Q & A | 08/04/2009 8:45 am
How to Die Well in America: A Conversation With Jane Brody

Editor’s Note: Joan Larsen, a committed community member of wowOwow since our debut, suggested that we feature Jane Brody’s Guide to the Great Beyond.
Published this year by Random House, the book profoundly changed her life.
Jane Brody needs little introduction to most of us. Author, longtime weekly health columnist for The New York Times — as well as newspapers throughout our country — we find her articles on health issues, as well as healthy living, "must reading." We find it no wonder that Jane has received so many prestigious awards for journalistic excellence along the way. But it is Jane
Brody’s Guide to the Great Beyond: A Practical Primer to Help You and
Your Loved Ones Prepare Medically, Legally and Emotionally for the End
of Life, the most compassionate of guides to making the end of our lives the best they can be, that make this book a "must" on all of our bookshelves. Jane walks us through the end of life in her latest book as comfortably as she does in my recent conversation with her.
JOAN LARSEN: We at wowOwow are so delighted to welcome you, Jane. We are especially proud to have you with us today.
JANE BRODY: Thank you, Joan. I’m delighted to be with you.
JOAN: Thank you. Your newest book, Jane Brody’s Guide to the Great Beyond, treads on new ground. To be honest, it is ground that most of us are still not comfortable with – death and dying. What was it that made you switch gears as you have done in writing a book about dying?
JANE: Well I don’t even think of it as a book about dying. I think of it as a book about the spectrum of living. I’ve written about birth. I’ve written about rebirth. I’ve written about staying healthy through the life span and it’s a logical extension to want people to help people stay well until their last breath. And what that means is being prepared; being prepared while you are still healthy, while you’re as rational, while you still can make good decisions about how you want to be treated as your life grinds to an end, that will really help make things a far more pleasant experience – not just for you, who’s dying, but for everyone around you; for all the people who love you, for all the people who are taking care of you. That these kinds of advanced preparations are part of living.
JOAN: I think all of us here can understand that. I wanted to say, my own parents and all my relatives passed away at a very young age and being an only child, I became caregiver to the dying and did my best to arrange funerals for the dead. It was a terrible time for me as a young adult. I was very traumatized and no one stepped up to guide me. I had to do this solely myself. And now, much later in life I find that we still read little to help us. We don’t have enough information. We don’t know. We are scared, we’re full of emotions, and so many thoughts pass through our minds. But largely we, too, still remain silent about death. It is a subject about which most of us avoid talking.























33 Reader Comments (so far…) Sign In or Register to comment
What an excellent interview! Our Joan whips! I am so proud of her.
Death is not an easy topic to discuss for many, but it’s crucial to prepare as best we can for the final exit. My husband and I both agree we do not want to linger after a certain period. We understand each other’s wishes. I would not hesitate to pull the plug nor would he because of this understanding. The advice from Brody re: wills is so important––"stuff" has got to be written down.
How I would love to just take a pill when I decided to say goodbye. I’d put my house in order, pick one last bouquet of flowers, put on something filmy, and having written to everybody I love, lie down and die. Now that’s what I call a good death.
This is a wonderful interview, and your post made me smile. We all want to say good bye with dignity. I love the way Uncle Lowrey made his exit. As was his custom, one Sunday he went to church, came home to a nice fried chicken Sunday dinner, and then lay down for his nap. One Sunday he did not awaken. But what a wonderful way to go! A talk with God first, then good home cooking, and a comfortable bed.
(Yep.. it was probably one fried chicken dinner too many.)
You covered a lot of ground in this interview, and I am so glad you spent extra time discussing Living Wills, because often it can come down to that one document. I needed it with both parents, and while you may keep one copy in a safe deposit box, absolutely have one at home. Pay the lawyer to make up several copies of everything. If you are at a hospital at 2 a.m. on a Sunday, and a doctor takes you to "the small room" to have "the discussion" you want to be able to go home and get that legal document. Hospitals are very wary about proceeding without it.
A good attorney will offer you several options, and I know I went for many with my parents and myself. Not just a Will, but a Living Will (which is a separate document,) and Power of Attorney and Living Trusts. With my parents, short of the house, they put my name on everything. Every bank account, stock certificate, savings bond, the car, the safe deposit box (with key), credit cards. Obviously there has to be a great deal of trust in doing these things, but in the end, for us, it made it much more smooth sailing. It also saved in taxation once the probate process began. These are things you can discuss with an attorney.
As for good deaths—some people laugh at this concept thinking "How can death be good?" But if you’ve seen a bad death…you know the answer. The last four I’ve had to deal with I would classify "bad," and they left their scars….even with all of the planning.
I did discuss over and over again with my father what he wanted for his funeral. My mother absolutely refused to discuss it at all and found it very upsetting, so I had to fly solo making decisions for her, but I nailed it. The thing is, if you have been dealing with the illness and let’s say…a week of death watch by the bed, once the moment arrives, you are worn and not thinking at your best. It takes a lot of strength to get through it. Like another wOw reader, I had everyone take ten steps back and had it all land on me, and I am still paying the price for that effort. It also taught me a lot about myself and my character.
I’ve seen some odd deaths in my time, too….or heard of them. My good friend had both her parents die in the same year. Her mother, who was healthy, got up one morning, bathed, dressed, put on her makeup and earrings, made the bed, lay back down on it and died. Just. Like. That. I worked with another woman where her husband had been in the fatal illness category, then she died in the same month he did, so the children lost both of their parents at once. My best friend had a pain in her tummy, went for exams, and was dead in a month, so you just never know. Be prepared. You can learn a lot about yourself during these moments. You also learn about others and just what their strengths and weaknesses are.
All in all, an excellent interview. You covered a lot of ground on a topic most people find too gloomy to face down.
I’ll close with one story full of black humor, I suppose. When I was little and would visit in the South, they would still lay people out in the family parlor at times. I know I attended my first funeral before age five, so I wasn’t one of those shielded from death. When my mother died, her sisters came up from the South, and they said we should go to the funeral home before the service to "check on things." That hadn’t even occurred to me, but then I was exhausted from the death watch and planning of the past week. When we got there, and standing over Mom’s open coffin, the sisters said, "We have to redo her hair," and they got out their combs and brushes and started changing things. I don’t mean to be crass saying this, but when you are dead, you no longer have muscles to support skin, so I had the funeral director come in and note how I wanted my mother repositioned. My mother was a fair skinned blonde, and despite the photographs I had provided (for makeup) they put bubblegum pink lipstick on her, so my Aunts had me lift my jacket sleeve and we all whipped out our lipstick tubes which they started marking up my arm with, trying to find the most suitable shade of "rose." So there I am, standing over my mother’s body with my arm marked up with lipstick and my Aunts and I debating. Ultimately, we got it all perfect, as my mother would have wanted it to be. But in retrospect, it’s odd what we go through to honor our dead.
I read once that the Queen of England and the Royals always travel with black in their wardrobes "just in case." Good practice. I think once you reach a certain age, you should always have some formal black daywear around. It will spare you a bleary eyed trip to the department store.
…and as a postscript I will say this, but it may not happen to you. For every death I’ve dealt with, some people look on it as an open target event where they can say things to you that they may have spent decades suppressing. It’s a no holds bar event, even in front of the coffin. I’ve told stories of things said to me, and it’s unbelievable. And that’s just what they say, let along ripping plants out of the garden "to remember them by" or going into a bedroom and pawing through jewelery "wanting something to remember them by." It makes you redefine our advancement into being civilized people. So…be prepared for that, too. Oh yes, the drunks and pill poppers, too. Who knew a wake could be like a bad cocktail party?
Good, WC - however, I’d place one note of caution on putting anything into another’s name - do not do it without legal cousel. I did it - during breast cancer, and lost more than my hide! Trust goes out the window, many times, when money is involved.
More over, your doctor and hospital should have a copy of your Power of Attorney, and Medical Power of Attorney in your medical records, and keep them updated with copies as they are changed, altered, etc. However, remember too that they are not viewed until one is declared incompetent - thus that may be too late. Wills are not read until one passes, so any decisions one wants may go un-attended to until it is too late.
Remember the stories about people putting names on their possessions to be certain they went to the right people? Not too shabby advice; however, frankly, after I’m gone, I could care less. ;-)) I’ve been "denuding" my life and possessions for a long time, and want for myself what I eek out of them. My kids have their lives, their children, their responsibilities, and I do know what they want from "home," and they have it, or will have such, shortly. Today, most people are very late in intellectual development — they don’t begin to think concretely, much less know how to deal with ambiguity, until well into their 50s. Perhaps they’d prefer a rip-roaring memorial party - that’s fine, I won’t be there.
PS - my beloved mid 90s aunt just got rid of all of her furnishings, and many kitchen items for the 3rd time, and when she moved acorss the street into a smaller home, she bought all new, and loves it. Her kitchen decorative items are now RED, so I sent her a set of "Old Fashion" glasses from the Pottery Barn and you would have thought I sent her a check for $1M. Her bedroom is now all in a soft pink, and she’s delighted with a new "bed-in-a-bag" set. The only thing troubling her is that she cannot find a ‘minute table and chairs for this tiny kitchen, and I want one to set!"
C jay: I know only too well how people react when money is involved. United by blood and family goes right out the window. I did note there has to be a high level of trust involved to do these things. Otherwise I would never recommend it. I’ve seen it all, I’m afraid, including those who died without a Will—another mess, or divorced their husband 15 years ago, yet still had a high yielding IRA in his name. Guess what? He got it. Like you, and because I had to deal with estates so much during "tender years?" After cleaning out about the fourth relative’s house (and so many were pack rats,) I said to myself, "For every year I live, I will get rid of more, and then even more."
Jacqueline Kennedy Onassis had time, before she died, to go around and not even put little notes on the bottom of things, in terms of who got what, but she added history to the items as where the chair was bought, or what the painting had meant to her, and I thought that was a good idea that you could do even without a terminal illness hanging over your head.
I’ve seen family members (and heard similar stories from others) about siblings that never spoke to one another again, because one had made off with the inheritance, or taken some item without discussing it with others. Things get very "base" and cruel during a time that should be spent in mourning. It’s made me rethink just how civiized any of us truly are.
Our hospitals almost require them now. If you can’t present a legally written one, they will send someone to you who will.
I have written reams about Wills, Living Wills and POA’s here on wow. I can’t get close to explaining how essential these three instruments are and how important it is to update them periodically. At least have the lawyer review your circumstances regularly. And, the kits you buy at the Office Depot are not usually the correct documents to prepare because state law varies, and they have to be done By The Rules….
The only bad thing about death is all the legality of it.
Nice interview though. There does seem today to be to many people ignorant of it.
Well, this was very appropriate. I had just been talking about "what will happen if………" with my son.
I also happen to find my husband’s "do not resuscitate order" while cleaning some files today. Never thought of keeping it closer so I would not have to scramble for it. Oddly I do not have one and want it, will make a note of it when I go to the dr. next.
Joan, you did such a superb job, I am extremely proud of you.
Thank you, Ms Brody for writing the book. I surely will get a copy.
However, the topic covered the what is perceived as an ideal situation—dying with caring family members. In the 1980s, academically, “the family” was closely examined, and what forms such take; at this time, it must be revisited, again (many books were published on that topic).
Having been in attendance with many people who have either not had family members close for many reasons, or chose not to, it became patently obvious to me that everyone has a right to their life, personal decisions, and most importantly, someone to travel with them—and in many cases, only ones doctor was the trusted ally—a point many physicians seem to forget (they take long vacations at the most troubling times imaginable).
In that regard, because of my medical, and personal experience the past 49 years, I have chosen to not put the onus of my last wishes on family members—they have not asked for that, either (though do skit around ignoring the facts I have presented to each/all). In fact, the PBS documentary on aging and dying in America, featuring the gerontologist (physician) in the NE clarified what I have personally experience—many, in fact most, people who have signed DNRs, and/or made known how they wanted their remaining days to be if (critically ill, terminal illness, last days, “take me out behind the shed and shot me…”) changed their minds, and wanted to fight for their lives. This is something that doctors’ experience, and no amount of “family wishes,” can change such decisions—it is between the patient and their physician.
Personally, having “died,” I, and others I know, can tell you that we do not know it! It is akin to sleeping, in my humble opinion, but few of us know that, or even want such an experience. Being resuscitated is no fun, either, in fact, it carries with it what I suspect is a form of PTSD, for a very long time. Recently, I thought about that when I was told that my heart would be stopped, perhaps several times during a procedure and I have to admit, I gave that a lot of consideration—and would more so if that ever comes up, again. I add this to let everyone know and give them something to think about, as well as the assurance that none of us are getting out of here, alive. In that regard, we will not know ‘troubles’ others experience over our remains, and should we be concerned while alive? I don’t think so.
For the past 10 years, I have looked into, and chosen, a natural deposition of my remains (forest ‘burial). In the 90s, I helped a friend (bless her cotton gizzard!!) secure her mother’s remains without an “undertaker” (we purchased a plain wooden box from a funeral home, and drove her body to lie with her deceased spouse, 392 miles to south Texas coast) after the memorial service.
I experienced the culture of death and dying in Italy (on vacation!), thus will never permit any of America’s exorbitant cash on dyingin relation to myself. The death and final disposition of remains that I experience there—I was called on to “help” the widow prepare her spouse’s body—was a wonderful, and awesome experience, and one that an entire community responded to, not even knowing the decedent. He was merely prepared, cleansed, and dressed in his bed, where he died, thus laid in state as family, friends, respectful neighbors, and compassionate others arrived, paying alms to the widow—most did not know either person, in fact. Once the priest placed a decorative (black) item on the door, in they came with money, food, gifts, caring, and company—and all brought their children, there was nothing hidden. It was incredible.
What that taught me—giving is receiving, and receiving is giving, even in death. It should be a community experience, not the family—in most cases family knows less about one another than close friends, and community. Everyone has death in their future, including children, and life, sickness, and dying is community.
C jay: Just read your postscripts. There are online sites that sell specifically for the small home, re: your Aunt. I am currently in the process of emptying out and restoring the home of a 96 year old relative that died last year (once again into the breech, dear Executor) so the emptying out phase is in the forefront of my mind—-and I’ve sworn I never want to do it again. If you’ve ever done it….well…you know.
The experience you witnessed in Italy is ideal and the way it should be. Having been present at other’s deaths, I can only say I felt it was a privilege to be present. It’s a very sacred time and if you don’t come away from the experience changed, then something’s wrong with you. Unfortunately, when I had to deal with these deaths, I never saw any of that. It was just the absolutely worst, crudest behaviors, and from people you would not expect it from.
I’ll tell you a story my former dental hygienist told me, when she heard about an experience I had to deal with. Her mother predeceased her father, at a relatively young age, and a relatively quick death, so not a lot of preparedness. She said, "I always thought we were a very close-knit, loving family." (I think she had about four other siblings.) Before her mother was even cold in the ground, her father found himself some younger tootsie, and off they ran to Las Vegas to get married. The "bride" sent a picture back to the family of them in the hot tub, hoisting champagne flutes. The hygienist told me, "I threw it away. I didn’t want my children seeing their grandfather like that." Her father changed his Will, left everything to his new bride…everything…completely cut his adult children out of the Will, died not too long after that, and to quote the hygienist, "She got everything. I didn’t even get one of my mother’s teacups." Heartbreaking things like this go on all of the time.
Look at Anna Nicole Smith. I never watched her reality show, but I did catch a bit of it once, and she had just gone to pick up her husband’s ashes. She came back and put them on top of the cable modem box for the television. All I could think of was the humiliation and sadness that man’s grown children must be feeling; that their father acted like an old fool and walked off the earth looking stupid and lacking dignity and the gravitas of being older and supposedly wiser. Not to mention the money spent out fighting that mess in court.
I am sure there are those out there who would argue, "It’s his life, and his money, and why not go out the way you want….happy." I would counter, "You are a part of a family, and that means you still need to adhere to some unwritten code of conduct." I’ve seen many, many times (and it’s usually a man) where they are just…..for lack of a better expression, hellbent on what I call "bringing down the temple in destruction." "If I am dying, then I will kill everything I created around me. Nothing will survive." It’s control. It’s ego. And it leaves a lifetime of wounds that will never heal.