Explainer
Creed
Death & life
5 min read

The lost art of dying well and what we can learn from it today

Living well in order to die well doesn’t simply happen. It takes work. It takes preparation. For All Souls Day, Lydia Dugdale asks if we are prepared for death.

Lydia Dugdale is the author of The Lost Art of Dying. She is Professor of Medicine at Columbia University and Director of the Center for Clinical Medical Ethics. She is a specialist in both medical ethics and the treatment of older patients. 

A medieval book illustration of a person dying in bed.
A 15th Century ars moriendi, or ‘art of dying’ image.
Basel University, via WikiCommons.

The first of November marks All Saints Day on many church calendars—a day when we Christians remember our martyrs together with all the faithful, both living and departed. On that day, we celebrate that our communion is not simply with one another on earth but is also with all saints of all time, including those who have died.  

For some people, the notion of fellowship with departed saints might be quite exciting. They may have pondered questions about the saints since school assemblies or RE lessons. What was racing through Abraham’s mind when he attempted to sacrifice his son Isaac? What would Mary say a sinless Jesus was like as a toddler? Did Jonah float around inside the great fish, or did he find something on which to perch himself?  

But others among us might wish to skip All Saints Day altogether. Talk of dead saints feels positively medieval, even a bit morbid. Some of us might wonder about our own saintliness—or lack thereof. Could we really experience ineffable joy in an afterlife? Moreover, the very suggestion of an afterlife implies that we ourselves must die—an uncomfortable prospect for most of us.   

Such divergent reactions to the day are revealing. On the one hand, the idea of having saints to remember is to inspire us to live well. They invite us to examine their lives and to grow ourselves in response. On the other hand, they remind us that our days are numbered. And because our days are numbered, we should attend carefully to what it means to live wisely. Saints teach us that if we want to die well, we must live well. 

But living well in order to die well doesn’t simply happen. It takes work. It takes preparation. Which is why this year on All Saints Day it’s worth asking the question: Am I prepared for death? 

Death exists as a paradox for Christians—as something at once lurking and vanquished. 

In the late Middle Ages, the ars moriendi, or ‘art of dying’ genre of literature developed in response to mass loss of life from a fourteenth-century outbreak of bubonic plague. The genre consisted of a number of handbooks on how to prepare for death. Although the earliest text was anonymous, historians believe that its authorship had a connection to the Western Church. After the Reformation, Protestant versions began to circulate, and later handbooks omitted religious particularity altogether. The handbooks grew in popularity throughout the West for more than 500 years. 

This notion of living well to die well lay at the core of the various iterations of the ars moriendi. Early texts warned readers that five temptations lead to dying poorly—temptations to doubt, despair, impatience, greed, and pride. If you don’t want to die a doubting, despairing, impatient, greedy, and proud person, you must cultivate the virtues of faith, hope, patience, generosity, and humility now. But the ars moriendi texts were very clear that virtue did not happen to a person all at once at the end of life. Rather, it required habituation. Cultivating virtues was the work of a lifetime. If you want to be remembered as a person of sound character, a generous person of hope and good will toward others, you cannot delay making such attributes a regular practice. If you are willing to be martyred for your faith—as some of those early saints were—you have got to be sure it is a faith worth dying for. 

I once met a man who had converted from the religion of radical self-centeredness to Christianity. When I asked him why, he told me that of all the world’s religions, Christianity had the best story. As with the martyred saints, it was for him a story worth dying for. And All Saints Day reminds us that in Christianity, death is stranger than you might think. 

Death exists as a paradox for Christians—as something at once lurking and vanquished. Death is the enemy that at long last will be destroyed, and death has already been swallowed up in victory. But you might ask: if death has already been defeated, what remains to be destroyed? And if death will be destroyed, how has it then been defeated? This enigma might partially explain why many regular church attenders are neither physically nor spiritually prepared for death. Researchers at Harvard University have shown that people who describe themselves as most supported by their religious communities are also most likely to reject hospice care and instead to elect aggressive life-extending technology. 

The story goes as follows. Death is an enemy because it suggests rejection of God. From the beginning, God tells our forebearer Adam that he can freely eat of any tree in the garden but one. If he eats from the tree of the knowledge of good and evil, he will die.  Thus, from the beginning, God equates the possibility of human disobedience with the actuality of death.  

Of course, Adam and Eve eat the proverbial apple. And when they do, they don’t immediately die, but they experience a sort of death. For the first time, they become filled with shame and fear. They hide themselves from God. They cast blame. God tells them that moving forward their life will be filled with great suffering. God says to Adam, ‘By the sweat of your face you shall eat bread until you return to the ground, for out of it you were taken. You are dust, and to dust you shall return.’ Disobedience is what Christians call ‘sin’—and it brings death. Sin severs that once harmonious relationship between God and people—a fact that also grieves God, which is why God does not let death have the final word. 

The story gets better. Since we humans cannot possibly undo the drastic results of our disobedience, God becomes fully human in Jesus Christ, so liable to death, while also retaining full, divinity which cannot die. Then, as a human on a cross, he dies as the ultimate sacrifice on behalf of humankind. But this God-Man does not stay dead. After three days in the tomb, Christ is resurrected, defeating death, on what has come to be known as Easter Sunday. Christ’s resurrection functions as a sort of guarantee that all God’s people will one day be resurrected and receive new bodies, that day on which the great enemy of death will be destroyed once and for all. If Adam and Eve brought death into the world, the resurrection hope is that death will be no more.  

This year on All Saints Day we have the opportunity to consider what it means to commune with ‘all saints’ extending back to Adam and forward to future generations. We have the opportunity to study the saints and then examine ourselves. What sort of people are we becoming? Are we living well to die well, as the ars moriendi handbooks teach? And of all the stories out there, which provides the greatest hope in life and in death? 

Snippet
Advent
Care
Christmas survival
Creed
Weirdness
3 min read

The mess, grit, and dirt of the post-partum stable

No cheerleaders, nor midwives, no older women who had walked Mary's path before.

Imogen is a writer, mum, and priest on a new housing development in the South-West of England. 

A Korean style historic illustration of the nativity.
Kim Hueng Jong (Korean, 1928-), Christmas Scene.

Clean, calm and collected, 

That’s how it would have been. 

The stable of filtered imaginings, 

A picture perfect scene. 

  

Perhaps more messy - 

Undignified, unexpected, unseemly - 

A not-so dream-like site, 

As a king’s birthing barn that night. 

  

Our unimagined stable. 

No perfectly planned polaroid, 

But in mess, mud, blood, 

Is God with us 

The stable of our Christmas cards, illuminated shop window scenes, and our children’s nativity plays is neat and tidy. A newborn babe lies quietly sleeping in a straw-filled trough, wrapped perfectly in a Persil white blanket. The mother, clothed and clean, looks on adoringly, standing over her child. Any animals present are gentle, still, and lying on the ground, unaffected by this unusual occurrence in their home. This is the stable of our imaginations.  

However, the Bethlehem stable was the delivery suite for the Saviour of the world. And even a Saviour’s birth includes mess. I have experienced a variety of delivery rooms over my three pregnancies and each one has been messy. From birthing pool to theatre there is noise, blood, water, and tears. Birth is messy. And that’s not even beginning to acknowledge the mess that would have been in the stable to begin with! Despite this, the stables we see and celebrate never include the mess that Jesus would have been born into.  

Birth is also extreme. It pushes the woman’s body to the limit of her physical and emotional capacity. She has laboured - aptly named for it is indeed hard work. Her body has been torn to enable this little life to be pushed or pulled into the world. She is exhausted. And now the work begins to sustain this little one outside of the womb. While inside he has been given all that he needs, now outside they must learn together how to feed. As the newborn babe is held close to his mother, he recognises her rhythmic heartbeat, his temperature regulates, his smell and touch encourages her milk to develop, and as he feeds, he contracts her womb for the placenta to be born and her body to begin to heal. They are still dependent on each other in these early hours. 

Usually, this extreme and messy moment is done in community. It is not something we embark on alone. We have a support network of skilled people to help and guide us through birth. We have birth partners who encourage us, champion us, and remind us of our body’s innate ability to birth this baby. But Mary did not have this normal group of cheerleaders. There were no midwives at her birth, no older women who had walked this path before. Only her new husband, afraid and unsure of what his young wife was about to do. And then soon after, the Shepherds arrived. A bunch of slightly smelly, nocturnal chaps walking into a delivery room. Although they would have been familiar with mess, noisy animals, and birth, I’m not sure I would have rejoiced at their unexpected arrival. Somehow though, Mary graciously welcomes them into the space of what was probably a very messy stable.  

Perhaps instead of the sanitised stable of our imaginations, we might consider an alternative imagining - the messy stable of the Saviour. A stable where the humanness of birth, of mother and child, and of life’s mess is fully felt. Because it was into the mess, grit, and dirt that the Saviour came. And it was from this mess that he was going to save.  

Join with us - Behind the Seen

Seen & Unseen is free for everyone and is made possible through the generosity of our amazing community of supporters.

If you’re enjoying Seen & Unseen, would you consider making a gift towards our work?

Alongside other benefits (book discounts etc.), you’ll receive an extra fortnightly email from me sharing what I’m reading and my reflections on the ideas that are shaping our times.

Graham Tomlin

Editor-in-Chief