Let's talk about death

DEATH ISSUE: Saying goodbye isn't easy, but it's an important part of life. We explore the Bay Area's evolving relationship with the end of life, from Boomer care and Death with Dignity to the "death midwives" movement.

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Image from Paul Koudounaris's book "Heavenly Bodies: Cult Treasures and Spectacular Saints from the Catacombs"

steve@sfbg.com

DEATH ISSUE  Death comes for all of us, sometimes with advanced warning, other times suddenly.

Loved ones get a chance to say goodbye in fewer than half of all deaths, so I was fortunate to see my 92-year-old Grandma Elinor Bonin in the week between her massive heart attack and her passing on Oct. 7. And I was doubly lucky to catch her while she was still fairly stable and lucid, before she went downhill, wracked by pain, fighting for each breath, and wishing for the relief of death.

Her health had been deteriorating for years and she was ready to die, as she told me in her room at Sierra Vista Hospital in San Luis Obispo, the same hospital where my daughter Breanna and I were each born.

Grandma was already suffering from pneumonia and congestive heart failure when she had a massive heart attack in the early morning hours of Oct. 1. The prognosis wasn't good, so she worked with my mom and others to craft an exit plan: creating an advanced care directive with do-not-resuscitate order, setting up home hospice care paid for by Medicare, and going home to die.

"I'm ready," she told me — sweetly if wearily, with a resolute resignation in her voice — as we waited for the ambulance that would take her home from the hospital. "I just don't want to live in agony anymore."

We all want to believe that we'll show that kind of grace, clarity, and courage as we greet death. Society is beginning to wake up to the realization that extraordinary efforts to prolong life as long as possible can be as inhumane as they are costly, finally opening up a long-overdue conversation about death.

As we explore in this issue, the Bay Area is the epicenter for evolving attitudes towards the end of life, from the death midwives movement and home funerals to the complex discussions and confrontations of taboos now being triggered by the Baby Boomers facing death, both their parents' and their own.

"The reality now is we're kickstarting the conversation about death. We're at the very beginning of this," says San Franciscan Suzette Sherman, who just launched www.sevenponds.com, an information clearinghouse designed to elevate the end of life experience. "Death is a wonderful part of life, it's a profound moment."

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Read more about: death midwives, AIDS obit archives, passing pet care, and Death with Dignity in California

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We honor and celebrate death in San Francisco more than they do in most American cities. The AIDS crisis forced San Franciscans to grapple with death in once unimaginable ways. We continue to pioneer comforting passages with programs such as Hospice by the Bay and the Zen Hospice Project.

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