With on-demand diversion and death-defying delusion, modern consumer culture invites us to do the opposite: deny our mortality. We chase eternal youth with cosmetic surgery, caloric restriction, and anti-aging elixirs. Dying bodies are regarded, or defensively disregarded, as other, though we will all inhabit one sooner or later. When my eyes fall on the mottled skin of Miriam’s puffy ankles, thick yellowed nails curling around her toes, it’s hard to imagine my feet in that condition. Many of us don’t encounter a corpse until we are well on our way to becoming one, and even then the cadaver is likely to be chemically preserved and prettified, far from its natural state. This is a recent development. Until the early 20th century, most people died at home, where families laid out the body in the parlor for the funeral. With the emergence of funeral parlors, the
Ladies’ Home Journal proposed renaming the home parlor, no longer needed for the dead, the “living room.”
As we smash through climate records—so far this summer we’ve had the hottest day, the hottest June, the lowest Antarctic sea-ice, and the highest ocean temperatures—Miriam’s admonition—Don’t wait—reverberates as a message for us all.
Thus began the increasing distance between the living and the dead, which grew until the vast majority of Americans were dying in nursing homes or hospitals, often after aggressive care that traumatized patients and their families, “heroic measures” that neither prolonged life nor permitted humane death. The mentality driving this overmedicalization considers death a failure to be avoided at any cost rather than the natural counterpart to birth in the cycle of life.
Though aware of her poor prognosis at age 95, Miriam declared, “I’m a fierce old biddy, and I’m not ready to die!”
In her pronouncement, I heard a mixture of determination and distress that mirrors my own. Since the dawning of my consciousness, I’ve been terrified of its annihilation, flooded by waves of existential terror, full-body awareness of the inescapable extinction of my spirit, the irreversible blackout of my brief crack of light between eternities of darkness. My adolescent self found the sensation unbearable, so I’d blast the radio, call a friend, run outside—anything to escape the fear.
Paulette, a turbaned Haitian woman with warm hazel eyes and a heavy accent that Miriam strained to understand, opened the door and announced my arrival.
“I’m still here!” Miriam exclaimed, “even if I can’t sing like Elaine Stritch. Thank goodness you came. I’ve been missing you for weeks.”
I gently reminded her that I’d been there a few days ago.
“Well, it felt like weeks, which I filled with thoughts of how nice it would be to have a cat. I want another living being with me. There’s only my plant. But pets aren’t allowed.”
It occurred to me to draw her attention to the fact that an aide was always with her, but I knew she would reply with an exasperated “Oh please,” which Paulette might hear from the kitchen.
While Miriam thanked me effusively during every visit, she expressed only dissatisfaction with her “help,” dismay at their poor work ethic, contempt for their ignorance, indifference to their humanity. They bore the brunt of her frustration, as if they were the cause rather than a result of her condition. Like our dissociation from the reality of death, this is a form of denial, as in “the need to be innocent of a troubling recognition,” to borrow Stanley Cohen’s definition in States of Denial. Miriam’s disdain for her aides shielded her from the troubling recognition of her own vulnerability, her inability to manage without them, and from the equally troubling recognition that there’s no good reason Miriam could afford to pay Paulette to wipe her bottom instead of vice versa. When Paulette is dying, she will not have enough money for 24-hour home care.
One sweltering afternoon, Miriam asked Paulette to apply rouge and lipstick in preparation for a visit from Miriam’s sister, which she had been anticipating with excitement and apprehension, fretting about her clothes hanging off her “like a scarecrow.” Three minutes after the designated arrival time, she frowned at the clock.
“I’d think I was in purgatory,” she said, “but I’m hot, so I must still be alive.”
I was contemplating whether to add that mortuary technicians refer to their charges as having “assumed room temperature,” when “little sis” Leah, 89, mother of four, grandmother of seven, joined us. In acclamatory tones they might have used to compliment each other’s appearance, they observed how much the other had changed in the years since they’d last been together, noting saggier skin, new liver spots, less hair. With a pang of sympathy for Miriam, I saw, as if through Leah’s sororally critical eyes, that the maraschino cherry color of Miriam’s make-up, rather than concealing her age, garishly accentuated it. After childhood reminiscences, Leah brought Miriam up to date on the extended family, Miriam keenly attentive to anecdotes about the rambunctious 9-year-old twins.
As Leah prepared to depart, Miriam teared up. “You know, we won’t see each other again,” she said plaintively.
“You never know,” Leah replied, not meeting Miriam’s gaze.
“Believe me, sometimes you do,” Miriam insisted.
When we were alone, she wondered why God gave Leah so many children. “I would’ve been a good mama, but I missed my chance.” After a melancholy pause, she counseled: “Don’t wait,” her eyes brimming with unfulfilled wishes.
* * *
Raging fires, rising sea levels, and bleached coral reefs remind us that death’s reach extends well beyond our individual bodies. Climate change could spell the death of civilization as we know it. As with respect to our personal mortality, here also there are two kinds of people: those living sustainably, and the rest of us. Yet we all need a habitable planet. The trick, as Greta Thunberg and other climate activists are trying to teach us, is to change before it’s too late.
As we smash through climate records—so far this summer we’ve had the hottest day, the hottest June, the lowest Antarctic sea-ice, and the highest ocean temperatures—Miriam’s admonition—Don’t wait—reverberates as a message for us all. Adapting Montaigne’s aphorism on death, we might say, since we cannot conquer nature, the best course is to keep it conscientiously in mind.
But denial arises here too. Just as modernity can obscure the reality of death, it enables billions of city dwellers across the globe—more than four-fifths of Americans—to live at a dangerously misleading distance from the natural world. With prepared food delivered to our door or displayed in fluorescent-lit aisles, concrete rectangles as our ground, steel and glass towers monopolizing our sky, the nonhumans below leashed and slavishly obedient, it is as easy to forget our place in nature as it is to forget our mortality during the multitasking workday.
In July we had the hottest days in about 125,000 years, yet with regard to the disastrous effects of global warming, many of us act as if “It can’t happen to me,” the personal equivalent of the cultural ethos, a denial of individual vulnerability and disregard for that of others.
We have already waited to address the warming climate since NASA scientist James Hansen foretold the coming crisis to Congress in 1988. Even then oil executives knew that burning fossil fuels was heating the planet but decided to prioritize profit. As a result, the amount of carbon dioxide in the atmosphere is higher than at any time in at least 4 million years, according to National Oceanic and Atmospheric Administration officials. And despite a cascading series of climate disasters around the world, the political dynamic remains dominated by the fossil-fuel industry and CO2 emissions continue to rise.
In The Great Derangement: Climate Change and the Unthinkable, Amitav Ghosh asks: “Will our future generations, standing in a rising pool of swirling waters, not beseech us with this question—‘Why didn’t you do something?’”
We’ve seen this collective nonresponse before in recent memory. Americans watched Covid-19 death counts rise in one country after another while doing nothing to prepare for the virus’s plainly foreseeable arrival on our shores. In other words, we waited—until bodies piled up in 18-wheelers. Sinclair Lewis’ 1935 novel, It Can’t Happen Here, depicts this kind of communal denial, the dismissal of realities too troubling to countenance: it can happen/is happening/will happen here—the pandemic, a president impervious to the rule of law, unbreathable air—pick your calamity; we are exempt from nothing.
So denial operates at individual and societal levels, in both cases upholding an unsustainable status quo. We cannot escape death or the consequences of climate change, which for many will be one and the same. A key difference between those who know they’re dying and the rest of us resides in their embodied awareness: Unlike the abstract possibility that we might not wake up tomorrow, Miriam’s understanding that she won’t see her sister again is concrete, visceral, and impossible to ignore. Likewise for the difference between those on the front lines battling climate change and the rest of us: They have metabolized the reality that continued use of fossil fuels will render much of the planet inhospitable to humans and are living in the light of that awareness, while we go about our business as usual. At the societal level, corporate capitalism promotes consumers as a means to generate profit rather than people as inherently worthy, encouraging self-concern and immediate gratification rather than communal well-being and care, personal rather than systemic solutions, in other words, business as usual.
But the climate is far from usual. In July we had the hottest days in about 125,000 years, yet with regard to the disastrous effects of global warming, many of us act as if “It can’t happen to me,” the personal equivalent of the cultural ethos, a denial of individual vulnerability and disregard for that of others.
We hide our vulnerability most of the time. This can be necessary to guard against genuine threats, but it can also metastasize into hypervigilance that leads one to shoot a garden hose mistaken for a snake, say, or build a wall to keep out people deemed undesirable, usually with darker skin. The extent to which we rely on this self-protection is “a measure of our fear and disconnection,” says Brené Brown, whereas welcoming “the discomfort of vulnerability teaches us how to live with joy, gratitude, and grace.”
In dying we meet our ultimate vulnerability. Any aspect of our being may break down: Clear vision turns cloudy or dark; chewing requires arduous effort, swallowing goes awry, and digestion induces distress; loss of bladder control plunges us back to infantile dependency; our arthritic hands can’t button a shirt or trim our fingernails (forget about reaching your toes). Even the mind, the epicenter of our sense of self, may lose its bearings.
“What can I say? I’m having hallucinations,” Miriam announced. “I’ve been lost in another world with a little white cat. It felt so real. He put his paws on the bed, then jumped up and nestled in my arms, comforting me after a frightful dream. I don’t know which is worse, falling into my nightmares or waking up.” She cast a sidewise glance at the stack of diapers on her bedside table. “At least I still have my memories,” she said.
She waxed nostalgic about ballroom dancing when she was nineteen, the distant past as clear as today’s cloudless sky. She described a “divine vacation” in Paris with Joe: “He’d call me ‘Mimsy’ and I’d go weak in the knees. I kept the nickname, but I should’ve kept him.” They arrived at the Folies Bergère too late for the New Year’s Eve show, but had a grand time dancing in the foyer, “our own private ballroom.” She loved him, but he was an intellectual and she was just a girl from the Bronx; fearing he would tire of her, she shied from commitment. He married someone else. With girlish glee she confided that at his funeral his widow told Miriam that he’d never stopped loving her. “My life would make a good story. I’d call it ‘Mimsy’s saga,’” she said, baring a toothless grin. “But where did my kitty go?”
Even those of us with a steadier grasp of shared reality believe in our own inventions, not necessarily more plausible than an imaginary pet. Historian Yuval Noah Harari posits that our collective myths—from religion to the nation-state to the corporation—undergird our success as a species because they enable us to cooperate effectively in large groups. Setting aside the fact that such cooperation is no guarantee of success or honorable goals, I’m struck by the often-unquestioning nature of our belief in these stories. We live so deeply inside them that we mistake them for properties of the world rather than our collective imagination. In this sense, we inhabit a simulation of our own design, a communal virtual reality in which we embrace secular myths with religious piety: The more money the better; ideal love equals marriage; everything on Earth is a resource for human consumption.
Yet however inventive we may be, to survive we need climate stability within a fairly narrow temperature range, and we already face devastating volatility and heat—from Dubai to Death Valley—with worse to come. Despite the fact that every one of us wants to inhabit a clean environment, we continue to poison it.
“The sunrise turns everything pink and then in the evening it’s all gold, it’s beautiful to see,” Miriam said tearfully. “But I’m about to be shut out of this world.” Even while still here, she began to drift away, lapsing more often into delusion. “The sleazebag superintendent is hellbent on evicting me. I caught him trying to break my little Ketzel’s neck. He told me, no animals are allowed in the building. I wanted to ask him, ‘So why are you on the payroll?’ but I didn’t dare,” her repartee sharper than her grasp of reality, her psychic theater as vivid as actual events, the threat of expulsion looming in both realms. In her remaining weeks, the boundary between internal and external became increasingly fluid, a duality destined to disappear during death.
Acting on the misguided conviction that our stories represent reality, we break real necks. Our idées fixes of self and other devolve into destructive dichotomies of self versus other, as in racial, ethnic, and ecological violence. A necessary distinction leads to a distorted sense of difference. This story of separation—as individuals from one another and as humans from other animals—may be our undoing. The two misperceptions form a feedback loop of exceptionalism, a double helix of denial. Our notion that we stand apart from nature, though as insubstantial and delusional as Miriam’s cat, has real, ruinous impact.
Employed as a defense, denial becomes self-defeating. Our unwillingness to acknowledge this or that troubling recognition leads us to tolerate the status quo, in other words, to wait. In the context of corporatocracy and climate change, this passivity produces immense suffering and loss. Global temperatures are already at 1.2°C above preindustrial levels; with a 2°C rise, we will face utter catastrophe, making the pandemic disruption seem mild by comparison. A 3°C rise will take us “to a level of global heat no human has ever experienced—you have to wind time back at least to the Pleistocene, 3 million years ago, before the Ice Ages,” according to Bill McKibben. What’s more, over our decades of inaction, climate change has outpaced scientific predictions, suggesting that current forecasts, grim as they are, may be insufficiently so. In Greenland, for example, melt rates have already reached the level once predicted for 2070.
To have a chance of saving civilization, we must act now, “at dramatic scale and with dramatic speed,” writes McKibben. As biblical bushfires threatened to engulf homes in New South Wales, the Australian authorities issued this alert: “You are in danger and need to act immediately to survive.” Climate scientists are sending the same message to us all.
* * *
Throughout the fall and winter, Miriam shrank, her royal blue sofa seeming to grow around her. Once she was bedridden, her shriveled body made barely a dent in the quilted blanket. As she neared the end, her rigid sense of difference from others dissolved into soft openheartedness. She lost her contempt for her aides. “I couldn’t manage without Paulette,” she said, tenderly stroking Paulette’s hand. “She’s very good to me.” No longer preoccupied with cultural disparities, for the first time Miriam saw in Paulette another human being, a fellow traveler a few steps behind her en route to the same destination. When Paulette adjusted the pillow to make her more comfortable, Miriam thanked her in the gracious way she had thanked me from the beginning.
Closeness to death unveils the emptiness of customary boundaries and the absurdity of competitive striving that pits us against one another, as denial vanishes along with artifice. An unguarded heart pulses with gratitude for our connectedness, replacing the alienation and hatred that fuel strife and suffering. But our culture’s sequestration of death has made it seem remote from life, a collective deception that offers the faux comfort of rejuvenating serums and revolutionary nutraceuticals, buttressing a perceived boundary that impoverishes both life and death.
Though Miriam continued to declare, “I’m still here,” she lost the exclamation point. “I’ve been out of touch with reality, but Ketzel welcomed me back.” The cat became as real to her as I was; he pawed her face when he wanted attention, he had the most exquisite emerald eyes, he was hiding under the bed right then. “I’m worried about what he’ll do without me.” Miriam’s sphere of concern, shrinking along with her body, didn’t include climate change. But her anxiety about her cat’s future brought to mind philosopher Samuel Scheffler’s Death and the Afterlife.
The stark clarity of our circumstances presents a choice: We can deny the mounting temperatures, monumental inequities, and mass immiseration until we are engulfed by them in “the era of global boiling,” to borrow United Nations Secretary-General António Guterres’ phrase, or we can design an economy to maximize mutual care rather than individual consumption.
By afterlife he doesn’t mean a personal continuation of life after death, but rather the survival of others after we have died. Our assumption that others will outlive us plays a surprisingly significant role in our lives, he argues, and the prospect of near-term extinction changes our feelings about our present life, reducing its capacity for meaning and purpose, much of which hinges on leaving a better world for generations to come. Observing that we see ourselves as linked to a continuum of human endeavor, he suggests that even activities whose value comes from their immediate enjoyment, such as listening to music, are diminished by knowledge of the imminent end of civilization. People often talk in terms of the need for us to sacrifice now for future generations who depend on us to pave the way for them, but from Scheffler’s perspective it is we who depend on them and their lives to find value in our own, so we should live in such a way as to optimize their chances—for our own sakes.
The stark clarity of our circumstances presents a choice: We can deny the mounting temperatures, monumental inequities, and mass immiseration until we are engulfed by them in “the era of global boiling,” to borrow United Nations Secretary-General António Guterres’ phrase, or we can design an economy to maximize mutual care rather than individual consumption and promote biodiversity rather than monoculture. We can build a society in which everyone lives with dignity, a decent wage, and access to healthcare no matter their occupation, with equal opportunity to thrive, no matter their zip code. To those who doubt the possibility of such profound change, Ursula Le Guin said, “We live in capitalism. Its power seems inescapable. But then, so did the divine right of kings.”
In September, Secretary-General Guterres will host a Climate Ambition Summit and press leaders for an end to fossil-fuel expansion, notably President Joe Biden, whose nation surpasses all others in oil and gas production.
“But this moment feels as if it calls for something larger,” writes McKibben in The New Yorker, “comparable to the Earth Day demonstrations of a half century ago, which brought 10% of the American population into the streets. It’s eruptions on that scale that change the political reality.”
* * *
Miriam was asleep, her mouth agape. As I touched her shoulder, she opened her eyes and moaned with pleasure upon recognizing me. She had difficulty speaking, but after a few tries, I understood she was asking for water. I held the cup beneath her head and placed the straw in her mouth, which with effort she closed to suck on the straw. After a few swallows, she began to cough, so I set the cup aside. To relieve her of feeling she needed to expend effort to talk, I reminded her of laughs we’d shared and other memories I thought she’d enjoy. When I paused, she said, “Thank you for everything.” I held back tears.
She had thanked me hundreds of times, for visiting, listening, helping her with this or that, my friendship, my patience, my sympathy, and so on, but only on this occasion did she thank me “for everything.” She knew her end was near and we would not see each other again. She showed no more resistance. “I’m going to sleep now,” she said, “Good night.” I kissed her cheek and left her to her rest. The next morning she was gone.
After leaving a patient, I relish the fresh air, swaying trees, and luminous sky, mindful that one day I’ll be bedridden, and someone else will leave the last room I’ll ever know. Though proximity to death hasn’t made me less afraid, it has given me a measure of equanimity with my fear; rather than a troubling recognition that disrupts my life, I experience it as an enriching awareness. My aversion to death arises from my ardor for life. Like Georg Christoph Lichtenberg, I think the smell of a pancake is a better motive for staying in this world than all of young Werther’s ponderous reasons for leaving it. I’ve learned to reframe what I once labeled terror as a hot flash of ontological alertness, borrowing a phrase from Ernest Becker. Now when this feeling overtakes me, rather than rocking my world, I see it as a sensation that arises and passes away like any other, albeit a uniquely intense one, in a life lived more fully the rest of the time. I’m more grateful, for every sunrise, every hug, my ability to use the toilet, and much more—even grief in its searing intensity. I’m fully alive when I grieve, which is, after all, a manifestation of love. And my closeness with people on hospice has made me more compassionate toward everyone else. When it comes to death, Epicurus observed, we human beings live in an unwalled city.
Imagine if instead of fearing for our children’s future, we knew that our afterlife—the world that survives us—would be verdant, robust, and joyful.
We must love one another or die, Auden wrote. To do this, we must first love ourselves. Not the narcissism on display in filtered smiling selfies, but a tender yet unflinching acceptance of all our warts and waywardness. “One can only face in others what one can face in oneself,” James Baldwin said. “Not everything that is faced can be changed, but nothing can be changed until it is faced.” With due respect to FDR, fear isn’t the only thing we have to fear; rather, the danger lies in our aversive relationship to the feeling. We overcome fear not by denying it but by accepting it. Our denial disconnects us from ourselves and from the sensitivity and tenderness that can save us.
When we grasp our deep interdependence—at the individual, societal, interspecies, and global levels—we abound with belonging and awe at life’s splendor, and as in Scheffler’s continuum of human endeavor, we want it to continue after we’re gone. Imagine if instead of fearing for our children’s future, we knew that our afterlife—the world that survives us—would be verdant, robust, and joyful.
Miriam gave me a photo of herself in middle-age, her fullness of body and face a startling contrast to her terminal emaciation. She sports a prim, herringbone skirt suit, angular black glasses perched on her aquiline nose, lips pinched in silent reproof. At first glance, I thought pettily that she looked like the meddlesome office manager she surely was. Then it struck me that all my patients elicit my sympathy to a degree that their younger selves might not. I might have found them dull or self-absorbed, judged them in some uncharitable way, felt little in common with them, but my heart opens reflexively to anyone in their final days.
Notwithstanding my extensive rumination on death, I have not wholly internalized the fact that any of us might die at any time. My dichotomy between those who know they’re dying and the rest of us oversimplified matters. Many of us lie somewhere in between: We both know and don’t know that we will die. We know in the way we know that our bodies are comprised mostly of bacteria, that is, we know as a matter of fact, but not as a phenomenological feeling. We don’t know in the way we know that someone we’ve lost is gone. Even that understanding takes us a while. About his late wife Jane Kenyon, Donald Hall wrote: “It was long before every cell in my body believed in her death.”
Similarly, between Greta Thunberg and most of us, there are probably many in the muddled middle who want to live sustainably but find it challenging to change habitual patterns of consumption. It’s hard, even counterintuitive, to connect our individual choices with the weather, particularly when we are being asked to change those choices in potentially inconvenient ways. How much easier to deny the causality and believe that the climate is a force of nature over which we have no influence. Easier, but wrong, and dangerously so.
Thanks to our inaction since 1988, increase in the Earth’s temperature is inevitable. We may surpass the 1.5°C rise that the Paris climate agreement pledged to avoid. But, as McKibben emphasizes, the scale of the increase is “an open question: A rapid end to burning fossil fuel would arrest the heating; and that rapid end is possible, because solar and wind power and batteries to store it are now cheap and available.”
When people are depressed, they believe nothing will change their misery. Rebecca Solnit suggests that there is a public equivalent to private depression, a belief that the nation or society is irremediably stuck. But this viewpoint is as misguided as the depressed person’s sense of stagnation; things don’t always change for the better, but they do change, and, Solnit argues, we can play a constructive role in that change if we act.
However improbable success may be, inaction is sure to fail. We might not be alive tomorrow, but if we are, what better way to spend our time than trying to build a world in which our children and grandchildren can thrive? Let death be what takes us, palliative care specialist BJ Miller advises, not lack of imagination. Mimsy’s saga is over, but our next chapter promises to be riveting and momentous. Like death, it’s coming whether we’re ready or not.
