On Being with Those Who Are Dying

The Jewish tradition of being at the bedside of the dying is of immense value, not only for the dying person but also for those about to be bereaved--and for all of us, who must learn to face death.

The concept of wisdom (hokhmah) in the Bible is not that of sage philosophy or metaphysical abstraction. Wisdom in the Bible means doing what is right in each situation. It is in this sense that the Jewish perspectives on death and the Jewish mourning practices are “wise.” They are wise because they pro­vide a total framework within which [humanity] learns to accept death, to mourn completely, and to live again fully.

When the family and community are faced with the pros­pect of the death of one of its members, Jewish law reminds us that “a dying man is considered the same as a living man in every respect.” But in American culture today, dying is treated as if it were a separate realm of existence. America is essentially a death-denying society; consequently we treat the dying dif­ferently from the way we treat the living. We avoid them, or avoid honest communication with them. We try to spare them the problems of everyday living, and we thereby deprive them of its joys. The dying person lives alone in an artificial envi­ronment created by those who do not wish to cope with the fact of death and its inevitable call to every living being.

Halacha [Jewish law] forbids this dishonest approach. The dying per­son must be treated as he was always treated, as a complete person capable of conducting his own affairs and able to enter fully into human relations even unto death. Further, the Jewish tradition of never leaving the bedside of the dying is of im­mense value, not only to the dying person but also to those about to be bereaved. How helpless and how guilty we must feel when we hear of the death of a loved one, especially if no one was there to ease the fear of uncertainty and the pain of separation.

All kinds of questions spring to mind from the wellsprings of guilt: “Was everything done that could have been done?” “Why didn’t the doctor or nurse get there sooner?” “What could I have done to prevent this?” “Did he suffer?” “Why was he alone?” And underneath these questions lie another series of questions: “Will I suffer?” “Will I be alone?” “Will anyone care for me though I didn’t care for him?”

Judaism shields mourners from being overwhelmed by this kind of guilt because the community shares in the care of the dying so that they are never left alone. The community provides reassurances that everything appropriate was done. To the extent that I am a part of the community, part of me was there when he died, and so I need not fear.

The bedside vigil serves one more purpose. As death ap­proaches, a crisis of faith occurs as the life cycle draws to an end. A personal confessional is encouraged from the dying as a rite of passage to another phase of existence. This type of confessional occurs throughout the Jewish life cycle whenever one stage has been completed. So we confess on the Day of Atone­ment as we end one year of life and begin another. So grooms and brides traditionally said the confessional and fasted on their wedding day, for they sensed that it marked the end of one stage in their lives and the beginning of another.

The con­fessional on the deathbed is the recognition of the ending of one cycle and the beginning of another. This and the recitation of the Shema in the last moments before death help to affirm faith in God precisely when it is most challenged, and help the dying person focus on those most familiar rituals of his life just at the moment when he enters the most mysterious and un­knowable experience of his life. This comforts him together with those who share his vigil.

The wisdom in actually observing the death is that the real­ity cannot then be denied. Psychiatrists know that the relatives of those missing in action or those who are lost in battle and whose bodies are never recovered have the hardest time re­cuperating from grief, for they have no body around which to focus and express their grief and so they are vulnerable to the temptation to deny the reality of the death. Judaism does not permit the mourner to escape the reality of death; it bids him see it, and then it leads him through a whole network of burial and mourning procedures whose purpose is to help him come to terms with it.

In doing this it is in harmony with psychiatric literature, which abounds with examples of the fearful conse­quences of death-denial and repression of grief. The talmudic sages centuries ago seem to have sensed the same truth that psychiatrists now articulate, which is that the recognition of death is a necessity for continuing life, and grief is a necessary and unavoidable process in normative psychological functioning. (Vivian M. Rakoff, “Psychiatric Aspects of Death in America,” in Arien Mack, ed., Death in American Experience)

Excerpted with permission from “The Psychological Wisdom of the Law” in Jewish Reflections on Death, edited by Jack Riemer (Schocken Books).

Audrey Gordon is assistant professor of community health science in the University of Illinois at Chicago School of Public Health, and is an expert on current thinking about death and dying. As a graduate student, she worked with Elisabeth Kubler-Ross. She is the co-author of the book They Need to Know: How to Teach Children about Death.

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