It was October 2019, just before everything, and my now-husband and I were celebrating our engagement at a fine dining establishment; a quiet, grown-up, sophisticated little spot. They served escargot and triple-filtered water.

The owner of said restaurant brought us complimentary glasses of champagne, and I said to my husband, “Instead of toasting ‘to our engagement,’ let’s each say something we love about the other person.” My husband agreed, raised his champagne flute, stared into my eyes, and said:

“Squirrels are excellent climbers.”

I chuckled, a bit confused, and clarified, “‘I’m sorry, did you just say, ‘Squirrels are excellent climbers?’”

“Yes.” He said, not missing a beat.

I start laughing now. This is when he gets defensive.

“They are!” My fiancé asserts.

I laugh harder.

“They can climb backwards, they can climb upside down, they can climb sideways!!!”

The more he defends the squirrels, the harder I laugh. He tells me people are staring. Did I mentioned we were seated in the dead center of this little gem? We were. So yes, I’m now bent over the side of my chair, tears streaming down my face, laughing, and people are staring. I finally manage to compose myself and choke out, “I said we should toast to something we love about the other person,” and he said, “I thought you said we should each state a fact.”

Seven years later, simply recalling this memory gets me laughing, and makes me feel euphoric. Why is that?

Let’s first define humor and laughter. According to Britannica, humor is communication in which the stimulus produces amusement.1 By that definition, humor is unique to the individual. I find the character Eslbeth, namesake of the CBS series, highly amusing, while my husband is too confounded by the number of tote bags she carries to appreciate her endearing wit. So humor is what we each find amusing; that which produces laughter.

And laughter is?

Laughter is a physiological response, characterized by metronomic contractions of the facial and respiratory muscles (the sound of laughter), elevating heart and respiratory rates, and sometimes triggering tears.

Laughter also sets off a frenzy of brain activity, calling in seven different brain regions2 and releasing four neurochemicals:

Endorphins

Serotonin

Dopamine

&

Endogenous opioids

What do these neurochemicals do for us, you ask?

Endorphins are our bodies’ natural painkiller, and increase our pain tolerance.

Serotonin provides a sense of calm, balances your mood and is a key player in emotional regulation.

Dopamine gives us feelings of pleasure, as when we eat a good meal, reward, such as when we score a point in a game, and motivation, to keep us going.

Endogenous opioids are our body’s very own morphine-like chemical, giving a sense of profound calm and raising our pain threshold. When we experience shared laughter, our limbic systems are in sync with the other person’s, and mirrored opioid release occurs, enhancing the pain-alleviating effects of laughter.

As these neurochemicals ramp up, cortisol and epinephrine are reduced, dampening the stress response, thereby protecting the immune system. Meanwhile, immunoglobin A increases, as do the presence of antibodies in our blood, boosting mucosal immune defense.3

One minute of laughter bolsters the immune system for an entire day. Isn’t that beautiful?

When facing a life-threatening illness, humor can be a useful coping mechanism to bring levity to a serious situation, find connection with your medical team and personal support system, and provide a healthy distraction from a difficult reality. In addition to mental reprieve, turning to humor in times of serious illness can strengthen your immune system, manage pain, and fuel the attack against cancer. Watching a one-hour segment of humorous material, such as Tig Notaro’s Netflix special, “Happy to Be Here,” multiples our army of T cells, a natural born killer of malignant cells.

The prescription of laughter can be a potent one. In a study of 35 patients at a rehabilitation hospital, 74% agreed laughter can be as effective as a pain pill. And in a study of 26 cancer patients, the majority of participants reported a significant reduction in pain after receiving laughter therapy, in which they practiced laughing exercises for ~25 minutes a day, five days a week.4

Gallows humor; humor that targets tragic situations, is a useful tool when confronted with one’s own mortality.5 The term originates from the humor used by prisoners on their way to the gallows. Literally walking towards their own death, they coped with laughter. Whereas dark comedy is theoretical, gallows humor is about the immediacy of the situation; poking fun at the darkness right in front of you.

My father, one of the funniest people you’ll ever meet, had a serious surgery many years ago, for a serious illness. While being briefed for his MRI and learning he couldn’t wear any metal in the machine, he asked the tech with a straight face, “But what about my abs of steel?”

The day of the surgery, he followed his nurse into his hospital room, and there was no hospital bed.

“This is how bad my health insurance is,” he quipped, “they won’t even pay for a bed.”

Many say gallows humor is an unhealthy defense mechanism that denies the problem at hand, but the myriad benefits of laughter apply equally to dark material as it does to light. Very different material, very different context, but the physiological response is identical. We’re still helping ourselves with humor, as long as we’re using it as a way to deal, not deny.

Gallows humor disarms the threat at hand, making it no less real, but allowing us to perceive the harsh reality as less threatening because of the mechanisms of laughter. Humor grants us the ability to engage with situations that we otherwise might feel the need to compartmentalize or avoid. In this way we can process our grief, our fear, our trauma, without feeling heavy and overwhelmed.

My childhood friend is now a resident of Colombia, and he experienced the deadly earthquake that struck the Chocó region two weeks ago. Hundreds were killed and thousands more injured.6 He was kind enough to let me share his admittedly hilarious account of this devastating event:

I was getting dressed when the quake hit and I was terrified our apartment was going to collapse, so I hobbled down the stairs, naked, and was fully prepared to run out into the street in my birthday suit and flip flops. Fear of violent death hits different.

This story is a prime example of the human ability to find humor in an otherwise dark situation. And for my friend, his ability to recall the earthquake and find a humorous anecdote helps him to process this traumatic event.

As humans, we are designed to handle earthquakes, cancer, divorce, and yes, we are designed to handle death. Our very makeup tells us, “Hey, you don’t need to escape this, you can go through it.” And our body is working for us. It gives us laughter, and provides relief.

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Patient A has been diagnosed with an aggressive terminal illness and has five months left to live. A decides they want to end their life on their own terms instead of waiting for nature to take its’ course, avoiding a painful and tortured passing.

Patient B is in need of a new heart, and will soon die if they don’t receive one.

Patient A chooses the new Death by Organ Donation option, donating their heart to Patient B, saving B’s life, and in the process, ending their own.1

That’s the idea, but first, I’d like to clear up some basic terminology.

The paper in question, and much surrounding commentary, uses the term euthanasia to describe what Patient A is asking for. Euthanasia comes from the Greek eu, meaning “good,” and thanatos, meaning “death.” A good death. Historically, a good death refers to a peaceful passing, surrounded by loved ones, free from angst and suffering, after a long, rich life.

However, it’s been a while since the collective conscious thought of euthanasia in this way…

Euthanasia is also thought of in reference to:

1) Something we do for our pets to relieve their suffering.

2) Ending another person’s life for their own good, with or without their consent.

Because the term euthanasia can conjure images of putting down a beloved pet or a family member surreptitiously disconnecting life support, I prefer to discuss what the authors of this paper are referring to as medical aid-in-dying.

The majority of Americans are in support of or feel no moral opposition to the practice of medical aid-in-dying, according to a 2025 Pew Research study.2 The American Psychological Association takes a neutral stance, and the Association of Suicidology recognizes medial aid in dying as separate from suicide.3 Yet, this topic is still hotly debated and remains illegal in 36 states.4

A form of medical aid-in-dying that has been legalized in some states is called Death with Dignity, after the organization by the same name.

Death with Dignity is a practice in which a terminally ill person, with less than six months to live, obtains a medication from their doctor, which they administer themselves. The medication quickly and painlessly ends their life.

To qualify for Death with Dignity, the patient must meet the basic criteria:5

• An adult living in a state with a Death with Dignity statute;

• Mentally capable of making and communicating healthcare decisions;

• Diagnosed by two healthcare providers with a terminal illness that is expected to lead to death within six months; and

• Able to self-administer the prescribed medication without assistance.

A concern I’ve heard in response to this criteria is this: What if a person qualifies and ends their life, when they could have lived years longer, the doctors just got the prognosis wrong? Valid question, and here is what the research shows in response:

The majority of doctors overestimate life expectancy 60% of the time, up to five times.67 To put that in perspective, it’s not rare for a doctor to tell their patient they have 2 years left to live, when in fact they have five months. The chance of two doctors underestimating a patient’s prognosis are much lower than the chances that they overestimate, which would likely disqualify a patient from eligibility for Death with Dignity.

There is also the argument that medical-aid-in-dying is suicide. In both instances a person is ending their own life, but the circumstances, motivation, and process of the two are drastically different. Kenneth Norton, a Licensed Independent Clinical Social Worker who has spent more than 40 years working in suicide prevention, helps us to understand the difference:8

People who die by suicide, for whatever reason, no longer wish to live and feel that they have no other option than death. The person who chooses medical aid in dying wants to live yet has been diagnosed with a terminal illness that will end their life, and may cause intense suffering before they die. They are fully informed of other options including palliative care, hospice, and comfort measures. This is not a decision they are allowed to take lightly or at the spur of the moment. It requires thoughtful controls and two medical opinions in support of specific terminal illness.

A high correlation exists between suicide and mental illness. The person who dies by suicide may or may not be rational, or even competent in that moment. Research shows that many suicide deaths are impulsive. Although the person may have contemplated suicide for some time, it may only be a matter of minutes between making the decision to die and then taking their life. By contrast, in medical aid in dying, people go through a formal process with two medical professionals that includes: an assessment of their mental capability, a determination about their terminal illness, an informed consent process including a review of available options, and a mandatory waiting period.

As a person who has been bereaved by suicide, and has conversed with hundreds of patients and their families exploring medical aid-in-dying, I can say this: At the core, a person wishes to alleviate suffering, sometimes believing this will also lift a burden from their loved ones. But when you step back and take in the bigger picture, that’s where the similarities end.

Now that we’ve cleared up some basic terms (no doubt raising more questions), back to the thought experiment presented by the bioethicists at Harvard…

The notion of Death by Organ Donation takes someone who is already facing the end of their life, and uses the very act of their death to extend the life of another.

Dr. Carter Winberg, a critical care physician pursing a master’s degree in bioethics at Harvard who co-authored the paper on Death by Organ Donation, sees the act this way:

“If there are people who want to donate organs, this would be the way to maximize their wishes and their altruistic goal to help others…These are people who are already consenting to voluntary euthanasia and already consent to organ donation.”9

What interests me here is the term altruistic goal. Patient A’s primary motivation is to end their own suffering and/or avoid a terrible death, and they’ve found a way to save a life in the process. How altruistic is an act if it is also self-serving, given that altruism is defined as a selfless act? I posed this question to Dr. , of the Substack, The Sociology of…Everything, and here is what she had to say:

I don’t believe there is any pure altruism. Whether we’re conscious of it or not, we experience a psychological boost whenever we do something kind or generous. I talked about this a lot while I was serving in the Peace Corps, always reminding my fellow volunteers that we were getting as much or more as we were giving. I think anyone who’s ever “sacrificed” something would attest to that. So I don’t see the measure of altruism to be whether it’s one-sided enough because that’s an impossibility. It therefore makes sense to acknowledge the potential gains of both parties when considering an altruistic act.

The “psychological boost” Anna refers to is the release of dopamine and endorphins, meaning that giving is on the same neural network in our brains as eating, socializing, and exercising. The “runner’s high” and the “volunteer’s high” are the same when viewed from a neurological standpoint.

I experienced this giving reward system myself, just this morning.

I was in a down and irritated mood after a poor night’s sleep, facing the stress of day-long, cross-country travel. Despite the need to hit the road, I chose to honor my commitment as a hospice volunteer, and took an hour out of my morning to visit my patient. While I admit my heart was not in it on the drive, as soon as I walked in the door and saw their expectant face, I felt lighter, happier. At the end of my visit, the patient expressed her sincere gratitude, and I noted a significant mood boost; my upcoming travel didn’t feel so stressful.

But how can Patient A experience the rewards of achieving their “altruistic goal” if they are anesthetized at the time they’re performing the act of giving an organ? A study by the University of Zurich showed that simply thinking about giving activates these neural networks and positive results.10 Additionally, in the book, The Molecule of More,11 we learn that dopamine is a chemical of expectation. Dopamine is released when we anticipate something is going to happen. Thus, Patient A can experience the pleasures of giving during the planning process of Death by Organ Donation, they need not be cognizant at the event.

What also interests me about this altruistic way to die, is that it is not, by definition, sacrificial or martyrdom. Patient A is not dying because they value Patient B’s life above their own, and they are not dying for the sake of a cause or person greater than themselves. In my interactions with people curious about medical aid in dying, they are exploring the option because of the value they place on themselves, and especially the lives they have lived. The same can be said for their family members. They want Patient A’s life to, above all, be honored and treated as sacred, through their death.

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If you would like to learn more about the history of medical aid in dying in the United States, I recommend the film “You Don’t Know Jack” and the book Between the Dying and the Dead.

This informative piece of information flooded me with relief. It was over 100 degrees with close to 100% humidity, I was mortified to be meeting a new group of people with my hair looking like a Brillo Pad. Madison’s notice of my discomfort and readiness to put me at ease made her an instant friend.

Madison has been diagnosed with a rare, progressive autoimmune liver disease called Primary Sclerosing Cholangitis (PSC). I’ve just learned that she is in urgent need of a liver transplant in order to save her life.

I have no presence on any social media platforms, I only have Substack. If I could repost this a hundred times on a hundred platforms, I would. So please forgive this breach in propriety as I do what I can to help my friend.

Madison’s husband, Louis, has created a GoFundMe to support their family through this journey. Please visit the link and read about my friend. Thoughts, prayers, and dollars are all equally appreciated by their family. Thank you.

Madison's Liver Transplant Journey

Great news for them, but what does this mean, phenotypically speaking?

A phenotype is a set of observable traits resulting from how your genes respond to your environment: I have fair skin, it will burn under prolonged sun exposure.

The phenotypic blood test measures changes in nine observable traits in the body that are strong indicators for morbidity and mortality:

Liver and kidney function

Metabolic health

Inflammation

Immune aging

Red blood cell quality

Oxidative stress

Liver and bone enzymes/proteins

Immune activation

These results are calculated by your chronological age to get your PhenoAge. When examining the modifications in Khloe’s DNA, her rate of aging was .72, meaning for every year she ages chronologically, her body ages .72 years. Thus, at 40-years-old, she was biologically 28.

Aging causes most non-communicable diseases such as cancer, heart disease, and diabetes. PhenoAge is a better predictor of risk of disease and of all-cause mortality (the number of people who die from any cause in a specific demographic, over a given period of time) than chronological age because it’s looking at how rapidly your genes are changing in reaction to your environment, as opposed to how long you’ve been around.2

The good news is that we have influence over our rate of aging, and therefore, our PhenoAge. You can be 20 again! How we choose to engage with our environment can have a profound effect on our body’s pace of aging.

Eating healthy may reduce and reverse artery blockage, exercise can help manage or prevent diabetes, and, most recently, engaging in the arts has been found to slow biological aging.3

It turns out how we spend our leisure time, this UK study finds, can have an impact on our pace of aging, especially for those 40 and over. From visiting an art museum to playing the cello or simply listening to Yo-Yo Ma, arts activities proved to be as beneficial to your health as going for a run.

Why would this be?

The arts are rich and complex; combining mental challenge with social interaction, multi-sensory features, physical involvement, and so much more. We can participate in the arts with our whole selves, bodies and minds, and it gives us back, life.

Engaging in the arts once per week was found to decrease PhenoAge by one year.4 The arts range from dancing, singing and painting, to visiting libraries, museums, historical sites, and simply listening to music or watching a play. Enjoying these activities make us younger as we enjoy them.

Slowing aging can’t guarantee a longer lifespan, but it does make for a longer healthspan; the number of years we live in good health.

The reverse is also true for taking control of our pace of aging: We can make ourselves older.5 While we may guess the usual suspects for rapid aging; smoking, binge drinking, obesity, sedentarism, an enlightening overview from Harvard Medical School exposes surprising ways in which we speed up our pace of aging (see the article to find out why):

Shift work

Social isolation

Loneliness

Bright lights

Loud music

Gut health imbalance

In the United States, we are living sicker, longer lives, experiencing disease such as breast and colon cancer at much younger ages than before. This results in managing chronic disease for a far greater percentage of our lives than we did when life expectancy was shorter. We’ve managed to increase our number of years while decreasing our quality of life.6

Sedentary lifestyles and ultra-processed diets are largely to blame in a society set up for convenience and consumption. It’s become so easy to make ourselves sick. But living long, healthy lives is as much in our heads as in our minds and hearts. The aforementioned Harvard overview listed these less salient, but proven, ways to make 40 the new 20 (or 28, in Khloe’s case):

Positivity

Good friends

Sense of purpose

May you experience all of this and more. Studies show, that might be enough.

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One of the nuances of organ donation, such as heart, lung, and liver transplants, that make it possible, is that brain death does not equal cardiac death. And recent studies have found that cardiac death, does not immediately equal brain death.

Our brain cells continue to function for a minute or two after cardiac death, when blood supply to the brain is cut off.

Once blood supply ends, the brain enters hypoxia and stops receiving oxygen. During hypoxia, brain cells begin to die and nerve cells lose their electrical charge. This is known as depolarization. This process triggers the brain to dump neurotransmitter chemicals, sodium, potassium, calcium, and more.

During said “brain dump,” there is a burst of neurological activity consisting of gamma waves, the highest frequency brain waves produced, and a marker of sophisticated consciousness processing.1

A note on consciousness:

After cardiac death, a person is overtly unconscious: Their eyes are closed, they don’t talk, or respond to external stimuli. The same can be said for someone who is deeply asleep. But the deeply asleep person, we know to be conscious. They may even report having felt you trying to shake them awake, or shout their name. They were conscious of your efforts to wake them from a deep slumber. Similarly, studies have found that when a person becomes overtly unconscious upon cardiac death, they remain, for a brief time, covertly conscious.2

As a hospice volunteer, the staff reiterated the importance of treating our overtly unconscious, dying patients, as conscious beings. In their final days, patients with whom I sat vigil were usually unresponsive, and looked to be asleep. Regardless, I would introduce myself when I walked in the room, and give them my full presence just as though they were visibly responding to my every word.

The high-level conscious processing happening in the moments following cardiac death largely occur in the area of the brain associated with memory. This may explain why people who have had Near Death Experiences (NDE) report seeing past loved ones, or seeing their entire lives flash before their eyes.3

After the explosion of high frequency brain waves come low frequency brain waves, then an EEG flat line, signaling brain death.

A question that remains here is why? Why do our brains flood us with memories in our last seconds of life? Some say the frenzy of brain activity is a last ditch effort to survive, and if that is true, are the memories motivation to live? Being reminded of our precious life experiences and loved ones, is our conscious self telling us that this is where our meaning and purpose lies?

Or are these memories a good-bye from our last bit of conscious selves, a final farewell from our brain? A private eulogy of sorts.

I was asked a few day ago if I’m able to do this work because I’m “desensitized” to death. I told them no, quite the opposite, I am able to do this work because I accept death as a part of life. As soon as our heart takes its’ last beat and brain death begins, that very process of death is supercharged with life.

So what exactly is a sneeze?

Sneezing is a protective reflex. A burst of air originating in your lungs and exiting through your nose and mouth at over 100 mph, clearing its’ path of irritants like dirt, dust and pollen from your nose or throat. A sneeze involves coordination between the nose, brain, and respiratory muscles. This is your body’s prophylactic way of fighting off potential threats,1 not just physically, but emotionally as well.

There are four types of sneezes:

Irritative: Caused by irritation of the nasal lining by physical or chemical irritants.

Allergic: An immune response triggered by allergens.

Epileptic: Connected to abnormal electrical activity in the brain.

Emotional: Resulting from the shrinking and swelling of the nasal membranes in response to emotion.2

Emotional sneezing, also known as psychogenic sneezing, takes place as part of our body’s stress response. Chemicals such as adrenaline, cortisol and histamine are released into our system when we encounter a stressful situation or overwhelming emotion, producing cold-like symptoms.

Sneezing can become habitual while remaining involuntary, a defense mechanism to put a situation, conversation, or feeling on hold.3 This explains why someone may have a sneezing fit when they walk into their therapist’s office, anticipating confronting difficult topics and buried emotions. Another may have a sneezing fit when an argument starts with their spouse, or when they visit a childhood home filled with less-than-rosy memories. Sneezing is your body’s way of saying, “Let’s not go here; physically, mentally, or emotionally.” Because when you’re in the midst of a sneezing fit, what else can you do? Nothing.

Sneezing is a Red Flag, by of the Substack Wise and Unruly, aptly explains how sneezing can be a form of emotional dysregulation in people who have experienced trauma:

Dysregulation is when your body responds in a way that is not appropriate for the situation. Maybe you feel antsy during a normal work meeting, or you constantly check your phone to see if he texted (stuck in sympathetic “go” mode). Or you are expressionless when your partner tearfully shares some news, or you can’t speak when your mother criticizes you (stuck in parasympathetic “shut-down” mode).

Dysregulation, and the subsequent psychogenic behaviors, are common in folks who have experienced trauma, have complex PTSD, are dealing with chronic stress, or regularly suppress their emotions. Our bodies “convert” this internal, emotional stress into outward, physical responses when they’re overwhelmed. Think of how your dog shakes their entire body after getting scared. We’re both trying to discharge the stress from our bodies through mechanical means.4

Discharging stress is good, uncontrollable sneezing fits? Bad. Let’s consider what is happening when your grief or trauma is manifesting itself in such an inconvenient way.

What is the sneeze really saying?

Did you just walk past a restaurant you frequented with your late loved one? Or did you catch the scent of their perfume on another person? Maybe your GPS took a shortcut, that led you down the street they lived on. Whether it be sneezing, sweating, or tremors, try to connect the context with what your body is doing and recognize it as a reaction. Not an allergic reaction, an emotional reaction. Sit with that emotion for a few deep breaths, and see what changes.

Thoughts and feelings may feel threatening, and certainly the painful thoughts and feelings associated with grief. Our body goes into survival mode when what we need isn’t to survive our physical surroundings, but to survive a passing memory or stab of longing for the person you love. This is where a bit of mindfulness comes into play. Acknowledge the triggering thought and accompanying feeling, and let it pass. This is much more effective than letting your body try to sneeze it out. And maybe next time, it won’t try.

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A Holiday PSA

This time of year is full of triggers. Taking in a shimmering Christmas tree can feel like a gut punch, as the brilliant gifts you didn’t buy for the person who isn’t there, are not sitting wrapped under that festive tree. This time of abundance5 is filthy with lack when you’re mourning someone who died. All you can see is what isn’t there; the place setting missing at the Christmas dinner table, the stocking not hung. The toasts not shared.

But I’m here to tell you, we can do both. Appreciate the spirit of the season while feeling your spirit is crushed. We can celebrate the holidays and mourn those we’ve lost. Sing the Christmas carols and shed those tears halfway through the chorus. And maybe reframe those triggers as a reminder of the enduring connection that remains with the one you have lost.

Today I address terms often used interchangeably in the funeral realm, that in reality carry their own distinct definitions.

Coffin v. Casket1

A casket is a square shaped box made of wood, lined with plush fabric. There are metal handles on the sides for carrying, and the lid swings open at the mid and bottom points, for full or partial viewing of the body.

A coffin is a six-sided wooden box, tapered at the head and feet, with a wide girth at shoulder height. The interior is lined with fabric, and the lid must be lifted up and off.

Both coffins and caskets are used for viewing and burial today, however, caskets are more commonly used and manufactured.

Interment v. Internment

One letter makes a big difference.

Interment refers to the burial of a body, and/or the burial process.

Internment is the detainment of a person, such as in wartime.

A body is interred, a person is interned.

Cemetery v. Graveyard

A cemetery is a large public space designed expressly for burying bodies. All are welcome.

A graveyard is a plot of land on church property, set aside for the purpose of burying members of that church, or in some cases, of their religion.

Headstone v. Tombstone v. Gravestone

A headstone, also called a tombstone, is a stone that stands upright at the top of a grave, marking the burial plot. Personal details about the deceased, such as name and dates of birth and death, are etched into the stone.

A gravestone is a large stone slab that covers the burial plot, engraved with information about the deceased.

Visitation v. Viewing

A visitation is an opportunity for friends and family to greet the family of the deceased and express their condolences. The body may or may not be present at the visitation, as the focus on is on supporting the family.

A viewing is an opportunity for friends and family to view the body of their loved one, which has typically been embalmed and dressed by the funeral home, and placed in a casket. This is a quiet time of contemplation used to pay respect to the person who has passed. It often takes place just before the funeral service, but is sometimes held as a separate event.

What about a Wake?

A wake is a social gathering where the body is often present for viewing. It is usually held a few days before the funeral and is a time for mourners to gather with food and music, supporting one another as they pay their respects and remember their loved one.

Funeral v. Memorial

A funeral is a formal ceremony, often religious in nature, that takes place shortly after a death. The body is typically present in a closed or partially open casket and is buried at the burial service immediately following. Alternatively, the urn is present if cremation was chosen, and is interred or otherwise homed after the funeral.

A memorial is a service remembering and honoring the person who died. The body is not present, and it can take place at any time following the death. A memorial service can be casual or formal, and allows for a less structured service where more people can speak and share memories.

If there are more funeral terms you’d like clarifying on, please let me know in the comments!

Here I’ll make connections between our earliest death experiences, our relationship with mortality, and how we grieve. If you would like to be interviewed for My First Encounters with Death, please message me.

In part one of this series, I told the story of my grandmother’s death, and how my four-year-old self internalized the way in which I was included in this event, normalizing the emotion, language, and facts of death.

Part II recalled the sudden passing of my uncle, and how by the age of 10, I had learned from society to link tears, grief, and shame.

Part III revisited a day in my early teens, supporting my best friend at her father’s deathbed.

Today, I close my portion of this series with the sudden death of my neighbor, a mother of three in her forties.

I was halfway through my senior year of high school, and had just turned 18. I was at home, in the kitchen with my parents, when the phone rang. My mother answered it, and after a brief and nondescript conversation, hung up the phone and announced, “Theresa Post died!”

Theresa lived two blocks down the street, and during the decade between ages 8 and 18, I spent nearly as much time in her house and I did my own. I babysat her children, organized her cabinets, cleaned her house, really, any odd job you can give an industrious girl who longs for the entire Juniper Breeze line from Bath and Body Works. I was Theresa’s de facto household employee, playmate to her children, and occasional confidant.

The last thing Theresa said to me was, “Look how skinny I am! I’m dating again!” We had run into each other at Farm Crest Milk Store, filling up our gas tanks. She was vibrant and excited about life.

To go from a peak interaction to hearing she was dead, was a shock.

I let my mother’s proclamation sink in for approximately ten seconds, then burst into tears. Being a teen ashamed of grief and tears, I crawled up the stairs to my bedroom and hid under the covers.

The source of my despair stemmed not from sadness, but horror. How could a healthy, middle-aged woman who loved her life just die?1 It felt wrong and unfair.

A few days later, my mom and I went to Theresa’s viewing. The room across the hall held the viewing for my classmate. It was eerie, being sandwiched by the caskets of two people I knew.

We walked down the long aisle to the front of the chapel, where her body lain. I looked at Theresa and thought, “She would never wear that lipstick.” I also didn’t think she would have liked her outfit very much. But it must have been picked from her closet, right? I was 18, I didn’t know how these things worked.

Aside from the fashion blunders, I felt better. Seeing Theresa’s body comforted me. She wasn’t out in some great unknown being tortured by death, she was tucked safe in her casket. She was dead, but she was okay.

Death is, and certainly was in my formative years, unpredictable and uncontrollable. But there’s autonomy in being able to view a loved one’s body. What I needed was to see Theresa, to not have my last cognitive encounter with her be that of shock and horror at the news of her sudden passing. Instead, we got to have a private moment, in a calm, peaceful environment.

A nice, tidy viewing is a privilege. It’s a privilege of timing, circumstance, and resources. Some people don’t receive this privilege either because the body did not survive death in tact, they couldn’t make it in time, or because a body was never recovered.

Not everyone needs to view their loved one’s body, nor wants to. We all have unique cognitive and emotional needs for processing loss. Many prefer to remember their loved one as the last time they saw them, healthy and happy.

I prefer to look death in the face. I need to see and know that person is gone, employing my brain’s natural way of rewiring in order to incorporate the presence of death in my life. This eases the transition of the person from someone in my physical world, to a person I relate to through memory, ritual, and new experiences.

Looking death in the face is far less scary when it’s the face of someone you love. Sad, yes, painful, certainly, sometimes even traumatizing. But death is not the boogeyman or the grim reaper, death is human.

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Here I’ll make connections between our earliest death experiences, our relationship with mortality, and how we grieve. If you would like to be interviewed for My First Encounters with Death, please message me.

In part one of this series, I told the story of my grandmother’s death, and how my four-year-old self internalized the way in which I was included in this event, normalizing the emotion, language, and facts of death.

Part II recalled the sudden passing of my young uncle, and how by the age of 10, I had already learned from society to link tears, grief, and shame.

Today, we move forward four years to my 14-year-old self.

My best friend’s dad had cancer, and it was very much not a big deal. Mr. Baker now wore a baseball cap more often than before, but he was still his active, lively self. Then one day it was a big deal. And the day after that, Mr. Baker was dead.

I had known Mr. Baker since I was six-years-old. I spent a lot of time with his family, and in his home. But this encounter with death was less about grieving a person I loved and more of a, “drinking from a fire hose” lesson in supporting a friend in grief.

It was a warm Friday afternoon in April, and I had just arrived home from school. The phone rang in the kitchen. It was my best friend, Christina. She calmly told me her dad’s cancer was back with a vengeance, and he had been given 24 hours to live.

She asked if her mom could pick me up on their way to the hospital, conveniently located a few blocks from my house. I hung up the phone and announced, “That was Christina, her dad’s going to die tomorrow,” as though we had just scheduled a sleepover for the following day. It wasn’t that I was callous towards Mr. Baker’s impending passing, it was that I knew my role, and my role was to be there for my friend in her time of grief.

This was a very tall order for a girl who had just recently memorized all the state capitols and was still 2 years away from her drivers license, and nothing quite prepared me for it.

While I had already attended several funerals by the time I entered high school, was familiar with viewings and graveside services, this was not that. It was my first experience waiting for someone to die, my first time watching someone as they died, and the first time I was called upon to provide support to someone in crisis.

A few minutes later, Christina’s mom’s beige Chevy Tahoe pulled up in our driveway. My mom said, “I’m going out there and JoAnn’s going to tell me it’s not true!” So we walked out to the car, my mom looked JoAnn in the eyes, and said, “Tell me it’s not true.” JoAnn rested her head on the steering wheel, and began to weep.

My mom’s response wasn’t denial, it was logic. Logically, a middle-aged man in relatively good health (you know, besides the cancer), should not be on his way to remission one week, and on the cusp of death the next. We had run into JoAnn and Christina at Foot Locker in the mall the week before, and nobody was planning a funeral. Far from it. My preposterous statement after hanging up the phone ten minutes earlier warranted disbelief. My mind, however, wasn’t analyzing facts, it was solely focused on my friend, and I was going to rise to the occasion. I climbed into their SUV, and we drove down the street to the hospital.

I hold so many sharp, distinct memories from the 24 hours that followed, it’s hard to believe they all occurred in the course of a single day and night. The tension of knowing there were hours left for Mr. Baker, but not knowing exactly how many, stretched out time and made everything we did seem at once poignant and trivial.

We sat in the hospital cafeteria eating snacks from the vending machine, the setting sun cascading through the skylights.

We laid on our backs on the sidewalk at the hospital entrance, staring at the night sky.

We stood beside Mr. Baker’s bed, and I watched Christina press a cool washcloth against her dad’s hot forehead. He didn’t look like Mr. Baker anymore.

And finally, late at night the following day, we sat on the floor outside his hospital room door. Christina on one side, I on the other. Mr. and Mrs. Baker inside.

Mrs. Baker emerged from the room, and said, “He’s gone.”

We; Christina, myself, and myriad family members, rushed into the room. We packed ourselves in, surrounding Mr. Baker’s body.

I felt so strange, staring at a dead body. It wasn’t at all like a funeral. He looked alien to me; bald and sweaty and wrecked by sickness. But also, why did we all rush the room to stare at his dead body? I was at a loss as to what to do. Mrs. Baker didn’t love this either, and screamed at everyone to get out.

It’s so hard to know what to do in times of death, and what not to do. Being yelled at to leave my station by Christina’s side, it seemed I was doing right and wrong simultaneously. As I exited the hospital room, I stepped out of my role of strong best friend, and became a child again. That’s when the strain, the shock, and the trauma of the weekend hit me.

I called my house on the hospital phone for a ride home, but was unable to speak, tears choking my words. “Laura?” my mom intuited, “I’m coming.”

I went to church the next morning. My parents didn’t make me, but that’s what we did on Sunday mornings, and I didn’t think this Sunday should be any different. It was also an opportunity to pull myself out of the previous days, and know that I was okay.

She was in the room when he died, my youngest sister wrote on a church bulletin, passing the note to her friend.

We all used to be in the room when a person died. Before we moved death into hospitals, we died in our homes and welcomed the community in for our passing, children included.1 But in 2001, the presence of a child at a man’s deathbed was disturbing.

The distance we now place between humans and death relocated my experience from the category of the everyday, to that of trauma. I know parents today who would never have let their child get into that Tahoe that afternoon. But the more distance we place between humans and death, the more we distance ourselves from the experience of being human. I’m grateful my parents had the confidence in me as a human, to support my friend in death. They knew what the current literature overwhelming shows: people are resilient.

Christina is getting married next summer and I’m her maid of honor. 25 years later, she still tells me often how much my presence meant to her the night her dad died. I was years away from having multiple degrees and a string of letters after my name, but what I did have at 14 and still have now, is a willingness to be present with others in their grief, and the courage to feel all the pain, the sadness, and the inevitable end of this mortal life.

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Day one

I entered the room of the 90-year-old woman I was assigned to at the in-patient hospice center, and sat at her bedside. She turned towards me, looking very alert, and I introduced myself. She was my very first patient as a hospice volunteer, fresh out of training. I understood I was to sit and chat. So I did. I talked, she listened. Or so I thought. Some time later, a nurse walked in and said, “Oh no.” She gently pulled me up and wordlessly explained that the woman I had been talking to had passed. You think it would be easy to tell if someone were dead, but I assure you, she looked very alive. You would have kept talking, too.

Many subsequent days

The next several patients I was assigned also died during our visit. In case you’re wondering, no, that’s not normal. The average length of a patient’s stay in hospice is around three months, meaning people live in hospice care for several weeks after admission before they die. Therefore, the odds of my patient dying upon our first meeting, again and again, were slim.

The Hospice Cat

The charge nurse at the hospice started referring to me as their hospice cat, in homage to the famous feline, Oscar.

Oscar the therapy cat worked at Steere House Nursing and Rehabilitation Center in Providence, Rhode Island. Oscar resided in the advanced care dementia unit, and seemingly at random would emerge out of hiding, jump on a resident’s bed, and curl up next to them for hours. Then that person would die.

Steere House estimates this happened over 100 times in Oscar’s first ten years of service. The pattern was so reliable that a protocol was enacted; if Oscar curled up next to a patient, the family would be called and told to come in and say their final good-byes.1

The phenomena was studied closely by the medical community, making a splash in the New England Journal of Medicine, but a unifying conclusion as to how Oscar was predicting these deaths was never found. Some thought it was animal instinct, others an olfactory hypersensitivity to biological breakdown, and the skeptics believed the nursing home staff simply wasn’t paying attention to Oscar’s inauspicious visits.

Was Oscar an angel of death? A harbinger of death? Or was Oscar a comforter?

In addition to being deemed the (other) hospice cat, another role emerged. When I arrived at the in-patient hospice center, I would go to the charge nurse and ask where I was needed. She would identify which patient was most anxious, and tell me to sit with them. I became the anti-anxiety prescription for patients. I didn’t have Oscar’s record, they didn’t all die, but I believe there’s a correlation there, between Oscar and me, the quelling of anxiety, and the deaths; we both had a calming presence.

Elements of a calming presence

There’s nothing mysterious or illusive about being a “calming presence.” Think of it as social mindfulness. You’re being present, aware, and focused with the intention of supporting the person you’re with. This is part of what mental health practitioners call therapeutic presence. But in order to help others achieve a state of calm, you have to work on maintaining your own calm. This fact is rooted in the principles of self-regulation and co-regulation.2

Self-regulation is the practice of being aware of what triggers intense emotion for you, stepping back at the onset of arousal, and intervening with a technique that will level your stress hormones so you physically, and mentally, feel more relaxed.

Co-regulation takes place when our ability to calm ourselves has the ability to calm the person we are interacting with, on a behavioral and biological level.3 This means if my cortisol levels go down, my heart rate lowers, and my breathing become rhythmic, the biology of the person I am attending to will mirror this state.

So why do I think the comfort Oscar and I provided welcomed death? Facing one’s imminent death can be terribly distressing, not only for the obvious, that you’re encountering death head-on, but because there are many things you still want to do, or people you want to forgive, or thank, or continue loving.

In hospice, I’ve seen people’s emotional and psychic distress keep them alive, and suffering, for weeks after evaluations showed they were in their last hours. But if the calming presence of another can intervene on their behalf, co-regulating their bodies and quieting their minds, they can experience a peaceful passing.

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~Irvin Yalom

The idea exists that we die twice.2 The first death being the physical death of our body, when our heart stops beating, and the second being the last time someone says our name. Irvin Yalom takes this thought experiment one step further, positing that our final death is the last time a person thinks of us.

Part of humans’ difficulty in dealing with the death of another, whether it be someone close to us or a tragedy we hear about in the news, is that the death of others reminds us of our own inevitable death. Any type of death is a confrontation with our own mortality, even if just for a split second, before our brain refocuses our attention on less threatening matters.

Consciously and subconsciously, we seek to extend our lives past the point of physical death by striving for symbolic immortality. Simply put, we want to be remembered when we’re gone. As Yalom posits, we’re not truly dead if we’re alive in someone’s memory. In this case, we can think of a multitude of people who have died, and are very much alive in this world:

Aristotle celebrated his 2,409th birthday this year.

Shanidar Z turned 75,000-years-old in 2025.

Elvis turned 90 this year.

We strive to be remembered by achieving fame, Instagram or otherwise, accomplishing great things that will have a lasting impact on humanity, creating art that will outlive our presence on earth, and by raising progeny who will carry on our names, DNA, traditions, and passions.

There is so much we do during our lives intended to overcome our mortal nature, endeavors that will keep our names on people’s lips and in people’s minds far into a future where we cannot go. Just as we strive for a sense of permanency in our ephemeral lives, cultivating meaning and purpose in what we do, we want the same for those we love, especially after they’re gone.

Mini refresher course: Grief is a reaction to a loss, mourning is the outward expression of grief.

We can’t always choose our reaction to a loss. shared the story of a man becoming violently ill upon receiving news of a friend dying. This illustrates the uncontrollable, reactive nature of grief. But mourning, that we can choose with a great amount of autonomy.

Part of the way we mourn is by remembering. In how we remember, we’re strengthening our connection with the person who died, establishing their memory as a new type of presence in our lives, and in the world.

This leads us to establish foundations, non-profits, and scholarships to further the work or hobbies a loved one was passionate about. We commission memorials as simple as a grave marker and as grand as the Taj Mahal, or even devote our entire lives to a cause, such as becoming a cancer researcher if your loved one died of leukemia.

In the 2010 film “The Way,” a young man sets out to walk the El camino de Santiago, a historic pilgrimage through France, Portugal, and Spain. The man dies early on in his journey, and his estranged father is summoned to collect his body. In an act of mourning and remembrance, the father decides to have his son cremated and finishes the pilgrimage, scattering his son’s ashes along the way. The camino claimed his first death, but it couldn’t take his second.

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We all have someone we feel our lives would be easier without. This is not to say we wish them dead, mind you, this is to recognize there is something trying, difficult, maybe abusive or toxic about our relationship with them, and we wish it weren’t so.

We can feel unsafe with someone and love them.

We can be deeply irritated by a person and adore them.

We can be infuriated by their actions yet admire them.

Human relationships are a complex and contradictory universe. Yet, we crave social connection because it’s part of what keeps us alive; food, water, air, others. And the more entrenched we are in each other’s lives, the more nuanced our relationships.

From this vantage point, it make sense when emotions arise following a death that we don’t normally associate with grief. Emotions such as relief, happiness, and freedom. And that’s okay. Grief is a reaction to a loss, and these reactions are valid, too.

It’s okay to feel relieved that the cycle of confrontation and conflict has come to a halt.

It’s okay to feel happy that your mental and emotional world is a bit lighter.

It’s okay to feel the exhilarating freedom of autonomy and choice.

A main tenet of grief theory is that the death of a loved one can shatter your assumptive world; the world you once knew, the one that made sense to you and gave you order, purpose, and meaning. So let’s consider this; a death can also do the opposite. It can restore order, instill purpose, and invoke meaning.

When working with a woman whom had recently left an abusive relationship, she shared a glimpse into how this may work:

I now wake up each morning, and I’m free! I get out of bed, open the windows, and drink my coffee. He doesn’t restrain me so I can’t get out of bed, or ream me for opening the windows, or make me feel so bad that I can’t enjoy my coffee. I can start my day without fear of his judgement and consequences.

Her ex had shattered her world, and the death of their relationship restored it.

Feelings of relief and lightness may come even after the death of someone with whom you had a healthy relationship. If you had the arduous job of being their caregiver over the course of a long illness, and/or if they were suffering so greatly that a great weight has been lifted for you both. These dynamics may also result in “positive” feelings, not traditionally associated with bereavement.

As noted in a PWT exchange, feelings of grief can take one by surprise. Sometimes the deceased was absent from your life at the time of their death, but played a significant role in your life years prior. You may not be prepared for the onslaught of grief over someone you divorced twenty years ago. Perhaps you mourned the relationship, but now it’s time to mourn the person.

Similarly, being raised by an abusive parent, extricating yourself from that relationship, and years later learning of their death, can leave you in a fresh wave of grief: You’ve now lost your parent twice.

With all the relief, happiness, and freedom, we were speaking of, what is there to be sad about?

Losing the opportunity to improve the relationship or reconcile.

Letting go of the person you hoped they would be.

Knowing you’ll never hear or be able to say, “I’m sorry.”

Being left without closure.

Feeling things will never be fair or just.

Sitting with the pain and hurt of the relationship even though the person is gone.

That’s a hard spot to be left in. So I’m here to say, give yourself permission to speak ill of the dead. Yes! While they may be dead, you’re still here, grappling with the aftermath of your relationship. It is okay, in appropriate, trusted company, to continue to work through the pain of your relationship without them.

Be happy, be relieved, and be real.

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It can be mentally, physically, existentially overwhelming, and you need the pain to stop. At least for a moment. Or a TV episode. Or six.

When that moment came for me, I turned to Paris Hilton.

It was a dark day. Cloudy outside, but also, the darkest day of my life. On this day, I woke up in a different world than I had the day prior. In this world, someone I had never lived without was gone. During this shift, I fell into a dark hole, and was desperately struggling to climb back to the light. I had my husband get me my favorite breakfast sandwich and my favorite locally-roasted coffee. It didn’t seem to help. Coffee and croissants are no match for death. With the whole day ahead of me, knowing not what to do besides sit on the couch and stare at the wall, I turned on the TV.

There shined Paris Hilton, sparkling in pink and diamonds, riding a unicorn. It looked like the most ridiculous TV series I had been advertised in a long time. And it was exactly the light I was grasping for.

I sat and watched “Paris in Love” on Peacock for the next seven hours. I distinctly recall at some point startling myself with a laugh. In this new world, I was still someone who could laugh! At one scene, I nearly smiled. The absurdity, extravagance, and utter quirkiness of Paris Hilton was my respite. My lifeline. I drank my coffee, ate my breakfast sandwich, and by the end of the binge-watching session, I was even able to get off the couch and wash my hair.1

The next month was HARD. That month exists outside of time in my memory. Thank goodness, there was a season two waiting for me on Peacock. When I needed a little help getting from Point A to Point B, Paris was my rest stop in between.

While it’s important to allow yourself to feel the pain of your grief, entering the reality of your loss, there’s no need to force yourself to focus on your grief at all times. It may be tempting, as feelings of guilt can arise if you find yourself laughing, smiling, or otherwise enjoying life while the one you love has died. But just as we orient ourselves to focus on that loss, mourning and reflecting on what is no more, we can turn ourselves towards our new life as well. Or maybe just direct our attention away from our grief momentarily. It’s okay to allow yourself a distraction.

My distraction, was Paris. Yours may be learning a new skill, reading a book series, or training for a marathon. We can create for ourselves soft places to land after we’ve spent time doing the work of grief. Like a steam shower after a grueling workout (my gym isn’t that fancy, but I’ve seen it on TV).

Training your focus away from your grief can also help you complete tasks related to the loss, such as funeral planning, notifying friends, family, and employers of the death, and interacting with hospitals or the authorities. Unfair as it is, you also have to carry on with daily tasks in your own life, such as preparing meals for your children, paying your bills, and getting the car repaired. You can do these things, and return to your loss. Moving forward in life will not set you back in your grief process.

Psychologists Margaret Stroebe and Henk Schut observed this pattern of turning towards and away from loss in daily life, coining it the dual-process model of coping with bereavement.

The dual-process model highlights how both orientations are natural and necessary in working through our grief. You can have a season of stillness, during which you sit with what you have lost, and a season of taking on necessary changes. The balance is between acknowledging and accepting what you have lost, and investing in the new aspects of your life that this loss has introduced.

When the pain of grief becomes unsustainable, it is in our nature to seek stability. You’re moving forward when it hurts, and you’re moving forward when you’re allowing yourself a day of levity.

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After a few exchanges with Substack AI, I thought I had done just that. But alas, I had not. My apologies.

All posts in my publication are now free to read, so please pop by and see what catches your eye. Here are my most popular, previously paywalled, posts to date:

1. To Be a Happy Person, One Must Contemplate Death Five Times Daily

2. Flameless Cremation

3. Diseases, Cities, and Cemeteries

4. Day of the Dead

5. Herbs, Embalming, & Grief

I hope this provides interesting reading for your weekend!

In books, movies, TV series, nature, social gatherings. Not because it’s what I choose to surround myself with, but because I am attuned to the presence of death in life.

While the human brain naturally diverts our attention when reminded of mortality, I refocus mine. For the past twenty years, I’ve approached death in a variety of contexts, and found I didn’t die. It turns out we can’t catch death like we can catch a cold. I’ve chatted with terminally ill people, young and old, watched countless documentaries and films about death, sat with many in their grief, and come out feeling more alive, humbled by death’s gravitas.

A few gems to focus your attention on death:

“How to support someone who is grieving: five research-backed strategies”

This advice is practical, well-informed, and actionable. It glows with the wisdom of grief theory. My friend, a nurse who has walked with families through all types of loss, sent me this article, and I love it.

“Let’s Talk About Death”

The New York Times has launched an absolute treasure trove of information on all things death, “from end-of-life care to burials and beyond.” They list all the questions we have and will have about death, and provide knowledgeable answers. Thanks to my publisher/yoga instructor (don’t you just love that combo?) for bringing this to my attention. Please note: This NYT article may be paywalled for some, but I wanted to share the opportunity to read it.

“The Room Next Door”

Speaking of attention, the terminally ill heroine of this artistic film, based on the book What Are You Going Through, feels her life is no longer worth living when she has lost her ability to pay attention. The film centers around the concept of the right-to-die and questions throughout what keeps us here, and if we would ever feel it’s time to go.

And to share something from my summer hiatus purely meant to bring a burst of laughter to your day, a quote from my two-year-old niece:

“When I’m a grownup I can be married. And chew gum.”

Rest is the conversation between what we love to do and how we love to be.

~ David Whyte

This excerpt from ’s essay1 on rest is where I’ve been this past week; reserving times of rest, in order to more fully inhabit what I love to do. That love being researching, reflecting on, and reading about death.

What can I say? I’m a girl who knows how to have fun.

While I continue my summer hiatus from weekly posts, I’ll pass along gems I’ve unearthed while soaking in the thanatological springs. Here are a few recommendations for your times of summer rest, of which I wish you many:

I See You’ve Called in Dead by John Kenney

A superb recommendation by . To quote my father, “I See You’ve Called in Dead only would have been better if I could have found a copy with the whole book highlighted, and I could un-highlight the very few lines unworthy.” If you want a novel that will make you laugh and cry at the nature of existence, this one’s for you.

“OBIT”

An engrossing 2017 documentary following the day-to-day world of New York Times’ obituary writers. Get into the weeds of the stress, the depth, and the humanity of summing up a life in 500 words. A perfect companion to I See You’ve Called in Dead.

“A Real Pain”

After their grandmother dies, two cousins reconnect on a group tour of Poland as they journey to her childhood home. This film is a close examination of familial love, connection, and the very real pain of humanity and of being human.

In the meantime, I’ve removed the paywall from my archives, so please explore the fun and curious world of thanatology at no cost. All posts in my Grief Guidance section will always be free to read.

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His prospective adopter likes the cat, but under these circumstances, she will not be taking Billie with her. Instead she tells him,

The immediate concern of Lisa Jewell’s widower in her novel, The Third Wife,1 is one of rewiring the brain. When we develop a relationship with someone, neural pathways form in our brain made up of object cells that are a physical representation of that person.

The widower has object cells representing his wife, and his wife’s cat.

Place cells tell us where that person is physically located, and along with object cells, give us a mental map of where that person exists in our physical environment.

The cat is in the widower’s house, his late wife is nearby the cat when home.

When someone dies, the object cells formed by our relationship with that person stop firing, but the person continues to exist for some time in our brain matter through object trace cells. These cells fire when we expect to see the person who has died.

This is why though the widower knew his wife was not going to walk into the room after her cat, he still expected her entry. The cat’s presence triggered the neural pathways representing his wife to fire, making him feel as though she were still alive.

As time goes on and the cat walks into the room a hundred times without his wife trailing behind, the neural pathways in his brain will organically start to fade along with the expectation.2 The map in his brain will be a different map, one that keeps the old objects and places them in a new physical reality.

But this man wants to move on now, and thinks removing the cat, aka the expectation trigger, will proactively quiet those neural pathways. And quell the consequent crash of pain as he realizes he’s not going to see her walk into the room.

When we say we need to move on, are we really saying we don’t want to feel this way anymore?

While there are certainly healthy ways to be proactive about grieving, grieving does not equate moving on, and moving on does not mean you’re no longer grieving, nor does it mean you’re leaving that person behind. Such are the nuances of grief. If you have a strong desire to move on, or are beating yourself about needing to, “move on already!” ask yourself some “whys?”

Are you keeping your loved one’s belongings exactly as they were the day they died to preserve a sense that they never left, or because you need to ask a friend to help you with the task of going through their things and reallocating them?

Are you leaving that sticky note up on the fridge because you’re tortured by the thought that they will never leave you another, or because seeing their handwriting and care brings you a sense of warmth and comfort?

Are you continuing to pay their subscription to BritBox because you love “Downton Abbey,” or because you’re afraid of a losing that point of connection when you turn on the TV?

Examining why we’re trying to move on, or not, provides information on where we are in our grief. It does not assign a grade to our grieving.

An aside: Sometimes people do become stuck in their grief; losing a sense of self, completely absorbed by their loss, and unable to reengage in life long after their loved one has died. This is known as complicated grief, uncommon, but notable. If our widower suffered from complicated grief, he may rehome the cat in order to avoid reminders of his wife, but not as a means to move on.

At the end of Jewell’s vignette, the widower decides to keep the cat, recognizing they need each other. His perception of the cat evolves from a source of pain to a source of comfort, seeing that they both lost the same person whom they loved. His form of organically moving on involved developing a new relationship, and in this moving on, he’s bringing a part of his wife with him. Her cat is now his cat.

He took his prospective adopter’s advice, and was kind to himself.

The Academy of Nutrition and Dietetics surveyed 35,000 participants, aged 20 and older, over the course of five years. They were questioned on their habits surrounding eating meals prepared outside of the home; takeout, delivery, carryout, food trucks, restaurants, and the like. The academy followed the subjects for eight or more years after the surveys ended, and any deaths and causes of death were recorded.

The results found those who ordered out twice a day had a 50% increase in risk for all-cause mortality when compared to those who had takeout less than once a week. These frequent fliers were 18% more likely to die of a cardiovascular event, and 67% more likely to die of cancer.

Takeout twice a day? That seems like a lot.

Let’s say you’re an individual who still works in a good old fashioned office. Hearing on the news that traffic is a bear, you skip breakfast and your daily brew, popping into your local cafe for a coffee, throwing in a bagel sandwich. That’s one.

Lunchtime rolls around, and you didn’t have time to pack a lunch after your morning workout, so you run over to the market and grab a sandwich from their deli. That’s two.

After work, you swing by the store for a few sundries, eating up the time you had to cook dinner before heading to a live sports event. But that’s okay, what’s a baseball game without a hot dog anyhow? That’s three.

Notice how all three examples had nothing to do with laziness, and everything to do with the fast-paced, overworked, and overcommitted ways of modern-day life? When we prioritize our productivity over our health, it’s easy to imagine how something could go amiss two out of three meals a day. Many of us envision a bounty of fresh greens and filleted salmon on our dinner tables, but often default to a box of Singapore Mei Fun on the couch.

75% of restaurant orders are now takeout, according to a 2025 survey by the National Restaurant Association. Why? It’s fast and convenient. Cooking takes time, and many no longer want to invest their time in a homecooked meal, they want to invest it in watching Netflix while eating takeout. In US. Foods’ 2024 annual study, respondents cited wanting to watch TV while they ate, and not wanting to have to get dressed, as reasons they frequently ordered takeout.

The paradox is, after our fast-paced, overfilled days, with the demands of your professional and personal to-do lists maxing out your nervous system, you retreat to a disconnected existence, eating takeout alone and watching TV. While the findings that we prefer to have our food delivered in favor of pajamas and streaming reeks of sloth, maybe we’re simply making do.

There are obvious reasons why eating takeout twice a day would increase your chances of dying. Takeout food is higher in sodium, saturated fat, sugar and calories than homecooked meals, and typically lack vital nutrients, simultaneously depriving your body of what it needs while overloading it with what it doesn’t. Such fare contributes to health risks like heart disease, stroke, obesity, and diabetes. And as far as food source goes …I once ordered Chinese takeout that would have taken a forensic team to determine the origin of the “chicken” and “vegetables” in the fried rice.

As for the less obvious reasons why takeout could take you out?

Isolation: You’re less likely to cook when cooking for one, it doesn’t seem worth the effort or the mess.

Sedentary lifestyle: Cooking is a physical activity, and if you’ve been sitting all day with no more than bathroom breaks, busting out the pots and pans and chopping up some veggies feels like effort.

Stress: With one too many things to do and people to please, ordering takeout seems like a good way to take something off your plate (ironically).

Depression: Taking care of yourself is seldom a priority if you’re one of millions suffering from depression. All the negatives of takeout food feel meaningless while the break it gives you provides a worthy reprieve.

These factors which all feed into each other are linked to an increased risk for all-cause mortality and cause-specific mortality, such as heart disease, and would sway a person to routinely choose the path of least resistance when it comes to dinner.

Takeout as a noun is indisputably detrimental to our health. Takeout as a verb is a nuanced choice we make, an action when take, in regards to our very lives.

In 2022, the National Restaurant Association published a study finding 54% of adults say purchasing takeout or delivery is essential to the way they live.2

Other things essential to a human life?

Engaging with community. Caring for others. Physical activity. New experiences. Human connection. Vitamins and minerals. Challenge. Friction. Participating in society. Nourishing rest.

Take back takeout

Make takeout an intentional choice, a fun Friday night, a new cuisine shared amongst friends. Use it to enhance points of connection and try new things. And if takeout is a vital part of your existence, take a closer look at why. You may be able to choose a more life-enhancing alternative, but if takeout is currently your lifeline to sanity, take a cue from , author of the Substack The Reset, and infuse a sense of slowness into your outsourced meals. Turn off the screens, play relaxing music, invite over a friend to enjoy takeout together.

Overconsumption of takeout has real consequences that can decrease our lifespan and our healthspan. So before opening that app, ask yourself, is takeout your problem, or your solution?3

If you’re interested in a deeper existential dive on our need for convenience, I suggest Poetic Outlaws’ essay, The Comfortable Life is Killing You.

Here I’ll make connections between our earliest death experiences, our relationship with mortality, and how we grieve. If you would like to be interviewed for My First Encounters with Death, please message me.

In part one of this series, I told the story of my grandmother’s death, and how my four-year-old self internalized the way in which I was included in this event, normalizing the emotion, language, and facts of death.

In today’s story, things get complicated. As things do with tweens.

I was ten-years-old, it was early Saturday morning. Dark and cloudy. Walking to the bathroom to take a shower, I saw my brother’s bedroom door open, and my parents inside. This was odd. Eric was not one to wake up early on a Saturday (or any day). I walked into his room and my mom promptly said, “Uncle Bryan died.” Eric, age 12, reflexively rolled over and pulled the comforter over his head to muffle his tears. “I know, I’ve been crying all night,” my mom said.

I stoically turned and continued on with my plans, closing the bathroom door and turning on the shower full blast. I quickly got in and began wailing. For a second. My mom opened the bathroom door and asked, “Are you okay?” Feeling caught in the act, I cut off my tears and replied, “Yes!”

What is happening here???

Why did my brother instinctually cover his face, why did I pretend I wasn’t crying? My mom had just said, “I’ve been crying all night.” If that’s not permission to grieve, I don’t know what is. But still, we both felt we shouldn’t be seen crying.

My uncle, a husband and father of three in his thirties, died suddenly and unexpectedly. At the graveside service, with aunts and uncles and a multitude of cousins present, there was no shortage of tears. And yet, I buried my face against my aunt, not wanting anyone to see me cry. I felt shame. Shame in crying, and shame in grieving. It felt as though I was doing something wrong.

Our culture tells us what to feel ashamed of. Shame is universal, being ashamed of grief is not.

For the Trobriands of New Guinea, grief is a communal activity, highly prescriptive and inclusive. Yet they are taught that eating in front of others is shameful. Etiquette dictates each Trobriand eat in private, and if they must eat in the presence of another, they turn their backs to each other.1 Just as I turned my face away at my uncle’s funeral.

In deathwork,2 a death is categorized as natural, accidental, suicide, or homicide (NASH, for those of you studying for your thanatology certification). It’s perfectly acceptable to sensationalize accidental and homicidal deaths in books, film, and the news. We splash death across the screen while making no indication that there’s a tie to grief.

English sociologist Geoffrey Gorer coined our Western twist on mortality, “The Pornography of Death,” in his 1955 essay by the same name. He writes:

There seem to be a number of parallels between the fantasies which titillate our curiosity about the mystery of sex, and those which titillate our curiosity about the mystery of death. In both types of fantasy, the emotions which are typically concomitant of the acts-love or grief-are paid little or no attention while the sensations are enhanced as much as a customary poverty of language permits.

Gorer goes on to explain that the sanitization of modern society in regards to sickness and death has created such distance between ourselves and our inevitable end, that the less we encountered natural death, the less permission we had to acknowledge its’ existence. Death as entertainment? Sure! Death as part of the life cycle? No.

Since the evolution of death as both a commodity and a failure during the 20th century, death has become private, and grieving is something you do alone. While I was never taught by my parents that grieving was wrong, or reprimanded for crying, I received a message from society that these things were not fit for public. Death, dying, and old age happened behind closed doors, closeting our grief with them.

Simultaneously, death was everywhere.

At the age of 10, I had no misconceptions about the who of death. Death doesn’t happen to other people, to the very old, the very sick, or soldiers at war. My middle-aged grandma died, my young uncle died, my cats died nasty deaths.3 I was starting to get the picture. Death was not a product of circumstance, death was a product of existence.

Into my tween and early teen years, I grew to accept death and the precarity of my lifespan. But I still didn’t quite know what to do about grief. It felt so unnecessary, cumbersome, and at odds with my enthusiastic, perky nature. Death I could take, grief, I decided, I could do without.

More on that in my next installment of My First Encounters with Death.

Share The End-of-Life Educator

During my years of studying death in the basement of Rosenstock Hall at Hood College, I shed many tears. Those tissue ratings of Dr. Martin’s were no joke. We shared heartbreaking stories, watched heartbreaking stories, and examined death, dying, grief and loss from every angle imaginable. Yet somehow, we always walked out the door, back up the stairs and into the sunlight, in one piece.

Our thanatology program was not therapy, this was made clear from day one. We were academics, and it was accepted that we would cry as we learned. In fact, it’s possible that our tears made our learning possible.

Our eyes produce three types of tears, each with a different chemical makeup:

Basal tears: Keep eyes lubricated throughout the day.

Reflex tears: Protect our eyes from irritants, such as smoke.

Emotional tears: Produce in response to sadness, happiness, fear, etc.

Each type of tear has it’s own composition in addition to a unique purpose, which is part of what makes the tear of grief above look different under a microscope than, say, a basal tear released in an arid office space.

Emotional tears contain high levels of stress hormones and other toxins in comparison to basal and reflex tears, meaning that when you have “a good cry,” you’re physically flushing stress out of your body. Additionally, the neurotransmitter leucine enkephalin is released with the flow of emotional tears, acting as a natural painkiller.

Crying activates the parasympathetic nervous system (PSNS), responsible for our “rest and digest” response, in tandem with the sympathetic nervous system’s (SNS) “fight, flight or freeze” response. Thanks to this PSNS activation, our heart rate slows, respirations decrease, blood pressure stabilizes, and we’re gently lowered to a state of calm as we cry it out.

What else does a cathartic crying session do for you? It releases into your system:

Oxytocin: A hormone promoting feelings of bonding and well being.

Endorphins: Which improve mood and reduce pain,

and

Prolactin: A key player in emotional regulation and stress reduction.

While most animals have tear ducts for producing basal and reflex tears - reflex and emotional tears are dispensed from the lacrimal gland, in the upper perimeter of the eye socket - humans are the only animals who produce emotional tears. But why?

The most popular theory is that emotional tears are a social cue; a silent distress call invoking support from the community. Seeing another person cry triggers an empathetic response in others, as we are hard-wired to offer aid at the sight of emotional tears.

Think about when you see a person crying in public: As you spot tears coming down the cheek of a downturned face, your attention is redirected towards them, perhaps you feel a constriction in your chest, thinking this person and possibly yourself are faced with a threat. Your heart rate increases as your sympathetic nervous system kicks in, and as you continue to assess the situation…you realize this person is looking down at their phone, laughing hysterically at a video.

They were crying happy tears, but it still got your attention, and in today’s social climate, we love to be noticed. Maybe they don’t need to be sincerely happy tears or sad tears to get us the likes we crave. , sociologist and author of the Substack, The Sociology of…Everything, gives us these questions to ponder about the performative aspects of tears:

We love to reward actors for their ability to cry on-demand and we celebrate their ability to seemingly access such raw emotion (nevermind that those tears are often assisted by a tear stick - menthol-infused wax that generates tears). Is crying an accomplishment? I don't know. A modern twist on this which fascinates me is the trend of filming yourself while crying and posting it to social media - perhaps to speak out about an issue or show how devastated you are by something. If we break down the mechanics of that, wouldn't the act of taking out our phones and filming ourselves remove us from that genuine state of feeling? It flips us out of our emotional state and into a logical, strategic mode, which usually stops the tears, rather than encouraging them. And what is the purpose of wanting to be witnessed in that state of crying? Are tears meant for private moments spent alone, with those we trust and love? Or have we decided as a society that there is value in broadcasting our tears? What is the social value gained there? Is it a "cry" for empathy? Or a demonstration of an Oscar-winning performance?

As Anna points out, tears are awarded in contexts in which they’re a few degrees removed from genuine emotion. But when they are a genuine emotional reflex, they feel vulnerable. You’re telling someone you’re emotionally distraught, or blissfully happy, as it may be, giving them a glimpse into your inner world. Whether you want to or not. And sometimes you don’t want to.

Not everyone loves a good cry. If you’re trying to suppress an undercurrent of sobs, that doesn’t feel good. If you’re uncomfortable or ashamed to cry in front of others, or even by yourself, that also does not feel good. An individual’s personality, culture, and upbringing play an important role in shaping how they feel about tears, and how tears feel to them.

Many cultures view crying as a sign of weakness; a mental and emotional breakdown when things get too tough. But as we’ve learned, crying is the body’s mechanism for coping with and processing difficult situations and feelings. When you allow yourself to cry, you’re utilizing an evolutionary tool. But if you’re taught from a young age to put on a brave face and persevere, you may not know how to use that tool.

In Japan, Hidefumi Yoshida has devoted his career to teaching his fellow Japanese how to cry. His service is called Rui-Katsu, meaning, to seek tears. Yoshida refers to his job as a tear teacher, and he helps people access their internalized, suppressed emotions so they may experience the mental and physical benefits of emotional tears.

But the work of the tear teacher doesn’t end after class. Over the years he has established crying clubs, where people gather in public to watch emotionally evocative videos, crying tours, and crying cafes. He feels so strongly about the physical and mental benefits of crying, that he’s all but turned it into a public service.

As humans, we’ve taken control of our emotional tears. We have bottled them up, sold them for profit, weaponized them, and ostracized them. But the grief therapist in me is suggesting you give tears a chance. You don’t need to take a course in crying, but the next time you start to well up, whether it be over the death of a dear friend or Sarah McLachlan’s SPCA commercial (it’ll get you!), remember that tears are a service your body is doing for you, relieving stress and supplying comfort.

References

Using crying to cope: Physiological responses to stress following tears of sadness

Crying as a Powerful Stress Reliever: The Surprising Truth

Crying Benefits: How Shedding Tears Can Boost Your Mental Health

Humans Are the Only Animals That Cry — And We Don’t Know Why

The Microscopic Structures of Dried Human Tears

tearsteacher.com