Tag Archives: death

Cats, Computers, or Doctors: Who’s the best at predicting death?

In society, there are many omens associated with impending death. Some may say they had a dream about death while others may associate death with the portrayal of the grim reaper. In the case of Steere House nursing home in Rhode Island, impending death is in the form of a black and white cat named Oscar. He was adopted as a kitten by the medical staff and his sharp acumen has never led him astray. As soon as the doctors see Oscar curl up next to a patient, they inform families to come visit their loved one for one last time. Out of the 50 patients the cat has cuddled up next to, all 50 have died within a short span of time after their visit with Oscar.

This story was first published in 2007 in the New England Journal of Medicine and has stuck with oncologist, Dr. Mukherjee, since. While he may not have the ability to smell the air of death like Oscar, his medical knowledge has helped him predict the viability of a patient’s condition. However, what happens if your predictions are wrong?

Oscar, the cat that can sense death in Steere House nursing home in Rhode Island

Oscar, the cat that can sense death in Steere House nursing home in Rhode Island

In the case of a 32-year-old plumber (patient X) suffering from esophageal cancer, treatments and surgery left this patient with a good prognosis. While there were no signs of tumor left in his body after surgery, Dr. Mukherjee prudently approached the topic of relapse. It was unlikely that the cancer would return; however, the small chance of a relapse still remained. Dr. Mukherjee believed that it might be better for X to have a conversation with his family about this possibility and plans for the future. X was reluctant to follow through with this because he had just defeated cancer and what was the point in worrying about a distant (and unlikely) future anyways? Two months after X was released from the hospital, he relapsed and only the highest doses of painkilling drugs that left him spending his last living weeks in a coma-like state could treat it. His family was devastated and accused the doctor of misleading them about his diagnosis.

Armed with their medical knowledge and results from medical tests, doctors still have a difficult time predicting the death of their patients. For some physicians, they are able to accurately predict how much longer their patients have to live, others tend to underestimate this time, or even overestimate it. This variability makes it difficult to find “the sweet spot of palliative care.” However, what if a computer with an algorithm could predict how long you have left to live?

In 2016, a Stanford medical team and an engineer developed an algorithm that could be taught to identify patients that had 3 to 12 months to live. This was the ideal window of time for doctors to treat patients in the manner that was most effective and appropriate for the patient. Any time less than three months was not enough time to prepare for death and more than twelve months could place an unnecessary strain on the already limited resources in hospitals. As the algorithm underwent a deep learning process and absorbed patient data from more than 100,000 cases, the results were startlingly accurate. Computers using this algorithm were able to correctly predict which patients were going to die within 3 to 12 months nine out of ten times.

However, what is it that this algorithm has that doctors don’t? They both have access to medical information such as a patient’s diagnosis, how many medical tests are ordered, procedures conducted, prescriptions ordered, and the duration of stay in the hospital. Yet, this algorithm, that was recently developed, was better at predicting which patients had 3 to 12 months to live than physicians. It turned out the analyses differed. In the case of a patient diagnosed with bladder and prostate cancer, he was assigned a high probability of 0.946 of impending death. While doctors did not consider the patient’s MRI scan of his spinal cord as a sign of impending death, the algorithm recognized this as a predictor and was able to accurately predict the amount of life left in the patient.

The development of this “dying algorithm” is a huge step in technological advancement. From a medical perspective, it allows physicians to administer palliative care. From a patient perspective, it gives them ample time to discuss goals and futures with their loved ones. However, this also opens up a different side to medicine. What happens when a computer with a dying algorithm is able to understand death better than most humans, including your doctor? Would this result in a decrease in trust in physicians and turn into machine vs. doctor phenomenon? While this may be an issue in the near future, there is much room for growth in both the algorithm and physicians in predicting impending death. So how would you like to be told when you’re going to die? Would you rather be told by a fluffy black and white cat that will cuddle up next to you, an analytical computer spewing algorithmic probabilities, or a human M.D.?

 

When Expectations Do Not Match Reality

Over the course of this class we have read and seen many examples of how different people relate to death. That being said, there has always been a sort of unspoken rule that discussing death should always be done in a respectful and mature way. What happens when that is completely turned on its head?

Well adorned casket set up for viewing

Casket, Museum of Funeral Customs, Springfield, Illinois, 2006 by Robert Lawton

The musical Fun Home has a lot of layers to discuss. It follows the true life story of Alison Bechdel, an American cartoonist who grew up in her father’s funeral home. The musical goes on to follow Alison discovering her sexuality, dealing with her closeted gay father’s infidelity to her mother, and ultimately her father’s apparent suicide. There is a lot to unpack there. However, one of the most striking moments for me, the moment that really turns all expectations on its head, is the song “Come to The Fun Home.” This song is the imaginary advertisement child age Alison and her siblings try to make for their family’s funeral home. 

Photo by mohamed_hassan

When you witness children running across stage, singing a happy and childlike melody, but having the lyrics “You’ve got to bury your mama / But you don’t know where to go” or “Our caskets (ooo) / Are satin-lined (ooo)” you cannot help but laugh. This humor comes from the inherent disconnect between children playing around and a song about funeral home practices. The catchy little rhymes continue as they mention that the Bechdel Funeral Home has folding chairs, smelling salts, ample parking, and more. It goes so drastically against our perceptions of a funeral home and those who work there that it is hard to even frame them in the same mental image. The fact is we think of funeral homes as somber locations and playing children are practically the symbol of life.

Now why else is this so shocking? For one our western society has the tendency to try to hide or diminish death from young children, not let them play sword fight with aneurysm hooks. This openness with death with those so young immediately sets off alarm bells. Also there is a lack of reverence to death within the lyrics, the staging (the kids playing on a casket), and the melody that completely disorients our normal perception of the processes and rituals surrounding death. All of this leaves the audience hysterically stunned.  What I believe the general public should take from this moment within the play Fun Home is the reminder that death is not inherently somber. Our relationship with death is entirely a societal convention and while it is not necessarily bad to be conditioned in such a way, it is important to recognize that it is there.

Watching Fun Home was one of the most powerful theatre experiences I’ve had in recent years and I highly recommend either seeing the show, reading the graphic novel it was based on, or listening to the soundtrack if anyone is interested. Keep your eye out for this particular scene and see if it challenges how you view death.

Are Selfies Worth the Risk?

What would you do for the perfect selfie?

The emergence of the front-facing camera has revolutionized the way we make memories and document our lives. We can’t go anywhere without documenting our latest vacation or trip to the most artsy place in town. If we don’t take a selfie, where we even there at all?

It turns out there have been a number of accidental deaths linked to this seemingly innocent activity. In 2016 alone there were more selfie related deaths than shark attacks.

  1. In 2015 a man reportedly died from a lightning strike that hit his selfie stick, electrocuting him and killing him.
  2. A 66 year old tourist fell backwards down the steps of the Taj Mahal in 2015. He sustained head trauma that led to his death. Witnesses stated that they saw him trying to execute a selfie before the man lost his balance.
  3. In the past few years there was a series of incidents in which young people trying to show off guns on live video accidentally shot themselves and died.

In our society there is the pressure to get the perfect selfie. This causes people to become less aware in their surroundings, opening the door for accidents to happen. Apps like Snapchat have instituted warnings to not take selfies while moving/driving in order to limit the amount of car crashes due to distracted driving. It seems that anything, even the most innocent of actions, when taken to the extreme or done in an unsafe environment can cause harm. The deaths of each of these individuals is tragic. The adage, with more power comes more responsibility, should hold true in our use of technology. As we are able to do more and more things due to technology, we must remember that are actions have consequences. It is wonderful that we can text and call people while we are on the go, but killing ourselves our someone else in a car accident because we were busy texting is not the way to embrace the strides we have made.

The #SelfieOlympics, a viral selfie phenomena a few years ago, shows how the art of the selfie has evolved. The goal was to take the craziest most elaborate photos, all while in the comfort of one’s bathroom. The use of props was encouraged, and the more one could defy gravity the better.  Eventhough social media crazes such as the #SelfieOlympics are super fun and relatively harmless, we should be mindful that actually living our lives is more important than capturing every second of them.

The reality is that while trying to capture every moment of our lives, we are actually letting a lot of it slip past. We must ask ourselves is having the wildest selfie worth it? Maybe not if it means we are risking our lives or the lives of others.

Here’s a video of selfie fails that resulted in accidents, but nobody died. Enjoy.

**WARNING: LANGUAGE**

Sources:

https://www.cbsnews.com/news/death-by-selfie/

https://www.rollingstone.com/culture/pictures/death-by-selfie-10-disturbing-stories-of-social-media-pics-gone-wrong-20160714/ultimate-selfie-gone-wrong-20160714

Video

The Living Dead

While avoiding starting my homework, I was watching clips on YouTube from different TLC TV-shows. I quickly fell down the rabbit hole of watching clips from the Untold Stories of the ER and one particular video title stood out to me: “Girl with ‘Walking Corpse Syndrome’ Thinks She’s Dead!”

Intrigued, I clicked on it.  Although poorly acted, the case presented was very interesting. It was about a young woman who believed she was dead and consequently refused to eat. She had Cotard’s Syndrome: a mental illness in which a person believes that they are dead, decaying, non-existent, or have lost internal organs or blood.

It was first described in 1880 by neurologist Jules Cotard who was presented with a patient known as Mademoiselle X who did not believe certain parts of her body existed.  She believed she did not need to eat and explained that she was condemned to eternal damnation. She died of starvation, which unfortunately is a common consequence of the illness due to patients believing they do not need to eat. Cotard’s is described in the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) as a type of somatic delusion that involves bodily functions or sensations. Although not outlined in detail in the DSM, an individual is more likely to be afflicted with the disorder if they have schizophrenia or experience psychosis, neurological illness, another mental illness such as depression, brain tumors, or migraine headache.

The syndrome normally exists in three distinct stages. The first is the germination stage, in which depressive and hypochondria symptoms appear. The second stage is called the blooming stage, in which delusions of negation start appearing. The last stage is the chronic stage, in which the patient suffers prolonged severe delusions and chronic psychiatric depression. All three stages severely impact the patient’s ability to care for themselves, leading them to neglect their physical health and personal hygiene.

The syndrome can have severe impacts on a person’s interactions with the world; their negation of self often comes with a distorted view of the external world. For example, a patient described in the article “Betwixt Life and Death: Case Studies of the Cotard Delusion” was hospitalized in 1990 because he believed that he was dead. His mother took him to another country after he had been discharged. He believed that he was being taken to hell. He had lost touch of where he was in the world and he interpreted external sensory output differently. The weather which was hotter in the country they were visiting was seen as a reason to confirm that he was in hell. Because of the extremity and rarity of Cotard’s Syndrome, it is often hard to diagnosis and therefore treat, so the patient often suffers with the symptoms for an extended period of time.

 

Celebrating the Death of an Evil Person

In our society, when someone is on the brink of death it is common for the patient’s loved ones to ask for prayers. We pray for the person to overcome whatever it may be that is ailing them and hope they get back on their feet as soon as possible. If this person should die, it is natural for everyone who has been praying for them become sad. Following the death, a mourning period ensues with the goal of remembering the life of the patient and in a good amount of situations still wishing he or she were alive. But, is this always the case? Are there instances where we wholeheartedly hope that someone dies or celebrate instead of mourn when they do pass away?

I came across a video on Facebook recently, and I got thinking about whether it is morally wrong to celebrate an evil person’s death. This video I saw was from a MLB game featuring the Philadelphia Phillies vs the New York Mets in Philadelphia on May 1, 2001. May 1, 2001 was the day the U.S. successfully executed a mission to kill Osama bin Laden. The video showed the Phillies fans celebrating in the stadium upon learning through their phones and word of mouth about the death of the Bin Laden. At that point, the baseball game took a clear back seat, and the crowd was in a frenzy.

I do not have a clear opinion on whether it is morally “wrong” to celebrate an evil person’s death, but I am able to see both sides of the coin regarding this question. Technically speaking, one human life isn’t worth more than that of another human. However, we as a society are quick to label people as “good” or “bad” and these labels no doubt affect the value we place on people. With Bin Laden though, I think it is fairly safe to claim as a whole most people find him to be a person with evil intentions. As mentioned before, however; his life isn’t worth any less than a “good” person’s life, per se.

Although the majority of people thought similarly, obviously not everyone believed Bin Laden was an evil person. For example, his followers and other extremists certainly didn’t think of Bin Laden in a bad light, and most even saw him as a respected leader. Those who respected him definitely had a different reaction than the Phillies fans the day Bin Laden was killed. These questions can be applied to Adolf Hitler as well, a man who may be regarded as the evilest person in human history. As an American, I was proud to hear about Bin Laden’s death. I believe he was an evil person and that was the only just punishment for him. Ultimately, I think mourning or celebrating a person who is considered evil on the level of Bin Laden comes down to several factors. One of them is how you value a life. If you think that all lives are equal, then perhaps you may think it is wrong to mourn ANYONE’S death. Another factor is obviously your relationship to the person. All Americans were happy about Bin Laden’s death but as mentioned before the rest of Al-Qaeda was probably not. I do not advocate for either side, but I certainly do think this is a viable question that has several variants of both sides of the coin.

To see the atmosphere at the Phillies game, take a look at this video.

The Desire and Fear of the Immortal

A phrase from the immensely popular series, A Song of Ice and Fire, valar morghulis is translated as “all men must die,” an idea prevalent in human culture.  Humans tend to define many things in duality: light and darkness, positive and negative, life and death. These concepts are thought of to only exist in relation to one another; without light, there can be no darkness. So, can life as we define it exist without the notion of death; in other words, is something that doesn’t die even alive.

The Fantasy

From the desire to create Philosopher’s Stone, to the search for the Fountain of Youth, to modern stories of vampires, the idea of immortality pervades much of human history. What exactly about the notion is so fascinating? I believe it stems from a fear of death, or the unknown that follows. It is a completely normal fear to have due to the modern world’s obsession with “cheating death.” The idea of living indefinitely seems great, ignoring the looming downsides. These include the loneliness that comes with knowing everything around you is mortal or becoming bored when you’ve seen  and done everything. Immortality is rarely depicted as perfect; however, it is still viewed romantically and longed for.

However, even if someone doesn’t long for immortality, it seems that almost everyone is afraid of another’s immortality. This can be most readily seen in fiction writing. For example, the demon or such that cannot be killed by normal means (i.e. Voldemort, Dracula). This is typically shown as being achieved through a Faustian deal or something similar. The soul is given up, but the consciousness remains in the body. Is this why the notion is scary? Why are these characters shown as bad for achieving something that is so desired? I really can’t answer this, but it is an interesting double-standard nonetheless.

The “Reality”

Aside from the fantasy of immortality, the actualization of immortality is becoming not so far off. For better or worse, it may not be humans that will attain this immortal status. Research into AI (artificial intelligence) is moving forward every single day. In my biology classes, we discussed that consciousness is probably not be a single entity, but rather the various regions of the brain all working together (this theory is called the neural correlates of consciousness).

This theory is what many researchers in AC (artificial consciousness) are studying; although they must first discover what a consciousness is. But is it possible to synthetically create a consciousness? Is the consciousness equivalent to the soul, is the AC truly alive, can humans use similar technology to extend their existences? These have always been topics in science-fiction, but it may eventually become science-fact. Regardless if an AC is created in a decade, a century, or never, it still remains that we need to redefine life and death. How can we define a living being if it is no longer a requirement that it will eventually die?

The Obsession with Death, But Fear of Dying

In my observation of society there has always been an obsession with death. Death is everywhere in pop culture from blazing articles on tabloid pages at the supermarket to brutal deaths being common place on the television screen. Yet as a culture we also seem to have this intense fear of dying.

Painting of a mourning female statue

Mount Olivet Cemetery – Nashville, TN by Don

Recently I found myself binge watching Buzzfeed’s Unsolved series, a YouTube series where two men try to prove that ghosts are real or dig into famous mysteries usually pertaining to gruesome, to unsolved deaths. I do not know why I started watching it, but clearly other people are doing the same for their most recent video, posted less than 24-hours ago, has over a million views. While the ghost and demon episodes will often get my heart racing, it is the one’s that explore real unsolved deaths or murders that stick with me. In a completely morbid sense it is compelling. One would think that because we are so open about death and exploring how someone might have died, that the process of dying should not be a taboo topic. But, as soon as death is brought up in the personal sense the discussion ends. Suddenly, it is completely unreasonable to talk about death. A guy’s head being put on a spike on Game of Thrones = fine, but talking about your own opinions surrounding your unavoidable death = over sharing.

There are exceptions to this of course. I am very lucky to still have three of my grandparents alive, and recently the topic of dying has been a discussion between my maternal grandparents and me. While at first I was uncomfortable, after taking a deep breath I realized the topic was not morbid at all. In fact, it was in some ways heartwarming. My grandfather described his desire to have his and my grandmother’s ashes mixed and my grandmother told me their plan to meet at “the pearly gates of heaven,” though they have yet to decide on which side of the gate. Here were two people I love with all my heart talking about their own deaths and it brought a smile to my face. 

 

Heavenly image of a sun peaking through the clouds

susan.clue_n_you

But, this is a discussion I know many do not have. My grandmother recounted a story of her friend that refuses to talk about his own imminent death with his grandchildren, “because it is too sad.” And I can understand that point of view. Everyone should be able to make their own decision on their level of comfort when it comes to discussing death, but from my personal experience I feel reassured after my discussions with my grandparents. While the thought of losing them breaks my heart, it is also mended by the fact that I know that they are not scared of what death may bring. I am becoming more and more curious as to why these conversations on death cannot be public discussions, as well as private ones.

Older couple hugging

Hug by Namor Trebat

 

Death in the Spotlight

A look at what happens when the rich and famous die.

Many of us are familiar with death whether it is someone close to us or a friend of a friend. The deceased is often remembered and mourned for in a relatively private way. However, all the rules seem to be thrown out of the door when the deceased is not the elderly man next door, but a celebrity.

An interest in the lifestyles of the rich and famous is something that seems universal across the globe. Their every move is documented, publicized, and largely criticized. Pictures are taken and articles published for tasks as insignificant as grocery shopping or jogging. Celebrities, for some, have reached a god-like status. Their fans are dedicated, passionate, and quick to combat the haters. The life of a celebrity is seemingly not their own. It belongs to the fan, the critic, and the consumer. The same goes for their deaths. The death of a celebrity often prompts more fanfare and acknowledgment than the deaths of millions at the hands of disease and hunger. A celebrity death tends to prompt news specials, award show tributes, and sometimes public displays of distress by people who were merely fans of the individual. The public mourns the celebrity’s  ability to inspire, encourage, and provide an escape. The fan is mourning the loss of a connection, a figure that to them was maybe more than a person.

An LA Times article referenced the phenomenon saying, “We don’t cry because we knew them, we cry because they helped us know ourselves.” The way we ritualize death often seeks to serve the needs of the living over the needs of the dead. We view death from how it affects us. The death of an ordinary person is made more about those left behind then celebrating the person who is no longer here. The celebrity experiences this to a greater extent. For most it was not the loss of Prince the person that caused tears to roll down their face, but the loss of hundreds of unrecorded songs and the persona of a man who dared to defy the status quo. The connection between the fan and the artist is one that is cherished by many.

Some celebrities are defined by their deaths as much as their life especially when their death is a “bad” one such as suicide, a drug overdose, or murder. Their legacy, more so than the average person’s, is shaped by this death. Whitney Houston, Michael Jackson, and Prince will always be remembered for their indelible contribution to music. In the same breath their overdose related deaths will forever be tied to their name in the public sphere. It is through the death of a celebrity that we get a glimpse of life in the spotlight. Despite what we learn we cannot help but place their death back under the same spotlight. It seems as if their celebrity demands consumption by the public, even when they are no longer alive.

Whitney Houston on stage

Whitney Houston Welcomes Heroes by PH2 Mark Kettenhofen licensed under Wikimedia Commons

K-pop star Jonghyun

Jonghyun at 2016 Korean Pop Culture an Art Awards by Im’ Sorry licensed under Wikimedia Commons

 

 

 

 

 

 

 

 

 

 

 

Sources:

http://www.latimes.com/opinion/op-ed/la-oe-0427-friedman-public-grieving-prince-20160427-story.html

 

 

 

 

 

Funeral Traditions in Tana Toraja

Death is something that is unavoidable. Whether you have experienced the death of a close one or have yet to do so, it is a universal experience. However, it is not experienced in the same way all over the world. In Tana Toraja, located in the Sulewesi highlands of Eastern Indonesia, cultural anthropologist, Kelly Swazey, explores how death is not a singular event in her TedTalk, “Life that doesn’t end with death.” The physical cessation of life is not considered the same thing as death. Instead, the deceased are referred to as “to Makala” (a sick person) or “to mama” (a person who is asleep). These people continue to live with and be members of the household, where they are “symbolically fed and cared for.” It is during this time, that families will begin a series of ritual orders that informs the community that a member of their family is transitioning into the Puya (the afterlife). The deceased member is considered truly dead only when the extended family reaches an agreement and when the family has enough resources to hold a funeral ceremony that is deemed appropriate for the status of the deceased.

These funeral ceremonies are lively affairs that can last from a few days to weeks. They are considered the most important social moment in someone’s life, outweighing births and weddings. Through these ceremonies, a reciprocal debt society exists within the community that depends on the number of animals, such as water buffalo, pigs, and chickens, that are given and sacrificed in honor of the deceased. In a way, the sacrifice of the water buffalo and the ritual display of wealth is a way for the family to exhibit the status of the deceased member and by default, the family. These funeral ceremonies are required to take place in front of the entire community and involves everyone’s participation. Once a person is deemed physically dead, their body is placed in a special room in the tongkonan (a traditional residence). The tongkonan represents both the family’s identity and the life cycle. The shape of the tongkonan that you are born into is the same structure that brings you to your ancestral resting place.

A Torajan family with a deceased relative shown in Kelly Swazey's TedTalk

A Torajan family with a deceased relative shown in Kelly Swazey’s TedTalk

While the Torajans practice ways to live long, healthy lives, they do not put as much effort in prolonging life if they have reached an old age or have a terminal illness. They believe that everyone has a predetermined amount of time to live that is like a thread, and that it should be “allowed to unspool to its natural end” without artificial interruptions. While this funeral practice may be something that is foreign to us, it is familiar in that it is a way for people to come to terms with the death of a loved one. The Torajans recognize that their relationships with other people do not end with the physical death of someone close. They are able to extend their relationship with the deceased by transitioning from a relationship to a living person to a relationship with the deceased as an ancestor.

Death – The Great (In)Equalizer

A traditional Western European plague doctor; they were hired en masse during the “Black Death” epidemic. Retrieved from http://www.themiddleages.net/plague.html

Death is an omnipotent force, inescapable and looming. For this reason, it has been quite often referred to as the “Great Equalizer.” This designation masks the inequality of death as a culturally constructed process affected by social power dynamics. A quintessential case in the regard is the relationship between African-Americans in the United States and death.

The social oppression of individuals of African descent in the United States has been subject to scrutiny since the inception of American slavery, a “peculiar institution,” according to Frederick Douglass via his published autobiography (1845). Hence, we know that there is no facet of African-American culture that remains unaffected by the history of racism and prejudice in the United States. The experience of death is no different.

For African-Americans (and perhaps other marginalized groups) death remains a queer dyad, consisting of the social death in addition to the physical death. The concept of social death was originally described by Orlando Patterson in Slavery and Social Death: A Comparative Study (1982) where he argued that the dehumanization of enslaved Africans related to the enforced erasure of their culture and deprivation of what are now more widely considered universal human rights constructed a slave as a “socially dead person.” He writes: “Alienated from all “rights” or claims of birth, he [the slave] ceased to belong in his own right to any legitimate social order.” In other words, an individual who does not possess capacities that are conventionally seen as common to all living humans cannot be rightfully considered to be alive in the typical sense. This state of existence can, and should, be applied contemporarily to African-Americans who still do not have equitable access to fundamental resources such as housing, education, healthcare, and education. It should also be noted that physical death rates between Blacks and whites in the United States are also still unequal (Payne & Freeman, 2006). The realization of the tension African-Americans may feel between the social death and physical death can be seen in literature. August Wilson’s 1983 play Fences (and its 2016 film adaptation), an enduring gem of playwriting on African-American experiences, provides a stellar example of this.

Viola Davis and Denzel Washington in their roles as Rose Maxson and Troy Maxson, respectively, in the 2016 film Fences

Viola Davis and Denzel Washington in their roles as Rose Maxson and Troy Maxson, respectively, in the 2016 film Fences. Retrieved fromhttp://www.npr.org/templates/story/story.php?storyId=126195963. Taken by Joan Marcus

(**Spoiler Alert**) Though the protagonist of Fences, Troy Maxson, dies physically at the age of 62, the story told by the play is very much concerned with the social death. Frequent references to death and dying throughout the play avail readers of the characters’ relationship with the end of life. Gabriel, Troy’s younger brother, who was wounded in World War 1 causing him to have a mental disability, says of St. Peter, the Christian apostle: “[He] Ain’t got my name in the book. Don’t have to have my name. I done died and went to heaven. He got your name though. One morning St. Peter was looking at his book, marking it up for the judgment, and he let me see your name.” This is a representation of the social death Gabriel underwent, as his disability caused him to become a ward of the state, unable to make decisions for himself.

Troy, a sanitation worker, expresses his dissatisfaction with his own life several times throughout the play, illuminating his awareness of his social death. He says: “Woman . . . I do the best I can do. I come in here every Friday. I carry a sack of potatoes and a bucket of lard. You all line up at the door with your hands out. I give you the lint from my pockets. I give you my sweat and my blood. I ain’t got no tears. I done spent them[…] I go out. Make my way. Find my strength to carry me through to the next Friday. (Pause.) That’s all I got, Rose. That’s all I got to give. I can’t give nothing else.”

By characterizing tears and strength as objects external to himself, Troy positions himself here without basic characteristics of humans. This aligns with Patterson’s above definition of socially dead.

Finally, the following impassioned dialogue occurs between Troy and Rose, who are married:

“Troy: Rose, you’re not listening to me. I’m trying the best I can to explain it to you. It’s not easy for me to admit that I been standing in the same place for eighteen years.

Rose: I been standing with you! I been right here with you, Troy. I got a life too. I gave eighteen years of my life to stand in the same spot with you. Don’t you think I ever wanted other things? Don’t you think I had dreams and hopes? What about my life? What about me?”

During the exchange, which occurs following Troy’s reveal that he has impregnated another woman, both Troy and Rose lament their long unfulfilled, i.e. dead, hopes and dreams, cuing us in to the social death they have experienced as a poor African-American couple circa 1960.

Nina Simone once said, “An artist’s duty, as far as I’m concerned, is to reflect the times.” August Wilson beautifully reflected the aberrant relationship between African-Americans and death by telling the story of the two deaths, which serve as a testament to the inequality of death.

 Works Cited

DOUGLASS, F., & GARRISON, W. L. (1845). Narrative of the life of Frederick Douglass, an American slave. Boston: Anti-slavery Office.

PATTERSON, O. (1982). Slavery and Social Death: A Comparative Study. Cambridge, MA: Harvard University Press.

PAYNE, R., & FREEMAN, H. (2006). Racial Attitudes and Health Care Disparities in African American Communities: Historical Perspectives and Implications for End-of-Life Decision- Making” in Key Topics on End-of-Life Care for African Americans. North Carolina: Duke University

WILSON, A. (1983). Fences. New York: Plume.