0:06

If we were at a party and everybody

0:09

had two beers, and then I

0:11

asked, what do you do for a living? Like, what do you actually

0:13

say? In social setting? It depends how quickly

0:15

I need to leave. If

0:22

I need to leave soon, I'll usually

0:24

say I teach sociology,

0:27

which isn't really true, but

0:29

I know it's really boring sounding, so

0:31

then everyone's like, okay, bye. However,

0:36

if it looks like I've got some time

0:39

and I know the person will want to talk to

0:41

me, I'll say I'm Director of the Center for Death

0:43

and Society and I do research on

0:45

death, dying, and the dead body, and interdisciplinary

0:48

studies around everything to do with death

0:51

and dying. That

0:53

is Dr John Troyer, who lectures at the University

0:56

of Bath in England and is the m v P of Every

0:58

party. I am ess a

1:00

host of Deeply Human and

1:03

Deeply Human is the podcast you're

1:05

listening to, And a

1:07

podcast is like a balsamic

1:09

reduction of pure knowledge drizzled

1:12

in through your ears to season your brain. Today's

1:15

episode is about dying and

1:17

why you shouldn't put off talking about it until

1:19

you're dead. So part

1:21

your hair down the middle and your best Wednesday Adams

1:24

and stretch out for rigorous conversation

1:26

about death, activism, the guillotine,

1:29

and the ferocity of human love. Love

1:33

of mine, someday

1:36

will die, but I'll

1:38

be close behind.

1:40

I'll follow you into

1:43

the dark. You're blinding

1:46

line. Okay, So back

1:48

to the party scene. How does John introduce

1:50

himself when he's off the clock in

1:53

that scenario where you give him a long, interesting

1:56

answer? Do you know what they're going to say next?

1:59

Yeah? Usually this is actually

2:01

almost always the way it happens. They'll

2:03

say, oh God, wow, Okay,

2:06

I have to ask you this question, and then it just

2:08

goes into about thirty minutes to an hour or a couple

2:10

of hours of just relentless questioning

2:12

about everything and anyone's ever wanted to know about

2:14

death and dying, which is normal. I expect that because

2:17

people are genuinely interested in it, like

2:19

it is a constant and if you can say anything

2:21

about humans as a species, and this might

2:24

strike some listeners is a bit grim, but I think it's

2:26

completely accurate. Is that if there's anything we're good at,

2:28

it's dying, that eventually it's

2:30

going to happen. I

2:35

met John a bunch of years ago before

2:38

he'd moved to England and before he was a

2:40

death rock star. We met in our

2:42

twenties, both of us competing in the slam

2:44

poetry scene in Minneapolis. He

2:46

seemed funny and weird and smart,

2:49

an assessment that still holds. And my

2:51

delivery of a rhyming poem about metaphysics

2:54

at one of our competitions must have passed

2:56

mustard because he invited me to sit

2:58

in on the defense of a PhD

3:00

dissertation, and that seemed like a

3:03

terribly adult way to spend an afternoon. So

3:05

I went, and I was mesmerized

3:08

listening to John talk about the science

3:10

and culture of death. How

3:12

the first embomed bodies were carted around

3:15

the US like sideshow attractions,

3:17

how people used to pose for pictures with their

3:19

recently deceased relatives, and

3:21

unless you look really closely at the photos,

3:24

it's tough to tell who's warm and

3:26

who's dead. Death,

3:28

as it turns out, runs in John's

3:30

family. So my dad

3:32

was a funeral director for many years,

3:35

owned a couple of funeral homes, worked at other couple

3:37

of funeral homes, and you

3:40

know, I just grew up watching him organized,

3:42

run and do funerals. But He also

3:44

taught cosmetology, so he taught the makeup classes.

3:47

Apparently he was a very good at matching skin

3:49

tone. His students would tell me, it's like

3:51

Dan really good at the makeup, and I

3:53

was like, well, it's good to know. For

4:00

the record, John didn't want to follow in his

4:02

dad's footsteps, and yes, dude,

4:04

he has seen the HBO series six ft

4:06

Under. John's interest was more intellectual.

4:09

He wanted to investigate how technology

4:12

affects the way that society treats

4:14

death and dead bodies. For

4:16

example, these days, we're living further

4:18

apart from our families, which means that

4:20

we're dying further apart. Two and

4:22

so embalming services are in steady

4:24

demand because by injecting

4:27

a body with preservatives, we get a shelf

4:29

stable corpse that allows the family time

4:31

to gather. Because

4:33

of this embalming technology, the

4:35

dead body in your imagination might

4:38

look sort of like a living person who's

4:40

asleep, But before the Civil

4:42

War, dead bodies looked really different than

4:44

living bodies. They start to decompose,

4:47

they turned black. Okay, quick

4:49

extra credit fact. Abraham Lincoln

4:51

played a really big part in popularizing

4:53

embombing after his assassination. His

4:56

body was taken across the country in a special

4:58

train car for public viewing, and it

5:00

was embombed more than once along the way.

5:03

New technologies can shape the way

5:05

that we handle are dead, and

5:07

new political ideas can change the

5:09

way that we die. For

5:14

example, California becomes

5:17

a first state to pass in what's called the Natural

5:19

Death Act, and the Natural Death

5:21

Act states you have a right to refuse treatment

5:24

and to die naturally. And we think

5:26

about that today is almost being given,

5:29

But it wasn't. It wasn't. There

5:31

had to be a law that was created and then passed

5:33

along you could tell people both

5:36

medically and ethically, but also philosophically

5:38

and politically. And again I think the political side of this is very

5:40

important. You have a right to die by

5:43

refusing treatment if you no longer want it. And

5:45

why is that political? Well, because it was a statement

5:47

of autonomy. I will die

5:49

as I choose. And there's a longer

5:52

history here of a break than from religious

5:54

tradition because of course, for many

5:56

centuries you did not die the way you chose.

5:58

You died the way God chose. Is well,

6:01

if you say I die the way I choose,

6:04

that means then that the state or

6:06

whatever governing powers in place,

6:09

no one will tell me how I can die. In

6:12

the nineteen seventies, universities

6:14

in the US and the UK taught sociology

6:16

of death, courses and activists

6:19

fought to change our approach to death with

6:21

conversations about assisted suicide,

6:24

end of life, rights and dignity and death,

6:27

and the living Will was invented, a document

6:29

that expresses a person's wishes for healthcare

6:32

when they're no longer able to make those decisions.

6:37

I thought that all these shifts in thinking

6:40

and practice were designed to provide people

6:42

with a good death. John

6:45

not so much. There's

6:47

been lots of conversations around this idea

6:50

of a good death. I've never been big on that terminology

6:53

because then it suggests there's a bad death. And

6:55

I'm not saying you can't create qualitative

6:58

judgments around these things, because I think we

7:00

can talk about preferred ways of dying.

7:02

But I think ultimately what we're

7:05

talking about in terms of death is, you know, death

7:07

is a phenomena you're, regardless of goodness or

7:09

badness, is going to happen. But

7:12

I'm see I'm confused. I mean, in some

7:14

ways it feels like, oh,

7:16

I don't know, like why

7:18

shy from normative terms,

7:21

because if I were to compare two ways of shark

7:24

attack versus in the arms of my beloved,

7:26

like one of those deaths is clearly

7:28

sort of lousy and one is like why better?

7:31

Right now, I understand that the concern

7:33

you can come up with, and this is something that it's been

7:35

discussed that because once

7:38

you start to create expectations

7:40

around dying, people can start to feel like they're

7:42

doing it wrong. And that's

7:45

always been one of my big concerns

7:47

with a lot of the

7:49

discussions around death and dying in

7:51

all different kinds of facets society,

7:54

which has been going on out for like the last twenty years.

7:56

It's never not been a hot topic as it were.

7:58

But I think that what happened is families,

8:01

and usually families more than the dying,

8:03

but sometimes the dying they can feel like they're

8:05

doing it wrong. That

8:12

fear that I'm somehow messing

8:14

up at this basic biological function

8:17

is one you might have also heard. In relation to childbirth,

8:20

Moms can face a lot of pressures about how

8:23

and where to deliver at home, at

8:25

the hospital, in a birthing center, with or without

8:27

pain meds in a tub of water, preferably

8:30

on a weekday. A lot

8:32

of parents hire birth doulas to help

8:34

with their pregnancy and delivery. Doulas

8:36

aren't part of the medical team, but there are a

8:38

source of support and encouragement and

8:41

they've got a lot of experience helping tykes

8:43

into the world. There are also

8:46

death doulas who help people to

8:48

leave the world. I die with people.

8:51

I say die with them

8:53

because I feel like with every person I die

8:55

with, I'm a little closer

8:57

to understanding what death is. And

9:00

that's just the last breath. There's nothing more magical

9:02

about it. Denise Love

9:04

has worked as a death duela for twenty eight

9:06

years. She's also helped set up

9:08

hospices and worked as a registered nurse,

9:11

and part of her motivation in life is to

9:13

help people talk about death, to

9:16

be less afraid of the whole conversation.

9:18

I think the fear is just too great. I could talk

9:20

about it, you might drop dead. It's

9:22

just terrified to use the word.

9:25

Even most people don't ever use the word. In their

9:27

eyes. We pass away or somebody's

9:29

ill, we avoid the language

9:32

of death. Denise has spent a lot

9:34

of time working in the developing world

9:36

with people in Nepal, Myanmar, Cambodia,

9:39

and Thailand, which is where she was when I spoke

9:41

with her. The death's Denise

9:43

has witnessed and the developing world look really

9:46

different than those she's been a part of in Western

9:48

societies. Whatever this thing we're

9:50

telling everybody is to fight, that's a lot

9:52

of nonsense. There's nothing to fight. Surrendering

9:55

to death means a comfortable death. That's my

9:57

theory behind it. To die people

10:00

often have to fight

10:03

with their loved ones to die,

10:06

absolutely, So come on,

10:08

dad, you can do it. Fight it. You're going to

10:10

be seventy six tomorrow,

10:12

or you know. A young pregnant

10:14

woman kept saying to her husband, could

10:16

you just hold on and do I have

10:19

the baby? And he looked

10:21

at and he said, I can't. How do I tell

10:23

her I'm done? I don't want to do this anymore? So

10:25

I said, let's bring her in and tell her. And he just had

10:28

terror in his eyes. And we had the most amazing

10:30

hour of if you love me, you'll

10:32

live, and if you love me, you'll let me die. And we

10:34

had that beautiful, difficult conversation

10:37

which was sort of a bit heated at times,

10:40

but really negotiations, so

10:42

a big death. Doller's job is

10:44

getting a family talking in an

10:46

honest and open way. But

10:50

again there's a lot of disagreement, and one daughter

10:52

wants this, and one daughter saying, come on, you can

10:54

help you live. Let's give him vitamins and

10:57

let's duce another twenty three thousand karat

11:00

to be giving kale, and it's

11:02

making drink his own urine. I mean, I've been through

11:04

everything, and then I just say, let's all go inside

11:07

and talk to them, and I say, do you want to live? What do you

11:09

want to die? I mean, nobody answer

11:11

that question because it seems selfish,

11:14

and I've already told me they want to die usually,

11:16

So you know, I feel really comfortable bringing the family

11:18

and just saying can we let him go if you love

11:21

him? Just saying about I've

11:33

always thought a lot about death, even

11:35

as a little kid, and you hope

11:37

that when the time comes, you can spare the

11:39

people you love pain or discomfort.

11:42

But it hadn't occurred to me that I might help

11:44

my loved ones by releasing

11:46

them from any obligation they might feel to stick

11:49

around when someone's really

11:51

sick and maybe dying. I

11:53

already know to ask, does

11:55

it hurt? Okay, then let's

11:57

talk to the morphine nurse. Now.

12:00

I also know to ask, hey, do

12:03

you just want to leave now? Because

12:05

I don't want to keep you. This is your show,

12:08

so don't stay late for me. That's

12:11

a kindness, that question, and

12:13

I'm grateful to Denis for handing it to me. Our

12:28

next guest, Dr Sam Parnia

12:31

deals in total totally

12:33

different sorts of questions. Do

12:41

you think that there might be a future where

12:44

a good number of us died? Many times?

12:47

I think what you're going to see is when resuscitation

12:49

advances, then there'll be many people

12:52

who can say, oh, I had, like you know, full cardiac

12:54

rest in my life and nothing mattered. I was

12:56

dead for twelve hours, sixteen hours they brought me back.

12:58

If our body is still in good shape, we

13:01

will be able to be revived and allowed to live

13:03

another ten or twenty or thirty years. Dr

13:06

Sam Parnia is the director of the

13:08

Critical Care and Resuscitation Research

13:10

Program at New York University.

13:13

He specializes in bringing people

13:15

back to life, and he thinks that

13:17

his technology advances will have a lot

13:19

more lazaruses and lazarettes

13:21

amongst us, I asked him

13:24

to start with a working definition of death in

13:27

practice, How would a physician know if

13:29

a patient is dead like dead

13:31

dead dead. It's

13:34

interesting because I think most people listening

13:36

will think that they understand death and it's pretty

13:38

simple. You're either dead or you're alive. And the

13:41

reality is that was true because

13:43

for thousands of years, whenever

13:45

a person's heart stopped, they would essentially

13:48

reach a point where they were irreversibly dead.

13:51

So, to answer you a question, the way

13:53

the physicians declass somebody dead is

13:55

that their heart stops. When the person's

13:57

heart stops, they also stop breathing, and

14:00

because there's no blood flowing around the body, there's

14:02

no energy, and the brain also shuts

14:04

down almost immediately. So

14:06

the three criteria that they look for are

14:08

no heartbeat, no breathing, and

14:11

absence of brain response. But

14:14

as our tools and understanding have evolved,

14:17

the heart, breath, and brain don't

14:19

always stop on the same time. Ventilators

14:22

can breathe for a body that's unable to respire

14:24

on its own, for example, So what

14:27

if machines performed the duties of the heart

14:29

and lungs but the brain has stopped working.

14:32

Is that person dead. To

14:37

answer that question and others like it, a

14:39

commission appointed by US President Jimmy

14:42

Carter published a report called Defining

14:45

Death. It

14:47

said a person was dead if one of

14:49

two criteria were met, either

14:52

irreversible cessation of circulatory

14:55

and respiratory functions, so

14:57

like your heart stopped and you're not breathing, or

15:01

irreversible cessation of all functions

15:03

of the entire brain, including the brain

15:05

stem. But not all

15:08

the states adopted this definition in exactly

15:10

the same way. New Jersey, for

15:12

example, provides an exemption for

15:15

patients whose religious views might be compromised

15:17

by declaring brain death, so their

15:20

families can ask that doctors use only

15:22

the cardio pulmonary definition, the

15:24

heart and long one, which means that a

15:26

person would be considered dead in one

15:28

state might not be dead

15:30

in another. As

15:38

definitions get more clinical, even

15:40

our fundamental intuitions about death

15:42

can start to give way. We socially

15:45

have defined death as this irreversible

15:47

moment where a person becomes

15:49

lifeless, motionless, and they can never come back

15:51

to life again. But it's important to understand that's just simple

15:54

social and philosophical notions, and

15:56

that as medicine and science have evolved have understood

15:59

that actually death this far more complicated

16:01

than we ever thought it could be. To

16:03

further complicate the question, not all

16:06

of the cells in your body die at the same

16:08

time, So how long does it take

16:10

for the human brain to go offline? If

16:12

you were to be decapitated, would consciousness

16:14

stop instantaneously? That

16:22

question was not at all hypothetical

16:24

when the guillotine was in vogue. The device

16:27

was invented specifically to serve as a humane

16:29

method of execution, which would hardly

16:31

be true if a head severed from its body had

16:33

the chance to appreciate its circumstance.

16:36

In nineteen o five, a physician

16:38

named Gabrielle Bourier conducted

16:40

an experiment. He witnessed

16:42

an execution of a criminal, approached

16:45

the decapitated head and shouted the man's

16:47

name. The doctor said that the

16:49

man's eyelids lifted normally as they

16:51

would in life, the pupils focused,

16:54

and the eyes fixed on his own. Okay,

16:57

trying to play the cool former goth kid over here

16:59

holding steady in her combat boots, But I cannot

17:02

fathom more chilling experience

17:04

on all of the earth than commuting with a severed

17:06

head. It

17:10

may be difficult to demarcate the exact

17:13

threshold where life ends, but of

17:15

course all of us will die eventually,

17:17

and we'll lose people we love too. The

17:20

human animal is fully aware of our own impermanence

17:23

and the fragility of our family and friends, but

17:25

we go ahead and love them anyway. John

17:30

Troyer, the expert and poet who we met

17:32

at the beginning of the show, devoted his career

17:34

to contemplating death and dying. But

17:37

all those years of professional expertise

17:39

didn't prepare him for a big personal

17:41

loss. So

17:43

on July, my

17:47

younger sister, Julie, died from

17:49

brain cancer at age

17:52

a couple of young kids, husband

17:54

lived in Italy, so she died in Italy.

17:57

I was diagnosed in flight July, and

18:00

then, you know, had a year of life and

18:03

it was shocking, and I

18:05

discovered a couple of blind spots that

18:07

I had in the context

18:09

of my sister's dying process, which

18:11

is one it was clear at

18:14

the end of April that she was dying,

18:16

like there was no coming back from where she was the

18:19

cancer of progress. And I

18:21

knew it, My dad knew what, my mom knew it,

18:24

and no one was saying anything about

18:26

dying. Fast forward,

18:29

I will then actually be the person who tells my

18:31

sister she's dying. Used the word dying in

18:34

July of twenty

18:37

eighteen, so sixteen days before

18:39

she dies, and she was already

18:41

in the summer receiving outpatient hospice

18:43

care from a wonderful hospice in Italy. So

18:46

as to why I was actually talking about that, I don't

18:48

know. Partly that's a cultural practice in Italy,

18:50

but too because I think, you know, some of her friends

18:53

just were they were unsure what to say,

18:55

and my brother in law was being told by the counselor

18:57

is like, well, you know, let her ask, And I mean, they're

18:59

a whole lot of things going on involved, and it all

19:02

in a way it makes sense. But I think it was also very important

19:04

to tell Julie she was dying, because

19:06

one I did, and she said, well, yeah, I mean

19:08

I guess I knew, but thank you for saying

19:10

this. And it changed

19:13

then her end of life trajectory and care because

19:16

suddenly then everyone was saying dying

19:18

and it no longer meant that

19:20

we had to pretend, right, how

19:24

does it change it using that word?

19:26

You know? How does that change care well,

19:29

I think. And what I told my sister was, Julie, I

19:31

can tell you you're dying. You're hearing me say dying.

19:34

You have to be the one who says I'm dying

19:36

because everyone needs to hear you saying it, because

19:40

you saying it will make people take it more

19:42

seriously. And she said, okay,

19:44

I understand. Um,

19:48

That'sai. Well I got choked up, but that's

19:51

okay, Um,

19:53

I'm happy to talk about because it's it's

19:56

it's interesting to me that I've gone for so long

19:58

without getting choked up about t story about the one

20:00

thing she said to me that I has

20:04

always stuck with me. You know, she

20:06

says, I would do the same for you, and and

20:09

she would and she would have done the same exact

20:11

thing for me, and I the thing

20:13

that I think this is why I always

20:15

think about it, Like for everything I know

20:18

about death and dying, which is

20:20

perhaps a lot more could be learned

20:22

than on the first to admit that for everything

20:24

I know, when presented

20:26

in this moment, I will always

20:29

wonder why I didn't say what

20:31

was clearly obvious. And and again

20:33

it's not a moment of regret. I just won't

20:36

I don't understand why, fellow

20:49

immortals. Now would be a

20:51

great time to pause this podcast and

20:53

send a text to someone you love. I'm

20:57

gonna

21:00

h While

21:05

Julie was dying, John was

21:07

working on a book called Technologies

21:09

of the Human Corpse. He included

21:11

some poems about his sister, and at

21:13

the end of the book he lists a bunch of questions

21:16

that you can answer now to make choices

21:18

about the way you'd like to die and be memorialized.

21:22

I'm going to paraphrase a few of them here. Think

21:24

about drotting down your responses and sharing

21:27

them with someone you love, or maybe listen

21:29

together and swap answer sheets. Number

21:33

one, the price range

21:35

I would like spent on my funeral is

21:39

Number two? Does someone have

21:41

all your passwords and log ins? If

21:44

so, who? Number

21:47

three are there's certain songs

21:50

you'd like included on your funeral playlist?

21:54

Number four? Do you want

21:56

life support? Under what conditions

21:59

would you like to be removed from it? Number

22:03

five? Do you have an outfit

22:05

you'd like to be dressed in? I

22:13

really like that last one. There's

22:15

this almost universal protocol that dead

22:17

people should be dressed in their Sunday best, But

22:20

I suck in high heels. I want to go

22:22

out in my combat boots. I've

22:24

walked the world in those, I've done

22:26

my best work in them. I've fallen

22:29

in and out of love in them.

22:31

So lace them tight and double not

22:33

them, please, I'm clumsy. Special

22:37

thanks to Dr Troyer for his time and

22:39

his candor John you

22:42

aren't class act. And

22:47

thank you, esteemed listener for hanging out.

22:50

Our time is finite and ever fleeting, and

22:52

so I'm very grateful you've spent some of yours with

22:54

me. Deeply Human is a

22:56

BBC World Service, an American public

22:58

media co production with I Heart Media.

23:06

Many humans of great depth have been involved

23:08

in the making of Deeply Human, so credit

23:11

where it's due to Senior commissioning editor

23:13

Steve Titherington, editors Rich

23:15

Knight and Hugh Levinson, series

23:17

producers Ben Crighton, Sandra Canthal

23:20

and Simon Mabn, producers Monica

23:22

Whitlock, Jemma Nuby and Hannah Moore, researcher

23:25

Beth and head production coordinators

23:28

Janet Staples and Blaze Hesselgren,

23:30

and for making it all sound beautiful. Our

23:33

studio managers James Beard and

23:35

Tom Bricknell, and the composer

23:37

of the deeply human theme that is in your ears

23:39

right now is Nick Thorburn. I

23:48

think I said this already, but I'm Dessa. Thanks, see

23:51

you next time.