The Death Class: A True Story About Life - Softcover

Hayasaki, Erika

Softcover

ISBN 10: 1451642946 ISBN 13: 9781451642940

Publisher: Simon & Schuster, 2014

Synopsis

The poignant, “powerful” (The Boston Globe) look at how to appreciate life from an extraordinary professor who teaches about death: “Poetic passages and assorted revelations you’ll likely not forget” (Chicago Tribune).

Why does a college course on death have a three-year waiting list? When nurse Norma Bowe decided to teach a course on death at a college in New Jersey, she never expected it to be popular. But year after year students crowd into her classroom, and the reason is clear: Norma’s “death class” is really about how to make the most of what poet Mary Oliver famously called our “one wild and precious life.”

Under the guise of discussions about last wills and last breaths and visits to cemeteries and crematoriums, Norma teaches her students to find grace in one another. In The Death Class, award-winning journalist Erika Hayasaki followed Norma for more than four years, showing how she steers four extraordinary students from their tormented families and neighborhoods toward happiness: she rescues one young woman from her suicidal mother, helps a young man manage his schizophrenic brother, and inspires another to leave his gang life behind. Through this unorthodox class on death, Norma helps kids who are barely hanging on to understand not only the value of their own lives, but also the secret of fulfillment: to throw yourself into helping others.

Hayasaki’s expert reporting and literary prose bring Norma’s wisdom out of the classroom, transforming it into an inspiring lesson for all. In the end, Norma’s very own life—and how she lives it—is the lecture that sticks. “Readers will come away struck by Bowe’s compassion—and by the unexpectedly life-affirming messages of courage that spring from her students’ harrowing experiences” (Entertainment Weekly).

About this title

About the Author:

Erika Hayasaki spent nine years as a reporter for the Los Angeles Times before becoming an assistant professor in the Literary Journalism program at the University of California, Irvine. She is a recipient of the Los Angeles Times Best Writing Award, the Association of Sunday Feature Editors Award, and the American Society of Newspaper Editors Breaking News Award.

Excerpt. © Reprinted by permission. All rights reserved.:

Death Class ONE

The Professor

When it came to death, Norma Bowe had the fearlessness of a swift-water rescue team; when everyone else wanted to get away from the force of the current, she went charging straight into it instead. Not many threats in this world seemed to rattle her: not guns, murderers, or the criminally insane, and certainly not death. With cheeks that swelled when she smiled as if she’d stuck a Tootsie Pop beneath each one and a high-pitched reverberating laugh, she made you feel as though, if you could only hold on to her hands long enough, you might just be the one person lucky enough to escape.

There was an air of invincibility surrounding her, a feeling so magnetic that long after class had been dismissed students found themselves wanting to hang out with “Dr. Bowe,” which was what they called her, despite her insistence that they call her Norma. They lingered in her office for hours, even when she wasn’t there. When she actually did get sick or injured, some of them reacted with stunned disbelief, as if they didn’t think a woman like that could be mortal. But she knew there was an art to surviving. That is what she wanted her students to learn.

Norma had a fondness for cemeteries and could spend hours perusing inscriptions on tombstones or kicking back on a freshly mowed patch of grass next to the grave of a stranger. If she had enough free time, which was rare, she might even bring along one of her favorite Jodi Picoult novels to read. When traveling to a new city, Norma did not think it at all odd to pay a visit to the local graveyard, snapping photos as if it were a regular tourist destination. She believed cemeteries held the stories that history books could not always document; they were the overlooked, underused classrooms beneath our feet, so it made sense to her to teach a lesson inside one every once in a while.

The Rosedale & Rosehill Cemetery in Linden, New Jersey, where her students convened one summer night, was bordered by an auto-stripping business, a school-bus yard, a truck repair shop, a warehouse, and a headstone company, Payless Monuments. As dusk fell, students parked their cars in a line as if part of a funeral procession along a quiet road that meandered through the cemetery. The memorial grounds would have been mostly empty without her class, except for the squirrels, crickets, and crows. Norma planned to give a lecture here on the biology of dying, and she had warned the students beforehand that it would be important to take notes; questions about it could end up on the final exam.

“Hi, everyone,” she said, waving with a wide smile as she pulled up late to the cemetery in her silver Mazda minivan full of students. Norma and her students jokingly referred to it as the “party bus,” because the van spent its days shuttling students on field trips to prisons, funeral homes, hospice care centers, mental hospitals, and morgues. Its bumper sticker read AMERICA NEEDS A WOMAN PRESIDENT, and its floors and seats were littered with pink highlighters, an unopened Doritos bag, a dozen stuffed purple bunnies, a Celtic Thunder CD, the sound track of Hairspray, and clusters of straws sealed in paper wrapping.

She emerged like a fairy godmother before her students, hopping out of the van and hurrying into the graveyard with all eyes on her, walking with a side-to-side wag, a slight stoop of the shoulders, her feet nudged outward like a pair of wings.

“Nothing like a good cemetery, right?” she asked, rounding everyone up.

She had long brassy hair that she usually wore down, like today, or in a high ponytail when it frizzed in humidity. Her eyes changed colors in the light, like speckled brown jade, and her skin was flushed in the face, more suntanned on the arms and chest with a spattering of freckles. Her underactive thyroid made it easy for her to gain weight and hard to lose it, and she barely ate with her nonstop schedule, subsisting on unsweetened iced Dunkin Donuts’ lattes. She was pear-shaped and pretty, with a sturdy frame that locked her soft edges into place. During non–work days, she dressed folksy: long, flowing skirts, walker’s sandals, turquoise and silver jewelry, and trinkets the color of bones. At work, she sometimes dressed as if she might be called to attend a funeral at any moment, which happened occasionally: black skirts, black dresses, black stockings, black heels. For color, she’d add a bright scarf.

Today she wore black billowy pants and a black cardigan over a pink blouse, with scarlet lipstick and a green gemstone bracelet. Her heavy key chain jangled as she walked, containing more keys than any one person could possibly need, along with membership cards for places such as Petco Pals, Borders, Brooks Memorial Library in Brattleboro, Vermont, and Curves health club for women.

“Guess what?” she said in her singsong voice, which always seemed as though it were stuck in falsetto. “There’s a crematory across the street.” That was where they burned bodies, she explained to the students, suggesting that maybe they could stop by and check it out later.

The professor led everyone on a tour of the grounds, straightening roses on graves and standing tipped-over fences and flags upright. Dandelions and white clover pushed through the ground as Norma took moments of silence to pay tribute to the bodies beneath.

The cemetery was divided into neighborhoods, mirroring a typical big city: Chinese, Spanish, Ukrainian, Polish, Russian, Greek.

If the Chinese section had been a real neighborhood, it probably would have boasted the highest property values. Its tall arched pillars bore the name Greater Chinatown Community Assn. Rows of polished pink or shiny gray headstone blocks, some as big as refrigerators, stretched into the horizon. Engraved into the facades were intricate bamboo designs and horizontal Chinese characters, but English lettering could also be found on some, names such as Low, Lam, Lau, Chung, Wong, Kong. Small red rocks balanced atop some headstones, as if placed there as offerings.

Norma parked herself here, sitting cross-legged in front of a thirty-six-ton granite sculpture of a 1982 diesel Mercedes-Benz 2400 with a license plate reading RAY TSE. Rising from a low stone slab behind a Roman-style pillared mausoleum, the memorial had been built to look like an entombed car, right down to the headlights, windshield wipers, door handles, and Mercedes logos on the trunk, nose, and rims—except for a missing hood ornament, left off because it would have been too easy to break off and pocket.

Students rubbed their fingers along the smooth granite. As the story went, fifteen-year-old Raymond Tse, Jr., had wanted his own Mercedes, but he had died in a car accident in 1981 before ever having a chance to earn his driver’s license. His millionaire older brother, the landlord and businessman Raymond David Tse, paid for the tribute, estimated at $250,000.

“When I think about what the body does when we die, it’s not like there’s a point where everything shuts down,” Norma noted. “It doesn’t happen all at once.”

She made clear that she was speaking of natural deaths from disease and physical ailments, not sudden deaths from murders or car accidents. In violent deaths, bodies don’t have time to make those little adjustments for our comfort. “It’s wild how the body works,” she went on. “Our bodies take care of us our entire lifetime, take care of us when we’re sick, when we’re ill. At the very end it does that too.”

“The first thing that happens is, the circulatory system begins to shift the blood supply to all of the major organs,” Norma said. “We’re very hardwired to survive, so the brain gets the message; rather than the heart pumping blood all the way to the tips of the toes and back up again, it really just starts to pool to the major organs, heart, lungs, brain, digestive system, kidneys, liver. So a lot of times people will begin to complain of feeling cold. They will ask for a blanket, even if it’s a hundred degrees in August.”

That meant death is near, she explained, three weeks away, maybe two. The body temperature can drop a degree or more. Hands and feet take on the frigid feel of refrigerated poultry. Arms and legs begin to look pasty, draped over bones like pie dough, sometimes gray or violet, blotchy, like a web of bruises. Nail beds turn blue; the lines around the mouth, blue too. Blood vessels protrude near the surface of the skin, like varicose veins. The blood lacks oxygen and is no longer cherry red, as healthy blood should be. Instead, it turns a deep, black merlot, so dark it appears blue beneath the skin. This, Norma explained, is called “cyanosis.”

Another sign of impending death: fading eyesight. A dying person might want brighter lighting, the curtains open. While sight is among the first senses to go, she said, hearing is last. You must not assume that a dying person doesn’t know what is going on around him or her, she explained, but carry on as if he or she can hear everything. You can read the newspaper to him or her, leaning close to his or her ears as you speak.

A week or so before death, the blood shifts again, this time away from the digestive system and to the kidneys, heart, lungs, and liver. “That makes it so people stop feeling hungry,” she said. “They don’t want to eat any more.” Favorite meals do not spark the same glimmer of delight. They won’t complain of hunger or thirst, even in the absence of intravenous feeding tubes. The body won’t miss the satisfaction of an overstuffed belly, won’t crave what it no longer needs. If you hold a stethoscope to the abdomen, Norma said, listen for bowel sounds: the contracting movement of muscles pushing food down the digestive tract—or peristalsis—has slowed, maybe even stopped. “So what do we do?” she said. We who love them want to feed them anyway. “We tell them, ‘You’ll like it, it’s good,’ ” she said. They might become bloated, nauseous, constipated, or begin vomiting. “We force-feed people,” she said. “It makes us feel better, folks, it doesn’t make them feel better.”

When the liver has begun to shut down, usually a few days before death, a person might become more agitated, shifting around in bed, and the whites of the eyes turn yellow. “It might look like they’re in agony,” Norma explained. Toxic waste has been building up in their bodies because the liver has stopped filtering it as it used to.

The breathing becomes rapid and shallow, up to fifty breaths per minute, mostly through an open, drooling mouth. The respiratory rate slows, the heart beats staccato. Death may be just hours away now. At times it might seem as if there is little attempt to breathe at all, a pause of ten seconds, as when a sleeping person snores deeply, then does not inhale for a few seconds, before letting out a long, rapid whoosh of air. “Those periods of apnea will get longer and longer,” Norma said. This phase might be accompanied by short heaving gasps or barking: the “agonal phase.”

Saliva, unable to be swallowed, builds up deep in the back of the throat, too deep for nurses to suction it out, causing a congested, purring sound—the “death rattle.”

This is known as Cheyne-Stokes respiration, named after John Cheyne and William Stokes, two physicians who first described and documented the breathing pattern in the nineteenth century. “Air comes into the mouth, and it just goes about as far as the trachea, that’s it,” Norma said. “Breathing is more rapid. Cheyne-Stokes breathing, when it starts, you have just a few hours, maybe twenty-four hours.”

“It is like asthma?” a student asked.

“No,” she replied. “With asthma, bronchioles are constricted, you can hear wheezing and people struggling to breathe.” Cheyne-Stokes breathing, she said, “is very peaceful. It’s just a little bit of air being exchanged.”

Euphoria sets in. The body takes care of the dying mind. The mind takes care of the dying body. “You know that great feeling, when you first meet somebody you’re really attracted to, when you fall in love? We’ve all had that feeling,” Norma said. It’s caused by seratonin, dopamine, and norepinephrine. “Those chemicals will continue to increase, and they are at peak in the moment when you die.”

The neurotransmitters that carry nerve impulses between cells, causing feelings of joy or euphoria, counter pain, even as the blood pressure continues to plummet, the skin turns a dull grayish hue, and the capillaries in the nose thicken. “Imagine, your dying brain gets flooded with this stuff,” Norma went on.

Little by little, the pulse rate and blood pressure go up and within an hour start to drastically drop. “Your heart rate will continue to drop until your heart stops.”

“Your breathing will stop first,” Norma said. “The heartbeat will stop last.”

The time of death will be recorded once the heart has stilled, she said. If you examine the pupils, they will look dilated and dull, vacant.

“The appearance of a newly lifeless face cannot be mistaken for unconsciousness,” wrote Sherwin B. Nuland in How We Die: Reflections on Life’s Final Chapter. “Within a minute after the heart stops beating the face begins to take on the unmistakable gray-white pallor of death; in an uncanny way, the features very soon appear corpselike, even to those who have never before seen a dead body. A man’s corpse looks as though his essence has left him and it has.”

The body temperature cools by one degree per hour. Livor mortis, a red marbling of the skin, sets in. Within twenty-four hours, rigor mortis, a stiffening of tissues, ensues, beginning with the face and moving down through the corpse. Then, as though thawing, the body again goes limp. Norma had seen all of this happen hundreds of times while working as a nurse, in places such as the neurology intensive care unit. But, she added, “there’s a lot we can’t explain. We just don’t know everything that happens when people die.”

TO EMPHASIZE THAT point, she followed her biology of dying lecture with a story from when she had been a young nurse on hospital rounds. As she explained to her students, patients often awoke from very bad illnesses or cardiac arrests, talking about how they had been floating over their bodies. “Mm-hmmm,” Norma would reply, sometimes thinking, Yeah, yeah, I know, you were on the ceiling.

Such stories were recounted so frequently that they hardly jolted medical personnel. Norma at the time had mostly chalked it up to some kind of drug reaction or brain malfunction, something like that.

“No, really,” said a woman who’d recently come out of a coma. “I can prove it.”

The woman had been in a car accident and been pronounced dead on arrival when she was brought into the emergency room. Medical students and interns had begun working on her and managed to get her heartbeat going, but then she had coded again. They’d kept on trying, jump-starting her heart again, this time stabilizing it. She’d remained in a coma for months, unresponsive.

Then one day she awoke, talking about the brilliant light and how she remembered floating over her body. Norma thought she could have been dreaming about all kinds of things in those months when she was unconscious.

But the woman told them she had obsessive-compulsive disorder and had a habit of memorizing numbers. While she was floating above her body, she had read the serial number on top of the respirator machine. And she remembered it. Norma looked at the machine. It was big and clunky, and this one stood about seven feet high. There was no way to see on top of the machine without a stepladder.

“Okay, what’s ...

About this edition

• Publisher: Simon & Schuster
• Publication date: 2014
• ISBN 10: 1451642946
• ISBN 13: 9781451642940
• Binding: Paperback
• Number of pages: 288