death by Sherwin Nuland and Socrates. It has 4 sources.
One of the most mystifying phenomenons that keep most of us wondering is death. For the ordinary individual death is not only a topic that they have no clue about but also that they will never be able to satisfy their curiosity unless they experience it themselves. For medical professionals like Sherwin B. Nuland death is something that they see day in day out but never actually could explain unless they get into the technicality of it. Thus, in essence no one from the time of ancient civilization to the modern technological age could really explain the exact nature of death. They can only in fact attempt to explain the nature, cause and effects of death. There are several factors attached to the reason why death cannot actually be explained but only experienced.
In the following sections, the researcher attempts to explain how Sherwin Nuland’s view of death with dignity does not clearly explains the causes and consequential painful experience of death as compared to the views held by Socrates.
Nuland’s World View
Modern day medical professionals treat the issue of death and dying as a natural process. Doctors can best explain the process of death as the stoppage of the function of the heart and the brain. Furthermore, they attribute the pain and agony of death to the disease that causes death. For these doctors death is the eventual consequence of the deteriorating condition of diseases like AIDS, Alzheimer, cancer and heart attacks etc. By going into the technical side they often negate the mythological aspect of the issue of death. They rule out the emotional factor that is attached with it and thereby eliminate the spiritual healing that is required in coming to terms with death. Thus, it can be said that death cannot be explained simply by recounting the technical aspect neither can it be explained through the mythological understanding that we derive from our ancestors. These two diversified views often confuse people as to what best explain the process of death and how best to cope with it.
To understand, the researcher is of the opinion that one need to clearly understand the theoretical background, that is the notions, ideas, culture and the spiritual views that we have inherit through our western ancestors, as well as the practical view.
In Sherwin B. Nuland’s book “How we die,” the author too offers demythological explanation of the process of death and attribute the fear of death as stemming from individuals lacking from such knowledge. According to Nuland death is unique and “The uniqueness of each of us extends even to the way we die.” (Nuland 3) And at the same time he presents the opinion that death is the end of the chain of events that take place in the life of the individual. Once one learns to accept and understand this chain of events, then death becomes easier. Thus Nuland not only categorizes death as the repercussions of these chain events but they are also responsible shaping the event of death of the individual. Those who do not learn and acquire knowledge about their conditions, they remain fearful of the end and they only add agony to their painful death. Nuland thus offers the world view that how an individual experience death depends on how he/she accepts and come to terms with it through understanding and knowledge.
To illustrate, Nuland narrates his medical view through his patience’s experience of death. For example in the first chapter he narrates of his first patient’s death resulting from a coronary attack and despite his (Nuland’s) attempts, failed to save the patient McCarty (Nuland 4). This first experience has taught him the fact that death is the result of McCarty’s ignorance of his health condition and eventually this ignorance had caused a heart condition that became irreversible. Inadvertently Nuland attributes McCarty’s death as a “bad death” because he considers McCarty minimal effort in perceiving his condition as the main reason for his painful end. From this point, Nuland offers the view that a good death or as most of us categorize as ” ‘Death with dignity’ is our society’s expression of the universal yearning to achieve a graceful triumph over the stark and often repugnant finality of life’s last sputterings.” (Nuland 10).
From Nuland’s “death with dignity” one understand that one should not treat death as the enemy but the final destination as he writes “It is simply an event in the sequence of nature’s ongoing rhythms” (Nuland 10) and therefore must not be considered as the enemy that we must struggle and fight against. Alternatively, he attributes disease as the real enemy that one must combat with. Disease is the “malign force that requires confrontation” (Nuland 10). It is the disease that eventually breaks down the system of the body including the function of the heart and brain. In losing these vital functions, the body then fails to respond to the critical factor that makes a death dignified – that is acceptance. According to Nuland, medical science no doubt offers explanations and information regarding the disease that one is inflicted with but it is the individual who is responsible for understanding and accepts the physical condition in which they are in and therefore enable one to combat the disease either through spiritual healing or mental preparation.
In presenting this view Nuland further introduces the fact that “modern biomedicine has also contributed to the misguided fancy by which each of us denies the certain advent of our own individual mortality” (Nuland 10). He dubs the fact that medical professionals no doubt are well versed in their fields but nevertheless do not have the art of healing as such. This art had been inherent in our ancestors the Greeks; they have been able to determine the death and furthermore enable the individual to transition from life to death (Nuland 12).
Comparison with Plato’s views
Plato in his analysis of Socrates offers similar views. Death according to Socrates “is one of two things. Either it is annihilation, and the dead have no consciousness of anything; or… It is really a change; a migration of the soul from this place to another.” Thus, the Greeks through Socrates also hold the view that death is not a confrontation in actuality but a natural process of transition of the soul. Like Nuland, Socrates offers the view that if one understands this process, then it becomes easier to accept the event of death. In denying it, one is always engaged in fear of the “migration” and consequently only adds to the agony of the same. Socrates does not believe in this but rather prefer that one remain unfearful of death; once that is established in the psyche of the individual he would come to treat it as a mere process that he has to go through. The transition process according to Socrates is the journey of the soul from one environment to the other and fearing it is irrational (Treddenick 2004).
Furthermore, Socrates believes in the survival of the soul and presents the hypothesis that the after life is no different from the life we live in this mortal world. A person is judged by his conduct and if he has good conduct throughout his life he need not fear of this transition process. For example in the Phaedo Socrates present the view that death may and may not be annihilation but it is a logical explanation of the corrective measures one should take to make this journey easy. Thus, death if approached from a practical view can be beneficial and worth risking because in the end it is only fruitful to the individual who experience it. This explanation is given with the view that since individual understand what is ahead (that is the after life) then death becomes one of the events of life which has no mystery attached to it. (Tredennick and Tarrant 1993).
Socrates’ view of death is thus made practical and is similar to Nuland in the sense that it does offers a world view to life and death; it also encourage one acceptance of the eventuality of death rather than considering it as a mystery with the notion of something painful. However, Nuland adds to this view the fact that death is only painful if one is inflicted with a painful disease such as a heart attack or cancer while Socrates limits his view to the demystification of the transition of the soul from one place to another and its acceptance.
Socrates furthermore attaches the painlessness of death with the concept of justice and the conduct of the individual whereas Nuland offers a very pragmatic and scientific view of the same. Individuals are not judged by the moral conduct as Socrates explains but rather on the lifestyle they adopt and their attitude towards the acquisition of knowledge of death. Hence, lies, misconduct, character and injustice are the main components that Socrates attribute to a “good death” while Nuland emphasize on the knowledge that one have to enable one to understand the struggle between disease and death l (Treddenick 2004).
From the above discussion there is no doubt that the above views and analysis of death by both Nuland and Socrates are practical in the sense that it offers one the insight to a dignified death through knowledge. Yet it can be seen that Nuland focuses too much on the technical and medical aspect of the transition of life to death of the body. According to him we lose our dignity once our body fails which result in death. How one experience death depends on how one bears the pain of the disease or the condition in which one lives. Thus, even if one dies naturally as a result of growing old without any affliction Nuland’s explanation does not offer an understanding for them as to why they are painful or peaceful; his explanation although claims to demythologize death as a painful process but it does not offer one an understanding of death by accident that usually result in sudden and painless/painful but without the knowledge or understanding of the victim. Hence, in the researcher’s opinion this aspect of Nuland’s explanation is limited and needs elaboration. It cannot be explained through technical jargon nor through the simple explanation of knowledge acquisition since these individuals may lead a perfectly healthy life without any disease or they may not even be old yet they die suddenly without any premonition. There is no real explanation for its cause and consequence. In this regard, Socrates’ explanation of the conduct of the soul and the resultant painful/painless journey proves more meaningful as it allows one to understand the real essence of life and death both from the pragmatic and spiritual view.
Sherwin B. Nuland. How We Die: Reflections on Life’s Final Chapter. 1993, ISBN: 0679742441
Plato. The Last Days of Socrates. Ed, Hugh Tredennick and Harold Tarrant. New York: Penguin Books, 1993.
Treddenick, Hugh (Tr.). Last Days of Socrates. Accessed on 6-2-2004 at http://lilt.ilstu.edu/drjclassics/texts/Plato/Socrates.shtm
Canavan, Francis. Letting Go: How We Die. First Things 44 (June/July 1994): 54-56.
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