By Eric Goldscheider / Published December 6, 2011

As an anthropologist who in recent years turned his professional gaze on his own culture’s attitudes and practices around death, Professor of Anthropology Donald Joralemon has a message for America: “We need to talk.” He has set up a Web site to kick-start the discussion.

Technology, medicine and a generally higher standard of living have, in the past 60 years, changed a key equation around death, argues Joralemon. We are prolonging the amount of time we are able to spend on the earth and, as a consequence, most of us now expect a more drawn-out exit for our kin and ourselves. A significant number of us will die in a social sense—becoming marginalized and isolated by our impairments and our associations after passages such as retirement—well before we finally expire.

Joralemon believes that to help get past this “cultural free fall,” academicians have a responsibility to promote discussion around dying and death. (As distinct from “death and dying” the wide use of which he sees as a tellingly logical transposition showing that we really think of people as being dead while in fact they are still dying.)

That is why he posted a draft of his upcoming book to the Internet.

Mortal Dilemmas: Why Is It so Hard to Die in America? is a work in progress awaiting your input. Asked what message he wants to send to the readers of Insight, Joralemon says, “an invitation to engage in the conversation...and that I would very much like to have input from as many people as possible to advance my own thinking and to incorporate into the final version of the manuscript.”

The discussion will reflect a raft of what Joralemon calls “cultural trouble spots” about ideas of death and values, which are roiling the nation. Vicious political fights break out regularly over issues of these sorts from how to pay for a health care system mandated to lavish resources on the last weeks and months of life to other hot-button issues, like assisted suicide, the marketing of body parts, prescribing drugs for grief and appropriate uses of life-support for people in a persistent vegetative state.

One indication, from an anthropological perspective, that we would have difficulty digesting these technical feats of modern medicine is what Joralemon calls our culture’s “off the charts” obsession with memorializing our dead. At the other end of the spectrum are peoples like the Wari’ of the Amazon rain forest, who believe the greatest gift for the bereaved is to help them forget the deceased as quickly as possible. As part of that ritual, they used to eat their dead (though the practice is now discouraged). In some cultures your name dies with you—never to be used, or even uttered, again. At the opposite extreme is the obelisk that Americans erected to our founding father at the heart of a city bearing his name. Other cultures take a more middle-of-the-road approach, like some in India; there they may give you a big send-off, secure in the knowledge that it is just a ceremonial passage to the next life.

While memorializing is an entrenched and lucrative industry in the United States, funerals, by contrast, have become almost perfunctory compared to what they once were. This, Joralemon argues, is because the work of grieving has often been completed by the time the body has become a corpse. Before penicillin came into widespread use in the mid 1940s, pneumonia was known as “the old man’s friend” because it tended to end patients’ suffering when they were still closer to the top of their game. The same can be said in the opposing sense of advanced trauma care, organ transplants and treatments that turn acute diseases into chronic conditions. Now people can easily linger a decade or more, which brings us back to the enormous amounts of money spent on end-of-life interventions, usually through private insurance, by those who can afford them.

So far, about a hundred people have registered for the discussion, including a hospice nurse, a palliative care physician at Cooley Dickinson Hospital in Northampton, Massachusetts; a Smith alumna who is an oncologist in Rochester, New York; and academics in a variety of disciplines from as far away as Australia, New Zealand and France. The big idea, he says, is that this forum is taking anthropology to the public. He believes that both the quality and then the dissemination of the thinking will be at a higher level if he can attract greater participation. At some point, he will “pull the plug” (pun possibly intended) on the site and seek to publish the book, including “dialogues” with readers, in a more traditional format.

This enterprise is roughly modeled on a format used by musicians who freely distribute their work on the Web as a way of attracting attention. As a full professor and department head with tenure, Joralemon is not in need of another esoteric publication for the library stacks of learned institutions in order to further his career. “I’m free to try to find the advantages in this electronic world without worrying about whether or not there are consequences for my profession,” he explains. “Since I’m touching on some pretty controversial aspects of our management of the end of life, I thought this would be a way to encourage a conversation in the wider public.”

Smith Professor Donald Joralemon has posted a draft of his upcoming book Mortal Dilemmas: Why Is It so Hard to Die in America? on the Internet. He’s not only asking some engaging questions about death in America but also inviting public input on the topic.

Professor Joralemon’s path to a hard look at how Westerners, especially Americans, treat death started with his earlier research on shamans in northern Peru. “Once I had written as much as I wanted on that subject, I did the classic anthropological thing of coming back to study my own culture,” he says, “and I wanted to study a medicine that was dramatically different from the one I studied before.” He made a name for himself as a medical ethicist on the topic of organ transplants, still being drawn to the liminal period between life and death—in this case, for both recipients and donors.

He remembers as a youth, looking at a photo of Louis Washkansky, the world’s first recipient of a transplanted heart, on the cover of Life magazine in 1967. He wondered at the time, “How could you do that? How could you live knowing that the heart beating in your chest is somebody else’s who had to die?”

His career “went from shamans to surgeons,” says Joralemon, and from there it was a short journey to offering a course to fill what he saw as a gap in Smith’s social science curriculum on the topic of death. “If not now, then when will students have a chance to ask some of these big questions, other than when they don’t really have the time to think about them?” says Joralemon. The first text in the course is the personal account of the father of a Smith woman who died of cancer soon after graduating.

Now that he is taking the ideas that have bubbled up from his teaching to the Internet, Joralemon is using his “emerging text” to challenge all of us to look deeply at this aspect of how our culture is responding to advances in science. “The first thing I would want is for people to take seriously this idea that our current circumstance of prolonged dying and fast death is new. In the history of humankind, it’s new.”