“[A] perfect sense of death is free from fear” – St. John Climacus, The Ladder of Divine Assent
Orthodox theologian Vigen Guroian begins the second chapter of his book, Life’s Living Toward Dying, with an extended excerpt from St. John Climacus’s The Ladder of Divine Assent, and as I clicked my way through story after story covering Brittany Maynard’s decision to end her life, this phrase kept resounding in the background of my thoughts. Like church bells that have become just one of the thousands of sounds we hear, St. John’s words may be dismissed as just one man’s opinion; yet if we are attentive, his insight, like the church bell tower, draws us into beauty and truth.
In recent weeks we have all become well acquainted with Brittany Maynard. The story of the young California native has already blazed its way across the internet, capturing the American imagination and re-igniting the well-worn debate over the right to die. Hailed as fearless, Maynard has refused hospice care, moving instead with her family to Oregon, one of five states in which assisted suicide is legal. In a mere three weeks, she has become the face of a newly invigorated 'death with dignity' campaign. To date, the attractive, articulate young woman has twice appeared on the cover of People Magazine; the October 27 issue features a photograph of Maynard standing next to her bed, where she plans die after ingesting a lethal dose of barbiturates on November 1. Along with People, dozens of other news outlets including CNN, the New Republic, the Washington Post, the New York Times, and Atlantic have all picked up the devastating story of this young, talented woman who has embraced death in the face of suffering. Maynard, whom Brian Williams described on NBC Nightly News as being “in the prime of her life,” was diagnosed nearly 11 months ago with terminal brain cancer. This is perhaps what makes her particular case so compelling for many Americans. Maynard’s narrative awakens our own slumbering fear of death’s arbitrary cruelness, as well as the suffering that can precede it.
The grammar of fear is suffused throughout this story. Yet I have come across relatively little in the media’s coverage of Brittany Maynard that even hints at the acute anxiety that bubbles to the surface each time she speaks of her disease. In fact, the October 6 edition of People hails Maynard as fearless: “For the past 29 years,” writes columnist Nicole Weisensee Egan, “Brittany Maynard has lived a fearless life – running half marathons, traveling through Southeast Asia for a year and even climbing Mount Kilimanjaro. So, it's no surprise she is facing her death the same way.”
Despite a few notable exceptions, the popular news media has barely even entertained the possibility that Maynard’s anxiety about suffering and death is wholly consistent with modernity’s simultaneous preoccupation with and aversion to suffering and death. No matter how stridently we undertake practices that push death to the margins of our lived experience, we remain anxiously fixated on it. How eager we are to consume her story; nothing speaks more plainly to this anxiety than People’s most recent coverage of Maynard’s story in the magazine’s October 27 edition. Sandwiched between an article on actress Emma Stone’s Oscar hopes and the sexual abuse scandal involving 7th Heaven star Stephen Collins, we read the Maynards’ tragic story. With the loss of a transcendent eschatological imagination, death become the final frontier of mystery, and the modern disposition, writes Guroian, “seeks to turn all mystery—including the final mystery of death—into a spectacle or solution” (xxiv). In Maynard’s case it has become both.
Maynard poignantly defends her painful decision to end her life, describing her cancer as a “terrible, terrible way to die.” She is right. Patients who, like Maynard, suffer from stage four glioblastoma daily face the reality that their living is a dying. Total deterioration of mind and body occurs in a matter of mere months. In less than half a year, one can expect to lose one’s ability to walk and speak and to control one’s urinary and bowel movements. One’s alertness will diminish in conjunction with cognitive impairment. The devastation is complete. The woman whose face is currently splashed across the internet and print media for the past several weeks would be nearly unrecognizable 6 months from now. Should she choose not to end her life, this bright, attractive, vivacious young woman will die hundreds of painful deaths as she moves toward death. She will become totally dependent on the loving care of others. If ever a compelling case for assisted suicide were to be made, it seems surely it is in a situation like Maynard’s.
There is something compelling about her proposal to forestall coming months of a brutal, messy death and instead grasp what little control seems to remain in a terminal diagnosis. "I'm dying, but I'm choosing to suffer less," she says in explanation of her decision, "to put myself through less physical and emotional pain and my family as well." Indeed, People reports, “Maynard says it’s easier to bear the pain now that she knows she is in control […] That’s left her space to make the most of her remaining days.”
Such assertions are shot through with contradiction. For all our planning, any one of us could die suddenly and tragically at any moment. But what I find more puzzling is the author’s assertion that an absolute sense of control over diminishment, suffering, and death gives meaning to one’s life and capacitates one for joy. Statements like the one found in People belie the insidious logic that Guroian observes in Life’s Living Toward Dying. “Secular moderns,” he writes, “cling to the belief that they can celebrate life at the same time they embrace a culture of death. Some argue that they can best embrace life by putting an end to the lives they no longer value” (17). To kill oneself is to say, at least implicitly, “I am better off dead because my life no longer has value.”
Maynard wants her death to be on her terms, as painless and as uncomplicated as possible; she wants to die comfortably in her own bed, surrounded by her family and friends, in control of her body and mind. We all want a death like this; indeed, Catholics petition for this kind of death every night in Compline when they pray, “Lord grant us a restful night and a peaceful death.” This certainly includes a death without suffering, but it does not foreclose the possibility that a peaceful death may be a painful one. We need only look to the witness of the martyrs to see such a logic unfold. With the advance of medical technology and utilitarian idealism, however, it seems this may become for many the only kind of acceptable death. Unhinged from a scriptural and ecclesial imagination, the idea of a peaceful death has been reduced merely to the absence of pain, and a painless death has begun to chip away the value of a life with suffering. Likewise, death has begun to chip away at the value of life, and in this configuration death is easily commodified. If we can’t master death, at least we can control it, make it more efficient and convenient, and make it involve less suffering, less anguish. And yet …
Death, Dignity, and Fear
As I have sifted through over a week’s worth of media coverage of Maynard’s tragic story, I have been struck that a decision lauded by many as courageous is motivated at its core by fear—fear of suffering, fear of diminishing, of losing one’s capacities, fear of being an emotional burden to others. Indeed, Maynard’s own words betray the depth of her anguish and anxiety—of our anguish and anxiety over death. Describing the effects of cancer as “scary” and “very frightening,” she explains that being “able to die with my family with me, to have control of my own mind, which I would stand to lose—to go with dignity is less terrifying.” In this context “dignity” is reduced to an exercise of autonomy and control; “to go with dignity” means to die without the suffering and unseemliness of diminishment. While the logic of dignity based on choice goes entirely unexamined (see, for example, Maynard’s comment in the October 6 edition of People: “I believe this choice is ethical, and what makes it ethical is it is a choice.”), the logic that emerges from self-gift is all but rejected out of hand. There is also a subtext in such understanding of dignity, which implies, as Ross Douthat noted, that the person who cannot “make sense of suffering that’s bound to lead to death, […or who] does not have a mountain-climbing, op-ed writing recovery” somehow dies a less dignified death.
In his unapologetically theological work, Guroian observes, “Death either sends us back to the faith that reveals the true Source of life which overcomes death or it robs us of all hope and any reasons to go on living” (25). Whatever else it has done, the Maynard case has made plain the depth of our collective fear of suffering unto death. Our experience of death revolts against any attempts to minimize its gravity by making it just one more marker on the continuum of life. Death disrupts communion. It separates us from those we love, and though many would resist the vocabulary of evil, death still remains an evil in our experience of it. Yet modernity lacks the resources to see beyond the horizon of suffering and death. This lack of vision is correlative to our inability to see our abilities, indeed our very lives regardless of state of physical imperfection, as gift.
An early death forecloses possibilities of a more profound experience of love in midst of suffering. Indeed, Maynard, like many of us, would eventually be stripped of her abilities, perhaps even her mind. She would be unproductive, unattractive, and uncomfortable. She would just be. She would just be accompanied by her husband, her mother, her step-father, her friends. She would just be cared for by hospice nurses and doctors. She would just be valued because she is present in a web of relationships. She just would be washed, dressed, cried over, kissed, held. She would just be loved.