It doesn’t mean you’re paranoid. It makes you pragmatic. Uncertainty surrounding how to honor those we love contributes greatly to lasting grief and needless guilt. It’ll make your loved ones feel much better knowing you thought of their troubles ahead of time.
How do we handle our emotions in death’s wake? Our reluctance to even acknowledge it is evident in our language, in words like “life-saving” and “heroic measures.” The subject alone is enough to cause the shivers. The mere mention of death is a cultural taboo in some places. I even hesitated to write this piece for fear of summoning the death of a loved one. But writing about death is not taboo, and talking about it shouldn’t be either. It’s the way to mitigate the fallout should any of these circumstances knock on your door.
I’m thinking of an early Six Feet Under episode in which Nate (Peter Krause) comforts a grieving woman at a funeral.
Distraught, she asks, “Why do people have to die?”
Nate waits. “To make life important,” he says.
For more pragmatics on death and dying in your community, check out the insights of Bay Area non-profit organization You’re Going 2 Die.
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