Views & Reviews Review

Death becomes us

BMJ 2010; 340 doi: (Published 06 January 2010) Cite this as: BMJ 2010;340:c79
  1. Richard Smith, director, UnitedHealth Chronic Disease Initiative
  1. richardswsmith{at}

    Thinking about mortality helps us to achieve a fuller and more contented life, argues Richard Smith in a review of two new books on death

    Death is tragic, arbitrary, and meaningless but at the same time opens us to a fullness of life that would not exist without it. That it can negate every other element of our lives, including love and wisdom, is what makes it the most important fact about us, argues the American philosopher Todd May. So how should we live in the face of complete negation? How should we think about death? And should doctors, who are sometimes accused of being charlatan salesmen of immortality, pay more attention to the philosophy of death?

    May tackles these questions in his short, readable book—part of a philosophical series on the art of living that also includes books on hunger, fame, work, money, and sex.

    Most people who have ever lived have believed in an afterlife, but this book is not for them: it assumes that we don’t survive our deaths. It is written for those of us privileged enough to have been educated out of a belief in the afterlife.

    Death is the end of us and our experience and is, argues May (following Heidegger), not an accomplishment or a goal but simply a stoppage. Importantly, death is inevitable but uncertain: we don’t know when we will die, but it might be in the next few moments. These characteristics of death potentially render our lives meaningless, which is the source of much of the pain associated with death.

    Many try to deal with death by denying it, and ours is a time when it is easy to do so. Until recently dying was a public event, and before the first world war the average 16 year old would have seen six people die. Now it’s common to be 50 and never to have seen a corpse. The Economist has argued that the uncontrollable costs of US health care are driven by fear of death. But, argues May, to be fully human and alive is to live with the omnipresence of death; denial of death leads to a diminished life.

    The other “cure” for death, apart from denial, is immortality, and May discusses its pros and cons, concluding firmly that immortality would be unbearable and inhuman. Most philosophical and literary examinations of immortality have reached the same conclusion, meaning presumably that a bearable immortal afterlife would need to be other than human.

    How then are we to live with the dilemma that both death and immortality are inimical to us? This is the central challenge of our lives, and there can be no neat resolution. It is a puzzle and contradiction that we must all live with: we must find our own formulas, the most important test of our lives. May gives us the stories of two people who have lived well with this contradiction: the unlikely combination of Marcus Aurelius and John Coltrane.

    Aurelius was a stoic who urged meditation on death, and his book Meditations is really a set of “spiritual exercises,” says May. Stoics believe only in the present: the past is no more, and the future is not yet. Thinking of death pushes us firmly into the moment but also brings us peace and makes us treat others well and think hard about who we are.

    Coltrane’s brilliant music was also intensely spiritual, becoming ever more original and otherworldly towards the end of his life. May postulates that the intensity of his music came from Coltrane’s living intently in the moment, constantly practising, but always searching, pushing, experimenting. What matters, my wife’s art teacher told her, is “the quality of the search.”

    It illustrates the limits of philosophy that May has to resort to these stories to help us how to learn to live with death; but, he concludes, “if we are willing to face it squarely without illusion or escape, we might use its power to make something of ourselves that we do not regret.”

    The Book of Dead Philosophers is the fifth book on death that I’ve read in the past few months, and it’s much the funniest. Simon Critchley is another American philosopher—a follower of Cicero, Seneca, and Montaigne, all of whom believed in the importance of thinking about death—and is scornful of a death-denying world.

    Critchley has taken up the challenge of Montaigne “to make a register, with comments, of various deaths.” His goal by teaching a readiness for death is to promote “the meaning and possibility of happiness.”

    The deaths and thinking of “190 or so” philosophers are described in short (sometimes one line) accounts that are enlightening and easily read. Here are some of the deaths: Heraclitus suffocated on cow dung; Bacon died after stuffing a chicken with snow in the streets of London to assess the effects of refrigeration; Diderot choked to death on an apricot; and Heidegger died saying, “Only one man ever understood me . . . and he didn’t understand me.”

    Ironically, this is a marvellous book for the bathroom, encouraging regular meditation on death in the pursuit of a fuller and more contented life.


    Cite this as: BMJ 2010;340:c79


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