Philippe Ariès “The Hour of Our Death”

Ariès, Philippe 2008 [1981]. The Hour of Our Death. The Classic History of Western Attitudes Toward Death Over the Last One Thousand Years. New York: Vintage Ebooks.

Part V – The Invisible Death
In the course of the twentieth century an absolutely new type of dying made an appearance in some of the most industrialized, urbanized, and technologically advanced areas of the Western world – and this is probably only the first stage. Two characteristics are obvious to the most casual observer. First is its novelty, of course, its contrariness to everything that preceded it, of which the reverse image, the negative. Except for the death of statesmen, society has banished death. In the towns, there is no way of knowing that something has happened: the old black and silver hearse has become an ordinary gray limousine, indistinguishable from the flow of traffic. Society no longer observes a pause; the disappearance of an individual no longer affects its continuity. Everything in town goes on as if nobody died anymore. The second characteristic is no less surprising. Of course, death has changed in a thousand years, but how slowly! […] Today, a complete reversal of customs seems to have occurred in one generation. […] Phenomena that had been forgotten have suddenly become known and discussed, the subjects of sociological investigations, television programs, medical and legal debates. Shown the door by society, death is coming back in through the window, and it is returning just as quickly as it disappeared. (530-531)

It is useless for Tolstoi’s [Three deaths] heroine to protest that she is being treated like a child, for it is she who has placed herself in that position. The day will come when the dying will accept this subordinate position, whether he simply submits to it or actually desires it. When this happens – and this is the situation today – it will be assumed that it is the duty of the entourage to keep the dying man in ignorance of his condition. How many times have we heard it said of a husband, child or relative, “At least I have the satisfaction of knowing that he never felt a thing.” “Never feeling a thing” has replaced “feeling his death to be imminent.” (532)

Curiously, he [Ivan Ilytch] is frequently on the point of crying out while they are telling their little stories around him, “’Enough lies, we all know that I am dying! Stop lying to me, at least! But he never had the courage to do this.” He is himself the prisoner of the character [merely a man who is sick, and not dying – sickness masks dying; instead of death, thought is occupied by the floating kidney – O.P.] he has allowed them to impose on him and that he has imposed on himself. The mask has been on so long that it is stuck, and he cannot take it off. He is condemned to live out the lie. Compare Tolstoi’s phrase, written in the 1880s, “This lie that degraded the formidable and solemn act of his death,” with the last words of Père F. de Dainville to Père Ribes in 1973 when he was lying in an intensive-care unit with tubes all over his body: “They are cheating me out of my own death!”. (537)

After the concealment of death by illness and the establishment of the lie around the dying man, the other new element that appears in Tolstoi’s writing is the dirtiness and indecency of death. In the long accounts of deaths of the La Ferronays or the Brontes there is no mention of the uncleanness of the great terminal diseases. Why? A Victorian modesty, which shrank from mentioning bodily excretions, as well as long habituation to disagreeable smells and to the disfiguring effects of pain. (537)

The agony of Emma Bovary is described in merciless detail, but it is brief. The illness of Ivan Ilyich, however, is long, and the odors and the nature of the treatments make it disgusting and – something death never was with the La Ferronays, the Brontes, or Balzac – indecent, improper. (537)

During the second half of the nineteenth century, death ceases to be always seen as beautiful and is sometimes even depicted as disgusting. It is true that Ronsard and the other macabre poets of the fifteenth and sixteenth centuries had felt a sense of repulsion in the face of the decrepitude of old age, the ravages of disease, the devastating effects of insomnia, decaying teeth, and bad breath. But they were only amplifying the theme of decline in an age when a more brutal and realistic imagination was discovering the decomposed cadaver and the unspeakable interior of man. This interior seemed more repellent than the exterior of the old man and the invalid. (538)

In the eighteenth and early nineteenth centuries, the decrepit old man of the late Middle Ages was replaced by the handsome patriarch of Jean-Baptiste Greuze, an image more suitable to the romantic theme of the beautiful death. But in the late nineteenth century, we see a return of the hideous images of the era of the macabre, which had been repressed since the seventeenth century. The difference is that now everything that had been said in the Middle Ages about decomposition after death is transferred to the period before death, the agony. (538)

The dying man’s bedroom has passed from the home to the hospital. For technical medical reasons, this transfer has been accepted by families, and popularized and facilitated by their complicity. The hospital is the only place where death is sure of escaping a visibility – or what remains of it – that is thereafter regarded as unsuitable and morbid. The hospital has become the place of the solitary death. In a study of English attitudes conducted in 1963, Geoffrey Gorer showed that only a quarter of the bereaved in his sample had been present at the death of a close relative. (539-540)

[Vladimir Jankélévitch]: “Is not the taboo word death above all others the unpronounceable, unnamable, unspeakable monosyllable that the average man, conditioned to compromise, is obliged to shroud modestly in proper and respectable circumlocutions?” (540)

After the funeral and burial comes mourning in the true sense of the word. The pain of loss may continue to exist in the secret heart of the survivor, but the rule today, almost throughout the West, is that he must never show it in public. This is exactly the opposite of what used to be required. In France since about 1970 the long line of people offering their condolences to the family after the religious service has been eliminated. And in the country the death notice, which is still sent out, is accompanied by the dry, almost uncivil formula, “The family is not receiving,” a way of avoiding the customary visits of neighbors and acquaintances before the funeral. (546)

As [Geoffrey] Gorer says, “At present, death and mourning are treated with much the same prudery as the sexual impulses were a century ago.” One must learn to dominate them: “Today it would seem to be believed, quite sincerely, that sensible, rational men and women can keep their mourning under complete control by strength of will and character, so that it need be given no public expression, and indulged, if at all, in private, as furtively as if it were an analogue of masturbation.” (547)

From now on, the denial of death is openly acknowledged as a significant trait of our culture. The tears of the bereaved have become comparable to the excretions of the diseased. (547)

It is significant that when this attitude began to emerge, psychologists immediately pronounced it dangerous and abnormal. They have never stopped insisting on the necessity of mourning and the dangers of repression. Freud and Karl Abraham went to some pains to show that mourning is different from melancholia, or depression. […] Their view of mourning and its role is exactly the opposite of the attitude of society. Society regards mourning as morbid, whereas for the psychologists it is the repression of mourning that is morbid and pathological. (548)

Whether we like it or not, we have all been transformed by the great romantic revolution in feeling. It has created ties between us and other people, ties whose destruction seems inconceivable and intolerable. It is this first romantic generation that was the first to deny death. It exalted death, it deified death, and at the same time it transformed not just anyone, but the loved one, into an inseparable immortal. This attachment is still with us, despite an apparent relaxation that has to do with a more discreet language, a greater modesty – the modesty of Mélisande. At the same time, for other reasons, society no longer tolerates the sight of things having to do with death, including the sight of the dead body or weeping relatives. The bereaved is crushed between the weight of his grief and the weight of the social prohibition. (550)

The hospital is no longer merely the place where one is cured or where one dies because of a therapeutic failure; it is the scene of the normal death, expected and accepted by medical personnel. (551)

Death has ceased to be accepted as a natural, necessary phenomenon. Death is a failure, a “business lost.” This is the attitude of the doctor, who claims the control of death as his mission in life. But the doctor is merely a spokesman for society. When death arrives, it is regarded as an accident, a sign of helplessness or clumsiness that must be put out of mind. It must not interrupt the hospital routine, which is more delicate than that of any other professional milieu. It must therefore be discreet. (553)

What today we call the good death, the beautiful death, corresponds exactly to what used to be the accursed death: the mors repentina et improvisa, the death that gives no warning. “He died tonight in his sleep: He just didn’t wake up. It was the best possible way to die.” (553)

The opposite is the “embarrassingly graceless dying,” the bad death, the ugly death of a patient who knows. In some cases he is rebellious and aggressive; he screams. In other cases, which are no less feared by the medical team, he accepts his death, concentrates on it, and turns to the wall, loses interests in the world around him, cuts off communication with it. Doctors and nurses reject this rejection, which denies their existence and discourages their efforts. In it they recognize the hated image of death as a phenomenon of nature, whereas they had turned it into an accident of illness that must be brought under control. (554)

Death no longer belongs to the dying man, who is first irresponsible, later unconscious, nor to the family, who are convinced of their inadequacy. Death is regulated and organized by bureaucrats whose competence and humanity cannot prevent them from treating death as their “thing,” a thing that must bother them as little as possible in the general interest. (554)

[Nowadays, at the end of the 70s and the beginning of the 80s] It is the dignity of death that is at issue. This dignity requires first of all that death be recognized, not only as a real state but as an important event, an event that should not be conjured away. One of the conditions of this recognition is that the dying man be informed of his state. English and American doctors have yielded to the pressure very rapidly, no doubt because it enabled them to share a responsibility that they were beginning to find intolerable. Are we on the eve of a new an profound change in attitudes? Is the rule of silence becoming obsolete? (556)

The most recent model of death is associated with the medicalization of society, that is, with the segment of industrial society in which the power of technology has been most widely accepted and is still least contested. For the first time, people are questioning the unconditional benevolence of this power. It is in this area of the collective consciousness that a change in contemporary attitudes might well occur. (559)

Our modern model of death was born and developed in places that gave birth to two beliefs: first, the belief in a nature that seemed to eliminate death; next, the belief in a technology that would replace nature and eliminate death more surely. (561)

It is of paramount importance to create the illusion of life [in funeral rites]. This illusion enables the visitor to overcome his intolerance, to behave as if the deceased were not dead and there were no reason not to approach him. In this way he is able to circumvent the prohibition. Thus, embalming serves less to preserve or honor the dead than it does temporarily to maintain the appearance of life in order to protect the living. (564)

The most ridiculous and irritating aspects of the American ritual, such as the making up of the body and the simulation of life, express the resistance of romantic traditions to the pressures of contemporary taboos. (565)

Conclusion – Five Variations on Four Themes
Having abandoned my preconceived ideas along the way, I turn and cast my eye over this thousand-ear landscape like an astronaut looking down at the distant earth. This vast space seems to me to be organized around the simple variations of four psychological themes. The first is the one that guided my investigation, awareness of the individual. The others are: the defense of society against untamed nature, belief in an afterlife, and belief in the existence of evil. (566)

The tame death
The ritualization of death is a special aspect of the total strategy of man against nature, a strategy of prohibitions and concessions. This is why death has not been permitted its natural extravagance but has been imprisoned in ceremony, transformed into spectacle. This is also why it could not be a solitary adventure but had to be a public phenomenon involving the whole community. (567)

Death may be tamed, divested of the blind violence of natural forces, and ritualized, but it is never experienced as a neutral phenomenon. It always remains a misfortune, a mal-heur. It is remarkable that in the old Romance languages physical pain, psychological suffering, grief, crime, punishment, and the reverses of fortune were all expressed by the same word, derived from malum, either alone or in combination with other words: in French, malheur, maladie, malchance, le malin (misfortune, illness, mishap, the devil). It was not until later that an attempt was made to distinguish the various meanings. In the beginning there was only one evil that had various aspects: suffering, sin, and death. Christianity explained all of these aspects at once by the doctrine of original sin. There is probably no other myth that has such profound roots in the collective unconscious. It expressed a universal sense of the constant presence of evil. Resignation was not, therefore, submission to a benevolent nature, or a biological necessity, as it is today, as it was no doubt among the Epicureans or Stoics; rather it is the recognition of an evil inseparable from man. (568)

The death of the self
The second model, the death of the self, is obtained quite simply by a shift of the sense of destiny toward the individual. We recall that the model was originally limited to an elite of rich, educated, and powerful persons in the eleventh century, and still earlier to the isolated, organized, and exemplary world of monks and canons. It was in this milieu that the traditional relationship between self and other was first overthrown, and the sense of one’s own identity prevailed over submission to the collective destiny. (569)

It was inevitable that such an exaltation of the individual, even if it was more empirical than doctrinal, would cause some changes in the third theme, the nature of the afterlife. […] The strong individual of the later Middle Ages could not be satisfied with the peaceful but passive conception of requies. He ceased to be the surviving but subdued homo totus. He split into two parts: a body that experienced pleasure or pain and an immortal soul that was released by death. The body disappeared, pending a resurrection that was accepted as a dogma but never really assimilated at the popular level. […] This new eschatology caused the word death to be replaced by trite circumlocutions such as “he gave up the ghost” or “God has his soul.” (569)

This fully conscious soul was no longer content to sleep the sleep of expectation like the homo totus of old – or like the poor. Its immortal existence, or rather its immortal activity, expressed the individual’s desire to assert his creative identity in this world and the next, his refusal to let it dissolve into some biological or social anonymity. It was a transformation of the nature of human existence that may well explain the cultural advance of the Latin West at this time. (569-570)

Remote and imminent death
[…] profound changes were beginning to take place by the end of the sixteenth century, to some extent in actual customs and conscious ideas, but more especially in the secret world of the imagination. […] Where death had once been immediate, familiar, and tame, it gradually began to be surreptitious, violent, and savage. Already, as we have seen, the old familiarity had been maintained only by means of the artifices of the later Middle Ages: more solemn rites and the camouflage of the body under the representation. In the modern era, death, by its very remoteness, has become fascinating; has aroused the same strange curiosity, the same fantasies, the same perverse deviations and eroticism, which is why this model of death is called “remote and imminent death.” (571)

At first sight it may seem surprising that this period of returning savagery was also characterized by the rise of rationalism, the rise of science and technology, and by faith in progress and its triumph over time. But it was at this time that the barriers patiently maintained for thousands of years in order to contain nature gave way at two points that are similar and often confused: love and death. Beyond a certain threshold, pain and pleasure, agony and orgasm are one, as illustrated by the myth of the erection of the hanged man. (571)

An early manifestation of the great modern fear of death now appears for the first time: the fear of being buried alive, which implies the conviction that there is an impure and reversible state that partakes of both life and death. (572)

The death of the other
If the momentum really did carry from the eighteenth to the twentieth century, it hardly seems that way to the unsophisticated observer. The continuity exists on deeper levels, but only rarely does it show above the surface. This is because in the nineteenth century, which saw the triumph of the industrial and agricultural techniques born of scientific thought of the previous period, romanticism (the word is convenient) gave birth to a sensibility characterized by passions without limit or reason. […] Affectivity, formerly diffuse, was henceforth concentrated on a few rare beings whose disappearance would no longer be tolerated and caused a dramatic crisis: the death of the other. It was a revolution in feeling that was just as important to history as the related revolutions in ideas, politics, industry, socioeconomic conditions, or demography. (572)

An original type of sensitivity now came to dominate all others, a type that is well expressed by the English word privacy. It found its place in the nuclear family, remodeled by its new function of absolute affectivity. The family replaced both the traditional community and the individual of the late Middle Ages and early modern times. Privacy is distinguished both from individualism and from the sense of community, and expresses a mode of relating to others that is quite specific and original. (572)

The ancient and intimate relationship between death and physical illness, psychic pain, and sin was beginning to break down. Our fourth theme, the belief in evil, which had long been stationary, was preparing to withdraw, and the first stronghold it deserted was the heart and the mind of man, which was believed to be its original and pregnable seat. What a revolution in thought! It is a phenomenon as important as the return of untamed nature within the human psyche, and indeed, the two are related; it is as if evil and nature had changed places. (573)

The first barrier that fell in the eighteenth century – perhaps as early as the seventeenth in England – was belief in hell and in the connection between death and sin or spiritual punishment. […] No sense of guilt, no fear of the beyond remained to counteract the fascination of death, transformed into the highest beauty. (573)

The nineteenth century saw the triumph of another image of the beyond. The next world becomes the scene of the reunion of those whom death has separated but who have never accepted this separation: a re-creation of the affections of earth, purged of their dross, assured of eternity. It is the paradise of Christians or the astral world of spiritualists and psychics. But it is also the world of the memories of nonbelievers and freethinkers who deny the reality of a life after death. (573)

The invisible death
Our contemporary model of death is still determined by the sense of privacy, but it has become more rigorous, more demanding. (574)

It is obvious that the sense of the individual and his identity, what we mean when we speak of “possessing one’s own death,” has been overcome by the solicitude of the family. But how are we to explain the abdication of the community? How has the community come to reverse its role and to forbid the mourning which it was responsible for imposing until the twentieth century? The answer is that the community feels less and less involved in the death of one of its members. First, because it no longer thinks it necessary to defend itself against a nature which has been domesticated once and for all by the advance of technology, especially medical technology. Next, because it no longer has a sufficient sense of solidarity; it has actually abandoned responsibility for the organization of collective life. The community in the traditional sense of the word no longer exists. It has been replaced by an enormous mass of atomized individuals. (575)

If the sense of the other, which is a form of the sense of the self taken to its logical conclusion, is the first cause of the present state of death, then shame – and the resulting taboo – is the second. But this shame is a direct consequence of the definitive retreat of evil. As early as the eighteenth century, man had begun to reduce the power of evil, to question his reality. Hell was abandoned, at least in the case of relatives and dear friends, the only people who counted. Along with hell went sin and all the varieties of spiritual and moral evil. They were no longer regarded as part of human nature but as social problems that could be eliminated by a good system of supervision and punishment. The general advance of science, morality, and organization would lead quite easily to happiness. But in the middle of the nineteenth century, there was still the obstacle of physical illness and death. There was no question of eliminating that. The romantics circumvented or assimilated it. They beautified death, the gateway to anthropomorphic beyond. They preserved its immemorial association with illness, pain, and agony; these things aroused pity rather than distaste. The trouble began with distaste: before people thought of abolishing physical illness, they ceased to tolerate its sight, sounds, and smells. (575)

Evil was no longer part of human nature, as the religions, especially Christianity, believed. It still existed, of course, but outside of man, in certain marginal spaces that morality and politics had not yet colonized, in certain deviant behaviors such as war, crime, and nonconformity, which had not yet been corrected but which would one day be eliminated by society just as illness and pain had been eliminated by medicine. (576)

But if there is no more evil, what do we do about death? To this question modern society offers two answers. The first is a massive admission of defeat. We ignore the existence of a scandal that we have been unable to prevent; we act as if it did not exist, and thus mercilessly force the bereaved to say nothing. A heavy silence has fallen over the subject of death. […] And yet this attitude has not annihilated death or the fear of death. On the contrary, it has allowed the old savagery to creep back under the mask of medical technology. The death of the patient in the hospital, covered with tubes, is becoming a popular image, more terrifying than the transi or skeleton of macabre logic. There seems to be a correlation between the “evacuation” of death, the last refuge of evil, and the return of this same death, no longer tame. This should not surprise us. The belief in evil was necessary to the taming of death; the disappearance of the belief has restored death to its savage state. (576)