Dying and Death: Inter-Disciplinary Perspectives

Dying and Death Inter-Disciplinary Perspectives At the Interface Series Editors Dr Robert Fisher Dr Margaret Sönser ...

Author: Asa Kasher

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Dying and Death Inter-Disciplinary Perspectives

At the Interface

Series Editors Dr Robert Fisher Dr Margaret Sönser Breen

Advisory Board Professor Margaret Chatterjee Professor Michael Goodman Dr Jones Irwin Professor Asa Kasher Dr Owen Kelly Revd Stephen Morris

Professor John Parry Dr David Seth Preston Professor Peter L. Twohig Professor S Ram Vemuri Professor Bernie Warren Revd Dr Kenneth Wilson, O.B.E

Volume 37 A volume in the Probing the Boundaries project ‘Making Sense Of Dying and Death’

Probing the Boundaries

Dying and Death Inter-Disciplinary Perspectives

Edited by

Asa Kasher

Amsterdam - New York, NY 2007

The paper on which this book is printed meets the requirements of “ISO 9706:1994, Information and documentation - Paper for documents Requirements for permanence”. ISBN: 978-90-420-2245-4 ©Editions Rodopi B.V., Amsterdam - New York, NY 2007 Printed in the Netherlands

Contents

Introduction

PART I

Practices of Mourning Embalming the American Body: Sentimental Mourning on the Cusp of the Civil War Ashley Byock

PART II

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1

Collective Emotions and National Mourning Asa Kasher

17

Issues of Death and Dying for Adult Children Of Holocaust Survivors Paula David

27

Death and Images of Womanhood and Manhood: The Case of Serbian Epic Poetry Mira Crouch

41

Extreme Makeovers and Reciprocal Relations between the Living and the Dead Kathleen Z. Young

57

Reflections on Mourning The Death of a Friend: Some Themes in Jacques Derrida’s The Work of Mourning Gary Peters

71

Death and the Other: The Ambivalence of Mourning Havi Carel

81

Grace towards the Dead Dana Freibach-Heifetz Death and Mourning: Logistics and Mystery Marguerite Peggy Flynn

PART III

107

Culture and Suicide For Fear of What the Neighbours Might Say: Social Networks and Suicide in Early Modern Holland Laura Cruz

PART IV

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121

When a Young Woman Dies: Gender, Youth and the Meaning of Suicide in the Jazz Age Kathleen Jones

135

“Voluntary Death” in Japanese History and Culture Lawrence Fouraker

153

Medics Facing Death and Dying Medics Facing Terminal Diagnosis? Angela Armstrong-Coster Between Organizations, Family and Death: Caring Creatively within the Hospice Organization Elizabeth Gill

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Reflections on the Needs of Palliative Patients after Being on the Receiving End of Care Anna Wreath Taube

203

Notes on Contributors

215

Welcome to At the Interface/Probing the Boundaries By sharing insights and perspectives that are both inter-disciplinary and multi-disciplinary, ATI/PTB publications are designed to be both exploratory examinations of particular areas and issues, and rigorous inquiries into specific subjects. Books published in the series are enabling resources which will encourage sustained and creative dialogue, and become the future resource for further inquiries and research. Dying and Death: Interdisciplinary Perspectives is a volume which belongs to the research and publishing project Making Sense Of: (www.inter-disciplinary.net/mso.htm). The project is an opportunity to engage in creative and innovative inter-disciplinary and multi-disciplinary research dialogues which seek to examining the links between living and dying, and some of the contradictions and paradoxes which arise that we appear to accept without question . Key themes that are central to the project include; •

contradictions and paradoxes

•

dealing with and responding to different kinds of death and dying

•

technology, dying and death; the impact of advances in medical technology

•

Institutions, dying and death

•

legal issues in dying and death

•

philosophical and ethical issues in dying and death

•

the management of dying and death

•

who deals with bereavement?

•

religious issues

•

the representation of dying and death in media Dr Robert Fisher Inter-Disciplinary.Net http://www.inter-disciplinary.net

Introduction Asa Kasher Death is a topic people are reluctant to ponder. Neither is dying a process that is usually being openly discussed. However, on a variety of occasions, dying and death are on a person’s minds, under some sensitive circumstances, he or she are eager to discuss with a close person, a friend, a professional. Some warm and clever discussions of death or dying can draw upon personal experience of either. However, resources of insight and understanding as well as of comfort and support are much broader, richer and sometimes even deeper than personal experience. In addition to one’s personal experience there are the experiences of other human beings, under similar conditions, but during some other period, or within the framework of a different culture. Moreover, in addition to personal experience, which undoubtedly is of paramount significance, there is understanding, knowledge of deeper conceptions and perspectives, which are acquired by scholarly pursuit and scientific research. The present volume, the second in the Series on Dying and Death, is meant to enrich personal experience of dying or death by providing its reader with the above mentioned additional resources of both kinds. It enriches personal experience by shedding light on related events or phenomena, even if of remote times or places, as well as by analysing familiar attitudes and common practices with respect to death or dying and disclosing underlying conceptions, assumptions and ideals. It is our firm conviction that both of those ways of enrichment of personal experience are not only possible, but also desirable. They are of general importance, regardless of one’s original perspective or resulting attitude, first, because they enable persons to better understand their own life, views and practices, and secondly, because they present persons with new forms of life, thought and practice, to which they can resort, if they so wish. Papers of the present collection are all new. They reflect their authors’ scientific research, scholarly pursuit or practical advancement of issues related to death or dying. Professional investigation of such issues often rests on personal experience, on the author’s personal implicit interest in aspects of loss, be they causes or effects, meanings or conceptions, emotions or expressions, or other ones. However, papers can be read and well understood without any acquaintance with such personal background stories. The collection is divided into four thematic parts:

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Introduction

____________________________________________________________ Section 1 describes practices of mourning, in different times and places, including USA during the Civil War (paper by Ashley Byock), the Island of Viz, which is between Croatia and Italy, during several periods (paper by Kathleen Young), as well as present day Israel (paper by Asa Kasher), medieval Serbia (paper by Mira Crouch) and post-Holocaust USA (paper by Paula David). Section 2 consists of several reflections on mourning. It includes philosophical discussions of Friendship (paper by Gary Peters), Grace (paper by Dana Freibach-Heifetz), and the Other (paper by Havi Carel), all in the context of mourning, as well as Mourning itself as a skill (paper by Marguerite Peggy Flynn). Section 3 brings papers on culture and suicide, in early modern Holland (paper by Laura Cruz), in historical Japan (paper by Lawrence Fouraker), as well as in the Jazz age (paper by Kathleen Jones). Section 4 discusses different predicaments of medics facing death and dying. Perspective under consideration are those of the medic facing terminal diagnosis (paper by Angela Armstrong-Coster), palliative patients (paper by Anna Taube), and the hospice setting (paper by Elizabeth Gill). Our collection of themes related to death and dying is neither exhaustive nor arbitrary. Its first two sections reflect our conviction that one can significantly enrich one’s conception of death and dying only by becoming more familiar with the two dimensional plane of practice and theory. Moreover, each of these dimensions involves a highly variegated family of themes, related to a variety of periods and places, viewed from a variety of cultural perspectives, discussed within a variety of disciplines. That rich nature of the dimensions of theory and practice is manifest in the papers of these sections. The other two sections of the present collection reflect another stance that we have taken. As is clear from the first two section, at the first and foremost foci of any significant discussion of dying and death are the dying person and the person facing death, whether of oneself or of a person dear to one’s heart. However, what we find near these two foci does not exhaust the space of dying and death. Section 3 discusses people who are neither dying nor face death, but rather people who desire death, which is an utterly different attitude towards it. Section 4 discusses medics who play certain roles in contexts of dying and death. They are, indeed, persons facing dying or death, but they bring with them into these contexts their professional experience, which is of evident significance.

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___________________________________________________________ We are grateful to the authors of the papers for having accepted our invitation to contribute to the present volume. We hope our readers will enjoy these papers as much as we have. We thank Ms. Liat Ireni for her most professional assistance in preparing the MS for production. Last but not least is our friend, Dr. Rob Fisher, whose warm encouragement, during all stages of preparation, has been of crucial significance. Rob Fisher and each of the contributors to the present volume on dying and death have certain dear persons in mind when he or she makes one’s scholarly or scientific or practical contributions to the sphere of treating death and dying. We dedicate the present volume to the memory of all those beloved persons.

Asa Kasher

Part I Practices of Mourning

Embalming the American Body: Sentimental Mourning on the Cusp of the Civil War Ashley Byock This chapter explores the convergence of national identity, mourning tradition, and political commemoration in the Northern United States during the opening stages of the Civil War. I argue here that the public commemoration of the first Northern martyr of the American Civil War, Colonel Elmer E. Ellsworth, illustrates how a collective work of mourning in the public sphere can become politically productive. For Northerners on the brink of war, Ellsworth became the embodiment of the Union cause when he was killed by the proprietor of an Alexandria, Virginia boarding-house just one day after Virginians voted to approve their secession from the Union. Having chosen to diverge from his appointed mission of interrupting the telegraph lines in Alexandria, Ellsworth mounted to the roof of the boarding-house to remove a Confederate flag that had been plainly visible from Washington, and was shot upon his descent. This event seemed to Northerners to exemplify the rebelliousness and depravity of the secessionist cause, and became an ideal rallying point for Unionists faced with national dissolution. The historical record shows that Ellsworth was the first American to be embalmed arterially – a very invasive method of bodily preservation – in order to be displayed at funerary exhibitions in four locations between Washington and his Mechanicville, New York home. I argue here that this soldier’s embalmment sustained a distinct relationship to the Union’s articulation of and consolidation around a distinct socio-political cause. This case presents an excellent occasion for exploring the relationship between mourning in the public sphere and the collective cultural work of expressing and constructing a sense of national identity. 1.

Introduction: Mourning and National Identity. Four years before President Lincoln’s assassination in April of 1865, tens of thousands of mourners gathered around the embalmed corpse of Colonel Elmer E. Ellsworth, whose death was hailed as the first martyrdom of the Civil War. Lincoln’s death at the end of the war induced panic about the future of the recently reconstituted nation that was partly consoled through collective mourning for the fallen President that

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Embalming the American Body

____________________________________________________________ celebrated his legacy as the icon of reunion. The “murder” of Ellsworth was also symbolically powerful – it signalled the beginning of war, the inevitability of more fallen soldiers, and the dissolution of the Union. Following the sentimental logic of what Mary Louise Kete has called “collaborative mourning,” the public commemoration of Ellsworth provided a potent symbolic nexus for Northerners seeking to establish and enunciate a coherent ideological foundation for Northern aggression against the South in May of 1861. Thus, in both cases, public mourning proved to be a most effective vehicle for transforming the discrete event of death into a forceful ideological statement of cause. I will show how widely shared antebellum structures of mourning provided a powerful blueprint for Americans, particularly Northerners, faced with a crisis of meaning on the cusp of national division. This study was set in motion by two questions that presented themselves to me as I sought to understand how death and mourning figured in public discourse between 1830 and 1865: “What social function did Ellsworth’s martyrdom fulfil?” and “What was the significance of the embalmment of his body?” These two questions are necessary intertwined, and the key to both lies in the precedent that antebellum mourning set for transforming the negativity of death and loss into a schema of resurrection, redemption, and transcendence. Scholars of literature and history have long associated nineteenthcentury America with a “culture of sentiment” that expressed the positivist attitudes of evangelical Christianity such as communitarianism, sympathetic humanism, and emotional expression. Because death was so familiar, the growth of a distinct middle class facilitated a standardisation of mourning rituals characterised by sacred memorial objects and fixed periods of mourning. At the same time, the abstract ideas associated with mourning became increasingly typologised around the concept of transformation. This potent cultural rubric provided one of the strongest and most familiar structures of meaning-making for Americans faced with the crisis of Civil War in 1861 for writers from journalists to poets who memorialised Ellsworth. This chapter’s focus lies at the junction of this shift from the localised sphere of antebellum mourning to the nationalised sphere of wartime mourning. As Alice Fahs shows, “with the start of war, officers’ deaths were perceived to be of national importance, requiring not just commemoration by family and friends but national commemoration. Within Northern popular literary culture, an elaborate martyrology grew up around the early wartime deaths of a small group of officers in the summer and fall of 1861.”1 By looking closely at the commemoration of Colonel Ellsworth as the first Northern martyr, I examine how Americans

Ashley Byock

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___________________________________________________________ deployed the work of mourning to narrate and make sense of the relationship between the Union cause and the deaths that this righteous purpose entailed. Ellsworth’s case is especially unique because it inaugurated the wartime practice of embalming the dead. While this technique was touted as a pragmatic solution to the problem of returning dead soldiers to their homes, in Ellsworth’s case physical embalmment served a host of other ideological and symbolic purposes in May of 1861. Ellsworth’s body became an icon of the Northern cause and a focus of widespread attention. This preoccupation with the physical remains of the dead functioned symbolically to establish and stabilise the assertion of Northern unity in the face of national division by attaching ideology to a material symbol. The technology of embalming not only made it possible for tens of thousands to participate in the transformation of Ellsworth into an icon of the emerging Northern cause, it also sustained a very significant, if vexed, relationship to the antebellum rubric of mourning. The very sacredness of the body that underwrote sentimental mourning simultaneously reviled any treatment of the body that violated its sanctity as a natural and divine object. In order to preserve the role of the body as the centre of ideological mourning, one of the fundamental presuppositions of the sacred sentimental body was violated. The embalmment of Colonel Ellsworth was thus paradoxically both functionally conservative, because it preserved the sacred body at the centre of mourning ritual, and socially progressive in its unnatural violation of a body whose sacredness had been associated with its naturalness. As such it reveals how profoundly important antebellum rituals of mourning were for Northerners seeking to convert the chaos of early wartime events into a script of unified purpose and collective engagement in shared ideals. I conclude here that the transformation of the work of mourning into a spectacle for mass consumption in the public sphere played a vital role in the ideological work of wartime Northerners. Ellsworth’s mass commemoration grounded the formulation of a collective socio-political identity in the same way that mourning for Lincoln became symbolic of the reunion of North and South at the war’s end. 2.

Antebellum Sentimental Mourning: The Sacred Body and the Deathbed Tableau. Because death was pervasive and most parents could reasonably expect to lose at least one child, mourning was a very popular topic for a wide range of writers from poets to ministers. Across a variety of genres and publications, the deathbed tableau provided a way of representing the

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____________________________________________________________ abstract and complex experience of profound loss in a symbolic language that would have been familiar to any kind of reader. This familiar typology furthermore consoled loss by imagining death in terms of transcendence, as in this 1852 poem: “Murmur not, mourner, that the year is brief; / For even mutation speaks the eternal soul.”2 The power of the deathbed tableau for representing and consoling grief not only pervaded literary productions like Harriet Beecher Stowe’s 1852 popular novel Uncle Tom’s Cabin, it also provided a powerful script for Northerners confronted with all the problems and crises that the first prominent death of the Civil War seemed to conjure and express. I focus here on the deathbed tableau because it was a very common and very stable expression of how sentimental mourning converted the negativity implicit in loss into a constructive typology of redemption and resurrection as conceived in religious as well as social terms. Furthermore, all the primary components of this literary and cultural trope – the encircling of the deathbed, death as a form of transcendence, and focus on the dying or dead body as the sacred site of profound meaning – were activated in the collective mourning of Ellsworth that I explore in this chapter’s third section. The iconic scene in which the dying or dead body was surrounded by loved ones whose shared experience of mourning bound them together into a sympathetic circle expressed the highly esteemed sentimental values of sympathetic identification and divine transcendence. As in the following example, mourners and readers alike were encouraged to find in the “sleep” of death a model of transition from the worldly to the heavenly: “Mourner, the dear one, whose departure you lament, has but gone before you to your common Father. Be of good comfort. Live the true life in the world, and you shall be reunited in the true home in heaven!”3 It is in this movement beyond the immanent toward the divine that those who mourn will find their consolation and their moral imperative: “It will be more easy, at such a time, to convert the sorrow of this world, that worketh death, into that godly sorrow that worketh repentance unto life.”4 The teleology of this formulation of mourning is almost always toward some version of redemption and the promise of resurrection in this period. Daniel Eddy’s 1852 consolation manual, Angel Whispers, recounts several anecdotal deathbed scenes that depict the edifying experience of witnessing the event of death. In one typical case, as “drew closely around her the loving hearts of that sorrowing circle,” the “young [female] disciple” cried out, “Mother . . . I—see—a light—I’m almost home!”5 Two exemplary sentimental values - redemption (“disciple”) and resurrection (“I’m almost home!”) – are explicitly embedded within the way this scene is constructed. A third key

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___________________________________________________________ sentimental term – transcendence – is implicitly expressed here on at least two levels. In one sense, the heavenly transcendence of the moribund central figure confirms the ephemerality of earthly life. At the same time, a parallel lesson is confirmed: the gathering of “sorrowing hearts” into a circle confirms the mourners’ transcendence of their individualism through sympathetic identification with others. These three key sentimental terms – redemption, resurrection, and transcendence – together convey the reason why mourning presented such a potent script in the sentimental culture of antebellum America. The power to transform the negativity of loss into a productive divine experience offered grounds to console not only the death of someone beloved, but a host of other individual and social crises. The fundamental dynamic of sentimental culture was transformation, and the typology of mourning might redress even abstract losses like the dissolution of national unity in 1861. Although the transformative possibilities of sentimentalism were usually directed toward the distinctly soteriological ends of spiritual transcendence and moral goodness, in cases such Uncle Tom’s Cabin, this literary typology could ground a strongly politicized message that derived its power from the reader’s affective response to and identification with the inspirational mourning of literary, or even anecdotal, characters. In Stowe’s novel, Little Eva’s deathbed scene harnesses this typology of transformation and directs its energies toward an abolitionist polemic. As the emotional heart of Stowe’s novel, this young daughter of a plantation owner exemplifies sympathetic humanity in her benevolent treatment of slaves. Eva’s transition from “death unto life” is gradual and allows her to impart to Tom, an adult slave and Eva’s most avid spiritual student, “those mysterious intimations which the soul feels, as the cords begin to unbind, ere it leaves its clay forever.”6 The legacy of her mourning is furthermore embodied in the kinds of object-reminders that attested to sentimental culture’s fetishisation of the materiality of the body as a core component of death’s divine associations. The locks of hair that Eva distributes to the motley collection of family and slaves that gather around her bed recur throughout the rest of the tale as a moral imperative for the righteous and as a haunting for the sinful as the novel works through the tragic results of slavery and the death of Uncle Tom. As she admonishes from her deathbed: You are thinking only about this world. I want you to remember that there is a beautiful world, where Jesus is. I am going there, and you can go there. . . . I’m going to give all of you a curl of my hair; and, when you look at it, think that I loved you and am gone to heaven, and

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____________________________________________________________ that I want to see you all there.7 The culture of sentiment in nineteenth-century America was steeped in the power of the symbolic. The morally elevated economy of affect that eclipses the de-humanizing system of slavery in Stowe’s novel is always grounded in material signifiers: Eva’s locks; a dead mother’s letter; the scrap of mourning weeds that Eva’s most wretched mourner – Topsy, the ragged young slave – saves; and the bible Tom receives from Eva. None of these objects is unique; indeed, they each establish their role in the narrative as types borrowed from the rich sentimental store-house of iconic signifiers. The grounding of narrative meaning in symbolic objectrelations also structures such sentimental novels as Susan Warner’s The Wide, Wide World, in which Ellen’s mother assembles a sewing box, a writing box, and a trunk of clothes, each laboriously selected with motherlove, as compensation for her own impending death. Such grief-work as Stowe describes enmeshed the mourner in a richly symbolic economy of meaning that extended beyond the realm of death toward an understanding of one’s social identity. The work of mourning brought the bereaved – and even the reader – into contact with the most sacred sentimental axioms of emotional expression and uplifting self-transformation. The ability of objects to stand in for a moral imperative, for mother-love, and for the dead themselves reflected a culture in which the abstractions of loss were enshrined in material reminders. Within this system of divine interpretation, one of the most sacred objects was the corpse. Gary Laderman argues, “At the centre of this network of practices and significations [of death] was the corpse, an irreducible object that evoked feelings of dread, fear, and resignation, as well as reverence, respect and hope.” 8 Death’s association with transcendence and transformation, which I have identified as two key sentimental dynamics, endowed the corpse with a potent role in the world of the living. The relationship between the treatment of the dead and the culture of the living was the subject of Harper’s Weekly magazine’s April, 1854 “Editor’s Table” commentary. Following a logic that is parallel to that of Stowe’s novel and innumerable other literary meditations on death and mourning, the Harper’s editorial asserts the moral edification of proper treatment of the dead as a metaphor for the retention of both their human and divine aspects in collective memory. The piece rails against the misuses of the corpse, asking whether the “necessities of medical science . . . [e]ven where the want is conceded, . . . might be purchased too dear.” 9 Dissection, which takes the body apart, violates its physical and moral integrity. By extension, the imagined integrity of society, and respect for the living individual, are endangered.

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___________________________________________________________ It does no hurt to the dead, but it does an immense injury to the living. We refer not now to the more immediate pain given to the sensibilities. Severe as this is, there is an evil far greater in what may be styled the demoralizing consequences that must flow from the loss of that reverence which has ever been connected with all that reminds us of the departed. . . It breaks up the sympathies which unite us with the dead and thus tend more than all things else to preserve the past as well as present brotherhood of the race. An increasing indifference to the grave and its sacred contents must produce a state of mind at war, in feeling, if not in abstract dogma, with some of the most solemn revelations of Scripture. We do not make enough of the resurrection in our modern theology. 10 Thus the corpse does not become significant for its own sake – its holiness may be partly innate, but its greatest importance arises from its figurative role in the collective imagination of its survivors. Reverence toward the corpse does more than signal cultural moral integrity, such proper deportment is so powerful that it produces social cohesion. For a culture so attached to preserving the naturalness of the body after death, embalming was so unthinkable that it was very rarely discussed in antebellum public discourse. Extraordinary circumstances were thus necessary for this most invasive preservative technique – arterial embalming – to become acceptable and even sought after by the few who could afford it during the war. 3.

Embalming the Body Politic. In his First Inaugural Address on March 4, 1861, President Lincoln addressed his secessionist “dissatisfied fellow-countrymen”: “You can have no conflict without being yourselves the aggressors.” Colonel Elmer E. Ellsworth seemed to be the first fatality of this aggression, and he quickly became the emblem of the North’s response. As one commentator on May 25, 1861, noted, “We are heart-broken, and Virginia has contracted a debt that centuries of grovelling cannot wipe out.” 11 In the days and weeks after Ellsworth’s death, witness accounts appeared alongside reports of funerary obsequies and elegies in daily journals and periodical magazines. In addition, commemorative envelopes and songs published in broadsheet form contributed to a widespread circulation of Ellsworth’s name and image throughout the North. Witness reports recounted his final moments in distinctly sentimental terms. His final

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____________________________________________________________ words, reportedly “My God,” were duly related along with details of his bodily comportment and the reactions of his men. Such reports of his death, burial, and commemoration incorporated such details into a broader narrative of Ellsworth’s heroism. When the very Confederate flag that Ellsworth had made it his mission to remove was then used to cover his dying body, one account asserted that it was “stained with his blood, and purified by this contact from the baseness of its former meaning.”12 The same narrative and ideological structures of mourning that Stowe deployed in Uncle Tom’s Cabin informed the way reporters, witnesses, poets, and even Lincoln himself collaborated to construct Ellsworth as a representative citizen-soldier whose death signified the transgression of the ideal of Union by rebellious Southern aggressors. The Atlantic Monthly’s obituary characterised Ellsworth’s battle against the boardinghouse proprietor as one between Freedom and Slavery. While Ellsworth was “brave, refined, courtly, generous, tender, and true; the other, not lacking in brute courage, [was] reckless, besotted, ignorant, and cruel.” 13 Likewise, the New York Times opined, “Never before has a man of Col. Ellsworth’s age commanded such national respect and regard in so short a space of time; certainly the Metropolis [of New York] never paid greater honour to one of her own sons.” 14 In May of 1861, collective mourning for Ellsworth became an ideal occasion for Northerners on the brink of war and in danger of losing a great deal to focus their anxieties around one funeral bier. In the same way that Little Eva’s deathbed consolidated her disparate mourners – slave-owners and slaves alike – into a congregation of sympathetic believers, the circulation of Ellsworth’s body through the North both physically and imagistically constructed a confederacy of mourners: “His memory will be revered, his name respected, and long after the rebellion shall have become a matter of history, his death will be regarded as a martyrdom, his name will be enrolled upon the list of our country’s patriots.”15 The danger of secession lay in its destruction of the “more perfect union” that Lincoln defined in his First Inaugural Address to be “perpetual” by definition: “if destruction of the Union by one or by a part only of the States be lawfully possible, then Union is less perfect than before the Constitution, having lost the vital element of perpetuity.” Not only did Southern rebellion threaten the reality of a Union of States, it endangered the abstract principles upon which these states had been bound together less than a century before. The very designation throughout periodical accounts of Ellsworth’s death as the result of “assassination” reveals how politically inflected his “martyrdom” was from the very first. The Northern cause was thus conservative in the sense that it sought to preserve the essential definition of the Union of States from the retroactive

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___________________________________________________________ negation that the ability to secede from this Union would necessarily signify. The death of Ellsworth occurred at the very moment when the inevitability of military aggression heralded a great many more deaths, and when, simultaneously, the more abstract loss of a consolidating national identity was likewise vitally threatened. The collaborative construction of Ellsworth as a representative martyr thus projected the more abstract dangers of national division and the dissolution of the Union onto a singular event. Furthermore, the metaphorical power of sentimental mourning-work to signify redemption, resurrection, and transcendence, offered an ideal rubric for consoling and consolidating all these potential losses. As the following witness account reveals, Ellsworth’s first mourners, “his men,” reacted with outward signs of grief revealing that, despite their “rough natures,” they were men of great feeling. We endeavoured to keep the melancholy death of our leader from the ears of his men, who had learned to love him as dearly as their rough natures could. Those, however, who heard of his fate, vowed to avenge his murder. How harrowing was the scene! Strong men came and looked upon the pallid features of him whom they had seen a moment before full of health and vigour, and as they gazed a convulsive sob and unbidden tear told how sincerely the gallant spirit that had so lately tenanted that mortal frame was mourned.15 The demonstration of grief is, here, attributed to the greatness of the fallen leader. The ability to induce such strong feeling, to the degree that even men will give way to it in public, confirms Ellsworth as a sentimental hero whose example is edifying to those below him. This same logic extends to the public figuration of Ellsworth’s heroism in the press. As Glenn Hendler argues, “sympathy in the nineteenth century was a paradigmatically public sentiment.”16 Furthermore, Hendler shows, the language of sentiment in the public sphere – across literary and non-fiction genres – sought to induce to reader into a position of sympathetic identification. Here, the men whose feelings are overwhelmed become for the New York Times’ readership on May 26, 1861, both compelling evidence of Ellsworth’s exemplary character and, also, the grounds for interpellating the reader, as fellow mourner, into a believer in the cause that Ellsworth’s martyrdom is presumed to epitomize. The fact, furthermore, that Ellsworth’s comrades took pains to recompose the body’s humanity after death suggests how profoundly the

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____________________________________________________________ body retained its sanctity, as E.H. House recounted for the New York Tribune: We removed some of the unsightly stains from the Colonel’s features, and composed his limbs; his expression in death was beautifully natural. The colonel was a singularly handsome man, and, excepting the pallor, there was nothing different in his countenance now from what his friends had so lately been accustomed to recognize gladly.17 The composition of the limbs and the restoration of the body to an honourable position seeks to counter the negation of identity through death. This description echoes that of Little Eva after her death: “the head was turned a little to one side, as if in natural sleep, but there was diffused over every lineament of the face that high celestial expression” of “the long sacred rest which ‘He giveth to his beloved.’”18 In both cases, the “celestial” trace is inscribed in the face. As Jay Ruby shows, antebellum post-mortem photography, which was widely popular within ten years of photography’s invention in 1839, sought to compose the body to look natural, as if in sleep, with particular focus on framing the face prominently. By reconfiguring Ellsworth’s humanity, and insisting on the continuity of something natural and recognizable in his face, House and his fellow Zouaves acted upon the very familiar sentimental presumption that identity is not erased in death, and that this singularity is retained in the bodily form of death. After Ellsworth’s body had been safely returned across the Potomac to the Navy Yard, Thomas Holmes, later identified as the “father of modern embalming,” proceeded to empty the body of its blood while injecting a preservative solution that he later patented. This full procedure of embalming also necessitated the removal of all internal organs and their replacement by an absorbent material like sawdust. Ellsworth became, so far as the historical record shows, the first American to be arterially embalmed for the purposes of public display. Previously, arterial embalming appears to have been limited to medical uses for educational dissection. The preservation of bodies for mourning might be effected with the help of ice, or sometimes only the chest might be stuffed. Tightly sealed coffins, especially metal coffins, began to appear before the war. And, at times, a body might be stored in a barrel of whisky, as President Washington was according to some reports. But, for the most part, the dead were watched over for signs of life, were then washed clean and dressed, and were finally escorted to either the church or directly to the

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___________________________________________________________ churchyard for burial. While the sentimental conception of the sacred body pervaded religious, sociological, and literary texts in nineteenthcentury America, the corpse itself, though presumed to retain a great measure of its humanity, also presented certain dangers, particularly in summer. But why was Ellsworth embalmed? And how did his embalmment become the embodiment of the ideal of Union for a large collection of Northerners for whom the danger of secession threatened their core relationship to a stable national identity? Embalming bodies had been, Laderman notes, “impractical if not inconceivable to the majority of the population” before the war.19 Yet this physically invasive preservative technique proved to be the only practicable solution to the crisis of mass death at the front. A practice that had represented everything antithetical to sentimental mourning suddenly became the only way to preserve the semblance of traditional practice at a time when mourning was quickly becoming a national preoccupation. Reports designating who made the determination to embalm Ellsworth’s body vary. While many accounts give no attribution, many assert that Lincoln arranged for Ellsworth to be embalmed. Whatever the genesis of this decision, it facilitated a mass public congregation of citizens, soldiers, and politicians in an extended process of mourning and display through which all could identify their own relationship to a greater cause. This process itself helped construct and solidify this cause. Although it is impossible to determine how Ellsworth came to be embalmed, it is certain that his known relationship to the President provided excellent grounds for his elevation as a national figure deserving of a hero’s commemoration. Indeed, the President’s attendance at the Navy Yard and in the East Room of the White House while Ellsworth lay in State were widely noted. Ellsworth’s relationship to the President bolstered the strong associative link between his death and the cause of preserving the nation-state. What was being protected, as I noted above, was the assumption that the nation’s constitutional foundation must be proven to be unbreachable. As it circulated through the North, the embalmed body of Ellsworth generated a vast array of newspaper stories, witness accounts, songs, poetry, and even commemorative envelopes. Together these cultural productions built up a story around Ellsworth that positioned him as the representative hero of the Northern cause. In this way, the work of mourning became a broad cultural narration of the story of its unification around abstract ideals that were figuratively legible in Ellsworth’s very body. The following account of Ellsworth’s first funerary exhibition in the East Room of the Presidential Mansion, published by Colonel John W.

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____________________________________________________________ Forney in the Philadelphia Press, conflates the individual mourning of prominent political figures with the role that Ellsworth’s martyrdom plays in providing the grounds for a Northern rallying cry: While gazing upon the scene and listening to the religious services over the bier of poor Ellsworth, many peculiar reflections suggested themselves. The most interesting figure of the group was General Scott. . . . Before him lay the dead body of one, almost a boy in years, who had died for his country; around him gathered the great ones of the land. There was the President, still a young man, with Mrs. Lincoln, whose grief could not be concealed; on his right, the Secretary of War, not yet sixty, and in the prime of health; leaning over the back of General Scott’s chair, the Premier, Mr. William H. Seward, looking almost youthful at his side.20 Forney goes on to enumerate what he calls “champions of the flag” ranging from Commodore Paulding of the Navy to Senator Sumner and others. He concludes: As the clergyman prayed and preached for the country, for victory for the right, for strength and virtue in our rulers, and implored God to so govern that not one act of crime, like that at Fort Sumter, or the Baltimore bloodshed, or the Ellsworth assassination, should disgrace our cause, the battle-scarred veteran [General Scott] raised his gray head and seemed to feel that all is well, and that the end would be glorious as the most earnest patriot could desire. 21 Here, the encirclement of the mourners around the funeral bier confirms Ellsworth’s exalted position as a patriot of the North. Notably, he is surrounded in death by a more prominent collection of mourners than he would have encountered together in life. Constructed as a martyr, although Ellsworth’s death was, as Lincoln admitted, the result of “an act of rashness”22 and not battlefield valour, the clergyman and Forney collaborate to interpret Ellsworth’s death as exemplary of Southern immoral rebellion and cruelty. Ultimately, as this depiction suggests, Ellsworth’s death became an ideal occasion for the consolidation of Northerners as a congregation of mourners figuratively represented by

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___________________________________________________________ their lofty statesmen around Ellsworth’s funeral bier. Mass mourning for Ellsworth collaboratively constructed a story of the war’s causes and meaning and to galvanize around that ideal. Commemoration of the dead during the American Civil War was simultaneously nostalgic and politically potent. I have argued here that perhaps the most apt example of how this worked came in the form of embalming, especially in the service of commemorating the North’s first martyred soldier and later the assassinated President. This form of bodily preservation, while virtually unimaginable to Americans before the war, quickly became an accepted technology for the preservation of the body because it enabled Americans to retain the most familiar codes of sentimental mourning. By returning the soldier’s body to the domestic sanctum that anchored Northern middle-class sentimental culture from the 1830s through the 1850s, bodily preservation reclaimed the soldier from the potential anonymity and dislocation of death and burial at the battlefront. Wartime attitudes toward death adapted the tableaux and rituals of antebellum sentimental mourning to the dramatically new set of conditions around death. As the war progressed, the death toll rose beyond all expectation, soldiers were sometimes unrecoverable from the battlefield or were buried anonymously, and grievers were left without any familiar rubric for adapting to these conditions of loss. Embalming alone could preserve soldiers’ bodies to facilitate their return to their Northern homes and families. While we now conceptualize the Civil War as a kind of breaking in two; in fact, the ultimate danger was the disintegration of the very tenability of unification itself. If states could secede from the Union, then they suddenly always already existed outside that unified whole. Lincoln’s address at the consecration of the Gettysburg battlefield-cemetery reflects both the drive to preserve the image of the nation as articulated at its founding as well as the profound relationship that pervaded wartime sensibilities of the relationship between this nation and the deaths of its citizen-soldiers. Lincoln formulates a distinct relationship between the continuity of a nation “conceived in liberty” and the dead who alone can consecrate the ground in which they are buried: [F]rom these honoured dead we take increased devotion to that cause for which they gave the last full measure of devotion; . . . that this nation, under God, shall have a new birth of freedom; and that government of the people, by the people, for the people, shall not perish from the earth.23

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____________________________________________________________ Thus, the dead in this war did not become martyrs solely within the context of the current struggle – for the cause of the North as an entity distinct from the South. Rather, their deaths must be interpreted as serving the principle of unification around an abstract and sacred set of ideals. Ultimately, the final referent of all these ideals, from which derives their ability to endow death with the hallowed signification of martyrdom, is the principle of a collective presumption of unification. By drawing out a series of linkages between the Northern cause, the founding of the nation entitled “the United States,” and an implicit matrix of meaning through which death becomes martyrdom, Lincoln’s commemoration enacts a historiography of national identity through the metaphorics of mourning. The President (of the North) here restates, with astounding brevity and clarity, the underlying assumptions of Northern discourse about the war’s motivations and meanings. For all Northerners, and for Southerners too although in notably different ways, death and mourning transcended individual experience and became a primary component of how the unfolding events of war were integrated social constructions of national identity.

Notes A. Fahs, The Imagined Civil War: Popular Literature of the North and South, 1861-1865 (Chapel Hill: University of North Carolina Press, 2001), 83. 2. G. Burleigh, The Dew-Drop: Tribute of Affection (Philadelphia: Lippincott, Grambo & Co, 1852), 126. 3. R. Griswold, The cypress wreath: A Book of Consolation for those Who Mourn (Boston: Gould, Kendall and Lincoln, 1844), 47. 4. Grosvenor, x. 5. D. C. Eddy, Angel Whispers; Or, The Echo of Spirit Voices. Designed to Comfort those Who Mourn (Boston: Dayton and Wentworth, 1852), 25. 6. H.B. Stowe, Uncle Tom’s Cabin; Or, Life Among the Lowly (New York: W. W. Norton & Company, 1994), 257 and 255. 7. Ibid, 251. 8. G. Laderman, The Sacred Remains: American Attitudes toward Death, 1799-1883 (New Haven: Yale University Press, 1996), 26. 9. “Editor’s Table,” Harper’s Weekly, April 1854, 690. 10. Ibid, 691. 11. The New York Times, 24 May 1861, 1. 12. C. Ingraham, Elmer E. Ellsworth and the Zouaves of ’61 (Chicago: University of Chicago Press, 1925), 152. 1.

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___________________________________________________________ 13. 14. 15. 16. 17.

18. 19. 20. 21. 22. 23.

The Atlantic Monthly, July 1861, 125. The New York Times, 27 May 1861, 1. The New York Times, 27 May 1861 1. The New York Times, 26 May 1861, 8. G. Hendler, Public Sentiments: Structures of Feeling in NineteenthCentury American Literature (Chapel Hill: University of North Carolina Press, 2001), 12. Ingraham, 152. Stowe, 258. Laderman, 26. Quoted in Ingraham 159. Ingraham, 159. Quoted in Ingraham, 157.

References Burleigh, G. The Dew-Drop: Tribute of Affection. Philadelphia: Lippincott, Grambo & Co, 1852. Eddy, D. C. Angel Whispers; Or, The Echo of Spirit Voices. Designed to Comfort those Who Mourn. Boston: Dayton and Wentworth, 1852. “Editor’s Table.” Harper’s Weekly, April 1854, 690-694. Fahs, A. The Imagined Civil War: Popular Literature of the North and South, 1861-1865. Chapel Hill: University of North Carolina Press, 2001. Griswold, R. The cypress wreath: A Book of Consolation for those Who Mourn. Boston: Gould, Kendall and Lincoln, 1844. Grosvenor, B. The Mourner: Or The Afflicted Relieved. Bridgeport: Lockwood & Backus, 1810. Hendler, G. Public Sentiments: Structures of Feeling in NineteenthCentury American Literature. Chapel Hill: University of North Carolina Press, 2001. Ingraham, C. Elmer E. Ellsworth and the Zouaves of ’61. Chicago: University of Chicago Press, 1925.

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____________________________________________________________ Kete, M.L. Sentimental Collaborations: Mourning and Middle-Class Identity in Nineteenth-Century America. Durham, N.C.: Duke University Press, 2000. Laderman, G. The Sacred Remains: American Attitudes toward Death, 1799-1883. New Haven: Yale University Press, 1996. Ruby, J. Secure the Shadow: Death and Photography in America . Cambridge, MA: MIT Press, 1995. Stowe, H.B. Uncle Tom’s Cabin; Or, Life Among the Lowly. New York: W. W. Norton & Company, 1994. Originally published (1851-52), The National Era. Boston: John P. Jewett and Company.

Collective Emotions and National Mourning Asa Kasher The present paper is about collective emotions in general and about collective mourning in particular. The first part of the paper will outline a philosophical conception of collective emotions. The next part will present an application of that conception to the case of public mourning, as practiced in various states. Proposals will be mentioned for the proper practice of national mourning, which have recently been made by a public commission, headed by the author. 1.

Collective Emotions: Three Interpretations. We seem to have no difficulty in using the same expressions for describing both individual persons and human collectives: (1a) (1b) (2a) (2b) (3a) (3b)

John moved from the city to the country. The family moved from the city to the country. Mary is of the view that stem cell research should not be banned. The committee is of the view that stem cell research should not be banned. Bill wishes Suzie to be the mayor of town. The townsfolk wish Suzie to be the mayor of town.

Speakers of English know how to use and understand simple sentences that ascribe to a certain person some action, view or wish (1a-3a), but they seem to know how to ascribe the same actions, views and wishes to groups of persons (1b-3b). Similarly, speakers of a natural language ascribe the same emotions to both individual persons and groups of persons: (4a) (4b)

Harry is very sad, having heard the news. The nation is sad, having heard the news.

However, the similarity between ascription of collective actions, views and wishes and ascription of collective emotions is only apparent. There is a major difference between the meaning of sentences such as (1b)-(3b) on the one hand and the meaning of sentences such as (4b) on the other hand.

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Collective Emotions and National Mourning

____________________________________________________________ To see the difference, consider the conditions under which sentences such as (1b)-(3b) are assertible. Sentences (1b) is assertible, by a certain speaker in a certain context of utterance, only if the speaker believes in that context that every member of the family or almost every member of the family moved from the city to the country. Sentence (2b) is assertible, by a certain speaker in a certain context of utterance, only if the speaker believes in that context that the committee has followed a procedure of deliberation. Moreover, the committee’s deliberation, so the speaker believes in that context, has resulted in what counts as the committee having made a decision that the view of the committee is that stem cell research should not be banned. Sentence (3b) is ambiguous in the following sense. It is assertible, by a certain speaker in a certain context of utterance, only if certain conditions obtain: conditions that are similar to those we mentioned with respect to the assertibility of (1b) or conditions that are similar to those we mentioned with respect to the assertibility of (2b). That is to say, the sentence “The townsfolk wish Suzie to be the mayor of town” can be happily used for assertion, only if one of two conditions obtains. First, everyone among the townspeople or almost every one of them wishes Suzie to be the mayor of town. Second, the townspeople have performed a procedure that resulted in what counts as the town having established the wish that Suzie be the mayor of town. Generally speaking, assertibility conditions of sentences that ascribe an action, a view or a wish to a group of people, such as a family, a committee or a town, are of the following kinds: (CA1) Distributive meaning: What is ascribed to the group holds for it since it holds for every member of it or for almost every member of it; (CA2) Formal meaning: What is ascribed to the group holds for it since according to the norms of the practice that regulates the group, the state of the group counts as one in which what is ascribed to the group holds for it. Now, sentence (4b) does not lend itself to such an analysis, neither in terms of assertibility condition (CA1) nor in terms of assertibility condition (CA2). Imagine the following situation, holding for a town: (S1)

(S2)

The town consists of six large communities. Each of them has its distinct form of life. Almost all interactions of a person of the townsfolk take place within the framework of one’s community. All members of different communities live in the vicinity of members of all other communities, but also quite separately of each

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____________________________________________________________ (S3)

(S4)

(S5)

(S6)

other. Among the casualties of a recent war are numerous members of each of three communities. All members of a community that has suffered casualties are sad. Their emotion is manifest in their daily activities. All members of a community that has not suffered casualties behave cordially but are not sad. The Town Council has not proclaimed any period of Communal Mourning, nor has it decided to change any aspect of the daily life of the townsfolk in a way that expresses sadness.

Assume, furthermore, that the sentence “The town is sad” is being used by a certain speaker as a description of the current situation of the town. Obviously, it cannot be happily used in a distributive meaning of ascribing sadness to the group of townsfolk, since condition (CA1) does not hold. It is not the case that every one or almost every one among the townsfolk is sad (S5). Similarly, the same sentence cannot be happily used in a formal meaning of ascribing sadness to the group of townsfolk, since condition (CA2) does not hold. It is not the case that a formal decision has been made by the Town Council to proclaim a mourning period or change any aspect of the daily life of the townsfolk in a way that expresses sadness (S6). However, the sentence “The town is sad” can be happily used as a description of the current situation of the town, when it fulfils (S1)-(S6). Imagine you are a tourist in that town. Wherever you go, you see people in a sad mood, flags at half mast, pictures of persons who died in the recent war, centres of entertainment closed down, and other manifest features of sadness and bereavement. You notice that there are people who seem not to share the emotions of their neighbours, nor do they manifest any features of grief or mourning, however in the vicinity of every such person, you encounter sad persons, clearly in grief, commonly mourning. “The town is sad”, you tell yourself, and you are right. Thus, in addition to assertibility conditions (CA1) and (CA2), which specify conditions for ascribing to groups of persons actions, views and wishes, as well as emotions, we have an assertibility condition (CA3), which holds for conditions not covered by (CA1) and (CA2): (CA3) Diffusive Meaning: What is ascribed to a group holds for it since in

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____________________________________________________________ the vicinity of every member of the group or almost every member of it, there is a member of the group for whom it holds. Under circumstances (S1)-(S6), sentence (4b) “The nation is sad, having heard the news” is assertible in the diffusive meaning. The diffusive meaning is different from the distributive meaning and the formal meaning in an important way. To grasp the difference, let us consider the following pairs of sentences: (1b) (1c) (2b) (2c) (3b) (3c)

The family moved from the city to the country. The family stayed in the city. The committee is of the view that stem cell research should not be banned. The committee is of the view that stem cell research should be banned. The townsfolk wish Suzie to be the mayor of town. The townsfolk wish John to be the mayor of town.

Clearly, none of such pairs of sentences can be asserted at one and the same time, since what is asserted by means of one member of such a pair is incompatible with what is asserted by means of the other member of the pair. For example, the family cannot, at one and the same time, move from the city and stay in it. Sentences such as (1b) and (1c) are used in the distributive meaning (CA1). For (1b) to be assertible in some context of utterance, every member of the family or almost every member of it moved from the city to the country. For (1c) to be assertible in the same context, every member of the family or almost every member of it stayed in the city, that is to say, did not move. Thus, what is required for (1b) is incompatible with what is required for (1c). Similarly, the pairs (2b)-(2c) and (3b)-(3c) can be shown to involve a parallel incompatibility. Now, consider the following pair of sentences: (4b) (4c)

The town is happy. The war is over. The town is sad. Casualties are numerous.

We take it that a single person cannot be both sad and happy, at one and the same time. A person can have, at one and the same time, reasons for being happy, such as “The war is over”, and reasons for being sad, such as “Casualties are numerous”. A person can even show, at one and the same time, both features of happiness and features of sadness, in his behaviour. However, a person cannot be, at one and the same time, both happy and

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____________________________________________________________ sad. However, the town can be, at one and the same time, both happy and sad. When the first sentence of (4b) and the first sentence of (4c) are used in the diffusive meaning, under circumstances similar to those of (S1)(S6), the town is both happy and sad. The town is happy, since in the vicinity of every member of the townsfolk there is a happy person and there are public features of happiness. The town is sad, since in the vicinity of every member of the townsfolk there is a sad person and there are public features of sadness. Generally speaking, it seems that when sentences that ascribe emotions to a group of persons are used they can have the diffusive meaning. Moreover, when they are used in the diffusive meaning seemingly incompatible emotions, such as sadness and happiness, can be successfully asserted to hold at one and the same time for the same group, what is not the case when sentences are used in the distributive or formal meaning. Our observation of the diffusive meaning of sentences that ascribe collective emotions is of some practical significance. Consider circumstances under which a population is described, in the diffusive sense, as both sad and happy. Assume, furthermore, that under the circumstances, both emotions appear to an extreme extent. A typical example would be the end of a war of independence. Thus, when the State of Israel was founded and the War of Independence was over, both happiness and sadness prevailed. Happiness was natural, given the independence enjoyed by Jews in their homeland after millennia of their being in exile. Sadness was natural, given that about one percent of the Jews in the area fell during the war. When and where extreme sadness prevails, it is reasonable to assume that some people suffer to an extent that calls for clinical support or intervention. However, when extreme happiness prevails, it is reasonable to expect that attention to grief and suffering is going to be lower than it would have been, if happiness did not prevail at all, and even much lower than it would have been, if only sadness prevailed at the time. Hence, the very possibility of diffusive collective emotion requires that special attention be paid to the fate of those who suffer darkly, behind the glittering curtains of collective happiness. 2.

National Mourning: Constraints and Criteria. In a nutshell, our view of collective emotions includes among its conceptual ingredients the distinction between different meanings of sentences that ascribe an emotion to a group of people. The simplest meaning is the distributive one: “The class is sad”, in the sense that

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____________________________________________________________ everyone in the class or almost everyone in it is sad. The most intricate meaning is the diffusive one: “The town is sad”, in the sense that in the vicinity of everyone in the townsfolk there is a person who is sad. We turn now to the third meaning, the formal one: “The nation is sad”, in the sense that a national authority formally proclaimed what may be called “national sadness”. A new practice will be described of proclaiming “national mourning”, which involves manifesting a variety of features of sadness. The new practice has been suggested by a public commission, which was appointed by the government of the State of Israel. At the background of the appointment is the sad event of two Israel Air Force helicopters collision, several years ago, in which 73 IDF officers and NCOs died on their way to missions in a military zone that Israel held at the time in Southern Lebanon. Facing the wave of funerals that covered the state, the government decided to proclaim a short period of national mourning. The decision rested on no law or regulation but on a rarely invoked tradition of proclaiming national mourning under appropriate circumstances. As much as the proclamation of national mourning on the occasion of the helicopter accident did not raise public objections, it did raise the problem of delineation of those occasions on which national mourning ought to be proclaimed. Although the fall of so many persons at one and the same time is very rare, the fall of a similar number of persons during a period of some months or a few years is not rare at all. The apparent principle that there ought to be a period of national mourning when and only when many citizens die on a single occasion did not seem justifiable. Accordingly, the ministerial committee of emblems and ceremonies appointed a public commission that was asked to propose a characterization of the conditions under which the government ought to proclaim an appropriate period of national mourning and suggest appropriate ways of formal expression of national mourning. For some technical reasons, the commission was replaced by another one, which was assigned exactly the same duties and headed by the present author. An international survey of practices that different states have for proclaiming national mourning was conducted by the commission, but turned out to be not very helpful. Many states do have some form of national mourning. Usually, in such a state, a period of national mourning may be proclaimed by the Palace, the president, the government, etc., but the parameters of the decision to proclaim national mourning are not specified in much detail. Hence, periods of national mourning vary from a day or so to three months. Expressions of national mourning vary from

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____________________________________________________________ flags at half mast, during the funeral, through special educational programs used by schools during the period of national mourning, to closure of all entertainment institutes for the whole period. Most significantly, there seem to be no established standard for the circumstances under which a state ought to have a period of national mourning. If a state wishes to have a well justified criterion for proclamation of national mourning, such a criterion has to be devised. Before a proposal for some criterion is put forward, it is advisable to set some constraints on any criterion to be proposed. Setting constraints is, indeed, part of a delineation of the occasions on which national mourning ought to be proclaimed. Our commission suggested two constraints. The first one was: (C1)

A criterion for proclamation of national mourning should not be strictly numerical.

What is meant by this constraint is that a criterion for proclamation of national mourning should not be of the following form: “If more than X citizens of the state die during the same circumstances, national mourning ought to be proclaimed”, where X is some number that is considered “large”. To see the reasons for such a constraint, consider the difference between a disaster in which X-1 persons died and a disaster of the same nature in which X persons died. The difference between the case of X-1 casualties and the case of X ones does not seem to be of any significance that would warrant a formal difference between the former, as not leading to a national mourning, and the latter, as leading to it. Sometimes we do use numerical criteria. For example, according to any practice of elections, citizens are eligible to vote only if they were born before a certain day. A one-day difference between the dates of birth of two citizens does not seem to involve any significant difference in their general qualifications with respect to those elections, but we still use it in delineation of eligibility to vote. However, what fits eligibility criteria, does not fit national mourning criteria. The distinction is clear: Eligibility to vote naturally rests on considerations of age. Only the exact specification of any particular age seems at least somewhat arbitrary, though indispensable. National mourning does not seem to naturally rest on any numerical consideration. Therefore, any specification of a threshold X would be strictly arbitrary and completely unjustifiable. The reason underlying constraint (C1) rests on principles of human dignity. When we consider two events, in which human life is lost, it would be immoral to consider one of them as a disaster and the other one as not being a disaster, on grounds of the numerical difference

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____________________________________________________________ between them. It would be immoral to consider an event to be a disaster only if it involves the death of so many persons, as if the death of a single person or of few persons is not a disaster. Strictly speaking, the death of 73 persons at one and the same time is not a single disaster but rather a cluster of 73 disasters taking place at one and the same time. Moreover, a cluster of 73 disasters can be created during a longer period. Again, it would be immoral to draw a distinction, when principles of human dignity and fairness should be strictly followed, between two clusters of 73 disasters, one that was created by a single collision, another that was created by a series of battles, accidents and other disastrous events. Our second constraint is of a different nature: (C2)

National mourning should not be frequently proclaimed.

Notice that (C2) is a constraint on proposed criteria for proclamation of national mourning. (C2) means that a criterion should pass the following test: If it is used, under more or less ordinary circumstances, as the sole grounds for proclamation of national mourning, chances are very high that national mourning won’t be frequently proclaimed. The reason for constraint (C1) was strictly moral. The reason for (C2) is of a different nature. A period of national mourning must be exceptional for it to involve special and manifest respect paid to the mourned. Respect should, indeed, be paid to every deceased person, whether privately or within a community. National mourning is meant to express respect for the deceased within a broader sphere. The only natural reason for a move from the sphere of a community to the sphere of the nation is that the occasion is unique to an extent that justifies special attention of an appropriate kind. Hence, regular proclamations of national mourning would involve regular attention. The distinction between the attention paid on the national level to that paid on a communal level would disappear and the whole idea of national mourning would become superfluous. On the background of these constraints the following two criteria were proposed by our commission. Let us dub them the “top down criterion” (TD) and the “bottom up criterion” (BU). (TD)

National mourning ought to be proclaimed when one of the following officers of the state dies during one’s tenure in office: The President of the State; The Speaker of the Parliament;

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____________________________________________________________ The Prime Minister; The President of the Supreme Court. The reason for having a “top down” criterion is that some officers of a state stand for it, whether directly or indirectly. The president of the state stands, in a clear sense, for the whole state. The head of any of the three authorities, the legislative, the executive and the judiciary, stands for a major constitutive element of the democratic state. The reason for having that particular top down criterion (TD) is that those four persons hold the highest offices of the state, according to any conception of the nature of the state and the structure of the regime. Notice that not every officer of the state is on a par with the head of one’s authority, as far as the symbolic nature of standing for the state is involved. No minister, for example, stands for the state in the same symbolic way and to the same practical extent as the Prime Minister does. To be sure, the list of officers according to some alternative to (TD) could have included many other high-ranking officers, without violating our former constraint (C2). However, any extension of the list would have resulted in violations of the very rationale of a top down criterion. An extension of the list to include justices, for example, beyond the President of the Supreme Court, would have led to a required extension of the list to include members of the parliament beyond the Speaker. However, even the deputy speakers of the parliament are generally viewed as directly standing for their parties more than indirectly standing for the state. The only list of officers that is compatible with common societal conceptions of the regime and conceptually justified is that of criterion (TD). We turn now to the second criterion for proclamation of national mourning, a “bottom up” criterion. Naturally, a “bottom up” criterion involves two steps, one at the “bottom” and one at the “top”: (BU)(bottom)

(BU)(top)

Every municipality may proclaim a period of communal mourning and its public expressions, on grounds of its own statutes. National mourning ought to be proclaimed when communal mourning has been proclaimed in a group of municipalities that covers the map of the state or almost all of it in a diffusive way.

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____________________________________________________________ Since the idea of a diffusive cover of a map is not easily understood and implemented, several practical approximations were suggested: (BU)(top-1)

(BU)(top-2)

National mourning ought to be proclaimed when communal mourning has been proclaimed in a vast majority of the municipalities of the state. National mourning ought to be proclaimed when communal mourning has been proclaimed in a group of municipalities that counts as a cover of the map of the state or almost all of it, according to the view of a public commission or a governmental officer in charge of proclamations of national mourning.

The major justification for a “bottom up” criterion for proclamation of national mourning, such as (BU)(bottom)-(up), is that under the circumstances specified by such a criterion, it is assertible that “the nation mourns”, in the diffusive sense of the expression. It is also held that when the nation mourns, in the diffusive sense of the expression, the state, as an organization, ought to proclaim national mourning and specify its official expressions. The move, from a situation in which the nation mourns, in the diffusive sense of the expression, to a situation in which the nation mourns, in the formal sense, is of significance in two respects. First, it brings the expressions of mourning to each and every part of the state, beyond the appearance of such expressions in the given diffusive way. Such a step of extending the sphere of mourning broadens the respect paid to the related deceased and to all those who mourn the deceased in the diffusive way. Secondly, it shows in a symbolic way that the state is of the people, on the special level of personal and collective emotions of grief and bereavement. Facing so many citizens of the state mourning the deceased, even if in a diffusive way and not a distributive one, the state joins its citizens, so to speak, embraces them, respects their emotions.

Issues of Death and Dying for Adult Children of Holocaust Survivors Paula David 1.

Introduction. Baycrest Centre for Geriatric Care, located in Toronto, Canada offers a comprehensive range of services to the community's older adults. The Baycrest campus includes a complex continuing care Hospital, the Jewish Home for the Aged, supportive Housing, Day Care Services and a range of speciality services, community medical clinics and outreach programs. For staff, families and residents in a geriatric facility, themes of death, dying and loss are part of the fabric of living. Normal aging implies a series of expected losses, often emotionally or physically difficult and painful. Abnormal aging that may include dementia or age related illnesses and increased vulnerability are even more difficult. Given these challenges and the commitment of all concerned to focus on the quality of life, issues of death and dying are often not discussed in a manner that supports family adequately. A significant percentage of patients and clients are Jewish, and of those, almost half are survivors of the Nazi Holocaust. This paper will explore the unique difficulties of adult children of Holocaust survivors in dealing with the death and dying of their parents, in hopes that a better understanding will then anticipate distinct needs and the ability to support them. At the end of World War II, most of those who managed to survive were young adults between the ages of eighteen and thirty. Therefore if they are still alive today, they and their families are dealing with the challenges and end of life issues, while their adult children are trying to help them through this process. Once again themes of loss intrude on all aspects of everyday life while survivors must cope with the changes associated with aging. Considering that the label and meaning of their parents’ post-war existence is ‘survival’, the concept of parental death and dying may generate unique anxieties for this group. Since they became aware of parental identity, the children saw their parents as ‘survivors’ with the ability to survive a genocide that killed almost everyone in their parents’ universe, the ability to survive the loss of all material goods, the ability to survive deprivation, humiliation and victimization. Now, decades later, their children must deal with the reality that their parents cannot survive

28 Issues of Death and Dying for Adult Children of Holocaust Survivors ____________________________________________________________ terminal illness or old age. Once again the survivor family faces losses it is not prepared for. Despite the variants regarding the manner in which survivors of the Holocaust transmit their early life experiences to their children, the children still have to confront the implications of their parents’ aging. As their parents’ age, and when care demands and responsibilities increase, they often have fewer practical resources to utilize. Survivor families often consist of a nuclear family, the second generation often being raised without the extended support of aunts, uncles and cousins. Most survivor families lack familial models of aging and have little experience with the challenges, illnesses and consequences of aging. Institutional placement for elderly survivors may precipitate great anxiety in their children. In recent years, adult children of Holocaust survivors have worked hard to reclaim their own experiences and feelings in order to combat labelling and diagnosis that manifests as a result of the symptomology. Adult children have raised social consciousness and often express a collective identity and the need to work together to discuss, clarify and explore their feelings regarding their identity as ‘adult children of survivors’. These same children emphasize strength, vitality and a high rate of success. As with their parents, it is also crucial to recognize the range of individual issues and perceptions of the Holocaust from the perspective of survivors’ children. Family members are and should be considered key participants in the care plan of their aging family members. In the case of families of survivors of the Holocaust there are unique family issues that must be considered and recognized by staff. Like their parents, the children of survivors cannot be assessed as a homogeneous direction. Based on mutual aid and mutual support, a group work approach for the second-generation is an excellent non-intrusive approach to offering support. Discovering commonalities amongst each other and a safe venue for discussing their fears, concerns, dismay and family issues has proven very validating for the children of Holocaust survivors. The Baycrest Group for adult children of survivors of the Holocaust is called “Aging Parents, Aging Children”. This group best reflects a self-help paradigm, providing peer support and mutual aid relieving the stress related to difficult life situations. The adult children’s group deals either with caregiver issues associated with their aging parents or the recent loss of an elderly parent. The group is an informal one, reacting to members’ stated needs and themes of discussion. The group meets bi-weekly for two hours and has been in existence for six years. There are an equal number of men and women and the age of the members is generally in the late forties and early fifties. In

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____________________________________________________________ all cases except one, both parents of the group members were survivors. They came together as complete strangers, their families’ countries of origin all different, their parents’ Holocaust experiences also different and their current family constellations ranging from divorced and alienated to healthy and thriving. The children of survivors are also aging, and by virtue of the trauma their parents shared, have unique commonalties and Holocaust perspectives. Not only do these ‘children’ often have ambivalent and unresolved feelings towards their parents or their parents’ experience, but also the threat of losing parents increases their sense of vulnerability. Loss, whether expressed or repressed, has been a shared theme in their lives. Over time, members have come to know each other’s life narratives, their perception of the impact of the Holocaust on their lives and how this particular trauma has informed their existence as parents, spouses, and children and in their careers. The level of mutual acceptance and support within the group is remarkable based on their differences and understandable when they define and discover their own commonalties rooted in the Holocaust. All adult children, in mourning their parents’ death cope with the pain of inevitable separation and this study was conducted to establish whether the issues, mourning process and response to parental death notable differed in adult children of Holocaust survivors. In order to understand how survivor families respond to the challenges of parental loss and to see how their response differed from non-survivor families, a questionnaire was developed. Members of the second generation participated in the survey as well as offering qualitative response. Group members consistently identified their reactions and emotions as ‘different from the norm’. Emotional pain and degree of personal loss tend to be very subjective, so the survey was based on individual perception with the compiled evidence providing insight to the group response. Parental loss is an ongoing theme within the group. The rationale for this study was based on clinical evidence within the group and a direct outcome of a perceived need to offer more sensitive clinical support to survivor families. It is an attempt to quantify the sentiments being expressed over the years by the support group for adult children of aging Holocaust survivors at Baycrest Centre, and echoed by the participants of an online Internet Discussion Group for children of survivors. Group discussion in both venues continuously reflected a sense of ‘difference’ and inordinate fear and anticipatory grief on the part of children of survivors that seemed different than that of their non-survivor family counterparts. All adult children, in mourning their parents’ death

30 Issues of Death and Dying for Adult Children of Holocaust Survivors ____________________________________________________________ cope with the pain of inevitable separation, and this study was conducted to establish whether the issues, mourning process and response to parental death notable differed in adult children of Holocaust survivors. In order to understand potential differences and see similarities in response, an equal number of questionnaires were distributed to a comparator group whose parents were not survivors. Figures 1a and 1b show the countries of origin of both groups’ respondents. The children of survivor group indicates the international flavour of the internet membership and since English is the designated language, the majority of participants are from North America. The non-survivor respondents are mainly Canadian, for reasons of accessibility, but all participants were invited and participated online. All participants are middle-aged, have post-secondary education and have Jewish parents. The group of children of survivors have one or both parents who survived the Holocaust, in most cases both. The comparator group’s parents were either born in North America or left Europe before World War II began. Figure 1a: 45 Adult Children of Survivors Respond 20 15 10 5 0 Canada

USA

Israe l

O the r Countries

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____________________________________________________________ Figure 1b: 45 Adult Children of Jewish Parents who are not Survivors Respond 35 30 25 20 15 10 5 0 Canada

US A

Israel

Other Countries

Figures 2a and 2b show a remarkable difference. Survivor families often consisted of the nuclear family only, with perhaps a distant cousin or two. Surrogate families were often created with fellow survivors, usually from the same town or county. These landsmen formed mutual benefit societies in their new homes and acted as extended family. Therefore, the children of survivor families often existed in these reconstituted family groupings where all parents were virtually the same age. Therefore, all parents are aging and dying simultaneously. Families that did not experience the Holocaust would have larger extended families with a more typical age range. It is likely that children would experience within their extended family circles the normal life events and passages, including funerals Figure 2a: Had you ever been to a funeral before? Families)

40% yes

60%

no

(Survivor

32 Issues of Death and Dying for Adult Children of Holocaust Survivors ____________________________________________________________ "The first funeral I attended was when my uncle died when I was 19. My mother didn’t want me to go, thought it would be ‘upsetting’. I had no idea what it would be like, and put on black clothes, like in the movies. When my parents came to pick me up my mother screamed, ‘Only Goyim (Gentiles) wear black to funerals’ and made me change. I think I was numb through the whole process, and just didn’t know what I felt." (adult child of Survivor)

Figure 2b: Had you ever been to a funeral before? (Non-Survivor Families)

4%

yes no

96%

"My first funeral ever was my grandmother’s. Within two years, the other three followed. Each time, at each funeral, I looked to my parents for direction. In the case of all four, they chose to celebrate life, so I did also. I had been close with all my grandparents, and have only warm memories, which I cherish to this day." (adult child of non-Survivor) Figure 3 examines where bereaved adult children turn for help. There seems to be a marked difference between the two

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____________________________________________________________ groups in that survivors tend to turn to close friends more than non-survivors, who more readily turn to siblings. Survivors’ children do not seem to have the resources for support in the older generation for reasons previously discussed, perhaps explaining an increased use of professional help. Figure 3:

Who of the following supported you through the loss of your parent(s)?

Survivor Families From my Generation: Sibling: 14 (31%)

Non-Survivor Families From my Generation: Sibling: 9 (21%)

Close friend (spouse): 3 (84%)

Close friend (spouse): 15 (33%)

Cousin: 4 (8.8%)

Cousin: 6 (13%)

Therapist: 8 (17%)

Therapist: 2 (4%)

Outside my Generation: Aunt or Uncle: 4 (8.8%)

Outside my Generation: Aunt or Uncle: 8 (18%)

Friend of parents: 3 (6.6%)

Friend of parents: 5 (11%)

“My parents spoke very little about the Shoah or about death. It was always spoken of in hushed tones and nothing was explained. We did not have a proper religious education. My mother’s idea of teaching me about the Jewish rituals of death was to scream at me that she was still alive when I walked around the house in my stocking feet. I had to go barefoot or wear slippers. When I was 14 the roof caved in. My father died at the age of 41 after a threemonth illness. Nobody told me anything: they had no ‘patience’ to explain anything. They had plenty of patience to talk to each other. As I write this, I realize that profound affect on who I am today.” (adult child of Survivor)

34 Issues of Death and Dying for Adult Children of Holocaust Survivors ____________________________________________________________ “When my father was diagnosed with cancer, we knew he was terminal. I was so desperate for any emotional support, that I got into a disastrous personal relationship with a woman; oblivious to the problems, because ‘she was there for me’. But, at least, unlike my immediate family, she was ‘there’ for me when my father died. My being in ‘role’-the one counted on to do arrangements, to ‘be there’ to ‘do the right thing’…9 years later still have not been able to ‘feel’ all the emotional consequences of my father’s death.” (adult child of Survivor) Figures 4a and 4b are interesting in the significant differences in the two groups and how death was explained or not to children. Also the number of parents of survivor families who did not discuss their death underlines the paradoxical familiarity and distancing of the concept of death and loss. Figure 4a: When was your first opportunity to discuss your parent(s) pending death? (Survivor Families)

9%

as a child

31%

as adult at death 7%

53%

never

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____________________________________________________________ Figure 4b: When was your first opportunity to discuss your parent(s) pending death? (Non-Survivor Families)

10%

4%

30%

as child as adult at death never

56%

My mother was dying of cancer and my father would only sit and hold her hand. I’d ask a question, and he would shake his head. I didn’t even know where she would be buried. My father told me in intimate detail more than I ever wanted to know about the death of six million Jews. I didn’t even know what to do about the imminent death of one. (adult child of Survivor) Figures 5a and 5b demonstrate that parental loss generally impacts on how adult children discuss death and dying with their own children. As with any major life event, it makes sense that personal experience will deepen understanding and sensitize the individual. This fact seems to have more consistency amongst survivor families.

36 Issues of Death and Dying for Adult Children of Holocaust Survivors ____________________________________________________________ Figure 5a: Did your experience of loss impact on how you discuss, or will discuss death and dying with your children? (Survivor Families)

45 40 35 30 25 20 15 10 5 0

yes

no

somewhat

Figure 5b: Did your experience of loss impact on how you discuss, or will discuss death and dying with your children? (Non-Survivor Families)

25 20 15 10 5 0

yes

no

somewhat

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____________________________________________________________ "I learned better ways to deal with death from my 2 nd generation American husband. His family did not make a mystery of it. I decided to try to do better and took my children to the cemetery to visit my fathers’ grave. I spoke of him often. He is a real person to them, not like my many dead relatives who are ghosts to me. I always took them on shiva (bereavement) calls. They grew up understanding the rituals and most of all, not being afraid. My mother used to tell me that I told them too much. I told her there was no such thing as telling them too much. Nobody likes funerals, but they don’t have to scare you either.” (adult child of Survivors) Since the children of survivors felt less prepared to cope with the loss of a parent, the question was asked if they were better prepared after their first parent died. It would be expected that both groups would answer in the affirmative, as the experience of loss would seems less formidable once experienced. While there is a slight disparity between the two groups, it is not as marked as other differences. It should be noted that since a greater number of children of survivors experienced their first major loss when a parent died (see Figure 2) that their coping abilities would be further challenged. Figure 6a: Since the loss of your parent(s) do you feel better able to cope with the loss of a loved one? (Survivor Families)

11%

yes

4%

no some what 85%

38 Issues of Death and Dying for Adult Children of Holocaust Survivors ____________________________________________________________ Figure 6b: Since the loss of your parent(s) do you feel better able to cope with the loss of a loved one? (Non-Survivor Families)

8%

yes no 38%

54%

some what

“Years after my father died, my mother's death didn't bring much more clarity to the concept of mourning. We buried her next to my father but it still felt like we were performing rituals - in my heart I recognized terror and loneliness - my built-in fear of abandonment had turned true. Now, though, it is no longer a secret mystery.” (adult child of Survivors) “I think losing a parent is something that can’t be anticipated… only experienced. Now that it has happened, I only feel more vulnerable. I realized that no matter how many funerals I have attended and how many losses I have experienced; there is nothing that resonates like losing a parent. My religion and the rituals provided a great comfort.” (adult child of nonSurvivors) 2.

Conclusions Grief, loss and mourning are crucial components both of living and clinical practice in working with older adults. How staff and families respond to older adults’ losses, illnesses and ultimately their deaths,

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____________________________________________________________ contributes both to the dignity of the process and the quality of the subsequent bereavement and mourning period. The loss of a parent is traumatic for the child regardless of age. While younger children obviously face a different range of losses from the very practical protective aspect to the challenges of potentially losing the stability and security that is associated with the parental role, it is still a traumatic loss for all ages. This survey has shown the depth of loss felt amongst middle-aged adult children upon losing a parent and that the impact of that loss is not diminished with age. The responses have also indicated that a large proportion of adult children of Holocaust survivors have different perspectives on death and dying. It would seem that survivors’ possible difficulties in speaking about their traumatic losses with their children have subsequently impacted on their children’s abilities to cope with parental loss. Families of Holocaust survivors have fewer resources and less experience with issues of death and dying. It is a paradoxical irony that this group of adult children is intimately familiar with the death of so many, while the death of an elderly parent is shrouded in mystery. There are important implications of this survey for professional caregivers in hospitals, nursing homes and community settings that care for elderly survivors. Staff must be cognizant of the unique sensitivities and vulnerabilities of this group when discussing prognoses, end-of-life directives and bereavement issues in general. There are also implications for children of survivors of subsequent genocides, and by examining the issues of the children of Holocaust survivors, improved coping mechanisms might be developed prior to experiencing possible difficulties. It is obvious that the children of survivors of genocide and extreme war trauma must cope with an additional level of loss when their survivor parent dies. Issues of grief and bereavement are coloured by their understanding of death, dying and loss, often as taught them by their parents. The children of the Holocaust survivors have demonstrated how professional healthcare providers must be aware of how parents’ personal trauma impacts on their children. Like their parents before them, these adult children are coping with losses beyond that of a parent, and also like their parents, they are often ill prepared to meet the challenges. The Holocaust and the impact it had on the survivors, their families and humanity in general is a complex and never-ending area of study. The Holocaust is synonymous with visions of multiple deaths and trauma. Today as the last of the survivors of the Holocaust are coping with the challenges of aging, their adult children are dealing with the issues of death and dying and losing a unique group of people. Adult

40 Issues of Death and Dying for Adult Children of Holocaust Survivors ____________________________________________________________ children of Holocaust survivors continue to consider their family lives and existence in the shadow of the Holocaust in order that they continue their parents’ commitment to rebuilding shattered families. Regardless of the difficulties these adult children face even after their parents’ death, they recognize and can articulate their challenges. While their parents’ collective sorrow and trauma may be reflected in their worldviews, so is their resilience, adaptability and ability to commit to the future.

Death and Images of Womanhood and Manhood: The Case of Serbian Epic Poetry Mira Crouch The past is another country, it has been said. From a “Western” standpoint, medieval Serbia is another country in more ways than one: another culture, and long ago. Yet persons living in today’s world – the so-called “civilised” part of the world - may have much in common with the people in that other country. Then as now, we all die, and we all know about death, both our own and that of others. We know that it will come to pass and we recognise when it has taken place. Everywhere and at all times death casts a long shadow over human existence, not because it ends life, but rather because our lives matter only by virtue of their impermanence. The major premise of this paper is that death is an universal signifier. Awareness of mortality renders human action consequential; faced with human finitude, we seek to comprehend life’s meaning. It is therefore reasonable to expect that death, and all of its vicissitudes, will have a telling part in a culture’s imagery of its own morality, as every death questions the value of the life ended by it. In the medieval Serbian poetry discussed here, heroism and death are intertwined core threads around which the poets weave their images. While these images project many aspects of our complex human existence, I shall focus specifically on the ways in which the poets of the past have shown men and women to stand delineated from one another through death. As is the case with much poetry in the oral or folk tradition, the exact origins of Serbian epic poems are unknown. Since most of these poems concern events and circumstances associated with combat in medieval times, one view has it that this poetry is the creation of the military aristocracy and its courtly way of life. On the other hand, equally plausible is the suggestion that the poems spring from the profound effects historical events and the major actors in them have had on common folk.1 These two processes could also have overlapped significantly, since the social distance between the aristocracy and common folk among the Serbian people at that time would have been negligible. One great battle has been the focus of much of this poetry. On the 15th day of June 1389, Sultan Murat’s advancing army met and was engaged by the defenders of the lands threatened by it. Serbian princes,

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Death and Images of Womanhood and Manhood

____________________________________________________________ dukes and sundry other clan-leaders assembled under the supreme command of Prince Lazar, acknowledged Tsar and leader of all the Serbs for the purposes of the occasion. The battle took place at Kosovo, a windswept undulating valley surrounded by medieval monasteries, many of them reminders of the Serbian empire, a powerful Balkan state during the two previous centuries. At the end of that day most of the warriors were dead. Sultan Murat had been assassinated in his tent just before the battle; according to legend, he was knifed by a Serb disguised in Turkish clothing.2 Nonetheless the Turks won, and their scant remaining forces managed to establish supremacy over the Serbs. Other Turkish armies followed Murat’s and a few more battles were fought before all of the Serbian territory and people were completely subjected. But Kosovo was the decisive mortal blow for the Serbs; the battle had wiped out most of the able-bodied men of the generation, including almost all men of the patrician military families and clans. By the end of the 14th century only the peasants were still alive, wrote the Serbian 19th century historian Svetozar Markovich.3 The court was wiped out and gone, too, were all the sons of the great warrior families of the sovereign “Old State” governed by the Nemanja dynasty. These dead men are the legendary heroes of the “Kosovo cyclus” poems which have been recited, chanted and passed on from generation to generation through 500 years of Turkish rule, and thereafter, too. Much lauded by the whole populace for both their beauty and their meaning, the poetry’s stories and images have come to constitute a major component of the people’s common stock of knowledge within which the identity of the emerging nation has been formed. During the last two centuries or so the poetry has become enshrined in print as “cultural capital” of the increasingly educated elites. Yet for the best part of their existence, these free-flowing verses were most commonly sung and recited by folk poets of “the people” – the poor, illiterate, backward, starving and diseased, cruel and suspicious peasants, constantly under threat by pestilence and famine, oppressed by the Turks and often despised in the more civilised parts of the world. In the sweep of the 19th century Romantic movement in Western European literature that revived the interest in folk-stories and poetry, many writers of the period began translating Serbian folk poems and commenting on their beauty and expressiveness. Among these were Goethe, Mickievicz, Prosper Merimèe, Sir Walter Scott, and later H. M. Chadwick. Perhaps the greatest champion of the poetry was Jacob Grimm who pointed to its effectiveness in conveying the outlook of a “patriarchal civilization which rests on man’s deeply felt affinity with nature and

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____________________________________________________________ history,” 4 expressed in rich language and inventive imagery. In common with other poetry in the oral, “folk” tradition, variants of particular poems have developed. This implies sequential modification by multiple reciters/authors. The work of Parry and Lord suggests that “creation in performance” from stock phrases and extant formulae for themes and plots has been the modus operandi of the “singers of tales” perpetuating the poems/songs.5 Parry and Lord have further suggested that tradition, and not history, is embedded in these formulae. Lord’s view certainly has been that the force of Serbian epic poetry lies in its matrix of myth rather than history: “history (merely) enters into …epic and ballad tradition, rather than originating it.” 6 Literary theorists still argue about the precise characteristics of “a formula” – and, indeed, whether such entities really exist. But all such postulates already presuppose the cultural significance of the poetry’s images that have been in circulation for literally hundreds of years – thus revealing their importance for the people who have kept the poems alive. As Mircea Eliade points out, “the fidelity of a people to one or another mythical scenario, to one or another exemplary image, tells us far more about its deeper soul than many of its historical accomplishments.”7 This “deeper soul” is my main concern here. More specifically still, I will attempt to identify some characteristic features of female and male protagonists in Serbian heroic poetry, with particular attention to the ways in which death differentiates between women and men. In the first part of the paper, I shall discuss poetry from the Kosovo cyclus. The themes introduced in the first section will be given a broader basis, in the second part, through an analysis of archetypal women and men as imagined in poems which pre-date the battle of Kosovo. A synthesis will be attempted in the third part. The interpretations offered in this paper are based on the assumption that the creators of the poems have given expression, through their artistic efforts, to indirect, essentially “inarticulable and imageric” social knowledge, to their implicit and “nondiscursive knowing about what moves people.”8 1. Only a small selection of poems from the huge Kosovo cyclus will be discussed here. These will be some of the best known and best loved poems – in which, notably, women, as well as men, have important roles to play. Since the material may be unfamiliar to most readers, a brief summary of each poem’s story line will be provided, together with translations of a few key passages. In the poems of the Kosovo cyclus, the same families and characters feature over and over again: Tsar Lazar and his wife Milica, her

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____________________________________________________________ father Yug Bogdan, his wife and their nine sons, as well as Yug Bogdan’s other son-in-law, the intrepid and sagacious Strahinja Banovich. There are sundry other feudal lords, all of them loyal and brave; for instance, Milosh Obilich (Sultan Murat’s legendary assassin), who is married to Lazar’s and Milica’s daughter. Loyalty and deep affection permeate the portrayed relationships between the men, even in the absence of family ties. A brief account of four of these poems is given below. “Tsar Lazar and Tsaritsa Milica” In this poem Milica beseeches Lazar, on the eve of the battle, to let one of her nine brothers remain in the castle, so that she would not be “left without a male head.” (It is to be noted that the death of all men folk in battle is already anticipated here.) Lazar grants permission, and at dawn Milica is at the gate as the army is leaving, led by her brother Boshko Yugovich who rides out Upon a stallion, in shining garments; His cross-bearing banner covers him, Oh brother, down to the horse’s belly; Atop his flagpole a knob of gold, On it golden crosses are affixed, From the crosses golden braids hang And toss about on Boshko’s shoulders. 9 Milica clutches the reins of his horse, holds tight and whispers her plea, but to no avail…Eight more times this scene is repeated, and eight more brothers refuse to stay with her. Milica faints and Lazar orders his personal servant to take her up to the tower and remain with her. The attendant obeys, weeping, but still leaves the unconscious Milica in the castle and rides off to Kosovo. “The Death of Mother Yugovich” On the day after the battle, the mother of the nine Yugovich brothers prays to God to give her falcon’s eyes and swan’s wings so that she can fly to Kosovo and look for her husband and her nine sons. Her wish is granted; hovering over the field, she finds all ten of them dead. Each son is watched over by his falcon, stallion and hound; at the sight of her Nine faithful horses screamed, And nine angry hounds howled And nine falcons cried out;

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____________________________________________________________ But the mother’s heart was as stone And it yielded her no tears. She rounds up all the animals and goes home with them. The nine daughters-in-law, waiting inside the castle, see her and her entourage. Then nine widows lament, the numerous orphans weep, nine faithful horses scream…but still the mother’s heart is a stone and she does not weep. The following morning she sits forlornly on the castle’s parapet. Two bloodstained ravens fly to the castle from the battlefield, carrying a torn-off warrior’s arm. They hover above the mother and throw the arm in her lap. The youngest daughter-in-law recognises the arm as her husbands. Then the mother sings: “My son’s arm, my arm, my green apple, You ripened, then were wrenched away; I nurtured you in my warm embrace But you were torn apart at Kosovo!” And now the mother could not withstand The pain and grief that shattered her heart, Mourning for her nine Yugovich lads And the tenth old father Yug Bogdan.

“The Maiden of Kosovo” Early in the morning after the battle, a maiden walks in the field among the bloody corpses and the mortally wounded men, dispensing wine to those still (barely) alive. One young man (his right arm severed, his left leg missing, his ribs broken and his entrails protruding) asks her why she is there. After the Mass preceding the battle, she tells him, the Lord Milosh (Obilich) rode by, a Beatific hero, yet of this world, His sabre clangs on the paving stones, Precious plumes tremble upon his head, Embroidered robes adorn his body, A silken kerchief caresses his neck… He had left her a keepsake – part of his robe – and a promise to arrange, after the battle, her betrothal to his brother-at-arms, Milan. Another warrior, Ivan Kosanchich, followed Milosh (description as above), wearing a gold ring, which he then left with the girl as a keepsake; he made her the same promise as Milosh did. Then Milan himself came

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____________________________________________________________ by, also a “beatific hero, yet of this world…”; along with his promise to marry her after the battle, he left a gold mitten with the girl. This is why she is on the battlefield; she searches for these men. The dying young warrior tells her that all three have been killed. She walks home, weeping and crying: Woe, pity me and my ill fate! If I held on to a sapling green tree, It would wilt, wither and die away!

“Building the Ravanica Church” Lazar is holding court, drinking wine with his lords. Milica strolls by and says to him My Lord, renown Prince Lazar, I cringe at the very sight of you, And am loth to converse with you, But it must be, I will address you and she proceeds to reprimand Lazar for his neglect of worthy projects, and for the waste of his energy and riches in idle pursuits. She draws his attention to all the monasteries and churches that were built by his predecessors (the rulers of the Old State), and berates him for not using his power and wealth in the same way. Promptly Lazar promises to build a church for her – the Ravanica – in the most precious materials available. Milosh suggests that marble and stone are best since the advancing Turks would demolish anything else. Lazar thanks him for the suggestion and says “So be it!” It is clear that the characters in these poems are meant to portray the heroic spirit of the people. But men and women have different ways of embodying this spirit – and not only because men fight, and women do not. Quite unselfconsciously, it seems, the poets have captured the complexities of circumstance and action that are contained in these differences. Thus men are depicted as fiercely courageous, going into battle knowing that they may – indeed, will – be killed. But the poems do not merely portray heroic death in battle. Much more poignantly, they celebrate sacrifice – and through it, the values which life has been given away for. Indeed, no victory could make so strong a statement; only defeat underwrites the significance of the sacrifice. The following poem speaks further to this point.

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____________________________________________________________ “The End of the Serbian Kingdom” In this song, a saint, in the shape of a falcon, brings a letter from the Holy Mother to Tsar Lazar. The letter tells Lazar that he must choose between the Earthly and the Heavenly realms. If he chooses the former, he must gather his armies forthwith and rush into attack on the Turks; in this case, the enemy will be defeated. If, on the other hand, he chooses the heavenly realm, he needs to prepare his armies by holding mass and offering communion to the men; the battle action that follows will be sacred, but all the men will be killed. Lazar then deliberates: earthly reign is short-lived, but heavenly existence is forever. So he chooses the heavenly Kingdom, assembles his army, calls in the patriarch and his twelve bishops, and holds the ceremony. Just as soon as the men are thus put to rights, the Turks attack and the Serbs are defeated and slaughtered wholesale. King Lazar and 300,000 men perished, according to the poem; yet in the end “All was holy and all was honourable, and the goodness of God was fulfilled” (as quoted in Rebecca West’s Black Lamb and Grey Falcon).10 Implicit in this is a profound dichotomy: victory in this earthly life is profane, but death as life given away is sacred, especially in defeat.11 Here no one dies in vain; on the contrary, death is the threshold of eternity. In battle men are shockingly mutilated, they lie about in pools of blood and die in their thousands. (In the poem, Lazar lost 77,000 men from his own division, the Yugovich clan lost 99,000, and the combined forces of various other chieftains added up to another 120,000 men.) In life, the men are glorious to behold, their appearance and lavish apparel described in picturesque detail. Another example is worth noting: He (Milosh) is dressed in gossamer fabric, Above the waist, of pure woven gold, Below the waist, of palest white silk; Over his shirt he wears three vests And a topcoat of thirty buttons; Engraved armour encloses the coat, Golden armour, three layers strong; His legs are covered in hide and studs… All this splendour points to the lasting impression the heroes make on their people; at the same time, it also emphasises the enormity of the loss entailed by their deaths. By contrast, there are few descriptions of women’s appearance, particularly concerning dress. It is as though the poet is making sure that only men – the heroes – can be seen “in the mind’s eye,” shining bright. Women are sometimes described in terms of

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____________________________________________________________ beauty – but they are not adorned; rather, they are beautiful in themselves. For example: They say this maiden is magic; Of slim waist but tall stature, Her tresses a bunch of pure silk, Her eyes two precious jewels, Eyebrows like sea-leeches, On her cheeks pink roses bloom, Her teeth are two rows of pearls, Her mouth a sweet sugar-bowl; When she speaks, a dove calls, When she smiles, diamonds shine, Her teeth are two rows of pearls… (From "The Wedding of Milich the Flag-bearer") Most often, though, rather than being visually depicted, women are endowed with internalised emotional and moral characteristics, either by attribution or through their own revealing words and deeds. While this also applies to men, it occurs much less commonly and in a much less complex way. For instance, in the two poems concerning Tsaritsa Milica summarised above, the woman expresses a far greater range of opinion and feeling than do the much more pragmatically oriented men. In further contrast to women who are almost always at home, or very clearly home-based, men are constantly on the move. In some poems (not cited here) which describe the period immediately before the battle of Kosovo, men have numerous adventures: they carry out various errands for friends and relations, escort brides from abroad, negotiate deals and work on military contracts. They undertake journeys for both business and pleasure, visit one another’s homes, drink and argue. According to one poem, for example, only a few days before the battle of Kosovo, Strahinja Banovich goes to visit his in-laws (the Yugovich family, it will be recalled) in another locality. The visit is social: the men drink and tell yarns. Meanwhile a stray Turkish unit attacks his home, burns, plunders, kills his serfs and abducts his wife. Strahinja’s mother sends word to him, pointing out at the same time that while she sits on a charred doorstep lamenting, he is merrymaking. (Of course, he takes off after the Turks and, with courage and cunning, after many a skirmish, defeats them and gets his wife back.) Women, too, are brave. But their heroism is not displayed in action; rather, it is contained in their endurance of suffering. Overwhelming grief is as inevitable a fate for them as death is for their

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____________________________________________________________ men. And just as the death of men and the pain of women are inextricably bound together, so men’s flamboyant, mobile and unsettled life determines women’s monotonous, captive and constrained existence. While men are up on horseback roaming the land, women are at home, close to walls and doorsteps, confined in towers of their castles and forts, alone, waiting, afraid for their men and perhaps even endangered themselves. Where men drink and make merry, and sometimes even act irresponsibly, women stand guard watchfully and try to preserve what is nearest and dearest. Milica wants a church as a memorial and the Kosovo maiden keeps the pledges given to her by the three heroes who ride past her to their death (impressively – though fleetingly – letting her catch a glimpse of what she will never be able to keep alive). The women do, of course, protest and lament, but they abide, dying of broken hearts only when their fortitude is tested to the extreme. Thus the poems recognise that women and men are creatures who respond to taxing circumstances in characteristically different ways. Men do not go into skirmishes and battles simply because circumstances call for it, but because they are adventurous and courageous and therefore seek out opportunities for action. Women, too, do not simply wait and grieve; they have their own domain of action where they display qualities of stoicism, loyalty and wisdom that enable them to endure their plight with dignity. But that is not all: as some poems of the pre-Kosovo times show, deeper moral issues are at stake – and these are illuminated by the manner in which women die. 2. “The Marriage of King Vukashin” King Vukashin is in love with Vidosava, the wife of a prince in another region. She reciprocates Vukashin’s feelings and arranges, through complex subterfuge, for Vukashin to defeat her brave husband Momchilo and his men (including his eight younger brothers) in combat that she provokes. The mortally wounded Momchilo belatedly realises what has taken place and warns Vukashin not to marry Vidosava. She will do the same to him, warns the dying Momchilo, and he advises Vukashin to marry his sister instead, a chaste, honest girl who will bear Vukashin many sons. Then Momchilo expires and Vidosava takes his cloak, helmet and ring and gives them to Vukashin. Upon which, magically (and in eloquent metaphor) Momchillo’s coat, just down to his knees Vukashin now drags on the ground;

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____________________________________________________________ Momchilo’s tight-fitting helmet Falls on Vukashin’s shoulders; Momchilo’s custom-made boot Takes both of Vukashin’s legs; Momchilo’s gold wedding ring Calls for the other’s three fingers Vukashin repents and tells Vidosava that she is a bad woman, having deceived a great and powerful hero like Momchilo. He orders Vidosava to be torn apart by wild horses and marries Momchilo’s sister with whom he raises, in due course, two sons, both destined to become mythological warriors who feature in many other epic poems. “God’s Retribution Comes to All” Two brothers, their sister and their wives, all live together. The brothers are very fond of their sister and frequently demonstrate their care and affection for her. One wife is very jealous of this. She kills her husband’s horse and then his falcon, each time making it appear as though the sister has done it. When the sister denies the crimes, her brother believes her. Then the jealous wife takes her sister-in-law’s gold-handled knives (a gift – among many – from her brothers) and with them slays her own baby son in his cradle, leaving the knives on the pillow. The bereaved father now believes his sister to be to be guilty of the murder and has her torn apart by wild horses. Then Wheresoever a drop of her blood fell, Flowers and holy basil sprang forth; And where her body last came to rest, A church emerged, complete overnight. But the wife becomes ill and lingers for nine years and “Grass grows and tangles through her bones; And in the grass poisonous vipers dwell.” She asks to be taken to her sister-in-law’s church, where a voice tells her that there is no forgiveness for her. She asks her husband to kill her in the same way as he killed his sister, and he complies with her wish. Subsequently Wherever a drop of blood fell, Thorny bushes and nettles grew; Where her body last came to rest

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____________________________________________________________ A lake of deep waters opened: In the lake a black stallion swims, On his back a golden cradle With a grey falcon at its head; In the cradle a boy child sleeps With his mother’s hand on his chest, His own hands on the golden handles Of his mother’s deadly daggers.

“The Building of Skadar” Three brothers are building a city. They have been engaged in the task for three years but still not even the foundations are laid. An evil mountain witch destroys at night what work is achieved each day. Eventually the witch calls for a sacrifice – the wife of any one of the brothers. The brothers agree to let fate decide: whichever wife brings food to the site next day will be the victim. The two elder brothers let their wives in on the secret; and so the youngest wife is made to turn up at the building site at midday. When the walls of the fort start coming up around her, the brothers pretend that it is game. But soon she perceives her plight and pleads for her life. No one responds; she then asks the master-builder to leave two openings in one wall through which she may be able to nurse her infant son. This having been done, she further asks for an opening at eye-level, so that she can see her son as he is brought to her and taken away again. After the entombment, her voice is heard, crooning to her son, for another week, but the nourishment for her son lasts for a whole year. The poem concludes: As things were then, so they are today, Still the milk flows from these stone walls – A miracle and a medicine For women who cannot nurse their own. In these poems womanhood embodies moral distinctions. Here women are either completely good or totally evil, but it takes death to make this clear. Unlike men who die collectively and in action, women die immobilised and singled out as individuals. Their deaths are not valorised, but the consequences of these deaths are nonetheless significant markers of the community’s moral code. A good woman and a loving mother lays down the foundation for a city – a symbol of communal existence. The manner of her death portrays and seeks to preserve the qualities necessary for a community –

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____________________________________________________________ as symbolised by the building of protective walls around it - to endure. The death of a good woman also gives rise to a church – a permanent home of righteousness and a sanctuary for the weak and intimidated. Flowers and healing herbs flourish in the aftermath of a martyred innocent woman but the ugly misdeeds of an evil woman remain in sight forever. Significantly, while men can be exonerated, women are never forgiven: Vukosava dies for her sins, but Vukashin is allowed to redeem himself. 3. Women cannot escape the consequentiality of their deeds. Appraisal must always obtain, notably following death. Such posthumous judgments are moral lessons for the community whose principles of justice are not human creations but rather God’s design, contained in the living essence of the world. Because the springs of women’s actions lie in their very natures, they are judged by those principles and the judgments are inscribed on their deaths, thus to become permanent, in this world and the next. By contrast, retribution does not seem to apply to men. The poet does not condemn Vukashin for betrayal and adultery; similarly no ill fortune befalls the two deceitful brothers in “The Building of Skadar”, nor is their guilt commented upon in the poem. No responsibility is ascribed to the man who kills his innocent sister: he simply acts in terms of the knowledge on hand, like almost all men in these poems. Men’s virtue lies in their willingness to die for principles and ideals which are known explicitly, whereas women’s deaths reflect a fundamental morality that is implicit in everyone’s life, and to which all women and all men are subject. There is an apparent contradiction here, since it is only men who have the power to dispense justice, though they can be mistaken in this process. Not that this matters, since, clearly, men are mere instruments that bring about the inevitable deaths of women through which the community’s morality tales are told. Hence guilt and responsibility have no place in the lives of men who merely act out what they know, however erroneous that knowledge may be at times. But in any case, unencumbered and unfettered, they are free to do as they see fit; they are heroic by virtue of the power, prowess and independence that are their birthright. Their presence in life is striking but temporary; and so are its effects. Only in death are they truly valued and valuable. By contrast, women are entangled in the basics of existence; they have little freedom and no autonomy and are barely visible, appearing out in the open only every now and then. Their lives are at the mercy of men, shaped by men’s actions and often arbitrarily and cruelly taken away. At the same time, women have influence: they ennoble or corrupt, foster or

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____________________________________________________________ undermine, nurture or kill. And because of this, their lives are always open to question and evaluated by both earthly and heavenly powers. While men act in response to circumstances, women commit deeds following good or bad inner motives. Women’s lives embody God’s principles of morality and justice which merely inform, and not always successfully, the actions of men. But men die in the full knowledge of those principles, while women simply live them and are killed so that their truth may be revealed. The contrast in the images of women and men makes sense in functional terms. Like any mythology, these poems are models for action in the world. After the battle of Kosovo, this world was harsh and oppressive. The Turkish administration was ruthless and cruel; it taxed the people very heavily and severely punished non-compliance. The Turks collected not only produce and money, but also blood tax: young boys to be trained as janissaries. Adult men, too, were often away from home, as insurgents hiding in forests and mountains. According to Trajan Stojanovich, pagan Neolithic culture was still prevalent in the Balkans - Christianity notwithstanding – at the time. Its rituals were universally observed, their form only thinly overlaid with Christian discourse.12 Bands of men would take to the mountains during the spring festival of St George’s Day and the autumn feast of St Dimitrius’ Day, and this custom provided the basis for rebellion against Turkish rule. The well-established pattern of men’s transitory presence in the community made women take care of day-to-day living while men roamed the countryside – and carry the burden of existence when the men perished, again and again. The celebration of men’s deeds was necessary not only as inspiration for future heroic acts, but also as compensation for their absence – and, more often than not, the loss of their lives. Hence the poem’s brilliant images of men of action, covered in silk and gold, loved, honoured and obeyed by falcons, stallions, hounds, mothers, sisters, wives and children. Scarce, precious and valuable, men were to be as cherished in life as they were honoured in death. And for the reason of being mothers, tillers, sowers and reapers, care-takers of the sick and infirm, but most of all wives, mothers and sisters of sacrificial heroes, women had to be virtuous. Men reach for the heavens only in death, but the goodness of women must be ever present; death merely supplies the proof. More generally speaking, the poems seem to suggest that women are society’s fundament, the entrenched inhabitants of its institutions for which they are – and are made to be – responsible. Their roles are much more profound than are the tasks of the variably present, albeit more conspicuous, men, who are brilliant images, outstanding in the simple

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____________________________________________________________ dynamic of their splendid actions. Their high visibility enhances the memory of them after they are gone, dying dramatically in a blaze of glory bestowed on them by the community from which they have had to absent themselves in order to defend it. For this reason the records of their intermittent spectacular doings become, and are perpetuated as tales of significant events. In sum, then, in these poems men appear as phenomena of history, but women are the noumena of life, of the ineffable nature of the world. In argument with de Beauvoir, I suggest that here men are the Other(s) who tug and pull at the threads of the dense fabric of everyday existence; they are the moving figures against a seemingly ordinary background, without which, however, they could not be seen at all.13 In this duality, the sacred and the profane are in reciprocal balance. Men are unconstrained, adventurous and self-indulgent, but they die, in exaltation, for sacred ideals. Women’s lives, on the other hand, are at all times circumscribed within the quotidian, and their deaths often take place in a web of profane desire and deceit; only after death is the truth about them revealed. While men’s glorious sacrifice is anticipated in the splendour of their apparel, women signify good and evil in living matter that sprouts from the ground soaked in their blood. Like rare gemstones, men glitter here and there in that enriched soil. But it is the earth that abides and, ultimately, sustains the everlasting spirit

Notes 1. These arguments have been treated extensively by Vojislav Djurich in his “Introduction” to Antologija Narodnih Junachkih Pesama, ed. Vojislav Djurich (Beograd: Srpska Knjizevna Zadruga, 1977), 9-159. 2. Ibid. 3. Svetozar Markovich, Srpske Obmane; Srbija na Istoku (Beograd: Beogradski Izdavachko-Grafichki Zavod, 1973). 4. Svetlan Koljevich, “Osnovni pravci stranog interesovanja za nashu narodnu poeziju,” Zbornik Matice Srpske za Kjizevnost i Jezik 28 (1980):169-199. My own translation of the quoted passage. 5. Michael L. Parry and Albert B. Lord, Serbo-Croatian Heroic Songs: Novi Pazar I (English translation) (Cambridge, Mass. and Belgrade: Harvard University Press and Serbian Academy of Science, 1954). See also Albert B. Lord, The Singer of Tales (New York: Athenaeum, 1968). A broad and eclectic discussion of “folk” and oral poetry is provided by Ruth Finnegan in her Oral Poetry

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____________________________________________________________ (London: Cambridge University Press, 1977). 6. Albert Lord, “History and tradition in Balkan oral epic and ballad,” Western Folklore 31 (1972), 53-60; 60, quoted in Thomas Butler, “Introduction”, in Monumenta Serbocroatica (Ann Arbour: Michigan Slavic Publications, 1980), 27-122; 47; original emphasis. 7. Mircea Eliade, Zalmoxis: The Vanishing God (Chicago, University of Chicago Press, 1972). 8. Maurice Taussig, “History as sorcery,” Representations 7 (1984): 87-109; 87. 9. All translations are mine. Translations of the whole of “The Fall of the Serbian Empire”, “The Maid of Kosovo”, “The Death of the Mother Jugovich” and “The Building of Scutari (Skadar)” are available in Butler, Monumenta Serbocroatica. 10. Rebecca West, Black Lamb and Grey Falcon (New York, Penguin Books, 1982[1941]), 1145, translator unknown. 11. The sacred/profane distinction as it is made here draws on the work of Durkheim; see Emile Durkheim, The Elementary Forms of Religious Life, Trans. Joseph W. Swain, 2nd edition (London: Allen and Unwin, 1976). 12. Trajan Stojanovich, A Study in Balkan Civilization (New York: Alfred A. Knopf, 1967). 13. Simone de Beauvoir, The Second Sex (London: Landborough Publications, 1960[1953]).

References Butler, Thomas. “Introduction.” In Monumenta Serbocroatica, 27-122. Ann Arbour: Michigan Slavic Publications, 1980. de Beauvoir, Simone. The Publications, 1960[1953].

Second

Sex.

London:

Landborough

Djurich, Vojislav. Antologija Narodnih Junachkih Pesama. Beograd: Srpska Knjizevna Zadruga, 1977. Durkheim, Emile. The Elementary Forms of Religious Life, trans. Joseph W. Swain. 2nd ed. London: Allen and Unwin, 1976. Eliade, Mircea. Zalmoxis: The Vanishing God. Chicago: University of Chicago Press, 1972. Finnegan, Ruth. Oral Poetry. London: Cambridge University Press, 1977.

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____________________________________________________________ Koljevich, Svetlan. “Osnovni Pravci Stranog Interesovanja za Nashu Narodnu Poeziju.” Zbornik Matice Srpske za Kjizevnost i Jezik 28 (1980):169-199. Lord, Albert B. The Singer of Tales. New York: Athenaeum, 1968. Markovich, Svetozar. Srpske Obmane: Srbija na Istoku. Beograd: Beogradski Izdavachko-Grafichki Zavod, 1973. Parry, Michael L. and Albert B. Lord. Serbo-Croatian Heroic Songs: Novi Pazar I (English translation) .Cambridge, Mass. and Belgrade: Harvard University Press and Serbian Academy of Science, 1954. Stojanovich, Trajan. A Study in Balkan Civilization. New York: Alfred A. Knopf, 1967. Taussig, Maurice “History as sorcery,” Representations 7 (1984): 87-109. West, Rebecca. Black Lamb and Grey Falcon. New York: Penguin Books, 1982[1941], 1145.

Extreme Makeovers and Reciprocal Relations Between the Living and the Dead Kathleen Z. Young Historical, social, and cultural perspectives shape-shift identity as the living and the dead are expelled, picked up and moved, made-over or remodelled. There is currently a popular television show in the United States called “Extreme Makeovers,” in which the audience voyeuristically witnesses plural plastic surgeries and various makeovers with extreme impact. The intention is to make the person look more culturally appropriate or younger in a youth and beauty-obsessed society. In another environment, where individual identity is more closely associated with family and community, youthful, standard features, and ageing are less verboten. Death is less likely to end a relationship lived in a less embodied realm. For the purposes of this paper, I focus on various kinds of death and burial rites in the village of Komiza on the island of Vis, a part of the Dalmatian Coast of Croatia. In Komiza, the dead have been the beneficiaries of “extreme makeovers” following the war that resulted in Croatia’s independence. The island of Vis, almost halfway between the coasts of Italy and Croatia, has been inhabited since about 3,000 B.C and extant archaeological remains include an altar to the goddess Artemis. The island was called Issa and then Lisa in past-times, a legacy of tribute to the goddess Isis, according to local speculation. A winter solstice bon-fire ceremony, a “pagan” artifact later converted into a Christian rite associated with Saint Nicholas, has been an annual ritual for as long as anyone can remember. Ancient Celts, Illyrians, Greeks, and Romans left their cultural influence and there are still extant colloquial references to the evil-eye, spirits, demons, etc. From before conception to the afterlife, prescriptions and prohibitions of behaviour are often noted, if not followed. Even so, up until the Second World War Croatia was an openly Roman Catholic country. Catholicism remained entrenched on Vis during the communist-socialist era following the war. A picture of the Virgin Mary hung next to picture of the communist ruler, Josip Tito, on the walls of many homes in Komiza until the 1990s. People, especially older women, meet for daily Catholic mass preceded by recitation aloud of the rosary. There are two main churches in Komiza, one on either side of the village. There is also a smaller chapel in the centre of town for daily mass. Every evening at 5pm, the chapel fills with villagers as older women dressed in black lead the rosary, chanting the “Our Father” and “Hail Mary” in an unusually high-pitched register. Most of these women are widows routinely praying for their dead. There are often a few

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____________________________________________________________ older men at daily attendance, usually standing or sitting in the back. There is one male priest for the approximately 4,000 people on the island but priests from the mainland visit the approximately 1500 people in Komiza regularly. Although traditional women usually defer to men, especially priests, the older women are in charge of the chapel and the daily mass and rosary. Their age, assiduous attendance, and customary “ownership” of their daily practices in the small village church behoves the priest to defer to their schedule and expectations. Praying for their dead takes precedence over social or typically Roman Catholic convention. The island of Vis belonged to Italy at various times historically. The dialect is replete with Italian words most things Italian are met with a sense of simpatico. It is a point of pride that the current peripatetic Pope has visited Croatia more than any other country.1 There is a strong element of Catholicism within Croat nationalism. On the island of Vis and the village of Komiza on the island, that religious/national patriotism bears the emblem of a unique blend of Catholicism with the communist-socialism of the former united Yugoslavia. This is in part because many Komizans died in support of the united communist-socialist Yugoslavia during World War II, but also because the refuge of Catholicism has distinguished Croatia from the state religion of Serbia, the Serbian Orthodox Church. Komizans enjoy friendly relations with the dead if they know they have fulfilled the obligation to send the soul on its way to heaven. Applying van Gennep’s schemata on rites of passage to the death and dying rituals of Komizans, rites of passage include separation, the communicative isolation between the living and the dying during the process of dying and the act of death (the death watch, a gathering in prayer at the bedside of the dying), transition, preparation for burial and the funeral act, and re-incorporation.2 The re-incorporation focuses on sending the dead properly into heaven and establishing their new persona as deceased. The re-incorporation includes religious rituals employing incense and candles, specially sanctioned words and prayers led by a religious expert or experts, proper handling of the body, and all the associated social features of public burial. While dying may be ultimately an individually isolative act, death is ultimately social. The dead body is not static and the repercussions of death are not terminated with the death of the body. Most funerary rites on Vis traditionally involved a body that had not been embalmed. Non-embalmed bodies decay at different rates and, depending on circumstance, may explode. The dead may make rumbling noises in the grave in response to these natural processes of decay, especially in the Mediterranean climate of the Adriatic Sea and islands. The period of time wherein the body is in the process of decay is the transitional or liminal phase. The period of mourning for the deceased corresponds to this liminal phase. This is the time in which women

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____________________________________________________________ traditionally wore black, restricted social activities and engaged in specific religious practices. What happens to the corpse of the loved one during this liminal phase affects the living. In turn, the living should employ rituals of dress and appropriate social behaviours. It is consistent with women's familial role as caretaker and nurturer that death rituals extend into the relationship beyond death. A woman brought the deceased into the world through gestation, lactation, and motherly service. A woman carries on the business of service to the dead through her prayers in the spiritual realm and physical caretaking of the place of internment. Similarly, a man was necessary for conception to take place and a man, a priest or deacon, is necessary for the Catholic burial ritual. It is women who typically make the moral standard and go on “being” while tending to the dead.3 A "good death" is made in time, over time, and with reciprocal relations. Identity is both individual and collectively shared or "made" through relationships built around reciprocal obligations. In extended families and clan systems there is often a sense that what happens to one happens to all individuals in differing and sometimes predictable ways. Death modifies but does not obliterate these obligations. Individuals and groups incumbently honour their association with the dead by social-religious rituals recognizing they are separated only by the thin veil of flesh and bone. The body houses the immortal soul but has sacred spiritual significance, too. As the corpse decays, the period of mourning among the living corresponds to the decrepitating of the deceased’s body and the closeness of the kinship ties between the living and the dead. Similarly, when a relative immigrated it was a kind of social death. The emigrated relative would be kept alive through connections with "someone who knew someone who knew someone" in the new land. The ways of knowing were providentially enhanced when kin migrated to a specific place and joined previously migrated kin from the same village of origin. Pictures and letters from one relative were shared with everyone in the village, or brought to someone who could read and write and then share the information via overlapping social networks of kin. Similar sharing of information occurred with the news of the death of immigrant kin. It was customary on the island, where there were few land phones and cell phones were a luxury until recently, to send a picture of a respectfully dressed corpse in a well-appointed coffin to the Old Country. Gone to the West or gone to heaven or hell, the beloved no longer walked among the living or lay with the dead in Komiza’s cemetery, but at least there was proof of proper burial. For relatives who could not read or write, the picture provided visual proof that the deceased was given the means to make the spiritual transition from life to death and that the body of the corpse was

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____________________________________________________________ respected and cared for with the proper burial. The visual affirmation of the propriety of the death and burial rituals was intended to comfort all connected to the deceased through kinship or association. The closeness of the kin relationship and the kind of death often determined aspects of the length and kind of funerary rituals (and attendant emotional, psychological, and social expressions). Gratitude towards the dead or the familial obligation of gratitude also predicated involvement in the death ritual, even by individuals who never knew the deceased “in the flesh.” One informant recalled spending hours every day, for what seemed to her like days on end, on the hard wooden pews of the Catholic Church in her village on Vis in vigil prayer for some first generation American-Croatian fishermen who had died in a fishing related accident in Alaskan waters. The Mardesich brothers were related to many people in the village and although the brothers had been born in the United States and few in the village knew them personally, the Mardesich family had continued to send money to kin in the village. Their deaths were cause for extensive communal praying. Closer relatives to the Mardesich brothers on Vis were expected to make a novena, a nine day or nine week (depending on the closeness of the relationship) ritual of temporal prayers morning and night. Prayers for the dead are so important because, as a point of belief, a dead person could move from purgatory to heaven, based on the prayers of the living. Old prayer books and missals list plenary indulgences for different prayers. According to informants, these plenary indulgences can be banked like money and saved up to redeem or release a dead person from purgatory and get them “out early.” There is no escape from the fires of hell, but those with venal sins are kept in purgatory until cleansed of sin. Once in heaven, the beloved dead can be called on to intercede in the heavenly realm for favours for the living, especially those who prayed long and hard to get them into heaven in the first place! When does a person stop praying “for” the beloved’s soul and start praying “to” them? Heaven’s time is not as easily marked as a person’s birthday, death, or a nation’s Independence Day. In the realm of the spirit and relations of a spiritual nature, it is the communion of spirits via prayer that consummates relations between the embodied and disembodied. Time cannot measure the movement of souls. The sense of shared identity modifies van Gennep's schemata of a rite of passage as a finite act of separation, transition, and re-incorporation. Death and disposal of the body are not so definitive or bounded by a beginning, middle, and transformative end without regard to the on-going social context. The sense of shared identity welds the living and dead, sustaining the relationship over time. The circumstances of the individual death are collectively discussed and shared. If the circumstances were onerous, the sharing of the responsibility and the repercussions of the death

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____________________________________________________________ were also potentially onerous. An individual who “had the power of the evil eye” (usually an older woman who did not fit the social norm), a noted sinner, someone considered selfish or marginal by social standards, those who had committed suicide or murder, as well as those who had been denied proper Christian burial, could all potentially and problematically complicate the social nexus for the living. Bad behaviour makes for bad deaths and bad deaths (by homicide or suicide) may complicate things for the living. It especially hurts the living when a beloved is killed because of brutality, as in war. Without a proper death and burial, the dead are owed an obligation by the living, making it more difficult for the living to call upon the dead for their own intercession. Gossip, social pressures and the necessity for reciprocal obligations are ways of exerting vigilance and keeping the social nexus functioning even when physically separated by immigration or death. Talking about immigrated relatives (alive or dead) and the actual dead is common practice, especially at funerals. Funerals and cemeteries are the locus of "spirit clubs," where stories are swapped affirming the transcendent aspects of the social nexus. Relationships are no less "real" because one of the individuals is not physically present. Body and soul emigrate from one place to another; the body dies and the soul emigrates again. Just as men and women adjust to loving a friend or relative who has emigrated and is not physically a part of their everyday lives, so too, the dead have a new home (presumably heaven). The fact of the death of the body, especially through war, has been a major precipitator of both emigration and cultural response to war death. World War I fuelled the diaspora; many Croat-Dalmatians (Croats living on the islands or the coast of Croatia, an area known as the Dalmatian Coast) would not allow themselves or their sons to be conscripted into the army of the Austro-Hungarian Empire. The Post World War I experience of living under a Serbian monarchy was bitter for many, however, and areas of Croatia were willingly co-opted into a Nazi puppet government know as the Ustasha and civil war waged in other areas during World War II. Most Croat-Dalmatians, fought with the Partisans who were eventually the victors. The island of Vis was the base of operations for the Partisans, a point of pride which lent nobility to the deaths of men and women from the island who fought and died with the Dalmatian Brigade. Komizans have asserted there were no Ustasha on Vis. Partisan deaths in World War II were viewed as heroic and meaningful in that the dead "did not die in vain," they liberated the country. One devoutly spiritual elderly woman on Vis, Katica, who never ever would swear, found it normative to refer to “the f**in’-Ustasha.” She was shocked when Serbs from the Milosevich regime expected an apology from Croatians

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____________________________________________________________ because Croat-Ustasha persecuted and murdered hundreds of thousands of Serbs during World War II. Katica’s husband fought the Ustasha and died a hero; she felt that expecting an apology from Croatia placed her in the category of Ustasha. It was an insult to her husband’s soul, and therefore, an insult to her. Like all relations, relationships with the dead are set in specific historical and social contexts, the "social geography" of death relations. Upholding the reputation of a dead spouse can be a complicated matter in the Balkans. Mrs. B., who emigrated many years ago, suffers because her mother, in the Old Country, died hungry. Mrs. B. feels the loss of her mother and the requisite vestigial guilt that she emigrated to marry at age 17 and never saw her mother again. What pains her physically, what she professes to feel in her body, is the hurt of her mother's hunger. The circumstances of her mother's death over 50 years ago are carried in her body, not from behaviours she regrets or anything she would do differently, but because the misery of a mother’s starving to death is felt half-way across the world by a daughter, long grown old herself, who loved her and was loved by her. A bad death lingers, wounding again and again through expressions of grief. If Mrs. B. had been able to at least feed her soul with attendant prayers and burial witness she might have transformed the death (a kind of homicide by social circumstance – starving during World War II) through a kind of spiritual psycho-therapy, at the very least. There are risks that the recent dead will molest the peace of the living, with or without the intention to do so. Fear is well-founded in a state of siege. A metaphysical disquiet also obtains when the near-dead and the traumatized collective call for help, articulating realistic assessment of incipient war, actual war, or collective suffering because of the war. The calling out in prayer for help is part of the transition, a kind of verbal arsenal in the spiritual or metaphysical enlistment process. War has always been expressed via language but these spiritual dimensions to dying and death from war are less obvious. If one is attacked because of a characteristic shared with others (ethnicity, nationality, gender, religion, etc.) then all who share the characteristic are attacked. Further, the death of one because of a shared characteristic (particularly the death of family members) requires a proper response according to the expectations of reciprocal obligations. The language used by anthropologists has associated war deaths of young Croatians in the 1990s war with war deaths of Serbs generations ago in reciprocal ways, as well. When the anthropologist Eugene Hammel asserted with reference to the war in the former Yugoslavia, "The past is the present," he was, at least partially, denoting World War II as explanation for Serb soldiers killing Bosnians and Croats in the 1990s4. The killing of today's living is explained with reference to past dead. In another example, the

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____________________________________________________________ anthropologists Halpern and Kideckel write, “It was Croatia, not Serbia proper that suffered killing, rape, and destruction in the early 1990s. The Croatian people feel violated, not withstanding the horrors visited on the Serbs by the Croatian state in World War II…”5 The language may seem more rational than explanations of suffering or killing based on metaphysical relationships with the dead, but both are part a similar rhetoric. From a cultural relativist’s position, circumstances of deaths long past explain mass killings manifest recently. A critique of the relativist’s perspective seems to imply, “The dead made them do it,” or “More than 50 years ago, some Croatians killed Serbs and this explains why Croatian boys or girls born in the 1980s were killed or tortured or raped by Serbs in the 1990s.” There is almost a vesting of the sins of the grandfathers on their grandchildren. Different groups express their resistance and mobilization in different ways. Slavic women have traditionally worn black as a symbol of mourning but other kinds of death and relationship with the damaged, the near dead, and the socially dead or ethnically "cleansed," are also expressed by women through black. When news of the rape camps in Croatia and Bosnia became widespread news, one informant wore black in protest and in mourning. Rape was another kind of social homicide, along with siege, starvation, and forced immigration. Another example is "The Women in Black," a pan-ethnic resistance movement in Serbia whereby women show their solidarity and support for other women from any of the former Yugoslav republics whose sons and daughters are dead or missing in war.6 Mothers and grandmothers I interviewed both before and after the war of the 1990s expressed their mourning for their lost "flesh and blood" kin and for their husbands with physical idioms. The death, both the predictable and the inappropriate or untimely death, of a close loved one could cause spiritual and emotional wounding and lasting physical trauma. Two women both told me, "When he died the air went out of me." On separate occasions, both said they did not breathe, and literally could not breathe, as easily as they could prior to their husband's death. I took them at their word and also interpreted their words as acts of protest and resistance to their husband's premature deaths. To breathe is to have life, and without their husbands, their lives were diminished. Those missing in war are associated with their own generation of unease. It is incumbent upon the living to bury the dead properly and if the living cannot fulfil this obligation, for whatever reason, the results are unfortunate. A funeral mass may be performed in absentia, but there is no atonement for less than "a good death." Mamma's or Grandma's pain, experientially vested in her descendants, may stem from the homicidal acts of war; it may be that circumstances did not permit funerary rites consistent with her familial importance. Regardless, such disruption necessarily

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____________________________________________________________ interferes with the spiritual benefits for the living and the dead acquired through appropriate death and proper burial. It is impossible to bury the dead individually and properly throughout areas of Bosnia and Croatia where there are mass graves waiting study by forensic anthropologists and others for possible use in war crimes trials. The corpses are mixed together, decayed one into another. Sufficient rituals must be group rituals in the case of some mass graves. From the perspective and experience of men and women with friends, relatives, and countrymen in a mass grave the fact of their death and burial in this illegitimate manner coalesces the grieving into a kind of spiritual family, ethnic or national linkage, shared relations with the disembodied and the poorly interred. It is fitting then that memorials be collective. If death is never the end of relationship, however, some refashioning of reciprocal relations with the dead is possible. Proud of their dead Partisans, the Komizans erected a large memorial to them after World War II bearing the communist star, the emblem of the unified Socialist Republic of Yugoslavia and placed it as the centre-piece of the village of Komiza on the island (see picture).

World War II Monument in Komiza, Vis, Croatia Inscription reads (in translation): At the break of dawn on 7 June 1944, here on the free Island of Vis stood the leader of the Socialist Revolution of Yugoslavia, Josip Broz Tito.

The

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____________________________________________________________ Communist Party was strong on Vis following World War II. The island had become a military base for the Yugoslav National Army and Navy post World War II and closed to outside visitors. When Serbia attacked Croatia in June of 1991, the Yugoslav-Serb military quarantined the island and imposed martial law. As Yugoslav-Serb military and paramilitary were attacking other parts of Croatia, the people of Vis could have been subject to the same killing, rape, and destruction as other parts of Croatia but it did not happen. Perhaps, Vis was spared because it was ridiculous to suppose there had been Ustasha on Vis, Tito’s Partisan headquarters during World War II, or perhaps because Vis represented a unified Yugoslavia to many in the Communist Party. The Serb dominated Yugoslav army and navy left Vis, despite its strategic military position near the coast of Croatia. Nevertheless, when the Yugoslav-Serb military left the island, they attacked the nearest city on the coast, Split. The battleship, “Split,” left Vis where it was berthed in November of 1991 and attacked its namesake city of Split. Split was only saved because the Serb military had not first taken the hills above the city. Local men using weapons purchased illegally in defiance of the United Nations arms embargo drove the gunboat away. Komizans were shocked and terrorized by the attack along with the citizens of Split. Komizans destroyed the monument to the local Partisans who died for the Communist Party and the Socialist Republic of Yugoslavia. What had been central to their identity for 50 years was dismantled leaving an empty space where the monument had been. Headstones in Komiza’s cemetery that bore the communist star were taken down and the star removed, often replaced with a cross. This was not to symbolize the triumph of Catholicism over Communism, since they had previously existed in tandem. Families are buried together on the island of Vis, oftentimes in the same deep burial crypt and it made no sense to bury the dead under the symbol that had become the symbol of the murder of Croatians. Even the long-dead would be insulted to lay under the word “Yugoslavia” when SerbYugoslavs had killed their kin in the 1990s. While Serbs were digging up their own long dead when they left Sarajevo at the end of the war in 1995, rather than leave them in what would become Bosnian soil, Komizans remodelled their cemetery. Like a rite of passage at marriage or death, the cemetery got a face-lift. There was no question that the dead would not approve of this “extreme makeover.” Reciprocal relations between the dead and living may, in extreme situations, require such revision. Following the make-over of the cemetery, Komizans on Vis Island look forward to a younger and better future. Before the recent war, more people left the island than moved to it because there were few jobs. Since the island had been closed to tourists following World War II, islanders were deprived of the foreign currency enriching other areas along the coast. Vis

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____________________________________________________________ had been one of the least populated regions in the Republic of Croatia but now that is all changing. The post-war years have seen a boon in tourist dollars along the coast because more of the money is kept locally instead of being siphoned off to Belgrade, according to the locals. Now that Vis is open to tourists, people are moving on to the island instead of away. The legacy of the Communist past and the horrors of the recent war have not made the people look backwards in anger or anticipate revanchism. The future looks extremely different than the past.7 The extreme make-over began with the dismantling of the war memorial. The cosmetic changes to the Komiza cemetery were more than a surface make-over. Even the dead appear to enjoy a better, refurbished future. It remains to be seen if the changes brought about by the opening of Vis to tourists and Western capitalism will lessen the impact of relationships lived in the disembodied realm and place more pressure on the living to makeover their individual lives and personal embodiment. For the time being, reciprocal relations between the living and the dead are looking quite appropriate.

Notes 1.

2. 3.

4.

5. 6. 7.

I joined 6,000 Croatians in a special visit to the Vatican in November, 2003. Their visit and Papal audience was a thank you to the Pope for all that he has done in support of Croatia. Widows and war veterans from the most heavily damaged parts of Croatia during the war of 1991-1995 received the special honour of a personal Papal blessing. 1. Arnold van Gennep, The Rites of Passage (Chicago: University of Chicago Press, 1960). 1. I am grateful to my colleague, Mira Crouch, for pointing this out and noting that the fact of death is used to make meaning in the present. 1. Eugene Hammel, "Structural Factors in the Collapse of Yugoslavia and How to Do It Right Next There and At Home," Paper presented to the American Anthropological Association, November 20, San Francisco, California, 1997. 1. Joel Halpern and David A. Kideckel, eds., Neighbours at War (University Park: The Pennsylvania State University Press, 2000). 1. Radmila Manojlovic Zarkovic, I Remember. Writings By Bosnian Women Refugees (San Francisco: Aunt Lute Books, 1997). 1. The newly independent Croatia Airlines in-flight magazine makes no mention of the devastation of the recent war in their 2003 publications.

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References Halpern, Joel and David A. Kideckel, Eds. Neighbours at War. University Park: The Pennsylvania State University Press, 2000. Hammel, Gene. "Structural Factors in the Collapse of Yugoslavia and How to Do It Right Next There and At Home," Paper presented to the American Anthropological Association, San Francisco, November 20, 1997. van Gennep, Arnold. The Rites of Passage. Chicago: University of Chicago Press, 1960. Young, Kathleen. The Diversity of Croat-Dalmatian Ethnic Identity in Northern Puget Sound. Ph.D. Dissertation. Burnaby: Simon Fraser University., 1994. Zarkovic, Radmila Manojlovic. I Remember. Writings by Bosnian Women Refugees. San Francisco: Aunt Lute Books, 1997. Ziof, Ksenja. Croatia. Zagreb: Croatian Airlines. Autumn, 2003.

Part II Reflections on Mourning

The Death of a Friend: Some Themes in Jacques Derrida’s The Work of Mourning

Gary Peters In Memory of Deborah Nye

In Derrida’s recent work the theme of death has emerged as central. This is particularly evident in The Work of Mourning and The Gift of Death, but as his former work testifies this has, in reality, long been an important aspect of his work, albeit one overlooked. The work under discussion here, The Work of Mourning, is a collection of pieces written on the occasion of the death of Derrida’s contemporaries.1 They are all, to a greater or lesser degree, well-known and influential thinkers, writers and teachers ranging from Barthes to Foucault, Althusser to Deleuze, Lyotard to Levinas. But, more importantly, they were all his friends which accounts for the peculiar poignancy of these texts and the fascinating way in which he both reads death back into that aspect of their lives that he shared with them, and reads life forward into their death in his description of the complex way he still carries his departed friends within him. The following reflections will concentrate on two inter-related themes. Firstly; the finely-balanced dialectic of speech and silence when speaking (or not speaking) of the dead and the intricate way in which Derrida refuses silence in order to speak another silence that exists between friends through life and death. One that the occasion of death brings, often painfully, to the surface. Secondly; the particularly engaging way in which Derrida speaks of carrying the lost friend within himself will allow me to revisit from a different direction some of Asa Kasher’s thoughts in “Life in the Heart”.2 In particular, it is the detailed but fragmentary memories that Derrida introduces into, what often turns into a re-reading of the friend’s work that offers considerable insight into the experience of loss. Insight that, I believe, shows the real force and resonance of philosophy. To turn to Derrida: The friend can no longer be but in us, and whatever we may believe about the afterlife, about living-on, according to all the possible forms of faith, it is in us that these movements might appear, this being-in-us

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____________________________________________________________ reveals a truth to and at death, at the moment of death, and even before death, by everything in us that prepares itself for and awaits death, that is, in the undeniable anticipation of mourning that constitutes friendship.3 To speak philosophically of death from out of the experience of friendship and loss is something all too rare within the literature of Western philosophy, in Death: An Essay in Finitude, for example, Francoise Dastur begins her study by surveying what she sees as this evasion of the philosophers. From Aristotle to Hegel this absolute negativity, this radical caesura, this purely and simply unthinkable thing death, sees itself converted into “relative non-being”, and “determinate negativity”, into a “sublatable” caesura and a simple limit of the thinkable. This testifies ultimately to the inability of metaphysics really to face up to death.4 In light of this, it is interesting and, perhaps, telling that it is the most notoriously ironic of thinkers who does it best, a thought that will also form part of what follows, particularly as regards the place of what will be called the cliché in the articulation of grief and loss. This is the last of three essays written in the proximity of death, the death of a close friend from cancer, the death of a woman in her forties leaving a husband and two teenage children. Every word of these three pieces contains the “real” experience of this tragedy but, as I have seen so often, philosophical words are too often considered to be empty abstractions, devoid of existential content and thus resented as an intrusion into the “unspeakable” spirituality of death. I speak, I write, but the language I use, the only one available to me, does not register with those who might listen: who would listen? Certainly not philosophers in spite of my “philosophical” language, I have already tried that, with dismal results. Notwithstanding its virile self-image, philosophy is afraid of death and, even more, afraid of the fear of death, afraid of fear. I have sat in a room full of “professional” phenomenologists and heard them agree that, in the face of death, philosophy must be put to one side. As one of this number (who shall remain nameless) stated, “when it comes to death, I turn to my religion, in silence”. No more words, no more noise, a silent vigil pulsating with the reassuring substance of religiosity! When my friend eventually died last summer, after ten years of struggle, I was in France and unable to return for her funeral in England.

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____________________________________________________________ Instead, I decided to compose a piece of music for her that my wife took back to the funeral. It was played at the funeral and accompanied by a short text which begins as follows: This piece of music, short and unfinished like Deborah's life, was written for her as a small token of our mutual love of a certain type of music. I was never able to speak directly to Deborah of my profound sadness in the face of her singular predicament and struggle, but a number of pieces of music I have written and recorded over recent years contain this regret, and they are pieces that Deborah knew and appreciated. This, for me, was an unspoken acknowledgement of an understanding that did not require any other articulation. As is evident, when it came to the moment of death, I too failed to articulate philosophically my fears for her and her family in the face of this trauma, fears that I had spent so long turning over and over in my “cold” and “inhuman” philosophical mind. I too turned away from philosophy towards what is for me the most spiritual of all spiritualities: music, trusting in its incomparable, but incomprehensible communicative power. So maybe that is my vocation, composer/musician, purveyor of a certain kind of silence that, as Nietzsche expresses it, is “too silent for mere silence”, sotto voce, a silence beneath or within the sound or the voice that holds the silence in its proper place, not allowing it to dissolve into a dumb muteness articulating nothing or nothing of importance. Perhaps then, the music should take the place of the current text? But would you, or could you hear this silence between my friend and I, a silence prior to friendship one that wordlessly affirms the other person, beneath all differences and disagreements the “yes” that over time or sometimes instantly transforms being-with the other into being-for the other? When friendship begins before friendship, it touches upon death, indeed, it is born in mourning. But it is also doubly affirmed, twice sealed. 5 Well, maybe you would hear this because, like me and my friend, you will, no doubt be familiar with what might be called here a particular musical rhetoric that inevitably comes into play the moment specific and recognisable types of expression and communication are intended. In the face of, or on the occasion of death particular musical structures, phrases,

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____________________________________________________________ harmonies and timbres, sedimented in a whole history of mourning, remembrance and loss, impose themselves upon the composer with the full force of the collective will. To resist or deny this history, and the structures that articulate it, in grimly determined acts of jollity and celebration is as evasive as is the silent vigil that resents the rhetorical “inauthenticity” of all communicative strategies. Both are every bit as rhetorical as the rhetoric they seek to deny: no happiness is ever only happy, no silence is ever pure. It is for this reason, above all, that I felt compelled to draw attention, in my accompanying statement, to, what I refer to as, the musical “cliches” mobilised throughout the short piece mentioned. To quote myself again: In this piece I have deliberately brought together a number of, what might be described as, musical clichés taken from a certain music, loved by both of us. In spite of the fact that clichés border on the sentimental, they contain within them both a life and, indeed, a history of joy and regret that has no other voice---this is the incomparable beauty of music that I have seen reduce Deborah to tears. It might be useful to embark for a moment on a short detour through a fragment of the work of the novelist Thomas Mann who, more than anyone, is alive to the interpenetration of intense emotional substance and the inheritance and utilization of rhetorical figuration, what might be called in the present context, the irony of grief. Particularly pertinent is his conception of Jacob’s ritualistic mourning of Joseph’s apparent death, as described in Joseph and His Brothers, as the mobilization of what Mann calls “mythic clichés”. In the following passage Mann demonstrates in the most poignant way imaginable the crucial role of clichés in the expression of even the most intense personal affliction. “Crimson and swollen,” he said, his voice trembling, “is my countenance weeping. For deep-bowed in my affliction I sit down to weep, and my face is wet with the tears that flow down it.” The words, as one could tell, were not original with him. For Noah, according to the legend, was supposed to have said some such thing, and Jacob made it his own. And indeed it is good, it is convenient and consoling, that from the suffering of our ancestors we inherit right and suitable words in which to

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____________________________________________________________ clothe our own, which then fit it as though they were made for it…Certainly, Jacob could do his grief no greater honour than to set it on a level with the great flood and apply to it words which were coined for that catastrophe. At all events, he spoke and lamented much in his despair, in words already coined or only halfcoined. And over and over again came the wailing cry: “Joseph is rent, is rent in pieces”—which may easily have been already in existence, but lost nothing of the impressiveness by the fact. No, that they had, however much they had been used before.6 The cliché, for Mann, brings the whole weight of collective grief to bear on Jacob’s private anguish, pluralizing the singular event through the importation of another’s words, other events and a figuration of suffering and lamentation that allows singularity and universality to interpenetrate and thereby attain a level of intensity far beyond subjective pain. The solitary self alone with their loss is here empowered by identifying and submitting to given figures of meaning that are precisely in excess of subjective experience and singular articulation Cliché’s, it is true, have a bad reputation, being too often aligned with sentimentality, sterility, familiarity, and the formulaic; nevertheless, one should not lose sight of the fact that in spite of everything, there is something almost uniquely compelling about the manner in which great swathes of barely articulated human existence are compacted into such discredited, devalued and discarded forms. Clichés could not become clichés unless they at some time articulated the most profound concerns of human subjects in forms that achieve an extraordinary degree of universality, usually, it has to be said, on an empathetic level that ultimately obscures or undermines the integrity of this much-derided form: perhaps a serious hermeneutics of the cliché would be a way forward. The field of rhetorical figures (of clichés) is an infinite one. The mobilisation of the appropriate figures as an offering to the memory of a friend and to those who would remember with you, is a reminder that friendship itself is a form of attention, the recognition and accumulation of signs from the other, the patterns of choices and affirmations that draw the friends into a silent communion, one held in place by their particular, their unique co-respondence. To articulate this on the occasion of a friend’s death is an extraordinarily delicate matter that, as suggested, requires an acute sensitivity to what can and cannot be said, a sensitivity to the demands of rhetoric and the demands of silence. And, in particular, an obligation to

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____________________________________________________________ speak with and for the dead friend, but not necessarily in their words or one’s own (if such ownership can be claimed) but in the appropriate forms, the figures that (we hope, at least) they themselves would have chosen…all of this requires the aforementioned attention. This brings me back to philosophy, for me the most attentive attention of all. It also brings me to the most attentive of philosophers: Derrida, whose words will now move these ideas along a little further: I quote from The Work of Mourning where he wrestles with the delicacy necessary to talk of his dead friend Roland Barthes: Two infidelities, an impossible choice: on the one hand, not to say anything that comes back to oneself, to one’s own voice, to remain silent or at the very least to let oneself be accompanied or preceded in counterpoint by the friend’s voice. Thus, out of zealous devotion or gratitude, to be content with just quoting…to let him speak, to efface oneself in front of and follow his speech…But this excess of fidelity would end up saying and exchanging nothing. It returns death to death. It points to death, sending death back to death. On the other hand, by avoiding all quotation, all identification…so that what is addressed to or of Roland Barthes truly comes from the other, from the living friend, one risks making him disappear again, as if one could add more death to death and thus indecently pluralize it. We are left then with having to do and not do both at once, with having to correct one infidelity with the other.7 Who should speak? One friend is gone, one remains; the survivor must speak, but not for himself, rather, for the other who is absent, who is now silent, silenced. Derrida suggest a manner of speaking that both places the speaker into the silence of the friend and draws the silence out of its muteness into a language that is, in turn, hollowed by what might be called the presence of this absence. A present absence infinitely intensified when, as he does on occasions, Derrida speaks beside the body of his lost friend. Beside the body of Louis Althusser, less than twenty four hours after hearing of his death Derrida is already engaged in this dialectic of speech and silence. I quote: Forgive me for reading, and for reading not what I believe I should say – does anyone ever know what to

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____________________________________________________________ say at such times? – but just enough to prevent silence from completely taking over, a few shreds of what I was able to tear away from the silence within which I, like you, no doubt, might be tempted to take refuge at the moment….It is almost indecent to speak right now…but silence too is unbearable. I cannot bear the thought of silence, as if you in me could not bear the thought.8 To whom is Derrida speaking, to the assembled friends and relatives or to Althusser himself? Or not himself but to the presence of his absence within Derrida, within his “heart” to echo Asa Kasher’s words, the “heart” so cruelly denied to philosophy by the professionals. He speaks to both, both to the presence of the friend in the hearts of the others and to the presence of the friend in his own heart. But he does not speak his own words, he speaks in a “strange tongue” that he does not “believe” in but which allows him to resist the pull of silent oblivion and hold his friend a little longer, suspended between the rhetorical figures and ironic structures that allow speech to continue. In virtually every response to the death of a friend Derrida speaks of re-reading their work, at that moment, having their work before him, again in his “heart”. By thus directing the work of mourning through the act of reading and re-reading he reminds us of his longstanding commitment to the promotion of “writing” and, by implication, reading, in the face of the hegemony of speech, an echo of his earlier notoriety. Important here is not the dubious incestuousness of one living philosopher reading the philosophical work of his dead philosophical friend (philosophy-for-philosophy’s-sake) but the manner in which the reading of another’s writing is the primary form of attention that the philosopher can give to the other. It is the subtlety, the patience and the extraordinary (sometimes infuriating) detail of Derrida’s reading that is the mark of his friendship. The time he devotes to the texts of his friends is the measure of his friendship, even in death. And, of course, this time is also devoted to writing a text, the text we now hear or read the words of the living philosopher as he stands beside the body of his lost friend – death produces philosophy. A philosophy that in Derrida’s case is (to use Levinas’ words) “too human for humanism” one that, as an obligation to the otherness of the other, refuses to hark back to a human essence, now forever lost, but instead disperses the friend into the body of writing – not only their writing but what they read in order to write, what we write having read and re-read them, and how this, in turn, will be read…and so it goes.

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____________________________________________________________ And this returns us to the original irritation; all of this reading, writing, reading, writing, words and yet more words, and, worse still, abstract philosophical words – abstractions, evasions, noisy intrusions into the silence of death. But, then, why should Derrida (or myself for that matter) be silenced by those who are not themselves prepared to, or capable of giving due attention to the writing of the other, those who have never taken the time to learn to read, to read properly, to listen or “hearken” to the text? When one reads Derrida, really reads him, and to read Derrida is always to read him reading the text of a friend (this, incidentally, is the central difference between “deconstruction” and critique), when one reads with him, the abstractions, evasions, detours, the game-playing and innuendo are all signs of the life of the other and his own interpenetration with that life. Friendship itself in life and death is all of these things and more. Derrida’s texts, philosophical though they may be, are bursting with the fragmentary details of the other’s life held in the “heart”, both for Derrida and his lost friends in each singular play of language. I will offer some random examples, it doesn’t matter which friends he is referring to, and there are a few mentioned here: These capital letters that I myself used out of mimetism, he too played with, in order to mime and, already, to quote. 9 Suppleness…he never did without it, whether in theorization, writing strategies, or social intercourse, and it can even be read in the graphics of his writing, which I read as…extreme refinement…10 …what looks at us may be indifferent, loving, dreadful, grateful, attentive, ironic, silent, bored, reserved, fervent, or smiling, a child or already quite old; in short, it can give us any of the innumerable signs of life or death that we might draw from the circumscribed reserve of his texts or our memory. 11 I am rereading him right now, better no doubt than ever before. I would like to quote everything, read or reread everything aloud…I was thinking, for example, that words beginning in “int”, the letters i.n.t. suit him well, like a signature…They do indeed seem to sign the high tension that was his, and that could be felt

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____________________________________________________________ when you saw, heard or read him…”intense”, “intractable”, “interior”…”intransigent… I am at present rereading all the letters from that period…signed by his hand (his large and beautiful black handwriting, high, angular, quick, at once impatient and perfect).12 The above fragments witness an acute sensitivity to the manner in which friendship is never just the intimate presence of the other as a given human essence but is, rather more fugitive, more indirect, forever mediated by the plurality of texts that allow the other to emerge, to be held and also to slip away, to change and to surprise us. It is these we struggle to remember when they are gone. I would like to conclude now by returning for a moment to the death of my own friend. She was not a philosopher, she, like most people, left no body of writings to be read and reread in the way I have described. We rarely, if ever, spoke about philosophy, and certainly never of death, that was the unspoken dynamic of this singular friendship but having said that, a text has many forms; it is not only words that are read and reread. To go back to my piece of music, although an immediate and heart-felt response to her death, a whole friendship’s worth of reading is compacted into these few musical phrases. An attentive reading not of her writing but of her own reading, her loves, inspirations, interests and obsessions, all of those different texts that pulled her in the different directions that ultimately constituted the movement of her own singular identity. And the particular manner (a word often used by Derrida) in which she made this otherness her own both as a possession and an excess, the otherness that inhabited her (and me and you) and which made her death both singular and plural – more than itself, the death of possibility. The music was immediate, but still a work, this work, the work of mourning continues in these philosophical reflections as the best way for me to read and then write out, in my “heart” and in my speech this other place and manner of reading which is now dead and yet, at this moment thanks to these words, so very alive. I will finish, as is fitting, with the words of an other, the philosophical words of Francoise Dastur. Solitude, the defective mode of the actual presence of the other, is not the contrary of being-with-others, but the privative experience of this. And it is precisely this privation of the other that is experienced in mourning, which is being with the other in an eminent way, since

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____________________________________________________________ on account of the very fact that we have lost him or her the dead person is more totally present to us than he or she ever was in life.13

Notes 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

Jacques Derrida, The Work of Mourning (Chicago: University of Chicago Press, 2001). Asa Kasher, “Life in the Heart,” in Making Sense of Dying and Death, ed. Andrew Fagan (Amsterdam: Rodopi, 2004), 11-30. Derrida, p. 159. Francoise Dastur, Death: An Essay on Finitude, trans. John Llewelyn (London: Athlone, 1996), p. 38. Derrida, p. 123. Thomas Mann, Joseph and his Brothers, trans. H.T. Lowe-Porter (London: Secker and Warburg, 1981), p. 426. Derrida, p. 45. Ibid, p. 114. Ibid, p. 37. Ibid., p. 41. Ibid, p. 44. Ibid, p. 62. Dastur, p. 46.

References Dastur, Francoise. Death: An Essay on Finitude, trans. by John Llewelyn. London: Athlone, 1996. Derrida, Jacques. The Work of Mourning. Chicago: University of Chicago Press, 2001. Kasher, Asa. “Life in the Heart.” In Making Sense of Dying and Death, edited by Andrew Fagan, 11-30. Amsterdam: Rodopi, 2004. Mann, Thomas. Joseph and his Brothers, trans. by H.T. Lowe-Porter. London: Secker and Warburg, 1981.

Death and the Other: The Ambivalence of Mourning Havi Carel In the recent film Eternal Sunshine of the Spotless Mind, the protagonist, Clementine, decides to erase the memory of her lover, Joel, after a bitter fight. She contacts a company, Lacuna, which provides this service. Her brain is mapped, the memory traces involving Joel are carefully marked. She is instructed to gather all the objects in her house that are linked to him - photos, mementos, clothes - and bring them to the lab. That night, while Clementine is asleep, a technician enters her home, hooks her brain to a laptop, and erases all traces of him. A few days later Joel visits the bookshop in which Clementine works. She does not recognise him and is already involved with a new man. In his anger Joel decides to go through the same procedure, but at the last minute something within him rebels; he feels that this erasure, although providing redemption from the pain of mourning is somehow wrong. That his memories of Clementine and mourning for her should not be erased, despite the pain they afford him. The utopian idea examined - and refuted - in this cinematic thought experiment is that love should be painless. That we should experience love only insofar as it is good, only as long as it makes us happy. And when the going gets tough, when love turns into rejection or mourning, something (in this case, technology) will enable us to erase the love, forget the loved one and her place in our life. This is, roughly speaking, an amplified version of the implicit contract underlying certain modern relationships: you only stay as long as it is good. This ‘pure relationship’, to use Anthony Giddens’s term, shifts human relationships from the embeddedness of tradition, family, religion and society, to the pure domain of a relationship free from these bonds. The same idea, or wish, underlies a certain understanding of mourning as a process that has an end, and that the end means getting over the lost person (or at least getting over the loss) and ‘moving on’. Certain readings of Freud’s notion of mourning see him as advocating a technical, economic approach to mourning that is supposed to lead to this ‘moving on’ solution. I should like to challenge this understanding by demonstrating that both mourning and melancholia are complex processes whose central features are ambivalence and identification, and that mourning is not simply an efficient short cut to a

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____________________________________________________________ fresh start. Rather, it is a renegotiation of the relationship to the lost person both in relation to new bonds and to a reality lacking the loved one. In what follows I shall present the reading that sees mourning and melancholia as very different processes, and then suggest a different interpretation that emphasises their proximity and their common features: ambivalence, identification and the centrality of loss. In the 1917 essay Mourning and Melancholia Freud sets out to explain the process of mourning and its pathological derivative, melancholia. Freud realised that the process of detachment from a lost object is an active process, and not an automatic attenuation of suffering; it is a work of mourning, Trauerarbeit. In order to complete the work of mourning the mourner needs to retract the emotional investment in the lost object, resulting in the retrieval and freeing of her libido, which will eventually be ready for new attachment. This process is highly demanding in energetic terms, and is manifested through complete preoccupation with working through memories and emotions attached to the lost object, leading to a withdrawal of interest in the external world.1 This process of negating a negation, deleting a lack, is one of overcoming death and loss and a process that eventually leads to a renewed investment in life and in love, and is therefore termed ‘killing death’ by Lagache. This is the normal process of mourning, where the ultimate loyalty is to life, to Eros and to the renewed investment in a new object. On this understanding of mourning, in the attenuation of the investment both the positive and the negative emotions attached to the lost object become muffled, weakened, and with time are transformed into memories. In melancholia, on the other hand, normal working through of loss is turned into a destructive process of self-deprecation. 2 If mourning is life’s victory over death and loss, melancholia is the opposite process: death’s victory over life. In melancholia the ambivalence of the emotions towards the loved one becomes central. The ego of the mourner identifies with the lost person, but in a negative way. The portion of hate contained within the ambivalent attitude to the lost one is internalised and viciously redirected against the ego. A loss of someone becomes a loss of a part of the ego, the part that has become identified with the object. The loss of an external object is therefore replicated in an internal destructive dynamic: the superego’s vicious attack on the ego mirrors the destructive external event, and “[t]hus the shadow of the object falls upon the ego”.3 What is extraordinary is the fact that the superego, the psychic agency of conscience and guilt, is capable of treating the ego as an external object, attacking it with the full force of abjection. “In this way an object loss was transformed into an ego loss and the conflict between the ego and the loved person into a cleavage between the critical activity of the ego and

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____________________________________________________________ the ego as altered by identification.”4 Identification, the process of internalising an external person or part of a person, is an important feature of melancholia: it is the process that enables the superego to turn against the ego (after it has been altered by identification) and hence to internalise the ambivalence originally belonging to the attitude towards the lost person. Identification becomes central in melancholia, and is the reason Melanie Klein and others thought of melancholia as a regressive position, in which object-love reverts into narcissistic identification. Freud, too, saw the crucial link between narcissism and melancholia: “[m]elancholia, therefore, borrows some of its features from mourning, and the others form the process of regression from narcissistic object choice to narcissism.” 5 According to Freud the melancholic remains trapped in the undoing of the attachment, which instead of detaching her from the lost object becomes a repetitive process of self-destruction, an undoing of the self. “In mourning it is the world which has become poor and empty, in melancholia it is the ego itself”.6 What the mourner undoes in order to redo eventually, the melancholic tries, but fails, to undo. Trapped in repetition she is caught in her failure to undo. Putting aside the detrimental effect this has on the melancholic’s return to healthy functioning, the melancholic position can be seen as more authentic: she remains faithful to the original love object, to the unique attachment. The mourner, on the other hand, recuperates from the loss and is full of free libido once more, ready to love anew; but this healthy recovery is what makes her fickle, and her love - ephemeral. She undoes her lost love through the work of mourning and then redoes by loving a new object, whereas the melancholic refuses to give up her loyalty. She says: this love is not replaceable, this person is unique. I refuse to replace it; it has no substitute. It is this absolute loyalty anchoring melancholia that makes it so hard to treat, so destructive, but this is also the source of an important insight: that whenever we try to overcome death or loss, we stand the danger of becoming addicted to it, as the melancholic does. The melancholic is unable to transform the old love for the one who is no longer there, to keep the love alive but at the same time be aware of the fact that the love object itself is gone. She is incapable of separating the love, which remains alive inside her, from the love object that is no longer there. The love for a lost person acknowledges the intensity of the attachment but also accepts the loss. A prime cinematic example of the failure to realise the loss of the object but retain the love for it, is Hitchcock’s Norman Bates, the protagonist of Psycho. Bates, a faithful son (albeit a serial murderer), cannot mourn his mother’s death and instead

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____________________________________________________________ chooses to preserve her corpse in order to maintain the psychotic illusion that she has not died, has not left him. Because he is unable to acknowledge that his beloved mother is no longer alive, Bates must sacrifice reality and choose, so to speak, psychosis over mourning. The psychotic opposes the demand of reality testing to withdraw the libido from its attachment to the lost object, in a manner “so intense that a turning away from reality takes place and a clinging to the object through the medium of hallucinatory wishful psychosis”.7 This refusal to admit what reality tells us is also manifest in more common experiences, such as seeing the dead person in the street or dreaming about them. But whereas the psychotic refuses to acknowledge the loss, the melancholic amplifies the loss. She magnifies her loss so as to encompass the whole of life, turning life into a course of mourning that extends well beyond any specific loss. She mourns not just the lost object, but loss itself. For the melancholic, loss and finitude are inherent to any attachment, to any object, and hence she sees life as filled with danger and disappointment. Whatever we love might leave us, whatever we invest in could expire and disappear. Mourning becomes internalised, an integral part of the melancholic position: the melancholic ceases to mourn others and begins to mourn herself, herself as always losing, as always expiring. While the psychotic refuses to acknowledge the loss, the melancholic refuses to see anything but loss and the danger and pain it brings with it, so that all positive experiences are marred by this threat. She therefore loses her capacity to enjoy life, seeing the threat of demise and loss in all of life’s offerings. But is the melancholic’s position so unreasonable? Is not the ‘normal’ person simply denying a truth that the melancholic, in her grief, has come to see? As Freud astutely comments: “[the melancholic] merely has a keener eye for the truth than other people who are not melancholic… we only wonder why a man has to be ill before he can be accessible to a truth of this kind”.8 The truth the melancholic seems to have seized hold of is that loss is a central experience of human life and that transience is a feature of all our experiences and attachments. This view is discussed in Freud’s short essay On Transience [Vergänglichkeit], which describes the impasse between himself (as representing science) and his companions, a young poet (representing art) and a friend, encountered during a stroll in the dolomite mountains.9 The young poet is saddened by the transient nature of all things beautiful, and experiences the worthlessness of “all that he would have otherwise loved and admired”, which he now sees as “shorn of its worth by the transience which was its doom”. Freud, on the other hand, claims that “transience value is scarcity value in time. Limitation in the possibility of an enjoyment raises the value of the

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____________________________________________________________ enjoyment”.10 As Adam Phillips writes, for Freud “it is impermanence that confers value; it is the fact of death, of the prodigal forms of transience, that creates pleasure”.11 According to Freud transience “gives rise to two different impulses in the mind. The first leads to the aching despondency felt by the young poet, while the other leads to rebellion against the fact asserted”.12 These two attitudes towards transience are inherently linked to the question of mourning, as mourning is a process of coming to terms with loss. For Freud’s companions mourning is unbearable. “The idea that all this beauty was transient was giving these two sensitive minds a foretaste of mourning over its decease”.13 For them to mourn is to acknowledge the loss and transience of life itself; an unbearable psychic process. Because they cannot acknowledge transience they cannot mourn, and because they cannot mourn they cannot afford to love, as love is always love for the transient, expiring object. But for others, such as Freud, mourning is a creative force, because for those who overcome the fantasy of permanence, the value of an object is enhanced by its transience, “its evanescence only lends it a fresh charm”.14 For these people the possibility of loss creates pleasure, and loving life means loving transience. They can affirm life, beauty and desire because they are transient and temporary, and not in spite of this fact. The position of the poet, who is distraught and threatened by transience, is melancholic because he refuses to face transience, and chooses instead to refrain from love because of the danger of mourning that is rooted in that love. Whereas Freud, who understands the necessity of transience, is capable of love, of aesthetic enjoyment, of attachment. But I think Freud simplifies both positions; the melancholic is not simply motivated by fear and the one who understands transience as the condition of value is not exempt from the pain of loss. For both the challenge is to learn to love despite the threat of transience and to acknowledge the place of loss in life without giving in to melancholia. I will now turn to Melanie Klein’s account of mourning, which will provide us with the insight needed to respond to this challenge. According to Klein both mourning and melancholia cause a temporary regression to what she calls the depressive position, which characterises early childhood experiences and in particular infancy. Klein sees loss as marking early experiences, which lead to the infantile depressive position. These experiences include weaning (loss of the mother’s breast), the Oedipus situation (loss of the mother and the threat of castration) and ambivalence towards siblings (fantasies of destroying and thus losing them). The way to overcome the depressive situation is by

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____________________________________________________________ internalising the ‘good’ aspects of the lost object, thereby gradually constructing a stable and secure inner realm that is not threatened by external loss.15 External loss experienced later in life takes us back to the early depressive position, and is therefore “amplified by unconscious fantasies of losing the internal object as well”.16 Thus, according to Klein, mourning involves a sense of persecution, ambivalence and distrust.17 This emphasis on loss replaces the dichotomy that guided the initial reading of mourning and melancholia because it accentuates the presence of ambivalence and identification (which typify early loss experiences) in both processes. “In normal mourning, as well as in abnormal mourning and in manic-depressive states, the infantile depressive position is reactivated”. 18 And although there are significant differences in the ability to move successfully out of the depressive position, the reactivation of early reactions to loss stands at the basis of all loss experiences. What is important to Klein is to recognise the central role of loss and mourning in mental life in general, rather than stressing the difference between normal and abnormal mourning: “… any pain caused by unhappy experiences, whatever their nature, has something in common with mourning. It reactivates the infantile depressive position, the encountering and overcoming of adversity of any kind entails mental work similar to mourning”.19 In this sense, mourning and melancholia are similar processes, distinguished by the fact that “the person who fails in the work of mourning… has been unable in early childhood to establish the internal ‘good’ objects and to feel secure in their inner world… In normal mourning, however, the early depressive position which has become revived again through the loss of the loved object, becomes modified again, and is overcome by methods similar to those used by the ego in childhood.”20 So the point of mourning for Klein is the opposite of the ‘moving on’ idea: the point of mourning is not to forget or overcome the love or the lost person, but to remember them in the right way, to maintain a positive inner object that is an internalised positive part of the lost object. As Channing Lipton writes: “introjection is an attempt to preserve the object, but it is also a step toward giving it up. In fact, it does not take place until the loss is acknowledged.”21 So introjection and identification are processes active in both mourning and melancholia; the difference lies in the fact that in mourning the positive aspects of the object are internalised, whereas in melancholia, it is the negative aspects. And the capacity for reinstating the good internal object is what the melancholic is lacking.22 Returning to Norman Bates, the role of ambivalence in his incapacity to mourn for his mother is now much clearer. At the end of the

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____________________________________________________________ film we learn that Norman actually murdered his mother and her lover in a bout of Oedipal jealousy. This rapid change of love into hate expresses the ambivalent nature of attachment: to love means also, potentially, to hate, to be vulnerable to the loved person’s slights and rejection and to lash out with hatred with an equal amount of energy as that invested in love. Norman’s ambivalence allowed his hatred towards his mother to erupt but later made him regret his actions and try to reverse the situation by keeping his mother alive. This is an extreme example of the power of ambivalence, but if we turn to the world of the child, murderous impulses are not yet mediated and repressed with the same efficacy as an adult. Norman’s additional incapacity to keep his mother as a good internal object through the process of introjection made the denial of her death the only coping strategy left to him. Norman Bates is a truly tragic example of the force of ambivalence and the incapacity to mourn. A final step, linking ambivalence and identification is needed to complete this consolatory reading of mourning and melancholia. In Group Psychology and the Analysis of the Ego Freud says: “[i]dentification, in fact, is ambivalent from the very first; it can turn into an expression of tenderness as easily as into a wish for someone’s removal”.23 The example used by Freud is that of eating. In eating (and in the oral phase in general) the object of desire becomes assimilated, literally, into the body of the desirer. This assimilation is also annihilation, a destruction of the object that has been assimilated but has now disappeared. This is the point where the distinction between wanting to have something and wanting to be something, becomes blurred and where the dialectic link between love and aggression becomes apparent.24 If identification is always ambivalent and both are present in mourning and in melancholia, the emphasis on the distinction between the two should be replaced with a broader understanding of the complex demand - present in both processes - to retain the love for the lost object, while acknowledging its irretrievable loss.

Notes 1. 2.

3.

Jean Laplanche and J. B. Pontalis, The Language of Psychoanalysis (New York: W.W. Norton, 1973), 485-486. Freud significantly identifies melancholia as linked to femininity. For a study of feminine melancholia see Julia Kristeva’s Black Sun (New York: Columbia University Press, 1989). Sigmund Freud, The Standard Edition of the Complete Psychological Works of Sigmund Freud, translated under the general editorship of James Strachey (London: Hogarth Press, 1953-1974) vol.14: p.249

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4.

5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

16. 17. 18. 19. 20. 21.

22.

23. 24.

(grammar modified) (hereafter SE followed by the volume and page number). Ibid. As James Strachey emphasises, both narcissism and ego ideal enabled the idea of melancholia to emerge. The critical agency (the superego) has a major role for both melancholia and ego ideal. (see Strachey’s introduction to Mourning and Melancholia in SE 14:243). SE 14:250. SE 14: 246. SE 14:?. SE 14:?. On Transience, SE 14:305. SE 14:306. Adam Phillips, Darwin’s Worms (London: Faber and Faber, 1999), 26. SE 14:305. SE 14:306. Ibid. (grammar modified). Melanie Klein, “Mourning and its Relation to Manic-Depressive States” in Interpretations of Death, ed. Hendrik Ruitenbeek, (New York: Jason Aronson, 1973), 246. Ibid. Ibid. 247. Ibid. 264. Ibid. 254-255. Ibid. 264-265. Channing Lipton, “Denial and Mourning,” in Interpretations of Death, ed. Hendrik Ruitenbeek, (New York: Jason Aronson, 1973), 274. A similar point, using the metaphor of an unfinished book can be found in Asa Kasher’s “Life in the Heart”, Journal of Loss and Trauma, 3 (2003) SE For more on this issue see my “Born to Be Bad or Born to Die? Two Readings of the Death Drive,” in This Unweeded Garden: Evil in Theology, Philosophy, and Practice, ed. Stephen Morris (New York: Rodopi, 2004).

References Freud, Sigmund. The Standard Edition of the Complete Psychological Works of Sigmund Freud. Translated under the general editorship of James Strachey. London: Hogarth Press, 1953-1974.

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____________________________________________________________ Klein, Melanie. “Mourning and its Relation to Manic-Depressive States.” In Interpretations of Death. Edited by Hendrik Ruitenbeek. New York: Jason Aronson, 1973. Laplanche, Jean and J. B. Pontalis. The Language of Psychoanalysis. New York: W.W. Norton, 1973. Kristeva, Julia. Black Sun. New York: Columbia University Press, 1989. Lipton, Channing. “Denial and Mourning.” In Interpretations of Death. Edited by Hendrik Ruitenbeek. New York: Jason Aronson, 1973. Phillips, Adam. Darwin’s Worms. London: Faber and Faber, 1999.

Grace Towards the Dead1 Dana Freibach-Heifetz In her book, The Other Power, the Israeli author Yehudit Hendel writes: “It is also possible to live with a dead person. This inhuman and unrealistic conclusion can, under certain conditions, be the most humane and realistic situation”.2 In the present paper I shall try to discuss several philosophical aspects of this profound psychological truth, inter alia by examining it through the prism of the concept of secular-humanistic grace. 1.

Philosophical Discussion of the Attitude towards the Dead. There is almost no reference in philosophical literature to the significance and status of relationship with the dead (and the reasons why this is so will not be discussed in the present paper). A striking exception is the Danish philosopher Kierkegaard who, in his book Works of Love, asserts that the living have the duty of works of love towards the dead. He bases this theory on the general commandment to love, which is Christian in origin but undergoes an ethical transformation in his work. The duty to love the dead derives from this general commandment, because the duty to love is eternal, and the death of a loved one does not terminate it. In this context, the death of the other is perceived as the supreme ordeal. For Kierkegaard, death is the purest opportunity to examine the conduct of the living in relation to fulfilment of the duty to love. Moreover, he regards love of the dead as the freest, purest and most devoted love, since it is love without reward. It is also the most difficult to achieve, since the dead do not compel and do not help the living to remember them and, on the other hand, the passing of time and the routines of everyday life incessantly tempt one to forget the dead; the dead do not change, while the living are obliged to remain similarly static in order to preserve the relationships between them; naturally enough, the burden of preservation is borne solely by the living. However, he who overcomes these difficulties, and chooses to set alongside death a work of love for the dead, will find, according to Kierkegaard, that the dead person teaches him things which cannot be learned from any living person - the power of inalterability; the pride in silence, which does not demand for itself love or attention even in the face of forgetting; the generosity of non-coercion. All this in addition to the benefit inherent in the work of love, any work of love, which is intrinsically good; how much more so, when we are dealing with love on its freest and purest level: love of the dead.

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____________________________________________________________ But what can “work of love” mean with regard to the dead? Kierkegaard answers this question with a moving description: One must not disturb the dead with his complaints and cries; a person should move about one who is dead as he moves about one who is sleeping, one whom he has not the heart to wake up because he hopes the sleeper will wake up by himself. “Weep softly over the dead, for he has found rest,” says Sirach…, and I know of no better way to describe true memory than by this weeping softly, which does not begin sobbing one moment - and then softly subsides. No, one must remember the dead; weep softly, but grieve long. How long cannot be decided in advance, because no one remembering can with certainty know how long he shall be separated from the dead. But he who in love remembers one dead can make his own some words from the psalm of David…’If I forget thee, let my right hand forget its cunning…’3 Kierkegaard does not specify tangible actions which are expressions of the work of love towards the dead. One can envisage different types of action: studying the thought of the one who is dead, achieving the goals he set himself, intensive recollection of him, etc. Yet, Kierkegaard shows how rich and full such a human condition can be, to what degree the work of love and concern, alongside the nothingness of the death of the other, does in fact enable the continuity of the dead - if only in the world of the living - and represents inherent good in its supreme form. One finds an example of “work of love for the dead” in the same spirit in the eulogy of the French philosopher, Jacques Derrida, on his mentor and friend, Emmanuel Levinas: I will never stop beginning or beginning anew to think with [his ideas]… and I will begin again and again to rediscover them on just about any subject. Each time I read or reread Emmanuel Levinas, I am overwhelmed with gratitude and admiration, overwhelmed by this necessity to respect and give to the other person, which is… a very gentle force that obligates.4 In certain respects, Derrida goes even further than Kierkegaard, citing an extreme example of the influence of the dead on the living: Reading the

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____________________________________________________________ works of the dead person obligates the living to act in his spirit. It is important to clarify, however, that Kierkegaard does not propose the work of love for the dead as a substitute for relationship with the living. He explicitly depicts the former as a relationship which exists in addition to the relation to the living other, and as its natural continuation. In the same spirit and from a different angle, Derrida says that …[F]riendship for the deceased…carries this philia to the limit of this possibility: I could not love friendship without projecting its impetus towards the horizon of this death… I could not love friendship without engaging myself, without feeling myself in advance, engaged to love the other beyond death. Therefore, beyond life. I feel myself - and in advance… - borne to love the dead other. I feel myself thus (borne to) love; it is thus that I feel myself (loving).5 Another philosopher who proposes a way of comprehending the relationship between the living and the dead is Martin Buber. According to the philosophical theory he expounds, an individual can adopt one of two relationships which determine his identity: the I-It, whereby he relates to what he encounters (including human beings) as objects; and the I-Thou relationship, whereby he relates to what he encounters (including animals, plants and “spiritual beings”) as individuals with whom he maintains a dialogue. Buber states explicitly (although succinctly) that the I-Thou relationship with the dead is possible, within the framework of the relationship with “spiritual beings”. He writes: Let the questioner make present to himself one of the traditional sayings of a master who died thousands of years ago; and let him attempt, as well as he can, to take and receive the saying with his ears, that is, as though spoken by the speaker in his presence, even spoken to him. To do this he must turn with his whole being to the speaker (who is not to hand) of the saying (which is to hand). This means that he must adopt towards him who is both dead and living the attitude which I call the saying of Thou. If he succeeds (and of course his will and his effort are not adequate for this, but he can undertake it again and again), he will hear a voice, perhaps only indistinctly at first, which is identical with

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____________________________________________________________ the voice he hears coming to him from other genuine sayings of the same master. Now he will no longer be able to do what he could do so long as he treated the saying as an object - that is, he will not be able to separate out of the saying any content or rhythm: but he receives only the indivisible wholeness of something spoken.6 This statement is not easily comprehensible, but closer perusal reveals here two central characteristics of the relationship with the dead. First, it is conditional on a second-person approach to the deceased, which means that he is perceived as Thou (i.e. living) and not as an It. Such an approach demands that the living person dedicate himself “with his whole being” to the dead, and is conditional on his success; in other words: success in establishing an I-Thou relationship with the dead is not guaranteed, not even to those who invest their whole being in the effort; but these, according to Buber, characterize any I-Thou relationship. It should be noted that, in the same context, Derrida says that one should approach the dead straightforwardly, “to speak straight on… to address oneself directly to the other, and… speak for the other whom one loves and admires, before speaking of him”.7 The second characteristic of the attitude towards the deceased, according to Buber, relates to the significance of a dynamic and living relationship with him; because the Buberian dialogue is marked by dynamism and vitality, while the I-It is not. In what sense can one speak of such a relationship with the dead? Buber interprets it in the last sentence: when the living relates to the dead in his unique voice “and indivisible wholeness” which is not controllable by the living “he will no longer be able to separate out of the saying any content or rhythm”. Thus, although Buber does not elaborate on this, in light of the significance and centrality of the I-Thou relationship in Buber’s thought, one can realize the significance and importance he attributes to the relationship with the dead. Alongside these brief discussions, Asa Kasher devotes a particularly lengthy discussion to the relation to the dead. In proximity to Kierkegaard, Kasher presents a rich picture of a fully vital relationship with the dead, to the point where the border between living and dead is blurred: The border between life and death is not the border between multi-dimensional reality and unidimensional memory…. Upon his death, we remember someone dear to us… we love him…. think of him… can


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____________________________________________________________ continue to take pride in his qualities, continue to recreate his emotions, in order to rejoice in his joy and share in his sorrow… we cannot help him. We can continue to yearn for him in his absence, in his death… we live our relationships with the dead who are dear to us. These relationships can be very rich even if not full. The border between life and death… passes through the spiritual reality, but it is reflected… also in the overt movements of the individual and even in his conduct [in metaphorical gestures]… [a person can] shape his life in patterns which reflect his living relationship towards…the dead. Something that a person wants, in his lifetime, can be given a place in our lives, to the extent that we wish to give it such a place… even upon his death, we can respect his wishes… respect him… give [him]… a place in our heart… To give a beloved person life in your heart means to give life in your world to his values, his qualities, his conduct… to give them expression in the practical principles which rule your life…to give them a real place within the meaning of your life.8 Kasher calls this attitude towards the dead “life in hearts”. He explains the term as follows: The dead live among us, after their death, as they lived among us in their lifetime. After their death they live only within us, while previously they lived both without us and within us… The dead remain partners in living relationships, they continue to live within the wounded hearts of those who remain behind. In his lifetime, a person writes the story of his life. With his death, the story of his life continues, not in itself, but within the story of the life of those who love him. The one who loves writes his own life story in his lifetime and also the continuation of the life story of his beloved one. And in time, with his own death, the life story of the one who loves continues, not in itself, but within the life stories of those who love him, as does the life story

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____________________________________________________________ of his beloved one, who lives in his heart. Thus the life story of a person continues into the life stories of those who love him and those who love those who love him and those who love those who love those who loved him…endlessly. 9 According to Kasher, we can maintain a vital relationship even to a dead individual whom we never knew in his lifetime whether through the mediation of those who knew him, by loving those who loved him; or through relationship to the deceased by acquaintance with his “profiles”, profiles that can range over a wide continuum from perpetuation of his name to knowledge of numerous details about him and his world. However, in the main, the focus is on the fact that “a person who lives in the heart, after his death, is someone who has life within the meaning of the life of someone close to him during his lifetime.” Kasher goes on to discuss what the deceased bestows on the living: “A person who lives in hearts, after his death, bestows meaningful life here on earth.”10 Additional expression of that spirit of “life in the heart” can be found in Derrida’s eulogy on Emmanuel Levinas: The greeting of the a-Dieu does not signal the end… The a-Dieu greets the other beyond being…I did not want simply to recall what he entrusted to us of the aDieu, but first of all to say adieu to him, to call him by his name, to call his name, his first name, what he is called at the moment when, if he no longer responds, it is because he is responding in us, from the bottom of our hearts, in us but before us, in us right before us - in calling us, in recalling to us: a-Dieu. Adieu, Emmanuel.11 An examination of the philosophical implications of these remarks leads to two conclusions. The first, on the ethical plane: relationship with the dead can be perceived as a moral obligation, and even as the supreme good. In the same spirit, Aristotle too refers (though briefly) to the duty of devotion to a dead friend.12 The second, even more far-reaching conclusion refers to the relation between a relationship with the dead and relationship with the living: Kierkegaard regards the former as a direct and morally requiset continuation of the latter, and Derrida too says that, conceptually, it is impossible to maintain a profound relationship with a living person (in this case: friendship) without the assumption that the relationship will continue after his death .


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____________________________________________________________ There are, of course, other voices as well. Maurice Blanchot, for example, claims that when a friend dies, the friendship sinks into oblivion.13 But I would like to continue this discussion from the viewpoint of those who stress the feeling that the dead are living and that the absent are present, and single out for praise those who continue to love their dead. From this point of view, I would like to reexamine the relationship with the dead through the prism of secular-humanistic grace. 2.

The Attitude towards the Dead through the Prism of Secular-Humanistic Grace What is secular-humanistic grace? I am employing this term in the sense that I developed in my PhD thesis, the crux of which is: secularization of the concept of religious grace (which is the relationship between God and man) and its placement within the framework of a secular-humanistic worldview as a relationship between man and man. In essence, this is the relationship between two individuals, at least one of whom (“the inviter”) chose it as a way of life which is realized in concrete relationships, while the other (“the respondent”) chose at least to maintain the certain relationship with the inviter. Grace as a way of life implies openness and generosity towards the other, as a form of self-fulfilment. It seeks to express itself in relations with certain individuals, when there is continuity between these two planes - the concrete grace relationship is the realization of the fundamental choice, while that fundamental choice is the distinguishing feature and test for identification of the concrete relationship between two individuals as grace. Within this framework, the concrete grace relationship is a dynamic and open encounter of wills, which is realized in different ways since it is a dialogue anchored in the individuality of both sides, and which entails (at least on the part of the inviter) transcendence from the self. This encounter has a positive subjective aspect of love in the wider sense, which is manifested in the attitude and conduct towards the other. It is a unique combination of love of the self and love of the other, in which there is no room for oppression or sacrifice; although it is also (in the main and perhaps only on the part of the inviter) a demanding relation, both difficult and hazardous, which requires constant self-overcoming. This relation may lead to a positive existential change in the parties to a concrete grace relation: liberation in various senses, expression and strengthening of selfhood, bestowal of love and meaning on life, together with additional possible results: truth, pleasure, richness, wholeness and vitality, joy and serenity, when these results are achieved not for their own sake, that is to say, without effort or anticipation. In this light I would like to examine whether it is possible to

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____________________________________________________________ speak of a relationship with the dead as a secular-humanistic grace, by observing the characteristics of the latter, thereby to elucidate the meaning of such a relationship. A. First Characteristic: The Relationship between Human Beings Secular-humanistic grace, as noted, is the relationship between two human beings at least one of whom has chosen it as a way of life. In the case before us, if one can in fact categorize the relationship with the deceased as secular grace, then, by the very nature of the relationship, the living individual will play the role of inviter. It follows that one cannot speak of secular grace relationship with the dead except as a continuation and in parallel to concrete grace relations with living individuals, who also - and perhaps mainly - are the realizations of the inviter’s fundamental choice in a life of grace. An individual may maintain a profound and rich relationship with someone who is dead, but without additional relations with living persons, this cannot be considered as secular grace as defined above. It is in this spirit that one should interpret Kierkegaard’s remarks on the work of love for the dead not as a substitute for the relationship with the living but as existing in addition to the relation to the living other and as its continuation, as well as Derrida’s conception of friendship as including within it the continuation of involvement after the death of the friend. This is the first and essential condition for a secular-humanistic grace relation to the dead. However, this condition does not suffice. In principle, it can be argued that the dead person is no longer a “human being” with whom one can maintain a relationship. However, I have chosen to follow in the wake of the above-mentioned approaches, which reject this claim and regard the relationship with the dead as a relation to a human being, although that human being is no longer present in the actual world of the living. Hence, it would seem that the first characteristic of secular grace can also exist with regard to the relation to the dead. And yet, on second view, there is a problem here, exposed through Buber’s classification of the dead on the plane of “spiritual beings”; because, if this is so, what fundamental difference is there between relationship with the dead and relationship with a fictitious literary figure, or an abstract idea? As far as Buber is concerned, there is in fact no difference between them; one can maintain an I-thou relation with all of them equally. However, in the context of secular grace, a first limit can already be set: this notion clearly distinguishes between the dead and between fictitious and fantastic figures, and excludes the latter. The dead are not the spiritual inventions of the living, but have independent existence, in his heart as well. This first characteristic of grace - its being a relation between human beings - does


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____________________________________________________________ not run counter to its application to relationships with the dead. B. Second Characteristic: Personality The relationship with the dead is a relationship with a certain personality, which (at least when in a true relationship with it) I cannot shape according to my wishes. It has its own unique and independent voice, even if I can no longer hear it except in my spirit. The question now is what happens in the case of a relationship with as dead individual whom I did not know in his lifetime? Buber and Kasher offer a meaning for such a relationship. It may be said here that the closer and more familiar is the deceased to the living individual, the more personal is the relationship with him and the easier to classify this relationship as secular-humanistic grace. C. Third Characteristic: A Dialogue A central difficulty in perception of the relationship with the dead as secular-humanistic grace stems from its characterization as a dialogue: in what sense can one speak of a dialogue with the dead? On the part of the living individual it is manifest that a direct relationship to the dead is a typical characteristic - if not a condition - for such a relation; and in fact, the above-mentioned philosophers emphasize the direct approach to the dead person, in the second person. From the point of view of the deceased, he too may “speak” to the living: through his writings, his thoughts, the things he succeeded in expressing in his lifetime; Buber, Derrida and Kasher illustrate this very well. But the dead can speak to the living only metaphorically, and this speech is limited in scope. It is not a full dialogue. The difficulty which remains has been expressed by the Israeli poet Ory Bernstein, addressing his dead father: “…You are still sitting there, in what was, very much alive/ And when I dare to come over you greet me. / I alone am left to supply your wants // So that you may perhaps, if only for once, show a countenance I do not remember .”14 But this yearning to see a new countenance, to hear something new and surprising from the deceased, cannot of course be realized. Kasher’s view, however, is that the independent voice of the dead can be a new expression of his views or virtues. D. Fourth Characteristic: The Gift Secular grace is a gift in several senses of the word. First, as a form of being-with the other, that its very existence (as a relationship of mutual love in the wider sense of the term) is perceived as good for both sides. From another angle: as flowing of the giver's power, which is perceived as enriching and deliberate squandering. In this context, it is the

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____________________________________________________________ acceptance of the other as he is and the very act of approaching him with openness and respect for his otherness that are perceived as a gift. In all these senses, one can speak of secular grace on the part of the inviter as a gift. This sharpens the meaning of the term “good” that is not necessarily something pleasant and elating, because a relationship with the deceased generally entails pain and longing, but which is the expression of a love which is perceived as good and important by the loving person (and thereby does not differ fundamentally from any relation of secular grace, which can also cause pain to both parties, and in particular the inviter). Moreover, relationship with one who is dead can be perceived as the culmination of secular grace, a gift which does not and cannot expect a reward. Kierkegaard shows this well. However, in contrast to his “work of love”, secular grace entails no obligation whatsoever. And still the question remains what can a living individual give to the deceased and in what sense can we speak of something as good for the dead. I shall deal with these issues in the sequel. E. Fifth Characteristic: The Meeting of Wills Herein lays an additional major obstacle to perception of the relationship with the dead as a secular grace. It is clear that the living, by maintaining a relationship with the dead, is expressing his wish for such a relationship, and even - in light of the special difficulties involved in such a relationship, a particularly ardent wish. But in what sense does the relationship reflect the wish of the deceased? Here one can distinguish between three cases: first, between a deceased individual who, in his lifetime, expressed the desire for relationship with a living person, and another deceased individual who did not; and second, with respect to the latter: between the one who can be assumed (in light of acquaintance with him) to have wished it, and the one who cannot.15 In this context we can say that in the first instance it is easier to assert that the meeting of wishes occurs which is required for the existence of secular grace, and in the second and more so in the third it is more difficult to do so. F. Sixth Characteristic: The Subjective Aspect On the part of the living there may of course be a profound and rich subjective aspect of emotions, thoughts, wishes and choices within the framework of the relationship with the deceased; it is enough to recall what Kasher and Derrida have to say in order to clarify this. However, there is a difficulty involved as regards the subjective aspect of secular grace where the dead individual is concerned. One could say, in parallel to the distinctions drawn regarding the previous characteristic, that in the case of a dead individual who, when alive, maintained a grace relationship


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____________________________________________________________ with the living, it is now easier to assert that the continuation of the relationship is a kind of secular grace, as distinguished from the assumed existence or wish for existence (or non-existence) of such an aspect after his death. G. Seventh Characteristic: The Objective Aspect The objective aspect of the external manifestations of secular grace in conduct towards the other and action on his behalf. Here we face a twofold difficulty with respect to the definition of the relationship with the dead as a secular grace. The first difficulty is the absence of expression of this aspect on the part of the deceased. One could reply to this by emphasizing the asymmetry between inviter and respondent, and by attributing to the deceased (respondent) - in the spirit of the above analyses of his assumed wishes - a mere minimal degree of readiness to accept. However, it is also problematic to say that the objective aspect exists on the part of the living. It is, of course, clear that the living individual can express his relation to the dead in various practical and concrete ways; but can this be classified as actual giving to the dead himself, since, as Kasher says, we can no longer help him? There are several possible answers. First, it can be argued that in acting to commemorate him, in striving to realize his goals, there is an element of giving to the dead, which could have caused him happiness and of which it can be claimed (mainly in cases where this is possible because of acquaintance with him) that he would have perceived it as good. This, in analogy to the fact that when we speak of “dignity of the dead“, we refer to his own dignity. Secondly, even if we regard this as metaphorical giving, it does not refute the characterization of this relationship as secular grace. And even if we go so far as to say that there is no such thing as an objective reflection of a relationship with the dead, we can still regard the (subjective) pain involved in the absence of the ability for objective giving as a unique and constant expression of the objective aspect, which is to be found where a grace relation exists with a beloved person who is no more. In light of all these difficulties in finding practical manifestation of giving to the dead, it appears to be harder to speak of secular grace with the dead embodied in a relation which is not a relationship. The explanation for this is close to the spirit in which Kierkegaard explains the faith of Abraham, knight of faith.16 It is a total faith, because its object is paradoxical and there is need for an inverted relation between the feasibility of the content of faith and its power. The harder the objective expressions of secular grace, the stronger must be the subjective aspect; it is hard to say that there is such a thing as a grace relationship with the

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____________________________________________________________ deceased without the significant presence of the dead at least in the inner (subjective) world of the living. H. Eighth Characteristic: The Outcome of Grace A real and full encounter between human beings at least assumes the possibility of mutual influences and change in the two parties. On the face of it, this is not possible with regard to the dead person - his life is over, he is beyond the possibility of change. However, one can speak of an encounter in which one of the parties is static, in the sense in which a dead person is static (namely: “frozen” as it were in the memory of the living).17 Nonetheless it is characterized by a rich and profound dialogue, dynamism and vitality, and one of the parties - the living - may be profoundly influenced by the encounter. Kasher, Buber and Derrida have described this, Derrida even saying that the dead “compels” him to act. Moreover, Kierkegaard emphasizes the good such an encounter can bring to the life of the living individual; and Kasher points out that the deceased may instil meaning in the life of the living person, and the relationship with the dead can shape one's selfhood. These are, of course, possible only as corollary, and even then they entail pain and great difficulties, much greater than in the case of a grace relationship with the living. But it is clear that, at least of the part of the living, what we have here are the possible consequences of secular grace: love, the instilling of meaning into life, the impact and expression of individual selfhood. In a certain sense, there is also an opportunity here for liberation, mainly in the Heideggerian sense of liberation from the death of the other (as complete loss), and to the death of the other (as the possibility of continuing the relationship with the deceased), with all that each of these possibilities entails. In order to clarify this last point, I would like to return to Kierkegaard. The relation to the dead is permeated, first and foremost, with the deep agony of mourning, pain and inconsolable yearning. In Works of Love, Kierkegaard recommends adherence to this agony, for ethical reasons of duty towards the dead. And, paradoxically, despite and because of the fact that “works of love” for the dead contain within them the agony of their death, they represent a certain overcoming of death (since the deceased continues to exist in the world of the living individual who remembers), as well as a vital dynamic process of learning and development (of qualities which the living can learn from the dead). In this respect, one might say that this relationship with the dead offers a degree of salvation from death. 3.

Conclusion. In conclusion, it must be admitted that discussion of this issue


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____________________________________________________________ remains, to a large extent, metaphorical and not totally comprehensible, and for a good reason: it is hard to formulate clearly the status of discourse which mostly takes place within a person and the precise way in which someone who is gone can influence us. At the same time, it is indisputable that relationships with the dead are a prevalent and powerful phenomenon, which the above-mentioned thinkers have described vividly and profoundly. Still, the question of whether it can be classified as secularhumanistic grace is difficult to resolve. On the one hand, in light of the emphasis placed in such a relationship on the fact that it reflects generous devotion on one hand (of the inviter/living) without expectation of reward, which at the same time enriches the giver, it can not only be classified as a characteristic act of secular grace but can even be perceived, in the spirit of Kierkegaard, as its culmination. On the other hand, if we say that it is impossible to give to the dead or actually encounter them, we are dealing with secular grace in the metaphorical sense. If we go on to emphasize secular grace as a meeting of wishes which calls for objective expression, we can also arrive at the conclusion that what we have here is not secular grace as defined. Alongside these attempts at resolution, we can conclude that secular grace should be perceived as located on a continuum of phenomena: at the one end of the spectrum is the relationship (characterized in the above fashion) between two living individuals; its continuation is the relationship between a living and a dead who were closely acquainted and who enjoyed a grace relationship during the lifetime of the deceased; then comes the relationship between a living person and a dead one who were less well acquainted, when it is assumed that the deceased, when alive, wished to establish such a relationship with the living; and at the end of the continuum - perhaps - lies the relationship between the living and the dead who never met. Another possible conclusion one can draw is that the relationship with the dead is a type of reflection or variation on the central theme of the secular grace relation with the living. From another angle, one might say that relationship with the dead as a secular grace is a kind of secondary use of the term, resting on primary use of the concept as the relationship between living individuals, and draws its meaning from the latter. This means that there is no “independent” meaning to references to grace towards the dead but it is borrowed from the meaning whereby there is a grace relationship between living individuals, and one cannot say that an individual maintains a grace relation with the dead unless he maintains grace relations with living people. This approach returns us to the beginning of the discussion of the relationship with the dead as secular grace: one cannot characterize a relationship with the dead, however profound and rich it is, as a secular-humanistic grace without the existence

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____________________________________________________________ of grace relationships with the living, because the sign of secular grace is that, through this relationship, one of the parties is giving expression to the fundamental choice of maintaining such relationships with people as a way of life. Thus the relationship with the deceased is seen as the extension and strengthening of relationships with the living, and not as something which can serve as its substitute. Be that as it may, it is clear that what we have here is the expression of an intense human need for a living relationship with the other even after that other is gone, a fact which tells us a great deal about ourselves and about our relation to the people living alongside us.

Notes 1.

2. 3. 4.

5. 6. 7. 8.

9. 10. 11.

This paper is based on a chapter in my PhD thesis: Freibach-Heifetz, 2004. I am grateful to my advisor, Prof. Yuval Lurie, for his valuable comments. Y. Hendel, The Other Power (Tel Aviv: Hakibbutz Hameuchad, 1984), 26 [translated by C. Galai]. Soren Kierkegaard, Works of Love, trans.G. Kjerlighedens (New York: Harper and Row, 1962), 319-320. Jacques Derrida, Adieu to Emmanuel Levinas, trans. P-A. Brault and M. Naas (Stanford: Stanford University Press, 1999), 9-10 [my emphasis]. Jacques Derrida, Politics of Friendship, trans. G. Collins (London and New York: Verso, 1997), 12. Martin Buber, I and Thou, 2nd edition, trans. R.G. Smith (New York: Charles Scribner’s Sons, 1958), 128 [my emphasis]. Derrida, Politics of Friendship, 2. Asa Kasher, “The Ambiguous Borderlines between Life and Death,” in Spirit of a Man: Four Gates (Tel Aviv: Am Oved & Yehoraz Association, 2000), 402-405 (in Hebrew); Asa Kasher, “Life in the Hearts,” in A Little Book on the Meaning of Life (Tel Aviv: Hakibbutz Hameuchad & Yehoraz Association, 2002), 120, 135 respectively [translation by C. Galai]; See also: Asa Kasher, “Life in the Heart,” in A. Fagan, (ed.): Making Sense of Dying and Death (Amsterdam and New York: Rodopi, 2004), 11-30. Kasher, 2000, 403-404; Kasher, 2002, 114-116 respectively [translation by C. Galai]. Ibid., 135 [my emphasis]. Derrida, Adieu to Emmanuel Levinas, 13 [my emphasis]. In the same spirit, one can interpret Wittgenstein’s claim that what is said in a prayer at the grave is used “to tell someone something”. See: Ludwig


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12.

13. 14. 15.

16.

17.

Wittgenstein, Philosophical Investigations, trans. G.E.M. Anscombe (Oxford: Basil, Blackwell, 1968), 189. Aristotle, “Eudemian Ethics,” in The Athenian Constitution; The Eudemian Ethics; On Virtues and Vices, trans. H. Rackham (Cambridge, Mass: Harvard University Press, 1938), Book VII, chap. 4, ver. 1239a 40, 1239b1-2, 391-407; Aristotle, “Rhethoric,” in Rhetoric and Poetics, trans. W. R. Roberts (New York: Modern Library, 1954), Book II, chap. 4, ver. 1381b25-26, 100-103. M. Blanchot, L’amitie (Paris: Gallimar, 1971), 326-330. O. Bernstein, Remains (Tel Aviv: Am Oved, 1987) 54 [translation by C. Galai] [my emphasis]. It should be noted that in Judaism, for example, dignity afforded the dead is also interpreted as the demand to fulfil his wishes, and ways of identifying these wishes were developed. (See, for example, Talmud, Gittin Tractate 14:2; 15:1; 40:1). This approach has also been adopted by the Israeli legislator. See: Soren Kierkegaard, Fear and Tremblings: Repetitions, trans. and eds. H.V. Hong and E.H. Hong (Princeton: Princeton University Press, 1983). It can be argued that, at least according to Kasher’s model, that though the deceased is perceived as someone whose image has “frozen” in the sense that the life chapter on earth ended at a certain moment, nevertheless within the ‘life in the hearts’ it is not frozen but can develop. However, personally, I find it hard to comprehend the meaning of such development, or how it can be possible, without undermining the independence of the dead and without turning this ‘development’ into the working of the imagination of the living individual.

References Aristotle. “Rhethoric.” In Rhetoric and Poetics, translated by W. R. Roberts. New York: Modern Library, 1954. 1-218. Aristotle. “Eudemian Ethics.” In The Athenian Constitution; The Eudemian Ethics; On Virtues and Vices, translated by H. Rackham. Cambridge, Mass: Harvard University Press, 1938. 190-477. Bernstein, O. Remains. Tel Aviv: Am Oved, 1987. Blanchot, M. L’amitie. Paris: Gallimar, 1971.

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____________________________________________________________ Buber, Martin. I and Thou. 2nd edition, translated by R.G. Smith. New York: Charles Scribner’s Sons, 1958. Derrida, Jacques. Adieu to Emmanuel Levinas, translated by P-A. Brault and M. Naas. Stanford: Stanford University Press, 1999. Derrida, Jacques. Politics of Friendship, translated by G. Collins. London and New York: Verso, 1997. Freibach-Heifetz, D. A Suggestion for a Secular-Humanistic Grace. Ph.D. thesis. Beer Sheva: Ben-Gurion University of the Negev, 2004 (in Hebrew). Hendel, Y. The Other Power. Tel Aviv: Hakibbutz Hameuchad, 1984 (in Hebrew). Kasher, Asa. “Life in the Heart.” In Making Sense of Dying and Death, edited by A. Fagan. Amsterdam and New York: Rodopi, 2004. 11-30. Kasher, Asa. “Life in the Hearts.” In A Little Book on the Meaning of Life. Tel Aviv: Hakibbutz Hameuchad and Yehoraz Association, 2002. 109-140 (in Hebrew). Kasher, Asa. “The Ambiguous Borderlines between Life and Death.” In Spirit of a Man: Four Gates. Tel Aviv: Am Oved and Yehoraz Association, 2000. 402-407 (in Hebrew). Kierkegaard, Soren. Fear and Tremblings: Repetitions, translated and edited by H.V. Hong and E.H. Hong. Princeton: Princeton University Press, 1983. Kierkegaard, Soren. Works of Love, translated by G. Kjerlighedens. New York: Harper and Row, 1962. Wittgenstein, Ludwig. Philosophical Investigations, translated Anscombe, G.E.M., Oxford: Basil Blackwell, 1962.

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Death and Mourning: Logistics and Mystery Marguerite Peggy Flynn The words death and died tell us that something or someone has stopped. The car engine died. The business deal died. The boat is dead in the water. A person died yesterday. One gets the sense that this stoppage is an event with consequences. The event of a death always signals both the beginning of a permanent absence and that absence. It is important that the individual and his/her extended community come to an understanding that death is a real future event that cannot be prevented or avoided forever. This understanding of death and the dying process assists us to cope with an event that is unavoidable yet can be managed in ways that prevent or alleviate pain and allow the development of strategies for coping with suffering. 1.

Mourning. Mourning can be either the act of sorrowing; an outward sign of grief; or a period of time during which signs of grief are shown.1 Roget’s Thesaurus suggests additional words such as grievous, sorrowful, plaintive, lamenting.2 The word grief has its roots in the Latin gravis meaning heavy, grave, or serious. It can be defined as a deep and poignant distress caused by or as if by bereavement. 3 Mourning can be an action such as shedding tears or covering the mirrors. It can be a sign, for example, the black armbands of past generations or the spontaneous offerings of flowers, candles, and notes left at the scene of a car accident or other untimely death. It also denotes a period of time during which these actions and signs are deemed appropriate by the larger society. However expressed and for whatever period of time the purposes of mourning are: • to provide the means by which the individual and the community can come to terms with the stoppage and the resulting absence occasioned by the event of the particular death; • to provide an opportunity for the individual and the community to remember previous deaths and the resulting stoppages and absences; • to provide an opportunity for the individual and the community to affirm that in spite of these absences there

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still is a community; to alert the individual that this is his/her fate; and, to offer the individual the reassurance that the community will remember and will go on.

2.

Uppercase Death. In the life of an individual there is always Death with an uppercase D-he/she or someone in the relationship network loses his/her physical life-an irrevocable stoppage and absence beyond his/her control. The word that comes to mind is annihilation-a bit dramatic perhaps but that is what death is-annihilation. Whatever one believes about what happens to the person after the physical death, the fact is that the life lived in this body, in this era, in this community has ended. This particular life will never resume in this body, in this era, in this community. 3.

Lowercase Death. In the life of an individual there is always death with a lowercase d—the many radical changes over which the individual will have no control—which will happen to him or to her. What word should we use to describe all the little deaths that precede the Death that ends our becoming once and for all? Medieval art and modern cartoons portray the Grim Reaper using that scythe on any and all. What I propose is that little deaths can be credited to a Grim Gardener more than the Grim Reaper. This gardener goes about with a pruning shears trimming and shaping plants. Why does any gardener do this? The effort is intended to encourage growth and greater fruition. A gardener uses a variety of tools to lop off a branch or remove excess shoots or uproot or cull or pinch off new leaves. The plant has no say in this shaping even as each of these actions on the plant’s structure causes an ending or a frustration of expression. Admittedly we are not plants. Still everyone experiences this kind of ending and frustration. We could think of the Grim Gardener as a kind of assistant to and precursor of the Grim Reaper. We have thoughts and feelings about these experiences. We draw conclusions. These experiences shape our beliefs about life and about ourselves. Primarily, for this discussion, these experiences are painful perhaps especially because these are out of our control. These changes happen to us. For example, there are the radical changes experienced physically: puberty or pregnancy or menopause or the diminishments caused by accidents or the aging process. Relationships are vulnerable to radical change-divorce, death of a child or spouse, having to relocate because of work or catastrophe. Intellectually, exposure to new facts and ideas can make previously held concepts untenable. New patterns of

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____________________________________________________________ global trade might have eliminated our jobs, or even the industry. Our world-view can be irrevocably changed by what we learn. Spiritual understanding can be subject to a similar upheaval in the face of new realizations. 4.

The Individual. It is vital to appreciate the facts surrounding each radical change and the interface between these facts and each person’s uniqueness. For example, illnesses have specific symptoms, treatment protocols and eventual outcomes. In many cases, this information is now available on the Internet to any interested reader. But there is Alzheimer’s, and then there is John Johnson’s Alzheimer’s. And there is his family’s Alzheimer’s. There is Jennifer’s puberty and Jennifer’s family’s experience of Jennifer’s puberty. There are industry lay-offs and there is me losing my job. There are earthquakes on another continent and there is a 4.0 tremor in the earth under my feet. 5.

Logistics and Mystery It might be helpful at this point to distinguish between logistics and mystery. When we use the term, logistics, we are speaking about the arrangements of persons, places and things necessary to accomplish a task or create an event. Mystery is the unknowable, the unexplainable. Death happens to the individual in his or her uniqueness – it is the ultimate mystery. For millennia religions have presented us with very detailed maps of what they believe is the post-death reality. However intricate and widely embraced by a civilization, these maps are products of a belief system. We don’t know if some aspect of the person survives the last breath and what happens to the surviving aspect. Reports about near death experiences (NDE’s) are just that—reports about experiences that happened when the person was almost dead, nearly dead but not dead. Death also happens to a mortal body that is part of a relational network and a cultural context that will dictate certain norms and limitations -- logistics. In my work with individuals and families in the dying process I use the term logistics to include everything that has to do with the physical body and its affairs—business, legal, medical, transportation, housing. I use the term mystery to describe what death is and what might come after, if anything. 6.

How Mourning Relates to Logistics and Mystery. Logistics and Mystery represent two opposite poles:

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____________________________________________________________ tangible/intangible, and known and knowable/unknown and unknowable. Between these two sets of absolutes are whole realms of human experiences: personal growth and development, relationships, work, dreams and aspirations. The process of mourning encompasses these two polarities. It provides a container for the individual and the community. This container can be a safe place in which the individual and the community experience these extreme opposites. Anyone who has ever seen someone die knows the abyss between the warm, breathing person and the cold, still body. This abyss can appear in a matter of seconds. The person was alive and now is not. The logistics of mourning are the arrangements we make to dedicate time, design and implement signs and engage in actions that mark the stoppage and the absence that is death. For example, logistics include: • arranging the body (washing, embalming, wrapping); • transporting the body (crematorium, mortuary, grave, bringing the ashes home); • obtaining and preparing a place for the remains of the body (urn, grave, scattering ashes); • obtaining clothing appropriate to mourners; • designing and arranging a community event to mark the event of the life and the death (religious funeral service, memorial event); • giving notice to the wider community (obituary, eulogy); • creating a tangible marker for the death (gravestone, AIDS quilt, memorial scholarship); • handling of the person’s possessions; and, • completing his/her affairs. The mystery of mourning is, well, mysterious! We just don’t know. We can speculate. We can believe. We don’t know. 7.

Mourning as Coming to Terms. We sometimes use the words, coming to terms, to describe contract negotiations. The goal is for all parties to arrive at a mutually beneficial outcome. Successful negotiations take into account strengths and weaknesses of each party involved. It is assumed that there will be give and take on both sides in order to reach an agreement. Coming to terms with deaths and Death has elements of this kind of negotiation. Dr. Kubler-Ross describes bargaining as one of the stages


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____________________________________________________________ in the process of facing one’s own death.4 She suggests that acceptance signals that a person has achieved a state of peace with their fate and that this is the desired outcome. I propose that coming to terms with death, especially our own, is more akin to surrender to an unstoppable, implacable foe. It is possible to admit defeat without accepting it or feeling peaceful about it. It is possible to make every effort to delay the surrender even in the face of its inevitability. It is also possible to accept defeat graciously Mourning is about admitting defeat. Mourning provides a set time, specific behaviours, and tangible signs of the acknowledgment of this defeat. Mourning provides the means by which the individual and the community surrender, i.e. come to terms with the stoppage and the resulting absence occasioned by the event of the particular death. History shows us that to be defeated can be devastating to the self-esteem, livelihood, health, and sovereignty of the community and the individual. There can be terrible losses. Defeat can be incomprehensible and unacceptable to the psyche of the individual and the community. Mourning can be one process for dealing with the defeat, hopefully distilling out affirmation and reassurance. We think of mourning mostly in connection with physical death. I think it is equally important to apply mourning-as-coming-to-terms to the various little deaths that are part and parcel of human life. Two examples are menopause and the loss of a career. In menopause the woman’s body winds down the production of the hormones that made her fertile and chemically attractive (pheromones). Her body thickens and every aspect her body/mind is challenged by estrogen-withdrawal. It is the end of one way of being in her body and of being in the world. It can be immensely sad to say goodbye to the potential for creating embodied in fully functioning ovaries and uterus. It is one thing to decide not to have more children or any children. It is another to feel that choice erased by time. The attendant physical changes associated with menopause signal to the larger society what is happening and may result in further losses depending on the prevailing attitude toward women who’ve exceeded their childbearing years. In some cases divorce may occur, or difficulty in finding employment. Family and friends might be alienated by the inevitable emotional tumult. A way of being in her body and in the world has ended and not by choice. A vital potentiality has ended and not by choice. How does one come to terms with menopause? What should be the set time for mourning? What are the appropriate signs? Appropriate actions? The loss of a career is another kind of death. It can come in the form of an irreparable injury or an industry that has become irrelevant to

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____________________________________________________________ the present day. The industry or marketplace might have decided the employee is useless, for example, due to age. Whatever the cause an individual can find himself/herself ripped out of the marketplace and the community of colleagues and not by choice. Something has happened to the individual. Something has ended. How does one come to terms with this event? What should be the set time for mourning? What are the appropriate signs? Appropriate actions? 8.

Mourning as Remembering. Mourning is an opportunity for the individual and the community to remember previous deaths and the resulting stoppages and absences. It is a kind of paradox that when someone is lost to us our minds produce picture after picture of his/her life with us. It is as if when someone is alive we don’t have to remember the person because we can call or write or visit. Once he or she dies memory becomes both the place we go to visit and the mechanism for recalling the particulars of a life. The logistics of mourning-as-remembering focus primarily on images (photographs, movies) and mementos (cards, clothing, jewelry) which have worth by association with the one who is gone. The final service is often called a memorial signifying that people will gather to share memories about the person. More significantly the event signals the relocation of the knowledge about a person from present-tense to pasttense, from the realm of current events to the realm of memory. This newest relocation to memory can trigger a review of previous losses, other relocations. It can be hard to separate one loss from the collection of losses especially as one experiences more and more deaths in one’s community. We tend to associate this accumulation of deaths with the elderly but any survivor of the HIV/AIDS epidemic would be able to relate as would anyone living in the midst of famine, war, and disease. This review is often bitter/sweet. The time that has passed often allows for new perspectives on the remembered one’s life as well as our own. This kind of remembering is more a sifting, a processing of memories. Across the expanse of time-passed arise new insights and understandings that can be both pleasant and not-so-pleasant. 9.

Mourning as Affirming. Mourning is an opportunity for the individual and the community to affirm that in spite of this particular stoppage and absence, to use a cliché, life goes on. That person is dead and we are alive. The logistics of affirmation often centre on food. The reason is simple. The dead don’t eat. The living do. I would also suggest that if we did the research we


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____________________________________________________________ would find a significant number of children conceived at some point in the mourning period—the ultimate affirmation of life. 10.

Mourning as Wake-up Call. Mourning provides a wake-up call to alert the individual that this is his/her fate. We might cheat the reaper but our time will come. When we stay at a hotel and ask for a wake-up call we are asking to be awakened from sleep in enough time to prepare for the day. Every aspect of mourning is meant to jolt us even a little to wake up to our eventual fate so we can prepare for that day that is coming. 11. Mourning as Reassurance. Our participation in the logistics and mystery of mourning is meant to offer each individual the reassurance that the community will remember and will go on. Just as today people are sharing stories about a person, someday they will share stories about me. Just as today people are taking respectful care of this body, someday they will give me the same respectful care. Just as today people here are consigning a person to memory, someday I will be a collection of memories. 12.

Mourning as a Vital Skill. Given how assiduously our culture seems to avoid everything to do with dying and death, any and all activities associated with mourning might seem to be at best a nice thing to do and at worst a waste of time and money. I propose that mourning is a skill, one vital to the quality of life for the individual and the community. This skill set includes the following elements: • recognizing death in all its forms • knowing the logistics of mourning appropriate to each death • knowing how to be present to the mystery of death in its various forms. The payoff for having this skill and using it as necessary is an increased ability to deal with life as it is, especially life as a series of little deaths that ends in the Big Death---our own. Skilfully dealing with death teaches us • how to surrender • how to lose • how to keep living with loss, in spite of loss • how to make new attachments and forms of attachment • how to measure value and worth

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____________________________________________________________ 13.

Conclusion. Death is. The Grim Reaper is not going away. The Grim Gardener is not going to cease pruning and culling. As long as we’re alive we will experience radical changes - the little deaths challenging us to cope with new losses. Mourning is a skill we can learn. Life will give us many opportunities for practice.

Notes 1. 2. 3. 4.

Webster’s New Collegiate Dictionary, s.v. “mourning.” Roget’s Thesaurus, 3rd ed., s.v. “mourning.” Webster, s.v. “grief.” E. Kubler-Ross, Questions and Answers on Death and Dying (London: Collier Macmillan, 1974), 85.

References: Logistics Bernard, J. Miriam. The True Work of Dying: A Practical and Compassionate Guide to Easing the Dying Process. New York: Avon Books, 1996. Byock, I. Dying Well: Peace and Possibilities at the End of Life. New York: Riverhead Books, 1997. Capossela, C, Warnock, S. Share the Care: How to Organize a Group to Care for Someone Who Is Seriously Ill. New York: Fireside Book, Simon & Schuster, 1995. Committee on Medical Ethics. Toward a Good Christian Death: Critical Treatment Choices. Harrisburg, PA: Morehouse Publishing, 1999. Devine, R. Good Care, Painful Choices: Medical Ethics for Ordinary People. Mahwah, NJ: Paulist Press, 1996. Furman, J, McNabb, D. Dying Time: Practical Wisdom for the Dying and Their Caregivers. New York: Bell Tower, 1997. Golden, S. Nursing a Loved One at Home. Philadelphia: Running Press, 1988.


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____________________________________________________________ Institute of Medicine. Improving Palliative Care. Washington, DC: National Academy of Sciences, 2003.

References: Meaning Bowker, J. The Meanings of Death. Cambridge, UK: Cambridge University Press, 1991. Brown, N. Life against Death: The Psychoanalytical Meaning of History . Middletown, CT: Wesleyan University Press, 1959. Cline, S. Lifting the Taboo: Women, Death and Dying . London: Little, Brown and Company, 1995. Dalai Lama. Advice on Dying and Living a Better Life. New York: Atria Books, 2002. de Beauvoir, S. A Very Easy Death. New York: Warner Paperback Library, 1964. Dell, K. Shaking a Fist at God: Understanding Suffering Through the Book of Job. London: Harper Collins, 1995; under title Shaking a Fist at God: Struggling with the Mystery of Undeserved Suffering. Liguori, MO: Triumph Books, 1997. Donovan, J. The Mystery of Death: Reflections on the Spiritual Tradition. Mahwah, NJ: Paulist Press, 2003. Gervais, K. G. Redefining Death. New Haven: Yale University Press, 1986. Guroian, V. Life's Living Toward Dying. Grand Rapids, MI: Eerdmans Publishing, 1996. Hartman, M. T. The Matter of Life and Death: Surviving Loss and Finding Hope. Liguori, MO:Triumph Books, 1994. Hastings Centre Report. Death Inside Out. New York: Harper & Row Publications, 1974. Huxley, A. Heaven and Hell. New York: Harper & Brothers, 1955.

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____________________________________________________________ Jordan, M. Ceremonies for Life. London: Collins & Brown Limited, 2001. Kalweit, H. Dreamtime and Inner Space: The World of the Shaman . Boston: Shambhala Publications, 1984. Klein, A. The Courage to Laugh: Humour, Hope and Healing in the Face of Death and Dying. New York: Penguin Putnam, 1998. Kramer, K. Death Dreams: Unveiling Mysteries of the Unconscious Mind. Mahwah, NJ: Paulist Press, 1993. Kubler-Ross ,E. On Death and Dying. London: Collier Macmillan, 1969. Kubler-Ross, E. Questions and Answers on Death and Dying. London: Collier Macmillan, 1974. Kung, H. W. Dying with Dignity: A Plea for Personal Responsibility. New York: Continuum Publishing Company, 1998. Lachs, J. In Love With Life: Reflections on the Joy of Living and Why We Hate to Die. Nashville, TN: Vanderbilt University Press, 1998. Lee, T. Death's Master. New York: DAW Books, 1979. Levine, S. Healing Into Life and Death. Garden City, NY: Anchor Press/DoubleDay, 1987. Longaker, C. Facing Death and Finding Hope: A Guide to the Emotional and Spiritual Care of the Dying. Garden City, NY: Doubleday, 1997. Martz, S. When I Am An Old Woman I Shall Wear Purple. ???:PapierMache Press, 1987. Meltzer, D. Death: An Anthology of Ancient Texts, Songs, Prayers, and Stories. San Francisco: North Point Press, 1984. Miller, S. After Death: How People Around the World Map the Journey of Life. New York: Touchstone, 1997. Neilsen, M. Reaffirming Life In a Culture of Death: A Catholic Response to Critical Issues. Liguori, MO: Triumph Books, 1996.


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____________________________________________________________ Polster, E. Every Person's Life is Worth A Novel. New York: W.W. Norton, 1987. Rinpoche S. The Tibetan Book of Living and Dying. New York: Harper Collins: 1994. Roach, M.S. ed. Caring from the Heart: The Convergence of Caring and Spirituality. Mahwah, NJ: Paulist Press, 1997. Schmitt, A. Dialogue with Death. Waco, TX: Word, Inc., 1976. Shinoda-Bolen, J. Close to the Bone: Life-Threatening Illness and the Search for Meaning. New York: Simon and Schuster, 1996. Simmons, Mark. With God's Oldest Friends: Pastoral Visiting in the Nursing Home. Mahwah, NJ: Paulist Press, 1996. Singer, P. Rethinking LIfe and Death: The Collapse of Our Traditional Ethics. New York: St. Martin's Press, 1994. Sloyan, V. Sourcebook about Christian Death. Chicago: Liturgy Training Publications, 1990. Terkel, S. Will the Circle Be Broken?: Reflections on Death, Rebirth, and Hunger For a Faith. New York: The New Press, 2001. Ulanov, B. On Death: Wisdom and Consolation from the World's Great Writers. Liguori, MI: Triumph Books, 1996. Zaleski, C. The Life of the World to Come: Near-Death Experience and Christian Hope. Oxford: Oxford University Press, 1996.

Part III Culture and Suicide

For Fear of What the Neighbours Might Say: Social Networks and Suicide in Early Modern Holland Laura Cruz In 1587, Jacob Jacobs died under suspicious circumstances. When the criminal court of Leiden investigated, they ruled that he had committed suicide, likely because he appeared to have hung himself. In 1687, Adriaentje Questier, a 60-year old immigrant originally from Flanders, also died under suspicious circumstances. The court investigated her death as well but ruled that it was accidental, an unfortunate drowning. As historians, we may never know what happened to Jacob. Why did he commit suicide? Why did he feel compelled to do such a desperate act, one that would surely bring shame upon his family, should he have any, and imperil his mortal soul, should he believe in such ideas? Jacob’s story is lost to us. Similarly, we will never know if Adriaentje just tragically slipped off a pathway and fell into the canal below her or if she deliberately threw herself into the waters to escape the despondency of her life, hoping that drowning would protect her family from the ignominy of death by suicide. These examples show that the historical study of suicide is very limited. The lacuna between historical sources and historical reality looms especially large when dealing an experience as intense, conflicted, and above all- personal as the decision to take one’s own life. In the absence of what the Dutch call ego-documents, such as diaries and other individual accounts, the motives and thought processes of suicides in the past are impossible to recover. That does not mean, however, that the historical suicides do not have something to teach us about the past. A preliminary look at the example of the Dutch town of Leiden shows that even imperfect sources can provide insight into the hidden influences of external constraints on individual behaviour. When looking at studies of historical suicide, it is possible to discern two methodological tendencies. The first is the explication of the social meanings of suicide, an approach influenced by anthropological research. This perspective looks at sources such as literary and artistic representations of suicide in an effort to uncover changes in the collective representation and understanding of suicide for a given population.1 The second is the interpretation of suicide rates, particularly in regard to the relationship between those rates and the societies that produced them, an

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____________________________________________________________ approach pioneered by sociologist Emile Durkheim.2 In many of the best studies, the two approaches are mixed, the former used to bolster possible shortcomings of the latter.3 Many historians are justly skeptical of the accuracy of official suicide rates, usually culled from judicial records, especially those from the distant past. Suicide is tricky enough to determine in the modern age of mass information. Its definition, especially across religious or other cultural divides, is disputed and inconsistent, making broad comparisons across time or space problematic. 4 For example, in Dutch, the traditional word for suicide is zelfmoord, or self-murder. This reflects the belief, first forcefully argued by Augustine, that suicide is a transgression of the 6th commandment, thou shall not kill, and is, therefore, punishable as both a sin and a crime. As suicide became decriminalized in the eighteenth and nineteenth century, this sense of the word fell away and today many Dutch speakers prefer less pejorative language, such as the French suicide or the more literal term, zelf-doding, killing oneself.5 There are further complications. As suicide often carries with it moral and legal consequences, it is often accompanied by a strong urge towards concealment, making records more accurate reflections of the effectiveness of police and judicial authorities than actual suicide rates. As such institutions were far from omniscient in premodern times, underreporting is likely a problem. As one historian notes, “whatever the problems are for statisticians of nineteenth- and twentieth- century society, the problems get bigger the further we go back.” 6 In the early modern Netherlands, the problems with suicide records were compounded by the decentralized nature of the Dutch republic, formed after the northern provinces of the Low Countries gained their independence from Spain in the late sixteenth century. The decentralization resulted in wide divergences in practices among towns and provinces, making it difficult to compile ‘national’ statistics of nearly any sort. Historians have calculated suicide rates from court records for the southern towns of Brussels and Ghent and the northern towns of Amsterdam and Breda. 7 At first glance, their results suggest that underreporting might have been a problem. In Breda, for example, there were only 4 recorded suicides from 1626-1699 and just 1 from 17001795.8 In Leiden, the court conducted 399 post-mortem examinations between 1575 and 1646. The magistrates ruled that thirty eight of these cases were suicides. After 1646, no more cases of post-mortem investigation appear and it would seem that the criminality of suicide had, at least in practice, been suspended. A similar pattern occurred in Amsterdam, where juridical condemnation of suicide ended in 1658. 9 If decriminalization occurred this early (far earlier than in the rest of

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____________________________________________________________ Europe), then the lower numbers may not be the result of underreporting but changes in the law. Before decriminalization, Leiden’s suicide rate appeared low in comparison to records from other European countries in the seventeenth century. Jeffrey Watt, in his masterful study of suicide in Geneva, uncovered forty suicides during the same period, though that city’s population was less than half of Leiden’s.10 Arne Jansson’s study of suicide in Stockholm does not include sixteenth century figures but does suggest that if suicide and what she calls suicidal murders are counted, the rate was higher than Leiden’s and was rising rapidly.11 In England, McDonald and Murphy shy away from a great deal of statistical analysis, citing problems with the records, but still indicate that suicides rates in English towns appeared high to contemporaries already in the sixteenth century and rose rapidly in the latter half of the seventeenth century. 12 Was Leiden’s suicide rate actually (relatively) low? In the Netherlands, as elsewhere, there was a strong social stigma against suicide and, therefore, great motivation to disguise it for the sake of propriety. There were also more tangible disadvantages. The legal sanctions against convicted suicides included public display and condemnation, property confiscations, and dishonourable burial. While these penalties could certainly be substantial, there is evidence that they weighed more lightly in the Netherlands than they did elsewhere in Europe. Public ritual executions and draggings were common European practices for suicides.13 In 1587, for example, the Leiden court ordered the body of suicide Jacob Jacobs to be dragged over the threshold of his former house and afterwards to be hung in the gallows’ field to serve as ‘a mirror to others’, but such spectacles seem to have been increasingly rare in seventeenth century Holland.14 The Leiden court recorded only two other cases between 1560 and 1650, both with extenuating circumstances. In 1627, Jan Jorisz committed suicide while imprisoned for sheep rustling. After hanging himself in his cell, the court ordered that his body be displayed at the gallow’s field with sheep fleece glued to it.15 In 1638, the body of Joris Ballieu suffered the indignation of being displayed at the Gallow’s field, but he was a foreigner, originally from England.16 The confiscation of property was also rarely prescribed. In England, confiscated property reverted to the Crown under the crime of felo de se (a felon to himself). Between 1485 and 1660, English courts declared 95% of English suicides to be felo de se, as opposed to only 2% found to be non compos mentis.17 Tudor reforms strengthened the crown’s ability to prosecute suicides and to receive the confiscations as a source of revenue, likely some several hundred pounds each year. 18 In Leiden, on the other hand, the court prescribed confiscation in only one case of

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____________________________________________________________ suicide, that of the Englishman Joris Ballieu in 1638, though it was frequently invoked in cases of capital punishment for other crimes. Their actions had precedence in Dutch law. In the Carolina, a 1532 edict concerning crime including suicide, Charles V favoured using confiscation only in cases in which it was clear that the suicide was not motivated by disease, melancholy, or mental deficiency, and/or when the suicide occurred in connection to other crimes.19 The Carolina did allow for custom to override this clause, but there is little evidence that the Leiden courts frequently availed themselves of the option. In most suicide cases, the Leiden court did set restrictions on burial. Often suicides had to be buried during prescribed hours, usually at night, and often with the admonition that the ceremony be held ‘in full silence’. In some cases, bodies had to be buried in areas outside of the regular churchyard, perhaps symbolic of their separation from the community. In 1592, the court required that the body of suicide Annetgen Dircxdr be buried in the place normally reserved for criminals. 20 In 1602, Lijsbeth Bartolomeesdr died in prison where she was serving a term for infanticide. It is not clear from the records whether or not she committed suicide, but the court ordered that her body be donated to the University for anatomical research.21 The court usually dictated that female suicides be buried at the Vrouwenkerk, though in 1624 they indicated that the body of a male suicide, Pieter Isaaxszn Bats, be buried there as well. 22 Burial at night was certainly not desirable, but it was preferable to the alternative of public display in the gallow’s field. In 1633, the court explicitly stated that it would not condemn one suicide to the gallow’s field because it appeared that he was ‘not mentally normally’ and instead sentenced him to a night burial.23 In several instances, family intervention swayed the courts to hand down the lighter sentence of night burial. The Leiden court did not seem to be inclined to judge the crime of suicide harshly, even as their punishments for other crimes, such as theft, escalated. This suggests that underreporting of suicide may not have been as prevalent as it was in other places, as the need for concealment was not as strong. On the other hand, the Leiden judges still faced the problem of detection. Of the eighteen cases which reported the method of suicide, thirteen were death by hanging, two by stabbing, two by drowning, and one by poison. The court could call upon surgeons to perform the post-mortem investigations, but they were not frequently used and, even when used, their methods were certainly not foolproof. For example, in 1625, the case of the body of Dionijs Maertenszn baffled the authorities.24 They could not determine the method of death and the court noted that there was no apparent use of poison or signs of disease. In the absence of proof, they granted permission for her body to be properly

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____________________________________________________________ buried. Drownings were more problematic. The court performed the vast majority of post-mortem investigations upon bodies that had been recovered from one of Leiden’s many canals. Living in a community surrounded by water made drowning an all-too-frequent occurrence. While they could easily establish the cause of death, the judges were less able to ascertain whether the drownings were intentional or accidental. In light of this, several early laws required that drowning victims be left with their feet in the water by their point of recovery and other laws emphasized the importance of witnesses and extenuating circumstances. In the period from 1575 to 1646, the court investigated 130 cases of death by drowning.25 Forty four of these were children under the age of eighteen and so were unlikely to be suicides. Thirteen cases were noted as being clearly accidental. The other seventy three cases are all possible suicides, though the high incidence of drowning in the winter months strongly suggests that people frequently found themselves literally and figuratively skating on thin ice. The court consistently bestowed the benefit of the doubt in these cases and allowed full burial privileges. If the suicide rates in Leiden were low, then it is the historian’s responsibility not to just to note this fact but to explain it. Were there indications that suicide was especially encouraged or discouraged in Dutch society? Dutch leniency towards prosecuting suicides and their relatively early termination of juridical suicide might be a sign of modern enlightened attitudes towards death and the causes of suicide. Until the seventeenth century, popular opinion attributed suicidal tendencies to diabolic or demonic possession, usually as the result of witchcraft. 26 The Netherlands were among the first places to discontinue witch hunts and trials, and there is little evidence of a belief in possession stemming from the court records.27 It is possible that the judges took the principle of freedom of conscience, as espoused most eloquently by William of Orange, seriously and saw that it applied to the freedom to choose one’s own death, as is the case with modern Dutch laws governing euthanasia and assisted suicide.28 The rulings on suicide were not mitigated when it came to cases that did not involve mental distress and the few legal comments on suicide (including those of noted legal scholar Hugo Grotius) were uniformly condemning, even without diabolic intervention. During the middle ages, popular culture in the Low Countries had been replete with pressure not to commit suicide. The instigation for the defamation of suicide came from the Catholic Church, but the subject was definitely not ignored by Reformed Dutch or Anabaptist preachers who continued to expand on the evils of suicide, which had been recurrent topics with Luther and Calvin.29 Emblems, poetry, and plays repeatedly

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____________________________________________________________ spoke of suicide as squandering God’s gift of life. On the other hand, the attitude of Christian humanism towards suicide was more tolerant that the opinion of the church or canon law. Erasmus, in his popular satire In Praise of Folly, depicted suicide as a rational option in an irrational world.30 In the sixteenth and seventeenth centuries, the revival of classical motifs more generally resurrected ancient ambivalence towards suicide. Especially in art, the ‘noble’ suicides of such as Lucretia, Cleopatra, Sophocles and Cato were popular subjects. Images of biblical suicides were reproduced in other widespread forms, including Delftware tiles, which were usually placed around fireplaces in middle-class homes “where they could be ‘read’ to children.” 31 It would seem that Dutch society was gradually becoming somewhat less hostile towards the act of suicide. In perhaps the most influential tract on suicide written, sociologist Emile Durkheim attributed suicide rates to collective values. He said that variations in suicide rates were the result the effect of social forces, or the “collective tendencies” of a given society which produce external pressure or influence on individual decisions.32 Unfortunately, Durkheim’s intentions have often been confused with his conclusions. His main purpose, to uncover these social forces, has often been lost in efforts to test his hypotheses about the indicators of these forces: religion and modernity.33 Neither of these indicators could explain why Leiden might have had low rates of suicide. Durkheim suggested that Protestants had higher rates of suicide than Catholics. While the religious complexion of the Netherlands was highly varied in the seventeenth century, the majority of Dutchmen were Protestant, so rates should have been high, not low. Secondly, Durkheim suggested that modern life brought with it an increasing division of labour, leading in turn towards alienation and increased suicide rates. By seventeenth century standards, Leiden had a highly advanced division of labour, especially in the textile industry. Of the 38 cases of suicide in Leiden, fifteen were identified by profession and of those, 8 (53%) worked in textiles. At its height, the textile industry employed roughly half the urban work force in Leiden, so these percentages suggest that their numbers were not over-represented in the frequency of suicide.34 Durkheim focused on religion and economic alienation because he believed they were the main determinant of social cohesiveness in many nineteenth-century societies, but perhaps this did not apply in the seventeenth century, at least in Protestant countries. Durkheim identified two forces that he believed worked within societies to control suicide rates. Social cohesion, if it is not too restrictive, provides individuals with a sense of meaning and order in their lives and support groups to help

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____________________________________________________________ them in times of trouble ( force of integration) but also works to deter them from self-destructive impulses (force of regulation).35 When the forces that connect the society and the individual get ‘out of whack’, either through lack of integration or regulation, then more individuals will be pushed to the brink of suicide. On the surface, Leiden did not seem to possess the proper ingredients for a strongly regulated community. In the latter part of the sixteenth and early seventeenth century, the city’s population expanded exponentially, largely fuelled by the influx of immigrants from both outside and inside the Dutch republic. The booming textile industry led to increased social stratification and tension and religious debates contributed to public unrest. According to Durkheim, periods of transition often lead to problems with the regulation of social norms as new people take on new roles in society, which can lead to higher suicide rates. This does not seem to have been the case in seventeenth-century Leiden. The suicide rates remain remarkably uniform from the late sixteenth-century onward, with no noticeable spikes during periods of economic, political, or religious upheaval. Why not? In the Middle Ages, social disciplining had been one of the most important functions of the Catholic Church. By the sixteenth century, in both Protestant and Catholic countries, the responsibility for order and control shifted from the Church to the States or, the migration of the holy, as John Bossy calls it. The problem is that in the early modern Netherlands, the holy had nowhere to migrate—the central state was simply too weak to perform these functions. Instead, those functions fell by default on the new and previously existing intermediary institutions--guilds, church, family, the military, orphanages, etc. The strength of these institutions might explain why factors that would normally affect suicide rates-economic and political conflict, large amounts of immigration -result in very little change in suicide rates in Leiden. This suggests that these institutions acted to preserve and strengthen the integrative forces within the urban community. In the town of Leiden, and likely the United Provinces as a whole, the functions of social regulation and integration were performed by a myriad of institutions rather than a single, overarching state. The jurisdictions of these intermediary institutions frequently overlapped and there was no grand, large-scale design to their creation or growth. This made it possible to fall through the cracks. The circumstances of those poor souls who did commit suicide in Leiden suggest that they fell outside of the traditional sources of social control and were not well integrated into the mainstream of urban society. The court records support such a conclusion in several ways. First, the few suicides that are found are

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____________________________________________________________ drawn overwhelming from the ranks of those not fully incorporated into social networks. Most of the suicide victims had been born elsewhere and none of them appeared to have obtained full citizenship in the town, even during the period when the fees for this privilege had been greatly reduced. Only two of the Leiden suicides have entries in the rolls of the local churches. At least three had been prisoners. Most were not married and many did not practice a trade. These suicides were men (and women) on the margins of a carefully regulated social world. The two most powerful of these social intermediaries were traditional ones, the guilds and the church. In Leiden, guilds were not primarily instruments of economic regulation, but of social control, used by the town and industrialists alike to maintain order among the workers. Accordingly, in Leiden a large number of the suicides were apprentices or temporary workers (about 20% of those reported), many of them middleaged or older, who were not subject to the full benefits of guild membership. Another powerful social intermediary was the church. The disciplinary tactics of the Reformed Church are well-known and Calvinist discipline applied only to those 30% of the population who belonged to them, including those who held public office, who were required to be members of the Church. That 30% had to face formal and informal disciplinary procedures, from regular home visits from clergy to sentences passed by the courts, which included the ‘crimes’ of bankruptcy, drunkenness, or sleeping in church. Another 10% of the population fell under the disciplinary sway of the smaller Anabaptist churches, which were also noted for their strict disciplining of members. The Calvinists also worked to extend their influence to the rest of the population by building a host of charitable institutions, including workhouses, orphanages, and even prisons (first erected in 1598). 36 Only two of the Leiden suicides appear in the membership roles of the Reformed church. Even families, Protestant and non-Protestant, became increasingly important conduits for the transmission of behaviour norms as the nuclear family emerged as perhaps the most important site of associational identity in the Netherlands beginning in the sixteenth century.37 Protestant culture especially emphasized the importance of marriage and family while denigrating celibacy. The majority of the Leiden suicides were men, about two thirds, which was the typical pattern in most of Europe. In his study of Geneva, Watt posits the thesis that marriage was more important to men and that they found bachelorhood difficult. Women, on the other hand, often found the married state more onerous. His conclusions are supported by the Leiden records, as eighteen of the male suicides were bachelors, versus only three that had wives and ten of the female suicides were married, versus only one that was not.

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____________________________________________________________ Marriage, especially for men, clearly had integrative functions. Family, guilds, and church are the most studied of the social institutions in Dutch society. Much work remains to be done on the significance of other intermediaries, such as the town government, the military, schools, work houses, and literary societies. This essay has looked at suicide in seventeenth century Leiden from two different perspectives, the sociological (judicial records) and the anthropological (literary and artistic sources). The two approaches converge to allow a glimpse of how the men and women of Leiden might have used and enforced their social norms, especially in the absence of a strong church or a strong state, to maintain low rates of suicide. The fragmentary evidence suggests that the intermediate, corporate groups in Dutch society acted as effective agents of social cohesion, knitting together the disparate elements of the Dutch state, in a manner that was strengthened by the absence of interference from a centralized state. Rather than instituting a repressive regime, theirs was a grass roots movement, achieved not by any central mechanism, but by the collective decisions of thousands of Dutch people adapting to the circumstances in which they found themselves after independence. The social forces of the Dutch towns produced a state and a people much stronger, politically, economically, and morally, than either historians or contemporaries have been willing to give them credit for.

Notes 1.

2. 3.

4.

5.

Two examples of this school include Georges Minois, History of Suicide: Voluntary Death in Western Culture (Baltimore and London: Johns Hopkins University Press, 1995). An example of this approach is Olive Anderson, Suicide in Victorian and Edwardian England. Two outstanding examples of this mixed approach include Michael McDonald and Terence R. Murphy, Sleepless Souls: Suicide in Early Modern England (Oxford: Clarendon Press, 1990) and Jeffrey Watt, Choosing Death: Suicide and Calvinism in Early Modern Geneva (Kirksville, MO: Truman State University Press, 2001). Jack D. Douglas, The Social Meaning of Suicide (Princeton: Princeton University Press, 1967), 163-234; Steve Taylor, “Some Critiques of Official Suicide Rates,” chapter in Durkheim and the Study of Suicide (New York: St. Martin’s Press, 1982), 43-64; J. Maxwell Anderson, “Suicide Statistics,” chap. in The Sociology of Suicide: A Selection of Readings, ed. A. Giddens (London: Frank Cass, 1971), 87-96. Bart Demyttenaere, De Last van Leven: Zelfmoord in België en

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____________________________________________________________ 6. 7.

8. 9.

10.

11.

12. 13. 14.

15. 16. 17. 18. 19. 20. 21. 22.

Nederland (Antwerp: Icarus, 2000), 21-23. Alexander Murray, Suicide in the Middle Ages: Vol. 1: The Violent Against Themselves (Oxford: Oxford University Press, (1998), 350. For Brussels, see F. Vanhemelryck, De criminaliteit in de ammanie van Brussel van de late middeleeuwen tot het einde van het Ancient Regime (1404-1789). (Verhandelingen van de Koninklijke Academie voor Wetenschappen, Letteren en Schone Kunsten van Beligie— Klasse der Letteren, 43, 97, 1981). For Ghent, see A. van Werveke, Bijdragen tot de Geschiedenis en de Oudheidkunde van Vlaanderen (Ghent: Van Rysselberghe & Rombaut, 1927). For Breda, see J. van Haastert, “Beschouwing bij de criminele vonnissen van de schepenbank van de stad Breda uit de jaren 1626 tot 1795,” Jaarboek van de Geschied- en Oudheidkundige Kring van Stad en Land van Breda ‘De Oranjeboom’ 29 (1976), 77-79. Lieven Vandekerckhove, Van Straffen Gesproken: De Bestraffing van Zelfdoding in het oude Europa (Tielt: Lanoo, 1985), 46. Pieter Spierenburg, The Broken Spell: A Cultural and Anthropological History of Preindustrial Europe (New Brunswick?, 1991), 177. Jeffrey Watt, Choosing Death: Suicide and Calvinism in Early Modern Geneva (Kirksville, MO: Truman State University Press, 2001), 24. Arne Jansson, From Swords to Sorrow: Homicide and Suicide in Early Modern Stockholm (Stockholm: Almqvist and Wiksell International, 1998), 26 and 50. Michael Zell, “Suicide in Pre-Industrial England,” Social History xi (1986): 309-310. Lieven Vanderkerckhove, Van Straffen Gesproken: De bestraffing van Zelfdooding in het oude Europa (Tielt: Lannoo, 1985), 53-72. H.M van den Heuvel, De Criminele Vonnisboeken van Leiden 15331811 (Leiden: Rijnland, Tijdschrift voor Sociale Genelogie en Streekgeschiedenis voor Leiden en Omstreken 1977-8 n) 14, 15 and 43. Ibid, 171. Ibid, 205. Michael McDonald and Terence R. Murphy, Sleepless Souls: Suicide in Early Modern England (Oxford: Clarendon Press, 1990), 16. Ibid, 27. Vandekerckhove, 87. van den Heuvel, 51. Ibid, 72. Ibid, 159.

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____________________________________________________________ 23. Ibid, 190. 24. Ibid, 160. 25. For a comparison, see Karla Oosterveen, "Deaths by Suicide, Drowning, and Misadventure in Hawkshed, 1620-1700," Local Population Studies 4 (1970): 17-20. 26. For a general discussion of this shift, see Jeffrey Burton Russell, Mephistopheles: The Devil in the Modern World (Ithaca, NY: Cornell University Press, 1986) and P. Spierenburg’s The Broken Spell. 27. The last (known) death sentence for witchcraft in the Netherlands say was in Schoonhaven in 1597 (Source: van Deursen, 252), and persecution ended around 1610 (Spierenberg, The Broken Spell, 274). 28. For a fuller discussion of the modern debate over morality and euthanasia in the Netherlands, see David C. Thomasma et al, ed. Asking to Die: Inside the Dutch Debate about Euthanasia (New York: Kluwer, 1998). The Dutch law allowing euthanasia and assisted suicide was enacted on April 10, 2001. 29. Georges Minois, History of Suicide: Western Death in Western Culture (Baltimore and London: John’s Hopkins University Press, 1995), 68. 30. George Rosen, “History,” in A Handbook for the Study of Suicide, ed. Semour Perlin (Oxford: Oxford University Press 1975), 16. 31. Ron M. Brown, The Art of Suicide (London: Reaktion Books 2001), 116. 32. Emile Durkheim, Suicide: A Study in Sociology, trans. by John A. Spaulding and George Simpson (New York: The Free Press, 1951), 309. 33. Taylor, 22. 34. For a fuller discussion of the role of the textile industry in Leiden, see N.W. Posthumus’ classic multi-volume study, De Geschiedenis van de Leidsche Lakenindustrie (The Hague: Martinus Nijhoff, 1939). 35. Bernice A. Pescosolido and Sharon Georgianna, “Durkheim, Suicide, and Religion: Toward a Network Theory of Suicide,” The American Sociological Review 54 (1989): 43. 36. For prisons see Pieter Spierenburg, The Prison Experience (New Brunswick, NJ: Rutgers University Press, 1991). For orphanages and poor relief, see Anne McCants, Civic Charity in a Golden Age: Orphan Care in Early Modern Amsterdam (Chicago/Springfield: University of Illinois Press, 1997). 37. For studies on the family as a site for indoctrination and discipline, see the following: R.A. Houlbrooke, The English family 1450-1700 (1984); J. Flandrin, Families in former times (1979) C. Hill, `The spiritualization of the household' in Hill’'s Society and Puritanism

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____________________________________________________________ (1964), S. Amussen, An Ordered Society: Gender and Class in Early Modern England (1985); and L. Roper, The Holy Household: Women and Morals in Reformation Augsburg (1989). For a specific discussion of the role of families in the Netherlands, see P. Spierenburg, The Broken Spell, chapter 8: Family Life: Bonds Between Men and Women, Parents and Children”, 227-287.

References Anderson, J. Maxwell. “Suicide Statistics.” In The Sociology of Suicide: A Selection of Readings., edited by A. Giddens, 87-96. London: Frank Cass, 1971. Brown, Ron M. The Art of Suicide. London: Reaktion Books 2001. Demyttenaere, Bart. De Last van Leven: Zelfmoord in België en Nederland. Antwerp: Icarus, 2000. Douglas, Jack D. The Social Meaning of Suicide. Princeton: Princeton University Press, 1967. Durkheim, Emile. Suicide: A Study in Sociology. Translated by John A. Spaulding and George Simpson. New York: The Free Press, 1951. van Haastert, J. “Beschouwing bij de criminele vonnissen van de schepenbank van de stad Breda uit de jaren 1626 tot 1795.” Jaarboek van de Geschied- en Oudheidkundige Kring van Stad en Land van Breda ‘De Oranjeboom’ 29 (1976): 77-79. van den Heuvel, H. M. De Criminele Vonnisboeken van Leiden 15331811. Leiden: Rijnland, Tijdschrift voor Sociale Genelogie en Streekgeschiedenis voor Leiden en Omstreken 1977-8 n. Jansson, Arne. From Swords to Sorrow: Homicide and Suicide in Early Modern Stockholm. Stockholm: Almqvist and Wiksell International, 1998. McCants, Anne. Civic Charity in a Golden Age: Orphan Care in Early Modern Amsterdam. Chicago/Springfield: University of Illinois Press, 1997. McDonald, Michael, and Terence R. Murphy. Sleepless Souls: Suicide in Early Modern England. Oxford: Clarendon Press, 1990.

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____________________________________________________________ Minois, Georges. History of Suicide: Voluntary Death in Western Culture. Baltimore and London: Johns Hopkins University Press, 1995. Minois, Georges. History of Suicide: Western Death in Western Culture. Baltimore and London: Johns Hopkins University Press, 1995. Murray, Alexander. Suicide in the Middle Ages. Vol. 1: The Violent Against Themselves. Oxford: Oxford University Press, 1998. Oosterveen, Karla. "Deaths by Suicide, Drowning, and Misadventure in Hawkshed, 1620-1700." Local Population Studies 4 (1970): 17-20. Pescosolido, Bernice A. and Sharon Georgianna. “Durkheim, Suicide, and Religion: Toward a Network Theory of Suicide.” The American Sociological Review 54 (1989), 43. Posthumus, N.W. De Geschiedenis van de Leidsche Lakenindustrie. The Hague: Martinus Nijhoff, 1939. Rosen, George. “History.” In A Handbook for the Study of Suicide, edited by Semour Perlin. Oxford: Oxford University Press, 1975. Russell, Jeffrey Burton. Mephistopheles: The Devil in the Modern World. Ithaca, NY: Cornell University Press, 1986. Spierenburg, Pieter. The Prison Experience. New Brunswick, NJ: Rutgers University Press, 1991. Spierenburg, Pieter. The Broken Spell: A Cultural and Anthropological History of Preindustrial Europe. New Brunswick, 1991.

Taylor, Steve. “Some Critiques of Official Suicide Rates.” In Durkheim and the Study of Suicide, 43-64. New York: St. Martin’s Press, 1982. Thomasma, David C. et al, ed. Asking to Die: Inside the Dutch Debate about Euthanasia. New York: Kluwer, 1998. Full Citation of all the authors is required. Vandekerckhove, Lieven. Van Straffen Gesproken: De Bestraffing van Zelfdoding in het oude Europa. Tielt: Lanoo, 1985.

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____________________________________________________________ Watt, Jeffrey. Choosing Death: Suicide and Calvinism in Early Modern Geneva. Kirksville, MO: Truman State University Press, 2001. Werveke, A. Van. Bijdragen tot de Geschiedenis en de Oudheidkunde van Vlaanderen. Ghent: Van Rysselberghe & Rombaut, 1927. Zell, Michael. “Suicide in Pre-Industrial England.” Social History xi (1986): 309-310.

When a Young Woman Dies: Gender, Youth, and the Meanings of Suicide in the Jazz Age Kathleen W. Jones Suicide is the third leading cause of death among adolescents and young adults in the United States.1 In making sense of these suicides, the focus now is on psychological dimensions - the feelings of depression, hopelessness, and loss of control that appear to lead some young people to see suicide as an alternative to a debilitating emotional life. Suicide narratives, told in suicide notes or in the stories of survivors, capture this private torment. But suicide also has a public meaning. The research of sociologists and anthropologists reminds us that suicide can provide a window onto the soul of a culture as well as the psyche of the individual.2 For historians, too, the study of suicide has become a way to uncover the experiences of life and the meanings of death for people in past times. 3 When the self-inflicted deaths under examination are those of young women, making sense of the suicides brings historians to the nexus of a society’s beliefs about gender and generational relationships. How do these beliefs shape the interpretation of suicidal behaviour and conversely, in what ways is suicide made to serve as a commentary on femininity and youth? Those questions are addressed in this essay through a historical study of the suicidal behaviour of 113 adolescent girls and young women as reported on in the New York Times during the 1920s.4 As news items these stories tend to be formulaic, factual and brief; they consist of an identification of the victim, the location, the method used, who found her, what happened once she was discovered, and if known, the motive behind the suicide. Headlines announced without much fanfare: “Girl, 17, Commits Suicide;” “Girl, 17, Dies by Gas;” “Girl, 17, Tries Suicide;” Girl Dies in 20-Story Leap;” “Girl Drinks Iodine in Pew;” “Girl in Love Takes Poison;” and “Girl Kills Herself by Gas,” Taken together, these stories tell us nothing about changes in the numbers of suicides or the suicide rate during the 1920s. Nor can they tell us why these girls chose to die; newspaper accounts do not provide evidence for a psychology of adolescent suicide. It is the ordinary, banal quality of the news items, however, that makes these suicide narratives such excellent sources for exploring the cultural meaning of youth suicide.5 They can be used to uncover “folk beliefs,” the commonsense and widely shared

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____________________________________________________________ explanations of suicide. These folk beliefs are important, not only because of their distance from or nearness to the interpretations created by experts in psychiatry, sociology, and statistics, but also because they embedded the victim and her act in a social framework that provided for both public and private reconciliation to an untimely and violent death. 6 The wide circulation of the New York Times during the 1920s meant that the vast majority of its readers would have had no direct knowledge of the suicide victim. For them, the suicide notices would have been no different from other news stories, consumed as items that alerted readers to events and issues with public significance. Where, however, was the significance in a small article about a young girl’s suicide? To be sure, newspapers competed to sensationalise death during these years, in an effort to attract more readers. 7 Suicide stories were a part of that sensationalism and yet, it is evident in the framing and the content of these 113 stories that they offered something more. These stories, I suggest, provided moral directives to Americans trying to come to terms with the gender and generational tensions that caused such cultural discord during the 1920s. This was, after all, the “jazz age.” Readers could find in these stories commentary on the meaning and value of the decade’s modernity. Modernity is a slippery historical concept; its meanings range from literary genre to economic infrastructure. Here, I intend it to represent what one historian has called the “modern temper,” the perception by many in the 1920s that their society had undergone and was continuing to experience massive transformations in many areas of life.8 Urbanization, industrialization, and technological development were surely a part of what Americans meant by modern, although more was at stake than changes in where people lived and how they worked. The modern temper also encompassed a new set of social values that created upheaval in the daily lives and personal relationships of ordinary people. Mass culture and mass consumption were modern, and both offered new forms of recreation. Even as conformity became a symbol of the times, modernity privileged the individual over family or community. Among the most troubling of the changes associated with this modern temper were the challenges posed by individualism and independence to the power relationships implicit in gender and age hierarchies, hierarchies that assumed as natural the authority of male over female and adult over youth. No figure captured the essence of this modern temper better than the flapper, the hedonistic young woman whose lifestyle challenged a femininity that was submissive, domestic, matronly, and asexual.9 Certainly not all young women considered themselves “flappers,” yet wherever young people congregated it was clearly evident that the generation of women who came of age during the 1920s shared a different

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____________________________________________________________ adolescent experience from that of their mothers. The psychologist Phyllis Blanchard preferred to call them the “new girls” of the 1920s. “Freedom to work, to play and to love as they choose is theirs for the taking,” she wrote in New Girls for Old (1930). With old restraints gone “the contrast between generations is greater to-day than ever before.”10 As witnesses and reporters (and occasionally the victims) recounted the suicide stories, they did so in light of the behaviour, the manners, and the morals – the “cultural script” of modern young womanhood.11 1.

Who?: The Identity of a Suicide. In addressing the question of “who?” suicide stories constructed an identity for the suicide victim, a description that was unique to that individual but also made her recognizable to newspaper readers. 12 More so than name and address, her social pedigree, personality, and appearance established her membership in a specific group defined by age and gender. Her identity also positioned suicide in the contest between Victorian expectations of femininity and modern views of independent young womanhood. Her family’s social status, her family relationships, and her race established the young woman’s membership in the broad community of newspaper readers and writers. Racial identity contributed to one’s social pedigree in the 1920s; the New York Times reported only the suicides of young white women. In contrast, the suicidal behaviour of girls from all economic strata was newsworthy. The suicide victim’s identity, however, was framed less by class than by gender and age, a decision evident in reporters’ efforts to situate each young woman within a family configuration.13 Aged eleven or twenty-four, she was a daughter or a sister (and occasionally a wife). This identity softened the extreme individualism evident in every act of suicide by affirming the young woman’s dependent status and making a place for her within the family and the community. If the family connection reaffirmed her femininity, the life experiences of the young woman often showed her to be more closely identified with the “new girls” described by Phyllis Blanchard. The suicide victims were college students or working girls. Many lived on their own and died apart from their families. If still adolescents residing at home, their sights were focused outward, on the world of leisure activities or school. Of course, by the 1920s neither the college woman nor the independent working girl was a new social character. During that decade, however, independence was a particularly exciting, fashionable, and modern identity for a young woman to adopt. By acknowledging this element of her identity, the news story validated her modern lifestyle and pointed to suicide as one of the costs she might have to pay for her

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____________________________________________________________ independence.14 The concept of “despondency” gave reporters the means to connect independence with suicide. Witnesses might describe a girl as “melancholy” or “ill at ease,” but the press seemed to prefer “despondent.” Reporters did not use it as a synonym for insanity or for clinical depression, as we might today. Instead, its application had more in common with use of the term personality – the psychological attributes with which one faced the world and the key to the modern young woman’s identity. During the 1920s the popularisers of psychology told the public that a pleasing personality was something to cultivate and a grating personality, something that could be changed.15 In the suicide stories, therefore, despondency was not used to construct the suicidal individual as a “victim” of psychological pain and trauma as might be done today. Rather, despondency was usually situational in the suicide discourse of the 1920s. The suicidal individual became despondent because of some concrete experience – loss of a job, loss of a beau, loss of her health, or loss of access to educational opportunity. These were the shadows that marred a flapper’s freedom and independence. The press reported the suicide as a reckless or foolish choice made in light of specific events. Suicide might be a consequence of illness, but in these stories, it was not represented as a symptom of insanity. By finding despondency at the emotional core of suicide, the press accounts held these young women accountable for their actions, even as family relationships highlighted their dependence. Along with personality and family, appearance was at the core of female identity in the 1920s, and thus, it, too, presumably gave meaning to a young woman’s suicide.16 A flawed body image might explain suicidal behaviour; Anna Hartman’s suicide, for example, was attributed to a “leg deformity” that prevented her from taking part in the activities of other seventeen year olds. Freckles or a facial scar might explain despondency and suicidal behaviour, but beauty made a woman’s suicide incomprehensible.17 When a young woman was “pretty” or “beautiful,” reporters found it difficult to reconcile this positive attribute of feminine identity with a personality that chose suicide. Sometimes, however, it was not so much “beauty” as “style” that shaped reporters’ efforts to identify the victims, and here, the tensions surrounding modern young womanhood were sometimes expressed as a question of hair. If any one metaphor in these stories spoke to the gender and generational conflicts of modernity it was bobbed hair. To many young women, the short boyish haircut represented the vanguard of style in the 1920s, and in some instances it was a fashion statement girls literally did not want to live without. The sociologist Ruth Shonle Cavan,

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____________________________________________________________ one of the few social scientists to study suicide during this decade, thought that the girl who was scolded for cutting her hair turned to suicide because “the disapproval of her bobbed hair [represented] the disapproval of her entire range of ambitions and ideals.” As if to confirm Cavan’s analysis, Annabelle Lewis of Bridgetown, New Jersey, shot herself after being denied the opportunity to have her bobbed hair trimmed before entering high school as a sophomore. The consequences of being fashionable, however, were not always what the bobbers expected; the press also reported on two incidents in which young women attributed their suicidal behaviour to regret over the loss of their long hair. Norma Teffner, who drowned herself in Horseshoe Lake near Batavia, New York, wrote to her brother just before her death, “Since my hair is gone my looks are gone, too, and it makes me nervous.”18 In establishing identity, the reporters for the New York Times situated the suicide in her family and community, enabling the reading public to develop a sympathetic response to her unnatural death. Yet, even as these stories generated sympathy for the deceased, the discussions of identity also conveyed a troubling message about modernity. Suicide could be a deadly companion to the bold personality, independent lifestyle, and fashionable appearance craved by modern young women. 2.

Where? and How?: The Drama of Suicide. When these young women chose to die, they also chose the method and the setting. News accounts routinely included information about where the suicide took place and how it was accomplished, partly to complete the “where, when, and how” of the journalist’s standard five questions, partly to add sensation to objective, unemotional news reporting. The descriptions of the geography of each suicide added more than fact or sensation to their stories, however. As with the presentation of the suicide’s identity, the accounts of place - the bedroom suicide and the public suicide - both memorialized and moralized about the expectations of young women in modern society. Suicidologists today argue that through the choice of place and the writing of notes, suicide victims try to shape the aftermath of their acts. We cannot know what these victims from the 1920s intended by their staging, but when a young woman was found lying on her bed, with a picture of her lost love on the pillow, with a book open to a poignant passage, or with love letters strewn about, witnesses and reporters interpreted the poses as evidence of the failure of modern romance.19 The death of Betsy Tevis was one of these tragedies. According to the press account, she was found on the floor of her bedroom, “the gown which she had donned in anticipation of her visitor stained over the heart” from the self-inflicted gunshot wound

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____________________________________________________________ that killed her. Tevis, “a beautiful girl with a wealth of blond hair and a sunny disposition,” died twenty minutes after an “unnamed youth with whom she had become infatuated” broke a social engagement. 20 Other young women chose public spaces and audiences of strangers for their suicide performances, but the news reports often told stories of thwarted romance similar to those of the bedroom suicides. “What’s the trouble – love affair?” a police officer asked Gloria Seijo, on her way to the hospital after jumping in front of a subway train. “You’ve struck it,” the eighteen year old reportedly replied. 21 Easy companionship between young men and women was a hallmark of youth culture in the 1920s, and to many it seemed a benefit of modernity. Yet, it appeared in suicide stories as potentially disastrous for the girls. The flapper’s boyfriend, according to these dramas, was a fickle fellow, whose promises were not to be trusted.22 Although the news reports allowed readers to stare at both the private bedroom dramas and the public spectacles of youth suicide, the death notices offered more protection from lurid reporting to those who died in their beds. Based on these reports readers might assume that those who died at home did so decorously, with poison, gas, or the occasional gunshot wound. Their actions suggested elements of “true womanhood;” their deaths fit more closely the sentimental death scenes of nineteenthcentury Victorian melodrama. And their suicides could be contained within well-understood hierarchies of age and gender. In contrast, those who chose to act in public demonstrated the kind of flair typically associated with the new-style young woman of the 1920s. The settings ranged from high school corridors to ferry boats to subway platforms, from standing in front of a police station to standing in front of a church to standing in front of a Chinese restaurant, from Morningside Park in the morning when mothers were walking their babies to the corner of Broadway and 49 th at 1:00 AM with only a city patrolman nearby. According to these stories, modern young women could be found nearly anywhere, doing nearly anything, including dying, in public. Public settings pointed to the opportunities young women found in the modern city; the suicides, in contrast, cautioned that when young women attempted to take advantage of these opportunities, their expectations might remain unmet and their actions could culminate in an unnatural death. Settings outside the home also gave reporters license to describe the consequences of suicide in gruesome detail. Contrast the imagery in the death notice of pretty Betsy Tevis, found in her room, her gown “stained red with blood,” with that used in the item about Dorothy Wilson, the “pretty well-dressed girl” whose leap in front of a train left her wedged

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____________________________________________________________ between the engine and the platform, “being slowly crushed to death” or the even more gruesome description of the dismemberment of another subway jumper, her head and leg falling to the platform below.23 Descriptions of appearance after suicide made clear that despite their modernity, girls faced special risks in public, even when the ultimate aim was self-destruction. 3.

Why?: The Gendering of Suicide. Beyond who and where and when and how, reporters intended to write about why young women took their own lives. “No motive” gave no closure to the reporters’ accounts, so they seemed to work hard to extract explanations from notes left by the victims, from patrolmen who questioned the victims, and from parents (or their surrogates – landladies and college officials). Dorothy Wilson’s father was not entirely convinced that his daughter’s death was a suicide, and his doubts emerged from his understanding of the available explanations for youth suicide in the 1920s. As he told the New York Times reporter, Dorothy had had “no love affair, illness or financial trouble” to worry her, and she was “bright and successful in her studies.”24 The news stories confirm that Mr. Wilson’s assumptions about motive were the conventional ones. In these press accounts suicidal behaviour was attributed to unrequited love, poverty, and school problems. Although ill health was a commonplace explanation for suicide among the elderly, it was not frequently used to account for the suicide of a young adult. If he had studied the news accounts of youth suicide, Mr. Wilson might have substituted conflict with parents particularly over use of leisure time - for illness in his list of possible explanations. In her recent work on the gender “myths” found in current suicide research, the psychologist Silvia Canetto argues that, by projecting female suicidal behaviour as primarily a response to problems in personal relationships, the social science literature is merely reflecting popular assumptions about female dependence and passivity. 25 The current literature, Canetto might have added, rests on a longstanding tradition of assigning the explanation for a woman’s suicidal behaviour to unrequited love. The suicide stories from the 1920s certainly did a great deal to perpetuate commonly held beliefs that women turned to suicide when prevented from being with a particular suitor. The press was captivated by the suicides of young women who had been “jilted in love” and reported both local and national stories. In “Girl in Love Takes Poison,” May Farley, was described as “morose” after an unsuccessful attempt at reconciliation with her ex-fiancé. She pulled a vial from her purse and, screaming, “I cannot live without Eddie,” drank from the bottle labelled

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____________________________________________________________ “Lysol.” Reporters and editors also seemed attracted to the melodrama of a couple kept apart by unreasonable circumstances. The New York Times printed the announcement of Lucy Whittum’s death on page eight, even though she had lived and died in Corunna, Michigan. When her body was found in a ditch, her “pretty face splotched with acid burns” from the carbolic acid she had ingested, Lucy was assumed to have fulfilled her part in a suicide compact. The man involved, who was being held for murder, claimed that the girl’s parents had “objected to him,” so the pair had decided to die rather than live apart. 26 The references to “love” as a motive for the female suicides contained a message about the importance modern young women attached to marriage. These were women who had decidedly chosen marriage over independence, but they acted as modern women - boldly and decisively (albeit destructively) - when that choice was thwarted. “Men only look for beauty; they don’t care about the real homemaker any longer”, Virginia Hicks reportedly stated after drinking poison. She had been happy and expected to get married, until her suitor met “a prettier girl” at a dance; “classical features and a conspicuous lack of freckles” were, she concluded, the essential ingredients for happiness. Since she lacked both, she wanted to die. Margaret Gallagher, after what was described as an “all night tour of Hoboken cabarets,” jumped off the ferry on the trip home. The story intimated that Margaret had acted after her date, when asked if he loved her, failed to reply.27 In suicide stories, the modern young woman, despite the many opportunities available to her, was refusing to live without romance, without marriage; independence meant choice, and suicide stories suggested that the modern young woman might want to express her independence by choosing marriage. When we consider the audience for the messages in the jilted lover suicides, these stories have still more to tell us about age and gender during the 1920s. The press was a man’s world in the early twentieth century.28 Both reading and reporting the news was seen as a predominantly male activity and newspapers devoted a special women’s section to the interests of female readers. Like other papers, the New York Times did not hide suicide announcements in the columns of the women’s section; so male readers would have encountered the stories as they searched for the local or national news. As the suicide stories acknowledged the importance that young women attached to marriage, at the same time these stories served to caution young men about the consequences of treating lightly their relationships with modern women. The news items hinted that in blithely assuming independent young women were not seriously pursuing marriage and family in their romances, young men could precipitate suicidal behaviour. In a decade

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____________________________________________________________ rife with stories about companionate marriages and other expressions of sexual freedom, suicide stories were morality tales for the young of both sexes. Silvia Canetto has call attention to the erroneous distinction suicide researchers have made between the woman who dies “for love,” and the man who dies “for glory.”29 While achievement-motivated suicides may not be a part of current social science mythology about female behaviour, it was certainly a component of folk beliefs about the young female suicide in the 1920s. School provided a context for accomplishment for many young women. Academic failure or a teacher’s reprimand could explain the suicidal behaviour of adolescents, as it did for Philomena Glella, age thirteen, who swallowed iodine after her name was not listed among the year’s graduates. Glella recovered, but Pearl Kluger did not. The sixteen year old shot herself, her mother thought, because she had failed school exams and would not graduate with her class.30 For young adults, achievement could be measured by success in college. As young women began to attend college in the decades after the Civil War, popular concern focused on the effects of intellectual exertion on the physical health and mental stability of the sex. By the 1920s, however, the college experience was a routine one for young women; attendance at college by itself was not a sufficient explanation for a young woman’s suicide. Dorothy Wilson’s father, for example, was sure that her college work had had nothing to do with his daughter’s suicide. Nor were the suicides of Marie Bloomfield, a Barnard honour student, and Clara Held of New York University attributed to their college experiences.31 All three were described as bright and doing well in their studies. By implication, therefore, a failure to achieve rather than the hard work required for a college diploma, supplied an acceptable motive for campus suicides. 32 Indeed, in two instances, it was not the school experience itself that reportedly precipitated suicidal behaviour, but an inability to secure funds to train as a nurse.33 Although it was sometimes college, more often it was the world of work that shaped the ambitions and achievements of modern young women and also framed accounts of their suicides. News reporters deemed the failure to get or keep a job an understandable motive for suicidal behaviour. When Edith Kingston died from veronal poisoning, “it was believed,” the press wrote, that the loss of her job precipitated the act. And when Ruth Klahr of the Bronx was found dead in a Philadelphia hotel room, the press chose to relate the suicide to her failure to find work. Yet, even if not essential for their food and shelter, participation in the work world held symbolic importance for young adults. In the case of Edith Tirrell, the daughter of a mattress company president, testimony at the

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____________________________________________________________ coroner’s inquest attributed her suicide to an “unfortunate love affair” and her inability to pursue a career because of certain physical ailments. By the 1920s, employment for young women such as Tirrell was a matter of pride in accomplishment more so than a matter of economic necessity and her suicide story reflected this new perception of women’s work. 34 Contemporary folk beliefs provided reporters from the 1920s with one explanation for suicide that seems no longer relevant today – the young woman’s need for recreation. Or, as Lillian Feinstein put it in a suicide note to her mother, “all my life is work and there is no time for pleasure… I do not care to live.” The expectations of her work as a maid kept Lillian from “pleasure.” For Mary Higgins, a senior at the Connecticut College for Women, her suicidal behaviour was attributed to “overstudy.” In 1924, the year of Higgins’s suicide attempt, overstudy referred not to the physical and mental strain nineteenth-century physicians and educators thought so injurious. Rather, “overstudy” suggested the failure to find a balance between schoolwork and the social activities that were considered a vital part of college life. 35 An absence of social activities might also have been associated with the presence of illness, and ill health was occasionally offered as a motive in the suicide stories.36 More often, however, the restrictions on social activities that provided a context in these stories were restrictions imposed by parents. These accounts situated the motive for suicide specifically in conflicts between “traditional” mothers and “modern” daughters over appropriate female behaviour. Historians have suggested that the mother-daughter conflict, so familiar to us today, was far less apparent during the nineteenth century and emerged only in the early twentieth century. During the 1920s the battles between parents and their adolescent daughters seemed ubiquitous to contemporary observers, and experts in psychology and child development made mothers a scapegoat for much of the conflict. The suicide stories conformed to this pattern of mother-blaming.37 The new forms of public amusement were central to these conflicts, and in press accounts both mothers and daughters saw suicidal behaviour as a reaction to the limits mothers imposed on when and where daughters could go, and the punishment mothers imposed for “going out” without permission. “I want to die,” twenty year old Irene Cridge told police officers who took her to the hospital after she had ingested iodine. The press attributed her suicidal behaviour to the reprimands she received for going to dances with men her mother objected to and to her mother’s threat to send Irene to the country if she did not “change her mode of living.” Seventeen year old Estelle Corrigan’s suicide took place after her mother chastised her for going out so much in the evenings. And Bernice

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____________________________________________________________ Davidson, also seventeen, inhaled gas in the family kitchen because her parents had forbidden her to “receive her sweetheart in their home.” 38 If marriage was the goal to which young women aspired, they also expected getting there to be fun. The suicide stories reminded parents of the limits on their authority to constrain the social activities of their modern daughters much as the stories of thwarted love warned young men about the serious consequences of toying with modern romance. In ascribing motive, the reporters, witnesses and victims drew on popular beliefs about the opportunities modern life presented to young women. The suicide stories in the New York Times moralized about the degree to which young women could take advantage of these opportunities without enduring serious emotional harm. Whether the motive was expressed in a direct quote or as a reporter’s impression or surmise, the explanations offered in news accounts must be interpreted in light of the unstable boundaries of femininity and youth in the 1920s. Similar explanations for female suicide can be found in other eras, but how these explanations made sense of suicide in the 1920s was specific to the way young women were positioned and tried to position themselves in the decade’s realigning of gender and generational relationships. 4. Conclusion. The news stories of the 1920s presented the suicide of young women from two perspectives. The stories offered up the shared beliefs used by the press and the public to explain an individual’s untimely death. In seeking a motive for suicide, the press and the public defined the act as a conscious choice in light of a situation specific to the individual. This characterization contrasts with the medicalised view of suicide as illness signified by hopelessness, depression, and despair, a perspective that rules our current understanding of self-destructive behaviour. Both views help mourners rationalize the death that is not ordinary. Unlike the current psychology of suicide, however, the folk beliefs of the 1920s situated the prevention of suicide in the individual’s environment. By doing so, these stories also imbued suicide with a deeper cultural meaning, one in which accounts of suicide served as a conduit for messages about gender, youth, and modernity. If the situation that accounted for the suicide was specific to the individual, nonetheless, the situation was one made possible only by the unique attributes of urban life and social relations present during the jazz age. The suicide stories of the 1920s appeared in the press as cautionary tales not only for young women, but also for young men and their elders. In the descriptions of the victims, the accounts of the death scenes, and the interpretations of motives, the news stories warned that modernity brought

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____________________________________________________________ risks and came with costs. Taken together, these stories resonate with tension: between the limited opportunities for the young to affect their social situations and the power they claimed through acts of selfdestruction; between the individual expression of death and the blurring of individual identity in the explanations that followed; between the expectations of feminine behaviour and gruesome acts of self-destruction that these women perpetrated; and between the intimacy or privacy of death and the public forums in which young women chose to exhibit suicidal behaviour. In many ways, the suicides of these young women can be read as one of the signs of modernity. By telling these suicide stories, the reporters and the witnesses underscored the emotional ambivalence with which this culture confronted modern life.

Notes 1.

U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Injury Prevention and Control, Suicide in the United States, (20 December 2003). 2. Sources I have found particularly insightful include Michael F. Brown, “Power, Gender, and the Social Meaning of Aguaruna Suicide,” Man (new series) 21 (1986): 311-328; Silvia S. Canetto and David Lester, “Gender, Culture, and Suicidal Behaviour,” Transactional Psychiatry 35 (1998): 163-190; Lisa Lieberman, Leaving You: The Cultural Meaning of Suicide (Chicago: Ivan R. Dee, 2003); and E. Thomas Ewing, "Personal Acts with Public Meanings: Suicide by Soviet Women Teachers in the Stalin Era," Gender & History 14 (2002): 117-137. 3. In addition to Ewing, “Personal Acts,” and Lieberman, Leaving You, see Olive Anderson, Suicide in Victorian and Edwardian England (Oxford: Clarendon Press, 1987); Victor Bailey, ‘This Rash Act’: Suicide Across the Life Cycle (Stanford: Stanford University Press, 1998); Howard I. Kushner, Self-Destruction in the Promised Land (New Brunswick, N.J.: Rutgers University Press, 1989); Michael MacDonald and Terence R. Murphy, Sleepless Souls: Suicide in Early Modern England (Oxford: Clarendon Press, 1990); and Jennifer Robertson, “Dying to Tell: Sexuality and Suicide in Imperial Japan,” Signs 25 (1999): 1-31. 4. This number represents all female suicides, aged 11 to 24 indexed in the New York Times from 1 January 1920 to 31 December 1929.

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____________________________________________________________ 5.

Others who have examined suicide by using articles from the public press include Robertson, “Dying To Tell”; Simon Cooke, “A ‘Dirty Little Secret’? The State, the Press, and Popular Knowledge of Suicide in Victoria, 1840s-1920s,” Australian Historical Studies 31(2000): 304-324; and Steven Stack, et al., “Suicide and the Media: The New York Times’s Presentation of Front-Page Suicide Stories between 1910 and 1920,” Journal of Communication 44 (1994): 6483. On the formulaic quality of news reports, see James Fulcher, “Murder Reports: Formulaic Narrative and Cultural Context,” Journal of Popular Culture 18(1985): 31-42. 6. Howard Kushner, in “Suicide, Gender, and the Fear of Modernity in Nineteenth-Century Medical and Social Thought,” Journal of Social History 26 (1993): 461-490, has argued that during the nineteenthcentury psychiatry was the public language used to express a connection between suicide and modernity. In contrast, my research suggests that psychiatric models much less influenced folk beliefs about suicide than Kushner believes, and that in the press of the 1920s the connection between suicide and modernity was made through situational explanations. See Brown, “Aguaruna Suicide,” for a discussion of the significance of folk beliefs. 7. John D. Stevens, “Social Utility of Sensational News: Murder and Divorce in the 1920’s,” Journalism Quarterly 62(1985): 53-58. See also Silas Bent, “The Art of Ballyhoo,” Harper’s Magazine 155 (1927): 485-494; and Charles Merz, “Bigger and Better Murders,” Harper’s Magazine 155 (1927): 338-343. 8. Lynn Dumenil, The Modern Temper: American Culture and Society in the 1920s (New York: Hill and Wang, 1995). 9. Laura Davidow Hirshbein, “The Flapper and the Fogy: Representations of Gender and Age in the 1920s,” Journal of Family History 26 (2001): 112-137; Martin Pumphrey, “The Flapper, the Housewife, and the Making of Modernity,” Cultural Studies 1 (1987): 179-194; and Paula S. Fass, The Damned and the Beautiful: American Youth in the 1920’s (New York: Oxford University Press, 1977). 10. Phyllis Blanchard and Carolyn Manassas, New Girls for Old (New York: Macauley Company, 1930), 5, 13. 11. Silvia Canetto discusses cultural scripting in “Meanings of Gender and Suicidal Behaviour during Adolescence,” Suicide and LifeThreatening Behaviour 27 (1997): 339-351. See also Canetto and Lester, “Gender, Culture, and Suicidal Behaviour.” 12. This definition of identity is drawn from Charles Taylor, “Modernity and Identity,” in Schools of Thought: Twenty-five Years of Interpretive Social Science, eds. Joan W. Scott and Debra Keates

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____________________________________________________________ (Princeton: Princeton University Press, 2001), 139-153. 13. Others who emphasize age as a category of analysis in the history of suicide include Bailey, ‘This Rash Act’; and Simon Cooke, “ ‘Terminal Old Age’: Ageing and Suicide in Victoria, 1841-1921,” Australian Cultural History 14 (1995): 76-91. 14. Pre-World War I working girls were thought to face sexual dangers (Kathy Peiss, Cheap Amusements: Working Women and Leisure in Turn-of-the-Century New York [Philadelphia: Temple University Press, 1989]); in the nineteenth century college studies were thought to induce ill health (Margaret A. Lowe, Looking Good: College Women and Body Image, 1875-1930 [Baltimore: Johns Hopkins University Press, 2003]). These arguments had been tempered by the post World War I years, and yet the sentiment lingered. 15. On personality see Warren I. Susman, “Personality and the Making of Twentieth-Century Culture,” in Culture as History (New York: Pantheon, 1984), 271-284; and Ian A. M. Nicholson, Inventing Personality; Gordon Allport and the Science of Selfhood (Washington, D.C.: American Psychological Association, 2003). 16. Joan Jacobs Brumberg, The Body Project: An Intimate History of American Girls (New York: Random House, 1997). 17. New York Times, 4 January 1925, p. 28 (scar); 3 December 1923, p. 13 (leg deformity); 29 June 1922, p. 7 (freckles). (Hereafter cited as NYT.) 18. Bobbed hair stories: NYT, 28 July 1922, p. 1; 11 September 1922, p. 3; and 7 September 1927 p. 3. On the significance of the hairstyle see, Ruth Shonle Cavan, Suicide (New York: Russell and Russell, 1928), 153-154. 19. Katrina Jaworski, “Suicide and Gender: Reading Suicide through Butler’s Notion of Performativity,” Journal of Australian Studies 76 (2003): 137-146. Examples of romance stories with staging include NYT, 17 March 1922, p. 1; 20 November 1922, p. 3; and 21 June 1923, p. 23. 20. NYT, 10 December 1920, p. 1 (Tevis). 21. NYT, 17 June 1922, p. 2 (Seijo). 22. Blanchard and Manassas, New Girls for Old, thought the new-style romance a gain for young women. On the flapper’s boyfriend, see Kevin White, The First Sexual Revolution: The Emergence of Male Heterosexuality in Modern America (New York: New York University Press, 1993). 23. NYT, 10 December 1920, p. 1 (Tevis); 15 October 1921, p. 1 (Wilson); 11 June 1921, p. 14 (“mangled, her head and leg fell into the street below”).

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____________________________________________________________ 24. NYT, 15 October 1921, p. 1. 25. See Silvia Sara Canetto, “She Died for Love and He for Glory: Gender Myths of Suicidal Behaviour,” Omega 26 (1992-1993): 1-17. 26. NYT, 26 September 1921, p. 5 (Farley); 2 April 1921, p. 8 (Whittum). 27. NYT, 29 June 1921, p. 7 (Hicks); 8 May 1922, p. 1 (Gallagher). 28. Linda Steiner, “Construction of Gender in Newsreporting Textbooks, 1890-1990,” Journalism Monographs 135 (1992). 29. Canetto, “She Died for Love and He for Glory.” 30. NYT, 28 January 1920, p. 19 (Glella); 19 June 1920, p. 7 (Kluger). 31. NYT, 8 February 1923, p. 1. 32. NYT, 12 December 1924, p. 4. This story concerned the suicidal behaviour of two Radcliffe College students. College officials were “at a loss,” but the girls offered “failure in studies” as the reason. 33. NYT, 22 March 1922, p. 26; 29 May 1922, p. 2. 34. NYT, 5 February 1924, p.21 (Kingston); 19 January 1925, p.11 (Klahr); 8 March 1926, p. 2 (Tirrell). 35. NYT, 15 March 1923, p. 7 (Feinstein); 31 January 1924, p. 20 (Higgins). 36. See NYT 27 November 1926, p. 7 and 5 July 1923, p. 9. Illness could be used as a motive for suicide at any age, but was most often associated with suicide among the elderly. See Cooke, “‘Terminal Old Age.’” 37. See Kathleen W. Jones, Taming the Troublesome Child: American Families, Child Guidance, and the Limits of Psychiatric Authority (Cambridge: Harvard University Press, 1999). 38. NYT, 22 March 1922, p.26 (Cridge); 1 September 1922, p.3 (Corrigan); 8 November 1922, p. 17 (Davidson).

References Anderson, Olive. Suicide in Victorian and Edwardian England. Oxford: Clarendon Press, 1987. Bailey, Victor. ‘This Rash Act’: Suicide across the Life Cycle. Stanford: Stanford University Press, 1998. Bent, Silas. “The Art of Ballyhoo.” Harper’s Magazine 155 (1927): 485494. Blanchard, Phyllis, and Carolyn Manassas. New Girls for Old. New York: Macauley Company, 1930. Brown, Michael F. “Power, Gender, and the Social Meaning of Aguaruna

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____________________________________________________________ Suicide.” Man (new series) 21 (1986): 311-328. Brumberg, Joan Jacobs. The Body Project: An Intimate History of American Girls. New York: Random House, 1997. Canetto, Silvia S. and David Lester. “Gender, Culture, and Suicidal Behaviour.” Transactional Psychiatry 35 (1998): 163-190. Canetto, Silvia. “Meanings of Gender and Suicidal Behaviour during Adolescence.” Suicide and Life-Threatening Behaviour 27 (1997): 339351. Canetto, Silvia Sara. “She Died for Love and He for Glory: Gender Myths of Suicidal Behaviour.” Omega 26 (1992-1993): 1-17. Cavan, Ruth Shonle. Suicide. New York: Russell and Russell, 1928. Cooke, Simon. “A ‘Dirty Little Secret’? The State, the Press, and Popular Knowledge of Suicide in Victoria, 1840s-1920s.” Australian Historical Studies 31 (2000): 304-324. Cooke, Simon. “ ‘Terminal Old Age’: Ageing and Suicide in Victoria, 1841-1921.” Australian Cultural History 14 (1995): 76-91. Dumenil, Lynn. The Modern Temper: American Culture and Society in the 1920s. New York: Hill and Wang, 1995. Ewing, E. Thomas. “Personal Acts with Public Meanings: Suicide by Soviet Women Teachers in the Stalin Era.” Gender & History 14 (2002): 117-137. Fass, Paula S. The Damned and the Beautiful: American Youth in the 1920’s. New York: Oxford University Press, 1977. Fulcher, James. “Murder Reports: Formulaic Narrative and Cultural Context.” Journal of Popular Culture 18 (1985): 31-42. Hirshbein, Laura Davidow. “The Flapper and the Fogy: Representations of Gender and Age in the 1920s.” Journal of Family History 26 (2001): 112137. Jaworski, Katrina. “Suicide and Gender: Reading Suicide through Butler’s

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____________________________________________________________ Notion of Performativity.” Journal of Australian Studies 76 (2003): 137146. Jones, Kathleen W. Taming the Troublesome Child: American Families, Child Guidance, and the Limits of Psychiatric Authority. Cambridge: Harvard University Press, 1999. Kushner, Howard. “Suicide, Gender, and the Fear of Modernity in Nineteenth-Century Medical and Social Thought.” Journal of Social History 26 (1993): 461-490. Kushner, Howard I. Self-Destruction in the Promised Land. New Brunswick: Rutgers University Press, 1989. Lieberman, Lisa. Leaving You: The Cultural Meaning of Suicide . Chicago: Ivan R. Dee, 2003. Lowe, Margaret A. Looking Good: College Women and Body Image, 1875-1930. Baltimore: Johns Hopkins University Press, 2003. MacDonald, Michael and Terence R. Murphy. Sleepless Souls: Suicide in Early Modern England. Oxford: Clarendon Press, 1990. Merz, Charles. “Bigger and Better Murders.” Harper’s Magazine 155 (1927): 338-343. Nicholson, Ian A. M. Inventing Personality: Gordon Allport and the Science of Selfhood. Washington: American Psychological Association, 2003. Peiss, Kathy. Cheap Amusements: Working Women and Leisure in Turnof-the-Century New York. Philadelphia: Temple University Press, 1989. Pumphrey, Martin. “The Flapper, the Housewife, and the Making of Modernity.” Cultural Studies 1 (1987): 179-194. Robertson, Jennifer. “Dying to Tell: Sexuality and Suicide in Imperial Japan.” Signs 25 (1999): 1-31. Stack, Steven, et al.???? “Suicide and the Media: The New York Times’s Presentation of Front-Page Suicide Stories between 1910 and 1920.” Journal of Communication 44 (1994): 64-83.

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____________________________________________________________ Steiner, Linda. “Construction of Gender in Newsreporting Textbooks, 1890-1990.” Journalism Monographs 135 (1992): ???. Stevens, John D. “Social Utility of Sensational News: Murder and Divorce in the 1920’s.” Journalism Quarterly 62 (1985): 53-58. Susman, Warren I. “Personality and the Making of Twentieth-Century Culture.” Culture as History.New York: Pantheon, 1984. 271-284. Taylor, Charles. “Modernity and Identity.” In Schools of Thought: Twentyfive Years of Interpretive Social Science, edited by Joan W. Scott and Debra Keates. Princeton: Princeton University Press, 2001. 139-153. White, Kevin. The First Sexual Revolution: The Emergence of Male Heterosexuality in Modern America. New York: New York University Press, 1993.

“Voluntary Death” in Japanese History and Culture Lawrence Fouraker 1.

Introduction: Suicide as “Text”. This chapter is a rumination on the extent, nature, and significance of “voluntary death” in Japanese history in terms of persistent cultural attitudes toward this form of death held by many Japanese. Adding to this already challenging task is the intellectual baggage that Western readers bring to this topic. Think of suicide in Japan, and several striking images are apt to come immediately to mind. Typical examples of the radical Otherness of Japanese suicide in the Western public imagination are the ritual suicides (seppuku) of medieval samurai warriors or the one-way flights by fanatic kamikaze pilots in World War II. Based upon actual historical cases, these examples tend to suggest that the Japanese people are intrinsically more able and willing to die “voluntarily” than their Western counterparts. Like all stereotypes, this prevailing Western perception of the Japanese self-murder is based upon a kernel of truth. Japanese soldiers fighting in World War II in the Pacific did indeed consistently endure higher casualty rates than military historians considered sustainable, but nonetheless fought on to the death rather than surrender. The deaths of these soldiers were arguably no more “voluntary” than those of the kamikaze pilots; neither really had the free choice to live or die. These World War II soldiers were compelled to die rather than surrender because of the pernicious influence of fascist propaganda about the innate superiority of the Japanese race. Ironically, this propaganda was at least as effective in shaping the opinions of Westerners. Is it any wonder that, writing in the early 1950s, even as astute an observer as sociologist Emile Durkheim gave in to these stereotypes, proclaiming in his renowned study of suicide that: “The readiness of the Japanese to disembowel themselves for the slightest reason is well known.”1 Despite the ongoing prevalence of images of the Japanese as modern-day samurai warriors who slice themselves open on the least provocation, and recent news stories of Japanese businessmen who literally work themselves to death (karôshi), for the most part, in neither methods commonly used nor in average suicide rates has Japan significantly diverged from other countries. Japan currently ranks eleventh in the world in its rate of suicide (see the following chart). But this comparatively high suicide rate is actually a recent phenomenon. Until the late 1990s, Japan’s suicide rates were closer to the average of developed

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____________________________________________________________ countries, ranking behind both France and Austria. Japanese suicide rates only began climbing from this average in the late 1990s, rising 7% in a single year to reach a record 34,427 in 2003. 2 World’s Highest Suicide Rates 3 (annual, per 100,000 population)

1 2 3 4 5 6 7 8 9 10 11 12 13 15 17 19 27 43 45 48 71 77 83 93

Country LITHUANIA RUSSIAN FEDERATION BELARUS UKRAINE SRI LANKA LATVIA KAZAKHSTAN HUNGARY ESTONIA SLOVENIA JAPAN BELGIUM

Total 46.9 40.6 34.8 31.1 30.7 30.1 29.5 28.9 28.8 27.5 24.3 21.3

Males 80.7 69.3 60.3 52.1 44.6 48.4 50.2 45.5 47.7 44.4 35.2 31.2

Females 13.1 11.9 9.3 10.0 16.8 11.8 8.8 12.2 9.8 10.5 13.4 11.4

Year 02 02 01 00 91 02 02 02 02 02 00 97

FINLAND AUSTRIA SWITZERLAND FRANCE CHINA (select areas) INDIA USA SINGAPORE THAILAND MEXICO PHILIPPINES EGYPT Country

21.3 19.6 19.3 17.8 13.9 10.7 10.6 9.2 4.0 3.2 2.1 0.1 Total

32.3 30.5 27.8 26.1 13.0 12.2 17.1 11.5 5.6 5.4 2.5 0.1 Males

10.2 8.7 10.8 9.4 14.8 9.1 4.0 6.9 2.4 1.0 1.7 0.0 Females

02 02 00 99 99 98 00 01 94 95 93 87 Year

Where the culture of suicide in Japanese history has indeed diverged strikingly from values prevailing in the West involves Japanese attitudes towards those who die in this manner. Many (if by no means all)

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____________________________________________________________ Japanese have tolerated or even admired those who took their own lives. In a related tendency, with a history of at least several hundred years, there have also been many who searched for meaning in the suicide of fellow Japanese. Thus, many Japanese not only did not automatically scorn selfmurder, but have also tended to read suicides as “texts,” containing a potentially deeper meaning. Surely the tendency to find meaning in suicide has contributed to the tolerance or even respect many Japanese have shown for this form of death. A variety of cultural factors pertain to attitudes toward voluntary death in this distinctly non-Western culture. Though Buddhist religious leaders have repeatedly denounced suicide, as a predominately nonChristian country, Japan lacks the strong religious condemnation of suicide as a mortal sin. Other influences include notions of reincarnation coming from the imported Indian religion of Buddhism. (The novelist Mishima Yukio, whose suicide we turn to next, claimed he would be reborn seven times). Japanese acceptance and even preference for “groupism” over individualism, may have translated into less emphasis on the sanctity of individual lives. The historical cultural heritage of samurai seeking “death before dishonour” is surely another important factor. To the extent that Japanese attitudes toward suicide are culturally determined, one might expect traditional attitudes toward those who take their own lives to dissipate as Japan underwent rapid modernization (and Westernization) from the late 19th Century. Yet public reactions to a series of suicides of novelists and intellectuals throughout the 20th century demonstrate a striking persistence of traditional attitudes. Even today, in spite of the ongoing globalization of popular culture, many Japanese still evince considerable respect for suicide, even in the shocking cases of mother-child “suicide.” The persistence of these attitudes suggests that a strong emotional resonance of traditional attitudes toward voluntary death constitutes part of the core cultural identity of the Japanese people. 2.

Voluntary Death as Japanese Culture. 25 November, 1970. Japanese novelist Mishima Yukio strode onto the balcony of the Self-Defense Force Headquarters at Ichigaya. After haranguing the crowd below, reading them his “Manifesto” lambasting Japan’s materialism and disrespect for traditional values (designed to rouse the “soldiers” to action), he shouted out three times: “Long Live His Majesty the Emperor.” Then, after retreating inside the building, in the midst the jeers of the young Self-Defense Force volunteers below, Mishima carried out a samurai-style seppuku suicide, slitting his bare abdomen with a razor-sharp short sword, and then literally disembowelling himself with a vertical cross stroke.4 Morita Masakatsu,

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____________________________________________________________ close follower of Mishima and member of his militaristic Shield Society, tried to serve as Mishima’s “second” by beheading the bleeding author with a long sword, but failed. Another Society member Koga Hiroyasu successfully completed Mishima’s beheading, and then cut off Morita’s head as well after the latter’s botched attempt to follow Mishima in ritual suicide. How did the Japanese “read” the text of Mishima’s suicide? Though a few were impressed with his self-sacrifice, Mishima’s suicide engendered surprisingly little sympathy. Perhaps Mishima’s invoking the samurai tradition of seppuku struck some Japanese observers as anachronistic nonsense. A roughly contemporary perspective on samuraistyle self-destruction was the movie “Seppuku” (1962, directed by Kobayashi Masaki). This film brutally emphasized the cruelty and barbarism of the seppuku custom, as a desperate young samurai in the early 17th Century was forced to carry out the ritual act with a bamboo sword, having pawned his real sword due to poverty. But there is considerable complexity in the meaning of suicide in this film. Though the death of this young samurai is cast as a cruel waste, the film’s hero is the young samurai’s father-in-law Tsugumo Hanshiro (played by Nakadai Tatsuya), who sacrifices his own life in pursuit of revenge. The film concludes with a dramatic sword fight in which Tsugumo takes on all of the samurai who wronged his son-in-law. Tsugumo is of course doomed, but comes across as a tragic hero, one who upholds the honour of the samurai tradition. One possible reading of the popular response to Mishima’s death in Japan is that the traditional respect for suicide was on the wane. Alternatively, the scorn many Japanese felt for Mishima could be seen as confirming the strength of that traditional respect for suicide. In this view, Mishima sullied the mythical image of heroic samurai that lurks in the Japanese (as well as the Western) imagination. Mishima’s death seems in this light to have been more likely the product of egoism than selflessness or heroism. In any case, as the method of Mishima’s suicide suggests, one key to understanding the culture of suicide in Japan lies in the past, in the traditional values embedded in its long history. 3.

The Samurai Cult of Death. “The Way of the Samurai is found in death.”5 The opening line of Yamamoto Tsunetomo’s Hagakure seems to confirm that the “Way of the Warrior” (Bushidô) is in fact a cult of death. Yet Yamamoto penned these lines in 1616, a year after the last significant samurai battle for more than two centuries. In other words, this “classic” of Bushidô was actually the product of an age of peace, not a time of war.

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____________________________________________________________ Not only are some of the most-cited glosses upon the “Way of the Warrior” (bushidô) a later construct. Further complication emerges from a study of the centuries of battle from which samurai practices of selfmurder actually emerged. For it turns out that voluntary death among warring samurai was actually quite rare. Earlier versions of Bushidô are more aptly called the “Way of the Bow and Arrow” (kyusen no michi) or the Way of the Bow and Horse. Even Tsunemoto’s famous opening lines about the way of the samurai being death can be read not so much as an endorsement of suicide as advise to be prepared to die and to not cling to life. It is, in short, a call to bravery, not a celebration of suicide. Certainly death itself was no stranger to the warring samurai of medieval Japan. The 11th Century Konjaku Monogatari recounts some of these early battles, which resulted in the display of the severed heads of defeated enemies. But many other battles were individual confrontations between two warriors, with much lower casualty rates. Mass slaughter on Japanese battlefields came only with the arrival of Western muskets in the late 16th Century. While many samurai even during ages of warfare died of old age, the practice of ritual suicide by samurai warriors (seppuku) does indeed occupy a prominent place in most considerations of suicide in Japan. The first probable case of seppuku was by Minamoto Tametomo, scion of a warrior family facing defeat by the Taira clan in 1170. Gradually the selfmurder by samurai sword became a ritual, with a “second” (kaishakunin) to lop off the dying man’s head, ideally after he has carried out the excruciating second “crosswise” cut (jumonji; literally “in the shape of [the Chinese character for] ten”) to fully disembowel himself. By the Tokugawa age (1600-1868), seppuku had become a Shintô-influenced ritual replete with ceremonial cleansing and pristine white cloths. In addition to the chief original motive for seppuku, to prevent capture by an enemy, there were other causes. Suicide for remonstration (kanshi) was a way to subtly influence one’s superior, who you would not dream of directly criticizing. In 1553, for instance, Hirate Nakatsukasa Kiyohide apparently took his life to encourage the young general Oda Nobunaga to alter his behaviour. One might consider Mishima Yukio’s death to fit at least loosely in this category as well, since he hoped to change the course of Japanese history with his act. Another type of seppuku was to make amends for one’s own wrongdoing (sokotsu-shi). Not a particularly common cause of death, it evinced a popular response in the premodern media. One famous case was of the Warring States general Yamamoto Haruyuku who launched a suicidal attack against the enemy to compensate for his own actions which endangered his lord in 1561. Wounded, he retreated from the fray to take his own life.

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Fact and Fiction: Gauging Medieval Attitudes. The fact that Yamamoto wrote his Hagakure in the Tokugawa period is full of insight to that peculiar and yet formative age for traditional Japanese culture and attitudes toward death. Following more than a century of war, the Tokugawa shôgun initiated policies designed to keep the country at peace. These policies were so successful that some samurai (and indeed, as we shall see, some non-samurai as well) looked back longingly to a golden age when warriors actually “lived by the sword.” Most historical cases of seppuku were a product of the Warring States period (1467-1600) preceding the “pax Tokugawa.” In addition to its practical purpose, offering an alternative to the disgrace of capture by one’s enemy, Seppuku was also uncontestable proof of a warrior’s loyalty and bravery in the face of death. During the two-and-a-half centuries of Tokugawa peace that followed the Warring States era, instances of seppuku were few and far between. But another type of suicide attracted great attention during the Tokugawa age—the suicide of lovers. The poignant emotional tragedy of lovers who saw no way other than to die together also became the topic of popular puppet plays and Kabuki dramas, often based on real-life incidents. Chikamatsu Monzaemon (1653-1725) wrote two of the undeniable masterpieces of Japanese drama dealing with the actual suicides of ill-fated lovers: “Love Suicides at Sonezaki” (Sonezaki Shinjû, 1703) and “Love Suicides at Amijima” (Shinjû ten no Amijima, 1721) 6 These poignant tear-jerkers, popular with theatre audiences from Chikamatsu’s time on, are dramatic largely because of the irresolvable dilemmas between duty and passion, chronicling the inevitable tragedy of impoverished lovers who find no way to remain together other than death. In a sense, the actual love suicides upon which Chikamatsu’s plays were based, as well as the plays themselves, constituted a tacit protest against the overarching power of the state. (The role of suicide as “text” in Japanese culture is strongly influenced by this historical background.) The Tokugawa Bakufu (literally “tent government”, a military rule by a hereditary line, to be distinguished from the imperial government in Kyoto) repeatedly banned these plays because of their potentially subversive message, even though they were always set in a fictional ancient setting. Yet another form of self-immolation in traditional Japan was “following one’s lord” in death (junshi). In times of war, this was a desperate act by samurai whose lord had fallen in battle. Rather than become “masterless samurai” (rônin), and in deference to their leader, they chose to die. Junshi had never been a particularly common cause of

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____________________________________________________________ death. Most samurai preferred to live on as rônin rather than die in this manner. But in the mid-17th Century, as Japan became a country at peace, the incidence of junshi was on the rise. Furthermore, these were cases of samurai who willingly died after the death of their daimyô from illness. Following a case in which twenty-six followers of Nabeshima Katsushige in 1657, the Bakufu (government) formally prohibited junshi.7 5.

Traditional Death in Modern Times. After the Meiji Restoration of 1868 Japan’s leaders issued order after order designed to destroy the immediate past and build Japan into a modern nation. Yet old ideas and attitudes persisted. The 20 th Century was only a few years old when the Japanese public was shocked by a suicide. In 1903 a promising higher school student named Fujimura Misao lept to his death from Kegon Falls. As a wave of copycat suicides took place, pundits feared the social consequences of these “anguished youth.” Many observers, at the time and since, attributed the suicide of Fujimura and other “anguished youth” to their social isolation and loneliness, portraying their anguish as the inevitable product of their pursuit of individualism. In this view, by breaking with convention and setting out to fulfil their individual potential, these young people inevitably became anguished as they abandoned traditional values and destroyed their relationship with their families and society. What actually motivated Fujimura to take his young life is debatable. His cryptic suicide note, carved on the tree above the falls where he plunged to his death, makes no mention of loneliness or isolation, but rather refers to his personal engagement with deep philosophical problems and the meaning of life. Indeed, what was so shocking about Fujimura’s case for many Japanese was that he was dying not for the sake of country or emperor but for his own individual reasons. Here is the text of Fujimura’s suicide note, “Thoughts from the Precipice” (gantô no kan), 1903: The philosophy of Horatio What means it in the end? All truth is but one word Unfathomable. Anguished, I think of this. In the end I decide on Death. Quiet. Quiet. Heaven and earth, past and present, Far, far distant. How to measure their greatness With my humble self. 8

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____________________________________________________________ Fujimura’s disenchantment with the power of ideas to explain existence had led him to a personal dilemma. His attempt to escape this intellectual dilemma through suicide terrified many Japanese, but inspired many others. For those who scorned him, his willingness to die for what they saw as trivial personal reasons suggested the need to inculcate traditional values more thoroughly among an increasingly individualistic younger generation. For those who admired him, Fujimura stood as a rejection of the call for young people to dedicate their lives to making themselves and the nation strong and rich. He was seeking deeper truths. Founder of the Iwanami publishing house Iwanami Shigeo recalls that many young people in those days were moved to tears by Fujimura’s anguish, which they saw not as the result of loneliness or isolation but as proof of his commitment to the search for answers to the questions they were all asking: “Where did I come from? Where am I going?” 9 (Note that both Fujimura’s detractors and his supporters stressed the individual motivation for his death, rather than the act of suicide itself, reflecting the fairly tolerant attitude toward suicide in Japanese culture.) Twenty years after Fujimura’s death, we encounter the death of an unusual intellectual and writer. Arishima Takeo (1878-1923) was a popular Japanese novelist and a founding member of the White Birch Society, an influential literary group advocating humanism and individualism. The last few years of Arishima’s life, and the manner in which he died, has provoked as much interest and controversy as any of his fictional works. The events leading up to his death seem to form a tragic teleology. From around 1920 he produced few works of fiction, suffering, literary critics argue, from an insoluble writer’s block. Then, in 1922, Arishima published “One Declaration,” an essay that predicts the collapse of the bourgeoisie of which he was a member, and denies the possibility of any productive involvement of people like himself in the working-class movements that were about to transform Japanese society. Many observers at the time and since have read this essay as a confession of Arishima’s social irrelevance due to his inability to participate in social change. The dramatic denouement of Arishima’s life came in 1922-1923, when he gave away his inherited land in Hokkaido, and then committed suicide with a married journalist. Yet my own research convinces me that, far from the desperate act of a tortured soul, Arishima’s suicide was actually the culmination of years of earnest pursuit of individual self-fulfilment. And the particular character of Arishima’s self-fulfilment through suicide reflects the powerful influence of traditional Japanese culture on what was in most respects a thoroughly modern man. On 9 June 1923 Arishima and Hatano Akiko, a journalist for the

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____________________________________________________________ Fujin Kôron, hung themselves in the Arishima family house in the resort town of Karuizawa. The best explanation of their death is found in Arishima’s 1920 essay, “Love the Plunderer,” which firmly endorses the view that even in death Arishima was seeking to fulfil his project of selfrealization. This essay serves as an indispensable corrective to the view that Arishima died to escape feelings of doubt and anguish. The connection between Arishima’s complex and unorthodox view of love and his death with Hatano Akiko in Karuizawa emerges in the following passage from “Love the Plunderer,” dealing with the ultimate realization of love in the impulsive life: Love takes as much as possible from the outside world, leading to the growth and freedom of one’s individuality. Beginning close at hand, love carries back its plunder from every which way. The stronger a person’s individuality, the more striking is love’s action. If I take all of the person I love, and in turn, all of me is also taken, at that time, we two become one. Thereupon, nothing remains for me to take, and nothing remains to be taken from me. Therefore, at such a time, my love’s death is my death. Following one’s lord to the grave or love suicide in this way is extremely natural. Even if the love between two people does not take from each other completely, if my love can intensively do its work, my individual growth will broaden more and more. In this manner, a certain world—a world unbound by time and space—will be firmly formed within my individuality. The ceaseless expansivity of this world will break my hitherto existing habits, change my life, and finally, destroy my weak and short-lived body. Thereby, my body will explode. In the final analysis, what does this sort of “selfdestruction” indicate for those who attack my view? Simply the loss of one’s physical body, and nothing more? We are human. Eventually humans must die. Eventually our bodies will decay. No matter what we do, we cannot avoid this. But if I were to die on behalf of love, these people would be wrong to think that therefore the growth and freedom of my individuality were lost as well. My physical loss is not my individuality’s loss. The ruination of my body goes

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____________________________________________________________ hand in hand with the expansion of the growth and freedom of my individuality.”10 A serious reading of this passage in light of Arishima’s steadfast sincerity and lifelong pursuit of consistency between thought and action makes it hard to see Arishima’s suicide together with his lover as nihilistic or the product of anguish and doubt. Indeed, in this essay Arishima pities those who were so afraid of death that they dared not truly love. In a short poem published two months before his death in his own magazine, Arishima explored the relationship between love and death. At the burning peak of love, he wrote, an embrace is insufficient. Death is what such a lover wants. So death arrives at the very moment life achieves its fullest glow in love. “What a contradiction!” Arishima concluded.11 This poem shows how Arishima privileged emotion above rationality. He was well aware that in terms of rational thinking it was contradictory or even foolish to seek to realize oneself in death, yet he believed that death was the highest culmination of love in the emotional impulsive life. Virtually every aspect of Arishima and Hatano’s suicide conform to the view of love suicide found in “Love the Plunderer.”And the letters Arishima left behind in the Karuizawa house were also consistent with his philosophy of love, what he told Asuke, and the letter of Akiko’s just cited. In two of these letters, one to Akiko’s husband, and the other to Arishima’s mother and three sons, he provided little explanation for why he was dying, but basically merely asks their forgiveness. He was apparently aware that to explain his death to these people was an impossible task. He told his mother and three sons that “I know that to act in this way is abnormal (ijô).”12 But, he continued, “it cannot be helped.” His farewell letter to his family ended with the seemingly cold: “Until it came to this decision, how much I loved you!” It seems that at the time of his death, Arishima’s love towards Hatano Akiko knew no bounds, even to the extent of making the love he felt for his children and mother only relative. In terms of the philosophy of “Love the Plunderer,” one would have to conclude that Arishima died a satisfied man, even as he acted in a manner sure to bring grief to his family. In Arishima’s final three letters he is more explicit about why he and Hatano Akiko were taking their lives, probably thinking it more likely that his siblings (who were fellow artists) and friends could understand his decision to die than his mother and children. Writing at midnight on the train to Karuizawa, he told his younger siblings that since he fell in love with Akiko, he had “realized my true fate for the first time in my life.” He emphatically stated that their death together had absolutely nothing to do with any outside pressure. Rather, the two were full of freedom and joy as

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____________________________________________________________ they faced death. He reported that even as the train arrived at Karuizawa, he and Akiko were laughing and chatting happily with each other. He asked his siblings to consider he and Hatano “apart from convention.” Likewise, in his brief note to Asuke Soichi, Arishima reported that they had finally arrived at the dark Karuizawa villa, drenched from their long walk in a heavy downpour, but that far from feeling gloomy, they were as playful as two infants. Why? “Until this moment, I had not realized that death is nothing in the face of love.” (He also asked Asuke to help take care of Arishima’s children, by providing them with the royalties from his writings.) The note concluded with the frank remark that their bodies would probably be rotten by the time they are discovered (indeed they were). In Arishima’s final letter, to Morimoto Kôkichi, his close friend since they were students together in Hokkaido, he requested that Morimoto keep an eye on the communal farm, and once again insisted, for the last time: “We are dying together at the peak of our love. We are not dying because someone is threatening us.” Further insight into Arishima’s death emerges in his Master’s thesis, a review of the entire course of Japanese civilization from its origins to the 19th century, written (in English) at Haverford College.13 In the same way he had pondered what had motivated Fujimura Misao to kill himself, in his thesis Arishima is fascinated by the highly emotional motives that led characters in Tokugawa-era drama to commit love suicide. He reveals the degree to which he treasures the emotional side of life. He deplores how the feudal Tokugawa regime used the imported philosophy of Confucianism to stifle the free expression of the Japanese people’s native sensitivity and sentiment, which he saw as an excellent cultural trait of the Japanese, and probably the only means they could make “some important contribution to the general progress of the world.” In the context of a Tokugawa clampdown on the free expression of feelings, the Japanese had to find some outlet for their innate emotional expressiveness. Thus, Japanese commoners (and indeed, many samurai as well) became great fans of the urban performing arts. Arishima saw this drama to have reached its peak in Chikamatsu Monzaemon, who he praised as “Japan’s Shakespeare,” and “a powerful defender of the true Japanese sentiment and character.”14

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____________________________________________________________ Yet another famous Japanese intellectual and novelist took his own life only a few years after Arishima and Hatano. The death of Akutagawa Ryonusuke in 1927 was at first glance a drastically different case. His oft-cited “Letter to a Dear Old Friend,” offers a much less clear explanation of his death than Arishima’s writings. Yet both ultimately did choose a “voluntary” death in pursuit of self-realization. That one cannot literally pursue self-realization through death escaped them both. 6.

Today’s World: Terrorism and Culture Redux. A few years after the deaths of Arishima and Akutagawa, with its 1931 invasion of Manchuria, Japan began its march down the path toward World War II in Asia. As we noted in the introduction, Japanese units in the Pacific War suffered casualty rates higher than fighting men in any other conflict. The defense of reinforced Pacific islands such as Iwo Jima could be called a form of “voluntary death,” as virtually the entire Japanese population of the island was eliminated rather than surrendering. Likewise, the one-way pilots of suicide torpedoes, bombs, and the notorious kamikaze pilots also seem to be in the tradition of suicidal behaviour. But I consider these to be a separate case, since the coercion of fascist Japan during the “Fifteen Year War” from 1931 to 1945 made these decisions far from voluntary. (Sometimes this was literally true; one survivor of the supposedly all-volunteer Kamikaze corps reported that he was “ordered to volunteer.”) Instead of that gruesome history, let us conclude with two more recent stories, horrifying enough in their own right. In January 1985 a 33-year-old Japanese housewife walked into the waves off Santa Monica, California. She took her 4-year-old son and infant daughter with her. Pulled from the water by two passing college students, Mrs. Kimura Fumiko survived to stand trial for the murder of her children, who drowned. She insisted that she had not intended to live, but was seeking to die and by taking them with her, to save her children from the horrors of life without a mother. For most Americans, regardless of any extenuating factors, Kimura was clearly a murderer. Yet in Japan, it is a common defense that such cases are not simply murder, but “parent-child suicide” (oya-ko shinjû). This form of “suicide” is illegal in Japan, but is generally punished more lightly than murder. Kimura’s attorney did not stress this cultural explanation for her behaviour at the trial, but rather argued that his client was temporarily insane. But the 20,000 signatures from Los Angeles Japanese Americans on a petition for leniency may well have swayed the judge’s sentence. The petition argued that in such cases, “the mother’s intent is to save the child from a life of suffering without her.” Indeed,

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____________________________________________________________ Kimura herself claimed that her children were “extensions of her.”15 For this Japanese mother, her death was really the same thing as the death of her children; she did not grant them an individual existence. Mrs. Kimura seems to confirm an ongoing distrust of individualism and borderline admiration for suicide among today’s Japanese. The response to Kimura’s case also suggests that the emotional resonance that Arishima Takeo had for love suicide in the plays of Chikamatsu persists in the attitudes of many Japanese (and Japanese Americans). As a penultimate example of this, consider one of the leading members of a small Japanese terrorist group, the Red Army. Three members of this group carried out a gruesome attack in the arrivals terminal of Tel Aviv’s Lod Airport in May 1972. These Japanese terrorists murdered 26 travelers (mostly Puerto Rican nuns) and wounded 76 other bystanders.16 One of the three apparently threw himself onto his own hand grenade after he ran out of machine gun ammunition. The only surviving member of the terrorists was Okamoto Kozo, who had also tried to kill himself by throwing grenades at a plane on the runway. Only when the plane did not explode did Okamoto try to escape. Only after the Israeli officer interrogating Okamoto, Major General Rehavam Zeevi, promised the Japanese terrorist a gun and a single bullet to commit suicide did Okamoto begin to talk. 17 Interviewed in jail, Okamoto spoke of his admiration for Japanese traditions of suicide old and new: “Even though Mishima and other Japanese suicide heroes believed in anti-revolutionary or reactionary ideologies, their emotions were the same as those of revolutionaries.”18 Denied his wish death, Okamoto was freed in a prisoner exchange in 1985 with the Palestinians, and welcomed as a hero by Qaddafi in Libya. Okamoto clearly displays both a flawed revolutionary consciousness and an ongoing grudging respect for traditional forms of voluntary death. Similar sentiments linger in the innermost emotional attitudes of many Japanese to this day.

Notes Emile Durkheim, Suicide: A Study in Sociology (New York: The Free Press, 1951), 222. Durkeheim was, of course, doubly wrong. Not only were the reasons for Japanese suicide far from trivial to those who died, but instances of suicide in Japan were not as numerous as he implied. 2. “Record 34,427 took own lives last year,” Japan Times. July 23, 2004. 3. “Suicide Rates,” World Health Organization (WHO), June, 2004. Rates are listed by gender, and are not totalled or ranked. I have included a sample of twelve other countries for comparison. Online: 1.

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____________________________________________________________ http://www.who.int/mental_health/prevention/suicide/charts/en/ The characters for seppuku may also be read (in reverse order) as hara-kiri, literally “belly-cutting.” 5. William S. Wilson, trans., Hagakure: The Book of the Samurai of Yamamoto Tsunetomo (Tokyo: Kodansha International, Ltd., 1979), 17. 6. Steven Heine, “Tragedy and Salvation in the Floating World: Chikamatsu’s Double Suicide Drama as Millenarian Discourse,” The Journal of Asian Studies 53, no. 2 (May 1994): 367-393. 7. Ikegami Eiko, The Taming of the Samurai: Honorific Individualism and the Making of Modern Japan (Cambridge, Massachusetts and London, England: Harvard University Press, 1995), 219. 8. Earl H. Kinmonth, The Self-Made Man in Meiji Japanese Thought: From Samurai to Salary Man (Berkeley, Los Angeles, London: University of California Press, 1981), 207. 9. Sumiya Mikio, Nihon no rekishi [History of Japan] (Tokyo: Chûô Kôron-sha, 1974), 22-196. 10. Arishima Takeo, “Oshiminaku ai wa ubau,” [Love the Plunderer] Arishima Takeo shû (Tokyo: Chikuma Shobô, 1987), 345. 11. Arishima Takeo, “Shi e no itsudatsu,” [Deviation to Death] Arishima Takeo zenshû, (Tokyo: Chikuma Shobô, 1985), 9: 157-158. 12. The letters discussed here are found in Arishima Takeo zenshû, 14: 666-669. 13. Arishima Takeo, Development of Japanese Civilization from the Mythical Age to the Times of Decline of Shogunal Power, Masters Thesis, Haverford College, 1904. 14. Arishima, “Development of Japanese Civilization,” 243-244. 15. “Japanese Mom who drowned children given probation,” Houston Chronicle, November 22, 1985, 2. 16. Ian Black, Israel’s Secret Wars: A History of Israel’s Intelligence Services (New York: Grove Press, 1992), 269. 17. William R. Farrell, Blood and Rage: The Story of the Japanese Red Army (Lexington, Massachusetts and Toronto: D.C. Heath and Company, 1990), 139. Despite making his promise in writing, Zeevi did not in fact offer Okamoto a gun. 18. Robin Morgan, The Demon Lover: The Roots of Terrorism (New York: Washington Square Press, 2001), 172. 4.

References Black, Ian. Israel’s Secret Wars: A History of Israel’s Intelligence

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____________________________________________________________ Services. New York: Grove Press, 1992. Durkheim, Emile. Suicide: A Study in Sociology. New York: The Free Press, 1951. Eiko, Ikegami. The Taming of the Samurai: Honorific Individualism and the Making of Modern Japan. Cambridge, Massachusetts and London, England: Harvard University Press, 1995. Farrell, William R. Blood and Rage: The Story of the Japanese Red Army . Lexington, Massachusetts and Toronto: D.C. Heath and Company, 1990. Heine, Steven. “Tragedy and Salvation in the Floating World: Chikamatsu’s Double Suicide Drama as Millenarian Discourse.” The Journal of Asian Studies 53, no. 2 (May 1994): 367-393. Lawrence Fouraker is Assistant Professor at the Department of History St. John Fisher College Rochester, NY 14618. Mikio, Sumiya. Nihon no rekishi [History of Japan] .Tokyo: Chûô Kôronsha, 1974. Morgan, Robin. The Demon Lover: The Roots of Terrorism. New York: Washington Square Press, 2001. Wilson, William S., trans. Hagakure: The Book of the Samurai of Yamamoto Tsunetomo. Tokyo: Kodansha International, Ltd., 1979. Takeo, Arishima. “Oshiminaku ai wa ubau.” [Love the Plunderer] Arishima Takeo shû. Tokyo: Chikuma Shobô, 1987. 345. Takeo, Arishima. “Shi e no itsudatsu.” [Deviation to Death] Arishima Takeo zenshû. Tokyo: Chikuma Shobô, 1985. Takeo, Arishima. Development of Japanese Civilization from the Mythical Age to the Times of Decline of Shogunal Power. Masters Thesis, Haverford College, 1904.

Part IV Medics Facing Death and Dying

Medics Facing Terminal Diagnosis Angela Armstrong-Coster Just as cats are not supposed to bark or pigs to fly, doctors are not supposed to become ill or to die. 1 This chapter explores and endeavours to explain the position of doctors who are themselves facing a terminal cancer diagnosis. It examines how professional medical knowledge influences how clinicians behave when they are ill and investigates, in more depth than I have previously, the interactions between medics and the doctors responsible for their treatments. 2 To learn more about the identity shift undergone by doctors who are dying, it is necessary to establish the relationship between the medical perspective and doctors. This chapter, therefore, begins by providing a thumbnail sketch of the roots of medicine, before moving on to examine how doctors perceive illness. To cast light on why some doctors find it difficult to consult with their colleagues about their own health, it applies both anthropological and sociological theory. The chapter will conclude with a case history of a woman doctor, Louise, who developed breast cancer, and focuses on the shifts in identity which she experienced over the course of her illness. It seems trite to observe that no one expects to be stricken with a terminal illness. Perceptions of the future seldom allow for the prospect of chronic or terminal illness. The present is most usually spent not just editing and reliving our past but also preparing for a future into which all our hopes are projected.3 It is this comfort zone that is threatened by the prospect of a terminal diagnosis.4 5 However, individuals who become ill find themselves challenged, not only physically by their symptoms, which constitute the illness for them, but also are subject to the shock of a disruption in both lifestyle and social role.6 This is particularly problematic as the flourishing of individualism in the West has encouraged the belief that lives unfold as orderly projects. 7 Once subsumed into the medical world, the patient is treated as an entity which has lost control and it is this rupture of power which medicine promises to repair.8 The goal of medicine is to restore optimal order to lives interrupted by the turmoil caused by ill health; doctors regard disease as disorder.9 10 History records how humanity has conceptualised, comprehended and classified illness and even in the earliest societies, individuals commonly cast around for explanations of illness, making a connection between sickness and sin.11 Thomas has traced these attitudes to biblical times and quotes Exodus which reads:

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Medics Facing Terminal Diagnosis

____________________________________________________________ If thou wilt diligently hearken to the voice of the Lord thy God, and wilt do that which is right in his sight, and wilt give ear to his commandments, and keep all his statutes, I will put none of these diseases upon thee, which I have brought upon the Egyptians: for I am the Lord that healeth thee.12 As societies progressed into classical antiquity, a corpus of medical thought evolved around the Mediterranean, focused on Greece, which was significantly influenced by Galen (AD c.130-c.200). This secular attitude to disease perceived illness as an entirely natural event, not influenced by sin but initiated by natural causes.13 The philosophies underlying this pragmatic approach to disease were carried by the Arabs into a Europe held wholly and firmly in the grip of the Roman Catholic religion. In the face of a society which appeared almost fatalistic in its attitude toward disease, it might seem surprising that Galenic principles would survive and graft successfully on to the Christian ethos. Gradually Enlightenment thinking took root and the intellectual atmosphere in Europe warmed sufficiently to support the exciting new shoots of knowledge which emerged, science became propagated by secularisation and the early medics were quick to exploit and develop its potential. 14 The Christian conceptions of disease came to serve as the rootstock on which Galenic ideas would propagate successfully and both schools of thought fused and flourished in chimerical symbiosis. To establish how bio-medicine gained dominance in perception and practice about disease and treatment, it may be interesting to observe that by the end of the sixteenth century, the early medics (physicians, apothecaries and barber-surgeons) whose fields had once been blurred, had become organised and established formally into separate professional groups: The Royal College of Physicians, the Worshipful Society of Apothecaries and the Company of Barber-Surgeons.15 Now officially recognized as distinct and separate fields, they were aware of the threat posed to them by the unlicensed ‘quacks’ on the fringes and were keen to distinguish, distance and delineate themselves away from these mountebanks.16 This point of segregation between those who considered themselves professionals and those they dismissed as charlatans is critical to the arguments within this chapter. It is important to note that, in marking off their territory, disassociating and divorcing themselves away from the work of those they considered to be frauds, the physicians who would grow to become the most prestigious of the groups were effectively erecting a bastion within which their own strain would proliferate and be

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____________________________________________________________ preserved in a pure, innocent and authentic form.17 The power to do this lay in the strength of medicine’s collegiate and professional status, its ability: To preserve and extend the medical access to its clientele by limiting and subordinating adjacent occupations. The possession of a knowledge base and access to patients as clients leads in the work place to considerable privileges in the form of occupational autonomy and control over the process by which the service is delivered.18 This power to silence those whom it condemned as ‘other’ was effective because of the physicians’ claim to an expert knowledge disseminated officially in approved schools of medical excellence. Bio-medicine’s strength rests too on the authoritative assertions it makes about its capability to cure as a result of its fast expanding knowledge and skills and over which it still attempts to maintain its monopoly.19 20 Where and how do doctors acquire their knowledge? Illness is culturally constructed; the manner in which individuals behave when ill is significantly effected by the culture which informs their beliefs.21 Kleinman proposes that there are three structural domains that contribute to health care: professional, popular and folk, arguing that each domain exercises its own perception of how the world is structured and possesses accordingly its “own explanatory systems, social roles, interaction settings, and institutions”.22 Modes of thought, or “habits of mind”, prevalent within domains stem from the educational and social ethos disseminated within these specific cultures. However, institutions are not vacuums but constructions of the individuals who build them.23 In turn, the individuals involved become dependent on those same institutions to order their thinking and shape their culture.24 This knowledge structures the activities, conduct and emotions influencing expectations of how members of that profession should behave.25 Along with technical skills, medical schools, having their own normative sub-culture, disseminate the various social rules and the cultural ethos that dominate within the medical domain, educating potential candidates about the values and norms which constitute and define the physician’s role. 26 The mind set governing bio-medicine, which dominates all other types of illness and healing, is therefore worthy of scrutiny. 27 The cost of the extension of human life, unfortunately, appears to be a dehumanisation of the sick. Leriche, quoted by Arney & Berger, argues that: “If one wants to define disease it must be dehumanized… In

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____________________________________________________________ disease, when all is said and done, the least important thing is man. [sic]”.28 But should this “objectivizing of the sheer fact of being alive” mean that the junior physician has to learn how to “transform human beings into subjects” reducing the patient to the status of an object?29 30 Medical training involves both the intellectual challenge necessary to assimilating the biological facts vital for the position and learning the psychological rigours entailed in confronting and conducting, for example, autopsies on cadavers. Conrad describes how medical students work on corpses where: “certain ‘intimacies’ were allowed, such as putting one’s hand inside a human body or removing internal organs, that were unavailable to most people.”31 Work like this calls for an ability to separate “soma from persona.” And would appear to be particularly difficult. The acquisition and management of such skills, unfortunately, entail a ‘hardening’ of self and carry also moral responsibility and duty. 32 33 Merton argues that: They are, presumably, values which serve as effective means to a socially important end… [namely] facilitating sound medical practice. … Medical schools are socially defined as the guardians of these values and norms.34 What messages regarding personal health are transmitted and received in medical colleges? As institutions, they tend to promote the idea that, somehow, doctors are a breed apart; highly competent experts not subject to the ailments afflicting more ordinary mortals. Medical culture attempts to present itself as a dichotomy to those whom it treats; there are patients and, then, there are doctors, who do not ever envisage themselves as patients.35 It is interesting, therefore, to consider how physicians perceive their patients. This question might best be managed, by contextualising it within general societal views of the sick. Thorne describes how the public perceptions of those who are ill generally: Discredit…rendering them incompetent and invalid if not invisible. Many of the chronic illnesses carry with them the potential of stigma… the chronically ill may be variously considered unclean, weak-willed, contagious, defective, or immoral.36 Thus, the biological symptom or disability of the patient has ‘spread’


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____________________________________________________________ beyond their physical embodiment acting negatively to influence the perceptions of their moral characteristics. 37 The impact of attitudes like these become directly problematic when it is understood that the attitudes of those in the health professions toward the ill are even more extreme, as they are underpinned by a hardening of negative public stereotypes. 38 How does the public perceive physicians? Such is the strength of their reputation that it is small wonder that physicians embody power and prestige, as legitimate experts who can be trusted.39 Preston posits the respect they are shown as stemming from public belief that credits physicians with special healing powers; this he describes as the “fundamental deception of medicine” which rests on the fact that the “alternative to faith in the doctor is the reality of being in the hands of a fallible human being who has limited power to act against diseases.”40 It is not surprising then that problems can arise when transactions occur across domain boundaries. The sick clinician challenges all these ideas. The doctor who becomes ill is, at once, a clinician and a patient, a condition that threatens the prevailing ideas of order: the doctor as patient embodies a risk that must be managed.41 Doctors, who are themselves ill and dying, and therefore should be in the role of patient, threaten the purity of the medical discourse, acting as agents of pollution. In response to this danger, their peers treat them as anomalous beings. Douglas’s classification model, although referring to dirt, might help shed some light on how these doctors who are ill behave and are treated by their peers. In her seminal, anthropological work Purity and Danger, Douglas examined why and how the anxiety triggered by confrontations with dubious elements is managed.42 She began her influential treatise by considering the origins of dirt, observing that it: Was created by the differentiating activity of the mind, it was a by-product of the creation of order. So it started from a state of non-differentiation; all through the process of differentiating its role was to threaten the distinctions made.43 The offending entity, dirt, or “matter out of place” as labelled by Lord Chesterfield, must therefore have originated within a pure and unpolluted classification. In borrowing Chesterfield’s phrase, Douglas extends the concept to embrace entities from one specific classification found situated within the province of another or as succinctly expressed by Ardener “...‘X’ in contrast to ‘non-X’”.44 Rendered conspicuous by their difference

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____________________________________________________________ from the uniform characteristics of the primary form, these encroachments create disturbance, causing a tension, as their intrusion threatens the innocence of the previously homogenous form. The offending entity, be it dirt or sick doctor, is perceived to be threatening or, in some way, menacing the purity of the strain of classification and it is because of this danger that these risky intrusions need to be treated differently. It is important to bear in mind that the exclusion of the offending entity is a positive rather than a negative act. The elimination of the pollutant functions to maintain and enforce the chaste nature of the pure strain, thereby enabling it to continue functioning as the ideal in its original and innocent form. It is, however, important to note that this desire to preserve a fixed and permanent form also threatens, as that which is static is not open to progress and therefore may shrivel and die. In the face of the cult of the indomitable physician stands the indisputable fact that doctors and nurses do, indeed, become ill. Just like all other individuals, doctors are subject to disease and death but, taking the fact that the medical community promote a discourse that focuses on doctors who are healthy and uncomplaining, illness for a doctor is worse than for a member of the lay public as it involves a potential loss of face.45 Elsewhere I have traced more fully the dying career of Louise, a general practitioner.46 The diagram (figure 1) clearly traces the switches as they occurred in Louise’s identity over the course of her terminal illness. When Louise first found the lump in her breast (stage 1), she was breastfeeding her baby. She explained to me that her initial reaction, of feeling her heart fall, was purely instinctive but she almost instantaneously dismissed it by opting instead for the more detached medical lens (stage 2) which she had learned in her training and which allowed her to relegate the lump to a temporary effect of breast feeding. Having discovered the lump, it was interesting to learn how, instead of conferring with either her husband or professional colleagues regarding its potential gravity, she by-passed both opinions preferring to consult instead with a mid-wife friend. Pleased when her friend also dismissed the lump, Louise was dismayed when, instead of going away, the lump eventually altered its form. In the face of this, however, she still delayed for a full eight months before reporting it to her colleagues. In view of her medical background, how can this hesitation be justified? She defended her procrastination by citing a list of excuses ranging from protecting her mother from the probable bad news to waiting until her husband finished writing his book. More importantly, it later transpired that she was also concerned about looking foolish before her colleagues should the lump prove to be benign.


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Doctor

Patient

2. Draws on medical background to dismiss lump.

1. Initial reaction to finding lump. A few seconds.

c. 8 months

4. Insists on personally reviewing test results.

A few seconds

A few seconds

6. Health crisis prompts personal health management.

3. Presents to colleague for medical opinion.

5. Accedes to nurse’s command.

c. 1 year

c. 8 months

7. Accepts final chemotherapy. 8. Death

Figure 1. Chronology of Louise’s Identity Shifts.

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____________________________________________________________ Well established in her career, Louise clearly understood the probable consequences because, as she told me “I knew I was in trouble but my powers of denial were so strong”. It was only the relentless pestering she received from a friend that eventually persuaded Louise to seek informed medical counsel. How can we account for this reluctance? Parsons interrogation of illness behaviour suggests that society manages those who are ill and thereby disrupting the normal flow of living, by prescribing a specific form of sick role behaviour. Should the conditions of this role be met, dispensation from duties and obligations will be allowed. One of the criteria which Parsons lists as affording entry to the sick role is in obliging the patient to find appropriately qualified medical counsel whose recommendations will be accepted. 47 Earlier in this chapter it was noted that illness is culturally constructed, therefore it should be observed that individuals who belong to various sub-cultures such as medicine May hold different norms pertaining to the same role. … Once an individual is defined as ‘sick’… it may be assumed that sick role expectations applied to him [sic] during his illness will be closely related to the role expectations that operate for him when he is well. 48 Conrad argues that “Medical school is a powerful socializing force” which, like other associations, believes that it acts in good faith “that the way things are done with them is ‘natural’ and ‘right’ and perhaps even the ‘best”.49 As a member of the medical profession Louise would have been encouraged to develop a solidarity with the other students she trained with as well as her colleagues and to establish loyalty to medicine itself. By disclosing her state of health on a professional basis to a qualified colleague, Louise was taking a significant step, which would cause massive shifts in her own self perception and in how others viewed her identity. She was aware that if the diagnosis was poor, she would be classified as being ill, and therefore be changing her identity from one of the robust to one of the weak, shifting domain from a physician to a patient. Accepting the sick role would mean a renegotiation of her self as person and coming to terms with this would not be simple. Although even in lay thinking, the discovery of a lump might suggest a potential link to cancer, it presented Louise with a dilemma. Louise’s concern of embarrassment and humiliation should the lump prove benign vied with her anxiety over the probable loss of status should it prove malignant. She suppressed her natural fears, effectively risking her life rather than jeopardize her professional reputation. The need to


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____________________________________________________________ maintain her dignity and self-respect put her in a situation where she gambled her life rather than risk appearing foolish before her peers. I have already observed how the prevailing medical culture promotes a radical segregation between the ill and their caretakers. Doctors, especially, do not enjoy any personal association with illness and, when this does occur, they struggle to accept the role of patient. 50 51 52 Disclosure of their frailties will, they fear, leave them vulnerable before their peers and, in seeking help, they will be admitting that vulnerability.53 Having discussed how Louise’s hesitation delayed critically the management of her fatal illness, it might be interesting now to explore how she experienced being treated by her colleagues. As a doctor, Louise was trained to be objective and keep control of her emotions but, in spite of her medical training and her ‘insider’ knowledge of how negatively patients are perceived by doctors, the diagnosis of her cancer directly threatened that constraint. She rapidly acceded to the patient role (stage 3) and lost emotional control. However, so stunned was she by the trauma it induced that she instantly reverted to medical mode and gravitated into physical action (stage 4) snatching the chart from her colleague, needing to evaluate the results personally. At that moment she was admonished by the nurse who was present, to ‘sit down’. The fact that she observed this instruction is important, as it marks the moment when she made the switch from medical mode to being a patient (stage 5). In choosing to obey that directive, she was effectively identifying herself as a patient before her peers, abrogating her more senior medical status. In revealing herself as sick to her colleagues, Louise was effectively risking losing her sense of self. I have already referred to the significance of loyalty in medical training and this fidelity in part rests on the assumption of the group sharing similar life goals and plans. These plans, however, are formulated on members remaining in good health.54 To retain the affirmation and respect of her colleagues, Louise had to be seen to be in good health. In accepting her new role as patient, Louise became subject to a series of tests and treatment including a course of chemotherapy which provoked such a radical health crisis that it resulted in her emergency admission to hospital. It is interesting to note how, when describing events during that awful period, she related to me how she had once pleaded with her nurses for morphine but beseeched them not to inform her doctors. In expressing this request to her nurses, Louise was articulating her recognition of the power held by the doctors. The extent of the deterioration engendered by this crisis rendered her both physically and psychologically helpless. She had surrendered

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____________________________________________________________ control of her physical body to others who were now responsible for its maintenance. In this incompetent condition, she was deemed to be, and treated specifically as, a patient, a role that did not threaten her colleagues. What does theory have to say about this? In referring to common rubbish, Douglas argues that “So long as identity is absent, rubbish is not dangerous, it clearly belongs in defined places. In the final stage of disintegration, dirt is undifferentiated”.55 Louise could be managed when in a coma; she was in one welldefined role. However, when she was ultimately able to regain some form of bodily control, it is interesting to note that her social instinct intervened and perceiving that her request for morphine might be construed as weakness to the doctors who were treating her she mitigated her request to her nurses with the supplication not to “tell the doctor”. Relieved to have survived this near fatal experience, Louise reevaluated her position and, believing herself sufficiently intelligent and medically informed to be able to make decisions about her own medical management, seized control of her own health care and thus slipped back into her position as doctor (stage 6). It might be interesting to explore how the relationships she had with colleagues developed throughout the illnesses. She believed her medical knowledge helped her manage her illness; she explained something of the interactions which occurred between herself and her health care providers. She felt that, although sharing a common medical lexicon with her doctors was useful, the fact that they also shared background knowledge about, for example, the efficacy and side effects of a specific drug was problematic. Louise believed that her doctors used two strategies to manage her; actually avoiding her or by acting as though she was one of her own treatment team. Louise was thoroughly versed in medical behaviour. She recognised the avoidance strategies adopted by her colleagues and this understanding shaped her response to them. She told me how difficult she found this but appreciated that her collusion in the latter tactic might be beneficial by yielding previously undisclosed medical information. Her problem was that her emotional reactions to her condition sometimes leaked out causing embarrassment to her treating doctors. As a clinician who was ill, Louise found herself being treated as a classic anomalous entity, “matter out of place”. Whilst she was a doctor, she was not behaving like one, she was sick. Whilst being a patient, she was not behaving like one, she clearly had medical knowledge. Her familiarity with the medical discourse and her background knowledge of the social lives of the very doctors who were treating her raised her status to “one of them”, the invulnerable. In spite of this privileged status,


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____________________________________________________________ however, by virtue of her diseased biological cells, she was now also a patient, who, in terms of the medical discourse is perceived as out of control, helpless and passive. 56 The doctors who were managing Louise’s treatment found themselves in the difficult position of not having a script. The traditional boundaries of patient and doctor had suddenly been shifted. The treating doctors felt awkward and uncomfortable and, for the most part, attempted to veil this discomfort with politeness. Louise was an embarrassment, “matter out of place”. More than that, her doctors were conscious that her knowledge extended to an awareness of their limited capacity to cure. At one stage, she actually felt in danger of being thrown out of a consultation because, as she said, she could “see that they do not know that much at all”. Her medical training afforded her knowledge of the realities of medical limits and that truth threatened her doctors. Louise realised that if, at least to her treating doctors, she could distance herself from her self as patient and instead become set in a medical persona, she would be better positioned to acquire more knowledge, which might act to her advantage. While speaking with her doctors she attempted to present herself as physician rather than patient. This cannot have been easy. In deliberately presenting herself in her professional role, she was attempting to balance the inequity that exists in the doctor/patient relationship, to avert the anxiety which would have been created if she had assumed her other role of patient or “matter out of place”. In an endeavour to learn more about the behaviour of doctors who are dying, this chapter began by focusing on the roots of medicine. It examined the relevance of the early doctors’ fight for jurisdiction over their field, describing how they finally instituted themselves as a professional body, able to govern both the content and direction of their new knowledge. It briefly explored how the medical colleges which serve to educate junior doctors distil technical skills as well as the attitudes to illness and a loyalty to the honour of the profession; these are significant in shaping doctors’ own illness behaviour. To explain this conduct, it draws on anthropological theory, especially Douglas’s classification model, which suggests how anomalous entities create an anxiety. To illustrate these ideas, I have drawn on a case study. I believe that this supports the research of others, especially that of Jaye and Wilson, who argue for a radical revision of medical values to include training to handle the difficult situations of a doctor treating a colleague, or even a more senior doctor. 57

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Notes 1. B. Ingstad and V. Christie, “Encounters with Illness: The Perspective of the Sick Doctor, ” Anthropology and Medicine 8(2/3) (2001): 201-210. 2. A. Armstrong-Coster, Living and Dying with Cancer (Cambridge: Cambridge University Press, 2004). 3. Bourdieu, P. “Time Perspectives of the Kabyle,” in The Sociology of Time, ed. J. Hassard (London: The Macmillan Press Ltd, 1990). 4. C. L. Nekolaichuk and E. Bruera, “On the Nature of Hope in Palliative Care,” Journal of Palliative Care 14(1) (1998): 36-42. 5. H. Nowotny, Time: the Modern and Postmodern Experience (Cambridge: Polity Press, 1994). 6. Kleinman, A. et al., “Culture, Illness and Care: Clinical Lessons from Anthropologic and Cross Cultural Research,” Annals of Internal Medicine 88 (1978): 251-258. 7. H. Brody, Stories of Sickness (Oxford: Oxford University Press, 2003). 8. A. Frank, “The Body as Territory and as Wonder,” in Health Studies: A Critical-Cultural Reader, ed. C. Samson (Oxford: Blackwell Publishers, 1999). 9. M. Bury, “Chronic Illness as Biographical Disruption,” Sociology of Health and Illness 4 (2) (1982): 82-167. 10. Kleinman et al., Annals of Internal Medicine. 11. C. Currer and M Stacey, eds, Concepts of Health, Illness and Disease: A Comparative Perspective (Leamington Spa: Berg, 1986). 12. K. Thomas, “Health and Morality in Early Modern England,” in Morality and Health, ed. A. M. Brandt and P. Rozin (London: Routledge, 1997), 15. 13. Ibid. 14. B. Turner, Medical Power and Social Knowledge (London: Sage, 1995). 15. S. Feierman, “Change in African Therapeutic Systems,” Social Science and Medicine 13B 4 (1979): 277-284. 16. L. McC. Beier, “The Creation of the Medical Fringe 1500-1700,” Bulletin of the Society for the Social History of Medicine 29 Dec (1981): 29-31. 17. M. Stacey, The Sociology of Health and Healing (London: Routledge, 1993). 18. Turner, 152. 19. Morgan, M. et al., Sociological Approaches to Health and Medicine (London: Routledge, 1993.) 20. Turner, Medical Power and Social Knowledge. 21. Kleinman et al., Annals of Internal Medicine. 22. Ibid. 23. M. Douglas, Purity and Danger (London: Ark Paperbacks, 1988).


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____________________________________________________________ 24. A. J. Saris, “Telling Stories: Life Histories, Illness Narratives and Institutional Landscape,” Culture, Medicine and Psychiatry (19) (1995): 39-72. 25. S. E. Thorne, Negotiating Health Care (London: Sage, 1993). 26. T. Preston, The Clay Pedestal (New York: Scribner, 1986). 27. S. Feierman, “Change in African Therapeutic Systems,” Social Science and Medicine 13B 4 (1979): 277-284. 28. W. R Arney and B. J. Berger, Medicine and the Management of Living (Chicago: University of Chicago Press, 1984). 29. M. Foucault, “The Subject and Power,” Critical Inquiry 8 (1982): 777-795. 30. Arney and Berger, 1984. 31. P. Conrad, “Learning To Doctor,” in The Sociology of Medicine, ed. W. C. Cockerham (Hants: Edward Elgar Publishing Limited, 1995), 455. 32. Ibid. 33. V. Kestenbaum, The Humanity of the Ill: Phenomenological Perspectives (Knoxville: University of Tennessee Press, 1982). 34. R . Merton, “Some Preliminaries to a Sociology of Medical Education,” in The Student-Physician, Introductory Studies in the Sociology of Medical Education, ed. R. Merton (Cambridge: Harvard University Press, 1957). 35. C. Jaye and H. Wilson, “When GPs Become Patients,” Health: An Interdisciplinary Journal for the Study of Health 7 (2) (2003): 201225. 36. Thorne, 7. 37. B. A. Wright, Physical Disability (New York: Harper & Row, 1983). 38. L. Gething, “Judgements by Health Professionals of Personal Characteristics of People with a Visible Physical Disability,” Social Science and Medicine 34:7 (1992): 809-815. 39. Morgan, M. et al., Sociological Approaches to Health and Medicine. 40. Preston, 153. 41. R. H. Hahn, “Between Two Worlds: Physicians as Patients,” Medical Anthropology Quarterly August 16:4 (1985): 87-98. 42. Douglas, Purity and Danger. 43. Ibid. 44. S. Ardener, Ground Rules and Social Maps for Women: An Introduction, (Oxford: Berg, 1981). 45. Ingstad and Christie, Anthropology and Medicine. 46. Armstrong-Coster, Living and Dying with Cancer. 47. T. Parsons, The Social System (London: Routledge & Kegan Paul, 1951). 48. G. Kassebaum and B. Baumann, “Dimension of the Sick Role in Chronic Illness,” in Patients, Physicians and Illness, ed. E. Gartley

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____________________________________________________________ Jaco (London: The Free Press, 1972), 132. 49. Conrad, The Sociology of Medicine. 50. Hahn, Medical Anthropology Quarterly. 51. Jaye & Wilson, Health: An Interdisciplinary Journal for the Study of Health. 52. R. Chambers, “What Should Doctors Do if they Become Sick?” Family Practice 10(44) (1993): 416-423. 53. Jaye and Wilson, Health: An Interdisciplinary Journal for the Study of Health. 54. Brody, Stories of Sickness. 55. Douglas, 161. 56. Hahn, Medical Anthropology Quarterly. 57. Jaye & Wilson, Health: An Interdisciplinary Journal for the Study of Health.

References Ardener, S. Ground Rules and Social Maps for Women: An Introduction. Oxford: Berg, 1981. Armstrong-Coster, A. Living and Dying with Cancer. Cambridge: Cambridge University Press, 2004. Arney, W. R and B. J. Berger. Medicine and the Management of Living. Chicago: University of Chicago Press, 1984. Beier, L. McC. “The Creation of the Medical Fringe 1500-1700.” Bulletin of the Society for the Social History of Medicine 29 Dec (1981): 29-31. Bourdieu, P. “Time Perspectives of the Kabyle.” In The Sociology of Time, edited by J. Hassard. London: The Macmillan Press Ltd, 1990. Brody, H. Stories of Sickness. Oxford: Oxford University Press, 2003. Bury, M. “Chronic Illness as Biographical Disruption.” Sociology of Health and Illness 4 (2) (1982): 82-167. Chambers, R. “What Should Doctors Do if they Become Sick?” Family Practice 10(44) (1993): 416-423. Conrad, P. “Learning To Doctor.” In The Sociology of Medicine, edited by W. C. Cockerham. Hants: Edward Elgar Publishing Limited, 1995.


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____________________________________________________________ Currer, C. and M Stacey, eds. Concepts of Health, Illness and Disease: A Comparative Perspective. Leamington Spa: Berg, 1986. Douglas, M. Purity and Danger. London: Ark Paperbacks, 1988. Feierman, S. “Change in African Therapeutic Systems.” Social Science and Medicine 13B 4 (1979): 277-284. Foucault, M. “The Subject and Power.” Critical Inquiry 8 (1982): 777-795. Frank, A. “The Body as Territory and as Wonder.” In Health Studies: A Critical-Cultural Reader, edited by C. Samson. Oxford: Blackwell Publishers, 1999. Gething, L. “Judgements by Health Professionals of Personal Characteristics of People with a Visible Physical Disability.” Social Science and Medicine 34:7 (1992): 809-815. Hahn, R. H. “Between Two Worlds: Physicians as Patients.” Medical Anthropology Quarterly August 16:4 (1985): 87-98. Ingstad, B. and V. Christie. “Encounters with Illness: The Perspective of the Sick Doctor.” Anthropology and Medicine 8(2/3) (2001): 201-210. Jaye, C. and H. Wilson. “When GPs Become Patients.” Health: An Interdisciplinary Journal for the Study of Health 7 (2) (2003): 201-225. Kassebaum, G. and B. Baumann. “Dimension of the Sick Role in Chronic Illness.” In Patients, Physicians and Illness, edited by E. Gartley Jaco. London: The Free Press, 1972. Kestenbaum V. The Humanity of the Ill: Phenomenological Perspectives. Knoxville: University of Tennessee Press, 1982. Kleinman, A., L. Eisenberg, and B. Good. “Culture, Illness and Care: Clinical Lessons from Anthropologic and Cross Cultural Research.” Annals of Internal Medicine 88 (1978): 251-258. Merton, R. “Some Preliminaries to a Sociology of Medical Education.” In The Student-Physician, Introductory Studies in the Sociology of Medical Education, edited by R. Merton. Cambridge: Harvard University Press, 1957.

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____________________________________________________________ Morgan, M., M. Calnah, and N. Manning. Sociological Approaches to Health and Medicine. London: Routledge, 1993. Nekolaichuk, C. L. and E. Bruera. “On the Nature of Hope in Palliative Care.” Journal of Palliative Care 14(1) (1998): 36-42. Nowotny, H. Time: the Modern and Postmodern Experience. Cambridge: Polity Press, 1994. Parsons, T. The Social System. London: Routledge & Kegan Paul, 1951. Preston, T. The Clay Pedestal. New York: Scribner, 1986. Saris, A. J. “Telling Stories: Life Histories, Illness Narratives and Institutional Landscape.” Culture, Medicine and Psychiatry (19) (1995): 3972. Stacey, M. The Sociology of Health and Healing. London: Routledge, 1993. Thomas, K. “Health and Morality in Early Modern England.” In Morality and Health, edited by A. M. Brandt and P. Rozin. London: Routledge, 1997. Thorne, S. E. Negotiating Health Care. London: Sage, 1993. Turner, B. Medical Power and Social Knowledge. London: Sage, 1995. Wright, B. A. Physical Disability. New York: Harper & Row, 1983.

Between Organizations, Family and Death: Caring Creatively within the Hospice Organization Elizabeth Gill Based on qualitative data obtained from open-ended interviews, survey questionnaires and participant observation, this paper examines how hospice volunteers reflectively and creatively “use” and manipulate the medical structure to achieve caring objectives that are often counter to the expressed goals of the health care organization. More specifically, I shed light on the ability of active, reflective human agents, within the bureaucratic system of hierarchy and complex division of labour, to, both formally and informally, reflectively carve-out space within these organizations, space that allows them to shape the course of events and enable them to substantively care for dying patients and their caregivers. Employing Joas’ concept of “situated creativity,” I focus on the unexpected and novel ways that volunteers may respond to a particular situation by considering the physical possibilities, normative expectations and institutional arrangements that structure the field in which the action takes place. Thus, for the purposes of my analysis, creativity becomes a form of action employed by volunteers in response to structural constraints. By considering creativity as an activity, and by empirically specifying the processes by which human agents carve-out communicative space within the organizational context, I further develop the idea of practical caregiving within organizational settings through the development of a modified Habermasian framework that bridges the gap between the pragmatist tradition and the Weberian heritage. Dying and death in today’s developed societies can historically be characterized as a movement away from ritual and community to bureaucratic management and medical treatment of dying patients. According to Moller, the modern image of a dying person connected by tubes and wires to life-sustaining equipment is a logical derivative of America’s bureaucratic and technological orientations, reflective of an every increasing percent of deaths within formal institutional settings embodying the loss of human dignity and autonomy associated with the powerful large-scale bureaucratic organizations and Weber’s “iron cage.”1 These organizations, characterized by a hierarchy of authority, division of labour, and emphasis on standardization and efficiency, have restructured peoples’ lives and deaths and brought into sharp relief questions of caring within public, organizational settings. The hospice organization, which is sanctioned by the medical

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Between Organizations, Family and Death

____________________________________________________________ community, focuses on the palliative control of symptoms of terminally ill patients so that they can live out their lives as comfortably and meaningfully as possible. Hospice was created as a means for overcoming some of the problems associated with contemporary medical services emphasis on the technical and curative dimension of medicine in patient care. The hospice philosophy of care attempts to preserve the dying individual’s life-world from system control by carving out a niche for the dying to achieve “a decent and fulfilling human life” until death. One important way for accomplishing this objective is the use of an interdisciplinary team, comprised of professionals and specially trained volunteers, designed to provide emotional support for both the dying and survivors. The focus on this study is on the unpaid hospice volunteers who not only offset operation costs for the hospice organization itself, but also uphold the hospice ideal of the holistic approach to death and dying. 1.

Statement of the Problem and Nature of the Data. This study offers an exploratory analysis of the distinctive role of the hospice volunteer which can best be understood in terms of the flexibility involved in each situation in which the volunteer must come to some kind of understanding with the dying individual, family, and medical system. More specifically, this paper examines how hospice volunteers reflectively and creatively “use” and manipulate the medical structure to achieve caring objectives that are often counter to the expressed goals of the health care organization. I will shed light on the ability of active, reflective human agents, within the bureaucratic system of hierarchy and complex division of labour, to, both formally and informally, reflectively carve-out space within these organizations, space that allows them to shape the course of events and enabling them to substantively care for dying patients and their caregivers. Specifically, my research seeks to: 1) Clarify the interrelationship between human agency and organization by placing the hospice worker and their activities in the larger organizational context.; and 2) More broadly, to examine hospice as a means of practical caregiving thus expanding upon the burgeoning literature on the sociology of caring. My analysis of hospice workers was drawn from a representative pool of volunteers at several hospices in two large metropolitan areas in Texas and Virginia, and is based on data gathered through a series of 40 indepth interviews, participant observation and 23 open-ended questionnaires collected over a ten-year period from 1992 to 2004. For the purposes of my research, the volunteer perspective proved invaluable primarily due to the fact that they are "in but not of" the hospice organization. Volunteers are not subject to the same professional mandate as the professionals and staff

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____________________________________________________________ associated with hospice. Their actions are not constrained by prescribed rules associated with professional caregiving; thus they typically held a unique position within the hospice team in relation to the dying individual, the family/caregivers and the medical organization. I now place the volunteer role in the general theoretical framework I have used for interpreting the data. 2.

Theoretical Background. In order to comprehend the intersection of the volunteer and the broader organizational setting, we must understand the ability of human beings to use and manipulate social structures. Although a growing body of work by symbolic interactionists and others addresses the interplay between agency and organizations, we still have very little understanding of the interface between the two. More specifically, until recently, symbolic interactionists have underemphasized the significance of social organization for social action in order to dramatize situated activity. 2-6 Thus symbolic interactionists do not specify how hierarchical arrangements and the division of labour that characterize organizations shape, and are shaped by, the nature of social interaction. Although these studies have proven extremely useful in mapping out the interactional and structural landscape of the negotiation context, I have sought to further specify the concrete strategies employed by individuals in response to both individual action and the boundaries and potential barriers of the structural context. On the other end of the theoretical spectrum, Max Weber argued that the human agent was destined to become enmeshed in the structural constraints of the “iron cage of bureaucracy” resulting in the loss of freedom, meaning, and respect for human life.7 Weber’s lack of attention to the possibility of agency within bureaucratic organizations runs counter to my findings about the hospice workers’ actions within large-scale bureaucratic organizations. My data indicate that a complete understanding of the interaction order and human agency, without denying the significance and influence of large-scale organizations, requires an examination of the overlapping, yet somewhat independent, spheres of human agency and the organizational structure. Thus, in order to escape the inevitability of Weber’s “iron cage” and the interactionists’ emphasis on the saliency of human agency, I sought a theoretical framework that could liberate the human agent within the bureaucratic organization while acknowledging the structural realities of the formal organization context. For the purposes of my analysis, I found Giddens’ focus on the enabling and constraining properties of organizational rules for proactive human agents and Habermas’ theoretical framework both useful in

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____________________________________________________________ highlighting the relationship between the broader societal structure and human agent, but silent with respect to the nature of social interaction within organizational structures.8-9 For the purposes of my analysis, I address the shortcomings of Habermas’ framework and the lack of specification of Giddens’ framework by drawing upon the recent work of Hans Joas, who, writing within a symbolic interactionist, or pragmatist, orientation, emphasizes the creativity of human agents.10 His work is directed to discovering the characteristics of all human action with an emphasis on creative action. Joas based his concept of creative action on the pragmatist model of situated creativity, the idea that new variations of action are generated by the tension of problems contained in situations. His framework acknowledges that often, the appropriate means of action are often not immediately available and have to be created with the concept of a skilful strategy that requires the application of an actor’s creative powers. Even when adhering to normative constraints, the actor must often devise a new, unfamiliar path of action that is fraught with risks. The strength of Joas’ approach lies in his expansion of concept of “situated creativity” which calls upon us to focus on the novel ways in which a human agent may respond to a particular situation, acknowledging the physical possibilities, normative expectations, and institutional arrangements that structure the field in which the action occurs. Joas specifically addresses Habermas’ oversight with respect to agents by objecting to the systems side of Habermas and the dualism of what Habermas calls “the uncoupling of system and life-world”. 11 In my view, Joas makes two moves that are important. One, his work is directed to discovering the characteristics of all human action with an emphasis on creative action. As the data indicate, hospice volunteers, in order to be effective, must respond creatively to both dying persons and their caregivers as well as the organizational structure of the health care setting. Viewed in this manner the human agent comes to be more proactive than generally understood. Second, we find in Joas’ writings specifics about the impact of institutional arrangements on action in general, and creative action in particular. For the purposes of my research, Joas’ framework is particularly useful because he expands the basic pragmatist model of situated creativity to include the importance of institutional arrangements in structuring the action context. My research further specifies Joas’ concerns with the variable ways in which social actors relate to institutions and structures by focusing on the interpretive process whereby human agents operate within structured organizational environments. The data emphasize a form of creative and reflective communication and action between the volunteer,

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____________________________________________________________ family/caregivers and dying individual within the boundaries of the healthcare setting. As indicated below, hospice workers carve out communicative space in order to carry out what the volunteer perceives as the essential ingredients of meaningful communication -- the ability to respond both verbally and non-verbally to the needs of a dying individual and their family/caregivers. The newly created role itself is an ephemeral one based on temporary or ancillary position-related behaviour pattern chosen by individuals to satisfy the needs of the patient/family which can not be completely satisfied by more dominant and lasting roles they regularly must enact in everyday life positions.12 This creative action becomes the process by which the volunteer is able to create a very personalized order thus allowing the volunteer to achieve the hospice ideal of enabling the dying to achieve a decent, fulfilling life until death. On the basis of the data obtained from in-depth interviews and questionnaires, it became clear that creative action became the means by which the volunteer was able to maintain the integrity of the dying individual within the broader medical system. It becomes necessary to consider the systemic barriers and constraints faced by the volunteer within the organization setting in order to understand the importance of creative action in the provision of a “good death.” 3.

The Volunteer within the System. A great number of the respondents had patients placed within either nursing homes or hospitals during the course of their illness. Typically, patients are placed in these settings for medical reasons. Often times, the home setting is unable to accommodate procedures that are necessary to ease the patient's pain. These are circumstances in which special medical and nursing care is required in situations in which relief from distress cannot be accomplished in the home. Patients are also placed in either a nursing home or hospital setting to give the family/caregivers respite from the day to day stress of caring for a terminally ill individual. The differentiation or segmentation characteristic of urban life in the United States, which has been fostered by the organizational nature of modern society, has restricted the effectiveness of the hospice volunteer. Volunteers are often required to provide care and support based on their training and hospice philosophy within organizations that are not structured to accommodate the individualized care necessary for what hospice defines as a "good death." Hospitals and extended care facilities are structured by a division of labour and specific organizational procedures that are not designed to the individualization of care that hospice requires. The principles of hospice care directly challenge the efficient nature of the medical organization as well as the medical system's goal of cure.

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____________________________________________________________ In general, respondents were cognizant of friction between the system and the hospice organization. Several volunteers, who have been with hospice since its inception in the Central Texas area approximately ten years ago, remembered in vivid detail a wing of a local hospital that had been dedicated to utilizing the hospice philosophy of care in providing for the terminally ill. Thus, care had been based on the hospice principles of pain control and attention to the needs of the dying individual. The hospital based hospice failed shortly after its inception and no others have been implemented in the area to date. One respondent recalled the reason for its failure: The hospital setting is dedicated to efficiency. Hospice principles challenge efficiency. I talked to one nurse who found it difficult to shift from caring for acutely ill patients, who required conventional hospital care, and hospice patients. The wing was a complete failure and I am unaware of any other attempts in this area to experiment with hospice in a medical setting to date. This is another example that hospice is not hospital, but a concept of care that cannot be based on efficiency. This respondent's understanding of the impact of institutional settings on patient care was typical of most volunteers. Most respondents were aware of the limitations the institutional environment placed upon their activities with the family and dying individual, but still expressed surprise at the realization that they were in some ways altered by the structured nature of care delivery in either the hospital or nursing home organization. One respondent in particular referred to this question as a "real eye opener." She had cared for several patients placed in institutional settings but had never given much thought to the effects of the organizational context upon her behaviour, as well as the family and dying patient's experience. After first negating the effects of health care organizations upon care delivery, she began to think about the manner in which deaths had been altered by the institutional settings: No, I don't think so. But now that you mention it....I do find myself deferring to the staff within a nursing home and hospital. In order to accommodate patient/family wishes, I get to know one or two staff members who are helpful and are willing to often go against nursing home policies in order to fulfil certain needs.

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____________________________________________________________ One case involved taking a patient to a local mall. It was against home policy to remove a patient without a family member's signature. His wife was the designated caregiver, but she was in a mental institution at this time. With a lot of wrangling, I was able to take this man to the mall. It was his last outing. She felt that not only the structured care of these organizations altered the death experience, but also the disappointment of all involved that the person would be unable to die at home. The structured medical environment poses several systemic barriers that challenge the volunteer in the performance of his or her role, not the least of which are the problem of legitimacy and the marginality of the role itself. A. The Problem of Legitimacy An almost universal difficulty experienced by respondents in the institutional setting was one of legitimacy. Several respondents expressed frustration at their inability to command respect within the formal health care environment. One respondent in particular went to great lengths to carve out a "niche" for herself within an extended care facility: From day one, I was treated with suspicion. Almost every time I visited my patient, I had to explain who I was and why I was there. Because of my lack of professional credentials, questions were raised by the staff as to my competency. It became clear that my patient was not receiving the proper care and was in constant pain. I felt like the very principle of hospice care, a pain free death, was being shunned by the staff. I called in the hospice nurse, who once again explained the concept of administering unscheduled painkillers before pain was experienced. I was then taken to the administrator’s office, by the nurse, and introduced as a vital member of the hospice staff. Outwardly, my standing within the organization improved, but I was still regarded as suspect by the staff. Another respondent recounted her literal adoption by the family in order to operate effectively within the extended care facility: Every time I visited my patient I spent more time explaining myself and my duties to the staff than I spent

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____________________________________________________________ actually caring for my patient. Nursing home staffs have a high rate of turnover, as well as flexible shifts, thus I hardly ever visited when there wasn't one or two new nurses aides, nurses or staff that I did not have to validate my presence to. Eventually I adopted the role of daughter to my patient. Despite the fact that my patient really believed that I was his daughter and his wife also considered me as a family member, I was finally able to spend quality time with the patient. The hospice organization in the community involved has adopted several policies that attempt to legitimate the role of volunteer within these health care settings. "Official looking" name tags with the volunteer's name and affiliation are required to be worn by the volunteer when they are caring for a patient in either a nursing home or hospital. In addition, an extensive outreach plan has been adopted to inform and educate professionals and staff within these organizations as to the nature, purpose and structure of hospice care. B. The Marginality of the Volunteer Role: Professional vs. NonProfessional As stated above, most respondents had some experience with caring for a terminally ill patient within a medical organization. As a result of their lack of professional credentials and loosely defined roles, the organizational nature of these settings often became the defining principle by which their role was constructed. Several respondents expressed dismay, frustration and anger at the ignorance coupled with professional egos that characterize the health care professionals within organizational settings. An example of the tension within these medical setting between the volunteers and health care provider is the controversy over the use of painkillers. In recent years, pain control has become a major priority in terminal care in general. Much of the progress made in this area can be directly attributed to the hospice approach to care. A priority of caring for the terminally ill in any setting has become the assessment and relief of pain. According to Michael H. Levy, pain is one symptom that is common to most terminally ill patients. Yet, equipped with the appropriate knowledge, most professionals in general medical practice fail to draw effectively upon existent resources to alleviate pain: Unfortunately, the pain of advanced cancer is all to often inadequately controlled, especially in the terminal period. This therapeutic deficiency is due more to improper

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____________________________________________________________ application of current knowledge than to lack of adequate knowledge regarding the mechanisms of pain and the modalities available for its control.13 A great majority of the respondents found themselves in the precarious position of demanding the appropriate amount of painkiller on an as needed basis rather than a bureaucratic timetable: My patient was in constant pain. Painkillers were being administered by the staff of the nursing home every four hours. This schedule was not effective in combating my patient's discomfort. I called the hospice nurse in charge of my patient's care. She came directly to the home a lectured the staff on the importance of administering painkillers before the pain was felt. This request is a direct affront to the bureaucratic organization of a medical setting, as well as the medical training of health care professionals. According to many respondents, these situations were characterized by a debate that plagues the medical profession: addiction versus alleviation of pain. Within the medical model, which is predicated on respect for infinite life, there is always a built in desire by professionals to preserve a quality of life, i.e. one that is free of addiction. Conversely, hospice care is based on the principle of alleviation of pain. According to Kastenbaum: Hospice staff do not expect dying patients and their families to endure as long as possible until forced to "beg" for relief, nor do they harbour the bizarre fear that adequate medication would make a drug addict out of a person who may have only a few week to live.14 As suggested above, and strongly supported by my own experiences as a volunteer, volunteers must adapt to a variety of circumstances in order to fulfil their role. One of the greatest challenges to the volunteer operating within a medical setting is the maintenance of the hospice philosophy of care. One respondent stated that the difference between simply being a volunteer and being a good volunteer is ones ability to make the system work for, not against, the patient and the family/caregivers. The respondents interviewed had developed several techniques for operating within the medical organization by creatively circumventing systemic barriers. 4.

Circumvention of Barriers.

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____________________________________________________________ Once institutionalized, the dying patient and family/caregivers abdicate some responsibilities and control to the medical organization. The personalized care that is characteristic of the hospice organization is supplemented and replaced to a certain degree by the staff of the long-term care facility or hospital. Respondents referred to the pain and dismay of patients and family members as a result of adjusting to the impersonal environment of these organizations. Often times familial guilt associated with placing a family member in a nursing home heightens the tension between the staff and family. One respondent recalled a frantic mother's reaction to the "atrocious" conditions of a nursing home in which her son had been placed: The woman clung to me like a life preserver. I was a familiar face in a sea of strangers. She was almost inconsolable: "They don't care about my son. They are all on death watch waiting for him to die. No one here knew him before he was sick. They don't care if he is clean or comfortable, all that want for him is death. I am terrified that he will die alone, with no one around him that cares." All I could do was promise her that I would sit with him while she rested and ate. I assured her that I cared about her son, and that he would not be alone when he died. I also talked to the nursing home staff and persuaded them to spend some quality time with mother and son. They were very accommodating, and the mother noticed the difference immediately. This particular case is indicative of many of my own and other respondent's experiences, particularly in long-term care facilities. Acting in this capacity, the volunteer would attempt, not to change the system, but reach a common middle-ground between the system and hospice ideals. Respondents typically viewed these situations in terms of "peacemaking efforts" in the face of a crisis (death). This often meant extra effort on the part of the volunteer to fill in the gaps of care delivered by the hospital or extended care facility, as well as efforts to further interest the staff of these facilities in the care of the dying individual. Respondents stated that they would seek out professionals within these facilities who were sympathetic toward their cause. These "sympathetic professionals" enabled the volunteer to carve out a "space" for themselves and the patient/family. Another strategy utilized by respondents was to indicate to medical personnel a certain degree of medical knowledge or experience beyond the

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____________________________________________________________ volunteer role. Several respondents had been health care professionals and utilized this experience to attain a certain amount of respect from medical personnel and staff within medical settings: Case 1: This particular nursing home is probably one of the worst in the area. The facility is filthy and the staff treat the patients like animals. Volunteers are generally treated as a nuisance and ignored. One day I walked in and saw the aides throwing my patient around like a sack of potatoes under the auspices of changing his bed. That was the last straw. I informed them that I had been a nurse and that I would report their activities to the proper authorities. Suddenly, I was transformed from nuisance to threat. After that, my patient received special care and respect (at least as far as I knew) and so did I. I have since used this strategy from the outset of my relationship with a particular facility. It is nice to be taken seriously. Case 2: Whenever I go into a medical setting I practically wear my old nurses uniform. I let them know at the beginning of our relationship that I know what they should or should not be doing for my patient and why... I give them the "big brother is watching" speech. I usually do not have the problems that other volunteers have because of my medical background. I use it to my patient's advantage and it certainly doesn't hurt my standing with the medical staff. Other respondents stressed the importance of not being "dumb" in situations in which you are already at a disadvantage as far as professional status: It makes no sense to walk into a situation unprepared. Nurses and doctors already view volunteers as sweet, wellmeaning people who probably are unable to do anything else with their lives. Why make the situation worse by playing into that stereotype... I always try to volunteer "smart." I want to have as much information as I can before I walk into a particular setting to meet a particular patient/family and medical personnel. I feel that this gives me an advantage with the medical staff... I have already broken their conceptualization of the typical volunteer.

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____________________________________________________________ One respondent learns as much about the illness of her patients as she can in order to pass herself off as an "expert" and receive the respect and power that goes along with it. I read everything I can about my patient's illness. I have many medical books at home and sometimes I go to the library. I have found that this not only helps me deal with my patient, it also allows me to appear to be pretty savvy to the nurses and doctors I have to deal with. I think they are never really sure if I have had medical training or not... I keep that kind of vague. They respect my knowledge, I like that, it also gives me the opportunity to oversee the care of my patient. In most cases if I complain about the care of one of my patients, I get results. Respondents and hospice staff members stressed again and again that the difference between a volunteer and a good volunteer is their ability to adapt to new situations, particularly medical environments. Since most hospice patients, at some point in their illness, will be placed in a medical facility, the volunteer must be able to operate within an organizational environment that is not designed to accommodate the inefficient, non-professional and unspecified nature of their role. In a sense, they must straddle the boundaries of the medical system and patient/family life-worlds in order to be effective. 5.

Analysis and Implications. One of contributions of this research is to specify, in greater detail, the role of hospice volunteers in relation to the dying individual both in terms of creative action and confronting organizational constraints. As indicated above, caregiving opportunities, as well as the limitations of each situation, are either self-defined by the volunteer or imposed by the patient/caregivers often within the confines the broader organizational setting. Thus, much of the action and interaction between the volunteer, dying individual and family does not involve simple compliance to a concrete set of rules and practices, but active construction among actors who seek to come to terms with each other while dealing with the inevitable death of an individual. The volunteer and those involved are afforded the opportunity to negotiate a sense of what death means to the dying person and the family. As indicated above, creative action often permits those involved with the dying individual to interact, cooperate and come to terms with each other and the circumstances surrounding death. As my research has indicated, the sense of flexibility associated with the volunteer role must be tempered with an awareness of the

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____________________________________________________________ constraints imposed by larger organizational context in which the volunteer must often operate. In relation to the broader medical system, the volunteer was usually considered by professionals and staff as marginal. Because of the biological and systemic marginality of the volunteer role, respondents were able to aspire to maintain the integrity of the dying individual through interaction based on need, not efficiency. This marginality appears to be paradoxical in relation to the ability of the volunteer to operate within structured medical organizations. As a marginal player, the successful volunteer must be able to maintain a certain amount of flexibility within their role enabling them to often circumvent the rigid procedures mandated by the hospital or extended care facility. Toward this end, my research data suggest that hospice stands as a buffer between the dying individual and system with hospice as a broker, mediating between the two. The role of the volunteer challenges some of Habermas’ basic principles concerning the relationship between the system and the life-world. In Habermasian terms, the volunteer attempts to maintain and buttress up the boundaries of the life-world within a system that threatens to “pathologically” intrude and destroy the life-worlds of the patient and family/caregivers. Respondents often acted to alter either the medical or hospice organization in a way that was more true to the original hospice ideals. Joas’ concept of “situated creativity” enabled me to address the shortcoming of Habermas’ system/life-world distinction by examining the human agent’s creativity with respect to particular situations, defined by the physical possibilities, normative expectations, and institutional arrangements that structure the dying process. An awareness of possible organizational constraints associated with medical environments would enable to volunteer to more effectively organize their actions in response to the dying individual and the family. Finally, in response to broader concerns about practical caregiving within structured settings, we must come to recognize the constraining and creative possibilities for human agency and caring within these large-scale organizations in order to understand the boundaries, potential barriers, and opportunities for caring. 15 According to Cancian and Oliker, “good care” requires committed, well-informed caregivers who have the time and autonomy, as well as the financial and social resources, that they need.16 Their working definition of caregiving involves both feelings of affection and responsibility combined with actions that provide responsively for an individual’s personal needs or well-being, in a face to face relationship. Thus caregiving includes physical care, as well as emotional care, involving both verbal and nonverbal communicative strategies such as touch, empathy, and affection. The constraints placed upon human agency by large-scale organizations

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____________________________________________________________ are often in the realm of the taken-for-granted that leads the human agent to respond to stimuli without thinking, without problem solving, and without providing “good care” for the dying and infirm. The possibilities of choice and alternatives are removed from the realm of reflective interaction into the realm of the taken-for-granted as defined by the organizational structure. The social constraints imposed by the large-scale organizations must be understood in a dual sense as both constituent features of people’s reasons and motives as well as part of the “external” set of cultural resources and obstacles to the fulfilment or achievement of objectives.17 More specifically, our concern must be directed toward how human agents reflectively “use” the structure to achieve objectives that are often counter to the goals of the organization. It is only by examining the ability of human agents within the bureaucracy to reflectively carve out space within these organizations that we can empower them in their efforts to shape the course of events and find substantive meaning – in other words, to carve out a space for caring within structured organizational settings.

Notes David Moller, Confronting Death: Values, Institutions & Human Mortality (New York, New York: Oxford University Press, 1996), 24. 2. Herbert Blumer, Symbolic Interaction (Berkeley, California: University of California Press, 1969). 3. Anselm Strauss, Continual Permutations of Action (New York, New York: Aldine de Gruter, 1993). 4. Anselm Strauss, Negotiations: Varieties, Contexts, Processes, and Social Order (San Francisco, California: Jossey-Bass, 1978). 5. David Maines, “In Search of Mesostructure: Studies in the Negotiated Order,” Urban Life 11 (1982): 267-279. 6. Peter Hall, “Meta-Power, Social Organization and the Shaping of Social Action,” Symbolic Interactionism 20(4) (1997): 397-418. 7. Max Weber, From Max Weber, trans. and ed. by H. Gerth and C. W. Mills (New York, New York: Oxford University Press, 1946). 8. Anthony Giddens, The Constitution of Society (Berkely, California: University of California Press, 1984). 9. Jurgen Habermas, The Theory of Communicative Action: Lifeworld and System: A Critique of Functional Reason (Boston, Massachusetts: Beacon Press, 1987). 10. Hans Joas, The Creativity of Action (Chicago, Illinois: University of Chicago Press, 1996), 133. 11. Joas, 216-220. 1.

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____________________________________________________________ 12. Louis Zurcher, Social Roles: Conformity, Conflict, and Creativity (Beverly Hills, California: Sage, 1983), 283. 13. Michael Levy, “Pain Control Research in Terminal Care,” Omega 18 (1988): 265-280. 14. Robert Kastenbaum, Death, Society, and Human Experience, 8th edition (New York, New York: Merill, 2000),176. 15. Gideon Sjoberg, Elizabeth Gill and Joo Ann Tan. “Social Organization,” in Handbook for the Study of Symbolic Interactionism, eds. Larry T. Reynolds and Nancy J. Herman-Kinney (New York: AltaMira Press, 2003), 411-432. 16. Francesca Cancian and Stacey Oliker, Caring and Gender (New York, New York: Altamira Press, 2000), 2. 17. Derick Layder, Modern Social Theory: Key Debates and New Directions (London, England: UCL Press Limited, 1997).

References Blumer, Herbert. Symbolic Interaction. Berkeley, California: University of California Press, 1969. Cancian, Francesca and Stacey Oliker, Caring and Gender. New York, New York: Altamira Press, 2000. Giddens, Anthony. The Constitution of Society. Berkely, California: University of California Press, 1984. Habermas, Jurgen. The Theory of Communicative Action: Lifeworld and System: A Critique of Functional Reason. Boston, Massachusetts: Beacon Press, 1987. Hall, Peter. “Meta-Power, Social Organization and the Shaping of Social Action.” Symbolic Interactionism 20(4) (1997): 397-418. Joas, Hans. The Creativity of Action. Chicago, Illinois: University of Chicago Press, 1996. Kastenbaum, Robert. Death, Society, and Human Experience, 8th edition. New York, New York: Merill, 2000. Layder, Derick. Modern Social Theory: Key Debates and New Directions. London, England: UCL Press Limited, 1997.

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____________________________________________________________ Levy, Michael. “Pain Control Research in Terminal Care.” Omega 18 (1988): 265-280. Maines, David. “In Search of Mesostructure: Studies in the Negotiated Order.” Urban Life 11 (1982): 267-279. Moller, David. Confronting Death: Values, Institutions & Human Mortality. New York, New York: Oxford University Press, 1996. Sjoberg, Gideon, Elizabeth Gill and Joo Ann Tan. “Social Organization.” In Handbook for the Study of Symbolic Interactionism, edited by Larry T. Reynolds and Nancy J. Herman-Kinney, 411-432. New York: AltaMira Press, 2003. Strauss, Anselm. Continual Permutations of Action. New York, New York: Aldine de Gruter, 1993. Strauss, Anselm. Negotiations: Varieties, Contexts, Processes, and Social Order. San Francisco, California: Jossey-Bass, 1978. Weber, Max. From Max Weber. Translated and edited by H. Gerth and C. W. Mills. New York, New York: Oxford University Press, 1946. Zurcher, Louis. Social Roles: Conformity, Conflict, and Creativity. Beverly Hills, California: Sage, 1983.

Reflections on the Needs of Palliative Patients after Being on the Receiving End of Care Anna Wreath Taube

I am a Canadian palliative physician who recently experienced a Neurosurgical Intensive Care Unit admission, due to suspicion of a ruptured brain aneurysm. From the first day of this admission some parallels between my position and that of bed-bound palliative patients were evident. I found myself reflecting on the insights I was gaining into my own patients’ needs from being on the receiving end of care in this way. By offering my own reflections in this chapter I hope to stimulate those of readers, pertaining to the needs of palliative patients. My own reflections say a great deal about myself, of course, and those of readers may differ. One salient comment after the presentation of the conference paper that led to this chapter related to unawareness that current care of palliative patients may not necessarily be characterized by insight into such needs. The chapter is divided into four major sections: Reflections on Patient Stressors; Reflections on Aids to Patient Coping: Professional Caregiver Behaviours; Reflections on Aids to Patient Coping: Personal Strategies; .Reflections on Aids to Patient Coping: Support and Solidarity from Friends and Family. 1.

Reflections on Stressors. In the Intensive Care Unit I was placed on the “Subarachnoid Bleed Protocol”, a situation in which the patient must lie with the head of the bed elevated less than thirty degrees at all times and in which minimal participation in Activities of Daily Living is permitted. Self-bathing, selfgrooming, self-toileting and reading were out! These enforced conditions were somewhat analogous to those of end-stage palliative patients confined to bed because of extreme weakness or other symptoms. A. The Stressor of Changed Sense of Personhood An immediately experienced stressor was a changed sense of personhood, due to the conditions of now total dependence and loss of control. The person who I normally am, relishing independence and selfassurance, a caregiver by nature, was having great difficulty to surface in these changed circumstances. The role reversal was crippling, making me

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Reflections on the Needs of Palliative Patients

____________________________________________________________ now highly sensitive to the challenge of role loss for my patients. B. The Stressor of Changed Sense of Body Image The second stressor was a changed sense of body image, due to hospital gowns and the inaccessibility to personal grooming. There was the issue of bodily functions! Never again will I offer a bedpan to a lying patient. Fluid finds access to nooks and crannies that no sponge bathing seems able to reach. By the second day I was begging for a urinary catheter. Again, the changed sense of body image somehow compromised my sense of personhood. The reality of this changed image was borne home by an outpatient visit to the neurosurgeon after discharge. He entered the examining room, stopped in his tracks, eyeing the street clothes and made-up state, and said “Oh, my goodness!” Now I have even greater respect for patients trying to maintain some semblance of normal body image and for family members attempting to aid totally dependent, disease-ravaged patients to do so. C. The Stressor of Waiting There was the stressor of waiting: for physician visits, for being on-call for tests, for test results, for diagnostic decisions, for management decisions, for treatment. For myself this situation lasted only two months. How much worse for palliative patients waiting through to the end of life? Waiting cannot be eradicated but can thoughtful professionals consciously aim to minimize this aspect of patient-hood? Would the professional tenor of care for these patients be tempered by the appreciation of the stress of repeated waiting for those who have little time left? D. The Stressor of False Reassurance: A tenet of western world palliative medicine is to avoid the trap of giving false reassurance and false hope. At one point I had just had a discussion with the neurosurgeon about the finding of a small brain aneurysm. Given its location, he had elaborated on the extreme technical difficulties and risks of neurosurgery. Shortly after, a friend appeared and asked how things were going. I described the news. I knew that his worldview, coming from a fundamentalist religious perspective, was different from mine. Nevertheless, his response: “Don’t worry. God will make everything all right” was hurtful. He cut off the opportunity for me to share my anxieties. I had a sense of his trivializing my concerns and fears, leading to strong feelings of disrespect, frustration and even anger. How much more hurtful and destructive is false reassurance and analogous trivializing for patients facing fears of dying and death?

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____________________________________________________________ E. The Stressor of Poorly Broken Bad News There was the stressor of poorly broken bad news, sadly a frequent experience for palliative patients. For myself, an initial electroencephalogram (EEG) was abnormal, raising the possibility of epilepsy. On returning for a second, now sleep-deprived EEG (no sleep for twenty-four hours, without the aid of caffeine), the technician initiated a conversation about my need to prepare myself for the loss of my driving license and about anticonvulsant drugs. I was exhausted and totally unprepared for this inappropriate information from a technician. Although knowing better, however, I could not help myself from asking at the end what this test showed? Her response was “Ah. You must talk to the doctor.” The anxiety during the 48-hour wait to do so is perhaps imaginable. Of the many experiences during this episode of illness, I found this encounter of poorly and inappropriately broken bad news the most anxiety provoking of all. How much worse for patients being told abruptly of the reality of terminal illness with no immediate opportunity for further discussion? Many patients recount such an experience. F. The Stressor Of Emotional Roller Coasting There were multiple experiences of this phenomenon as diagnosis and treatment decisions changed. Now, prior, for example, to seeing a cancer patient in palliative consultation, I find myself perusing the cancer centre consultation notes with a different perspective. The conscious reflecting on the patient’s roller coasting experiences, such as being told that there was no evidence of disease spread only to present with symptoms of incurable spread a few months later, enhances my sense of compassion and understanding of the illness experience. 2.

Reflections on Aids to Patient Coping: Professional Caregiver Behaviours –Person-Centred Care. I also found myself reflecting upon those professional behaviours I encountered that seemed to aid my coping with the challenges of the sudden turnaround in circumstances. For myself, and thinking of experiences related to me by so many of my own patients in the past, a great challenge appeared to be the maintenance of an intact sense of personhood. I would now like to draw upon my own reflections and upon examples from the literature to construct a concept of person-centred care of patients. I would propose that this concept is applicable in the practice of all spheres of medical and allied health care professional disciplines. The concept of Patient-Centred Medicine, as developed and disseminated throughout Family Medicine Residency Training Programs in Canada by

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____________________________________________________________ Dr. Moira Stewart and colleagues at the University of Western Ontario, has some parallels.1 A. The Wearing of Identification Perhaps a relatively minor issue, but after having been examined by six different physicians in the emergency department, I was so appreciative of those who were wearing identification. I could greet them on their second or third visits and keep track of who was who, thus giving myself some tiny sense of control. B. The Anticipation of Patient Physical Needs On the third day of admission I found myself contemplating the particular excellence of that day’s nurse and communicated this to her. She asked “Why?” After reflection I realized that her excellence was due to her ability to anticipate both my physical and emotional care needs, and that her ability to do so minimized my need to make requests, thus lessening my sense of total dependence. She revealed that a mentor during her training once asked her “What is the difference between a good intensive care nurse and an excellent intensive care nurse?” The mentor’s definition hinged on the ability of the excellent nurse to anticipate the care needs of totally dependent patients. I now find myself offering a last sip of water and asking bedridden patients if there is anything I can do for them before I leave their room. C. The Anticipation, Assessment, Validation and Support of Patient Emotional Needs In 1991 Dr. Eric Cassell published his now classic text The Nature of Suffering and the Goals of Medicine.2 He poignantly argues: The test of a system of medicine should be its adequacy in the face of suffering; this book starts from the premise that modern medicine fails that test… - bodies do not suffer, persons suffer…what is lacking in twentieth-century medicine is an adequate consideration of the place of the person of the patient. 3 In 2002 Dr. David Kuhl, a palliative physician who obtained his doctorate as one of the Soros Faculty Scholars of the Project on Death in America, published a book entitled What Dying People Want – Practical Wisdom for the End of Life.4 He contributes further to the concept of the importance of the person. In this book he documents his existential

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____________________________________________________________ phenomenology research findings into the question of “What is the lived experience of knowing you have a terminal illness?” He asked patients what they wanted others to know about their experience. A common theme was: “For the most part, they wanted to be heard and to be understood simply for who they were in the world – in their families, in their work, in their pain, in their isolation, in their grief, suffering and hope.”5 One patient, Marjorie, related to him how “She had spent the night weeping, not because she had learned she had cancer but because of the way in which she learned about it.”6 The following morning she confronted her physician: “It’s the way you told me I have cancer… I thought that you considered me a person, not just a disease, but them you stood in the door and told me I had cancer and went away.” 7 She “Looking back over the ten years since that diagnosis, Marjorie said that the emotional pain she experienced was greater than any of the physical pain she experienced.”8 Marjorie was a victim of poorly broken bad news: the impact of the news upon her emotional person was totally discounted in the telling. My own patient, John, felt that his personhood had been totally violated. He had been attending a cancer centre for several years and during this time had had little contact with his family doctor. He had been recently admitted to the centre but then transferred to a palliative unit in another location, for pain management. He was discharged home in good symptom control. A month later he was referred to myself for advice re management of his increased nausea. As I entered his home, an affluent setting, a home care nurse was establishing a drug infusion for him. I immediately felt a strong sense of hostility from John and his teary wife. She angrily indicated they had had to pay $160 dollars for this drug and made several references to the mismanagement of health care. I put away all materials. I asked if something bad had happened. John revealed that, as had been his practice, he had called the cancer centre nurse a few days earlier with some questions. The nurse informed him that his chart documentation indicated he was discharged from active treatment there; that his future care would be from his family physician. With tears, John asked, I’ve been seeing my cancer doctor for five years and he doesn’t think I’m worth enough to tell me himself that he’s discharging me! How do you think that makes me feel?” His person was suffering intensely. Not surprisingly, his nausea dated from this conversation with the cancer centre nurse and significantly lessened after the venting session with a committed listener. Professional and lay caregivers can aid immensely by anticipating, assessing, validating and supporting patients’ emotional

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____________________________________________________________ needs. Emotionally unsupported patients may be become “difficult patients”, through no fault of their own. Suchman et al. published the qualitative research findings of audiotaped or videotaped interviews between staff physicians or training physicians and patients in A Model of Empathic Communication in the Medical Interview. 9 The question for examination was whether physicians were able to pick up patient cues of emotional distress, reflect the assessment back to patients to validate both the assessment and the existence of the emotional states, and then to meet the assessed emotional needs. This skill was described as the cognitive skill of empathy. The research findings were that physicians missed or ignored the majority of emotional cues. It was also noted that many patients serially escalated their cues of emotional distress, without success in these being acknowledged. The lack of anticipation and meeting of Marjorie’s and John’s emotional needs, and the ensuing sense of disrespect to their personhood, contributed hugely and lastingly to their suffering. D. The Preservation of Dignity In 2002 Dr. Harvey Chochinov, a psychiatrist with a longstanding interest in the palliative population, published a seminal article in the Journal of the American Medical Association: Dignity-Conserving Care – A New Model for Palliative Care – Helping the Patient Feel Valued.10 Chochinov proposes that: The basic tenets of palliative care…may all be summarized under the goal of helping patients to die with dignity…The physician’s challenge in palliative care is to understand how a particular patient and his or her family perceive dignity and create interventions that enhance it…the concept of conserving dignity in endof-life care should become…the overarching standard of care for all patients nearing death. One of the most potent dignity-conserving strategies lies in understanding the notion of care tenor. This denotes the affective and attitudinal tone of care…it is most fundamentally based in the ability to see the patient as a whole person….Maintaining dignity goes beyond what one does with or to a patient, and often resides in how one sees the patient.11 On the basis of his qualitative research findings Chochinov proposes three assessment and intervention domains: Illness-Related Concerns

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____________________________________________________________ (addressing symptom distress and maintenance of independence); a Social Dignity Inventory (addressing social issues and relationship dynamics); and the Dignity-Conserving Repertoire (addressing and enhancing patients’ psychological and spiritual landscape, personality characteristics and internal resources). His Dignity-Conserving Repertoire offers approaches to assessment and interventions to maintain patient dignity in those areas found to be important through his research: continuity of self; role preservation; pride; hopefulness; autonomy and control; generativity and legacy; acceptance; and/or resilience and fighting spirit. Suffering caused by irreversible illness-induced would surely lessen with the adoption of the attitudes, the use of the skills and the care tenor he delineates. E. Meeting Patient Medical Information Needs, Aligned to Patient Desires In North America it is now the proposed norm to inform competent patients of their diagnosis, treatments options and prognosis, but to do so in a manner that is aligned to each individual’s understanding of his/her disease status, desire for information and wish for participation in decision-making. The pendulum has swung from non-disclosure to forced full disclosure to disclosure tailored to each individual patient’s needs landscape. I enormously appreciated my physicians’ ability to interact with me in this way. They were able and willing to discuss these issues in a manner that was respectful of and aligned to my own professional knowledge – but also ensured that I did not have inappropriate assumptions. Sadly, not all physicians in the patient role are as fortunate: they often find themselves perceived as threatening to their professional caregivers. In general, patients who find discussion of their medical information customized to their level of understanding, desire for information and emotional abilities to handle such information express great satisfaction with their professional caregivers. F. Professional Awareness of the Concept of Therapeutic Solidarity My own professional experience has led me to conclude that professional caregivers should never underestimate the therapeutic potential of just “being with patients”, of creating a human-to-human sense of solidarity with patients. 3. Reflections on Aids to Patient Coping: Personal Strategies. A. The Maintenance of Dignity From the first understanding of my reality, I was aware of a conscious need to preserve my sense of dignity, through emotional control

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____________________________________________________________ and maintenance of positive thinking. I only later came to the conclusion this was part of my attempt to preserve my sense of person. The thing was, I had no idea how much energy this would take! I appreciated, more than I would have expected, recognition of my attempts by others. I now find myself commenting to patients on their graciousness, dignity and courage and asking them how much energy it is taking to project these. The looks of gratitude on their faces are humbling. B. A Focus on Loved Ones This must be a universal strategy, for those fortunate enough to have loved ones. Although no cards or flowers were permitted in the Intensive Care Unit, I insisted on having a photograph of my one-year-old cousin pinned above my bed. Curious inquiries as to the identity of this beloved little one somehow enhanced my own sense of personhood. C. The Use of Imagery Never had I imagined I would one day use the technique of imagery myself. Prior to the admission my husband and I had just returned from a very special holiday in Alsace with close friends. As I was undergoing Magnetic Resonance Imaging (a not so pleasant experience, due to incessant loud knocking noises from the machinery as one is enclosed in a very narrow tunnel-like space), I decided to cross the threshold of the farmhouse we had rented together and to envisage the décor and contents of every single room. Two thirds of my way through the house I fell asleep, to be awoken at the end of the procedure. Similarly, at the start of a second brain angiography I decided to relive a recent ocean-kayaking trip on the west coast of Canada. The procedure passed quickly and without unpleasantness. I have since enabled patients to utilize this distraction tool successfully on a number of occasions. Prior to my own experience it was only an abstract concept. D. Establishment of Human-to-Human Relationships with Professional Caregivers I realized how important it was for me, as patient, to attempt to establish a sense of human connection with caregivers, knowing that their sense of commitment to my care would be stronger if they saw me as a person. David Kuhl’s Marjorie described her first breast biopsy: “It was the most horrifying experience, and I was angry…she felt absolutely alone, not connected to the physician performing the procedure, in pain and horrified.”12 The next biopsy occasion she took a friend with her. “The

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____________________________________________________________ result was painless, two absolutely painless biopsies.” 13 Could the physician performing her first biopsy have lessened her suffering by providing a sense of connecting to her as a human being, by providing a different care tenor? 4. Reflections on Aids to Patient Coping: Support and Solidarity from Family and Friends. I never before had experienced the supportive power of visits, phone calls, messages on answering machines, cards, flowers, gifts, food, support to my family in a time of serious illness. I also realized that those who “did” rather than said, “Let me know what I can do”, were priceless. Often I simply did not have enough energy to figure out what someone could do for me. I would like to conclude with this wonderful tale: One Stick, Two Stick: The Way of the Old African Kings An old man is dying. He calls his people to his side. He gives a short, sturdy stick to each of his many offspring, wives and relatives. “Break the stick” he instructs them. With some effort, they all snap their sticks in half. “This is how it is when a soul is alone and without anyone. They can be easily broken.” The old man gives each of his kin another stick, and says, “This is how I would like you to live after I pass. Tie your sticks together in bundles of twos and threes.” He waits quietly as his family ties the sticks together. There are many bundles, some of two sticks, some of three sticks. “Now break these bundles in half” No one can break the sticks when there are two or more in a bundle. The old man smiles. “We are strong when we stand with another soul. When we are with others, we cannot be broken.”14 For those palliative patients who so wish, can we help them to remain unbroken by being with them in soul, as well as by knowledge, attitudes and skills? I would also like to reinforce another comment from the audience: the care of these patients, although demanding and, at times, sorrowful, is never morbid or depressing. It brings enormous reward and can so fulfil the caregiver’s soul.

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Notes 1.

2. 3. 4. 5. 6. 7. 8. 9.

10.

11. 12. 13. 14.

Moira Stewart et al., Patient-Centred Medicine: Transforming the Clinical Method (Thousand Oaks, California: Sage Publications, 1995). Eric Cassell, The Nature of Suffering and the Goals of Medicine (New York: Oxford University Press, 1991). Ibid, ***. David Kuhl, What Dying People Want – Practical Wisdom for the End of Life (Canada: Doubleday Canada, 2002). Ibid, xxvi. Ibid, 45-46. Ibid, 46. Ibid, 46. Anthony Suchman, et al., “A Model of Empathic Communication in the Medical Interview,” Journal of the American Medical Association 277 (1997): 678-82. Harvey Chochinov, “Dignity-Conserving Care – A New Model for Palliative Care: Helping the Patient Feel Valued,” Journal of the American Medical Association 287 (2002): 2253-2260. Chochinov, ***. Kuhl, 114. Kuhl, 114. Clarissa Estes, Women Who Run with the Wolves: Myths and Stories of the Wild Woman Archetype (New York: Ballantine Books/Random House, 1997).

References Cassell, Eric. The Nature of Suffering and the Goals of Medicine. New York: Oxford University Press, 1991. Chochinov, Harvey. “Dignity-Conserving Care – A New Model for Palliative Care: Helping the Patient Feel Valued.” Journal of the American Medical Association 287 (2002): 2253-2260. Estes, Clarissa. Women Who Run with the Wolves: Myths and Stories of the Wild Woman Archetype. New York: Ballantine Books/Random House, 1997. Kuhl, David. What Dying People Want: Practical Wisdom for the End of Life. Canada: Doubleday Canada, 2002.

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____________________________________________________________ Stewart, Moira, Judith Belle Brown, W. Wayne Weston, Ian R. McWhinney, Carol L. McWilliam, and Thomas R. Freeman. PatientCentred Medicine: Transforming the Clinical Method. Thousand Oaks, California: Sage Publications, 1995. Suchman, Anthony, Markakis Kathryn, Beckman Howard, and Frankel Richard. A Model of Empathic Communication in the Medical Interview. Journal of the American Medical Association 277 (1997): 678-82.

Notes On Contributors

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____________________________________________________________ Angela Armstrong-Coster, School of Social Sciences, University of Southampton, UK. - [email protected] Ashley Byock, Department of English, Northwestern University, Evanston, IL, USA Havi Carel, Department of Philosophy, University of York, United Kingdom Mira Crouch, School of Sociology, The University of New South Wales, Sydney, Australia Laura Cruz, Western Carolina University, Carolina, USA Paula David, Coordinator, Holocaust Resource Project, Baycrest Centre for Geriatric Care, Toronto, Canada Marguerite Peggy Flynn, Director, The Good Death Institute, Palm Springs, CA, USA Lawrence Fouraker, Department of History, St. John Fisher College, Rochester, NY, USA Dana Freibach-Heifetz is a member of The Franz Rosenzweig Research Centre, The Hebrew University of Jerusalem, Israel Elizabeth Gill, Ph.D., is an Associate Professor of Sociology at the Randolph-Macon College, Ashland, Virginia 23005 USA Kathleen W Jones, Department of History-Virginia Tech, Blacksburg VA, USA Asa Kasher, Laura Schwarz-Kipp Professor of Professional Ethics and Philosophy of Practice and Professor of Philosophy, Tel-Aviv University, Israel Gary Peters, University of the West of England, United Kingdom Dr. Anna Wreath Taube is a consultant palliative physician, Regional Palliative Care Program, Edmonton, Alberta, Canada, and an Associate Professor, Division of Palliative Care Medicine, Department of Oncology,


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____________________________________________________________ University of Alberta, Edmonton, Alberta, Canada Kathleen Z. Young is an Associate Professor of Anthropology at Western WA University. Bellingham, WA 98225 USA

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