The Patient Body
Memorials and Body Counts
“The Patient Body” is a monthly column by Ann Neumann about issues at the intersection of religion and medicine.
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Photo by Don Murray / Getty Images
By Ann Neumann
“Hic locus est ubi mors gaudet succurrere vitae.” Latin, meaning, “This is the place where death delights in helping life,” at one time, a common motto or inscription used by morgues.
As I write, two enormous beams of light pin a heavily quilted sky to the concrete and glass skyline of Manhattan at twilight. The lights are a mirage: two towers still standing. They tether (whatever we project onto) heaven to what was once, fourteen years ago, a hell on earth. The “Tribute in Light” shines each year for several days before the anniversary of the death of nearly 3,000 people whose names are now carved into the bronze walls of the memorial at Ground Zero.
The lights, the long moments of silence, the reading and listing of the names of those killed on September 11, 2001, are all part of an annual public ritual, a schedule or practice of repeated events that serve to give order to the chaos and evil of that day. They echo the accepted funeral practices that are used to mark death, but they are also in service to a national purpose. Their performance is a demonstration of the kind of culture we hope to embody as a nation. And they shape and confirm our worldview—that we mark and remember our dead because we are a moral people and a moral nation.
The recording of names of the dead is commonplace to us now, but states have not always kept track of deaths, their interests more engaged with the living (for taxes, for military conscription). It is a mass death that, in the 14th century, spurred states to first track the dead with lists. As Kathryn Schultz tells us in her 2014 article for The New Yorker, “Final Forms”:
The modern death certificate owes its existence to the cosmological, scientific, and political revolutions that eventually overturned this entire world order. But its prototype emerged in response to something else: death itself, on an epic and horrifying scale. In 1347, the Black Death broke out in Europe. By 1351, a third or more of all Europeans were dead. With a huge percentage of the remaining population infectious and the rest of it terrified, the plague turned the formerly private experience of death into a matter of (extreme) public concern. Italy responded by passing the first modern quarantine laws, tracking the living. England took a different route, and began tracking the dead.*
Until that time, she tells us, churches were, “interested in the fate of the soul, not the body.” Most of the population was illiterate, unable to read or record their dead. As a way to protect the health of its people, states began keeping track of those who died, at first recording only the daily count of the lives wiped out by the plague. Eventually, death certificates listed individuals by name and cause of death (which was, it’s worth noting, no longer fully attributed to the wrath of God). Death certificates became a bureaucratic tool, “the saddest of diplomas, the most mysterious of passports,” Schultz writes. In developed countries, death certificates are now commonplace. So are lists of the dead—on newspaper obituary pages and on memorials. The September 11th memorial’s list of names is also a tool, like the death certificate, a ritualized method of proclaiming our loss and, in turn, the hope for our recovery.
But what’s in a name? For the families and friends of those who died, it is an intimacy with their dead loved one, a specific name for their loss. A dead person’s name signifies all they were and once meant to us. Saying their name keeps them close, though their body may be gone. Too, names of the dead, like the lists on public memorials, signify living physical bodies, once like ours, as well as our social body, our fellow citizens. Despite our rational understanding of what happened to those lives—on September 11th they were brutally ended by a gross act of violence that disintegrated their bodies—recalling the dead by their names re-enchants them, makes them real to us again. We know they are dust. But we can remember and imagine their presence when we say their names. The ritual of name-saying, then, is a way of enchanting our world with their memories.
Photo: AP
On September 11th we were shocked and scared by the images (in person, in the media) of people like us jumping from buildings, bodies suspended in dusty air. We saw them massed along window sills and rooftop ledges. Our chaotic horror at the images and events of the day is again ordered by our collective participation in these ceremonial acts of remembrance; our anxiety is channeled by our ritual practices of grief. Grieving makes, according to Polish anthropologist Branislaw Malinowsky, “a social event out of a natural fact.” Or a seemingly unnatural fact, like September 11th.
The power of the memorial at Ground Zero is rooted, planted in the bodies of the people who died there. “A body’s materiality can be critical to its symbolic efficacy: unlike notions such as ‘patriotism’ or ‘civil society,’ for instance,” writes Katherine Verdery in “Dead Bodies Animate the Study of Politics.” “The significance of corpses has less to do with their concreteness than with how people think about them,” she writes, “A dead body is meaningful not in itself but through culturally established relations to death.”** We imbue a dead body, even a disintegrated body, with meanings that serve our grief.
The “Tribute of Light” makes various appeals to immortality on behalf of society—“Never forget” is the refrain most associated with the attacks. The memorial asserts that the towers and those who died in them will live forever in our memory. Their needless destruction has unified us in a collective acknowledgement and remembrance. The lights are an apparition of towers, now reborn, reaching from the rubble into the heavens. Not only are the towers invincible, immortal, resurrected, but so are our dead, in their names. And so is our nation.
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The rituals of medicine before death help us to negotiate physical uncertainty and precariousness, just as the memorial rituals after death help us to negotiate our grief. End of life medicine falls exactly in that place between science and religion: the death ritual. A living body will soon no longer be living and we are left to mark this biological transition, often with formal services and traditional practices. Doing so in ways that are customary, orchestrated by professional doctors, nurses, morticians, clergy and hospital staff, helps us to make sense of death, to know how to prepare for it and to react to it. And it ameliorates loss by keeping our memories of the dying present. The ordinary becomes special, sacred, significant. Of course, God is most present in American culture around the death bed, animating our faith that the life we are about to see extinguished meant something, was not for naught, and that it has an afterlife somewhere—in heaven, in our memories, in an earthly legacy. Even avowed atheists will slip into spiritual and religious language or practices during those last weeks of life, theirs or their loved one’s.
Because of the medicalization of death, its removal from society and secreting behind hospital curtains, our fear of impending death has been eased by the ritual of medical practice. Hospitals are analogous to sacred spaces, like churches. Patients, like parishioners, look to the authority of doctors in white robes to make the best decisions for them, to guide them through their last days. To dictate their behavior. Despite our understanding of medicine as a science, secular in its methods and practices, a patient’s belief in the efficacy of medicine’s healing power is what animates the discipline. And it is our faith in medicine’s orderly routine at the end of life that helps us to make sense of death.
These rituals tell us what to do with the dead and with our grief: You’ve got this body. It is and is not the person you’ve known intimately. How do you reckon with its implications for your body? Rituals, with their vast religious inheritance, often guide those who are grieving through the first days and weeks of adjustment to a new world.
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Wars, plagues, the AIDS epidemic of the 1980s and 90s, acts of terrorism like September 11th, even daily individual deaths, are all matters of public health. Why do we die the way we do and what are the medical ramifications for the public body? Fear of mortal danger, in whatever guise, often accompanies the fear of moral corruption. What have we done to bring this death on ourselves? What lesson are we to learn from it? What can we do in the future to prevent it? As Anthony Petro writes in After the Wrath of God: AIDS, Sexuality, and American Religion:
Moral claims can translate ideas about sinfulness into statements about health because morality cuts across modern American religious and secular vocabularies. Morality is what’s “good” about modern religion: it is also what leaves room to debate how people ought to act—and what their actions say about their humanity—in the seemingly disenchanted world of modern medicine.
Claims about our country’s moral health after September 11th have made it difficult to diagnose the cause of the attacks, if less so over time. Conflating the bodies of the dead with our national body muddies grief for those killed with flag-waving nationalism. “De mortuis nihil nisi bonum,” in Latin, means “Of the dead, nothing unless good.” The grief rituals we have employed for September 11th inform the story that we tell ourselves about the health of our country.
Throughout modern history, the work of medicine has been twofold: to prevent death, and to tell us why we die. The work of mourning is also preventative and explanatory. It ascribes meaning to death and, through ritualized memorials, prevents the dead from ever straying too far from us.
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*With “this entire world order,” Schultz is referring to medicine’s disinterest in dead bodies: “Early medicine relied more on folklore than on physiology, and its practitioners were not in the habit of examining bodies, living or dead. Well into the nineteenth century, the limits of medical knowledge were such that doctors sometimes didn’t even know if someone had died, let alone how.” But also on the religious and “political irrelevance” of recording death.
**Verdery’s essay is published in the collection, Death, Mourning, and Burial: A Cross-Cultural Reader, from which the top quote also comes.
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Past “The Patient Body” columns:
How Ethics Saved the Life of Medicine
Reading HuffPo’s “Hospice, Inc.”
Your Ethical and Religious Directives
Hospitals and the Pretense of Charity
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Ann Neumann is a contributing editor at The Revealer and Guernica magazine and a visiting scholar at The Center for Religion and Media, NYU. Neumann‘s book, The Good Death, will be published by Beacon Press in February 2016.