Dying and death touches us all: the rich, poor, famous, unknown, men and women alike. According to proverbs and sayings death is the great equalizer. Death balances and makes recompense for the inequalities that life and human societies have constructed, emphasized and reinforced. This is true, of course, if and when we understand dying as the final point where what once was the life of an individual is extinguished, and if we understand death as the void after this point. In this void there are no differences between people.
From the perspective of individual suffering we can also see some beauty and justice in what can be metaphorically called "the work of death". If there is too much suffering and inequality in life, death's function is to finally repair it.
From the point of view of society, death is often said to disrupt the intersubjective and social structures that have to be repaired. Death calls for acts of reconciliation and restoration and the means with which to bring them about. Here differences and inequalities are often clearly visible. You die, and you are buried and remembered according to your membership in your community. In death your social and human value can also be denied.
Even when making recompense for and correcting inequalities, death also exposes them. In fact, death creates many inequalities. Among them are the considerable differences in responsibilities when it comes to rituals and acts of relating to the dying and the dead. This is one area where the question of gender becomes relevant. Women and men tend to relate to death and dying from different distances and positions.
Last autumn I finished my dissertation in the field of anthropology of religion entitled Women by the Side of the Dying. As part of my studies, I read hundreds of texts written by Finnish carers of the dying. I wanted to see and to listen to what it was that they were doing, sensing and feeling by deathbeds. I read the texts through and through. I tried to understand the essence of the situation from the point of view of the carer, who was attending to the needs, desires, fears and wishes of the person approaching his/her death. As I got more involved with the writings, I realized that the data - apart from comprising descriptions of people's most intimate experiences - had been produced in close cooperation with the hospice institution and its ethos of caritas. This observation motivated me to try to find an additional perspective for my theme by carrying out a short ethnography in a hospice.
During my two month ethnography I participated in the care. This enabled me to observe the elementary structures of the situations from a different perspective: I was involved. I tried somehow to grasp the minute details of this basic intersubjective situation: what was shared between the carer and the dying person, as well as what could not be shared because of the ultimate singularity of each person's own death. The carer is faced with one elementary difference, the difference between life and death, and between the living and the dying. For some reason it is traditionally women who cross this borderline and enter this subliminal situation. The gender-related practice of caring for the dying continues in the sexually equal, more or less secular Finnish culture, where the majority of carers today are still women.
The observation concerning the prevalence of women among those who have particular kinds of contact with death and the dying has been made by various researchers in different fields. Women are usually responsible for the immediate bodily contact in the process of dying and in the corporeal reality of death. Women feed the dying; they try to make the sufferer's situation more comfortable by caring gestures; they care for the intimate hygiene of the dying. It is women who most often hold their hands, close their eyes, and finally wash and dress the dead body.
Why is the practice of caring for the dying so poignantly gender-related? This question has been asked several times, and several answers have been proposed. These answers overlap to a considerable extent, and so the question might best be illuminated by juxtaposing the different views. The question of women and death weaves a net of experiences, images and power. Obviously, the whole question has to be seen in the context of the culture of caring, which is historically and traditionally the domain of women. Caring for the dying is one form of caring, of course. On the other hand, it is also a very special form of caring, since the one cared for will not be cured by the caring hands.
One point of view to the woman-death question is symbolical. It draws attention to how mythical, philosophical, theological and poetic depictions of death are often gender-based, and how the feminized depictions of death differ from the masculinized ones. The bodily, decaying, repressed, and abject aspects are predominantly feminized, whereas the enduring, honourable and sublime aspects of death tend to be masculinized. In our Christian cultural imagery it is Eve who carries death in her body, and some early patriarchs of the church depicted the feminine body as basically nothing but a vessel of death and decay (close to the image of the Greek Pandora with her box). Even birth from the female body could be seen as the beginning of decay that ended in the dying flesh.
Another school of thought suggests power is the explanation. Where death was feared and despised, those who were high in the social hierarchy avoided contact with it. Therefore in many societies the polluting aspects of dying and death would have been given to women to deal with.
Women's affinity to death has also been seen from the angle of the experience of giving birth, which can come close to death. Women have also known - and still know in many parts of the world - death from close experience through having lost children. Here woman is seen as a mother, and it would be more correct to say that it is the mother(ly woman) who is seen and wanted by the deathbed: the mother who provides solace and comforts, and who somehow protects from pain and anxiety, and also from the fear of the unknown.
The French philosopher and psychoanalyst, Julia Kristeva, writes that we overcome the incomprehensibility of death by replacing it with motherly love. This motherly barrier against death can, surely, be seen also in the image of Pietа which depicts the Virgin Mary with her dying and dead son. It also comes close to the ancient and traditional figure of the lamenter. For example in the Karelian culture, she was the woman who, with her very special songs of grief and sorrow, escorted and accompanied the dying to the borders of the other world.
But what would the carers of our own time say? I wanted to see if there was intrinsically something in the practice of caring for the dying which might help us to understand more about the dominance of women and femininity regarding this tradition. I wanted to ask how caring for the dying is experienced and expressed by the carers themselves. The questions with which I approached them were very simple: Who are you? What is it that you are doing? What does it mean to you?
They gave me an answer which was at first frustrating in its simplicity and seemingly self-evident. What they were doing was that they were just there, they were just present. These expressions repeat themselves through my otherwise heterogeneous data: "The important thing is just to be there"; "I'm trying to learn to be present"; "More than anything the dying person needs somebody who is present".
Presence? Just being there? Yes, I understand. But then what? Or do I understand after all?
Presence is the opposite of absence, and besides the carers, other significant others are very often absent from the side of the dying. The doctors, priests, and often the relatives too, find it impossible or difficult to stay as long as they are needed. The message of the hospice movement is that the dying must not be left alone, that to leave the dying alone is a serious form of indifference and even cruelty. The presence of the carer guarantees human dignity during the process of dying and at the moment of death. Being there is a basic ethical act.
All this is agreed upon by the carers I have listened to. But what is the experience of being present like? What does it concretely take and mean to be present?
Both through reading the texts by the carers and through my own participatory observation, it became evident that "just being there", and "just being present" were all but simple experiences and aspirations. The reality of the dying person is a singular one. The idea of terminal care is to give the dying person a status as a dying person. This means, among many other things, that he/she lives in a subliminal world very different from the world of others. He/she is approaching the total limit of life, waiting for his/her own extinction or an unknown other world. The experience of time, for example, has radically changed, the experience of one's own body can be inexpressible. Anxiety can be overwhelming. This is the situation in which the carer should be present. Being there to make a difference to the dying person's experience is to many carers one of the most important experiences and aspects of their life. But it is often also the most difficult one.
One aspect of being by the side of the dying is that you often can't do anything
to change the reality. You have to adopt a peculiar active passivity
towards the dying. You should stay without really acting. Even if this is not
easy for anyone to do (at least not for people in the modern society, who live
through action and deeds), perhaps "just being present" has, however,
been easier for women than for men? How and why this might be, leads to intriguing
and interesting questions concerning gender-based ways of relating to the world
and to others.
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