I’m working on a Lancet Commission on the Value of Death, and I’m gathering material. That’s what led me to my 2009 review in the BMJ of José Saramago’s novel Death at Intervals. http://www.bmj.com/content/338/bmj.b941 I and the rest of the team will be grateful for any material or thoughts you might like to share on the value of death.
“If,” wrote Ludwig Wittgenstein, “you were to think more deeply about death, then it would be truly strange if, in doing so, you did not encounter new images, new linguistic fields.” José Saramago, the Portuguese author who won the Nobel prize for literature in 1998, prefaces his novel Death at Intervals with this quotation—and presumably saw it as a challenge. He rises to the challenge with aplomb, and Wittgenstein would not be disappointed.
Saramago’s first way to think about death is to imagine that it stops. The “death strike” begins with the New Year in an unnamed country. It takes a while for people to realise that nobody is dying, and the health minister immediately gets into a mess by telling the people, as is the instinct with politicians, that nobody should be alarmed. A cardinal is, however, alarmed: “Without death there is no resurrection, and without resurrection there is no church.”
But once the people realise that death is no more “a high tide of collective joy sweeps the country.” The joy is, of course, short lived for some. Undertakers are the first to ask the government for support—rather as banks, car manufacturers, and private schools are doing now in Britain. The answer is for the undertakers to bury cats, dogs, and other domestic animals with full funereal rites. Next to complain are the directors of hospitals, which have rapidly filled and become “cemeteries of the living.”
In the middle of a characteristic Saramago sentence, more than two pages long, he writes of how “the rhomboid of the ages will be swiftly turned on its head, with a gigantic, ever-growing mass of old people at the top, swallowing up like a python the new generation, who, transformed for the most part into nursing or administrative staff to work at these eventide homes…” Such a future, which we are experiencing in the real world where death is only partly interrupted, is, he writes, “the worst nightmare that could ever have assailed a human being.”
The people, as they quickly begin to realise that the end of death is far from a cause of joy, demonstrate their initiative by taking relatives who are near death over the border, where they die and can be buried—overtones here perhaps of euthanasia. The “maphia, with a ph” quickly turn this transportation of the nearly dead into a business and blackmail the government into supporting them.
Eventually death has had enough. She—because death for Saramago is female—sends a violet coloured letter to the director general of the television station announcing that she’ll resume work at midnight and that henceforth people will be told a week in advance of their death. The note is grammatically weak, and one newspaper publishes a corrected version. This infuriates death, who sends a letter for publication: “Dear sir, I am not Death, but death, Death is something of which you could never conceive, and please note, mister grammarian, that I did not conclude that phrase with a preposition, you human beings know only the small death . . . one day you will find out about Death with a capital D.”
People hear of their forthcoming deaths in violet coloured letters delivered by the postman, and, unsurprisingly, the advance warning is hated. Death personally signs 250 letters a day but is very taken aback when one letter keeps coming back. Manifested as a beautiful 36 year old, death sets off to explore, and the last quarter of the book becomes small scale and personal in contrast to the large public stage of the first three quarters.
The letter that kept returning was intended for a 50 year old cellist, and death tracks him down. Seduced partly by the charms of the cellist and his dog and partly by Bach’s sixth suite for solo cello (and who couldn’t be?), death ends up in bed with the cellist, and, as she neglects her duties, the book ends with the same sentence with which it began: “The following day, no one died.”
Can doctors, many of whom deal with death every day, learn something from this fictional examination of death? I think so. The book might be thought of as a series of thought experiments, and they illustrate the centrality of death to human experience. Ivan Illich accused doctors of destroying cultural mechanisms of dealing with death in their implicit attempt to defeat it, and Saramago, while hardly mentioning doctors, warns too against attempts to push back death too far.