Miracles of modern science have robbed us of the dignified death

WE HAVE forgotten how to die well. That’s the thesis of a doctor friend of mine. He has done a study of Victorian art representing the moment of death, the time leading up to death, or the period immediately thereafter. The paintings inevitably portray a scene of sadness but, at the same time, a scene of peace and tranquillity and quiet.

Some of them show adults dying in their beds, neat and pale, surrounded by loving family members stilled in prayer. One or two show children, one of the most illustrative a picture of a child of perhaps four on a bed made by jamming two chairs together, the unconscious child’s doctor looking regretful but resigned in a room lit by a lantern.

Those were the days when the inevitability of death from a slowly advancing disease such as cancer was acknowledged when the family doctor, following an examination of the patient, sighed heavily, put an arm around their shoulders and told them it was time to settle their affairs. Having done so, the patient could be reasonably sure that when their death approached, were it to be accompanied by a growing level of pain, the doctor would administer morphine with a generous hand, easing the embrace of death.

Because we believe our generation is the apogee of progress and therefore manage any human process better than our ancestors did, we tend to figure that we have the dying thing down pat, whereas, according to my doctor friend, the reverse is the case. Instead of the shadowed quiet characterising death a century ago — or characterising death that wasn’t consequent upon a war or other trauma — we now die in high-sided hospital beds in rooms where the lights never go out, and where the alien tweets, clicks, and humming of green-eyed technology cease only when unplugged after each has certified that life has departed.

We die catheterised, intubated, and ventilated — all at the behest of those who love us and who decide that “everything possible” must be done for their parent, grandparent, or other relative, even if “everything possible” prolongs life for days or weeks to no purpose and without comfort.

It is as if we have abandoned the very concept of “the good death” in a frantic commitment to the postponement or even denial of any death. It is as if acceptance of mortality were a betrayal of a loved one, even if that loved one is deep-fogged in a dementia which has erased their every prior reality. Afterward, the living convince themselves that their energetic insistence on the application of every available science to their dead relative in some way ensured that that relative had the best death possible, although, in many cases, that is demonstrably not true.

So prevalent and deeply rooted is that view that many people sympathised with the death of Peggy Mangan, the 65-year-old Alzheimer sufferer who was found dead on land close to Ikea in Ballymun, north Dublin, after a day spent traversing Dublin in the company of Casper, her King Charles spaniel. During her last day, Mrs Mangan walked and walked and walked. Several people later realised that they had spotted her, but at the time, none of them would have seen anything untoward in a tiny slender little woman in casual clothes walking with a little dog on a lead.

AS SOON as it was clear that Ms Mangan was missing, her concerned and articulate son called for help and continued to call for help. Within hours, her smiling face was familiar from the breaking news sites. People in Dublin who would never have paid attention to small missing-person posters paid attention to her description in the vague hope that they might identify and rescue her. After all, how hard would it be to recognise her, particularly when she would be accompanied by her pet dog? Hundreds of people joined a more organised search for her. Nothing worked, and Ms Mangan, when found, was dead.

While the death carried no need for blame — people had responded and responded well before that happened — the way she was found cast an extra shadow over her demise; an assumption that her death was bad, as well as sad.

It may be worthwhile to challenge that assumption, not just by juxtaposing Ms Mangan’s death with the noisy hi-techery that surrounds most deaths in hospital these days, but by setting it against the deaths of other Alzheimer’s sufferers, the overwhelming majority of whom die in nursing homes (or are transferred to hospitals) at a point in their illness at which they may be beyond being reached by comfort because they no longer know faces which should be familiar and can no longer understand what is said to them.

Ms Mangan managed to live independently, in itself not just a great personal achievement, but also a gesture of faith by family and authorities which should not now be second-guessed because she died in the way she died. Not many Alzheimer’s sufferers get to spend their last hours walking with their dog on a reasonably pleasant day.

This story is infinitely sad, but it has a multiplicity of heroes, prime among them that little dog, Casper the King Charles spaniel, who was found guarding his dead owner. Casper is the latest representative of a history of canine fidelity that goes back to Ancient Rome. No other domesticated animal has quite the tradition of faithful guarding of the dead that the dog has. Some animals speedily desert the dead or even eat them. But dogs never seem to have any priority other than their owner, and so they stay.

They stay with the dead person, baffled and protective by their unusual passivity. In one case, a man who died in a snow storm in Patagonia was not found for three weeks. During that time, his dog protected his master’s body from attack by wild animals, kept himself alive by hunting small animals, and slept curled around the dead man’s body apparently in a futile attempt to keep him warm.

And even when dogs do not have the physical presence of their owner’s body, they remain faithful. I have written in this column before about the akita in Japan which went to the railway station each night at the time its owner would normally come home because nobody could explain to the dog that its master had died of a heart attack.

Casper the spaniel did what Ms Mangan asked him to do, no matter how onerous it was for a little dog to walk from one side of a big city to another. When his owner died, he stayed on guard over her until helpers came. And then he too died, his job done.

Ms Mangan had a sad death. But she was never alone — as she might have been in a hospital bed. She had a dog to whom she was the most important thing in the world.