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The Art of Dying

Edward R. Norris, M.D., F.A.P.M.

We spend so much of our lives as clinicians trying to fight death that, until recently, there has been little attention paid to the process of dying. There are many books and articles about how to die gracefully, and The Art of Dying is another thought-provoking addition. Throughout the book, the authors examine phenomena associated with near-death/end-of-life events and experiences of dying persons and their families. The authors place these events into a framework that can begin to be understood from both a neuropsychiatric standpoint and as a potential link to the soul. An argument is made that the mind is more than just collection of neurons, that it may actually may survive for some time after death, and perhaps be a link to our soul.

It should be noted that Peter Fenwick, M.D. is a Fellow of the Royal College of Psychiatrists and is a neuropsychiatrist. He has been interested in examining spirituality as a psychiatrist well before it became popular in the United States, and he has analyzed near-death events and life-altering events throughout a career that spans four decades.

I was initially skeptical about the content of the book and its personal and professional anecdotes of near-death experiences, visions, and coincidences. The authors worked to assuage this by acknowledging that there is a tremendous amount of folklore with religious overtones that might account for these events. They note that the experiences by the dying are usually comforting and that these anecdotes may be acknowledged by dying persons and their families to better understand and grieve during the process of death. However, thinking as western-trained clinicians, we may not be paying adequate attention to the details of death, thus missing out on what the experiences of dying persons may teach us about our patients and ourselves.

The book is written for both the lay public and the professional—essentially all who are interested in trying to understand death in a deeper manner. The perspective of the dying person is addressed in the initial chapters with a review of deathbed visions recounted by caretakers and professionals (I must add that care was taken to try to ensure that dying persons did not have delirium). This is followed by a discussion of deathbed experiences that are seemingly coincidental, such as distant clocks stopping at the exact time of death and the feeling of strong emotions by distant relatives at the time of death. The authors then take care in providing a number of potential explanations, including the paranormal, spiritual, and psychological.

Finally, the idea of how to die and the original Ars Moriendi ("The Art of Dying") written in 1450, is discussed in the final chapters of the book. Only in the latter half of the twentieth century have we, as a society, been able to avoid frequent and direct confrontation with death. As we move to postpone death, the purpose of dying has been marginalized. If we are going to improve our understanding of the dying process and ultimately improve how we die, further attention will need to be placed on dying persons, themselves.

In summary, The Art of Dying is an excellent book for all involved in healthcare. It is easy to read, with numerous real-life examples that the authors authenticate as best as possible. They provide a variety of interpretations of these events and review a number of diverse potential possibilities as to why they repeatedly occur. Finally, giving attention to the details of dying may help us all understand how better to live.

FOOTNOTES

 
Edward R. Norris, M.D., F.A.P.M, is Vice-Chair of the Dept of Psychiatry at Lehigh Valley Health Network, Allentown, PA.

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