This past fall, when we began work on a Nursing Clio series about death, we never imagined the world would look the way it does today. Early reports of illness in China were limited and, as they often are, written in the confident language of exceptionalism: epidemics happen over there, to other people, in other places. Not here, not to us.
But things changed quickly.
As of May 11, 2020, the United States has recorded 79,756 deaths from COVID-19. We’ve spent the spring on lockdown, attempting to slow the spread of the virus by engaging in social distancing and self-isolation. And as the situation became more dire, we began to look at the questions we’d asked months earlier with fresh eyes.
In our call for bloggers, we asked to hear from those who’ve been thinking about the history of death. We wanted to explore what it has meant to die in different times, places, and cultures, and what those differences tell us about the things we value most. We asked for—and so many of you responded with—an exciting range of approaches: new perspectives on the medical history of the corpse, intersectional approaches to death studies, and personal stories about the powerful act of sitting with a loved one through those moments at the end of life.
The questions we began The Deathbed with—about how we perform acts of care for the dying and the dead, how we memorialize those who have died, how rituals and communal practices allow us to shape meaning and order out of pain and chaos—become more difficult and even more urgent in times of mass casualties like we now find ourselves in. The bubonic plague in seventeenth-century England, for example, brought with it new ways of counting the dead. Faced with previously unthinkable population losses, Londoners developed new memorial strategies for keeping track of their changing city. In the West African Ebola outbreak in 2014, traditional burial customs—rituals that included families cleaning and preparing the bodies of their dead—had to be reconciled with new WHO guidelines for limiting the spread of infection.
In the US, epidemic diseases have helped advance the fields of medicine and public health, while also exacerbating inequality and revealing deep fissures in American society. Waves of cholera, yellow fever, smallpox, and polio spurred the rise of (imperfect) public health boards, the growth of epidemiology, and the development of vaccines. At the same time, epidemics have challenged American beliefs in individual liberty and deepened existing racism and classicism. For example, fears about disease amplified anti-Chinese sentiment during San Francisco’s bubonic plague outbreak, leading to an extensive quarantine of Chinatown, further segregating the city’s Chinese population and threatening their economic livelihood. Suddenly, the past and present feel closer than ever.
Like these previous epidemics, COVID-19 is forcing us to confront our attitudes about death head-on. For the first time in many of our lives, we’ve begun to think about and talk about death almost daily. We’ve listened as leaders debate the relative value of different lives: the freedom of the young and healthy against the safety of the aged and vulnerable, the strength of the entire US economy against the projected deaths of thousands. So many early reports assured us that “only” a small percentage will die, but how many deaths are acceptable? Whose deaths count in a crisis like this?
How will we mourn those who die from this disease, and how will we commemorate this global crisis in the future? The rituals and routines of death that we’ve come to expect have changed. Historically, death has been a communal experience; we gather around the dying, wanting to offer love and comfort in the last moments of life. But now, procedures designed to lower infection rates and isolate outbreaks have meant that those dying of COVID-19 are almost all dying alone. Chaplains administer last rites over FaceTime, and rabbis sit shiva with their synagogues on Zoom. This sense of isolation extends into the funeral itself—some have moved online, gathering mourners together in live-streamed services; others have been delayed or foregone all together. Restrictions on these rituals for all who have died–whether from COVID-19 or other causes–have led to new alternatives to traditional gatherings.
Talking about death in times like this is painful. Many of us are mourning loved ones, family members, friends. We are fearful about our own future, about our health and the state of the world when—or if—this ends. But, now maybe more than ever, these conversations are also essential. How we grieve, how we die, how we remember—in the wake of a pandemic, these are also the questions that, ultimately, define how we will live. Many of these ideas are already being addressed by scholars in the field of death studies, such as the members of the Collective for Radical Death Studies, whose work has laid important foundations for understanding the present moment.
And so we at Nursing Clio have decided to continue with publishing The Deathbed this summer. These essays help us understand how people from around the globe and throughout time have wrestled with the universal reality of death. Some stories reveal the very personal ways that individuals have reacted to grief and loss, and confronted their own mortality. Other histories reveal the effects of large structural forces on the experiences of dying and mourning, much as they continue to do during the current pandemic. Our hope is that this series helps us carry on these conversations about life, death, and our shared humanity.