There Is No Right Way to Die

Bill Keller thinks Lisa Adams is doing cancer wrong, but he’s the one without a clue.

By tweeting and blogging about the details of her pain, Lisa Adams helps to destigmatize our discussions of illness and mortality.

Image via AdamsLisa/Twitter

Bill Keller’s op-ed for the New York Times about the most respectable way to die from cancer could be the subject of 100 great lessons in how not to write about human beings. Keller contrasts the case of his father-in-law, who died at age 79 with a stiff upper lip, with that of Lisa Boncheck Adams, a fortysomething mother of three with breast cancer, who has been blogging and tweeting about her treatment and experience with the disease for years. Several excellent articles have already teased out the more glaring issues with Keller’s piece, including factual errors, his lame attempt to mine one woman’s social media activities for societal trends, and the problems of a man suggesting that he knows better than a woman about her own experience. (There’s also the odd husband-and-wife editorials—Keller’s wife, Emma, penned her own weird column about Adams in the Guardian last week, although the post was removed for violating the paper’s editorial code.) Even Adams’ appearance in an article about dying is a problem, because she isn’t. While the prognosis for her stage 4 breast cancer is dire, by her own account, she doesn’t know how long she has to live. As Adams tweeted to Keller soon after the article appeared, “The main thing is that I am alive. Do not write me off and make statements about how my life ends TIL IT DOES, SIR.”

But there’s another issue worth discussing: Bill Keller’s piece seems to suggest that to die well is to make as little fuss as possible. While the piece seems meant to encourage a conversation about dying, it’s hard not to read the words themselves as telling Adams to be quiet. Keller contrasts his father-in-law’s “peaceful” slip from life, his “humane and honorable” death, with a woman who dares to “peck” dark poetry about the experiences of cancer, of being haunted by one’s approaching mortality. Or as Adams “pecks” it, “The ebb and flow of cancer, Of life. And so too, Inevitably, Of death.”

Keller’s suggestion that it is better for people to avoid airing their legitimate pain and suffering aligns with a persistent Western discomfort with talking about real, unglamorous death and dying. I agree with the late English anthropologist Geoffrey Gorer, who argued that the modern taboo on talking about death replaced the Victorian squeamishness about sex. As a nation, we remain bad at talking about the most difficult facts of life—how we want to go, and what we want to be done about it.

That’s why we actually need more people like Lisa Adams. With a growing elderly population (the share of the total U.S. population 65 and older tripled over the past century) and advances in medical treatment that prolong life for disease sufferers, more and more of us are facing head-on confrontations with mortality even before our own time comes. According to a November report from the Pew Research Center, 47 percent of adults say they have had a friend or relative facing a terminal illness or in a coma within the past five years. But it often seems that we’re more confused than ever about how to prepare for and process death, especially since many Americans now lack the religious scripts that once supplied answers for death and illness-related questions. The same Pew study found that more than a quarter of U.S. adults have given little to no thought about what kind of medical care they want at the end of life, even though that care frequently leaves family members in an emotional and financial morass.      

­As the most ancient philosophers and religious authorities have told us, disease, pain, and death are inevitabilities of the human condition. Frank, honest discussions about how to grapple with the darkest of realities—the kind Lisa Adams shares—are helpful for people who are figuring out how to cope and for people who will eventually have to—which is pretty much all of us. We need models for how to talk openly with doctors, family, and friends about the worst of the worst ways that human bodies can go wrong. By tweeting and blogging about the details of her pain, Adams helps to destigmatize such discussions.

Many of us, myself included, have been schooled in an emotional style that prefers to stay away from the dark, icky facts of human life. And talking about sickness and death is undeniably difficult. But it’s reality, and those who dare to do it shouldn’t be shamed or silenced. The only way through this quagmire, this essential knot at the core of what it means to be human, this worm at the banquet, is through public and private conversations about our mortality—messy conversations that may make people like Bill Keller uncomfortable. I hope Lisa Adams keeps blogging, tweeting, and making noise as long as she possibly can.