Vivi e morti nella inevitabile spirale …
L’articolo che segue è apparso sul TLS, supplemento del quotidiano inglese The Times, il più antico ed autorevole settimanale letterario europeo. Riguarda la recensione di tre libri usciti di recente che si occupano di questo evento. Triste quanto si vuole, ma fatale ed inevitabile.
Uno degli autori del libro l’ha chiamato “coil”, che in italiano equivale a bobina, rotolo, serpentina, spirale. Insomma, lo sappiamo bene, nessuno sfugge alla sua morsa. Mi sembra utile proporlo in lettura ai miei tre lettori e conservarlo a futura memoria qui su MEDIUM.
Questo che stiamo vivendo è un tempo storico molto particolare, non soltanto perchè è la settimana santa, si “festeggia” il trionfo della Resurrezione sulla Morte, ma sopratutto perchè stiamo vivendo un periodo di guerra ormai da cinquanta giorni. E non sappiamo quanto durerà.
Una guerra voluta, cercata e praticata da uomini i quali, di per sè, sono già condannati in quella ineluttabile “spirale” chiamata “coil”, che riporta tutti, inesorabilmente, alla conclusione della vita.
Siamo tutti i coinvolti nel conflitto. Chi parteggia, il mondo intero, sembra voglia “anticipare” l’uscita dal mondo, andare incontro a quella che qualcuno chiamò “sorella morte”. Un paradosso, ma solo in apparenza.
Gli autori di questi tre libri hanno cercato di spiegare le cose. Sì, perchè ogni uomo nasce e finisce a proprio modo, ma sempre alla stessa maniera, finendo in quella inevitabile “spirale”.
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Andrew Doig: THIS MORTAL COIL - A history of death
384pp . Bloomsbury. £25.
An entertaining, eye-opening work of popular history that illuminates how death has changed across time
Dementia, heart failure and cancer are now the leading causes of death in industrialised nations, where life expectancy is mostly above 80. A century ago, life expectancy was about 50 and people died mainly from infectious diseases. In the Middle Ages, death was mostly caused by famine, plague, childbirth and war. In the Palaeolithic period, where our species spent 95% of its time, we frequently died from violence and accidents.
Causes of death have changed irrevocably across time. In the course of a few centuries we have gone from a world where disease or violence were likely to strike anyone at any age, and where famine could be just one bad harvest away, to one where excess food is more of a problem than a lack of it. Why is this? Why don’t we die from plague, scurvy or smallpox any more? And why are heart attacks, Alzheimer’s and cancer so prevalent today?
This Mortal Coil explains why we died in the past, the reasons we die now and how causes of death are about to profoundly change. University of Manchester Professor Andrew Doig provides an eye-opening, global portrait of death throughout time, looking at particular causes of death — from infectious disease to genetic disease, violence to diet — who they affected, and the people who made it possible to overcome them.
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Un’opera di storia popolare divertente e illuminante che illumina il modo in cui la morte è cambiata nel tempo.
Demenza, insufficienza cardiaca e cancro sono oggi le principali cause di morte nei paesi industrializzati, dove l’aspettativa di vita è per lo più superiore a 80. Un secolo fa, l’aspettativa di vita era di circa 50 anni e le persone morivano principalmente per malattie infettive. Nel medioevo la morte era perlopiù causata da carestie, pestilenze, parto e guerre. Nel Paleolitico, dove la nostra specie trascorreva il 95% del suo tempo, si moriva frequentemente per violenze e incidenti.
Le cause della morte sono cambiate irrevocabilmente nel tempo. Nel corso di alcuni secoli siamo passati da un mondo in cui la malattia o la violenza potevano colpire chiunque a qualsiasi età, e dove la carestia poteva essere solo un cattivo raccolto, a uno in cui il cibo in eccesso è più un problema che una mancanza di esso. Perchè è questo? Perché non moriamo più di peste, scorbuto o vaiolo? E perché gli attacchi di cuore, l’Alzheimer e il cancro sono così diffusi oggi?
Questa spirale mortale spiega perché siamo morti in passato, i motivi per cui moriamo ora e come le cause della morte stanno per cambiare profondamente.
Il professor Andrew Doig dell’Università di Manchester fornisce un ritratto globale e illuminante della morte nel tempo, esaminando le cause particolari di morte, dalle malattie infettive alle malattie genetiche, dalla violenza alla dieta, chi hanno colpito e le persone che hanno reso possibile superare loro.
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Katie Engelhart: THE INEVITABLE - Dispatches on the right to die
352pp. Atlantic. £15.99.
As much of the world’s population grows older, the quest for a “good death,” has become a significant issue. For many, the right to die often means the right to die with dignity. The Inevitable moves beyond margins of the law to the people who are meticulously planning their final hours — far from medical offices, legislative chambers, hospital ethics committees, and polite conversation — and the people who help them, loved ones or clandestine groups on the Internet known as the “euthanasia underground.”
Katie Engelhart, a veteran journalist, focuses on six people representing different aspects of the debate. Two are doctors: a California physician who runs a boutique assisted-death clinic and has written more lethal prescriptions than anyone else in the U.S.; an Australian named Philip Nitschke who lost his medical license for teaching people how to end their lives painlessly and peacefully at “DIY Death” workshops. The other four chapters belong to people who said they wanted to die because they were suffering unbearably — of old age, chronic illness, dementia, and mental anguish — and saw suicide as their only option. Spanning Australia, North America, and Europe, Engelhart presents a deeply reported portrait of everyday people struggling to make hard decisions, and wrestling back a measure of authenticity and dignity to their lives.
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Poiché gran parte della popolazione mondiale invecchia, la ricerca di una “buona morte” è diventata un problema significativo. Per molti, il diritto a morire spesso significa il diritto a morire con dignità. The Inevitable si sposta oltre i margini della legge verso le persone che stanno pianificando meticolosamente le loro ultime ore, lontane da studi medici, camere legislative, comitati etici ospedalieri e conversazioni educate, e le persone che li aiutano, i loro cari o i gruppi clandestini su Internet conosciuto come “l’eutanasia sotterranea”.
Katie Engelhart, una giornalista veterana, si concentra su sei persone che rappresentano diversi aspetti del dibattito. Due sono medici: un medico della California che gestisce una clinica di morte assistita boutique e ha scritto più prescrizioni letali di chiunque altro negli Stati Uniti; un australiano di nome Philip Nitschke che ha perso la licenza medica per aver insegnato alle persone come porre fine alla propria vita in modo indolore e pacifico nei seminari “Morte fai-da-te”. Gli altri quattro capitoli appartengono a persone che hanno detto di voler morire perché soffrivano insopportabilmente, di vecchiaia, malattie croniche, demenza e angoscia mentale, e vedevano il suicidio come la loro unica opzione. Attraverso l’Australia, il Nord America e l’Europa, Engelhart presenta un ritratto profondamente riportato di persone comuni che lottano per prendere decisioni difficili e che lottano per restituire una misura di autenticità e dignità alle loro vite.
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Hayley Campbell - ALL THE LIVING AND THE DEAD - A personal investigation into the death trade, 288pp. Bloomsbury. £18.99.
We are surrounded by death. It is in our news, our nursery rhymes, our true-crime podcasts. Yet from a young age, we are told that death is something to be feared. How are we supposed to know what we’re so afraid of, when we are never given the chance to look?
Fuelled by a childhood fascination with death, journalist Hayley Campbell searches for answers from the people who choose to make a living by working with the dead. Along the way, Campbell encounters funeral directors, embalmers, a man who dissects cadavers for anatomy students, and a former executioner who is responsible for ending 62 lives. She sits in a van with gravediggers who have already dug their own graves, holds a brain at an autopsy, visits a cryonics facility in Michigan, and goes for late-night Chinese with a homicide detective.
Through Campbell’s probing, reverent interviews with these people who see death every day, Campbell pieces together the psychic jigsaw to ask: Why would someone choose a life of working with the dead? And what does dealing with death every day do to you as a person?
A dazzling work of cultural criticism, All the Living and the Dead weaves together reportage with memoir, history, and philosophy, to offer readers a fascinating look into the psychology of Western death.
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Siamo circondati dalla morte. È nelle nostre notizie, nelle nostre filastrocche, nei nostri podcast sui crimini veri. Eppure, fin da piccoli, ci viene detto che la morte è qualcosa da temere. Come facciamo a sapere di cosa abbiamo tanta paura, quando non ci viene mai data la possibilità di guardare?
Alimentata dal fascino infantile per la morte, la giornalista Hayley Campbell cerca risposte dalle persone che scelgono di guadagnarsi da vivere lavorando con i morti. Lungo la strada, Campbell incontra direttori di pompe funebri, imbalsamatori, un uomo che seziona cadaveri per studenti di anatomia e un ex boia responsabile della fine di 62 vite. Si siede in un furgone con becchini che hanno già scavato le proprie tombe, tiene un cervello a un’autopsia, visita una struttura crionica nel Michigan e va a fare cinese a tarda notte con un detective della omicidi.
Attraverso le interviste riverenti e indagatrici di Campbell con queste persone che vedono la morte ogni giorno, Campbell mette insieme il puzzle psichico per chiedere: perché qualcuno dovrebbe scegliere una vita di lavoro con i morti? E cosa fa per te come persona affrontare la morte ogni giorno?
Un’abbagliante opera di critica culturale, All the Living and the Dead intreccia reportage con memorie, storia e filosofia, per offrire ai lettori uno sguardo affascinante sulla psicologia della morte occidentale.
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L’articolo del TLS qui in inglese. Buona lettura!
In Sophocles’ tragedy Antigone, performed in Athens around 441 BCE, the Chorus sings optimistically of the technological achievements by which humans have dominated the natural world: agriculture, sailing, horse-breaking, hunting, law, language and city-building. Death, the Chorus suggests, is the only element of nature that human mastery has failed to tame — despite the great advances of medical science. “Only from Hades humans will not find escape — / but they discovered ways to flee from unmanageable diseases.” Any “escape” or “flight” (pheuxis… phuga) from death is only ever temporary, and death resists human means of control.
In the millennia since the tragedian died of old age in his nineties, humans have discovered far more temporary exit routes from death than were known even to the finest doctors of Sophocles’ time. Andrew Doig’s This Mortal Coil shows how medical and technological advances have enabled modern humans to escape from a large number of the things that used to kill vast numbers in infancy, although, as he partly acknowledges, we have also created or enabled plenty of new ways to die. The most compelling section of the book is the account of infectious diseases, which describes how antibiotics and modern understanding of the need for clean water and sanitation have postponed billions of deaths. It is salutary to be reminded, for example, of how many people, mostly children, died of measles every year before the advent of the now standard vaccination programmes. But we have been saved from only a subset of the most deadly diseases and viruses of the past, while others are growing in power — such as dengue fever or the many variations on Covid-19. Presumably, many of the new causes of death in the twenty-first century will be the result of natural disasters (floods, storms, fires, tornadoes), as well as wars and migration caused by climate change. All four horsemen of the apocalypse are coming for us.
Doig has training in medical science, not history, politics, sociology or philosophy. His brave attempt to sketch a complete global history of death in fewer than 400 pages focuses primarily on medical technological advances, and his various attempts to interweave nuggets of cultural history tend to be broad and unconvincing. He discusses the Babylonian Code of Hammurabi, for example, in a couple of schematic paragraphs, and concludes that “human nature” and “what counts as a crime” have remained more or less constant for the past 4,000 years. It might have been better to leave ancient Babylon out of it and focus more precisely on modern medical science.
More disturbingly, Doig several times appears to skirt uncomfortably close to suggesting that disability is necessarily a fate worse than death, and one from which science will eventually save us. Without this repellent assumption, the long discussion of Down syndrome — which is not a fatal condition — surely has no place in a book about death. The claim that “soon we will have to address the ethical issues” entailed by new research into DNA editing is unintentionally horrifying; “soon” is much too late to start worrying about eugenicist uses of medical science.
Doig adopts a triumphally optimistic attitude towards the miracles that can be achieved through a combination of technical achievement and individual willpower, which will “hopefully” ensure that smoking, alcoholism, drug addiction, deaths by violence and diet-related illnesses eventually decline or disappear. Doig says little to acknowledge that these challenges cannot be adequately analysed, let alone cured, from a purely medical perspective, and he does not grapple with the dangers created by the medical and pharmaceutical professions in the late twentieth and twenty-first centuries through the overprescription of drugs and the overperformance of surgical procedures. Doig often uses the word “we” incautiously to refer to the relatively privileged inhabitants of rich industrialized countries — as in the claim that “science is why we live in the healthiest and wealthiest period that we have ever had”. A “global” history of death throughout all time and space ought not, ideally, to have an appendix of life-expectancy data focused only on the United Kingdom. The idea that “we” have “largely overcome” “famine and war” would be a welcome surprise to some human inhabitants of the world, and seems implausible as a prediction of the global future. Doig declares blithely that, once the science of disease is understood, “we can devise solutions” — as if poverty could be banished with the wave of a pen.
This Mortal Coil treats death largely as a matter of statistics. By contrast, Katie Engelhart’s study of end-of-life choices centres on the experience of human beings, in all its muddle and complexity. The Inevitable focuses on six individuals, two of whom work to support those who may want help to take their own lives, and four who are contemplating death because of old age, memory loss, pain and physical disability, and mental illness. All six protagonists are clearly indivuated and vividly characterized. Motivations are convincingly represented as mixed and often far from rational, even as they contemplate what is sometimes called “rational suicide”. At this point, I’d like to say that if you are having suicidal ideation for any reason, please call a suicide prevention hotline or a mental health professional; for most people this is a dangerous but temporary and treatable condition, and there is help available.
The debatable idea that one can choose death at the “right” time, to create the “proper” end to the narrative of one’s own life, has a long philosophical history. It is associated especially with the ancient Stoics. The Stoic-influenced Roman writer Seneca repeatedly insists that the power to die ensures that a person can always retain autonomy and, hence, dignity, however challenging the circumstances. As Hercules’ wife, Megara, declares in Seneca’s tragedy Hercules Furens, when she is threatened by a villainous tyrant, cogi qui potest nescit mori: “One who can be forced does not know how to die”.
Unfortunately, as Engelhart’s book vividly shows, many of us do not, in fact, know how to die, especially in the moments when we might in theory most wish to “play the Roman fool”, as Macbeth puts it. For many people, through no fault of their own, it is difficult or impossible to exercise what some modern philosophers describe as the “right” to die at a time of our choosing. If we develop moderate or severe dementia, we may lose the capacity to plan for our own death — a process that is, as Engelhart’s study shows, far harder in the modern world than it was when Seneca sipped his legally acquired cup of hemlock and died comfortably in a hot bath, with the help of several aides, many of them enslaved. Chosen death is more difficult for many people in rich societies even than a generation ago, when it was possible to poison oneself with relative ease in an oven or a car. Many of those who live under the life-prolonging protections of expensive modern medicine will be kept alive far longer than would have been conceivable even a century ago; an inability to die can be a function not of our own cowardice or incompetence, but of the medical expertise celebrated so effusively by Doig.
Engelhart’s study makes an excellent follow-up to Atul Gawunde’s Being Mortal (2014), which evokes how difficult it is for modern medical professionals to let anyone die, even if the patient may be ready for the end. If we are physically disabled — as most of us are to varying degrees, and will be increasingly so in the course of our lives, if we live past youth — we may not be able to make our way unassisted through any of the possible exits from life, and a painless, peaceful death may be far harder to achieve for ourselves than for a beloved old dog or cat. “Death with dignity” or “physician-assisted suicide” — the terms are much contested — is legal only in Canada, Switzerland, Belgium, the Netherlands and some states in the US, and only with many provisions that make the choice unavailable for most people (not least, in the US, those without health insurance).
As The Inevitable beautifully demonstrates, there are no easy answers in the cultural debate about when, how and whether people should have the right to choose to end their own lives in the most dignified and painless way possible. There are also no easy answers about whether there is ever a “rational” reason to take one’s own life. Engelhart vividly evokes the experience of a retired British academic named Avril, who orders lethal drugs from Mexico to end her life of chronic weakness, discomfort, incontinence and pain, at significant expense and after doing a significant amount of research. The self-chosen death of this white, highly educated, highly intelligent woman is, as Engelhart recognizes, a mark of privilege, unlikely to be available to others living with the same conditions. But the idea of making “rational suicide” more widely available has dangerous, potentially horrifying social and political implications.
A law that suggests death is “rational” for old or disabled or chronically ill people risks endorsing the repellent idea that certain categories of people ought not to be alive. Such laws risk creating social pressure and financial incentives for disabled, ill and elderly people to choose death, or have it chosen for them. Old age, sickness and disability are expensive, and modern societies, most obviously the US, have entirely failed to provide adequate care for those whose lives are extended by modern medicine. One of the most chilling threads in Engelhart’s book is that several of her subjects want to die in order to save money, or out of loneliness or preventable kinds of discomfort; as she asks one of the medical “providers”, “What kind of society do we live in to make people feel like burdens?”
The idea of “rational suicide” often hinges on the idea that there is a single true or authentic self, one true set of motives and stories about a person’s life — and this is ideally a narrative with the shit and mess and confusion edited out. Engelhart reminds us that we all contain multitudes, and that the sick, disabled, insane or demented versions of “me” may be no less authentic, no less human, and no less entitled to life. Several of the people in this account express a desire to die, only to postpone the end, or change their minds repeatedly, unable to “wean” themselves “off life”. The Inevitable is impressive for its author’s willingness to acknowledge mixed and murky motives: she vividly evokes a physically healthy young man whose desire to die is motivated by long-standing mental anguish, but also a desire for fame and an easy path to heroism as an advocate for his disturbing cause.
Engelhart’s book evokes the isolation often suffered by those who are dying or hope to die, who may lack people to care for them either in life or in their journey to death. All the Living and the Dead, Hayley Campbell’s study of those who work with the deceased, picks up where Engelhart leaves off, focusing on the invisible labour and care provided by funeral directors, embalmers, gravediggers and post-mortem medical examiners to people most of us do not want to see: the dead. Modern societies are peculiar in the degree to which we segregate the dead from the living. By contrast, ancient literature often centres on the need to care for the dead. The final sequence of the Iliad hinges on the desire of the enraged Achilles to deprive his dead enemy, Hector, of the care and honour his family can give him in death. The care for the dead, in Homer, is the work of all women, who wash and lay out and weep for dead loved ones, but also of all men, who fight and kill to defend dead comrades from desecration and dishonour. The most common Homeric images for death — an untying of the limbs, a veil of darkness cast over the eyes — suggest a change of state and abilities, but a lack of personhood. The dead Hector is still “Hector”: not the “body of Hector”, not a corpse, an empty shell, a horror or an abomination, but a person, a killer, husband, warrior and son. The care and memorialization provided by the living can preserve for the dead, as far as possible, the social position they had in life.
In Greek and Roman antiquity, as in many other cultures around the world, the wealthy hired professional mourners to sing and scream laments for the dead. In most modern societies, tears for the dead are shed only by those who knew them; but the physical care needed by the deceased is delegated to paid strangers. These workers’ largely invisible labour has to accommodate our peculiar modern desire to mourn the dead without having to touch them. Campbell’s fascinating study of the manifold workers who do lay hands on the dead is eye-opening, not least for its careful demonstration that, even in our disconnected societies, the care of the dead is not fundamentally different from the care of the living. Like carers and nurses and nannies, who look after the sick, the disabled, the very old or the very young, those in all branches of the death industry are providing care, cleanliness, order and dignity for those who are physically unable to provide these things for themselves. Campbell vividly evokes the careful way the man working with corpses donated to the Mayo Clinic restored a hundred transplanted faces back to their proper heads after a medical team had used them to practise for a living person’s face transplant — not because the families of the dead would ever know what fragments of their original cells are burnt to ashes in the crematorium, but because of his own sense of what is right.
A book about corpses might seem like a downer. Worse, the subject risks creating melodrama or glib horror out of grief. But All the Living and the Dead is surprisingly cheerful, even life-affirming. This is partly thanks to Campbell’s open-hearted, observant style of writing, which manages to be vivid without sensationalizing the horrors she records. Describing a collection of severed hands, she comments that hands are “the things that people held, they’re the thing we’re supposed to know the back of better than anything”. She also makes her own history and emotions present on the page, tracing her evolution from a childhood as the peculiar, death-obsessed daughter of a cartoonist (Eddie Campbell, who illustrated From Hell, featuring Jack the Ripper), through her years as a teenager in the early years of snuff videos and gory imagery on the internet, to the adult who shows tenacity and compassion in her attentiveness to her interview subjects. Campbell’s interest in death is not morbid, but humane and curious. She wants to know how people manage to care for other people — even the dead, the ultimate outcasts. Sophocles’ Antigone follows a fundamental need to care for a dead brother, even one who has become an enemy to the city; Campbell shows how death workers in a variety of modern professions provide similarly heroic care.
Her central goal is to break down the sharp boundaries between the binary in her title, allowing more of us to recognize the humanity of the dead and of those who care for them. She describes long hours spent observing corpses, whole and fragmentary, in every state of decay, and interviewing those who work with them. According to Campbell, many find a deep sense of purpose in their work; they are aware of providing an entirely necessary service, albeit one that is often invisible to the public. The former police officer whose job involves gathering and identifying fragmentary human remains from the mass casualties caused by plane crashes or natural disasters understands that he can give something immensely valuable not only to the families of the victims, but even to the dead themselves: “People deserve their identity, even after death. You know?”. Similarly, Campbell evokes a pathologist who knows that, through her work with her “patients”, she is giving “voice to the voiceless”, providing a narrative, a cause and a memory for people who may otherwise be forgotten. One of the most moving chapters focuses on a midwife who specializes in stillbirth and miscarriage, whose work involves normalizing parents’ pain and trauma, and witnessing the existence of the dead who never drew breath, naming them as “your baby”.
The death workers who, in Campbell’s account, have least job satisfaction are those whose labour erases the deceased rather than honouring them. The man whose job involves scrubbing bloodstains and pieces of brain from homes where violent deaths have occurred views the dead as a messy, smelly cause of trash, albeit a lucrative one, and he is an angry, cold man who treats his work as a way to earn money, not a calling. One of the most fascinating chapters deals with an executioner who pushed the button to cause dozens of lethal injections. This pleasant, friendly man is unable to acknowledge, let alone discuss, what he has done; God, not the executioner, must be responsible for these deaths.
A different ambiguity surrounds the embalmers, whose job involves disguising the process of decay, but who also work intimately with the dead, to present them to their loved ones as themselves. Campbell evokes the violence incurred in a set of processes designed to align death with modern bureaucracy and convenience. She also acknowledges that the workers who stitch tongues to jaws and pump chemical toxins through dead blood vessels are providing something more than an illusion: they offer the opportunity to recognize the living in the dead.
For Campbell, the most disturbing moment comes after she has seen many dead bodies and parts of bodies, many severed limbs, cracked skulls and exposed internal organs. The one she is unable to forget is a whole dead baby, awaiting autopsy in a bathtub. The horror seems to come, like a scene from the uncanny valley, because it is so close to something in the world of the living. Careful bathing in a tub is part of this baby’s care, as for any other — except that this baby has his head fully submerged. Campbell’s gripping study offers a compelling reminder that the dead, and those who care for these most vulnerable of “patients”, are closer than we might have wanted to believe. Late or soon, by our own volition or by natural means, we will all join their number. All of them, all of us, deserve to be seen, honoured and remembered.
Emily Wilson is a Professor in the Department of Classical Studies and Chair of the Program in Comparative Literature and Literary Theory at the University of Pennsylvania. Her verse translation of the Odyssey was published in 2017
Times Literary Supplement — April 15, 2022
