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A review by al13ex
How We Die: Reflections of Life's Final Chapter, New Edition by Sherwin B. Nuland
5.0
The book was written by a surgeon in 1995, when he was in his seventies. He provides down to earth descriptions of diseases and the processes that take place when people die. I am tempted to say that it can be very brutal to think and read about this, but I suppose it just takes a bit of time to get comfortable with such thoughts. There is also a lot of raw medical information that might require a little bit of background in order to follow it (or at least some years of watching medical dramas on TV). I wanted to know how we die and I have a better view on this aspect of life, the ending, after reading this book. I wanted to face man’s mortality and to understand it.
We live in a world where we deny death. We keep it behind closed doors and as far away from us as possible. Yet, it’s the most natural process one can imagine. “Dying begins with the first act of life”, says the author. Death is a process, rather than a moment. We refuse to think about it and we refuse to die when the time comes. Our survival instinct takes over and there are few people who accept it. I want to be one of those people.
”Though everyone may yearn for a tranquil death, the basic instinct to stay alive is a far more powerful force.”
There are facts, study cases, philosophical questions and even emotions rising throughout the pages. I was deeply impressed at times by accounts of dying and by the thoughts that invaded my mind in response. I have learnt that there’s no such thing as dying of old age, because everyone has a very specific thing that kills them. And today, people no longer die when their hearts stop, but when their brain dies. Our civilization has advanced up to a point where it changes everything we knew about life. We keep learning and developing, but we can’t stop death.
The human organism is frail and it has an expiration date. The best we can hope for as humans is to meet the life expectancy and not die before that. Without doubt, our genes and lifestyle combined will influence the illnesses and the time of death for all of us.
The author made efforts in explaining and persuading the readers that they should accept death. I saved some quotes from the book, because they present things very clearly.
“There is a vanity in all of this, and it demeans us. At the very least, it brings us no honor. Far from being irreplaceable, we should be replaced. Fantasies of staying the hand of mortality are incompatible with the best interests of our species and the continuity of humankind’s progress. More directly, they are incompatible with the best interests of our very own children. Tennyson says it clearly: Old men must die; or the world would grow moldy, would only breed the past again.”
“It is through the eyes of youth that everything is constantly being seen anew and rediscovered with the advantage of knowing what has gone before.”
“Persistence can only break the hearts of those we love and of ourselves as well, not to mention the purse of society that should be spent for the care of others who have not yet lived their allotted time.”
He also discussed old age and the health issues that appear from the wear of our bodies.
“Among living creatures, to die and leave the stage is the way of nature—old age is the preparation for departure, the gradual easing out of life that makes its ending more palatable not only for the elderly but for those also to whom they leave the world in trust.”
Despite this being a book about death, there are valuable lessons about life. Again, quotes from the book will express these ideas much better than I ever could.
“The fact that there is a limited right time to do the rewarding things in our lives is what creates the urgency to do them.”
“The utility of living consists not in the length of days, but in the use of time; a man may have lived long, and yet lived but a little.”
“The greatest dignity to be found in death is the dignity of the life that preceded it.”
“There isn’t much you can manage beyond trying to keep things neat and keep things painless—keeping someone from being alone.”
“To the wise advice that we live every day as though it will be our last, we do well to add the admonition to live every day as though we will be on this earth forever.”
“Malignant cells concentrate their energies on reproduction rather than in partaking in the missions a tissue must carry out in order for the life of the organism to go on. The bastard offspring of their hyperactive (albeit asexual) ‘fornicating’ are without the resources to do anything but cause trouble and burden the hardworking community around them. Like their progenitors, they are reproductive but not productive. As individuals, they victimize a sedate, conforming society.“
This paragraph was actually about cancerous cells, but unfortunately it made me think about the humans as a species. Basic human behavior, as history teaches us, hurts the environment and disturbs the balance of life and death.
The main lesson I got from reading the book is that “you have to live before you die.”
Ars moriendi is ars vivendi: The art of dying is the art of living.
In spite of everything, “as inevitable as death is and as likely to be preceded by a difficult period, especially for people with cancer, there are additional pieces of baggage we shall all take to the grave, but from which we may somewhat disencumber ourselves if we anticipate them. By these, I mean conflicts unresolved, breached relationships not healed, potential unfulfilled, promises not kept, and years that will never be lived. For virtually every one of us, there will be unfinished business. Only the very old escape it, and even then not always.”
Acceptance of death could ease the mental process and the agony caused by the instinct of survival; and we might have the chance to live better if we keep the ending in mind.
We live in a world where we deny death. We keep it behind closed doors and as far away from us as possible. Yet, it’s the most natural process one can imagine. “Dying begins with the first act of life”, says the author. Death is a process, rather than a moment. We refuse to think about it and we refuse to die when the time comes. Our survival instinct takes over and there are few people who accept it. I want to be one of those people.
”Though everyone may yearn for a tranquil death, the basic instinct to stay alive is a far more powerful force.”
There are facts, study cases, philosophical questions and even emotions rising throughout the pages. I was deeply impressed at times by accounts of dying and by the thoughts that invaded my mind in response. I have learnt that there’s no such thing as dying of old age, because everyone has a very specific thing that kills them. And today, people no longer die when their hearts stop, but when their brain dies. Our civilization has advanced up to a point where it changes everything we knew about life. We keep learning and developing, but we can’t stop death.
The human organism is frail and it has an expiration date. The best we can hope for as humans is to meet the life expectancy and not die before that. Without doubt, our genes and lifestyle combined will influence the illnesses and the time of death for all of us.
The author made efforts in explaining and persuading the readers that they should accept death. I saved some quotes from the book, because they present things very clearly.
“There is a vanity in all of this, and it demeans us. At the very least, it brings us no honor. Far from being irreplaceable, we should be replaced. Fantasies of staying the hand of mortality are incompatible with the best interests of our species and the continuity of humankind’s progress. More directly, they are incompatible with the best interests of our very own children. Tennyson says it clearly: Old men must die; or the world would grow moldy, would only breed the past again.”
“It is through the eyes of youth that everything is constantly being seen anew and rediscovered with the advantage of knowing what has gone before.”
“Persistence can only break the hearts of those we love and of ourselves as well, not to mention the purse of society that should be spent for the care of others who have not yet lived their allotted time.”
He also discussed old age and the health issues that appear from the wear of our bodies.
“Among living creatures, to die and leave the stage is the way of nature—old age is the preparation for departure, the gradual easing out of life that makes its ending more palatable not only for the elderly but for those also to whom they leave the world in trust.”
Despite this being a book about death, there are valuable lessons about life. Again, quotes from the book will express these ideas much better than I ever could.
“The fact that there is a limited right time to do the rewarding things in our lives is what creates the urgency to do them.”
“The utility of living consists not in the length of days, but in the use of time; a man may have lived long, and yet lived but a little.”
“The greatest dignity to be found in death is the dignity of the life that preceded it.”
“There isn’t much you can manage beyond trying to keep things neat and keep things painless—keeping someone from being alone.”
“To the wise advice that we live every day as though it will be our last, we do well to add the admonition to live every day as though we will be on this earth forever.”
“Malignant cells concentrate their energies on reproduction rather than in partaking in the missions a tissue must carry out in order for the life of the organism to go on. The bastard offspring of their hyperactive (albeit asexual) ‘fornicating’ are without the resources to do anything but cause trouble and burden the hardworking community around them. Like their progenitors, they are reproductive but not productive. As individuals, they victimize a sedate, conforming society.“
This paragraph was actually about cancerous cells, but unfortunately it made me think about the humans as a species. Basic human behavior, as history teaches us, hurts the environment and disturbs the balance of life and death.
The main lesson I got from reading the book is that “you have to live before you die.”
Ars moriendi is ars vivendi: The art of dying is the art of living.
In spite of everything, “as inevitable as death is and as likely to be preceded by a difficult period, especially for people with cancer, there are additional pieces of baggage we shall all take to the grave, but from which we may somewhat disencumber ourselves if we anticipate them. By these, I mean conflicts unresolved, breached relationships not healed, potential unfulfilled, promises not kept, and years that will never be lived. For virtually every one of us, there will be unfinished business. Only the very old escape it, and even then not always.”
Acceptance of death could ease the mental process and the agony caused by the instinct of survival; and we might have the chance to live better if we keep the ending in mind.