In the spring of 1994 my grandmother chose to go off dialysis. Four days later, she was dead. I still remember my parents waking me up in the middle of the night and taking me to the hospital. I don’t recall seeing her body that evening, but I remember sitting in a waiting room at Milder Manor in southern Lincoln. Later that day I remember being at school and being signed up for a grief class by one of the counselors. (Thankfully, when my parents found out they pulled me out of it. The last thing my seven year old self needed was to have some school psychiatrist—who had no personal knowledge of me or my family, much less of my grandmother—telling me how I should be handling my grandmother’s death.) In any event, I remember my grandmother’s death and the reason for her death: her choice to reject life-preserving medical care.

Truthfully, though, I don’t remember a single day that my grandmother was healthy. She was in a wheel chair for as long as I knew her. There’s an old family picture of us at the park with me, two years old, standing behind her wheel chair reaching up to the handles and trying to push. She suffered from diabetes, heart disease, kidney failure and a litany of other health defects, most in some way attributable to the diabetes or her long-term struggle with obesity. My mom tells stories of how her diet existed in a state of perpetual flux, as one week she could only eat one type of food and another week she could only have something else (and usually not whatever it was she had to eat the week before). At one point she wasn’t even allowed to drink water or chew on ice, a habit she’d acquired years before as a way of coping with the many other foods she wasn’t allowed to eat. Sometimes my mom snuck her Whoppers from Burger King or pieces of fruit, which she wasn’t allowed after going on dialysis. My mother knew the burger was bad for her, but she also knew—better, I suspect, than my grandmother’s nurses—that my grandmother had very few things in life that made her happy. And given that unhappiness, if a three dollar burger from Burger King might brighten her day . . . well, she should probably have one every once in awhile. (Once while eating a Whopper, my grandma heard the nurse coming down the hall and she slipped the sandwich into a drawer on the nightstand beside her bed. The nurse asked why it smelled like Burger King but she never found the burger.)

Alongside her considerable health problems and exceedingly restrictive diet, she also was entering the beginning stages of dementia. The Halloween before she died, my parents took me to the nursing home to visit her so she could see my Zorro costume. When I came into the room, she told my mother that they couldn’t bring Fallan (my mom’s German Shepherd) into the nursing home.

One of my favorite stories from my grandma’s last weeks is that after she decided to go off dialysis— meaning she would be dead within a week—one of her nurses loaded up a cart with nothing but fresh fruit and wheeled it down to her room. “Mary,” she said, “you can have as much of this as you want.” Fruit had always been my grandmother’s favorite but it’s strictly verboten for dialysis patients.

I couldn’t help thinking of my grandmother’s final years while reading Michael Wolff’s story in New York magazine. Most social conservatives read the story and responded like Matthew Cantirino at First Things, dismissing the story with a sniff while alluding to the “culture of death” and treating Wolff’s story as one more example of how The Godless Humanists have won. (I doubt the godless humanists have won, though I do suspect that one proof that modernity has won is that alleged traditionalists seem to be buying into modern myths; such as the belief that we need to artificially prolong a life as long as possible no matter how miserable the person living that life becomes.)  That, to me, seems a rather cold, ideologically-driven response. After all, as Samuel Goldman notes over at TAC: “The ideal of prolonging life as much as possible is not of Biblical origin.  Rather, it’s rooted in the conquest of nature theorized by Bacon and Descartes. According to the Bible, death is a central part of the human condition—a fate that should not be hastened but also is not to be escaped. According to the founders of the modern project, it’s a problem to be solved by technology, which is supposed to be infinitely improvable.”

Here we should consider three of the church’s greatest fantasists before turning to the patron saint of Front Porch Republic, Wendell Berry. One of the most valuable qualities of fantasy literature is that it allows the authors to construct a world governed by norms distinct from those of our own. They can plumb the nature of evil and goodness in new ways because of the new possibilities opened up by fantasy literature. And it’s striking to me that three of the foremost Christian fantasists of the last century, Tolkien, Lewis, and Rowling, have defined the highest form of evil as a desire to conquer death through some sort of controllable technique.

Tolkien makes the “conquering” of death a consequence of possessing the One Ring; his fellow Inkling, Lewis, makes the conquering of death one of the chief objectives of the N.I.C.E. in That Hideous Strength. Indeed, read thematically, that also seems to be one of the themes of the Tower of Babel account in Genesis 11 (which is the inspiration for Lewis’ That Hideous Strength). Death is a normal part of life in a fallen world and humanity doesn’t possess the means in itself to overcome it. And in attempting to obtain those means, we’re likely to do far more harm than good. Rather, we push back against lesser forms of evil which we are able to resist meaningfully and we trust to God the vanquishing of our greatest enemy. Isn’t that the most straight-forward way of reading the Resurrection? The Resurrection is the inauguration of a new order and it is the part that God does completely on his own. But then about seven weeks later, Christ ascends and the remainder of re-creation goes forward through the redemptive work of the church aided by the Holy Spirit and the Ascendant Christ. This is all Biblical Theology 101: Death cannot be conquered by human means. And, as Lewis warned, those convinced that it is are the most likely to do things hitherto regarded as “disgusting and impious.” Tolkien understood that the essence of the modern project was human knowledge used to develop a technique, which would insure human control. That’s why he put nearly those exact words in the mouth of his most modern character, Saruman the White.

We might also turn to Rowling to help us better understand the issue. Rowling built her entire series around the question of death and how we ultimately respond to it. And it is the series’ villain rather than its hero who seeks to conquer it. Lord Voldemort attempts to ensure his immortality through the creation of what’s called a horcrux. A horcrux is something an especially powerful dark wizard can make that will contain a part of his soul. Essentially, it severs a portion of the soul from the body, insuring that even when the body has been obliterated the soul remains alive and can reanimate another body. But this immortality comes at a high cost. The portion of the soul that remains lives a half life. It has been severed from its body, which is a “violation against nature” in Rowling’s words. Bodies and souls, it seems, are meant to exist in union. Such violations do not represent the transcending of a mere arbitrary tradition that can be violated without consequence. Rather, it is so fundamental a rejection of the natural way of life that the normal delights of life become utterly impossible for the horcrux-maker. While life-prolonging medical care doesn’t sunder body from soul in the same way, anyone who has known a person like Wolff’s mother or my grandmother knows that there is some sense in which the person in that hospital bed living off machines is not the person you knew before the hospital. Perhaps such life-prolonging devices, then, might be thought of as horcruxes, physical devices that allow a life to continue even when the body and soul no longer function in harmony.

All of these images and ideas serve as background for the story told in Wendell Berry’s Fidelity, one of the lesser-known but most touching and evocative of Berry’s short stories. Burley Coulter, one of Berry’s most beloved characters, is dying. Initially, his son and family do what everyone does in such a situation. They check their dying loved one into a hospital. But as they watch Burley dying, they realize their mistake and they realize that the modern world of scientific technique and human control is wholly inadequate in its response to death:

 When they returned on yet another visit and found the old body still as it had been, a mere passive addition to the complicated machines that kept it minimally alive, they saw finally that in their attempt to help they had not helped but only complicated his disease beyond their power to help. And they thought with regret of the time when the thing that was wrong with him had simply been unknown, and there had been only it and him and him and them in the place they had known together. Loving him, wanting to help him, they had given him over to ‘the best of modern medical care’ – which means, as they now saw, that they had abandoned him. If Lyda was wakeful, then, it was because she, like the others, was shaken by the remorse of a kind of treason.

This is what Berry expresses so clearly and so perfectly in Fidelity: The fact of death (to say nothing of the grotesque mode of death it has created) demonstrates conclusively the philosophical failure of modernity. We must eventually come to the end of our tether, the point beyond which our control is of no use, our technology rendered impotent. And when we come to that point, the naked lust of modernity is revealed as the dehumanizing system that it truly is. There are other resources upon which we must avail ourselves at such times: mutual knowledge, home (which must be an emplaced home, not simply a pleasant-sounding sentiment), tenderness, and the greatest of all, love. A system premised on control and exploitation can know nothing of these things.

This is not to say that Wolff’s argument is completely sound or even especially well-argued. As Ross Douthat notes, Wolff moves from a case for rejecting life-prolonging medicine to a case for assisted suicide without acknowledging the difference (though one can’t help wondering if he sees the difference himself). Further, I wouldn’t argue with anyone who finds the utilitarianism of Wolff’s argument off-putting. While it’s true that the sort of medical care described in his piece contributes in no small way to our out-of-control health care spending, it seems rather perverse to constantly cite that while arguing for the right to kill one’s aging mother.

Those disclaimers aside, however, the best response to Wolff is not to attack him as an ambassador of the culture of death. Rather it is to pity him. He is a victim of a world hellbent (I mean that quite literally) on eradicating the emotional and human resources needed to cope with death. Then, when we’ve eliminated those, we come to death and are unable to cope. What makes Burley’s death in Fidelity so remarkable is that in some sense readers know this is a good death, as good a death as can be had this side of Christ’s return. And what makes it so good is the relationship of mutual belonging between Burley and his place. But we are a placeless people and such a death is not a possibility for many of us. (Old Testament scholar Walter Brueggemann has said that the great crisis of the modern age is not a lack of meaning but a lack of place—“there are no meanings apart from roots,” he says.)  So we do everything in our power to put it off, even as we realize that such a prolonged life may simply be another form of dying. It’s what Mr. Wolff has seen in his mother, and it’s what I saw in my grandmother as well.

Clearly many people (perhaps Mr. Wolff himself) have, in Berry’s phrase, “thought up the wrong world.” But I do wonder, when reading such casual dismissals as those posted previously at First Things, if Mr. Cantirino hasn’t thought up the wrong world as well.


Jake Meador is a lifelong Nebraskan and lives in his hometown of Lincoln with his wife Joie. He blogs at Notes from a Small Place

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  1. John – In my experience it has been. My pastor and I are currently teaching a class on Berry at our church and in a group of 20, only two of us had read Fidelity. Then again, I’d love to be wrong on that assessment. It deserves a wide reading.

    I was actually surprised it didn’t get discussed more during the healthcare debate. Brooks’ even wrote a column about how one of the main factors in our sky high medical bills is a fear of dying. But no mentions of Fidelity. It was odd.

  2. I’m currently enrolled in a Grief and Crisis class, part of a masters program in counseling at a local Christian university. These matters you raise are precisely the ones we need to consider when talking about death . . . or life. I believe another one of Mr. Berry’s essays is titled “Health is Membership”, which posits the idea that health is not merely a matter of proper diet, exercise, medical care, etc., but also one of being connected – rooted – to one’s place, kin, and community. While those in the holistic medicine and health movement begin to grapple with some of these things, it still strikes me that they – along with the rest of us modern Babel-onians – are still grounded in much of the thinking that has caused the problem in the first place, namely, that even in Paradise – much more a fallen world – man was created with limits that we attempt to cross at our peril.

  3. What an excellent article.

    A long time ago I decided I would not increase the time of my life artificially. It’s not that I’m anxious to pass on, but I’m not going to spend tons of money (or worse, leave my remaining family in crushing debt) trying to hold off the inevitable.

    I’ve spent a good amount of time around nursing homes … I will not live like that.

  4. Dear Jake,

    Thanks for this wonderful piece. _Fidelity_ really challenges some of our preconceived notions about end-of-life concerns. I taught the text in a senior level college course on Berry this spring and received a range of responses from students, many of whom initially bristled at Danny’s actions. Interestingly, they all came around to appreciate his actions in the story, wondering what sorts of decisions they would make if in the same situation. A few were still bothered by the fact that Burley wasn’t buried in a known place where others could commemorate his life. Really, they began to think about death differently than they had before, wrestling with the implications for us when we fight to preserve a life by mechanical and scientific means.

    Blessings and Thanks,

  5. Jake,

    You inexplicably club Matt Cantirino (who happens to be a rather crunchy fellow) without explaining how he disagrees with you, or with Ross. The fact is, he doesn’t. At no point does he advocate for extending life indefinitely. In fact, he specifically notes that there are good aspects to Wolff’s article. It’s sad to see him criticized, for no reason at all, in what was otherwise a very nice piece.

    Keep writing.



  6. I’m not sure what to say, other than to point out that my primary objection was to the tone of the New York magazine article, which was really pretty, er, “snivelly” about the whole business of dying. I mean, who admits they’re “giddy” about their mother’s impending death?

    Anyway, I enjoyed the rest of this piece, and fully recognize the non-absolutist nature of many end-of-life of decisions. Indeed, the Catholic Church leaves lots of leeway here, too, distinguishing between “ordinary” and “extraordinary” means, provided one enters this harrowing process with the right disposition.

  7. I think anyone who has watched a family member die in the hospital understands that feeling of treason and abandonment. Mr. Berry has that exactly right.

    I was interested in the reaction of some of Mr. Baker’s students to the story–that the anonymity of Burley’s resting place was somehow wrong or hurtful. I think I might have felt similarly when I was younger, but I wouldn’t now. In the story Burley’s grave is hidden in the woods, but his son knows where it is, and we presume he will tell the family. The place will be known as long as there are people alive who remember the man who is dead, and I could argue that’s long enough.

    I say that in part because the most moving cemetery I ever saw was the old Harmonist one in New Harmony, Indiana, which is walled off but otherwise full of unmarked graves. I am not sure if there is even a complete list of who is there, though there may be. But it is a beautiful field of grass that speaks very clearly of its nameless dead, more so than many another burial ground. A person could be forgotten in ways that were far worse.

  8. As a counterpoint to Burleys’ attachment to “life sustaining machines” Berry writes in Nathan Coulter about Nathan’s refusal to have treatment after being diagnosed with cancer. I worked in critical care medicine for twenty years and always had great respect for the courage it took for a family or a patient to say “enough.”

  9. Thank you for this very thoughtful article. And, thanks also to FPR – I have found this site to be very challenging and inspiring. I was wondering if you could provide tthe source text for the Walter Brueggemann quote about “the great crisis of the modern age is not a lack of meaning but a lack of place”—“there are no meanings apart from roots”? Thanks very much.

  10. I read an article once by a doctor, a longtime head trauma specialist, describing medical events he had seen that he called miracles. In every case, the patient was a small boy so severely injured that the only possible medical prognosis was prompt death, and yet in every case the boy made a full recovery. They were all Hispanic, and the doctor attributed the recovery to the behavior of the immediate family, who more or less moved into the hospital and spent as much time as they could around his bed, pouring out love. Boys from English-speaking families with similar injuries were alone most of the day because their families, like the rest of us, were taught that the best thing we can do for them is to go away and let the professionals do their job. None of them experienced this sort of recovery. (I’m sorry I can’t attribute; I read it probably twenty years ago and don’t remember the author or title.) Thus, it isn’t only a good death that modern high-tech medicine denies us. By separating healing from love, it just might cost us miracles.

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