Why do we think about death? What happens after we die? Do we already know?
I started medicine in 1989 and as an intern one of my rotations was covering a pulmonology ward. Most of the patients were ex or current smokers (we will cover smoking in another blog) and were often older and needed oxygen. Patients getting confused was the par for the course. I was about 3 months out of medical school, very green and very naive. One afternoon, about 4 pm, a floor nurse called me because a patient became agitated and was on the 5th floor balcony and about to jump. I had my ready reference pocket book with me and flipped to agitation. The dose for this particular drug for acute agitation was 5-20 mg. Well, this man was about to kill himself, so I gave him the big dose! We got him back to bed. He became sick. He stayed sick. I worked on him for my entire 3 month rotation. He died. I went to his autopsy and never forgot that moment. Since then I’ve been up to my eyebrows and beyond in death as a neurosurgeon. Week after week, month after month I have seen death. Most die in spite of what I do. A few, because of what I did. i’ve seen a lot of death. I remember patients from 20 years ago who died. I carry a graveyard with me. Patients who were too young to die including babies. Patients who had miserable deaths. Patients who did not expect to die. Death for a neurosurgeon is every 2nd night on call. Its made me think a lot about mortality and what happens after we die. I’ll give you my take on religion in another blog. Death is the taboo topic. It’s a topic we don’t discuss. We all die, yet we don’t discuss it. Let’s dig a little into death. I’ll tell you what I’ve seen. I’ll tell you why I think we shouldn’t be afraid, but not for the reasons you think. I’ll tell you what I’ve learned from carrying around a graveyard that I often think about for the last 30 years
You can’t talk about death without talking about dogs and clocks. More specifically, about what makes us human and time. When you look at a dog you see a lot of differences between dogs and people. One difference that becomes obvious if you watch dogs long enough is that they live in the moment. A dog has no concept of tomorrow, yesterday, the future or the past. They don’t horde food in case tomorrow there is none. They eat until they are full and then some. This difference is in essence tied into our fears of death.
As humans we understand time and this has served us enormously well. By understanding time we were able to plan. We were able to understand seasons. We were able to develop a history. Dogs have no concept of time; humans do.
The concept of time really is at the heart of our philosophical angsts related to death and dying.
Think about it. If we are aware of time, we are aware that there was a yesterday and that there will be a tomorrow. More importantly, we are aware that there was time that we existed. By inference then, we know that there was a time that we did not exist. Now you’re getting warm. We are also aware that there will be a time when we don’t exist and this is the angst of humanity- what happens after we die.
This then cuts to the heart of what every human worries about- what happens when we die. The basis of religion has been dealing with this problem. Many religions have made concepts of heaven and hell after death, the afterlife, reincarnation and resurrection. Is it to give meaning to our existences? Is it to make peace with the fact that we realize that there is a time when we don’t exist? Most animals do not have a concept of time/existing versus non existing and so live in the moment, the here and now.
So what happens after we die? The answer lies in where we were before we were born. We remember nothing of it. There was no pain or suffering. It was a nothingness.
As a scientist I’m not that sure about religion anymore. Religion wants faith and science wants proof. Most religions thrived when the common person had a wretched life. The concept of an afterlife reduced the chances of revolt in this life with promises of riches and rewards in the afterlife. In 2020 most of us want proof.
I was a fan of the Sopranos. If you were too, watch the scene below to think about what happens after we die:
Nothing. Like before we were born. We didn’t feel any regret or pain or longing before we were born and won’t after we die.
My dad was very religious when he was young but, like me was a physician for decade. I remember asking him in high school what happens after we die and he said ‘nothing’. I was horrified but years later realized he was probably right. Most physicians become less religious as time goes one and deep down are probably atheists or at least agnostics. The surface religious practices may continue but they see too much bad stuff to think everything is a fairytale. We see a lot of people die. A lot. Given a lot of people die in hospitals, you’d think hospitals would be haunted, wouldn’t you? So many deaths, tens of thousands, maybe more, sometimes over centuries. Never seen a ghost or spirit, not one. Probably not the same as our ‘soul’ but it does make you wonder. If there are all those ghosts out there why don’t they haunt hospitals? Maybe we want some meaning to why we are here. Truth is it’s survival of the species. A fungus tries to expand and grow. Some dies here. Some dies there. At the end of the day the overall survival of the fungus is key. If a spore dies here or there it does not matter, as long as the fungus stays alive. Maybe then, our purpose is the same: survival of the human race. Propagate the species and ensure the race as a whole survives with less emphasis on any single element. The humanists in us want to give meaning to every unit in the human race. Thing is we don’t give meaning to every cell in our body- they come and go- its the whole organism that matters. Makes you feel less special? Biologically, maybe but, as I’ve said before it’s what we say and what we do that makes us special.
Dying is one thing, the manner of our death is another. No one wants a painful lingering death.
It is what it is. Facing our own death, for all of us, is our final challenge. On a personal note, I am a firm believer in euthanasia. Death with dignity. We treat our dogs better than we treat ourselves when it comes to being allowed to die. When you see people die miserable deaths robbed of all dignity, made less human and not themselves any more, ‘life at all costs’ becomes less desirable. Turn on the TV and any night you will see that as humans we don’t make life sacred and priceless, be it wars in Syria, droughts in Africa or the endless march of disenfranchised people from Central and South America to the United States every day. There are are over 7 billion people alive on Earth today. The acturalists put a price on life every day and as this number rises, the price goes down.
This brings us back to the title. Human beings, in their understanding of time, gained an understanding of being, past and future. They also gained an understanding that there was a time that they existed and there will be a time when, we as individuals don’t exist. After we are gone, it is probably the same as before we are borning. Nothing. It’s ok. We don’t fret the before? Why fret the after? As Roy Batty said, “All those moments will be lost, in time, like tears in rain.”. RIP Rutger Hauer.
The Clocks are really killing us. Do your best right now. Be your best. Be nice and help others. It’s good for your inner peace now and today. There are no other guarantees. We will touch on religion in another blog!
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