Article
Change
Death & life
7 min read

How to face the space of death

Losing family and friends across a life, leads Natalie Garrett to navigate the space of death we all face. Part of the How to Die Well series.

Natalie produces and narrates The Seen & Unseen Aloud podcast. She's an Anglican minister and a trained actor.

An experimental image mixes distance people with watery paint-like filters of green .
Jr Korpa on Unsplash.

Death is something I’ve thought about quite a lot. As a bereaved friend, granddaughter, niece and daughter. Also, as an Anglican priest who has pastoral responsibility for those who are grieving and who conducts funerals. And as the mother of children who live in a vicarage and hear a lot about Mummy and Daddy doing funerals, too. Death is a part of our life in a way it doesn’t seem to be in a lot of families. 

My first experience of death was when my grandfather died; I think I was about six. My memories of it are mostly about how the adults behaved. I remember, with uncharacteristic clarity, the evening when Grandma came to tell us that Grandad had died. I don’t remember what she said but I remember the feeling in the room. I remember it feeling as if someone had sucked all the air out, as if we were floating in a strange and uncomfortable space. I remember sitting in the kitchen with my mother not knowing the rules of engagement for this situation and feeling scared by that. 

And in my experience, over the many years since then and in many different situations, I think most people faced with death for the first-time experience that same fear of not knowing how to be in the space of death; “I don’t know what to say”… 

While I was a student, I had a friend who was the only Christian any of us knew. He also had cancer and didn’t have long to live. He made the choice do what people his age who didn’t have a death sentence to carry around with them were doing and went to Uni. He was one of the bravest people any of us had ever met. And at his funeral, a whole load of us from Uni turned up to pay tribute to this amazing young man who had touched so many lives by the way he had so courageously lived with death. 

I could hold that space that I had been so afraid of all those years ago; I could give form and shape to the place of that which we must all face but which we all avoid so passionately in our western culture.

One of my daughter’s godmothers died of bowel cancer. She was one of the most faithful Christians I’ve ever known. When she was diagnosed, the whole church prayed for her healing. But the cancer grew and the chances of survival shrank. But wow did she use her last few months, weeks, days well. She wasn’t afraid of dying so she talked openly about it to everyone and the healing that came from how she lived then was powerful and widespread. She was an incredibly organised person and wanted to make sure she tied up all possible loose ends, like selling her house. She told with such joy about the conversation she had with the estate agent who came round to value her house who asked all the usual questions, “So are you looking to move soon? Where are you going?” I can only imagine his face as she answered with complete honesty about where she knew she was going. And I remember, with a powerful mixture of emotions, the conversation I had with her when I went to say goodbye. “I’ll see you there.”  She said as I closed the door behind me. 

Several decades after that visit from my grandmother, as a grown up and now a Christian, I had the privilege of conducting my grandmother's funeral. Grandma had been such a huge and influential part of my life and it was unthinkable that I should lead the service and not be allowed to be a grieving granddaughter – but it was even more unthinkable to risk someone else doing it, in case they didn’t do it “well”. I visited her in a Chapel of Rest, a couple of days before the service, so that I could say what I needed to say and cry as much as I was able. As I led the service and thus guided my family through the process of saying goodbye to the matriarch of our clan, I could hold that space that I had been so afraid of all those years ago; I could give form and shape to the place of that which we must all face but which we all avoid so passionately in our western culture. Because as a Christian, I know something, I know Someone, bigger than death. 

Death seems to be the final taboo of our culture, the most intimate and unmentionable part of life. Which means we’re not very good at death. And a good death is a beautiful thing. 

There’s a famous story in the Bible when Jesus’ friend Lazarus died. Jesus isn’t there while Lazarus is ill, in fact he isn’t there when he dies – he turns up four days later. In the Jewish culture of which Jesus was a part, there were all sorts of rules to comply with around death and one of the traditions was to gather the local community, including professional mourners to weep and wail, to encourage the expression of emotion.  

Lazarus’s sisters were angry that their good friend Jesus hadn’t been there when they needed him. They were angry that their brother, Lazarus, had died. They were angry and needed someone to blame. I think we can all relate to that. When someone we love is suffering, when someone we love dies, a natural part of the grieving process is anger. And that anger is often directed at God, whether we believe in him or not. 

When Jesus arrives, he generously receives their emotional rebuke, allowing them to give voice to their pain. And then he goes to the grave where Lazarus has been lying dead for four days. And in the shortest verse in the Bible, we are privy to his reaction. Jesus wept. Even God is distressed by the reality of death. Death was never meant to happen; death was never part of God’s good plan for humanity. And it makes him weep. He turns up, unafraid of the raw reality of death and bereavement. 

Of course, in that situation, there was a reprieve – Jesus raised Lazarus from the dead. And the mourning turned to celebration. But of course, although we never hear about Lazarus’s final death, he did die, just like all the rest of us.  

Death is the one thing we all have in common. Different cultures react to death differently. In some cultures, the entire community stops doing normal life and gather round the bereaved. In our culture, all too often, we pretend nothing has happened. We are determined to keep death in a box, packed as far deep as possible so we don’t have to look at it. Death seems to be the final taboo of our culture, the most intimate and unmentionable part of life. Which means we’re not very good at death. And a good death is a beautiful thing. The Christian friends I’ve known who died untimely young deaths have shown me that. People who are not afraid of death, people who know what’s going to happen after they’ve died can pave the way for us to walk into the place of death and find beauty there. 

As we face death head on, we stare into the place of what’s really important. Everyone says glibly that on our deathbed we won’t be wishing we’d spent more time at work. But let’s not wait till our deathbed to work out where we need to spend more time. Let’s learn how to live well now, not hiding from the only guaranteed fact of our future. 

At Lazarus’s graveside, Jesus made the rather elliptical claim:  

“I am the resurrection and the life. The one who believes in me will live, even though they die; and whoever lives by believing in me will never die.”  

When Jesus died himself, naked and nailed to a cross, he took on the greatest enemy of life. And he won. As Jesus rose again on the third day, he claimed victory over death. As Christians follow Jesus through this life, they do so in the assurance of eternal life with him after death. Wow, that’s the place of hope. That’s the place where you can look death right in the face, unafraid. 

The Christian message of hope is a life raft in the cold, choppy waters of bereavement. It gives form and shape to something we don’t understand and don’t want to have to navigate. It gives us courage to accept the truth, when we really don’t want to. Knowing that there is something, Someone, who is bigger than death. And knowing that death – either my own or that of someone I love – isn’t the end of the story gives me the capacity to walk confidently and unafraid through my life towards its inevitable end. And into what’s next. To quote my friend, I hope I’ll see you there. 

Interview
Change
Gaza
Israel
Middle East
S&U interviews
Suffering
War & peace
11 min read

Eye witness: life and death in Gaza’s European Hospital

Returning plastic surgeon Tim Goodacre reports on the struggles, the despair and the dignity of the people and the medics of Gaza during their long nightmare.

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

Medical staff stand beside a bed in which a man lies with an amputated leg.
Medics confer about a patient in Gaza's European Hospital.
Tim Goodacre

Tim Goodacre is a vastly experienced plastic surgeon who recently spent two weeks in a hospital in Khan Younis treating the extensive injuries of the people of Gaza. I caught up with him to ask about his experience there.  

Graham: Let me start by asking what was it like getting into Gaza? What was the process and how difficult was it to actually get in in the first place? 

Tim: We went in as an emergency medical team under the under the auspices of the World Health Organisation, which is coordinated with UN OCHR. It was easy obviously to get to Cairo. Then we joined a convoy, a group of cars convening in the small hours of the morning in Cairo and then being escorted across the Sinai desert. We got to the border in time for dusk. What was staggering at that stage was seeing the number of lorries lined up, waiting on the Egyptian side to get in. They were two deep on one side, one deep on the other with a thin passageway through which we could drive through for mile after mile after mile of these lorries. 

Was this humanitarian aid sent from other nations? 

Absolutely. It was aid labelled from different countries or agencies. Crossing Rafah the next morning was all pretty haphazard and chaotic, but we met our driver on the other side. We then had to travel to Khan Yunis on the coast road because it was the safest part of the south Gaza strip. We went through a route called the Philadelphia Road, which is a gap between the two borders. As we drove along, we immediately were jumped on by some young lads who had put razor wire across the road. We picked up two of them who hung onto the car each side, with our window s firmly shut. As we sped along, they were our ‘protectors’, taking a pitiful sum to ensure that we would not be stopped at further razor wire and our vehicle plundered. It was our first experience of the lawlessness that's inherent at the moment in Gaza. 

All along that side of the road there were people putting up new tents after a recent further mass displacement, as far as the eye could see. It made a huge impact on me - the devastating plight of the people who were there. It looked like those pictures of Glastonbury or Woodstock, where as far as you could see, the rolling fields or sand dunes or whatever were totally covered in makeshift dwellings. It was pretty cold and windy. And subsequently, while we were there, it rained an awful lot and your heart just went out to these people.  

So these were people living in tents and temporary shelters? 

 Well, not really. They're barely tents. They're just finding flimsy bits of wood, putting them up and nailing them together. And these are not just the very poorest of the poor. This is everybody. Many of them were people from very well-to-do houses whose families have been displaced. I've worked in many parts of the world where there's poverty, but I’ve never seen so many people displaced.  

One of the things that's remarkable however is the relative cleanliness, the desire to maintain dignity in the most appalling circumstances. But a young lad who’s now a young doctor (who I have worked with for a decade now) came to see me and he was the most dejected person I've ever met. He said to me ‘they've taken away my dignity’. The abject pain in his face was something that I won't forget.  

You’ve been to Gaza many times before. What was different about this time? And you've seen it in the aftermath of previous wars and conflicts. What was what was particularly different this time? 

 It's utterly different – it’s the displaced population with nowhere to go and seeking shelter. When I first went in 2014 after Operation Protective Edge, I was taken to a huge neighbourhood of northeast Gaza, which had been flattened and at the time the impact on me was extraordinary. When I’ve visited subsequently over the last decade, they will show you this bombed out building and that flattened area, but I've never seen such vast numbers of displaced people. On the second day we moved into the European Gaza Hospital (EGH), which is where we were going to stay for the two weeks we were there. Inching slowly along amidst endless hordes of people walking around, seeing the dejection, despair, the hopelessness with nowhere to go - this for me is what defines this whole episode and makes it very different from others. This is in no way a diminution of other conflicts and human tragedies, but when there was bombing in Baghdad or in Kiev and Ukraine, people might go into underground shelters - there are places they can perhaps go to escape. Even in massacres such as in Darfur or Congo, there are places to run to. There is nothing like that in Gaza. 

Was there a pattern to the kind of medical emergencies and wounds that you were having to deal with? 

 The vast majority of injuries were the impact of high explosives, so we naturally saw quite a lot of burns, although the majority of severe burns alone were being managed by the Red Cross team also at EGH. Some of them were people who had been crushed and pulled out of buildings which had collapsed. But that was that was the minority. The majority of our cases were direct results of bomb blasts. Every time you hear a bomb, somebody is being killed, yet many others are caught on the fringe of that. Shrapnel travels at astronomical speeds and hits people in in a completely random way. These injuries are devastating. There were scores of people coming in with limbs missing. Seeing somebody with a leg off at the thigh, a leg off below the knee, an arm ripped off was all too common. It was hard to take in - you have to become somewhat immune to the backstory behind each dreadful injury, and concentrate on the carnage in front of you, to be able to deal with the constant onslaught of cases. 

How were the medics coping with it? You were there for two weeks. They are there for months, presumably on end? 

 I think it's incredibly important that we don't focus on the visiting medics. I usually peeled off at about 9pm or so in the evening - I had to go to bed and had to have a rest, but there were people trying to work through the night. What I want to focus on is the local people, particularly a young colleague, Ahmed, who was 36 years-old. He was statesmanlike in his ability to pull things together. His family are actually mostly in Dublin as they've got Irish passports. I cannot tell you how much admiration I have for that young Gazan man who shared his room with me.  

He has been managing to create a team who work alongside him, since many of the staff who had worked at the hospital before (some of whom we had trained over several years in limb reconstruction) were not there. That is because they might not be alive, or having to support their displaced families, or simply are afraid to travel in daily to the hospital, or whatever. It is a huge demand on individual doctors to leave a family group (who invariably try to stay together, so that if they are bombed, they all die together and do not have to be a sole survivor.) to then work away from such possible loss of all their family members. It's an incredible sacrifice to be working in medical care when your family are all huddled together in a place where they may all lose their life, and that gets to them in the end.  

The orthopaedic side is almost on its knees. Most of the system in the hospital is utterly on its knees. There were early years medical students who had been taught quickly how to manage wounds and to skin graft. They haven't got any pay, but some people have given a little money to my colleague’s account to try and give them some support. There were IT students and all sorts of others pulling together. How people can work in in such adversity and make things happen is quite a testament to the to the strength of humanity.  

It all begins to play on your mind, and you start thinking is there another one coming? And you get no warning when the attacks are unleashed. 

What was it like living under the bombardment, which was presumably pretty constant during your time there? 

There may have been the odd period of four or five hours when there was no sound of close bombardment at all, although during that time there was probably small arms fire going on somewhere. But otherwise, it was relentless. One became somewhat used to the bombs in the distance, but when they're close by… Every time one of these bombs goes off, there are people dying. And that really that played on your mind. So huge numbers were seeking shelter anywhere in the vicinity of the hospital. If you can imagine a hospital corridor where every route is full of makeshift shelters, and you just go up around a stairwell and on the corner of each stair, there will be a family which will be hanging drapes up, trying to find some sort of privacy and dignity among the utter destitution.  

I found it very difficult to sleep during those times. The hospital is in a quadrant, a square. On one corner there was a supermarket which latterly was hit by an F16 delivered weapon. You could hear the sound of the rocket go off alongside the scream of the low flying fighter jet, and the whole building shook. There's also the incessant sound of drones. It all begins to play on your mind, and you start thinking is there another one coming? And you get no warning when the attacks are unleashed.  

It made me realise what soldiers undergo when they get what used to be called shell shock. There, even if you're not injured yourself, this constant shocking damage gets to you. I knew we had the knowledge that after a short time, we would be getting out - but it made me realise how tough Ahmed and others working there have to be. It will be having a devastating impact on the population, and for a nation.  

I imagine the psychological effects of that are going to last for a long time in the lives of these people. You don't get over that quickly. If you live with that level of tension, thinking any moment now, I could die, that must stay with you and the marks of that stay for a long time. 

I'm sure that's true. I'm not an expert in PTSD and things like that. Ahmed is a Muslim and said to me more than once that when you believe in an afterlife, you believe that your time will come at some point, and you accept that. We don't know when it is or where it is, but it will come. I have frequently wondered whether any of the fighter jet pilots have ever experienced themselves what it’s like to be underneath the impact of one of their weapons? Having felt somewhat what it is like to be on the other side of such an onslaught, I do wonder whether very many of those involved in ordering conflict really have any kind of understanding of what devastation feels like, when there is nowhere to run? I fear for what this conflict does to the humanity of both sides. 

I genuinely don't feel brave, I don't. I'm not the kind of person who sees lights in the sky, but I know it was God’s calling to go there. It was simply the right thing, 

Did you see any sign of hope or anything that gave you a sense of the way out of this? 

 The sense of hope is within the people who are there. There are many people who say they still really don't want to leave. They feel this passionately. It's their land. They do want to see a new Gaza. I tried to be somebody who lifted spirits. Communities can be rebuilt and there may be a new future which will come from the dust. I've been in touch with people in my University Medical school in Oxford to see whether we can do something about getting these young people's education continued.  

You can imagine there wasn’t a lot of laughter in the whole environment, but on the few occasions when I did gather together with my colleague’s small group of young students and volunteers, usually late into the night, we would eat whatever food goodies they had to hand, and their sense of fun would burst out. Together there was a very strong sense of community amongst them. 

How did your Christian faith inform the way you interacted with the situation? How did your Christian faith help you process what you were seeing and experiencing there? 

 I must say it was a deeply spiritual time for me. It was absolutely powerful to me to know that God cares and loves each and every one of these people. I longed to organise a football game with the kids. I was told that they had tried to do that, and it had become too dangerous. So there seemed to be no organisation around looking after the well-being of the children, their education, or the deeper impact on them of this war. People were jammed into the hospital, obviously because it was seen as a safe space, and it was humbling to think that us (as foreign workers) being there made them feel somewhat safer. It humbled me immensely.  

I felt nothing but a sense of privilege in being a witness to all this. I was reading the Psalms regularly in daily prayer. There's also something about that land being the place where God himself suffered in Christ and went through his own agony, and that the Holy Family escaped through Gaza to Egypt.  

I genuinely don't feel brave, I don't. I'm not the kind of person who sees lights in the sky, but I know it was God’s calling to go there. It was simply the right thing, a privilege and an honour to have such access which comes with having my particular background of skills and past history with Gaza. God is over all these matters, and we are compelled to respond. 

 

Tim Goodacre is a Reconstructive Plastic Surgeon based in Oxford, with extensive experience of working in diverse environments outside the UK. He is immediate past Vice President of the Royal College of Surgeons of England.