Life and ​d​​eath: far too important to miss out on

“I’m not scared of dying; I just don’t want to be there when it happens” —Spike Milligan

A medical job includes plenty of atypical experiences, but one day ​in the spring of 2024 ​was especially surreal.​ That is because one ​of us ​received a eulogy​—​​​despite being in robust health​—​​​and the other delivered that eulogy​—​​despite still wearing pyjamas. This seemingly strange series of events was because​—​​​in an ongoing effort to better understand life and death​—​​Matt Morgan organised his own living-funeral, and ​Peter Brindley delivered the homily from eight time​ ​zones away.

Matt was happy and healthy in the verdant French countryside. Peter was on zoom​, while snowed in during a trip to the United States. Matt was surrounded by other people, just as alive, and just as eager for their upcoming oration. Peter was eager simply not to wake the house. Regardless, ​the coordinator of these living-funerals encouraged us to forego judgement and embrace whatever emotion showed up: sadness, joy, scepticism, epiphany, you name it. His presence provided the ritual needed during key events such as births, marriages, and funerals​.​ Accordingly, guitar strings were plucked, wine was poured, speeches were spoken, and internet signals were lost and recaptured.

If this all seems a tad new age, narcissistic​,​ or morbid then allow us to gently push back. This living-funeral, as well as being research for Matt’s new book about survivors from near-death experiences, gave everyone the opportunity to reflect on the gift of life, the inevitability of death, and the importance of connection. Compliments were delivered while recipients could hear them, and emotional constipation was briefly purged. All of us better understood that living means you will die​, ​and that we all exist on borrowed time. A few hours devoted to what matters in the (literal) end seems trivial compared with how much is wasted on pettiness, grudges, or feeling emotionally awkward.

The medical system will do all it​ can​ to delay death, and that is overwhelmingly to the good. The issue is that ​this can easily morph into a harmful collective delusion where practitioners, patients, and the public act as if death is optional, or at least can be infinitely delayed.​ Perhaps there is too much money and status to be made from the immortality fib; or perhaps denial is ​just part of the human condition​. Regardless, time will run out for every one of us. This is not morbid, it is just reality. Moreover, ignoring death will not make it go away, it will merely outsource it to those​—​​such as healthcare workers—​​who won’t know you well enough to always get it right. It also means that you might never hear how much you meant to others.

We should take solace in the fact that it wasn’t always this way. In stark contrast to modern times, preparing for one’s death was previously one of the most important parts of life. Halloween dates back to ​at least Celtic times, 2000 years ago​​​, and had nothing to do with consuming chocolates or playing dress up. It was a day that marked the beginning of the dark, cold winter, and hence a time to explore the boundary between the living and the dead. In Ancient Roman times, during a celebratory triumph of a general, an enslaved person delivered a “memento mori​.​”​1 In other words, despite the “hero” being at their zenith, someone whispered into their ear: “remember you are mortal​.​”​ ​​I​t shows how much the human acceptance of death has changed, even if the mortal coil has not. Whether or not we each get our 4000 weeks—​yes, it really is that few​—​​​this medical job has shown us that many people reali​s​​e, when it is too late, not ​take life for granted.2

Science and ​m​​​edicine have been slow to ​tackle ​the “good life” and the “good death,” but ​things are changing​​. For example, combined training in palliative care and intensive care previously seemed counter intuitive but is now increasingly self-evident. Regardless of your ​views​​​, it is also noteworthy that euthanasia and assisted suicide​—​​once universally opposed​—​​​are now sanctioned in 10 countries and are being actively debated in many more.3 Hospitals once equated death with failure, but many have now initiated a “three wishes programme.” The goal is to personali​s​​e end of life care and create comforting, meaningful, memories. It is a superb initiative; it is just a shame if we wait for bureaucratic sign-off before staff, patients, and family deliver the right mix of ceremony and silly.456

​​Finally, ​​may we recommend the scientist David Eagleman, and his wonderfully unscientific book: “SUM: Forty Tales from the Afterlives​.​”​7 It offers numerous brief vignettes that are funny, wistful, challenging​,​ and unsettling: just like life and death, really. For example, the opener posits an afterlife where we relive our life but with similar events regrouped together. This means that you would take all your physical pain at once​—​​​all 27 intense hours​—​​but are then pain free. Less salubriously, years are squandered feeling bored, and months are lost to holding grudges. Unfortunately, only three weeks are devoted to accepting that we could be wrong, two weeks to contemplating death, and one minute to accepting that our body is failing. It ​really ​makes you think​, or at least it should.

In closing, regardless of what you think​ about​​ ​living-funerals, the concept highlights a renewed focus on ​e​​nd of ​l​ife. This, in turn, helps to emphasi​s​​​e that life is precious and potentially fleeting, so don’t squander it. Funerals remind us that death can feel terrifying, and your doctors need to step up rather than look the other way, but so does everyone. The modern world has plenty of marvellous ways to postpone death​,​ and to distract from death, but perhaps the most meaningful antidote is to live to the fullest, show others that we care, and not waste time worrying if we seem silly, pretentious, or cringeworthy.