As the title of her current book makes clear, Sallie Tisdale is a provocative writer who likes to address uncomfortable (even taboo) subjects that many prefer to avoid. If you can get past the blunt, weirdly funny, and challenging title of this book, you’ll be okay with the contents: an interesting mix of personal stories, practical advice to assist you in preparing for your own death or caring for a dying loved one, details about the actual process of dying (the changes in the body at various stages, including the time after the death has occurred), information about options for the disposal of the body, and reflections on grief. There are four appendices, which address making death plans, advance directives, organ and tissue donation, and assisted death.
Tisdale has lived a “braided” life as a writer, a nurse/end-of-life educator, and Buddhist practitioner/teacher, and each of these roles has required her to confront hard truths. Since childhood, she says, she has been fascinated with bodies and anatomy, and her rural upbringing brought her into regular contact with death, both human and animal.
Early in her book, Tisdale, who was born in 1957, muses: “We’ve been a most fortunate generation and also one of the most delusional. We are energetically trying not to be as old as we are, to not look old, feel old, and most of all, to not be perceived as old.” She goes on to observe that her Buddhist practice has required her to confront the fact that we (and everyone we love) are constantly changing and will die. Throughout the book, Tisdale refers to a number of writers, scholars, and memoirists who have addressed aspects of death and dying—from American cultural anthropologist Ernest Becker (author of The Denial of Death, 1973 ) to health journalist Virginia Morris (Talking about Death Won’t Kill You, 2001) and Australian writer/memoirist/melanoma patient Cory Taylor, among many others. (I do wish Tisdale had included a bibliography.)
For me, the most valuable part of Tisdale’s book was her discussion of the changes the dying person undergoes and what caregivers can do and say to make him or her more comfortable. She’s very direct about what family and friends should not do, including burden the patient with their own guilt, grief, and need for consolation. I wish I’d had some of this information available to me as I helped to care for a member of my own family who was terminally ill.
While some topics are more thoroughly addressed than others, this is still a rich and worthwhile book. It is worth pushing oneself past the title and reading this guide, especially in an age in which the lives of terminally ill and demented patients can be uncomfortably and futilely extended by modern technologies.