When is a person dead?

"A person is dead only when you stop thinking about them", a friend recently said as we discussed death and dying issues.


I am accustomed to rituals that reinforce the absence created by death: open caskets, funeral/memorial services, graveside ceremonies and holidays to honor them.


I immediately thought of deceased loved ones who continue to live in my life.


Several years ago friend died on her 31st birthday. Her death rocked the community who loved her deeply: shocked by the death of someone so young, talented, compassionate and courageous. Her hope was to conquer her disease, devote her life work to comforting others who were suffering, continue traveling with her husband, have children and grow old surrounded by family and friends. Without a doubt, she would have maintained being the nurturing, loving person we all adored.


She battled her illness long and hard, wanting nothing more than the chance to live her dreams.


Near the end of her life, with grace and honesty, she delved into life and death issues. She asked questions about my sister Kathe's death. As she looked at photos of Kathe taken shortly before her death, she wanted to know what it was like for her and for me at the end of her life. Her curiosity and openness allowed others to go on the journey with her.


Her husband gave me her beloved denim jacket. She had worn it as they traveled--often on their motorcycle--to countless places around the globe.

It hung silently, reminding me of her death, during the year of mourning observed by her faith.

At first it felt strange to wear it. Then she visited me in a powerful dream and it was clear she wished to be remembered as fun loving, adventurous and at peace.


I wear the jacket often now. My daughter gave me a large dragonfly pin when my grandmother died (she loved dragonflies!). It sits on the right shoulder of the jacket. On the collar is a carved wooden dove, with an olive branch. Sometimes I add Kathe's favorite scarf.

Since her death, the jacket has been to a refugee camp in Africa, weddings, an ancient cathedral in Puerto Rico (where she once visited), writing groups, women's retreats, the birth of my first grand-daughter, my high school reunion, motorcycle trips, funerals, a cross-country road trip with my childhood friend, camping, hiking, church picnics, volunteering after Hurricane Katrina.

When I wear the jacket I imagine how she might experience the event. I recall the lessons she taught me as she prepared for her death.

My connection to her, through a physical object which represents her life, has helped move me from mourning to celebration of her life.

Is she still alive?

It brings me pleasure to plan the next place I will wear her jacket.

I think she would chuckle about that.

And I enjoy hearing her laughter.

Early Teachers

I decided to become a nurse when I was ten. I didn't know any nurses and had no personal experiences with illness. I just knew that was what I wanted to do and actively looked for care giving opportunities. I found several obliging animals--fallen baby birds, rabbits caught in traps, turtles hit by cars. The ones who didn't survive were tenderly buried under a nearby bridge, each given a proper ceremony and grave marker.

At fourteen I became a hospital volunteer. Dressed in our pink and white striped pinafores and starched white blouses, after school my friend Pat and I sold newspapers to patients.

"Newspaper today sir?" I called out as I entered the room of an elderly man, without legs.

"Girlie, why would I need a paper? I am no longer a producer, just a consumer. My time has come. Please let me go."

I ran to find a nurse. She explained he was a cranky old man who was demanding to be sent home to die. His wishes were being ignored as antibiotics coarsed through his body, to make him stable enough for admission to a nursing home.

She explained it was unlikely that he would ever see his home again.

His plea haunted me. I asked my mother what he meant by consumer and producer. She
helped me understand the message he clearly wanted someone to hear: he felt his usefulness in this lifetime had ended and he wanted to be free to refuse treatment and die on his terms.

That was forty years ago.

I am concerned that we have not progressed very far when it comes to honoring the wishes of a dying person.

A Living Will and/or Advanced Directive helps family members make informed decisions on your behalf. Unfortunately, health care providers--usually guided by fears of litigation--often over-ride the documents.

What can you do to make sure your wishes are honored? First, know what you want in the event you are not able to make your own decisions. Then...and this is the really, really important part--communicate that to your family, your health care provider, your clergy, your attorney. The documents provide limited directions. Additional information makes it more likely that your wishes will be granted.

Now is time to have the conversations. Whether sick, healthy, old, young....now is the time to begin the exploration.

You can change your mind at any time. As you learn more about options, accepted medical practices, and more, your opinions may change.

It is a process to prepare for death. Not an event. Today I am healthy and have certain beliefs about how I want decisions made for me if needed. If I become ill, injured or disabled, my directions to my family may change.

Initiating the conversations NOW only makes it easier as I age and my level of health and independence may change.

One thing I don't expect to change: feeling that I am making it possible to be treated tenderly, and compassionately, with my family and health care providers honoring my wishes, brings me peace and comfort today.

Now...off to marvel at another stunning sunrise!