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June 17, 2011
Death is much like the famous aphorism about opinions: everyone will have one. Unlike opinions, we tend to keep our thoughts about death to ourselves. On one level, this makes sense: death is scary and it's a downer, sure to put a damper on any conversation. But on another level, it is our avoidance of the topic that makes death scary. In Reflections of a Loving Partner: Caregiving at the End of Life, author C. Andrew Martin not only makes the case for a healthy discussion of death, he models how to talk about death and offers exercises to assist the reader in considering the inevitable.
Reflections is equal parts memoir and self-help book. Martin became an expert on death and dying in the worst way possible — through the AIDS diagnosis and eventual loss of his partner Gil Victor Ornelas in the mid-1990s. Rather than passively watch his beloved slip away, Martin took action, enrolling in a hospice volunteer-training program so that he could become a more effective caregiver.
Today, Martin is a certified nurse specializing in hospice and palliative care, and his knowledge and sensitivity informs every page. Despite his current expertise, Martin ably recreates the sense of floundering helplessness as well as the desire to learn from his early days. As readers, we accompany Martin in his education about hospice, benefitting from his education as well as the provocative questions his hospice teacher posed at the end of each training session. These questions, along with additional questions Martin includes in the appendix, provide opportunities for the reader to examine one's own assumptions and beliefs about death and dying. As Martin makes clear, this process is valuable whether one is struggling with someone dying at the moment or not. After all, it is inevitable that at some point in everyone's life, death enters the scene, and we're better off having some preparation.
At the beginning of the book, neither Martin nor Ornelas are religious. Theirs is not an interfaith family so much as it is simply a family that exists outside of organized religion. But when the hospice class invites religious leaders from a variety of traditions to explain their faiths' ways of understanding and ritualizing death and dying, Martin finds himself drawn to Judaism. The chapter in which he recounts the rabbi's presentation to the class is as clear a presentation of the Jewish understanding of death and the rituals surrounding it as I've ever read.
This initial attraction to Judaism returns years later, after Ornelas's passing, when Martin finds himself involved in a flirtation with a local rabbi. That flirtation blossoms into a relationship, and when the anniversary of Ornelas's death arrives, Martin's new rabbi boyfriend shares with him the ritual of lighting a Yahrtzeit memorial candle to mark the occasion. This chapter is valuable not only for its explanation and demonstration of this particular ritual, but also as a model for how a partner can share an element of his faith with a partner from another tradition. As Ornelas's Yahrtzeit falls on Easter Sunday, the poignancy of taking on a memorial ritual of another faith is heightened.
A book about palliative care and hospice could easily be depressing, and while Martin doesn't shy away from either the medical or emotional difficulties of Ornelas's decline, the book is surprisingly uplifting. Martin argues that by taking control of the details that can be controlled, and accepting those that can not, a loving partner can ease the pain of the death of a loved one.
It may seem morbid to read such a book when not in the midst of dealing with the death of a close friend or family member. But I imagine it's much easier to read about death when it's divorced from one's own feelings about someone a reader may be losing or have recently lost. The questions the book brings up, both implicitly and explicitly, are important for couples to consider before they become urgent. So while it may seem like an unlikely date night activity to cuddle up with your sweetheart and discuss your preferences for living will provisions or burial options, the book asserts the wisdom of doing just that while providing a framework to do so.