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The Lost Art of Dying: Reviving Forgotten Wisdom
A Columbia University physician inspires us to rethink death and offers insights on how we can learn to embrace the art of dying well in this wise, clear-eyed book that is as compelling and soulful as Being Mortal, When Breath Becomes Air, and Smoke Gets in Your Eyes.
As a specialist in both medical ethics and the treatment of older patients, Dr. Lydia Dugdale knows a great deal about the end of life. Far too many of us die poorly, she argues. Our culture has overly medicalized death: dying is often institutional and sterile, prolonged by unnecessary resuscitations and other intrusive interventions. We are not going gently into that good night—our reliance on modern medicine can actually prolong suffering and strip us of our dignity. Yet our lives do not have to end this way.
Centuries ago, in the wake of the Black Plague, a text was published offering advice to help the living prepare for a good death. Written during the late Middle Ages, Ars moriendi—The Art of Dying—made clear that to die well, one first had to live well. When Dugdale discovered this Medieval book, it was a revelation. Inspired by its holistic approach to the final stage we must all one day face, she draws from this forgotten work, combining its wisdom with the knowledge she has gleaned from her long medical career. The Lost Art of Dying is filled with much-needed insight and thoughtful guidance that will change our perceptions. Dr. Dugdale offers a hopeful perspective on death and dying as she shows us how to adapt the wisdom from the past to our lives today.
Part of living well means preparing for the end, Dr. Dugdale reminds us. By recovering our sense of finitude, confronting our fears, accepting how our bodies age, developing meaningful rituals, and involving our communities in end-of-life care, we can discover what it means to both live and die well.
Illustrated with 10 black-and-white drawings throughout, The Lost Art of Dying Well is a vital, affecting book that reconsiders death, death culture, and how we can transform how we live each day, including our last.
As a specialist in both medical ethics and the treatment of older patients, Dr. Lydia Dugdale knows a great deal about the end of life. Far too many of us die poorly, she argues. Our culture has overly medicalized death: dying is often institutional and sterile, prolonged by unnecessary resuscitations and other intrusive interventions. We are not going gently into that good night—our reliance on modern medicine can actually prolong suffering and strip us of our dignity. Yet our lives do not have to end this way.
Centuries ago, in the wake of the Black Plague, a text was published offering advice to help the living prepare for a good death. Written during the late Middle Ages, Ars moriendi—The Art of Dying—made clear that to die well, one first had to live well. When Dugdale discovered this Medieval book, it was a revelation. Inspired by its holistic approach to the final stage we must all one day face, she draws from this forgotten work, combining its wisdom with the knowledge she has gleaned from her long medical career. The Lost Art of Dying is filled with much-needed insight and thoughtful guidance that will change our perceptions. Dr. Dugdale offers a hopeful perspective on death and dying as she shows us how to adapt the wisdom from the past to our lives today.
Part of living well means preparing for the end, Dr. Dugdale reminds us. By recovering our sense of finitude, confronting our fears, accepting how our bodies age, developing meaningful rituals, and involving our communities in end-of-life care, we can discover what it means to both live and die well.
Illustrated with 10 black-and-white drawings throughout, The Lost Art of Dying Well is a vital, affecting book that reconsiders death, death culture, and how we can transform how we live each day, including our last.
272 pages, Hardcover
First published January 1, 2020
About the author
Lydia S. Dugdale
3 books11 followersLydia Dugdale, MD, is an internal medicine physician and Associate Director for the Program for Biomedical Ethics at Yale School of Medicine.
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Displaying 1 - 30 of 133 reviews
August 4, 2020
This is an excellent book by a medical doctor about the ways we used to die and how we could improve things today. Dugdale goes into the practices that were once employed and how they helped not just the dying but those who attended them in accepting, understanding and preparing for their own eventual deaths. She talks about the patients and their families who have had her repeatedly resuscitate them when it is clearly too late and prolong their deaths by miserable days hooked up to machines. She also talks about how hospitals were never a place for dying (or even being sick) until recently, and how she believes they should only be a place for urgent care. She presents a detailed look into some rituals that are used after deaths and how healing and helpful they can be for everyone involved, and also offers guides to know when it's wise to keep on with interventions and when it's not, among many other things. She also tells the stories of the deaths of many people she's known as a doctor and a loved one over the years, and uses these to teach lessons in preparing well for death. The book is not gloomy despite its title, and offers an interesting and helpful look at a topic we all need to think about, like it or not. I'll definitely keep much of it in mind moving forward.
I read a digital ARC of this book for review.
I read a digital ARC of this book for review.
July 11, 2020
A doctor's viewpoint on death. I've already read a couple of books about death written by another author Caitlin Doughty, which I loved. This book was fine but compared to the others I read, it just wasn't as good. I did learn a few new things about how hospitals work, but there were a lot of big questions asked in this book, with no attempt to offer answers.
July 15, 2020
I really enjoyed The Lost Art of Dying. Which feels weird to say considering the dark and depressing subject matter! I’ve always been fascinated with death and this book offers an in-depth look into topics such as how to “die well” and the ways in which different cultures/religions prepare the dead for burial. We have become so afraid of death that we avoid any talk or mention of dying, so much so that we fail to prepare for the inevitable. This is a great book for anyone who wants to explore the messy reality of dying, how to process their own finitude, and reflect on the over-medicalization of death and how this came to be. I couldn’t put this book down (even if it made me have a small existential crisis) and I think it’s such an important subject that should be openly discussed more often!
Thank you so much to TLC Book Tours and HarperOne for my gifted copy in exchange for an honest review!
Thank you so much to TLC Book Tours and HarperOne for my gifted copy in exchange for an honest review!
December 6, 2021
While enlightening and straight-forward, I feel like this book ended up beating a dead horse by the end. It was only 200 pages, taking me only about three hours to finish, but the three main concepts of the book were explained well enough in the first three chapters (about half the book). Perhaps because I am very familiar with the process of hospitalization of dying patients, as I worked in the EMS field for three and a half years, I feel like this was a bit redundant in the back half.
January 8, 2022
only because there were moments that i wish had been further expanded upon, and a variety of historical, cultural, and spiritual perspectives beyond the author's and those in the author's proximity that i would have loved to see taken into account. but definitely a "clear-eyed...compelling and soulful" book in every sense of those words.
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November 6, 2020The Lost Art of Dying provides a simple, and compassionately disarming, framework for how death has been historically considered from sociological, theological, and medical angles, and asks how we might benefit when reflecting on our personal encounters with the dying process. The deposit of wisdom in Dugdale’s retrieval of the ars morendi philosophy assumes a distinctively Augustinian character in my reading, as the virtues espoused throughout are littered with personal anecdotes of how practical commitments throughout one’s life can shape the desire for a more authentic reckoning with dying before that taking that last bow. Whether it’s her encouraging of humility through the inclusion of family when rehearsing for one’s final moments or her reimagining of ancient rituals such as tahara or shivah in Jewish communities for a more generative mourning process, there’s a pattern in Dugdale’s writing that decenters the singular experience of mortality in favor of an intentionally communal one. The result is an assuaging of fear with an invitation to thankfulness, an art that surely demands a lifetime to master.
September 2, 2020
I appreciated the physician’s perspective here, rooted in the humanities, theology and history. As a historian, I’m familiar with the ars moriendi and its great to see someone make use of it and connect us to this long tradition.
Her main point is we need to talk and prepare for this more, and root ourselves in community as we live. I might like more of a manual for the conversations to have with our loved ones as we age/get ill, but that wasn’t the point.
I also suspect that as a Christian, she is reminding those who don’t value the sorts of rituals, values and community of the Christian faith that those are important. She wants to point people to the importance of life and death and those issues beyond the materiality of our bodies.
I’m reading this in companionship with Swinton on Dementia and it was great to to be pushed to think about what gives human values and to be chastised for focusing too much on productivity.
I read it with my nurse husband and her stories provoked lots of conversations about what happens in hospitals. I was also very aware that she’s very much coming from a medical perspective and the NURSING view of human/patient care is different and she basically ignores nurses throughout the narrative. Perhaps if doctors listened more to nursing theory they would have more of the corrective that she’s going for.
Her main point is we need to talk and prepare for this more, and root ourselves in community as we live. I might like more of a manual for the conversations to have with our loved ones as we age/get ill, but that wasn’t the point.
I also suspect that as a Christian, she is reminding those who don’t value the sorts of rituals, values and community of the Christian faith that those are important. She wants to point people to the importance of life and death and those issues beyond the materiality of our bodies.
I’m reading this in companionship with Swinton on Dementia and it was great to to be pushed to think about what gives human values and to be chastised for focusing too much on productivity.
I read it with my nurse husband and her stories provoked lots of conversations about what happens in hospitals. I was also very aware that she’s very much coming from a medical perspective and the NURSING view of human/patient care is different and she basically ignores nurses throughout the narrative. Perhaps if doctors listened more to nursing theory they would have more of the corrective that she’s going for.
April 17, 2023
Dying. We all do it. And yet, the concept of our own death is so unfathomable.
Modern, western society has completely sanitized death and swept it under the rug. We rarely have to see it or experience it with someone as they are going through it.
I appreciate this book for stripping back all of the layers and laying death bare, as people experienced it for centuries before our era.
I can’t say after reading this book that I’m exactly prepared to die, but I certainly understand the art of dying well and the fact that you cannot die well without living well.
I have a lot to address and questions to answer. This book is an excellent reminder of our mortality and how to come to peace with it.
I’d recommend this book for anyone, especially anyone experiencing a long term illness or caring for someone who is.
Modern, western society has completely sanitized death and swept it under the rug. We rarely have to see it or experience it with someone as they are going through it.
I appreciate this book for stripping back all of the layers and laying death bare, as people experienced it for centuries before our era.
I can’t say after reading this book that I’m exactly prepared to die, but I certainly understand the art of dying well and the fact that you cannot die well without living well.
I have a lot to address and questions to answer. This book is an excellent reminder of our mortality and how to come to peace with it.
I’d recommend this book for anyone, especially anyone experiencing a long term illness or caring for someone who is.
June 21, 2023
A few interesting points about death but nothing groundbreaking. People need to talk more about dying. Reflect on your own mortality today and every day :)
May 16, 2023
This was a really interesting and thought-provoking read. It strikes me that how one approaches their own death says A LOT about how they lived their life.
July 6, 2020
Summary: A physician challenges our over-medicalized treatment of the dying, advocating a recovery of the "art of dying," which also makes it possible to live well.
He died three times in one night. Mr. Turner was an elderly man dying of metastatic cancer that had invaded much of his body. But the family insisted everything be done to keep him alive. So when he "coded," much of the hospital mobilized to resuscitate him. Chest compressions broke frail ribs. Breathing tubes were inserted. Injections of powerful drugs were injected to restart the heart. This happened twice more that night. The final time, the team worked twenty minutes to no avail. Mr. Turner was pronounced dead. The author, one of the physicians on this team asks whether this is a good way to die.
This incident, during her residency, began a process of questioning about what it meant to die well, leading to her discovery of the Ars Moriendi, The Art of Dying, a fourteenth century handbook arising out of the plagues, when anyone might expect to die an early death. Dying well begins with recognizing one's finitude, reckoning on and appropriately planning for one's death. Dying well happens best in community, where the dying acknowledges wrongs and seeks forgiveness, where love is expressed, and where bystanders rehearse their own death. Dugdale also talks about how context matters, and the preference where appropriate care can be given, for death at home, and in the hospital, only when that affords the best care.
Often our inability to die well, and the actions that hinder dying well reflect our fear of death. She confronts the real terror, even for the religious, of the unknown void of death. Dugdale's counsel is that each of us has to wrestle with what it means to die into life. In an extended reflection on the Isenheim Altarpiece, she considers what happens to the body in disease and death--its corruption into dust. She describes the reality summarized in one terrified patient's words--"I don't know what I believe"--and the vital work of facing the existential questions of meaning to both live and die well.
Her final chapters describe the rituals that follow death, and the wisdom in the Jewish tradition around grief. She concludes with some recommendations that might form a modern Art of Dying. Think twice about hospitalization. Discern when further treatment is futile. Live well at the end through good, and early, palliative care when death is imminent. Reconsider resuscitation. Start giving away your stuff. Live with purpose. Die in community.
The book concludes with a series of ink drawings by Michael W. Dugger, similar to the woodcuts in the original Ars Moriendi around the themes of each chapter of the book. They are a fitting way to invite us to reflect once more on this book's message: we desperately need to recover the art of dying well. It isn't to be found in the over-medicalized, hospital-centric practices of our modern way of death. Nor is it to be found in the denial of our finitude, our efforts to suppress our fears.
This book gives much to think about in our current pandemic, including the terrible tragedy of how it results in lonely deaths. A blessing upon the caregivers who treat the dying with dignity and compassion! It also makes me wonder if our inability to pursue for an extended time the disciplines that guard our health and that of our neighbors reflects the fact that we haven't done the work of preparing to die well. We act as if we are invulnerable. We risk our lives for a night of clubbing. To not adequately reckon with death is to not adequately treasure the gift of the life we have, the community with whom we share it, and betrays the thinness of our efforts to consider the existential questions of life. All this suggests that this book could not have come at a better time.
________________________________
Disclosure of Material Connection: I received a complimentary review copy of this book from the publisher. The opinions I have expressed are my own.
He died three times in one night. Mr. Turner was an elderly man dying of metastatic cancer that had invaded much of his body. But the family insisted everything be done to keep him alive. So when he "coded," much of the hospital mobilized to resuscitate him. Chest compressions broke frail ribs. Breathing tubes were inserted. Injections of powerful drugs were injected to restart the heart. This happened twice more that night. The final time, the team worked twenty minutes to no avail. Mr. Turner was pronounced dead. The author, one of the physicians on this team asks whether this is a good way to die.
This incident, during her residency, began a process of questioning about what it meant to die well, leading to her discovery of the Ars Moriendi, The Art of Dying, a fourteenth century handbook arising out of the plagues, when anyone might expect to die an early death. Dying well begins with recognizing one's finitude, reckoning on and appropriately planning for one's death. Dying well happens best in community, where the dying acknowledges wrongs and seeks forgiveness, where love is expressed, and where bystanders rehearse their own death. Dugdale also talks about how context matters, and the preference where appropriate care can be given, for death at home, and in the hospital, only when that affords the best care.
Often our inability to die well, and the actions that hinder dying well reflect our fear of death. She confronts the real terror, even for the religious, of the unknown void of death. Dugdale's counsel is that each of us has to wrestle with what it means to die into life. In an extended reflection on the Isenheim Altarpiece, she considers what happens to the body in disease and death--its corruption into dust. She describes the reality summarized in one terrified patient's words--"I don't know what I believe"--and the vital work of facing the existential questions of meaning to both live and die well.
Her final chapters describe the rituals that follow death, and the wisdom in the Jewish tradition around grief. She concludes with some recommendations that might form a modern Art of Dying. Think twice about hospitalization. Discern when further treatment is futile. Live well at the end through good, and early, palliative care when death is imminent. Reconsider resuscitation. Start giving away your stuff. Live with purpose. Die in community.
The book concludes with a series of ink drawings by Michael W. Dugger, similar to the woodcuts in the original Ars Moriendi around the themes of each chapter of the book. They are a fitting way to invite us to reflect once more on this book's message: we desperately need to recover the art of dying well. It isn't to be found in the over-medicalized, hospital-centric practices of our modern way of death. Nor is it to be found in the denial of our finitude, our efforts to suppress our fears.
This book gives much to think about in our current pandemic, including the terrible tragedy of how it results in lonely deaths. A blessing upon the caregivers who treat the dying with dignity and compassion! It also makes me wonder if our inability to pursue for an extended time the disciplines that guard our health and that of our neighbors reflects the fact that we haven't done the work of preparing to die well. We act as if we are invulnerable. We risk our lives for a night of clubbing. To not adequately reckon with death is to not adequately treasure the gift of the life we have, the community with whom we share it, and betrays the thinness of our efforts to consider the existential questions of life. All this suggests that this book could not have come at a better time.
________________________________
Disclosure of Material Connection: I received a complimentary review copy of this book from the publisher. The opinions I have expressed are my own.
May 18, 2023
4.5 stars.
I've been looking for this book - that is, a book that addresses this topic, of how to prepare for death - for a long time. Randomly found it while browsing a delightful indie bookstore in Estes Park.
Dr. Dugdale - a physician, medical ethicist, and co-founder of the Program for Medicine, Spirituality, and Religion at Yale - lays out a compelling premise: we* have forgotten how to die. For hundreds - rather, thousands - of years, death has been an unavoidable part of life. While of course we haven't discovered the fountain of youth, U.S. culture has successfully swept death under the rug, so to speak; banishing death from homes to hospitals, banishing deathcare from family and friends and faith communities to hospice and nursing homes and funeral homes and other professionals; and so extending longevity, and reducing rates of mortality, that the vast majority of us live to be elderly.
*The U.S./Eurocentric cultures
None of these things are inherently bad, but taken together, along with U.S. culture's obsession with youth, it does mean that many of us are more unprepared for death than our ancestors ever would have dreamed. The solution, at least according to Dr. Dugdale? Return to some of these ancient practices, as described in a common Middle Ages text called the Ars moriendi. The biggest takeaways are to a) face our finitude, our mortality. Reckon with the fact that, modern medicine notwithstanding, we will die one day; b) cultivate a community - family, friends, faith communities, whoever is meaningful in our lives and who can assist us as we begin to decline; and c) to start questioning medical interventions once we reach a certain stage (and age) in our lives. Quality over quantity of life, you might say.
What keeps this book from being 5 stars for me? Dr. Dugdale makes no effort to hide her Judeo-Christian viewpoint, and that's fine with me (actually, I find it refreshing that she makes no efforts to hide it and rather includes it in many relevant ways; I'm tired of reading books that I think will not have a particular religious lens based on their descriptions and then it ends up being very strongly Christian-centric). However, I am interested in learning more about what all/many faith communities believe about death and their deathcare rituals, so would have loved more inclusion here. Additionally, she seems to doubt that folks who are spiritual, rather than religious, can have as vibrant of communities and as strong of beliefs and tenets as religious communities, which I find to be untrue. Lastly, she's not a fan of medical aid in dying and seems to think people who choose this option aren't capable of squarely facing their death, whereas I think this is an important option for people to be able to have on the table.
I've been looking for this book - that is, a book that addresses this topic, of how to prepare for death - for a long time. Randomly found it while browsing a delightful indie bookstore in Estes Park.
Dr. Dugdale - a physician, medical ethicist, and co-founder of the Program for Medicine, Spirituality, and Religion at Yale - lays out a compelling premise: we* have forgotten how to die. For hundreds - rather, thousands - of years, death has been an unavoidable part of life. While of course we haven't discovered the fountain of youth, U.S. culture has successfully swept death under the rug, so to speak; banishing death from homes to hospitals, banishing deathcare from family and friends and faith communities to hospice and nursing homes and funeral homes and other professionals; and so extending longevity, and reducing rates of mortality, that the vast majority of us live to be elderly.
*The U.S./Eurocentric cultures
None of these things are inherently bad, but taken together, along with U.S. culture's obsession with youth, it does mean that many of us are more unprepared for death than our ancestors ever would have dreamed. The solution, at least according to Dr. Dugdale? Return to some of these ancient practices, as described in a common Middle Ages text called the Ars moriendi. The biggest takeaways are to a) face our finitude, our mortality. Reckon with the fact that, modern medicine notwithstanding, we will die one day; b) cultivate a community - family, friends, faith communities, whoever is meaningful in our lives and who can assist us as we begin to decline; and c) to start questioning medical interventions once we reach a certain stage (and age) in our lives. Quality over quantity of life, you might say.
What keeps this book from being 5 stars for me? Dr. Dugdale makes no effort to hide her Judeo-Christian viewpoint, and that's fine with me (actually, I find it refreshing that she makes no efforts to hide it and rather includes it in many relevant ways; I'm tired of reading books that I think will not have a particular religious lens based on their descriptions and then it ends up being very strongly Christian-centric). However, I am interested in learning more about what all/many faith communities believe about death and their deathcare rituals, so would have loved more inclusion here. Additionally, she seems to doubt that folks who are spiritual, rather than religious, can have as vibrant of communities and as strong of beliefs and tenets as religious communities, which I find to be untrue. Lastly, she's not a fan of medical aid in dying and seems to think people who choose this option aren't capable of squarely facing their death, whereas I think this is an important option for people to be able to have on the table.
July 17, 2020
I found what was different about this book compared to other cold-shower confrontations with mortality was a consistent allusion to beauty and the rightness of things despite outward chaos and decline. "... beauty in decay," is a phrase in the book. In a way I guess this represents a kind of faith we can all agree on.
There is a lyrical chapter on fear which is one of the best essays on the topic I've read.
There is a lyrical chapter on fear which is one of the best essays on the topic I've read.
February 14, 2021
We will all die someday. It's not something we should court but it is inevitable. If we will all die, then how will die? I don't mean what will we die of, but how will we approach our own deaths? Will we be prepared to die well? Or will we fear death? We will go kicking and screaming, asking that everything is done to keep us alive? As a pastor, I have been present for death. I've seen it resisted and welcomed. As for me, in the end, I do have the hope of the resurrection to hold me up.
In the medieval period, during the Bubonic Plague, as people died in massive quantities, the question of dying well became important. Out of this context came the "Ars Moriendi," manuals that spoke of the art of dying. Might we need similar manuals in our day? L. S. Dugdale, a medical doctor, and ethicist suggests that we would benefit from such a manual.
"The Lost Art of Dying" is not a specifically religious book, but the author acknowledges the role that religion plays in the art of dying. In fact, it appears that highly religious people seem to struggle with death and seek to put it off, asking for extreme measures more than others. That is odd. So, yes we need to know how to die well. Though she also notes that the medical profession has contributed to our culture's avoidance of death. Surely there is something to be offered that can extend life.
Dugdale begins with a chapter titled death that tells the story of a family that wouldn't let go and asked for continued resuscitation of their father even though there was no hope of survival. One of the elements of the story is our belief that CPR can rescue the dying, but the reality is that for most people CPR as administered in a hospital only succeeds in a small percentage of cases (not like we see on TV). There is a lot of similarity between Dugdale's book and Atul Gawande's Being Mortal: Medicine and What Matters in the End. Thus, in her words, the medical system has become in many ways a conveyor belt. It doesn't allow for a thoughtful deliberative approach. It reacts to the situation at hand. It's out of this conversation about modern death that the author takes us back to the 14th century, the plague, and the "ars moriendi."
As the book progresses, Dugdale invites us to consider the fact of finitude (chapter 2), the need for community and the challenge of dying alone (chapter 3), the context of dying, so often in hospitals (chapter 4). She speaks to the fear of death (chapter 5), the nature of the body, and the reality of aging (chapter 6). Then there is a chapter on the "Spirit," (chapter 7). It's here that she addresses some of the religious questions about the nature of life and death. Though a scientist, she understands the importance of faith to conversations about death. In fact, she notes that even as we become less religious, spirituality is on the rise. Here she notes that the "ars moriendi" deals not only with the physical but the metaphysical as well. To die well involves ritual. Those rituals include the medical (pulling the plug) and the spiritual (funerals). She speaks of the ritual of preparing the body, reminding us of what the process is of preparing the body for burial. This chapter (chapter 8) is very important, especially for clergy to consider.
The final chapter is simply titled "Life." (chapter 9). She writes that "if the ars moriendi teaches us anything, it's that the work of living well is what enables dying well. The tasks of living well include living each day in the context of community with a view to finitude" (pp. 180-181). This chapter is practical in some ways -- speaking to questions such as whether to be hospitalized when death approaches or what to do about resuscitation -- but it also speaks of living with the virtues. It offers a wonderful summation of the message of living well and dying well. In that, it is an art.
In the opening chapter, Dugdale notes that an early version of the ars moriendi was illustrated, so that whether one is literate or not one can contemplate the art of dying. With that in mind, she commissioned artist Michael Dugger to create ink renderings that illustrated the message of the nine chapters that simulated the original woodcuts. So the book concludes with the artwork with brief commentary taking us back to the chapters the art illustrates.
I highly recommend this book to clergy as we will walk with those who are dying and with their loved ones. I also recommend it to anyone who is wrestling with the concept of death. We are a culture that seems unable or unwilling to face the reality of death. We don't talk about it, even loved ones want to have the conversation. Perhaps this book will ease that conversation. So, yes, take and read so that you can not only die well but live well also!
In the medieval period, during the Bubonic Plague, as people died in massive quantities, the question of dying well became important. Out of this context came the "Ars Moriendi," manuals that spoke of the art of dying. Might we need similar manuals in our day? L. S. Dugdale, a medical doctor, and ethicist suggests that we would benefit from such a manual.
"The Lost Art of Dying" is not a specifically religious book, but the author acknowledges the role that religion plays in the art of dying. In fact, it appears that highly religious people seem to struggle with death and seek to put it off, asking for extreme measures more than others. That is odd. So, yes we need to know how to die well. Though she also notes that the medical profession has contributed to our culture's avoidance of death. Surely there is something to be offered that can extend life.
Dugdale begins with a chapter titled death that tells the story of a family that wouldn't let go and asked for continued resuscitation of their father even though there was no hope of survival. One of the elements of the story is our belief that CPR can rescue the dying, but the reality is that for most people CPR as administered in a hospital only succeeds in a small percentage of cases (not like we see on TV). There is a lot of similarity between Dugdale's book and Atul Gawande's Being Mortal: Medicine and What Matters in the End. Thus, in her words, the medical system has become in many ways a conveyor belt. It doesn't allow for a thoughtful deliberative approach. It reacts to the situation at hand. It's out of this conversation about modern death that the author takes us back to the 14th century, the plague, and the "ars moriendi."
As the book progresses, Dugdale invites us to consider the fact of finitude (chapter 2), the need for community and the challenge of dying alone (chapter 3), the context of dying, so often in hospitals (chapter 4). She speaks to the fear of death (chapter 5), the nature of the body, and the reality of aging (chapter 6). Then there is a chapter on the "Spirit," (chapter 7). It's here that she addresses some of the religious questions about the nature of life and death. Though a scientist, she understands the importance of faith to conversations about death. In fact, she notes that even as we become less religious, spirituality is on the rise. Here she notes that the "ars moriendi" deals not only with the physical but the metaphysical as well. To die well involves ritual. Those rituals include the medical (pulling the plug) and the spiritual (funerals). She speaks of the ritual of preparing the body, reminding us of what the process is of preparing the body for burial. This chapter (chapter 8) is very important, especially for clergy to consider.
The final chapter is simply titled "Life." (chapter 9). She writes that "if the ars moriendi teaches us anything, it's that the work of living well is what enables dying well. The tasks of living well include living each day in the context of community with a view to finitude" (pp. 180-181). This chapter is practical in some ways -- speaking to questions such as whether to be hospitalized when death approaches or what to do about resuscitation -- but it also speaks of living with the virtues. It offers a wonderful summation of the message of living well and dying well. In that, it is an art.
In the opening chapter, Dugdale notes that an early version of the ars moriendi was illustrated, so that whether one is literate or not one can contemplate the art of dying. With that in mind, she commissioned artist Michael Dugger to create ink renderings that illustrated the message of the nine chapters that simulated the original woodcuts. So the book concludes with the artwork with brief commentary taking us back to the chapters the art illustrates.
I highly recommend this book to clergy as we will walk with those who are dying and with their loved ones. I also recommend it to anyone who is wrestling with the concept of death. We are a culture that seems unable or unwilling to face the reality of death. We don't talk about it, even loved ones want to have the conversation. Perhaps this book will ease that conversation. So, yes, take and read so that you can not only die well but live well also!
January 29, 2022
The Lost Art of Dying: Reviving Forgotten Wisdom by L.S. Dugdale, MD (Harper One 2020) (155.937) (3616).
I strongly recommend this book to any readers who knows someone who has died or who expects to die themselves one day.
Historically humans were exposed to (if not surrounded by) the dead. Death was a normal state. The concept of ars moriendi - “The art of death” - was a familiar volume in medieval times. The art of a “good death,” argues author/physician Lydia Dugdale, has been forgotten in the twenty-first century, but it must be resurrected.
It appears that Dugdale wrote this most timely little volume to desensitize people to death and dying. Make no mistake: L.S. Dugdale is as fine a writer as I have run across in a long time. She makes her points in clear, cogent, concise, and convincing fashion. She’s easy to read, and easier still to follow.
Here are some highlights:
“Dying well means grappling with our existential questions and not avoiding them. The ars moriendi attends to the metaphysical as well as the physical.”< (p.150)
"Some religions make a point of encouraging reflection on human brokenness.” (p.130)
Health care professionals are “No longer considered ‘healers,’ we are called ‘providers’ - the purveyors of death-delaying goods to our consumer patients.” (p.149)
From the chapter called “Ritual,” the author poses the question of who should care for the physical remains of our dead:
“I wish to return to the theme of caring for the bodies of the dead. The question is this: whether or not we embalm, is it not curious that we willingly pass off responsibility for intimate rituals associated with attending to dead bodies? Shouldn’t we be the ones to care for the bodies of our loved ones?” (p.161)
She advocates patience and hopefulness as keys to a good life and thus a good death:
“Impatience, the ars moriendi taught, can be moderated through the lifelong cultivation of the virtue of patience. The transformation does not happen instantly when a person wills it. Patience must be practiced. Like any habit, you have to commit to exercising patience over and over again.
So too with the other virtues that the ars moriendi commended the dying to cultivate. The tendency to despair as death approaches can be remedied through a lifetime of exercising hopefulness.” (p.206)
Finally, she shares an allegorical tale about death:
“The Legend of the Merchant of Baghdad:
“A merchant sends his servant down to the market. The servant quickly returns. He is agitated and frightened. He says to his master, “Down at the marketplace I was jostled by a woman in the crowd, and when I turned around I saw that it was Death that jostled me. She looked at me and made a threatening gesture. Master, please lend me your horse, for I must hasten away to avoid her. I will ride to Samarra and there I will hide, and Death will not find me.
The merchant agrees, lends his horse, and the servant wastes no time in galloping off. Later that day, the merchant himself heads down to the market and finds Death standing in the crowd. He asks her why she made a threatening gesture at his servant that morning.
Death replies, “That was not a threatening gesture. It was only a start of surprise. I was astonished to see him in Baghdad, for I have an appointment with him tonight in Samarra.”
This story reminds us that none of us escapes our appointment with death. The solution is neither to flee it or to seek it out. Rather, we must each prepare for Samarra. Death is part of life. The art of dying well must necessarily be wrapped up in the art of living.” (p.207-8).
Here’s a little closing trivia that was too good to omit:
There is a “frailty index” that hospitals use to measure the elderly.
Don’t expect too much from CPR; only about ten to twenty percent of resuscitated patients survive to leave the hospital (p. 195-6).
Every reader will benefit from reading this little book.
My rating: 7.75/10, finished 1/28/22 (3616).
November 6, 2020
For those of us who are secretly confused and afraid of what those final moments/resuscitations attempts are going to be like to experience when we reach the end... Written by an ER surgeon who has seen lots and lots of hospital deaths from the other side of the bed, this is her informed and thoughtful ruminations on both what the experience of death is like currently in American culture, and what death was like/thought of as/treated as in less medically advanced times in the Western psyche (the chapter about first-hand accounts from people living through the bubonic plague are particularly interesting to hear about in our present, COVID pandemic situation...).
There is a lost "art of dying" culture/philosophy that has been a paramount part of the human experience since the dawn of civilization, and which we have summarily discarded in this god-toppling age of increasing scientific knowledge and mastery. Maybe science will find a way to stop us (or at least, the richest of us) from dying entirely someday, but consider that cancer cells occur when cells pervert their natural cycle of life to death and "live" beyond their intended life cycles. I'm not saying increasing rates of Alzheimer's and dementia in modern societies are a result of our bodies artificially outliving their natural, healthy/sustainable lifespans, but maybe there's something in facing and accepting that death is going to be a part of our life experience, and learning how to prepare for it and have a "good death." It's something to think about, at least, and this book is a well-researched, very readable, and fairly thorough (at least, as far as historical *western* attitudes about death are concerned; I'd love to see a second edition where Dugdale integrates a few additional chapters of well-researched eastern/Asian and other traditional philosophies on death) way to begin engaging with these ideas.
There is a lost "art of dying" culture/philosophy that has been a paramount part of the human experience since the dawn of civilization, and which we have summarily discarded in this god-toppling age of increasing scientific knowledge and mastery. Maybe science will find a way to stop us (or at least, the richest of us) from dying entirely someday, but consider that cancer cells occur when cells pervert their natural cycle of life to death and "live" beyond their intended life cycles. I'm not saying increasing rates of Alzheimer's and dementia in modern societies are a result of our bodies artificially outliving their natural, healthy/sustainable lifespans, but maybe there's something in facing and accepting that death is going to be a part of our life experience, and learning how to prepare for it and have a "good death." It's something to think about, at least, and this book is a well-researched, very readable, and fairly thorough (at least, as far as historical *western* attitudes about death are concerned; I'd love to see a second edition where Dugdale integrates a few additional chapters of well-researched eastern/Asian and other traditional philosophies on death) way to begin engaging with these ideas.
February 21, 2024
Erin and I heard this author give a presentation on her book during Calvin University’s January Series this year, so I decided to follow that up by reading it for myself. It’s not as dreadful as the topic might sound to some. In fact, it’s quite thoughtful in the amount of research that was done, digging deep into human history in order to present what should be a compelling and important case for reevaluating how we live and how we talk about the end of life… which is coming for all of us, so why ignore it?
This entire review has been hidden because of spoilers.
Read
August 26, 2023I lost access to the audiobook and had to read the last chapter in the form of a large print book. Perhaps as a consequence, the last chapter, “Life,” seemed the most important. It summed up the main point of the book: the art of dying is the art of living and vice versa. To die well, one must live well.
January 23, 2023
Dr. Dugdale does a great job addressing a topic often ignored and avoided but is essential for everyone. Everyone won't love her musings or writing style but her presentation of the ancient practice of "ars moriendi" (art of dying) is worth reflecting on. Lots of thought-provoking practices, stories, and questions in this book.
April 30, 2021
Informative and thoughtful.
September 10, 2022
This book was fantastic. So very thought-provoking.
February 27, 2021
It dragged a bit at times, but generally pretty interesting.
March 19, 2023
Interesting overview of the ars moriendi, the rise of hospitals, etc
June 27, 2023
Great Book Discussing the intersection of Death care and biomedical ethics
January 10, 2021
So thankful for the experiences and thoughts of Dr. Dugdale. I felt compelled to think about my own death more thoughtfully and ultimately how I live my life to lead up to it.
December 21, 2020
If you had told me at the beginning of the year that I would end it by voluntarily reading a book about how to die, I probably wouldn't have believed you. But then, there's not a lot about 2020 that I would have believed.
I have no reason to think I'll die anytime soon, but the big realization of this plague year for me was that any of us can die at any time, and that our fear and denial around death drives a lot of our most unhealthy decisions and behaviors. We refuse to think about it, talk about it, or prepare for it, and therefore, perversely, we let it dominate us. Allowing myself to contemplate what death might be like and how a person might best approach it has actually eased my fears a little bit, made the burden of my mortality less onerous. And it's something I feel like I'm just getting started with.
I read this book because I heard the author interviewed on the "Essential Conversations" podcast and found her insights fascinating, as a physician who has attended to hundreds of dying people. Many people, at least in the West, die poorly. They might ruin whatever quality of life they have left with violent medical interventions to extend their lives by a few weeks, days, hours, or even minutes. They might die without having cultivated a community of loved ones to help them. They might put the whole burden of preparing for their death on other people by their refusal to think about it. And they might die without giving much consideration to what is meaningful about life.
Lydia Dugdale's thesis is that you should live with a view to how you will confront death—live well to die well. I think there are ways in which she could have developed some of her points more fully, and the book is surprisingly unprescriptive given that she's a doctor and it bills itself as a sort of modern-day manual or field guide to dying. It's more philosophical than practical, and sometimes leaves even the philosophical somewhat half-baked, but there's a lot here worth thinking about and she's an elegant writer.
In the end the book gives a loose framework, not step-by-step instructions, for the art of dying. (Basically, don't do the things cited above, do the opposite.) It leaves the rest—what that means and how to do it—up to us.
I have no reason to think I'll die anytime soon, but the big realization of this plague year for me was that any of us can die at any time, and that our fear and denial around death drives a lot of our most unhealthy decisions and behaviors. We refuse to think about it, talk about it, or prepare for it, and therefore, perversely, we let it dominate us. Allowing myself to contemplate what death might be like and how a person might best approach it has actually eased my fears a little bit, made the burden of my mortality less onerous. And it's something I feel like I'm just getting started with.
I read this book because I heard the author interviewed on the "Essential Conversations" podcast and found her insights fascinating, as a physician who has attended to hundreds of dying people. Many people, at least in the West, die poorly. They might ruin whatever quality of life they have left with violent medical interventions to extend their lives by a few weeks, days, hours, or even minutes. They might die without having cultivated a community of loved ones to help them. They might put the whole burden of preparing for their death on other people by their refusal to think about it. And they might die without giving much consideration to what is meaningful about life.
Lydia Dugdale's thesis is that you should live with a view to how you will confront death—live well to die well. I think there are ways in which she could have developed some of her points more fully, and the book is surprisingly unprescriptive given that she's a doctor and it bills itself as a sort of modern-day manual or field guide to dying. It's more philosophical than practical, and sometimes leaves even the philosophical somewhat half-baked, but there's a lot here worth thinking about and she's an elegant writer.
In the end the book gives a loose framework, not step-by-step instructions, for the art of dying. (Basically, don't do the things cited above, do the opposite.) It leaves the rest—what that means and how to do it—up to us.
May 28, 2021
To be clear: overall I liked this book. If the subject matter seems intriguing to you I’d encourage you to pick up this book, there’s a lot of great material in here and Dugdale introduces a number of concepts to help readers begin to confront death. Despite the low rating this is a book I’d likely recommend to others interested in the topic and I do hope Dugdale continues to write in the future.
That being said Dugdale’s writing comes across as a first attempt at nonfiction rather than a complete and finished product. This book desperately needs more editing. The content is already there, some of it very well put together, but Dugdale’s writing doesn’t do her research and passion justice. There were multiple moments where a clunky sentence caused me to mentally re-write it and her references to the ars moriendi at times come across as forced instead of as a natural progression. It’s clear Dugdale was deeply inspired by the literature but the heavyhanded referencing of it reads as if an amateur essay, a feeling not helped by her blatant calling of “in Chapter One I laid out…” etc. in both the beginning and end. It’s not a death sentence by any means but it makes Dugdale’s end product feel like a prototype.
The overall themes are very similar Caitlin Doughty’s book From Here To Eternity, which searches cultures for the definition of a “good death,” and comes to similar conclusions as Dugdale. Doughty’s work doesn’t aim to be as direct as Dugdale’s and address the reader personally, instead simply offering up her summation of experiences as the best answer for a “good death” humans can decide upon, and because of that offers wider appeal to audiences that aren’t yet faced with questions about death directly. Dugdale’s work seems to be targeted towards older audiences and wants to address the people who might be impacted by these issues soon, if not imminently. Dugdale’s work tries to resolve issues of death by dying while Doughty’s work investigates death itself. It’s an interesting contrast, to the point where each book is strikingly reminiscent of the other thematically while also staunchly unique in terms of content.
Were it not for its technical/ editorial lackluster I’d likely sing the praises of this book. It was a worthwhile read and I enjoyed the references made from older arts and literature that Dugdale used to comprehend and modernize her theory on how to perfect the art of dying. I hope to read more from her in the future and appreciate her insight on dying from the lens of medical authority.
That being said Dugdale’s writing comes across as a first attempt at nonfiction rather than a complete and finished product. This book desperately needs more editing. The content is already there, some of it very well put together, but Dugdale’s writing doesn’t do her research and passion justice. There were multiple moments where a clunky sentence caused me to mentally re-write it and her references to the ars moriendi at times come across as forced instead of as a natural progression. It’s clear Dugdale was deeply inspired by the literature but the heavyhanded referencing of it reads as if an amateur essay, a feeling not helped by her blatant calling of “in Chapter One I laid out…” etc. in both the beginning and end. It’s not a death sentence by any means but it makes Dugdale’s end product feel like a prototype.
The overall themes are very similar Caitlin Doughty’s book From Here To Eternity, which searches cultures for the definition of a “good death,” and comes to similar conclusions as Dugdale. Doughty’s work doesn’t aim to be as direct as Dugdale’s and address the reader personally, instead simply offering up her summation of experiences as the best answer for a “good death” humans can decide upon, and because of that offers wider appeal to audiences that aren’t yet faced with questions about death directly. Dugdale’s work seems to be targeted towards older audiences and wants to address the people who might be impacted by these issues soon, if not imminently. Dugdale’s work tries to resolve issues of death by dying while Doughty’s work investigates death itself. It’s an interesting contrast, to the point where each book is strikingly reminiscent of the other thematically while also staunchly unique in terms of content.
Were it not for its technical/ editorial lackluster I’d likely sing the praises of this book. It was a worthwhile read and I enjoyed the references made from older arts and literature that Dugdale used to comprehend and modernize her theory on how to perfect the art of dying. I hope to read more from her in the future and appreciate her insight on dying from the lens of medical authority.
August 21, 2020
I thought this book has some very good insights into how patients are being overtreated, at the expense of their quality of life. The importance of community is stressed as well, something I'm a firm believer in. But I have some major gripes with this book as well.
First of all, the author portrays assisted suicide as a way of fleeing from death. I disagree. I think these people don't want to avoid dying, they want to avoid unnecessary suffering. They are trying to do what this whole book is about: they are trying to die well, at home, surrounded by family. I thought portraying that as flight from death was insulting.
A central statement of the author is that to die well, we need to consider the existential questions long beforehand. I think this makes sense. However, she doesn't give very many tools, other than going to church (of any religion).
Finally, rituals and traditions should play a larger role in our mourning process, according to this rule. The Jewish tradition is given as an example. I think rituals can definitely bring more comfort, and it can be a guide for friends and relatives to help their loved ones in a difficult time. But this also leaves very little room for individual differences. Some people may simply need a little more or less time than others. Putting mourning on a set schedule seems somewhat cold to me. (I am not commenting on the Jewish tradition: I don't know nearly enough about the culture for that. I am simply stating that integrating it in current western culture might not be a universal improvement. )
First of all, the author portrays assisted suicide as a way of fleeing from death. I disagree. I think these people don't want to avoid dying, they want to avoid unnecessary suffering. They are trying to do what this whole book is about: they are trying to die well, at home, surrounded by family. I thought portraying that as flight from death was insulting.
A central statement of the author is that to die well, we need to consider the existential questions long beforehand. I think this makes sense. However, she doesn't give very many tools, other than going to church (of any religion).
Finally, rituals and traditions should play a larger role in our mourning process, according to this rule. The Jewish tradition is given as an example. I think rituals can definitely bring more comfort, and it can be a guide for friends and relatives to help their loved ones in a difficult time. But this also leaves very little room for individual differences. Some people may simply need a little more or less time than others. Putting mourning on a set schedule seems somewhat cold to me. (I am not commenting on the Jewish tradition: I don't know nearly enough about the culture for that. I am simply stating that integrating it in current western culture might not be a universal improvement. )
This entire review has been hidden because of spoilers.
September 2, 2021
Much to my surprise, there was little morality discussed in this short epistle on death rituals. I thought she would cover more concepts about what constitutes the “good life” or “a life well lived” according to different schools of thought. Instead this is a commentary on “fast medicine” as opposed to “slow medicine” and how unusual it is that in the last 50 years we’ve move to an assumption of clinical death rather than community death.
It’s an interesting thought to consider death as a community ritual rather than a solitary affair that one endures.
It was interesting to read this during a pandemic where our communities and even the global community is cloaked in the pall of death every minute.
Though this book really went through various rituals and cultural approaches to death, where the instruction book for dying well originated during another catastrophic plague, I think it describes well the struggle we have to let go but also what happens psychically when we are constantly thinking about our own mortality. This new consciousness we all seem to have of “is this really what I want to be doing with my life?”
Most importantly I walked way thinking about this central idea- that not to grieve is to be inhuman. And how much American society has done away with grief rituals and even grief leave. How it’s convinced itself we are invincible and impervious to death. Perhaps that is why there is so much inhumanity about us here.
It’s an interesting thought to consider death as a community ritual rather than a solitary affair that one endures.
It was interesting to read this during a pandemic where our communities and even the global community is cloaked in the pall of death every minute.
Though this book really went through various rituals and cultural approaches to death, where the instruction book for dying well originated during another catastrophic plague, I think it describes well the struggle we have to let go but also what happens psychically when we are constantly thinking about our own mortality. This new consciousness we all seem to have of “is this really what I want to be doing with my life?”
Most importantly I walked way thinking about this central idea- that not to grieve is to be inhuman. And how much American society has done away with grief rituals and even grief leave. How it’s convinced itself we are invincible and impervious to death. Perhaps that is why there is so much inhumanity about us here.
March 17, 2023
In the day and age where we try and sweep death under the carpet and hide it from children, we lose the ability to cope with the thing that will come for us all - the time of our death. Dugdale offers insights from a medical doctor's perspective on key stages of making the dying process a holistic undertaking.
Dugdale presents the Judeo-Christian worldview concept of "ars moriendi" (The Art of Dying) that was specifically developed by the Catholic church during and after the Black Plague and War of Popes around 1450. It encourages those who are still healthy to acknowledge the possibility of death and those in later life to prepare for the coming of the end. Not only should preparation be undertaken by those who will experience first hand but also by the family and friends of those around that person. A big point of the book is showing that we die best when we are in community (friends, family, doctors, society, etc.). And this was not only intended for the religious but also for the carnal and secular, the elites and the rich, the poor and the common people. Jeremy Taylor published a Protestant version called, "The Rules And Exercises Of Holy Dying".
Dugdale presents first-hand accounts of the dying process and those who did so well and those you didn't seem to go well into that quite night. Providing historical background and development to dying, the art of dying, and the change in how we view medicine and hospitals offers an interesting and challenging concept that shows that we might have placed too much confidence in the hospital make up and that we kind of suck at dying.
The book covers nine different aspects of dying including death itself, the finitude of death, dying in community, the context of how ones goes, and then the psychological aspect like fear response, what happens to the body, the spiritual effects, and our rituals we take when dying, and also the life-preserving nature we hoist onto the medical community that maybe ill-placed to the degree we do. After the World War I and into the 1920's, the change in the art of dying succumbed to the art of living with the massive leaps in medical life prevention means and technology. We've always been good adopters of new things, especially after the Industrial Revolution, but we've been equally terrible foreseers of what effects will results due to those adoptions (just look at the effects of social media).
A highlight from the book is chapter three about dying well in community. Dugdale makes some really solid points on how important this aspect affects us in life as well as leading into our death. It's a highlight of what the Christian Church is supposed to be. This is not a religious book per se but it does cover aspects of religious elements and even ones adopted by the secular. The community being replaced by the hospital was interesting and that idea runs as a string throughout the book. Even though a medical, hospital practitioner, Dugdale making this point really adds to the strength of these points. Hospitals taking the place of homes as a place for offloading all sorts of care from families is a challenging subject matter and can lead to some good discussion for those reading with others. Also interesting was that when it comes to dying, mitigating pain management was far behind the fear of losing independence and dignity during the dying process. Similar to how most people are less fearful of dying than they are public speaking (they'd rather be in the box than being at the podium talking about the person in the box) shows how much pride plays a part in our lives.
One downside was chapter 6 about how we see the body through the dying process. This was mostly a set of stories that kind of meandered into a group of not-really cohesive narrative or impact point as the other chapters. This could have really been a strong chapter to be harshly honest take from a doctor - a kind of "What To Expect When You're Expecting...To Die" take that we often hide from collectively.
Not really a negative but something I would have expected from a book these days is a final chapter with a step-by-step guide on how to implement the ars moriendi. There is a concluding chapter that does offer some general oversights. It encourages the reader to impliment their own ars moriendi as it's a "useful model for anticipating and preparing for death" and encourages us to acknowledge own finitude and to fail to do so means we probably won't die well. And, a final encouragement that we don't die well in isolation, so we should seek to broaden our community boundaries and inclusions while there is still time.
Overall, I think this is a book for pretty much anyone since, ya know, 10 out of 10 of us won't make it out of this world alive. For parents of kids of any age, this provides a good avenue of discussion. For those who will experience the loss of a loved one it helps to prepare to have some hard conversations and how to help that person. Most obvious is for the person who will shirk off this mortal coil soon and gives some clear guidelines on what to do to start the end.
Final Grade - B
Dugdale presents the Judeo-Christian worldview concept of "ars moriendi" (The Art of Dying) that was specifically developed by the Catholic church during and after the Black Plague and War of Popes around 1450. It encourages those who are still healthy to acknowledge the possibility of death and those in later life to prepare for the coming of the end. Not only should preparation be undertaken by those who will experience first hand but also by the family and friends of those around that person. A big point of the book is showing that we die best when we are in community (friends, family, doctors, society, etc.). And this was not only intended for the religious but also for the carnal and secular, the elites and the rich, the poor and the common people. Jeremy Taylor published a Protestant version called, "The Rules And Exercises Of Holy Dying".
Dugdale presents first-hand accounts of the dying process and those who did so well and those you didn't seem to go well into that quite night. Providing historical background and development to dying, the art of dying, and the change in how we view medicine and hospitals offers an interesting and challenging concept that shows that we might have placed too much confidence in the hospital make up and that we kind of suck at dying.
The book covers nine different aspects of dying including death itself, the finitude of death, dying in community, the context of how ones goes, and then the psychological aspect like fear response, what happens to the body, the spiritual effects, and our rituals we take when dying, and also the life-preserving nature we hoist onto the medical community that maybe ill-placed to the degree we do. After the World War I and into the 1920's, the change in the art of dying succumbed to the art of living with the massive leaps in medical life prevention means and technology. We've always been good adopters of new things, especially after the Industrial Revolution, but we've been equally terrible foreseers of what effects will results due to those adoptions (just look at the effects of social media).
A highlight from the book is chapter three about dying well in community. Dugdale makes some really solid points on how important this aspect affects us in life as well as leading into our death. It's a highlight of what the Christian Church is supposed to be. This is not a religious book per se but it does cover aspects of religious elements and even ones adopted by the secular. The community being replaced by the hospital was interesting and that idea runs as a string throughout the book. Even though a medical, hospital practitioner, Dugdale making this point really adds to the strength of these points. Hospitals taking the place of homes as a place for offloading all sorts of care from families is a challenging subject matter and can lead to some good discussion for those reading with others. Also interesting was that when it comes to dying, mitigating pain management was far behind the fear of losing independence and dignity during the dying process. Similar to how most people are less fearful of dying than they are public speaking (they'd rather be in the box than being at the podium talking about the person in the box) shows how much pride plays a part in our lives.
One downside was chapter 6 about how we see the body through the dying process. This was mostly a set of stories that kind of meandered into a group of not-really cohesive narrative or impact point as the other chapters. This could have really been a strong chapter to be harshly honest take from a doctor - a kind of "What To Expect When You're Expecting...To Die" take that we often hide from collectively.
Not really a negative but something I would have expected from a book these days is a final chapter with a step-by-step guide on how to implement the ars moriendi. There is a concluding chapter that does offer some general oversights. It encourages the reader to impliment their own ars moriendi as it's a "useful model for anticipating and preparing for death" and encourages us to acknowledge own finitude and to fail to do so means we probably won't die well. And, a final encouragement that we don't die well in isolation, so we should seek to broaden our community boundaries and inclusions while there is still time.
Overall, I think this is a book for pretty much anyone since, ya know, 10 out of 10 of us won't make it out of this world alive. For parents of kids of any age, this provides a good avenue of discussion. For those who will experience the loss of a loved one it helps to prepare to have some hard conversations and how to help that person. Most obvious is for the person who will shirk off this mortal coil soon and gives some clear guidelines on what to do to start the end.
Final Grade - B
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