The Movement to Bring Death Closer
Heidi
Boucher loaded two big straw baskets into her Toyota Highlander. She
always kept them packed, ready for death. Inside were a pair of leather
work gloves and a hammer, a bunch of bed pads, a few adult diapers (dead
bodies sometimes leak), Q-tips for cleaning ears, noses and mouths and
for applying lipstick, cotton balls, disinfectant spray, a plastic zip
bag of safety pins to help drape silk and other fabrics around a gurney
or casket, a small screwdriver to tightly close a casket, latex gloves, a
hairbrush and oils infused with rose, lavender and rosemary.
Boucher
also had her black attaché case of paperwork on funeral planning, which
included a few funeral-home price lists for cremation and other
services, as well as the files of 20 or so clients who had already made
plans for Boucher to help with their bodies after death. Among them was
Susan L’Heureux, a 79-year-old wife, mother, grandmother, reading
teacher at a community college, lover of nature, spontaneity and books.
L’Heureux had died about an hour earlier in her home in Oakland, Calif.,
and Boucher was on her way to her.
Over
the last few decades, Boucher has helped more than 100 families take
care of loved ones’ bodies in the hours and days after death. Some of
their deaths were long expected, whether from cancer, multiple sclerosis
or another chronic disease. But she also helps families with the
sudden, inconceivable loss. The teenager who jumped from the Golden Gate
Bridge. The man who shot himself. The children and adults killed in car
and motorcycle accidents. The people who died of drug overdoses. They
have been atheists, Christians, Buddhists, Jews.
Boucher,
who describes herself as a home death-care guide, is in her mid-50s,
with an earthy, hip style — dark hair piled loosely atop her head, a
stack of gold bangles on her left wrist, silver hoop earrings, chunky
black glasses. The oldest daughter of five and a mother of three adult
children, she has a maternal warmth and deep-set blue eyes that draw
people to share their confidences. For the grieving, Boucher likens
death care to walking into a pool, “to avoid the shock of jumping into
the cold. Some people like jumping into the cold. But virtually everyone
who has had a conventional funeral and later comes to me says that they
wish they had more time.”
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Susan
L’Heureux wanted her children and husband to have time. She had been
living with amyotrophic lateral sclerosis, A.L.S., for a few years. Her
legs stopped working. Next, her arms. Then her breathing became more
difficult, and she had trouble swallowing.
She
knew she wanted to be cremated. And though she typically had strong
opinions, she left the funeral details up to her family. When we talked
late last year, Susan was in her bedroom overlooking a golf course and a
group of trees, including her favorite redwood. “I’m glad I’m not going
to be whisked away and waxed up in a funeral home,” she said. Her
daughter, Suzanne, an art-history teacher and a gallery owner, had heard
about Boucher from someone at her daughter’s school. She had also
watched a documentary on home funerals called “In the Parlor: The Final Goodbye,”
written, directed and produced by Boucher. (Boucher, who lives in Fair
Oaks, Calif., is also an independent TV-and-film and production
designer.) She was intrigued. In part it reminded her of home birth,
which she experienced with her youngest child. Each seemed about
“reclaiming the most fundamental aspects of life,” she said.
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Caring
for her mother in death would be an extension of what Suzanne did
during the last years of her mother’s life. Her older brother, David,
agreed. So did her father, Conrad, a thoughtful man who favors plaid
button-down shirts and keeps reading glasses perched on his almost bald
head. A former priest, he had long been interested in Buddhism and open
to creative rituals. When he was a religious-studies professor, his
favorite class was “The Inner Journey in Myth, Bible and Literature,” in
which he had students keep personal journals and led them through
guided imagery.
It was a Friday
afternoon in late February when Boucher arrived at Conrad and Susan’s
apartment with a bunch of flowers, her baskets and a chest holding 25
pounds of dry ice. David and Suzanne were in the living room with
Conrad, along with Suzanne’s two children, Miles, 15, and Lila, 10.
Everyone was tired but calm. After Boucher sat down, they told her about
the last day of Susan’s life, how she was surrounded by the family, how
they put their hands on her as she took her last breaths.
Then
the adults took Boucher back to the bedroom, where Susan lay in her bed
under a blanket that David bought for her, imprinted with four large
photos of Susan, Conrad, their children and grandchildren. Boucher
approached her silently, touching one of her feet, as a way to connect
to her. She asked everyone to gather washcloths and a couple of basins
with warm water. When Boucher wondered if Susan had a favorite scent,
Suzanne mentioned rose, and Boucher added rose oil to the water. Over
the last year, Suzanne had regularly massaged her mother’s face and
temples with rose oil. It had become an aroma of mother-daughter love.
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Then
Boucher lit a candle and began to guide the family. For the sake of
ease, they cut off Susan’s shirt. Next, Boucher asked if everyone was
O.K. if she pulled back the blanket, and as she did, she covered Susan’s
breasts and genitals with towels. Conrad dipped a washcloth into the
warm water and washed down along one side of his wife’s body. Suzanne,
on the other side, put a washcloth to her face, along her neck, down her
arm. All her life, Suzanne loved her mother’s skin, the way it looked,
the way it felt. Though she was grieving, touching and tending to her
felt soothing. They dipped and washed and dipped back into the warm
water again, before patting her skin dry.
That
evening in the bedroom, Suzanne and her daughter, Lila, looked through
Susan’s closet for her final outfit. Lila picked a green button-up
sweater and a pair of slacks that her grandmother liked. Boucher then
showed Suzanne and Conrad how to gather the sleeves of the sweater and
pull them up Susan’s arms, as if dressing a small child. It was easier
now than it would be in several hours after rigor mortis set in,
stiffening her muscles and joints for hours, before they relaxed again.
And it was also easier than it had been in the last weeks, when Susan’s
pain often grew intense. “Could you imagine trying to do this two days
ago?” David said. “She would have pitched a fit.”
David
helped with her pants and slipped warm socks on his mother’s feet.
Suzanne brushed her hair. To prevent Susan’s jaw from falling open,
which happens as the muscles relax, Boucher and Suzanne placed her head
on a pillow and tucked a rolled towel under her chin.
While
the family took a break in the living room, Boucher went to the balcony
with her ice chest. Using her hammer, she broke the dry ice into
three-inch-thick chunks. She wrapped each chunk in a piece of bed pad
and placed the packets along Susan’s body, from her armpits down to her
hips. She put some on her stomach and a small one under her head.
Suzanne still wasn’t sure how long to keep her home. Though Boucher’s
clients typically choose three days, for spiritual or religious reasons
or because that’s when they feel they’ll be ready to part with the body,
Suzanne thought that three days might be too “woo-woo.” Regardless, the
ice, along with the open windows, would keep her body cool and slow
down its decomposition.
Later that
night, Suzanne headed home with her family, while David slept in the
guest room. Conrad got under a down comforter on a narrow wooden bed
near Susan’s, where he had slept for weeks. He had designed the bed and
built it with his son-in-law, Tony, Suzanne’s husband; it was just the
height of Susan’s hospital bed, allowing him to hold her hand at night.
It was also narrow enough that he could tuck it away in the morning,
leaving room for him, a hospice nurse or a home health aide to care for
Susan.
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When
Conrad awoke the next morning, he went through his usual routine. He
made coffee. He looked at his favorite news websites. He did it all
quickly, anticipating that at any moment, Susan would call out to him.
She would need him for breakfast, for his companionship. Instead, that
morning there was silence, and then Conrad remembered she was gone.
The funeral
industry emerged over the following decades — faster in urban areas than
in rural ones. In 1890, there were 9,891 funeral directors in the
United States; 30 years later, the figure had more than doubled, despite
the fact that the death rate had dropped substantially, as Gary
Laderman, a professor of religion at Emory University, writes in “Rest
in Peace: A Cultural History of Death and Funeral Homes in 20th-Century
America.”
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By
the 1930s, with increasing numbers of people dying in hospitals instead
of homes, death became professionalized. Funeral-industry groups had
lobbied state legislatures to create laws about who could prepare and
bury bodies. And embalmed bodies, which funeral directors promoted as
sanitary, medical and therefore necessary, became the centerpieces of
funerals. Funeral directors, not families, became the new death experts.
Embalming
was performed on a majority of corpses by the middle of the 20th
century. Now, experts estimate, about 50 percent of dead bodies in the
United States are embalmed (the funeral industry doesn’t publish
statistics). During a roughly three-hour process, the embalmer washes
the body with a disinfectant solution and massages and moves the limbs
to loosen the stiffness from rigor mortis. He — most funeral directors
are men, though the number of women is rising — “sets” the facial
features. He closes the eyelids, sometimes using adhesive glue or a
plastic eye cap, and the mouth, suturing or sewing the jaw to the gums.
Next,
he cuts into the base of the throat, near the clavicle, to reach a
carotid artery and inserts a small tube through which a machine that
looks like an oversize blender pumps several gallons of embalming fluid
into the body. The fluid, a tinted potion of formaldehyde and other
chemicals (some funeral homes now offer a nonformaldehyde alternative),
is designed to erase the natural pallor of death and plump up the skin.
From a nearby vein, he is meanwhile draining the blood. Finally, before
fixing the hair, applying cosmetics and dressing the body in clothes
chosen by family members or friends, he makes one more incision, this
one in the lower abdomen. He inserts a tube attached to a trocar, a
long, sharp surgical instrument, to puncture the intestines, the
stomach, the lungs and the bladder and suction out fluids and gases,
replacing them with a stronger mix of embalming fluids.
Though
the industry has improved from Mitford’s days, many funeral homes still
promote embalming. They say it’s the choice that brings you peace of
mind and preserves the body (it delays but doesn’t stop decomposition),
while creating the “best possible appearance.” One funeral arranger told
me she was trained at a large Los Angeles funeral home to tell
customers that not embalming was illegal, “because of the danger to you
and the danger to your family.” In reality, a vast majority of people
die of noncommunicable diseases, and in general, people are more
contagious alive than dead.
A
symbiotic relationship has developed between our cultural assumptions
about what constitutes the “right” funeral and the funeral industry’s
interests, notes Tanya Marsh, a professor at Wake Forest University
School of Law, who specializes in funeral and cemetery law. “We were
complicit in handing over control of this sphere of life to a
profit-making industry. If we don’t like it, we can take it back.”
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