I once knew a couple whose young son was dying. The parents refused to talk with him about it. Perhaps this would not have been a bad strategy had they been able to persuade him that he would live, but they were not. The young boy knew—as people often do, somehow—that his end was near. He wanted to talk, but any time he broached the topic, the mother and father would insist that he would get better; that he wouldn’t die. As a consequence, he not only had to face the prospect of death at a very young age but he had to do it alone.
We often let each other face death alone for similar reasons. People diagnosed with a terminal illness report that friends withdraw and disappear from their lives.
This is, perhaps, not surprising. It is difficult to know what to say. The imminent death of a friend is not a topic one can move to casually, as one might go from discussing the latest news to talking about plans for the weekend. The issue is too solemn and far weightier than we know how to do justice to. Neither do we have suitable conventional expressions we can fall back on when we don’t know what else to say, as we do in many other cases. If a friend has a birthday or has just had a child and you cannot think of anything personal to say, you can always go for a simple if impersonal, “Happy birthday” or “Congratulations.” But what about someone with a fatal diagnosis? “I am sorry to hear that” just won’t cut it when the other’s days are numbered.
Marcel Proust captures both the difficulty and the avoidance strategy well. At one point in his novel In Search of Lost Time, a character named Charles Swann tells another, the Duchesse de Guermantes, that the doctors have given him a few months to live. Just then, the Duchesse is on her way to a party. Proust says the following of her reaction:
“Poised for the first time in her life between two duties as far removed from each other as getting into her carriage to go to a dinner party and showing compassion to a man who was about to die, she could find no appropriate precedent to follow in the code of conventions, and, not knowing which duty to honor, she felt she had no choice but to pretend to believe that the second alternative did not need to be raised, thus enabling her to comply with the first, which at that moment required less effort, and thought that the best way of settling the conflict would be to deny that there was one. ‘You must be joking,’ she said to Swann.”
The Duchesse then gets into her carriage.
How easy or difficult it is to talk about death may depend on how common death is. I suspect it is more difficult today than it was several decades ago. An elderly lady was heard saying recently that when she was young, people often talked about death but hardly ever about sex, while today, they have no qualms about discussing sex but have grown rather weary of mentioning death. I think there is something to that. Our relationship to death today is a bit like Voltaire’s relationship with God—we nod at each other from a distance but do not communicate. One may say, we used to pretend we never make love. Now, we pretend we’ll never die. This suggests another reason we may have to avoid the subject: A dying person makes it difficult for us to keep up the immortality pretense.
It is important to note that the dying too may pretend that it isn’t happening. There is more than one reason for this. First, a terminal condition may be experienced as humiliating, not simply frightening. It is as though the universe has singled us out for misery and misfortune. Though we know in theory that terrible things happen and that such things may happen to us, in practice, we tend to hold a self-protective and perhaps self-flattering belief that somehow, in some way, we’ll be spared. A terminal diagnosis, especially at a young age, shatters this belief, but if one can at least keep up appearances, then no one else will see that the universe has turned its back on us.
There is also a phenomenon that’s the opposite of survivor’s guilt: We may call it “guilt of the diagnosed.” A person with a terminal illness may not want to disrupt the fabric of daily life by dropping a terrible killjoy trump card: the prospect of his or her own death. For if you bring up such a thing, then your friends cannot continue telling you about what they meant to tell you about even if that’s what you’d want them to do. If, by contrast, they behave like Proust’s Duchesse and feign disbelief, they would not be acting as a good person would. But then, what could they do? The dying person may, as it were out of courtesy, avoid putting others in a situation of having to find something appropriate to say. The question remains, however: What should we do if we know another is dying?
Merely acknowledging the situation is not the answer. Sometimes, patients with a terminal diagnosis report a certain “look” on the part of hospital staff, the “I am so sorry you are going to die” look. It is difficult to imagine that this type of pity can help. It might be worse than feigning disbelief, in fact.
What else, then?
I don’t know. But I do know this: Silence can erect a barrier between the dying person and the rest of the world. Others may be there with you but—much like the parents of the dying child in the case I began with—they would not be with you. There is a kind of loneliness that isn’t due to a lack of friends or relations but to the fact a person carries a terrible secret such as an untreatable illness. Those who feel alone on account of a secret are sometimes surrounded by people who love them and whom they love in turn. It is just that burdens borne in private bring isolation in their wake. No matter how many others are in close proximity, it doesn’t matter: you remain alone. There is you, and then there is the rest of humanity.
Albert Camus makes a related point in The Plague. There is a character in the book, a man named Cottard, who has committed a crime for which he expects to be arrested. No one else knows about this, so Cottard carries the burden of his own fear alone. Then there is a plague outbreak in the town, and everyone else is gripped by fear. And for the first time, Cottard does not have to fear alone.
This explains also why the threat of mass extinction may seem less frightening than one’s own imminent demise when no one else is dying. Part of what makes the collective demise case easier to accept is that then, we would be able to talk. Dying would not be such a lonely business. As things stand, we don’t know how to talk about death; not with a person who is dying when we are not.
Perhaps, however, it isn’t as difficult as it seems. While a person may be on his deathbed when his friends are alive and well, none of us is alone in being mortal. If we simply acknowledged this instead of shying away from the topic of death, the barrier I mentioned between the dying person and everyone else would become porous, as it should.
And though we may not know what to say, being there for another need not involve words; not many. Togetherness, after all, is not only about what is said but about what is thought and felt; sharing hopes, fears, or tears. Both dying and losing a loved one are terrible things, but they need not be lonely. Quite the opposite, in fact. Grave misfortune may tear down some walls between people if we let it. Death, however frightening, can be intimate.