Why we need to talk about death

Eleni Gritzapis, Cláudia Santos e Conrado Santos

“Death is a day worth living” is the title of the lecture that made Dr. Ana Claudia Quintana Arantes known to the general public. The video of this talk, which has the format of a TED Talk, has almost three million views on YouTube. This same talk was turned into a book, which is already in its second edition by Sextante - and has remained one of the best-selling and recommended books since its first edition in 2016.

Ana Claudia Quintana Arantes (photo) is a USP medical graduate with a residency in Geriatrics and Gerontology at FMUSP's Hospital das Clínicas. She completed a postgraduate course in Psychology - Interventions in Bereavement, at the 4 Estações de Psicologia Institute, and a specialization course in Palliative Care, at the Pallium Institute and Oxford University. A founding member of the Casa do Cuidar Association, she currently teaches at The School of Life and Casa do Saber, giving classes on “How to deal with death” and “How to have better conversations”.

In this interview, she argues that we need to talk about death in order to cope better with grief and live better. Don't miss the full interview on the Folha Espírita Podcast, entitled Death is a day worth living, available on Spotify, Google Podcast, Apple Podcast and the main platforms.

Spirit Sheet - His TEDx presentation at USP's Faculty of Medicine in 2013, on the theme “Death is a day worth living”, has now been viewed almost three million times. Your book, which bears the same title, is a bestseller. Why do you think this subject attracts so many people, from health professionals to lay people?

Ana Cláudia - All of medicine's work is aimed at preventing death, and I think it should be about guaranteeing a good life, a life worth living, but we have thousands of procedures, techniques, interventions and treatments to postpone the day of death. I was even resisted by a publisher to release the book with this title, and I said at the time that the cover of the book is a screening for those who have the courage to live a life worth living. For you to have the courage to have a life worth investing in, you have to get it into your head that you'll die and then you'll get on the path of awareness of a life worth developing over the time you're here.

Need for change

FE - Is death still taboo?

Ana Cláudia - Taboo refers to topics for which you have a choice. So there's the taboo of sex, sexuality, drugs, marriage, femininity and masculinity. For death, there is no choice. There's no such thing as “I'm against it”, it has to be faced head-on. There's no question of if I'm going to die, but rather how I'm going to die, you're not someone in the bread line to say “I don't want to die”. In this sense, there needs to be a change in medicine and health professionals. Medicine has this thing about caring and thinking it's always going to cure, there's no such thing. We need to change, talk about death, I don't see any way of changing a society, of changing a culture, other than through education. We need to talk about the end of life. I'm on a Herculean task to bring this need to learn about palliative care to doctors, so that in medical school they have access to this knowledge, at least the discernment of what can be done, the identification of the patient who benefits from this work, an approach that aims to promote the relief of suffering. It's not just at the end of our lives that we suffer; patients suffer from the moment they are diagnosed, they suffer throughout their illness. I chair an institution that offers this learning, which is the Casa do Cuidar Association, Practice and Teaching in Palliative Care. This movement to disseminate and teach palliative care starts at the wrong end, which is post-graduation, making it a huge job to break down all the concepts that have been placed in the minds of doctors who think they can do anything and that “nobody dies on my shift”.

FE - On the question of education and the previous comment that we can't discuss whether or not we're going to die, The Gospel according to Spiritism teaches that if we could look at life as if it were infinite, change our point of view by understanding it as eternal, many of our sufferings would be different, including the way we deal with death. Do you think that when we understand and discuss death more, we will get closer to these conquests of the soul, making our lives lighter and different?

Ana Cláudia - I think that with pain we have a more critical perception of eternity. You may notice that when you're very happy, when you're alone, you think: “Oh my God, I'm afraid it's going to end”. Let's take the example of those people who are now in the throes of mourning, who don't even have the energy to listen, who are now in bed, not showering, not eating, even wanting to die... When we're in this pain, we have the false notion of eternity, the notion that this pain won't go away. Our notion of eternity is a notion of the eternity of suffering, people don't know how to deal with this because the concrete experience we have of realizing the truth of eternity is in pain: this pain doesn't go away, the fear doesn't go away, the anguish doesn't go away, this difficult phase in my life doesn't go away, so it seems eternal. I have a very clear vision that we are here to learn. This body is a uniform for this learning. We enter here in kindergarten, your body is your uniform for attending classes in this dimension. When you die, it's because you've taken the diploma. Can you get your diploma when you're 28? Yes. Can you get your diploma as a newborn? Yes, it depends on which course you enrolled in.

And we don't love people enough to lose them. If we loved enough, we could lose because everything would have been said, everything would have been shown, everything would have been forgiven, everything would have been done in the best possible way. But because we don't love enough, we can't lose. Then you always have that feeling that you missed out on something in the past. It's totally healthy to have the pain of the mourning process in relation to what you're going to experience in the future, along the lines of “gee, my mother isn't going to see my daughter graduate”, but I can't say “if only I'd traveled with my mother...”. You need to have pain about the loss of the future, that's legitimate.

FE - We have numerous studies from universities around the world on near-death experiences and deathbed visions. Doesn't science already have enough evidence to believe in life after death? In fact, do you believe in life after death?

Ana Cláudia - We have evidence of the continuity of the process of consciousness, evidence that consciousness remains despite death. As for whether I believe in life after death, I'll answer you as I do everyone else: it's none of my business. If there is an afterlife, I'm busy enough here that I don't need to waste my time thinking about what's going to happen afterwards, because it's none of my business, there are people responsible for that. If I'm in this envelope, wearing this uniform, my soul here in this world has a learning purpose and I'm going to take care of that. I'm going to live what I consider to be a valuable human experience for my soul here, that's my purpose, to do my best now. So this view of life after death needs to be a little more mature. Let's agree that there's no longer any such thing as wasting time trying to understand God's thinking. software how God thinks is none of your business and He knows best, because there's no one more competent than Him.

“Learn from nature”

FE - Dr. Elisabeth Kübler-Ross, a pioneer of the palliative care movement in England, says that we should discuss death with children at an early age. Do you think this practice would help people cope better with death as adults? How could we introduce this learning about the end of life to children?

Ana Cláudia - We are born knowing how to deal with death; children know how to deal with suffering and death much better than adults. We've disrupted the innate wisdom of the human being with our Western education. So you spare the child the illness and death of their mother, for example. And when that happens, they will need grief support as adults. I have patients in their 40s and 50s who lost their mother when they were 5 years old and to this day haven't realized it, because someone in the family has decided that the children can't go to the funeral, the children can't know that their loved one is dying. You want to know how a child thinks, go to the backyard, find a dead worm and ask it to tell you its story, or a leaf that has fallen and is still there. Nature is there to teach, learn from nature, this condition of blindness is absurd, because you close your eyes to the obvious: the child knows intuitively what death is.

There's an interesting study of newborn babies and another of babies aged 14 months. If a newborn hears the cry of another newborn, he cries. The other, with children aged 1 year and 2 months, shows that if one baby cries, the other will walk towards them to see what's going on. But you go to the mall with your child and a child in a stroller cries, he wants to go there and you say “no, he has a mother, let him, it's not your problem”. Then we grow up thinking that the person suffering is not just our problem. We come with compassion built in, a compassionate view of the other person's suffering and that you can help them overcome it. A child of 1 year and 2 months doesn't have a postgraduate degree in psychology, doesn't know medicine, isn't a volunteer or religious, but knows this intuitively, but our upbringing disrupts it, teaches it away.

FE - Now back to the subject of the moment, the pandemic. You've been running various courses and talks on death in recent years. Has demand increased recently?

Ana Cláudia - Yes, people want to listen, they want a safe space to talk about death. When you seek this contact at a time when you're not suffering, you turn your life into something lighter because you've already talked about the hardest part, everything else becomes easier. That's why it's important to talk about the end of life: the things that will become much easier to resolve when you look at your death. Death can't be seen as a way out, if you think of your death as a way out, you need help, therapy. Death is a non-condition that absolutely protects life, it's not threatening. It protects life because it sets a limit. Every mother who sets limits educates better. So, death protecting us, protecting our life with this limit, makes us really dedicate ourselves to that learning within life. Lessons in the school of life have a beginning, middle and end. So all the suffering you're going through will pass too, because no day, no matter how difficult, lasts more than 24 hours. So if today is very difficult, it will turn into yesterday, last week, last year, when I was little and so on.

“We need to be quiet”

FE - What advice would you give to people who are bereaved at the moment? There are so many people who have gone, and their families don't have time to say goodbye.

Ana Cláudia - There is nothing to say. We need to be silent, to sustain our presence and our company. It's compassion, it's being there and offering your heart as a source of support. And for you to offer your heart as a source of support, your heart has to be light. So perhaps my request goes to those who haven't lost anyone in this pandemic: don't push your luck by risking yourself or someone you love. Those who haven't lost anyone are the ones who will be able to really help the people who are going through this process, because there are no words that can ease this pain.

FE - You always say that we only die once and that we can't embarrass ourselves. What do you mean by that?

Ana Cláudia - There are many people who believe in life after death, so I tell them that in this life here, I, like Ana Cláudia, only have this one. It may be that my Spirit has come a lot of times before and a lot of times after, but, as I said, it's none of my business, at least not my conscience. Like Ana Claudia, I'm only going to die once, so we have to prepare for that. You can't embarrass yourself at the last party of your life, because your death is your last party, you can't be unprepared and embarrass yourself. Have you ever been to a wedding wearing shorts? It's embarrassing... People look at the sky, see the black clouds and say: “Wow, it's going to rain”, but they don't take an umbrella! It's thundering, the weather is heavy, you look at that and say no, it's going to be okay, God is going to help me and it's not going to rain... That's embarrassing! Another thing that's embarrassing: things are happening to you, you keep saying a bunch of prayers asking God to change his mind... It's like you're saying: “the Lord made a mistake, it wasn't for me, this bill came wrong, to the wrong address, I'll return it to the sender”. God doesn't make mistakes! If it's happening to you, it's your bill! It's not a bill to be paid, but a bill to be lived with. So when I say a prayer, ask God to be so kind as to offer you the necessary parameters of support, ask that Divine Mercy may enable you to get through this, to walk out of the front door and fulfill your mission on Earth. You need to have the courage to go ahead and take responsibility for the difference you are going to make in the world! We have to be aware that we have to make this world a better place once we have passed through it!

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Death is a day worth living