LN: Welcome to The Really Big Questions. I'm NPR's Lynn Neary. Death, the great unknown, the mystery we will all one day experience is simultaneously expected and completely unexpected. What would you do if you knew when your death was coming?

                              Woman: Try to enjoy it. It's short. You've got to enjoy every second of it, right?

                              Man:   Just go and spend more time with my mother.

                              Woman: What wouldn't I do? Make out with random strangers and then pray in the morning for forgiveness. [laughs]

LN: Some scientists believe that death shapes how we live and who we are, even when we have no idea how and when we're going to die.

                              Man: Very religious people, when reminded of death, become more convinced in the existence of God and that prayers will be answered. Very materialistic people become more interested in wanting more money.

LN: How does knowledge of our inevitable death affect the way we live? It's a really big question right after the news.

Act 1

LN: Welcome to The Really Big Questions. I'm NPR's Lynn Neary. In this series, we're exploring some of the great questions faced by humanity over the ages, and the ways that they've inspired artists, philosophers, and scientists. What's the nature of consciousness? How do emotions shape our world view? What's the significance of religious experience? And in this program, how do we face death?

00:00:26.05  As human beings, we share a profound dilemma. We are driven by the will to live, knowing that we face a certain death. In the next hour, we'll explore the profound impact this awareness has on the way we live.  It might seem odd to us now in this age of hospices and bereavement counseling, that at one time not too long ago, no one thought to study death, but in the decades following World War II, scholars began to look at the place of death in our lives. Reporter Nova Safo went to Tempe, Arizona to meet one of the pioneers of death studies.

                         NS:      Hello. Robert Kastenbaum?

                         RK:     It seems to be.

                         NS:      [laughs] Well, hello. Nice to meet you.

                         RK:     Come on in.

                         NS: Robert Kastenbaum looks just like a university professor should—scruffy white beard and bushy mane of unruly grey hair. But Kastenbaum is no ordinary scholar. He's been at the forefront of a major shift in how we deal with death and dying. It started in the 1960s and early '70s, when Kastenbaum and a handful of others entered academia and were dismayed with what they found.

   00:01:31.12 RK: Generation and generation of students in psychology and sociology, in medicine, in ministry, in social work, all these fields, were not given attention to what the whole human life course is, what they were studying and talking about were hypothetical people, people who didn't grow old, didn't die. Aging and death are kind of lumped together as "We're not interested in that."

                         NS: Kastenbaum says he wanted to sew together the human experience from childhood to old age and finally death.

                         RK: If you think of any part of life, you think about how money is made; you think about how people form relationships and so forth. All of these have implications for dying and death.

                         NS: Over the last four decades, Kastenbaum has established death and dying as a serious academic discipline. In 1977, he wrote one of the definitive textbooks on the subject titled Death, Society, and Human Experience. It's now in its tenth edition.  Kastenbaum's writings are filled with connections between science and history, art, music, and literature. His wife, Beatrice, who is a professor of nursing, worked with him on one of his books.

                         BK: When he gets to the point where he's on a topic, he look at it from every possible angle. Out of it comes an organized, simply communicated set of ideas.

                         NS: The Macmillan Encyclopedia of Death and Dying, which Kastenbaum edited, covers everything from suicide and assassinations to terrorism and Waco, to British royalty and rock music.

                         BK: He's a very, very creative, nonlinear kind of thinker.

                         NS: He's also a whimsical thinker. For example, there's the time Kastenbaum had to give yet another speech at an American Psychological Association convention in 1972. Instead he wrote a play about an old man facing death alone with a talking grandfather clock.  Beatrice Kastenbaum had a role in the original production and helped reenact it during our visit.

                         RK: Time, you're too damn fast.

                         BK: Tock, tock.

                         RK: You're tocking my whole life away.

                         BK: Tock, tock.

                         RK: There's so few swings left of the pendulum.

                         BK: Tock, tock, tock, tock.

                         RK: Slow down. Slow down.

                         BK: Tock, tock.

                         RK: Now that's torture, dripping like water.

                         BK: Tock, tock.

                         RK: Dripping like water.

00:03:52.22     NS: Kastenbaum has also tackled the subject of suicide in the form of an opera.

                         Man: [sings] I don't need to go on, going on. What for?

                         NS: This is Closing Time. Robert Kastenbaum wrote the story and lyrics. Kenneth LaFave [?] wrote the music. In the opera, a bartender and the last customer of the night decide to kill themselves. They feel they have nothing to live for. That's when the earth goddess, Erda, appears. Kastenbaum says Erda is an earth goddess with an edge.

                         RK: Mother Earth is there as kind of a slut. But she's very genial [?] [00:04:39.10]—you guys want to be buried deep some place? Here I am. So she makes the sexual offer to them. Sex and death are the same thing. She is so compelling; that kind of brings them to their senses. That's not the kind of death they want. They had to have a better life so they could deserve a better death someday. So they turn down her seduction, and each kind of go on with their life.

                         Man: [sings] Face it, kid, we don't deserve our better death. Look what we did with life.

00:05:07.24 NS: Kastenbaum believes that those who are touched by death are affected by how they live the rest of their lives. He knows this from personal experience. In 1985, his teenage daughter died after a car accident.

                         RK: It intensified my appreciation for life. I think a lot of things I put up with or been a part of seemed empty to me then. I was going to make my life a little more centralized and try to focus upon the things that had more meaning.

                         NS: Kastenbaum's research in essence has been about unmasking all of the different ways in which people grieve and the ways in which people deal with their mortality and the process of dying. Now in his mid-seventies, Robert Kastenbaum is still working on the persistent questions surrounding death. He's writing a new book and interviewing people on how their feelings about life and death mature as they age. Kastenbaum said the interviews are revealing a common theme.

00:05:58.08 RK: They're not terrified by death, but would like to live another day. They come too far just to give up life too easily, and no matter what they've been through and what they've lost, it's still something that they rejoice in and hold on to.

                         NS: For Kastenbaum, rejoice is the operative word. After all of this, he explains the study of how we die is really the study of how we live. I'm Nova Safo.

                         LN: Robert Kastenbaum is going to join us in just a moment, but first we wanted to find out a little more about how Americans today are looking death in the face. So we sent reporter John Kalish out into the streets of New York City.

                         JK: If you knew you were going to die like tomorrow or three weeks from now, what would you do?

                         Man: What can you do? Tell everybody I love them, right? Who wouldn't do that?

                         Man: I'd just go out and spend more time with my mother. I'd probably die in her arms.

                         Woman: I'll go swimming in Egypt in the River Nile.

    00:06:55.23 Man: I would take any time off for anything, and I would live fearlessly.

                         LN: Joining us now is Robert Kastenbaum, the man who developed the first death education course in the United States and has written extensively about our feelings and attitudes towards death. Good to have you with us, Professor Kastenbaum.

                         RK: Good morning.

                         LN: Professor, what was your reaction to those interviews that we just heard?

00:07:17.28 RK: One of the things obvious is that most of us don't go around thinking about the last few days of our life. So when we ask the question, we have to improvise. So when he asks somebody, "What do you think about your own death?" that often gets people to think about the fact that they're alive and, "Hey, I'm alive."

                         So to be made aware of death gives the person sort of an invitation to rethink about their life. The first responses you get including some people can be very adventuresome, the woman who's going to swim in the Nile. But people will often say the first thing that comes out of their minds. Then they'll reflect upon it. The person who gave a response like, "I want another orgy in the Eiffel Tower" will now be thinking, "Wait a second. Wait a second. Is that my life?  How do I really want to live my life so that when my time is up, I've done things I want to do."

00:08:05.11 LN: Something that you said made me wonder if there's a lesson here. You said that when you ask people questions like this and they have to kind of think about their death, then it makes them think about how they're living their lives, and it made me wonder: Is the lesson that one needs to live with that awareness of death to be thinking about what it means to be mortal as we live our lives?

                         RK: Not all the time. I wouldn't suggest that you get up in the morning and say, "I'm going to die," you know, and think about it all day long. But I think it's good to have that as part of our mind, part of our expectations for life, be aware that life is fragile, nobody goes on forever, and that adds extra value to life. People who have been really touched by death are more likely to appreciate life.

                         LN: Well, when do we become aware of our own mortality? Is it the first time that we experience the death of someone close to us? Is that really the moment?

00:08:54.15 RK: Well, we can have a lot of experiences without necessarily being touched. Some people will see the death of an animal, and they make the connection. Other people can be through all kinds of death experiences, violent experiences, and sort of live in a bubble wrap. So you have young children who have had momentary insights into death understand it as well as many adults do, and have adults who go through life, well, death is like the alfalfa crop in Patagonia or something. It doesn't concern them.

                         LN: What do little children understand about death when they first become aware of it? What do they think of it?

00:09:28.18 RK: Now there's research, pretty good research that suggests that kids have to go through a stage of cognitive development so that they understand death the way adults do. So there's a stage where they think death is not final, it can come and go, and death is a scary thing you might be able to avoid. But even the young child, it's a way of separation. Death is, it's separation.

                         So a young child will get a sense of separation as a source of anxiety, and they're curious about death. By the time a child is five or six according to the research, they realize that death is final but, you know, you can escape it, and sometimes they make death more concrete by seeing death as a person. Finally when you get to about eight or nine or ten, most kids understand that death gets us all. It's personal; it's universal. It's final, but it's only part of the story. The rest of the story is that children very early are already sort of practicing death, already aware of their vulnerability and survival.

                         LN: I was wondering what you meant by "practicing death."

00:10:25.11 RK: Practicing death is one way when you go to bed at night, if I die before I wake. That's one way. Another way is kids are not passive when they try to understand death. They'd be very active about it. Kids have their moments where they like to bring about death, where they like to flush things down the toilet, or they like to do things to practice being in control of absence, being in control of disappearance, the running away games, peekaboo. A lot of things kids do naturally are not just to understand death passively, but say, "What can I do about being left alone? What can I do about separation? How can I understand things that melt, things that go away and come back, things that don't go away and don't come back?" The child's mind is very actively dealing with dying and death.

00:11:03.28 Well, let me give you one example. A professor of medicine loved to go for a walk with his two-year-old grandson. One day they're in a park together and they're both noticing a little caterpillar on the walk. They see an adult foot come down and crunch the caterpillar. Well, the professor's impulse is to turn the kid away from it, but the boy wanted to approach it. So the boy bends over the caterpillar. The boy's obviously stunned. And he says, "No more."

                         I think many of us as very young children had some perception that life ends, but we put it away, because it's not very useful. We'd rather not think about it. By the time we get to adulthood, we've often put away our early fears and our perceptions, and we'd like to go on, as you said at the beginning of the program, as though death really doesn't matter to us. Inside us though is the smart child who realizes these things do happen and sooner or later, these feelings will come out again.

                         LN: You know, I think people these days are more open about talking about death.

                         RK: Yes.

                         LN: We were saying at the beginning of the program that it helps to make us a little bit more aware of what we're doing with our own lives. But even if we're less afraid of talking about it, are we any less afraid of death itself?

00:12:10.11 RK: It's the fear of the pain, of the disfiguration, of the dependency, of the bad things that can happen during dying that many people are afraid of. These are more palpable. Death is very abstract. "I'm afraid of death. What's that?" But they know what it's like to see people suffering and go through some of the indignities and pain that some people have suffered.

                         Now we have hospice now. We have a lot more concern with pain control, symptom relief, but there's still this cultural memory of dying being a really horrible thing, and if dying is horrible, that gets all the attention. Death may even been seen as a release.

                         LN: Professor Kastenbaum, thank you for joining us. Coming up, how much do we fear death, and what will we do to escape it? I'm NPR's Lynn Neary. That's just ahead on The Really Big Issues.