These days nature doesn’t have a monopoly on death. Often, we are able to decide when to pull the plug on the apparatus keeping a sick person alive. Professor Marcin Kula talks to Aleksandra Pezda about burial traditions, the moral dilemmas surrounding the extension of life, and ‘shaking the coconut trees’.
Aleksandra Pezda: We almost never talk about death today. From fear of tempting fate?
Marcin Kula: We have distanced ourselves from death and from the dead; we’ve even pushed cemeteries out of our local environment. In the past they were next to churches, in the centre of the village; today, we put them as far as possible away from the centre. I sometimes talk to a lady at the Staszic Palace in Warsaw, at the headquarters of the Polish Academy of Sciences on Krakowskie Przedmieście Street – long ago, the site was occupied by the Holy Cross parish cemetery. Close by, on Kanonia Street, in the Old Town, you can still see one of the cemetery sculptures, because here too was the cathedral cemetery of St. John’s parish. There are many reasons for the new order, including the rising density of populations in town and the rising prices of land. Ancient Rome was familiar with this problem. They resolved it by burying their dead underground in catacombs. That way, they didn’t ‘waste’ space on cemeteries.
A little later on in Paris for the same reason they set up underground catacombs, or ossuaries. At the end of the 18th century, they also began to make use of ancient underground stone quarries. Potential sources of disease were buried relatively deep – that is, the dead bodies of the infected. That way, the dead were close by, but didn’t take up valuable space from the living.
And today? Does anyone still remember that in the past, the whole community, neighbours and family, would gather around the bed of an old member of a family who was dying, in order to say goodbye? Death was preceded by preparations; the dying person said goodbye to everyone. He asked for forgiveness for the things he had done wrong, blessed everyone there and prepared himself for his meeting with God. Dying took place among his nearest and dearest. After death, the mourners kept vigil over the deceased. They prayed and sang and cried. From the 19th century onwards, the number of people who came to say goodbye to the dying dwindled – only the family gathered by the bedside.
These days we often die in hospitals and we can’t keep vigil over the sick in large numbers.
To be fair, I should point out that this is often because we want to save our sick; that’s why we ‘send them off’ to hospitals, to get treatment and not so that they die there. Moreover, apartments today aren’t really set up for the sick, let alone for the dying. And how do we retrieve a body from the 10th floor?
But, of course, death today is lonely and dehumanized. I remember a situation when I was visiting someone ill in hospital. We all recognize the scene, even if only from films: the machines around the bed display different measures of vital signs: the pulse, heart function, frequency of breathing. I was sitting by my sick friend when all the graphs that were normally pulsating on his neighbour’s monitors suddenly went flat. Without so much as a flicker from the man. The doctor came running, listened to his chest, switched off the machines, noted the time on his card and that was that. The end. Today, we die among strangers and as if on an industrial production line.
We also live in a culture that denies death.
Often we don’t take onboard that death is inevitable. In the old days, the approach to death was more natural. Death was frequent and close. People were reconciled to it, among other things because of child mortality and the fact that women died significantly more often in childbirth. Today it’s different: we’ve overcome post-partum fever, we can deal with many of the childhood illnesses, and prophylactic medicine is at such a level that the average age has risen significantly. We are deluded into believing that death doesn’t happen at all. We are afraid of death and its proximity, so we fear even talking about it. We don’t discuss it with those close to us who are preparing to leave us and we also don’t want to talk about it when we lose someone close. Wills have become something embarrassing. We push death far away from us.
Do you think that the COVID-19 pandemic will change anything?
Not for now. If we are talking about the pandemic, we have totally stopped taking death into consideration. Certainly, medical progress and universal health care have distanced us from this problem. These days people rarely include the words of this prayer on newly-erected crosses: “from the air [...] save us, Lord.” Bah! Who still knows that the words are a reference to fetid air, the plague? Because epidemics have been with us since the dawn of humanity. And although the first person to write about it, as far as we know, was Thucydides – who wrote about the plague in The History of the Peloponnesian War – we know that there were epidemics much earlier. And for certain they will continue to plague us, just as they did to people back in ancient times.
Why? Blame for the 14th century plague is placed on the low standard of living: the spread of the outbreak matched up with areas that were economically weaker. Another pandemic – and now we’re jumping way forward in time – the so-called ‘Spanish Flu’, was caused by the war. In other words: the mass movement of people, poor hygiene, malnutrition and widespread exhaustion. By the way, the name is misleading – it was brought to Europe by American soldiers and had come to them with workers brought in from China. After that came typhus, which also developed during World War I because of poverty, movement of people and lack of hygiene. Obviously, it would be difficult to blame the spread of COVID-19 in Europe on malnutrition or poor hygiene. However, other factors have been decisive: we live in gigantic communities and in an era of mass travel.
What interests an historian in the phenomenon of death and dying?
I wanted to show my students how different aspects of our lives, including social ones, can be looked at not just in terms of ‘it happened on such and such a day, in such and such a place’. Yet this is the tendency in discussions about history and the teaching of history, too. We like to collect events, although we could focus more on the process that led to those events. I wanted to show that birth and death are important subjects that have affected humans for ever, but also, as with many things accompanying humanity, they are subject to evolution. So I wrote a book Najpierw trzeba się urodzić [First, One Has to Be Born] and, after the Smoleńsk aeroplane crash of 2010, Ostatecznie trzeba umrzeć [Lastly, One Has to Die].
First of all, after the Smoleńsk catastrophe [in which an aeroplane transporting a number of Polish dignitaries to a memorial service for the Katyń massacre crashed, killing all 96 people on board – ed. note], everyone was talking about dying. Such a widely-experienced tragedy provokes deeper reflection. I went through that national mourning with others; I went to the vigils on Krakowskie Przedmieście Street. And when I realized how that tragedy was being used politically, I decided that it was after all worth writing about what death does, and used to mean for us. Please note that at the beginning, each of the victims of this tragedy was treated equally. We cried for each one the same. Symbolically, it expressed itself through the burials; similar coffins, the photographs on the coffins were the same size, even the font used on the descriptions was the same. But differences quickly started appearing – the deceased Polish president was singled out among the victims. They buried him in the Wawel Castle (in Kraków) and put up his statue, as if his sacrifice was greater than the other people on that tragic flight. I found it distasteful and decided to examine the phenomenon of equality at the hour of death.
But ‘we are all equal in the face of death’.
You must be joking! Of course, people want to believe this and, in our civilization, that conviction prevails, because death awaits everyone and spares no-one. In many depictions of the Final Judgment – and here I give the famous Polish example of the Gdańsk triptych by Hans Memling – we stand naked before God, and He judges us for our deeds, and not according to our birth or property. Everyone: the common man and kings, rich and poor. This concept probably derives from the need to compensate the de facto presence of inequality. Because, in truth, birth and money play a huge role both in maintaining our lives and in how we are buried. Neither in ancient times nor today have people been equal in the face of death.
Some are better fed and live comfortably; others must take on work that destroys their bodies, just to earn a living. One person can afford the latest innovative therapy and private clinics, others are treated in public hospitals, while others still can’t afford even that. One can be laid to rest in a worse cemetery, another in a better one – for example, in the Avenue of Merit (in the Powązki cemetery in Warsaw) – and a third in an unmarked grave. Please! Mozart was buried in a mass grave, designated for the lower classes, and today even chocolates carry the composer’s name. Another traditional saying goes: “In the end we all meet at the cemetery.” I would also like to clarify this. Well, some of us make it to one cemetery and others are not buried there. In the past, unchristened children and people who committed suicide were refused burial – their bodies were buried outside the cemetery walls. When the Toruń Highway was being built in Warsaw many years after the war, the remains of German soldiers were found under the walls of the Powązki Military Cemetery. Quite clearly those who had decided, in spite of everything, to respect the bodies of enemy soldiers, didn’t however recognize them as equals to their ‘own’ soldiers. So, they buried those ‘foreign’ soldiers outside the cemetery walls. But one should remember that the victims of genocide were also appallingly treated, even after death. Moreover, the bones of those murdered in Auschwitz were scattered on the fields so that all memory of them would vanish. It is a fantasy that all deaths are treated equally.
You write that the definition of death has evolved throughout history. How?
For centuries, the matter was quite simple: death was confirmed when there was no sign of breathing or a heartbeat. It was not a great problem. Of course, there were customs which were meant to avoid mistakes, so that a person was not buried alive. These included several days wait from the confirmation of death until the funeral or prayer ceremonies; keeping vigil in the home of the deceased (and in Polish folk tradition as late as the 20th century). Sometimes they invented tests, like pain tests, to make sure that the person was dead. These days, however, we understand dying not as a one-off act, but rather as a process. Thanks to the development of science, today we can reanimate patients and keep them alive with medicines and specialist equipment which we could never have dreamed of in the past. Because of this, however, the question of declaring someone’s death has become very complicated and, at the same time, institutionalized. Only a doctor can confirm death. The switching off of equipment is up to hospital councils and sometimes even a court. Since 1968, the cessation of brain activity has been accepted as the criterion for death – more precisely, the brain stem.
However, this has often been challenged. There have been cases where the decision to switch off life support has caused huge protests. You only have to remember the years-long battle around the death of the American Terri Schiavo, who was in a coma for 15 years. Her husband fought for permission to switch off her life support. The woman’s parents opposed him, supported by Christian pro-life organizations. The Governor of Florida, Jeb Bush – brother of the then president, George W. Bush – even changed the law to prevent the death of this one person. In the end, however, after another court decision in 2005, doctors stopped prolonging Terri Schiavo’s life. This case illustrates perfectly the great contemporary dilemma. We have wrested away nature’s monopoly on ‘adjudicating’ over death, but we are now left with the question of when we are allowed to pull the plug.
This dilemma is dictated by our fear of over-hastily ending life.
Of course, but on the other hand, let’s pray we don’t fall into the trap of being unable to pull the plug. It is ever harder to be absolutely certain about death. The matter is further complicated by organ transplants; we need still living parts of bodies, but we take them from a person and we must be sure that that person is dead. One can see in this a certain contradiction and conflict: a person has died, but their organs are still alive. So has the person died, or not?
A precedent-setting case occurred in the US in 1993. Doctors kept a pregnant woman alive for three months although she was brain dead. They were hoping to save the foetus that was still developing in the patient’s body, which was being kept alive by a life support machine. It was successful; the child was born and then the life support machine was switched off and the mother was allowed to die. It had been decided that the woman was not alive because her brain stem was considered dead.
For reasons like these, and others, the definition of death is very emotive. No less so than the arguments over the polar opposite end of the debate: abortion, in vitro fertilization, stem cell farming, and cloning. For in order to speak about death, we should also define when life begins.
These dilemmas have been with mankind for ever. Should we allow someone to die? To finish off a wounded enemy in war? What to do with prisoners of war? Should people be allowed to commit suicide? Should we save old people or leave them be? Or perhaps hasten their departure?
These days we are often faced with the question: how long should we try to save someone?
Because maybe at a certain point it would be better to let them go. I am not proposing systemic euthanasia here, but I just want to point out that this often happens. I remember an anecdote from a young doctor. He asked the senior doctor what medication to give an aged patient in a critical condition. The senior doctor replied: “None.” Because it is easier to stop treatment, than have to decide later to switch off the machines.
In the past, people were afraid of death and wanted to live a long time. Maybe they were afraid of the Final Judgement and punishment for their sins? These days, we more often fear a drawn-out death or incapacity. I wouldn’t dare say that I would like to live beyond 100. It would depend on what state I’m in.
We see that the average length of life is increasing. As a result of this and the falling birth rate, particularly in the wealthiest countries, the percentage of old people in society has been rising over the last 100, maybe 200 years. Meanwhile, society pays little attention to the issues of old age. Even science occupies itself much more with childhood, adolescence and youth issues. Geriatrics as a medical specialization? Not very attractive. In the end, however, we don’t allow a person to die, even when they really want to, exhausted by disease or incapacity. We treat old and sick people as if death shouldn’t happen. However, it always comes.
Death comes, although statistically much later.
In ancient societies, a person who stopped working and who couldn’t be used even for activities such as guarding livestock or weaving, became expendable. In French, there is a phrase, sécouer les cocotiers, meaning ‘shake the coconut palms’. It means getting rid of people who have been occupying space for too long. Allegedly, it derives from the observations of some tribe in Polynesia in the 19th century, who were said to send their old people up to the top of a palm tree and then shake it. It was a test. If the person could hold on, it meant he was strong enough and therefore could still be useful to society. But some fell down, effectively straight to their funeral. In a radically different society, in Ceauşescu’s Romania, the emergency services deliberately delayed sending ambulances to old people who were sick.
These days we’re not normally confronted with such brutal customs. We’re not in the habit of leaving our old people outside the house to die of cold, as once happened in old cultures that were dependent on mother nature. Today we are better prepared. We manage, even in difficult weather conditions, and even if, because of our age, we have no strength left. I myself am beyond the first flush of youth, although I still live with the conviction that I can be of use to someone, because I work intellectually and can still get by. I suspect, however, that even today, in a situation where physical strength continued to count, I would be just ‘another mouth to feed’.
In the end, one has to die – that’s what you called your book about death from the perspective of society. It is a truth that is as obvious as it is painful. How do you cope with this?
Actually, not long ago I had brush with death myself, due to a serious health issue. Fortunately, thanks to a well-performed operation at the hospital and the care of my family, the problem was resolved. So I have added personal experience to my theoretical knowledge. I’ll tell you this: believers think that death is not the end of their presence on Earth. The motif of the funeral ceremonies in many religions is that we don’t say goodbye to our dead, because we count on meeting up with them after death. Therefore, we look after the graves of our loved ones, visit them and, in some cultures, take meals to the graves for our dead. I am a non-believer, so I must satisfy myself with the biological approach. I was born, I have passed on life to the next generation, I also pass onto the younger generation my scientific experience and maybe some thoughts or certain behaviours. And that’s it. That’s the end of my role.
Parts of this interview have been edited and condensed for clarity and brevity.
A professor of humanities, a historian and sociologist, retired employee of the Institute of History at the University of Warsaw. He is the author of numerous books concerning social history.
Translated from the Polish by Annie Jaroszewicz
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