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Product Details
| ISBN-13: | 9781433569647 |
|---|---|
| Publisher: | Crossway |
| Publication date: | 07/01/2025 |
| Pages: | 208 |
| Product dimensions: | 5.50(w) x 8.50(h) x (d) |
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Read an Excerpt
CHAPTER 1
Where Is Thy Sting?
Compared with most of us these days, seventeenth-century French philosopher Blaise Pascal was obsessed with death. In his Pensées Pascal offers one of the most disturbing images of the human condition I've ever read:
Imagine a number of men in chains, all under sentence of death, some of whom are each day butchered in the sight of the others; those remaining see their own condition in that of their fellows, and looking at each other with grief and despair await their turn. This is an image of the human condition.
That's dark, isn't it? Try for a moment to imagine yourself in Pascal's nightmare. You're one of a line of prisoners condemned to die by firing squad, one at a time. You hear the captain's call: Ready. Aim. Fire. You hear the sound of the shots. You hear a body fall to the ground. Then you hear it all over again, only this time a little closer. One by one the others before you in line are killed. And you know in every one of their deaths your own is foreshadowed. You are implicated in what is happening to them. Each death implies your own.
This is how Pascal views all of life. He is the condemned man on death row. Every death he sees around him forecasts his own. It's a sign of what will happen to him, a reminder that his turn is coming. And all he can do is wait.
Pascal lived with a sense of solidarity with the dying that is mostly unknown to many of us. Of course, we know that people die, even people close to us. But I wonder how often you see your own death foreshadowed in the death of someone else.
There are many people, of course, whose circumstances don't allow the space necessary to avoid the reality of death. Perhaps you're a physician or a hospice nurse. Perhaps you serve in the military or in law enforcement. Perhaps you belong to a majority-world nation or live in a disadvantaged community in the West, where life expectancy is lower than average. You may have lost a spouse or a child. You may live even now with a terminal illness. To whatever extent you belong in a group like these, Pascal's perspective may not seem unfamiliar.
But for most people living in a modern Western context, Pascal's personal, regular engagement with death feels foreign. Perhaps Pascal's way of thinking strikes you as unstable, unhealthy, even dangerous. But before the past century Pascal's outlook was far more typical than ours. And the reality Pascal imagined hasn't changed at all. Every one of us lives with a death sentence we cannot escape. We're still waiting our turn. We're simply less honest about the facts. Most of us no longer see what he saw.
Before we move to the problem of death and how it exposes the beauty of Jesus, we need to consider how and why so many of us have stopped paying attention to death in the first place. I want to highlight four ways we often deny death in our culture, and then ask why we're avoiding the truth.
From Home to Hospital: Where We Die Now
In 1993, a Yale surgeon and professor of medicine named Sherwin Nuland published an awardwinning bestseller called How We Die. The point of the book was to introduce unfamiliar readers to what Nuland calls "the method of modern dying" — what death typically looks like in modern-dayAmerica. Each of the book's chapters takes up one of the six most common causes of death, causes like cancer and heart disease and Alzheimer's. Nuland describes the pattern of decline you can expect with each pathway and what you can do to prepare.
What is most striking to me, however, is the sheer fact that this book was necessary. In our culture, death is foreign. The book reads like a travel guide to a place you've never been. A good guide book tells you where to eat if you want to avoid the tourist traps. It tells you which sites are worth your time and money and which are overrated. It explains how to navigate transportation options, which neighborhoods have the best hotels, and how much you should expect to pay for what you'll need. You need all this from a travel guide because you haven't been to the city before. It's a stand-in for actual experience.
Nuland's book is necessary because for most of us, for most of our lives, death is a foreign country. It belongs to another world. It's not just a place we've never been. It's a process we've rarely witnessed. And above all it's a reality we don't often consider. This makes our time and place different from any other time in history and most other places in the world. And Nuland's book points to the first major reason death has been shoved out of our consciousness: the incredible accomplishments of modern medicine. Over the last century medicine has made our lives longer and far more comfortable, but it has also carved out space for us to live as if we're not going to die.
A little historical context helps us see how unique our experience really is. Three hundred years ago it was impossible to avoid death, because death was everywhere. "Death dwelt within the family," as one historian put it. It happened within the walls of every home. And it happened not only to your grandparents. It happened to your daddy. It happened to your little brother. It happened to your new bride. It happened to your children.
Imagine, for example, that you lived in Andover, Massachusetts, during the late 1600s. The average married couple in those years would give birth to roughly nine children. But three of the nine children would die before they were twenty-one years old. That is one of three on average. For some families the reality was far worse.
Take the family of New England minister Cotton Mather, one of the most prominent citizens of his time. Mather was the father of fourteen children. Seven of his children died as infants soon after they were born. Another child died at two years old. Of the six children who survived to adulthood, five died in their twenties. Only one child outlived his father. Mather enjoyed all the medical advantages available to anyone in his time. He could afford the finest care money could buy. And he buried thirteen of his children.
When you got married, in other words, you expected that you would have to bury your children. When you got pregnant, you knew there was a good chance you would not survive childbirth. When your children got a fever, you weren't annoyed that they would have to miss school; you were worried they might not recover at all, and that whatever they had could mean death for everyone else in your family.
The rise of modern medicine has had radical implications for the presence of death in our lives, most of them wonderful. Death in childbirth for mothers and for infants has drastically declined in the West. So has the occurrence of epidemics like smallpox or yellow fever. At the end of the eighteenth century, four out of five people died before the age of seventy. Average life expectancy was in the late thirties. Now the average is nearly eighty years old.
And we're not just living longer. We're also living better. The aches and pains earlier generations had to live with are now erased or at least covered up by new drugs, new surgical procedures, and always-developing technologies. We have drugs to attack everything from cancer cells to routine headaches. We have outpatient surgeries to relieve back pain from a herniated disk, knee pain from a torn meniscus, or cloudy vision from a cataract. These are problems our great-great-grandparents would have accepted as a normal part of life. Now doctors are remarkably good at solving them.
But all these medical marvels have come to us with a profound, often unnoticed side effect. The reality of death has been pushed to the margins of our experience. Every one of us still dies, but many of us don't have to think much about it.
In Being Mortal, surgeon Atul Gawande describes some of the effects of medicine on what he calls the "modern experience of mortality." Gawande's book reflects on how medicine shapes the way we think about, confront, and ultimately experience death.
Consider, for example, that by the 1980s just 17 percent of deaths occurred in the home. In previous centuries, death happened where life happened. Death by disease was often a slow, agonizing process without the help of pain-controlling medication. This happened to someone you loved, perhaps in the room where you slept, in a place where you would see the agony and hear the moans or the screams. There was no isolating the young from the harsh reality of death. Now the experience of death has shifted from a familiar event in a familiar place — an event that occurred at the center of life — to sanitized, professionalized institutions that most people rarely visit. In the modern era, more often than not, our final days "are spent in institutions — nursing homes and intensive care units — where regimented, anonymous routines cut us off from all the things that matter to us in life."
Gawande's main concern is how this relocation can be profoundly disorienting for the aged and the dying. But it has also meant a crucial shift for the young and the healthy. It is possible to live well into adulthood, even most of your life, without an up-close-and-personal encounter with death.
Great Expectations: How We Fight Death
If modern medicine has given us the space to live as if death is not inevitable, it has also ingrained in us a powerful expectation, even a sense of entitlement, that comes to the surface when we do finally confront some life-threatening problem. In practice, patients and doctors alike behave as if death, like disease, can be eliminated. Doctors are trained to save lives — to extend life, however possible — and in the modern world they're very good at it. With this competency has grown the hope that there is always something more to be done. Some new experimental drug to try out. A new surgical procedure to perform. Another specialist to weigh in. When doctors are accustomed to winning, and when patients or their families want to grasp at every sliver of hope, it can be incredibly difficult to know when to let go.
Doctors resist letting go, in part, because the culture of their field is aimed at overcoming what isn't yet curable. Sherwin Nuland describes how over the course of his training he came to view himself as a "biomedical problem-solver." What drove him and his colleagues is what he calls "The Riddle": "The quest of every doctor in approaching serious disease is to make the diagnosis and design and carry out the specific cure. ... The satisfaction of solving The Riddle is its own reward, and the fuel that drives the clinical engines of medicine's most highly trained specialists." When The Riddle determines why and how doctors practice medicine, death will always seem like failure. Not the inevitable end of every human life, but a lost battle with some specific disease. Rather than accepting death, Nuland argues, "the most accomplished of the specialists are also the most convinced and unyielding believers in biomedicine's ability to overcome the challenge presented by a pathological process close to claiming its victim."
Patients and their families resist letting go because there is always uncertainty about how much time more treatment might provide. Gawande captures the outlook in vivid detail:
Our every impulse is to fight, to die with chemo in our veins or a tube in our throats or fresh sutures in our flesh. The fact that we may be shortening or worsening the time we have left hardly seems to register. We imagine that we can wait until the doctors tell us that there is nothing more they can do. But rarely is there nothing more that doctors can do. They can give toxic drugs of unknown efficacy, operate to try to remove part of the tumor, put in a feeding tube if a person can't eat: there's always something.
As a result of this hope in something more, "we've created a multitrillion-dollar edifice for dispensing the medical equivalent of lottery tickets — and have only the rudiments of a system to prepare patients for the near certainty that those tickets will not win." In fact, Gawande observes that in the United States Medicare devotes one quarter of its spending to "the 5 percent of patients who are in their final year of life, and most of that money goes for care in their last couple of months that is of little apparent benefit."
Our approach to end-of-life care points to the cost we're paying for all the benefits we've received from medicine's ability to make life longer and more comfortable. For all that it has given us, modern medicine has enabled a powerful, pervasive self-deception. Death is no less universal now than it's ever been. Death is not a disease to be eliminated. It is the inevitable end of every human life. People don't die because medicine failed them. They die because they're human.
In Swimming in a Sea of Death, David Rieff describes the experience of his mother, writer Susan Sontag, in her struggle with cancer. This tension between the inevitability of death and the unflinching confidence in medical treatment is a major theme of Rieff's memoir. In 2004, when Sontag was diagnosed with an aggressive form of blood cancer, she threw herself into the search for a cure. Even if the available options could buy her only another year or two of life, Rieff recalls, his mother believed that in the meantime cancer research would uncover a way to buy another year or two, and so on. But, Rieff says, "it was life and not truth that she was desperate for." She found doctors who were as hopeful as she was. Together they tried everything they could. But her treatment, if anything, only made matters worse. Disease and treatment worked together to strip "her both of physical dignity and mental acuity — in short, everything except her excruciating pain and her desperate hope that the course she had embarked upon would allow her to go on living."
The lesson Rieff draws from this experience is a powerful check to our confidence in what medicine can do. Our success in treating a wide variety of once-fatal problems has blinded us to the fact that you have to die of something. Every time we cure one disease another will eventually rise to take its place. So many people die of cancer now because they aren't dying much earlier of influenza or smallpox or bacterial infection. If, as Rieff observes, we can "manage to turn at least many cancers into 'chronic' illnesses rather than mortal ones, what people will then have to die of will be something else — something about which we will not do better, something that cannot be long remitted."
Because we have conflated death and disease, we throw everything we can muster at an unsolvable problem. And in a way the harder we try to hold death off at all costs, the more ridiculous and ineffective we appear. If you've watched someone die in intensive care after being kept alive by drugs as devastating to the body as the disease itself, or tethered to life support machines for circulation of blood and oxygen, then you know what I mean. Nuland describes the intensive care unit as "a secluded treasure room of high-tech hope within the citadel in which we segregate the sick so that we may better care for them," a powerful symbol of "our society's denial of the naturalness, and even the necessity, of death." If the ICU represents our all-out attempt to beat back death, it is also in a sense a monument to death's power. Here modern medicine is to death what a comb-over is to a balding scalp. We may shield the reality for a time. But at some point the comb-over is no more than a monument to the power of baldness. The harder we try, the more obvious our weakness and the more obvious death's power.
Nothing to See Here: How We Handle the Dead
Through medicine we try to avoid the inevitable. But once the inevitable has occurred, we often continue to deny the reality of death in how we treat the dead body. Many American funerary customs are profoundly unique to this time in history and this place in the world. In ways subtle and not so subtle, these customs work to blind us to the ugliness and finality of death.
In 1963 investigative journalist Jessica Mitford published The American Way of Death, a satirical send-up of the American funeral industry. The book earned an unexpected spot at the top of the New York Times best-seller list, and for good reason. It's full of bizarre details that would be hilarious if they weren't true.
Studying trade magazines with names like Mortuary Management, Mitford found a startling range of products for the dead being marketed with qualities desired by the living. "The same familiar Madison Avenue language, with its peculiar adjectival range designed to anesthetize sales resistance to all sorts of products, has seeped into the funeral industry in a new and bizarre guise," Mitford wrote. "The emphasis is on the same desirable qualities that we have been schooled to look for in our daily search for excellence: comfort, durability, beauty, craftsmanship."
(Continues…)
Excerpted from "Remember Death"
by .
Copyright © 2018 Matthew McCullough.
Excerpted by permission of Good News Publishers.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Foreword Russell Moore 11
Acknowledgments 15
Introduction 17
1 Where Is Thy Sting?: 31
2 The Problem of Identity and the Promise of Union with Christ 57
3 The Problem of Futility and the Promise of Purpose 85
4 The Problem of Loss and the Promise of Eternal Life 117
5 The Problems of Life and the Promise of Glory 149
6 Grieve in Hope 173
General Index 185
Scripture Index 189
What People are Saying About This
“Through the lens of Scripture, McCullough looks death squarely in the eye and reminds us that it is nothing to be afraid of. For the Christian, it has truly lost its sting. Remember Death is a welcome conversation in a culture that doesn’t know how to think about mortality.”
—Andrew Peterson, singer-songwriter; author, The Wingfeather Saga series; Founder, The Rabbit Room
“This is a profoundly helpful book. With a preacher’s turn of phrase and illustrative eye, with a pastor’s care for precious people and their greatest fears, and with a theologian’s grasp of the Bible’s big picture and the heart of the gospel, Matthew McCullough writes to overcome our detachment from death and deepen our attachment to the Lord Jesus Christ. These pages will repay careful thought and meditative reflection on their surprising riches.”
—David Gibson, Minister, Trinity Church, Aberdeen; author, The Lord of Psalm 23: Jesus Our Shepherd, Companion, and Host
“I pray that you come away from a book on mortality with a sense of clarity about what really matters—about who really matters. I pray that this book, as it leads you to reflect on your own coming demise, gives you a sense of joy, of gratitude, of longing to be part of that great cloud of witnesses in heaven. Your life is worth living precisely because it is not your life at all. Your life is hidden with Christ. That gives you the freedom to lose your life in sacrifice to others, in obedience to God, in order to save it.”
—Russell Moore, Editor in Chief, Christianity Today; author, Losing Our Religion
“Matt McCullough’s meditation on death is haunting, profound, and stirring, reminding us of our identity and our destiny apart from Jesus Christ. Death casts a shadow over our lives, showing us, as McCullough points out, that we aren’t the center of the universe. Those who live rightly and those who live forever often think of death, but at the same time they live with hope since Jesus is the resurrection and the life. This book reminds us why we die and teaches us how to live.”
—Thomas R. Schreiner, James Buchanan Harrison Professor of New Testament Interpretation, The Southern Baptist Theological Seminary
“Can we face death and find hope? According to Matt McCullough, yes. Remember Death rightly reorients us to the impermanence of this world and the brevity of our lives, witnessing to the paradox that grief is necessary for faith. Richly informed by Scripture and a feast of other sources, this book vitally forms our longings for the world to come. I can’t wait to recommend it.”
—Jen Pollock Michel, author, Surprised by Paradox and Teach Us to Want
“This is a brilliant book. Rightly advocating ‘death awareness’ but not ‘death acceptance,’ McCullough powerfully demonstrates that in order to remember Christ well, we need to learn to remember death well. This book shines with scriptural truth, pouring forth the light of Christ upon our fleeting, fear-filled lives.”
—Matthew Levering, James N. and Mary D. Perry Jr. Chair of Theology, Mundelein Seminary; author, Dying and the Virtues