Discussion Post for THE LOST ART OF DYING, Chapter 5, Pages 91-99

In my comments this week, I am going to skip over the initial pages of this chapter in which Dr. Dugdale reflects upon Albert Camus’s novel, The Plague. Nevertheless, please feel free to include thoughts about these pages in your comments.

I will focus my reflections on the part on this chapter that is about the writings, concerns, and choices of Susan Sontag. Here are a few quotes:

In her 1978 book Illness as Metaphor, the literary giant Susan Sontag explains how the military metaphor was popularized in the 1880s when bacteria were identified as “agents of disease.” Eventually that language was appropriated for cancer.

Page 96

Sontag was so terrified of death that she could not speak of it . . . She could write about death with unusual eloquence. And she fully understood that one day she herself would die. But she could not bring herself to say it.

Page 96

Despite Sontag’s fear–or perhaps as a manifestation of it–she was obsessed with death. She visited cemeteries . . .. She even kept a human skull on her worktable–a true memento mori. The fact that she refused to resign herself to death “gave her resolve,” according to her son, “to undergo any treatment, no matter how brutal, no matter how slim her chances.”

Page 97

I can’t tell from Dr. Dugdale’s narrative whether Sontag was critical of the military metaphor she explained in her book, whether she expressed approval of it, or whether she applied it to her own experience of disease. Dr. Dugdale certainly applies the military metaphor in her description of Sontag’s diseases, recalling how Sontag “survived” breast cancer, “beat” uterine cancer, and was “defeated” by leukemia. Whatever Sontag might have thought about the use of such language to describe her history of illness, it does seem consistent with her son’s description of her “resolve.”

We have talked before about this kind of language and the frequency with which it is used. I hear it all the time in the hospitals in which I minister. Being treated for cancer is almost always a “battle” in which the sick are “fighting.” Even in eulogies praising deceased love ones, those people are said to have “lost” their “battle” with cancer after putting up a valiant “fight.” Cancer and other diseases win this battle when sick people die. And, since we will all die, we will all conclude our lives as losers. In the meantime, the sick live as fighters, defined in opposition to their disease, going down swinging in mortal combat with the inevitable.

Susan Sontag seems to have defined herself by her opposition to death in a remarkable way. For most people, I think, fearing death makes them want to ignore death, to put it out of sight and mind. Sontag’s reaction seems to have been the opposite. Her fear of death caused her to obsess over it. Dr. Dugdale refers to Sontag’s desktop skull as “a true memento mori.” But its purpose for Sontag is the opposite of it purpose in the medieval tradition. For medieval Christians, remembrances of death were aids for accepting death as the inevitable conclusion of earthly life and the transition to the heavenly life to come. For Sontag, remembrances of death seem to be ways of staying focused on an enemy whom she would resist at all costs. I don’t know whether that was morbid or courageous or both or something else? Maybe you have ideas about that?

All who were close to Sontag in her final months conspired to speak words of hope rather than truth. This was what she wanted, but such a conspiracy made it impossible to tell her that she was dying. They could not say goodbye properly or fully express their love for her–to do so would be to admit defeat.

Page 99

It seems strange to me that Susan Sontag, who fixated on remembrances of death throughout her life, wanted to remain ignorant of her own death when it drew near. I’m sure some of you have insights into that kind of mentality that don’t occur to me.

The kind of conspiracy described here, however, is familiar to me. I see this kind of deception happening frequently. It may be more or less explicitly conspiratorial, but people often try to shield their dying loved ones from the truth about their state of health. This may be justifiable in cases like Sontag’s in which such ignorance seems to have been the patient’s express will. But it remains sad, as Dr. Dugdale relates. I think this kind of deception usually has as much to do with the fears of family members and medical professionals as it does with the fears or wishes of patients. I also think dying patients frequently know more than people think they do. I myself have had the experience of being a patient (not dying, but recovering from major surgery) and hearing and knowing much more about my condition than everyone else seemed to think.

I will be interested to read your comments about how the fear of death leads us to talk and think, or avoid talking and thinking, about death and potentially terminal disease. Thank you for sharing your insights.

5 thoughts on “Discussion Post for THE LOST ART OF DYING, Chapter 5, Pages 91-99”

  1. After my mother was diagnosed with cancer, she embraced bright colors, happier television shows, happier movies, and happier books. Along with her resolve to fight the cancer and to seek medical care, she also resolved to look at the brighter side of life and to be herself. I think giving up is never the answer. This was her way of handling the fear of death.
    It is right to have hope, but it is also right to plan for our passing because some day we will all pass away. Society seem programmed to fight for every drop of life and to fear the unknowns of life ever after. I think Sontag had a fear the unknown. She did not know what was coming next. She is missing a part of hope. As Christians we hope for a better life in the hereafter. This does not stop us from fearing, but it is another element of hope.
    Camus on the other hand seems to embrace the extremes of human reaction. There are those who go forward in complete reckless denial, and then there is the flipside of those who wallow in misery and self-pity. Dugdale mention of these excess reactions seems to underline a human inability to accept the inevitable with some grace and practicality.

  2. WE make every effort to respect the will of the dying loved one. Some family members follow a spiritual code and believe they die into some sort of life- some struggle with their faith, but ultimately reconnect with Religion and hopefully believe, they will merit eternal life Others, convinced that Religion is a sham, believe there is nowhere to go but here and now. They live according to their own rules
    When a dying loved one is a nonbeliever, we make ongoing efforts to bring them into light, and continue to hope and pray for them. Despite their spiritual beliefs or religious affiliation, we want the maximum comfort for our loved ones especially when they are on death’s doorstep. We want to see them peaceful-and for them to know they are loved. For some of us, our challenge is to respect the will of a dying loved one – even if you do not agree with them
    In some cases, family members cannot accept that their loved one will be swept away from them, leaving a hole in their heart, – they deny the reality of death- They hold on as long as they can—even if it means pretending.

  3. ….The comment that “she visited cemeteries”….made me smile …..since this is a very long, deep seated tradition in our family…
    obiously less so as time goes on, children move, and elders pass on….however; my sisers and I made it a “tradition” on anniversaris
    or Christmas, or St Patrick’s Day….would gather to visit, pray, laugh, remember, and then “had a bite to eat”…You see our dad had done that, too….for many years…he took us…so, again, children learn what they live!! My Mom lost my dad in her 50s….a newly retired civil servant, massive heart attack, AMEN!I was only 20….a very lasting vivid impression of life’s cruelties….the only one left living at home….I would drive my mom, the non driver in my dad’s car, to Calvary….We, too would try to make a day of it!!!!!!!….then, with my own toddler, gram and I and baby, would take off…To this day, my grown up daughter now knows exactly “how to get there”….my father had taught us about the LIE and the bg trees over the BQU….background surrounding the “GRAVE” …which belonged to his grandmother….large for those days…and very nearby, a smaller one for his dad/mom…less disposable income, with raising three children!!…Anyway, my nephew now asks…”are you and mom going to the cemetery for your birthdays?? …with a grin…..we proudly answer in the affirmative…the two
    of us who are left…..My sister who we lost, youngest son, when small, “sang” at the grave to grandpa….and her daughter did cartwheels on the grass!!!! We all “missed” them…….but we all “enjoyed” our special time in Calvary!!! Fear was not really in our process….I think fear
    is many times “taught”…hence the words “fighting” “wining”…etc. knowing full well, when it’s your time, there is no win or lose, just
    process…..and “onward” to the hereafter…One of the classmates here noted the absence of religious/spiritual beliefts in Sontag…which is again, I agree, very important, since if you do not believe …..then skulls are scarey and death is frightening…..Fear of “coming to death”
    with tubes, pain, and so forth…that is the actually scarey part……………..the part our society needs to work on, I think. The Les Muerto in Hispanic culture with cards, photos and such on the side altars in some city churches….sheds yet a different perspective on “death”, too.
    The comment on “shielding people” from truth about illness…is one I appreciate, for others, but find totally counterproductive to all
    involved……My husband and my dear friend from law school, who lives in Mass. now….always loved to say “whatever you do, don’t tell me the truth” and they both meant it. He, no fool, and she, very very bright in her chosen field….both of whom prefer to “put their heads under the rug” ….no matter how big or small the issue. This makes it totally difficult for those having to deal with them….this peeking around things….just complicates issues……..something like in my sister’s case….nothing will change the truth…..as my husband’s advocate..I have to know the problem/issues,…heaven knows, he doesn’t!!!! How can informed decisions regarding risks and benefits be made in “ignorance”!! I don’t get it…..but I respect their twisted sense of reality!!…….most of the time!!!!!!!!!!!!!
    Vera O

  4. I also don’t want to belabor the military analogies, but I think it’s interesting to recognize how far back and how deeply they exist in our discussion of illness: Dr Dugdale includes words like “infiltrate” and “invade”, which, working in the hospital, I no longer even recognize for their war-based origins, while they still subconsciously lead my mind in a certain direction. Language is very powerful!

    I think it’s important to recognize the paradox of Sontag’s life & approach to death because as confusing as it is, it is probably not an uncommon thought pattern regarding death. As Jacqueline says above, it even makes sense with that worldview. Even coming at it from a different worldview (that includes some sort of afterlife), I think it is much easier to theorize about death or consider the art of dying in the abstract, but when it becomes more real, there’s always a temptation to push it to later. It’s funny, because recognizing that sometimes we cannot push that discussion – whether with ourselves, a family member, or a patient – off until later may require more “strength” than the sort of cavalier approach to “fight” at all costs. As much as I dislike the military analogy, it still applies – we must know when to cut our losses and move on.

    With regards to Camus’ The Plague, I think Dr Dugdale highlights another extreme that we may fall into with an eternal worldview, which is the fire-and-brimstone approach to viewing approaching death, especially in times of pandemic or seemingly unexplicable, random illness. We must be wary of this tendency, because as with fighting at all costs, in a way, it is an overly simplistic approach to suffering. The art of dying must fall somewhere in between.

  5. From Susan Sontag’s writings, we can deduce that she did not appreciate the use of metaphors for illness. She challenges the victim-blaming language and argues that the most truthful way to describe illness is without metaphors. That said, she makes these statements in the 1970s in the context of societal viewpoints on tuberculosis and cancer. Those patient-shaming theories included the notions that illness could be caused by a lack of passion, by repressing one’s feelings or even as a punishment for past actions. When she does speak about the military metaphors, she seems to place the duty of the “fight” on research, doctors and medicine. Science loses and wins the battles against disease. People simply pass in and out of states of illness and wellness. She seems to believe that asking patients to go to battle for their lives can be detrimental by exacerbating their burdens.

    Susan Sontag once remarked:
    “We no longer study the art of dying,…but all eyes, at rest, contain that knowledge. The body knows. And the camera shows, inexorably.”
    She also said:
    “All photographs are memento mori. To take a photograph is to participate in another person’s (or thing’s) mortality, vulnerability, mutability. Precisely by slicing out this moment and freezing it, all photographs testify to time’s relentless melt.”

    Although born into the Jewish faith, Sontag has at times commented that she has no spiritual values, does not believe in God and does not think there is life after death. If all you have is here right now, you would probably avoid the end at all costs. That would explain denying death and leaving this world literally kicking and screaming. Something–even something difficult–is better than nothing at all.

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