ATsa forensic pathologist, the dead of all ages, shapes and sizes have been the focus of my career. Numerous times a day, for the past 40 years, I have looked closely and directly at death, knowing that, for many – probably most – of the people I examine, the start of their final day had been completely normal. Death had come swiftly and unexpectedly. So, as I dress each morning, I often wonder where I will be at the end of my day. At home? Or in a mortuary, being slide into a fridge on a shiny tray?
In medical circles, we had been expecting a global pandemic for several decades. The HIV/Aids pandemic of the 80s was a grim milestone, resulting in about 36 million deaths worldwide, but I never anticipated that the first pandemic of the 21st century would develop from a virus in China. I had expected it to come from a lethal reorganization of the DNA of the influenza virus – as happened in 1918, when “Spanish” flu killed at least 50 million people worldwide, and in the subsequent, less lethal, influenza pandemics: 2 million died in the 1957 flu pandemic and 1 million each in 1968 and 1977. The last notable flu pandemic was swine flu, in 2009, which resulted in about 500,000 deaths. A serious influenza pandemic is about 50 years overdue.
I know that I am unusual in having had such a longstanding personal insight into death and the fundamentally precarious nature of our lives. Many of us have never seen a dead body, even of a close relative. In our westernised, urban society, the tradition of paying your respects to the body in an open coffin in the parlor is now rare. This offered the opportunity to recognize the normality of death: to look it in the face; to consider your responses; to remember your own impermanence.
By the start of this century, it seemed to me that death had become a subject generally to be avoided, glossed over, obfuscated and (if at all possible) simply ignored, at least until one was faced with it personally. Now, the lack of this experience often means it feels overwhelming.
Before Covid, I noticed how our language was becoming increasingly euphemistic. The noun is “death”, the verb is “die”, but these words were seldom heard. Dying had become “passing” – and the focus was usually on “easing that passing”, to sanitize and smooth it and manage death in a way that diverted distress. I felt I was seeing a significant disconnect develop between the profound, human process of grieving, with its incumbent pain, stress and sadness, and the emollient aims of the death industry. It was a disconnect that was welcomed by so many.
The pandemic challenged this approach in almost every respect. Suddenly, death and the consequences of death were the focus, day after day, of every news report. The facts were raw and painful, the words stark. The noun was “death”, the verb was “die”. These people had not “passed”. Covid, I hate your harvest, but I thank you for rewilding such endangered language.
As the pandemic continued, interviews with families became the modern equivalent of the wake beside the coffin in the parlour. Where once there was little or no desire to see the body after death, now the denial of contact, at the end of life and afterwards, was traumatising.
I hope one positive to come out of our new reality is a change in society’s approach to death. It is still too early to tell – and perhaps I never will be able to tell, since I am inside the taboo, looking out. But, from my perspective, I would say that a new willingness to engage with death would be a healthy change.
I have been lucky. Few of my close family have contracted Covid; none have died from it or even been hospitalised. However, during the course of the pandemic, three of my friends have died: two from natural disease – one suddenly, one slowly and painfully – and one from an accident. Covid has killed many, but, even in the depths of a pandemic, I was reminded that people continue to die of other causes – and that these causes also kill millions.
Let us face up to the inescapable fact that humans die. Until then, life is for living.
Dr. Richard Shepherd is a pathologist and an author. The Seven Ages of Death is out now (Michael Joseph, £20). To support the Guardian and the Observer, buy your copy at guardianbookshop.com. Delivery charges may apply