Death Redesigned

Re-posted from

By Jon Mooallem as printed in The California Sunday Magazine

Death, Redesigned

A legendary design firm, a corporate executive, and a Buddhist-hospice director take on the end of life.

There’s an ugliness — an inelegance — to death that Paul Bennett gradually came to find unacceptable. It seems to offend him the way a clumsy, counterintuitive kitchen tool might, or a frumpy font. At first, that disgruntlement was just “a whisper in my mind,” Bennett explains. “But it’s gone from being a whisper to a roar.” The solution, when it finally occurred to him, felt obvious. “Oh,” he told himself. “You need to redesign death.”
Bennett is 51 — 30.7 years to go, if the demographic data is reliable — a blindingly energetic British man with unruly brown hair. He works as chief creative officer at Ideo, the global design firm that’s renowned for its intuitive, wizardly touch. Over its 25-year history, as Ideo has expanded from simple product design into branding, organizational design, and management consulting, it has worked in virtually every corner of our economy: A list of recent clients includes Genentech, Bank of America, the Centers for Disease Control, JetBlue, and the Today show. Ideo’s founders designed Apple’s first mouse and the stand-up toothpaste tube. Its designers have overhauled San Francisco’s public school-lunch program and helped reorganize government agencies in Singapore and Dubai. They’ve developed a toilet for low-income families in Ghana. They’ve built a better Pringle.
Often, the firm’s brilliance rests on showing clients something obvious that’s been overlooked, or cutting through buildups of false assumptions. “I think we sense-make really well,” Bennett told me. One example he likes to cite involved attaching mirrors to the gurneys at a Minnesota hospital so that patients could actually make eye contact with the doctors and nurses wheeling them around.
Bennett works out of Ideo’s stylish San Francisco office, at Pier 28 on the Embarcadero, and like others operating at the top of the Bay Area’s innovation economy, he doesn’t have a concrete job description: It can be hard for an outsider to sense-make what he does. According to his company bio, he is responsible for “cross-pollination of ideas and insights” and “traveling, learning.” As Ideo has grown, the company has delved into more abstract, conceptual work, driven not by specific clients but by Bennett and the other partners’ own evolving fascinations. Bennett’s role is to stoke the firm’s bigger ambitions, then go out and excite clients about them, too, transforming those personal obsessions into business opportunities. (When we met one morning last spring, he’d just returned from chatting about “reinventing Judaism” with some unbelievably fantastic rabbi in Los Angeles. “I love this guy,” Bennett raved.) He is quick-witted, blunt, and irrepressibly optimistic about nearly everything. In meetings you can feel junior designers’ eagerness to impress him — to electrify him — and he carries himself with a kind of fidgety, ecstatic gravitas. Imagine Don Draper played by Ricky Gervais.
Bennett’s fixation on death began with the death of his father. He was close to his dad; in a recent talk, he likened his childhood to the plot of Billy Elliot, a story “about a little nelly gay boy who twirled in the northeast of England” and the exceedingly masculine father who dared to love him. Bennett, in fact, traces his identity as a designer to the day in 1974 when his father, Jim, a former military pilot, brought home The Golden Hands Encyclopedia of Crafts. Jim Bennett then spent the next two years sitting with his son, making macramé and knitting God’s eyes, so that sensitive little kid could explore his talent and find his confidence. In 2001, Bennett’s father wound up in a hospital bed, stricken with bone cancer. Bennett was 5,000 miles away at home in San Francisco. He told his father he’d be on the next flight, but Jim ordered him not to come. Eventually, Bennett understood why. His father had painstakingly maintained his dignity his entire life. Now “he was trying to somehow control that experience,” Bennett says. “He was designing the last granule of what he had left: his death.”
So much about death is agonizingly unknowable: When. Where. Lymphoma or lightning strike. But Bennett recognized there are still dimensions of the experience under our control. He started zeroing in on all the unspoken decisions around that inevitability: the aesthetics of hospitals, the assumptions and values that inform doctors’ and families’ decisions, the ways we grieve, the tone of funerals, the sentimentality, the fear, the schlock. The entire scaffolding our culture has built around death, purportedly to make it more bearable, suddenly felt unimaginative and desperately out of date. “All those things matter tremendously,” Bennett told me, “and they’re design opportunities.” With just a little attention, it seemed — a few metaphorical mirrors affixed to our gurneys at just the right angle — he might be able to refract some of the horror and hopelessness of death into more transcendent feelings of awe and wonder and beauty.

IN 2013, BENNETT started sharing his ideas with the other partners at Ideo, selling them on death as an overlooked area of the culture where the firm could make an impact. He had a very unspecific, simple goal: “I don’t want death to be such a downer,” he told me. And he was undaunted by all the dourness humanity has built up around the experience over the last 200,000 years. “It’s just another design challenge,” he said. His ambition bordered on hubris, but generally felt too child-like, too obliviously joyful, to be unlikable. One time I heard him complain that death wasn’t “alive and sunny.”
Ideo realized there was a big opportunity in death. There are currently 76 million American baby boomers inching reticently in its direction. “We’re a generation that’s used to radicalizing things,” Bennett explains. Now, as many boomers watch their parents die just as Bennett had, accepting the soulless, one-size-fits-all deaths that society deals them, they seem to be rebelling one last time. Everywhere Bennett looked — New York Timesopinion pieces and Frontline specials; assisted-suicide laws; the grassroots Death Café movement, where folks get together for tea and cake and talk about their mortality; a campaign in La Crosse, Wisconsin, that got 96 percent of the entire town to fill out advance directives, spelling out their wishes for end-of-life care — he saw his generation striving to make death more palatable, more expressive. And at the far extreme is the crop of phenomenally well-capitalized biotech startups working to get around the insufferable inconvenience of death altogether, either through science-fictionesque “radical life extension” treatments or by uploading your consciousness to the cloud. (These include Calico — Google’s so-called “Immortality Project” — and J. Craig Venter’s company Human Longevity, Inc. The founder of Oracle, Larry Ellison, who set up the Ellison Medical Foundation to defeat death, has explained his motivation succinctly: “Death has never made any sense to me.”) One way or another, Bennett told me, “We’re all holding hands and saying, ‘Forget that shit. Not going to happen.’”
I followed Bennett’s work over the past year — a journey that, in the end, may reveal less about the death of people than it does about the life of ideas, particularly the brand of Big Idea that distinctly Californian institutions like Ideo send careening through the culture. Right away, Bennett understood it would take years to see the sort of wholesale shift he was imagining — a generation or more. There was so much to do, he could really start anywhere. He just needed to find a few suitable clients, to locate a few fissures through which a genuinely different conversation about death could begin to flow. And because he was looking in San Francisco, in the year 2014, the first one he found was a startup building an app.

THE APP WAS CALLED After I Go. The president and ceo of the company building it, Paul Gaffney, had founded two other startups but had spent most of his career working near the top of large corporations such as Charles Schwab, Office Depot, Staples, and aaa, primarily helping them find their footing online. He was 47, a loose and affable guy despite being excruciatingly analytic at his core. Once, when I asked Gaffney about himself, he explained that his “personal value proposition” is “establishing a vision for a new outcome particularly in consumer-related spaces enabled by the novel use of technology” — but he managed to sound human when he said it, even warm.
Gaffney described After I Go as TurboTax for death: a straightforward app that would allow people to write wills or advance directives and, in general, preemptively smooth out the many ancillary miseries that can ripple through a family when someone dies. Bank accounts, life-insurance policy numbers, user names and passwords, what night the garbage goes out — all of it could be seamlessly passed on. Whatever fear or despair people feel about death is only heightened by the fear that, because they never got around to making the necessary preparations, their death might burden the people they love. Gaffney assumed there’d be a big market for an app that eliminated that risk. “Simply providing people with that sense of organization would be a huge emotional payoff,” he said. But he was spectacularly wrong. Bouncing his ideas off potential investors, he quickly understood that no one welcomed a chance to prepare for death. It’s thankless drudgery — plus, it reminds you you’re going to die.
Gaffney realized he couldn’t just build the right tool; he also had to build the motivation to do the job in the first place. That’s what people would pay for. Suddenly, the work After I Go needed to do was no longer rational but emotional — which is to say, far outside Gaffney’s personal value proposition. (“I learned a long time ago that I’m not a good test case for how human beings respond,” he explains.) And so he hired Ideo to help.

THE CONVENING, as everyone called the first After I Go strategy session, happened early last April, not long into Gaffney’s three-month residency at Ideo. About 25 people gathered in the large studio of the firm’s San Francisco office, arrayed on colorful armchairs and couches.
“How can death be designed?” Paul Bennett said, rising to set the tone. He explained that he’d grown up in Singapore, where it’s customary to burn intricate paper sculptures at funerals: paper televisions, paper houses, paper Cadillacs — all kinds of gorgeous extravagances that would, via their rising smoke, accompany the deceased into the beyond. As Bennett put it, “They wanted the dead person to go into the afterlife with all this awesome shit!” But Bennett’s family eventually returned to England, he went on, a place where even the joyful parts of life were muted by the gray and cold. And he was shocked by how different funerals were there, how leaden and awful. It was proof, he explained to the Convening, that how we feel about death is up to us. Then he looked at everyone and, with great earnestness, asked: “Why can’t death feel more like life?”
From there, the Convening broke into four smaller circles to think through the possibilities for After I Go. Bennett assumed the role of facilitator and secretary in his group, manically scribbling notes with a Sharpie. When one woman shared a clip on her laptop of a New Orleans jazz band marching behind a casket, Bennett told her, “I love it. I’m writing ‘jazz death.’” He scribbled jazz death on a pink Post-it and slapped it against the wall.
Paul Gaffney was seated in Bennett’s circle and explained that, like Bennett, his interest in death had been stoked by recent personal experience. His wife and her siblings were now organizing their parents’ affairs after their father had been diagnosed with dementia. It sharpened Gaffney’s understanding of just how much disarray survivors can be left to organize, and how much can get lost. Still, Gaffney confessed, while he’s filed his own important information in an orange folder at home, and periodically reminds his wife it’s there, he rarely gets around to updating it. “What’s your folder called?” Bennett asked him, Sharpie at the ready. “It’s called the Orange Folder,” Gaffney said.
From there, Bennett started posing a series of “how-might-we’s” to the group — Ideo-speak, it seemed, for questions. The first was, How might we get people to start using After I Go? Ideas started firing — “death Tupperware parties,” “will weekends” for couples in Napa, commandeering Groundhog Day as a national “Death Preparedness Day” — until someone brought the conversation back to Gaffney’s orange folder. Maybe After I Go needed to sell a physical object like that in stores, with instructions and a download code inside; it would be a kind of totem, committing you symbolically to starting the preparation process. This idea felt promising until one woman asked, “But if it’s in the consumer space, what’s the draw?”
And there was the underlying tension. In short, why would anyone buy death? Consumer culture is always aspirational: We’re lured along by desire and joy, chasing ever-receding rewards. Gaffney’s challenge seemed to be convincing consumers to step off that rapturous treadmill and think hard about the very thing it was arguably designed to distract us from. That’s why, in part, the business excited Paul Bennett: The app could help reintegrate death into our lives. It could encourage us to start making peace with the inevitability of dying and start making decisions to shape its other aspects — here and now, and not only at the last moment, like Bennett’s father had, when there are few decisions left to make. The question, really, was how to lure ordinary, preoccupied people into contemplating big, transcendent ideas like mortality, continuity, legacy. Once, religion had cleared that space in our lives. Now it was up to Ideo to whiteboard it out.
Eventually the group moved on to another exercise using a handout about Bob and Sherry Alvi, a fictional couple outside Boston. There was even a photo of the Alvis with their two daughters: They looked cornfed and chipper, grinning in front of a fireplace. Bob, the handout explained, was an After I Go user. He was also almost dead; he’d been in a car accident and was in critical condition. And so the Alvis found themselves on the cusp of one of After I Go’s Key Brand Moments — which is to say, death. The question was, How should After I Go make contact with the newly widowed Sherrys of the world?
The circle was quiet. This one was trickier. You can’t just email her, right? The consensus was no, though the idea seemed to hang there momentarily until Bennett finally concurred. (“Death feels very analog,” he explained.) Someone proposed sending Sherry a “condolence kit”: a courier could bring all of Bob’s passwords and information along with a nice bottle of wine. Then, quietly, one man asked, Why not deliver the information to Sherry in a letter, handwritten in advance by Bob?
Instantly, the circle felt electric. Bennett was vibrating; he loved it. Others chimed in, building off the idea, and Bennett began writing madly across multiple Post-its, not coming up for air. (An awkward disclosure: The person who suggested the handwritten-letter idea was me; Ideo strongly encouraged me to participate in the Convening, so I did.) Bennett kept on scribbling. When he finally turned around, a chain of Post-Its behind him read: “Selling a service → Delivering a Message → Executing A Wish → Providing Comfort.” This was the magnificent evolution that Gaffney’s company had just hurtled through in his mind. After I Go could carry back so much more than passwords and legal information from beyond; it could transmit memories, messages, love. That was the emotional payoff, the only way to entice people into filling out all those tedious, frightening forms. Bennett tapped at the word comfort. Then he circled it. “That’s our big idea,” he said. “Comfort is the product. That’s the genius of it. You sell that.”
They had started somewhere practical — living wills, checking accounts, who should cancel the gardener — and landed somewhere metaphysical: an opportunity to comfort your widow from the grave. It was break time. Gaffney and the Ideo designers got up for coffee and snacks, but Bennett stayed at the wall, writing more Post-its, shuffling and collating them, preparing a little presentation so that, when all four circles reconvened, he could unveil these insights for the group.
“We’re moving from estate planning to story building,” he said, to no one in particular. Then he sat cross-legged on the carpet and waited, twirling his Sharpie by the bent clip on its cap.

IN THE WEEKS after the Convening, Gaffney and a handful of Ideo designers got to work in a small windowless room at the southern edge of Ideo’s office. Gradually, they covered the walls in sketches, clippings, and printouts, teasing out the tone and aesthetic of the app and imagining all possible features they might build and test.
Some of the drier mock-ups included pages to help users draft a will or designate power of attorney, or offered portals into a network of vetted legal professionals who could help. But most took bigger, more inventive leaps forward, such as allowing users to curate shareable collections of “funeral inspirations” like a Pinterest page or Amazon wish list; samples were pinned with photos of blood-orange spritzers, Japanese lanterns, and succulents. (“For my sunset party, I want deviled eggs,” one read.) The team’s most mind-bending innovation was something it called After-Gifting, whereby a person could arrange to dispense preselected birthday gifts to family members for years after his or her death. Baby booties made from your favorite jacket could be delivered to a newborn child you’d never meet. The dead might also send time-delayed text messages on special occasions, or just to say hi. After I Go could even digitize your handwriting into a font so that fresh, personalized content could continue to be generated on your behalf.
In other words, After I Go wasn’t only a tool for mundane, administrative death prep anymore. It had inflated into something far bigger — even if, in this freewheeling brainstorming phase, it wasn’t always 100 percent intelligible what that was. There was also a strange shortsightedness to some of the team’s ideas. Ginning up years’ worth of texts for your widow might comfort the person who is dying, for example, but would an actual widow want to keep receiving them? (Imagine if one landed three years later while she was on a date.) Another write-up, meanwhile, explained an alternate brand concept the team had worked up called Bon Voyage. Bon Voyage was all about celebrating “our aspirational desire for richness, beauty and simplicity in this life and whatever comes next.” To illustrate that theme, designers had mocked up the Bon Voyage account of a hypothetical user named Wilfredo.
The screen caps looked like a Madewell catalog — spare and white, with old childhood photos of the deceased arranged around quotes from loved ones and floating images of his cherished possessions. It was gorgeous, but also jarring; essentially, they’d built a luxury brand for death. And yet any feeling of elitism or superficiality was also undercut, albeit a little awkwardly, by their choice of Wilfredo. “He was the best Midas muffler manager we ever had,” one testimonial read. Nearby was a photo of the canteen Wilfredo carried “while serving as a Sandinista.”
That spring, Gaffney’s original, strait-laced vision of the app began to recede into a cloud of more emotionally indulgent features and evocative marketing copy. This was fine with Gaffney, even thrilling: Investors, he found, were responding to the app in an entirely new way. (At one meeting, Gaffney says, a prominent venture capitalist interrupted his pitch and shouted, approvingly: “I want my mother’s damn frittata recipe!”) Gaffney told me, “We now have to pivot and operate exactly like any other startup would.” All he wanted was to build a product that people would use.

ONE AFTERNOON at the end of April, in the middle of that pivot, Gaffney and Paul Bennett gave a short tour of the project to a man named BJ Miller.
Miller is the executive director of San Francisco’s Zen Hospice Project, which since 1987 has quietly helped pioneer the field of palliative care. Loosely defined, palliative care is an empathic approach to medicine and end-of-life care that considers the many nuanced emotional, spiritual, and physical experiences of the patient and his or her overall well-being, rather than formulaically treating a medical condition. Zen Hospice deploys a corps of more than a hundred trained volunteers into homes and at a city hospital, but its centerpiece is a tranquil six-bedroom Victorian home in Hayes Valley known as the Guest House.
The Guest House has an extraordinary feel to it, deeply spiritual without being overbearing or mushy. Residents are invited to meditate with staff and often gather in the kitchen to casually enjoy the rituals and smells of cooking, even if they’re unable to eat. Miller told me he recently supported the decision of a woman at the Guest House with terminal cancer to start smoking again — as he explained it, it was worth it for her to feel and use the very lungs she was losing; it deepened her experience of letting go. In short, Miller explained, Zen Hospice’s power comes from recognizing that “dying is a human act, not just a medical one.”
Miller had been introduced to Ideo about a year earlier, and quickly achieved a kind of guru status among many at the firm. (“He came in and everyone instantly fell in love with him,” one Ideo staffer told me.) He is 44 and preternaturally poised, the sort of person who, after speaking about death and dying on a public-radio call-in show last year, not only read the comments that poured onto the show’s site later, but responded, compassionately, to each one. In person he is blessed with a blazing magnetism that can’t be overstated — a recent acquaintance described him to me, only half jokingly, as “the most magnificent human in the world” — and could pass easily as a Hollywood leading man, with tousled, slightly silvering dark hair and a dimpled grin. He is also missing half of his left arm and has two prosthetic legs.
In 1990, while an undergraduate at Princeton, Miller was out late with some friends and decided, for the fun of it, to climb atop an electric train car. The electrical current arced from a piece of equipment into his wristwatch, sending 11,000 volts through his arm and out his feet, nearly killing him. (Miller still wears the watch occasionally; it works.)
His recovery was long and taxing, but the injury intensified his intellectual curiosity about death and suffering. When Miller returned to school, he began studying art history, fascinated by how artists make sense of the darkness and pain of the human experience. Then, after playing volleyball in the Paralympic Games and founding a tea company, he went to medical school and eventually found his calling in palliative care, especially for terminal patients. (He still practices medicine part-time at ucsf.) Miller felt he was uniquely qualified. “A lot of physicians will work their whole life on a disease that they’ll never have,” he says. Miller, at least, had come as close to dying as anyone could.
Paul Bennett was drawn to Miller immediately. Miller was a physician, intimately familiar with how bodies fail and shut down, but he’d also spent the two decades since his accident attuning himself to the same aesthetic dimensions and deficiencies of the dying process that Bennett was now obsessed with. That is, Miller had a profound head start when it came to redesigning death, and he and Bennett quickly fell into a wide-ranging dialogue. In an email to Bennett early last year, for example, Miller wrote: “I’d say that humans have thrived by turning every need — every vulnerability — into something in its own right.” Shelter becomes architecture, he noted. Reproduction gets wrapped in romance and love. And “think of all the cultural significance and artistry and labor that goes into [eating].” Miller wanted to bring that same creative power and meaning-making to death, but he had trouble finding a sounding board for those ideas in the medical community. He was as grateful to find Bennett as Bennett was to find him.
Last February, Bennett invited Miller to an orientation for a small team of Ideo designers on the work he was hoping to undertake. Because it felt wrong to talk about death in a conference room, some junior designers took it upon themselves to build a Death Yurt at the center of Ideo’s studio — a black, candlelit enclosure reachable only by crawling through a long, dark tunnel. (“It was like a sweat lodge,” Bennett says.) As homework, Bennett had asked everyone to design their own funeral, and he kicked off the discussion. He explained he’s always been terrified by the knowledge that he’ll die alone. (Bennett’s partner is 15 years older than he is, and they have no children.) But lately he had been reshaping the image in his mind. If he was going to die alone, he said, he’d like to do it outside, in Iceland, under the quivering brilliance of the Northern Lights.
Huddled in the Death Yurt, Miller felt simultaneously invigorated and dubious. On the one hand, this was precisely the sort of more joyous conversation he wanted to encourage people to have long in advance of their own deaths. (“I felt like I was watching Paul be converted to the possibilities,” he says.) Miller had seen firsthand that, because we spend our entire lives avoiding thinking about death, when it finally comes into view, there’s a thicket of panic, denial, or disbelief to cut through before people can focus, more mindfully, on the experience and begin to make decisions to improve their last days. Then, of course, you still have to reconcile those hopes with the exigencies of the health care system, which can be torturously inflexible. When you sit with a dying person, Miller says, “Time is always in the room. … At best, you’re able to salvage some peace or comfort for a moment.”
And yet Miller also knew that these more imaginative conversations about death needed to be channeled in just the right way. In the Death Yurt, Bennett and his team seemed to be caught up in what Miller recognized as the “endocrine rush” of finally facing death head-on. That exuberance, while helpful, needs to be moved past; otherwise, it can wind up derailing more practical conversations, or alienating people on aesthetic or socioeconomic grounds. For one thing, Miller later told me, “Paul’s Iceland idea presupposes you can time all that” — that you could fly him over and wheel him out at just the right moment, then cue the Lights. “You don’t want to shit on somebody’s beautiful idea,” Miller said, but “if you start talking about dying well or dying a ‘good death,’ then you also set people up to fail at death.”
Miller seemed to bring that same sobering perspective to his tour of the After I Go workshop. At one point, the lead Ideo designer on the project, Denise Burchell, was talking him through a potential After-Gifting feature the team would eventually call Remembrance Maps: walking tours of sentimental locations, left to loved ones either as actual maps or location-based software. For example, your deceased grandfather could ping you to suggest you go sit on a particular park bench where he and your grandmother used to enjoy the view, 300 yards from where you’re standing. The power of features like this, Burchell explained, was that you wouldn’t be showering your loved ones with “generic memories” but “personally relevant ones.” “These,” she said, “are your memories.”
“Can I ask you a question?” Miller interjected politely. “The quest for immortality in general is very problematic,” he began. He seemed to be feeling the same mix of hopefulness and ambivalence he’d experienced in the Death Yurt. He wanted to know if they’d thought through the implications of catering to what, essentially, is our narcissism. Fundamentally, Miller’s work is about helping people let go of that fierce attachment to the self — the urge to hang on to it at all costs. Was Gaffney’s team finding they could tap into that impulse in a purely positive way? “Is there something good in that compulsion?” he asked.
Burchell seemed taken aback by the question. They hadn’t launched the app yet, not even in beta. “At this point,” she said, “we just have hunches.”

There had been remarkable progress before then, however. Gaffney’s vision of the app had sharpened. What they were building, he realized, was a “private social network,” a lockbox where families could collaboratively collect and curate their memories. It was as much a place for living people as for dead ones. Just as sites like allowed people to discover the identities of their ancestors, he told me, uploading material to Gaffney’s product would allow people to one day discover the stories of their ancestors. All the functionality of the app — they had renamed it Keeps by this point — started to snap into place around that insight; it felt full of promise. But even as Keeps started humming along conceptually, Gaffney’s belief in it was crumbling.
For one thing, there was uncertainty about how Keeps could ever be monetized. And it was proving impossible to hire the prototypical gang of slavish, single-minded twenty-something coders to work for the company. (Young people, it turned out, weren’t enthusiastic about building a digital lockbox for baby boomers to stuff their memories into; unlike apps that called you a car or delivered food to your door at 2 a.m., its mission was totally unrelatable.) Meanwhile, Gaffney was realizing it could take another year of development, maybe more, to build this new, sprawling incarnation of the app he was imagining — and that he would need to raise the money to fund that process. He told me, “I started to feel like I’d probably feel miserable trying to make that work, rather than feeling confident that wewould make it work.”
Then, just as all these unnerving roadblocks came into view, Gaffney was offered a job as senior vice president of information technology at Home Depot in Atlanta. He took it, putting Keeps on hold indefinitely. And by September, there he was: smiling on Home Depot’s senior-leadership web page, wearing one of those orange aprons over his dress shirt.
“You can imagine how disappointed people here are,” one Ideo staffer told me when I first heard the news. Paul Bennett had been imagining a massive cultural shift and had invested at least a share of that ambition in Gaffney’s app. But for Gaffney, closing down Keeps had been a simple, unemotional calculation: He’d sized up the obstacles, decided it wasn’t worth it, and walked away. He wasn’t on a quest to confront some metaphysical dilemma, after all; he was building a consumer product in Silicon Valley. Keeps was just a startup, and a seed-stage one at that. Startups collapse every day.
From a business standpoint, Keeps had arguably done everything right. The app kept pivoting, as apps must. It feverishly chased what it thought we wanted most, until satisfying those desires seemed too difficult, at which point it suddenly pivoted into oblivion.
And that trajectory felt familiar. It’s hard for any of us to face down what’s difficult, frightening, or fragile in life, no matter how earnestly we may want to internalize and reimagine it. Gradually, we get distracted; we drift away from what we suspect might really matter.
Bennett hoped the app could lead us out of that problem. And it might have. It did, however, wind up illustrating the problem exquisitely.

BENNETT MOVED on quickly. He was proud of the work Ideo did for Paul Gaffney and harbored no hard feelings. “Paul had other things he wanted to do,” Bennett told me. “The lesson was, you can’t just go into death lightly.”
That fall and winter, Bennett continued to proselytize about death and design. He talked to Ideo’s health care clients. He talked to philanthropists. He spoke at the launch event for a “healthtech incubator” in Chicago, for a crowd of 200 people. He talked to a “mortician in Los Angeles who wants to do groovy, Six Feet Under rock ’n’ roll funerals” and to a visual artist who’d designed a bodysuit made of fungi as an alternative means of burial. (“You become this organic sculpture at the end!” Bennett explained.) For the most part, these conversations were casual, but in January Bennett told me his goal for 2015 was to convert several of them into actual business propositions. Already he’d landed what might have been his ideal client all along: BJ Miller and the Zen Hospice Project.
Zen Hospice had hired Ideo for the better part of a year to work on several ambitious fronts at once. Miller told me Ideo would first help them “better articulate ourselves to ourselves” — zero in on what makes Zen Hospice’s philosophy and style of care valuable, and enhance it even further. A team of designers was already prototyping ways to improve the experience of residents and staff at Zen Hospice, including dreaming up new, more imaginative physical spaces designed specifically for dying. Then Ideo would help Zen Hospice to step into the public sphere as a potential model for reforming end-of-life care. Zen Hospice wanted to enlarge the public’s appreciation for how much more meaningful death could be. It wanted to build a coalition of similarly minded palliative-care workers and organizations, lobby for more enlightened health care policies, and get insurers to cover care at facilities like its Guest House, laying the economic groundwork for more of them to arise. “I think,” Miller told me modestly, “we’re interested in gestating something like a movement.”
By mid-January, the company had dispatched two researchers to the Guest House, where they’d spend two weeks observing and interviewing staff and volunteers and speaking with families of former residents. Zen Hospice was a small, bootstrapping organization that had never had the luxury of stepping back and codifying its organizational identity, much less a strategy for explaining its mission to outsiders. And so the two women from Ideo — an anthropologist and a “business designer” — were working up an ethnography of the place, allowing Ideo to key into the essence of Zen Hospice and then build out its brand. Dana Cho, an Ideo partner who oversaw the research, told me it’s always a challenge to hew through the stale vernacular that builds up inside any field and get people to loosen up and truly reflect on the work they do every day. And so the researchers came armed with props. In one exercise, Guest House staffers were shown pictures of celebrities — Julia Roberts, Oprah, Dame Judi Dench — and asked to describe what qualities Zen Hospice shared with each.
Ideo, meanwhile, had encouraged Miller to reach out to ted, and he was soon invited to speak on the final day of the ted conference in Vancouver in March. This was a tremendous opportunity: Bennett and Miller both sensed that the scattered but intensifying conversation about death in the culture was searching for some center of gravity. To become a genuine movement, it needed some stake to wrap around and grow — an ambassador like Miller, or an organization like Zen Hospice, or even an entire community, like San Francisco. “San Francisco feels like a very logical place to me for death to be normed,” Bennett told me. “It’s a place where radicalism was born. Why can’t the radicalism of death be something we help build here?” It’s a clumsy analogy, maybe, but it was easy to imagine Zen Hospice emerging as a kind of Chez Panisse of death, and Miller as death’s Alice Waters.
The firm’s partnership with Paul Gaffney had fizzled because Gaffney’s startup was a business with no ideological center. He wasn’t married to any particular idea; as Gaffney once told me, he was only “married to delivering real value.” Miller, on the other hand, was delivering compassion. His whole life seemed to cling to a certain hard-to-articulate ideal — a determination since his accident, as he put it, to live a full life and stay rooted in real things. Even as he opened his organization to Ideo’s efforts, in fact, he felt conflicted about being cast as a spokesman. He still considered himself a relative newcomer to palliative care and was too introspective, and too humble, to crave any celebrity. In short, what made him reticent was his integrity. It was also what convinced Bennett this could work.
An encouraging push and pull seemed to have developed between the two men. A year earlier, Bennett’s crusade against death seemed to be motivated entirely by his frustration with the way his father died. But over time it was evolving into something more nuanced, inclusive, and humane. When I asked what Bennett hoped to accomplish with Zen Hospice, he told me, simply: “Best-case scenario is that more people in more places talk about death in a design-rich way.” Miller, meanwhile, confessed he’d previously dismissed branding as “some kind of trickery,” but that since starting work with Ideo, he had begun “to appreciate it as its own craft” — a clarifying process, and a tool for doing good. He was fine-tuning his tedtalk, committing himself to his place on that stage.
In mid-February, Miller and a few of his board members arrived at Ideo’s San Francisco office for the same species of strategy session that Bennett had held to launch the work with After I Go. The tone of this meeting was much less rambunctious, though, and it was held in a smaller, more minimalist room around a loosely arranged circle of bare metal chairs. (I noticed no one used the word convening, either; everyone just called it a workshop.) Wooden boxes of Sharpies and brightly colored Post-its waited on a table at the back of the room. This time, it felt like something might stick.

JON MOOALLEM is a contributing writer for The New York Times Magazine.

AMY FRIEND is a Canadian artist working mainly with photography. For this series, she used a needle and projected light to hand-manipulate interventions directly onto the photographs.

JASON MADARA is a photographer based in San Francisco.



Mother sings to daughter in hospital

How many times have we heard it said that a mother should never have to bury their child, and likewise how often do we look the other way around, at children supporting parents through the hardest times of their lives? Yet, it is often the heartbreaking struggle of a parent loving a child that brings about the most beautiful moments. Case in point:

Eighteen year old Lindsey Lourenco has been battling cancer for years with her loving and supportive family by her side through it all. Even though she is in a coma, Lindsay’s dad says, “I truly believe that she can hear her mother singing and feel the love all around her. I can’t help but think that even in the most difficult and painful time of our lives, there are moments of beauty and powerful, unconditional love.”

See this touching video of love and devotion as her mother sings to Lindsey in the hospital.

Re-post from

Mom gives her daughter one last, beautiful gift

Re-posted from

Athena Krueger knew she was losing her battle with breast cancer, so the 33-year-old mom turned her focus to celebrating daughter Amari’s first birthday with the greatest tea party of all time.

“We knew things weren’t real great, and her point was, ‘If this is the only one of her birthdays I’m going to see, I want it to be grand,'” says Athena’s husband Ben Krueger, of Oak Grove, Minnesota.

Mom diagnosed with pregnancy-associated cancer dies day after daughter's first birthday
Courtesy of Stephanie Windfeldt

Athena Krueger of Oak Grove, Minn. died from cancer a day after her daughter’s first birthday. Krueger created an elaborate tea party for her daughter Amari.

Ben says his wife discovered a lump in her breast and learned of her pregnancy simultaneously, and after beginning chemotherapy at 15-weeks pregnant, delivered baby Amari via cesarean at 32 weeks.

“We always figure she’s got to be a special girl for everything Athena had to go through. She’s destined for something amazing—we just don’t know what it is yet. Someday she’s going to do it and it’s going to click,” Ben said of his daughter, who was named Amari because of its meaning: a precious miracle from God.

Mom diagnosed with pregnancy-associated cancer dies day after daughter's first birthday
Courtesy of Stephanie Windfeldt

The sign welcoming 300 guests to Amari’s Alice In Wonderland-themed birthday tea party.

After Amari’s birth, Athena underwent further chemotherapy, radiation and surgeries to fight the cancer. However, Ben says the disease spread to his wife’s lung, lymph nodes and brain, leaving her hospitalized and fighting for her life just weeks before their daughter turned one.

With the help of their family and friends, the Kruegers began planning an Alice in Wonderland-themed tea party for Amari, to be held the weekend before Amari’s birthday at their home, where Athena could be comfortable.

Mom diagnosed with pregnancy-associated cancer dies day after daughter's first birthday
Courtesy of Stephanie Windfeldt

A fancy dress up area entertained kids at the tea party.

Ben says his wife’s doctors advised against her returning home to have the party, suggesting they hold the event in a multi-purpose room within the hospital.

“We said, ‘Absolutely not. This is a big deal and we’re going to be home,'” said Ben. “They strongly disagreed, but I told them this was the way it was going to be — that they could either help me, or I would sign the forms to take Athena home without their help.”

Mom diagnosed with pregnancy-associated cancer dies day after daughter's first birthdayCourtesy of Stephanie Windfeldt

Athena Krueger of Oak Grove, Minnesota, holds daughter Amari on her lap. Amari’s name means “a precious miracle from God.”

The doctors did help, sending Athena home with hospice care and a pain pump to manage her final days comfortably.

The Kruegers held Amari’s birthday on May 2. With 300 of their family members, co-workers and friends present, the elaborate party was held under tents complete with a fancy dress-up area and elaborate place settings. Ben even dressed as the Mad Hatter — something that started as a joke.

Mom diagnosed with pregnancy-associated cancer dies day after daughter's first birthdayCourtesy of Stephanie Windfeldt

Athena and Ben Krueger watch daughter Amari taste her first birthday cake.

“That was a smart-aleck comment that backfired. I said, ‘I thought about renting a Mad Hatter costume,’ and the next thing I know, they were saying it would be delivered by the end of the week,” said Ben.

Ben says he and Athena loved the party, adding that the outpouring of support for their family touched them both.

Mom diagnosed with pregnancy-associated cancer dies day after daughter's first birthdayCourtesy of Stephanie Windfeldt

The Kruegers pose for a family portrait, with Ben Kreuger dressed as the Mad Hatter.

“It’s amazing what people do when there’s hard times — the benefit this was for Athena is huge. It sets you back and you’re so humbled by it. I can’t say thank you enough,” said Ben.

Ben told TODAY that Amari’s birthday fell on the following Tuesday. And, he believes Athena held out until she saw her daughter turn one; she died at home in his arms the following day.

Mom diagnosed with pregnancy-associated cancer dies day after daughter's first birthday
Courtesy of Stephanie Windfeldt

Amari’s lavish birthday cake and party treats.

“I’m hoping that between the pictures of this party and everything, they’ll help me teach Amari all about her mom as she grows up,” Ben said. “I don’t want her to ever forget who she is or where she came from — it’s pretty amazing.”

Time to have the Talk and plan

Re-posted from

Talking about death is such a taboo that millions leave issues unresolved when they die, says study

More than two-thirds of the population believe people in the UK feel too uncomfortable about death and dying to plan properly

Talking about dying remains such a taboo that millions of people leave their affairs in a mess when they die, a study shows.

More than two-thirds of the population believe people in the UK feel too uncomfortable about death and dying to plan properly.

While a third of people think about death and dying at least once a week the vast majority fail to set down their wishes for end-of-life care, make wills, register for organ donation or organise life insurance, a poll reveals.

It can be even harder to broach the subject of someone else’s death with just 18 per cent of adults daring to ask a family member about their “end-of-life” preferences.

The ComRes survey shows there is more willingness for people to talk of their own demise than a decade ago but that there remains deep unease and discomfort at addressing the issue, said the Dying Matters Coalition which commissioned the research.

Claire Henry, Chief Executive of the Coalition said: “We need to change the nation’s approach to dying, so that all of us become better at making our end of life wishes known and asking our loved ones about theirs.

“Talking about dying and planning ahead may not be easy, but it can help us to make the most of life and spare our loved ones from making difficult decisions on our behalf or dealing with the fallout if we haven’t got our affairs in order.”

Professor Mayur Lakhani, Chairman of the organisation which campaigns for greater openness about death, added: “There are encouraging signs that talking about dying is becoming less of a taboo than previously, but too many people are continuing to avoid facing up to their own mortality and are not putting plans in place.

“The public and health professionals alike need to become more comfortable talking about dying and discussion options for end of life care. We know that many people have strong views about their end of life wishes, but unless they talk about them and plan ahead they are unlikely to be met.”

In its poll of more than 2,000 people ComRes found that just 7 per cent of people have considered their likely demise deeply enough to have written down their wishes about care in the future when they are unable to make decisions for themselves.

Only 27 per cent said they have talked to anyone about their funeral wishes while 32 per cent have registered as organ donors, slightly higher than the 31 per cent who have taken out life assurance to provide for their families if they should die unexpectedly.

When asked how to ensure a “good death”, 33 per cent said being pain-free was the most important factor. Being with family and friends was named by 17 per cent and 13 per cent put dignity highest. A large majority – 79 per cent – agreed that quality of life was more important than longevity.

The most popular age to die at was identified as being from 81 to 90 years, an age bracket chosen by 27 per cent, while just 8 per cent wanted to get past their 100th birthday.

Seeing parents lose a child has changed what it means to be a mother

RE-posted from Helen Dickinson article in

I knew when I chose paediatrics as my career path that there would be difficult times and sometimes I don’t know how I cope

mother and daughter
‘My job is different since having children of my own. Those of a similar age to my daughter affect me more.’ Photograph: Tom Merton/Getty Images

Nothing prepares you for the first time you see a parent lose a child. The anguish and complete despair, the realisation that the most awful thing imaginable has happened and life will never be the same again. I knew when I chose pediatrics as my career path that there would be difficult times and that I would be emotionally affected, but you can’t know how you’ll cope with that situation until it happens.

I work in the emergency department of a children’s hospital, so sick children are a part of everyday life – from the coughs and colds, to the child being carried in by a running, shouting paramedic. Most fall into the first category, a minor illness or injury that is patched up, and then the patient is sent home that day or the next. If an acutely unwell child does come in, I have a job to do. I may have a moment, lasting seconds, when the reality hits me, then adrenaline and my training kick in and I do what needs to be done. It’s with the parents that I often struggle to keep my emotions in check. It’s them that have to hope, worry and deal with whatever happens.

Despite all the defense mechanisms, there will always be patients that break through, that will never be forgotten. Working in intensive care, I looked after a young girl with cancer, recently diagnosed but with a good outlook. She suddenly became very unwell and needed admission to intensive care. I spent a 12-hour shift with her and her family, arranging investigations, regularly updating her parents, but as the day went on, it became clear that she would never breathe again by herself. I was with the family as the consultant broke this news to them. As I left at the end of the day I watched her parents climb into bed with her and hold her in their arms in a very similar way to how I hold my own daughter at night. I managed to drive home, then sat in the bathroom and sobbed uncontrollably.

It is different since having children of my own. Those of a similar age to my daughter affect me more. I can’t help but visualize my own family in those circumstances. My attitude as a parent has also been influenced by my work. I refused to share a bed with our daughter and was very strict about safe sleeping methods as I have seen too many cot deaths to take any chances. I also worry about her mortality more than I presume other parents do. It affects my social life; I can’t join in conversations about a tough day at the office, especially with non-medical friends. I start to tell them about my day, then remember that talking about sick children or the death of a child is not what most people want to hear. We have debriefs at work, where we discuss certain cases and they can be very helpful to ally the automatic fear, “Could I have done anything differently?”

To me this is normal; I go to work, do my job and go home again to my family. I just get reminded more often than most that some are not so lucky.


Re-Post from Los Angeles Times writer David  Lazarus.

Undercover investigators visited 11 California funeral homes last year to make sure prices charged to grieving families were disclosed upfront, as required by federal law.

Nearly two-thirds flunked the test.

This was an eye-opening finding for Bob Achermann, executive director of the California Funeral Directors Assn.

“More than half the homes visited. I can’t believe the number is so high,” Achermann told me. “It’s kind of amazing.”

Federal Trade Commission investigators visited 100 funeral homes in six states as part of random inspections conducted annually since 1996.

More than a quarter — 27 facilities — came up short in meeting federal price-disclosure requirements, the FTC disclosed last week.

And funeral homes in California had the worst record of noncompliance. Seven of 11 randomly picked Bakersfield-area funeral homes failed to disclose prices adequately for caskets and other services.

“That was very striking,” said Lois Greisman, associate director of the FTC’s division of marketing practices. “It’s terribly disturbing.”

The agency’s report serves as a reminder that even though funeral homes play a highly sensitive role at a time when many people are at their most vulnerable, not all establishments place the interests of consumers first.

It also highlights the need for people to be familiar with their rights when it comes to decisions surrounding the death of a loved one to avoid being taken advantage of.

“There’s nothing more horrible than to go through the emotional experience of arranging a funeral and to come out with more debt than you can handle,” Greisman said.

Elsewhere, disclosure problems were found at three of 29 funeral homes visited in Westchester County, N.Y.; five of 15 homes in Seattle; five of 16 homes in northwestern Arkansas; four of 13 homes in Annapolis, Md., and three of 16 homes in St. Louis.

“There will always be bad actors in every profession,” Achermann said. “I’d like to think most members of our association follow the rules.”

The funeral industry has long been scrutinized for preying on people who, amid their grief, may not be in the best position to make wise or well-informed decisions.

Questions were raised long ago by muckraking journalist Jessica Mitford in “The American Way of Death,” her 1963 expose of methods used by funeral homes to fleece people with costly and unnecessary services.

She showed in painful and even humorous detail how funeral homes manipulated next of kin into high-priced options that constituted “a huge, macabre and expensive practical joke on the American public.”

@Mr. Lazarus. What does the unfortunate experience of Ms.Barajas have to do with the fact some funeral homes do not properly disclose prices? The best way to avoid the problems in your article is to preplan your funeral when you have time to comparison shop. Obviously not an option available…

Subsequent regulations at the federal and state levels were intended to impose much-needed standards of practice and transparency on the industry. But problems persist.

I spoke the other day with South Gate resident Evelina Barajas, 47, whose mother died last May from complications related to Alzheimer’s disease.

As Barajas was preparing for a wake, she said, a call came from Rosecrans Funeral Home in Paramount, which was holding her mother’s body.

“They said they buried my mother by mistake,” Barajas said. “They exhumed her body the next day, but they refused to say how this happened or how long she was in the ground.”

She said evidence of the body having been buried and dug up could be seen at the memorial service and that the family’s wake ended up being a traumatic experience.

Barajas is now suing the funeral home for emotional distress. A trial is scheduled for next May. A lawyer for Rosecrans declined to comment, citing privacy reasons.
The median cost of a funeral, including a metal casket, is $7,045, according to the National Funeral Directors Assn.

Roughly half of dead people in this country are buried and half are cremated. By 2030, the association estimates, 70% of the dead will be cremated. The figure already is almost that high in California.

About 86% of U.S. funeral homes are privately owned by families, individuals or closely held companies. The rest are run by publicly traded firms.

State laws relating to the funeral industry are more comprehensive than federal requirements. For example, states set casket standards and cremation procedures.

The FTC’s Funeral Rule applies primarily to ensuring that consumers receive the information they need to make informed decisions.

It requires that funeral homes clearly specify the cost of all services, which can include planning, permits, death certificate, storage of the body and coordination with the cemetery or crematory.

Funeral directors must give price information by phone if you ask for it and inform you that you can buy a casket or cremation urn elsewhere.

They must disclose that a casket can be a simple wooden box available for a few hundred dollars, rather than the thousands charged for top-of-the-line models. And they must inform clients that no casket is required for a cremation; a cardboard container will do.

California’s 1,038 licensed funeral homes are overseen by the state Cemetery and Funeral Bureau. Its rules and tips for consumers are spelled out on the bureau’s website.

“The bureau believes that an informed consumer is an empowered consumer,” said Monica Vargas, a spokeswoman for the state agency.

Vargas said the most common violations of state rules include casket prices that don’t match actual costs and failure to include all caskets on the price list.

In that latter case, I’m guessing that the less-expensive models go unmentioned unless someone thinks to ask.

It’s not the most appealing of topics, but experts say it can be very smart for people to make their own funeral plans — well ahead of their deaths, that is. That way, you ease the burden for loved ones and you have the satisfaction of knowing how you’ll shuffle off this mortal coil.

Achermann pointed out that budget-minded consumers can pick up a discount casket from Costco.

“But I wouldn’t want to do it,” he said. “I wouldn’t want to have to keep it my garage for later.”


From Eva Wiseman

Where have all the ghosts gone?

Eva Wiseman
A generation ago the nation was spooked by the Enfield Poltergeist and its tales of flying furniture and a haunted young girl… But what is scaring us now?

Hodgson family and enfield poltergeist
Hodgson family and enfield poltergeist
Fright night: the Hodgson children were at the centre of the Enfield hauntings at their home in Geen Street. ‘It’s a story about the suburbs as a site of creativity and darkness, and adolescent sexuality with nowhere to go,’ says Eva Wiseman.
In 1977, a chest of drawers slid across a room and began the best story I’ve ever heard. The Enfield Poltergeist, and the single-parent family it “haunted” for more than a year, is one of few such cases to remain unsolved – nobody has yet explained how 11-year-old Janet Hodgson flew across the room, or how the fireplace was wrenched from her bedroom wall, or how, when in trances, she spoke in the voice of the old man, Bill, who had died there years earlier. I’ve been obsessed with the Enfield Poltergeist since I was Janet’s age, so I’m excited about Sky’s reimagining and next year’s film. The story is rich with my chosen subjects: the suburbs as a site of creativity and darkness, teenage girls, and adolescent sexuality with nowhere to go, like a wasp in a glass.

There’s no such thing as ghosts, but people swear they’ve seen them. So it’s far more interesting to ask not: “Do poltergeists exist?” but instead: “What does a poltergeist stand for?”, especially when the answer is usually sex. Sex, banging on the walls and moving the bed and sending pubescent girls into fits on the carpet. “I felt used,” Janet told Channel 4, “by a force that nobody understands.”

Psychoanalysts have long been interested in the paranormal, in the idea that these experiences – the sighting of ghosts, the breaking of glasses – are projections of repressed or difficult memories. The haunted person is being haunted by her own thoughts. And if she sees a cupboard slamming in an empty room, she may not believe it was her hand that slammed it. The Enfield police officer who saw an armchair move, “unassisted, 4ft across the floor”, and the investigator Maurice Grosse who picked up marbles after they flew at him to find they were hot… were they caught in a collective hysteria? Were they lying, or scared, or confused? People see what they’re primed to see. Children abandoned by their father might seek the attention of men (like these investigators), and continue a “haunting” to keep them around.

Perhaps this makes me the worst journalist ever, but in a story about a child who thinks she’s seen a ghost it’s these detective details – sleep paralysis, vocal tricks – that I find the least interesting. I don’t want to listen to facts if facts mean pissing on wonder. The thing that I return to is the idea of a girl in turmoil. And where one person might cut herself or another get into fights outside the off-licence, this one bottled her emotions up until she flew across a room.

Teenagers are not having an easier time today. Their bodies still change too fast to keep up with, and their feelings, too. Many are bullied like Janet and her 14-year-old sister were, and live in homes like the Hodgsons’ (where in 1977 it was unusual for a woman to be bringing up four children alone). But one thing has changed. Where have all the poltergeists gone? Surely young people aren’t so at ease in their puberty, so comfortable in their sexuality and identity that they no longer repress their emotions to the extent that they believe they see ghosts. What’s the modern equivalent of an invisible spirit that breaks things with an unknown strength? Could it be catfishing, using false online identities for deception, bruising the furniture of every relationship? Is that where the ghosts are today, in the WiFi? Is that what’s making my streaming go funny?

Except there is something pure and effective in using your suppressed desires to move a whole double bed rather than to make a stranger on Facebook believe you look like Kate Upton. Real-life ghost stories offer the opportunity for a unique kind of unsureness. We know “science”, and we know “hoaxes”, but still there is something in many of us that yearns for the possibility that ghosts exist. Not as sheet-like apparitions – as unexplainable visions, mischievous movement, expressions of our guilt or frustration. As our very own special effects. Consider this column a ouija board. Summoning back our ghosts.

Email Eva at Follow Eva on Twitter @EvaWiseman

Life after death:

John had been dead about four hours before his body was brought into the funeral home. He had been relatively healthy for most of his life. He had worked his whole life on the Texas oil fields, a job that kept him physically active, and in pretty good shape. He had stopped smoking decades earlier, and drank moderate amounts of alcohol.

Lately, his family and friends had noticed that his health – and his mind – had started to falter. Then, one cold January morning, he suffered a massive heart attack, apparently triggered by other, unknown, complications, fell to the floor at home, and died almost immediately. He was just 57 years old. Now, he lay on the metal table, his body wrapped in a white linen sheet, cold and stiff to the touch, his skin purplish-grey – tell-tale signs that the early stages of decomposition were well under way.

Most of us would rather not think about what happens to our selves and loved ones after death. Most of us die natural deaths and, at least in the West, are given a traditional burial. This is a way of showing respect to the deceased, and of bringing a sense of closure to bereaved family. It also serves to slow down the decomposition process, so that family members can remember their loved one as they once were, rather than as they now are.

For others, the end is less dignified. A murderer might bury his victim in a shallow grave, or leave their body at the scene of the crime, exposed to the elements. When the body is eventually discovered, the first thing that the police detectives and forensics experts working on the case will try to establish is when death occurred. Time of death is a crucial piece of information in any murder investigation, but the many factors influencing the decomposition process can make it extremely difficult to estimate.

The sight of a rotting corpse is, for most of us, unsettling at best, and repulsive and frightening at worst, the stuff of nightmares.

Far from being ‘dead,’ however, a rotting corpse is teeming with life. A growing number of scientists view a rotting corpse as the cornerstone of a vast and complex ecosystem, which emerges soon after death and flourishes and evolves as decomposition proceeds.

We still know very little about human decay, but the growth of forensic research facilities, or ‘body farms,’ together with the availability and ever-decreasing cost of techniques such as DNA sequencing, now enables researchers to study the process in ways that were not possible just a few years ago. A better understanding of the cadaveric ecosystem – how it changes over time, and how it interacts with and alters the ecology of its wider environment – could have important applications in forensic science. It could, for example, lead to new, more accurate ways of estimating time of death, and of finding bodies that have been hidden in clandestine graves.

Decomposition begins several minutes after death, with a process called autolysis, or self-digestion. Soon after the heart stops beating, cells become deprived of oxygen, and their acidity increases as the toxic by-products of chemical reactions begin to accumulate inside them. Enzymes start to digest cell membranes and then leak out as the cells break down. This usually begins in the liver, which is enriched in enzymes, and in the brain, which has high water content; eventually, though, all other tissues and organs begin to break down in this way. Damaged blood cells spill out of broken vessels and, aided by gravity, settle in the capillaries and small veins, discolouring the skin.

Body temperature also begins to drop, until it has acclimatised to its surroundings. Then, rigor mortis – the stiffness of death – sets in, starting in the eyelids, jaw and neck muscles, before working its way into the trunk and then the limbs. In life, muscle cells contracts and relax due to the actions of two filamentous proteins, called actin and myosin, which slide along each other. After death, the cells are depleted of their energy source, and the protein filaments become locked in place. This causes the muscles to become rigid, and locks the joints.

“It might take a little bit of force to break this up,” says mortician Holly Williams, lifting John’s arm and gently bending it at the fingers, elbow and wrist. “Usually, the fresher a body is, the easier it is for me to work on.”

Williams speaks softly and has a happy-go-lucky demeanour that belies the gruesome nature of her work. Having been raised in a family-run funeral home in north Texas, and worked there all her life, she has seen and handled dead bodies on an almost daily basis since her childhood. Now 28 years old, she estimates that she has worked on something like 1,000 bodies.

Her work involves collecting recently deceased bodies from the Dallas-Fort Worth area, and sometimes beyond, and preparing them for their funeral, by washing and embalming them. Embalming involves treating the body with chemicals that slow down the decomposition process, primarily to restore it as closely as possible to its natural state before death. Williams performs this so that family and friends can view their departed loved one at the funeral. Victims of trauma and violent deaths usually need extensive facial reconstruction, a highly skilled and time-consuming task.

“Most of the people we pick up die in nursing homes,” says Williams, “but sometimes we get people who died of gunshot wounds or in a car-wreck. We might get a call to pick up someone who died alone and wasn’t found for days or weeks, and they’ll already be decomposing, which makes my work much harder.”

Human body at the funeral home

John lay on Williams’ metal table, his body wrapped in a white linen sheet, cold and stiff to the touch. Photograph: Mo Costandi

During the early stages of decomposition, the cadaveric ecosystem consists mostly of the bacteria that live in and on the human body. Our bodies host huge numbers of bacteria, with every one of its surfaces and corners providing a habitat for a specialised microbial community. By far the largest of these communities resides in the gut, which is home to trillions of bacteria of hundreds or perhaps thousands of different species.

The so-called gut microbiome is one of the hottest research topics in biology at the moment. Some researchers are convinced that gut bacteria play essential roles in human health and disease, but we still know very little about our make-up of these mysterious microbial passengers, let alone about how they might influence our bodily functions.

We know even less about what happens to the microbiome after a person dies, but pioneering research published in the past few years has provided some much needed details.

Most internal organs are devoid of microbes when we are alive. Soon after death, however, the immune system stops working, leaving them to spread throughout the body freely. This usually begins in the gut, at the junction between the small and large intestines. Left unchecked, our gut bacteria begin to digest the intestines, and then the surrounding tissues, from the inside out, using the chemical cocktail that leaks out of damaged cells as a food source. Then they invade the capillaries of the digestive system and lymph nodes, spreading first to the liver and spleen, then into the heart and brain.

Last year, forensic scientist Gulnaz Javan of Alabama State University in Montgomery and her colleagues published the very first study of what they have called the thanatomicrobiome (from thanatos, the Greek word for ‘death’).

“All of our samples came from criminal cases involving people who died by suicide, homicide, drug overdose, or in traffic accidents,” she explains. “Taking samples this way is really hard, because we have to ask the [bereaved] families to sign our consent forms. That’s a major ethical issue.”

Javan and her team took samples of liver, spleen, brain, heart, and blood from 11 cadavers, at between 20 and 240 hours after death, then used two different state-of-the-art DNA sequencing technologies, combined with bioinformatics, to analyse and compare the bacterial content of each sample.

They found that samples taken from different organs in the same cadaver were very similar to each other, but were very different from those taken from the same organs in other bodies. This may be due partly to individual differences in the composition of the microbiome of the individuals involved in the study.

The variations may also be related to differences in the period of time that had elapsed since death. An earlier study of decomposing mice had revealed that although the animals’ microbiome changes dramatically after death, it does so in a consistent and measurable way, such that the researchers were able to estimate time of death to within 3 days of a nearly 2-month period.

Javan’s study suggests that this “microbial clock” may also be ticking within the decomposing human body, too. The first bacteria they detected came from a sample of liver tissue obtained from a cadaver just 20 hours after death, but the earliest time at which bacteria were found in all samples from the same cadaver was 58 hours after death. Thus, after we die, our bacteria may spread through the body in a stereotyped way, and the timing with which they infiltrate first one internal organ and then another may provide a new way of estimating the amount of time that has elapsed since death.

“The degree of decomposition varies not only from individual to individual but also differs in different body organs,” says Javan. “Spleen, intestine, stomach and pregnant uterus are earlier to decay, but on the other hand kidney, heart and bones are later in the process.” In 2014, Javan and her colleagues secured a US$200,000 grant from the National Science Foundation to investigate further. “We will do next-generation sequencing and bioinformatics to see which organ is best for estimating [time of death] – that’s still unclear,” she says.

One thing that already seems clear, though, is that different stages of decomposition are associated with a different composition of cadaver bacteria.

Once self-digestion is under way and bacteria have started to escape from the gastrointestinal tract, putrefaction begins. This is molecular death – the break down of soft tissues even further, into gases, liquids and salts. It is already under way at the earlier stages of decomposition, but really gets going when anaerobic bacteria get in on the act.

Putrefaction is associated with a marked shift from aerobic bacterial species, which require oxygen to grow, to anaerobic ones, which do not. These then feed on the body tissues, fermenting the sugars in them to produce gaseous by-products such as methane, hydrogen sulphide and ammonia, which accumulate within the body, inflating (or ‘bloating’) the abdomen and sometimes other body parts, too.

This causes further discoloration of the body. As damaged blood cells continue to leak from disintegrating vessels, anaerobic convert haemoglobin molecules, which once carried oxygen around the body, into sulfhaemoglobin. The presence of this molecule in settled blood gives skin the marbled, greenish-black appearance characteristic of a body undergoing active decomposition.

As the gas pressure continues to build up inside the body, it causes blisters to appear all over the skin surface, and then loosening, followed by ‘slippage,’ of large sheets of skin, which remain barely attached to the deteriorating frame underneath. Eventually, the gases and liquefied tissues purge from the body, usually leaking from the anus and other orifices, and often also from ripped skin in other parts of the body. Sometimes, the pressure is so great that the abdomen bursts open.

Bloating is often used a marker for the transition between early and later stages of decomposition, and another recent study shows that this transition is characterised by a distinct shift in the composition of cadaveric bacteria.

Staff at the Southeast Texas Applied Forensic Science Facility in Huntsville, Texas.

Staff at the Southeast Texas Applied Forensic Science (STAFS) Facility in Huntsville, Texas. Left to right: Research assistant Kevin Derr, STAFS director Joan Bytheway, morbid entomologist Sybil Bucheli, and microbiologist Aaron Lynne. Photograph: Mo Costandi

The study was carried out at the Southeast Texas Applied Forensic ScienceFacility in Huntsville. Opened in 2009, the facility is located within a 247-acre area of National Forest, which is owned by the university and maintained by researchers at Sam Houston State University (SHSU). Within, a nine-acre plot of densely wooded land has been sealed off from the wider area, and further subdivided, by 10-foot-high green wire fences topped with barbed wire.

Here, scattered among the pine trees, are about a half dozen human cadavers, in various stages of decay. The two most recently placed bodies lay spread-eagled near the centre of the small enclosure, with much of their loose, grey-blue mottled skin still intact, their rib cages and pelvic bones visible between slowly putrefying flesh. A few meters away lies another cadaver, fully skeletonized, with its black, hardened skin clinging to the bones, as if it were wearing a shiny latex suit and skullcap. Further still, beyond other skeletal remains that had obviously been scattered by vultures, lay another, within a wood and wire cage, this one nearing the end of the death cycle, partly mummified and with several large, brown mushrooms growing from where an abdomen once was.

In late 2011, SHSU researchers Sibyl Bucheli and Aaron Lynne and their colleagues placed two fresh cadavers here, left them to decay under natural conditions, and then took samples of bacteria from their various parts, at the beginning and the end of the bloat stage. They then extracted bacterial DNA from the samples, and sequenced it to find that bloating is characterised by a markedshift from aerobic to anaerobic species.

As an entomologist, Bucheli is mainly interested in the insects that colonise cadavers. She regards a cadaver as a specialised habitat for various necrophagous (or ‘dead-eating’) insect species, some of which see out their entire life cycle in, on and around the body.

When a decomposing body starts to purge, it becomes fully exposed to its surroundings. At this stage, microbial and insect activity reaches its peak, and the cadaveric ecosystem really comes into its own, becoming a ‘hub’ not only for insects and microbes, but also by vultures and scavengers, as well as meat-eating animals.

Two species closely linked with decomposition are blowflies, flesh flies and their larvae. Cadavers give off a foul, sickly-sweet odour, made up of a complex cocktail of volatile compounds, whose ingredients change as decomposition progresses. Blowflies detect the smell using specialised smell receptors, then land on the cadaver and lay its eggs in orifices and open wounds.

Each fly deposits around 250 eggs, that hatch within 24 hours, giving rise to small first-stage maggots. These feed on the rotting flesh and then molt into larger maggots, which feed for several hours before molting again. After feeding some more, these yet larger, and now fattened, maggots wriggle away from the body. Then they pupate and transform into adult flies, and the cycle repeats over and again, until there’s nothing left for them to feed on.

Under the right conditions, an actively decaying body will have large numbers of stage-three maggots feeding on it. This “maggot mass” generates a lot of heat, raising the inside temperature by more than 10°C. Like penguins huddling, individual maggots within the mass are constantly on the move. But whereas penguins huddle to keep warm, maggots in the mass move around to stay cool.

Back in her office on the SHSU campus – decorated with large toy insects and a collection of Monster High dolls – Bucheli explains: “It’s a double-edged sword – if you’re always at the edge, you might get eaten by a bird, and if you’re always in the centre, you might get cooked. So they’re constantly moving from the centre to the edges and back. It’s like an eruption.”

The presence of blowflies attracts predators such as skin beetles, mites, ants, wasps, and spiders, to the cadaver, which then feed on or parasitize their eggs and larvae. Vultures and other scavengers, as well as other, large meat-eating animals, may also descend upon the body.

In the absence of scavengers though, it is the maggots that are responsible for removal of the soft tissues. Carl Linnaeus, who devised the system by which scientists name species, noted in 1767 that “three flies could consume a horse cadaver as rapidly as a lion.” Third-stage maggots will move away from a cadaver in large numbers, often following the same route. Their activity is so rigorous that their migration paths may be seen after decomposition is finished, as deep furrows in the soil emanating from the cadaver.

Given the paucity of human decomposition research, we still know very little about the insect species that colonise a cadaver. But the latest published studyfrom Bucheli’s lab suggests that they are far more diverse than we had previously imagined.

The study was led by Bucheli’s former Ph.D. student Natalie Lindgren, who placed four cadavers on the Huntsville body farm in 2009, and left them out for a whole year, during which time she returned four times a day to collect the insects that she found on them. The usual suspects were present, but Lindgren also noted four unusual insect-cadaver interactions that had never been documented before, including a scorpionfly that was found feeding on brain fluids through an autopsy wound in the scalp, and a worm found feeding on the dried skin around where the toenails had been, which was previously only known to feed on decaying wood.

Insects colonise a cadaver in successive waves, and each has its own unique life cycle. They can therefore provide information that is useful for estimating time of death, and for learning about the circumstances of death. This has led to the emerging field of forensic entomology.

“Flies will arrive at a cadaver almost immediately,” says Bucheli. “We’ll put a body out and three seconds later there’ll be flies laying eggs in the nose.”

Insects can be useful for estimating time of death of a badly decomposing body. In theory, an entomologist arriving at a crime scene can use their knowledge of insects’ life cycles to estimate the time of death. And, because many insect species have a limited geographical distribution, the presence of a given species can link a body to a certain location, or show that it has been moved from one place to another.

In practice, though, using insects to estimate time of death is fraught with difficulties. Time of death estimates based on the age of blowfly maggots found on a body are based on the assumption that flies colonised the cadaver right after death, but this is not always the case – burial can exclude insects altogether, for example, and extreme temperatures inhibit their growth or prevent it altogether.

An earlier study led by Lindgren revealed another unusual way by which blowflies might be prevented from laying eggs on a cadaver. “We made a post-mortem wound to the stomach [of a donated body] then partially buried the cadaver in a shallow grave,” says Bucheli, “but fire ants made little sponges out of dirt and used them to fill in the cut and stop up the fluid.” The ants monopolised the wound for more than a week, and then it rained. “This washed the dirt sponges out. The body began to bloat then it blew up, and at that point the flies could colonise it.”

Even if colonization does occur just after death, estimates based on insects’ age may be inaccurate for another reason. Insects are cold-blooded, and so their growth rate occurs relative to temperature rather than to the calendar. “When using insects to estimate post-mortem interval, we’re actually estimating the age of the maggot and extrapolating from that,” says Bucheli. “We measure insect birth rate by accumulated degree hours [the sum of the average hourly temperature], so if you know the temperature and the growth cycle of a fly, you can estimate the age of a fly within an hour or two.”

If not, time of death estimates based on information about insect colonization can be wildly inaccurate and misleading. Eventually, though, Bucheli believes that combining insect data with microbiology could help to make the estimates more accurate, and possibly provide other valuable information about the circumstances of death.

Every species that visits a cadaver has a unique repertoire of gut microbes, and different types of soil are likely to harbour distinct bacterial communities, the composition of which is probably determined by factors such as temperature, moisture, and the soil type and texture.

All these microbes mingle and mix within the cadaveric ecosystem. Flies that land on the cadaver will not only deposit their eggs on it, but will also take up some of the bacteria they find there, and leave some of their own. And the liquefied tissues seeping out of the body allow for the exchange of bacteria between the cadaver and the soil beneath.

When they take samples from cadavers, Bucheli and Lynne detect bacteria originating from the skin on the body and from the flies and scavengers that visit it, as well as from soil. “When a body purges, the gut bacteria start to come out, and we see a greater proportion of them outside the body,” says Lynne.

Lindgren and Bucheli found a scorpionfly, Panorpa nuptialis, feeding on brain fluids through an autopsy incision. Photograph: Natalie Lindgren

Thus, every dead body is likely have a unique microbiological signature, and this signature may change with time according to the exacting conditions of the death scene. A better understanding of the composition of these bacterial communities, the relationships between them, and how they influence each other as decomposition proceeds, could one day help forensics teams learn more about where, when and how a person died.

For instance, detecting DNA sequences known to be unique to a particular organism or soil type in a cadaver could help crime scene investigators link the body of a murder victim to a particular geographical location, or narrow down their search for clues even further, perhaps to a specific field within a given area.

“There have been several court cases where forensic entomology has really stood up and provided important pieces of the puzzle,” says Bucheli. “Bacteria might provide additional information and could become another tool to refine [time of death] estimates. I hope that in about 5 years we can start using bacterial data in trials.”

To this end, more knowledge about the human microbiome and how it changes across a person’s lifespan – and after they have died – will be crucial. Researchers are busy cataloguing the bacterial species in and on the human body, and studying how bacterial populations differ between individuals. “I would love to have a data set from life to death,” says Bucheli. “I would love to meet a donor who’d let me to take bacterial samples while they’re alive, through their death process, and while they decompose.”

A decomposing body significantly alters the chemistry of the soil beneath, causing changes that may persist for years. Purging releases nutrients into the underlying soil, and maggot migration transfers much of the energy in a body to the wider environment. Eventually, the whole process creates a ‘cadaver decomposition island,’ a highly concentrated area of organically rich soil. As well as releasing nutrients into the wider ecosystem, the cadaver also attracts other organic materials, such as dead insects and faecal matter from larger animals.

According to one estimate, an average human body consists of 50-75% and every kilogram of dry body mass eventually releases 32g of nitrogen, 10g of phosphorous, 4g of potassium, and 1g of magnesium into the soil. Initially, some of the underlying and surrounding vegetation dies off, possibly because of nitrogen toxicity, or because of antibiotics found in the body, which are secreted by insect larvae as they feed on the flesh.

Ultimately, though, decomposition is beneficial for the ecosystem – the microbial biomass within the cadaver decomposition island is greater than in other nearby areas; nematode worms also become more abundant, and plant life more diverse. Further research into how decomposing bodies alter the ecology of their surroundings may provide a new way of finding murder victims whose bodies have been buried in shallow graves.

“I was reading an article about flying drones over crop fields to see which ones would be best to plant in,” says Daniel Wescott, director of the Forensic Anthropology Center at Texas State University in San Marcos. “They were imaging with near-infrared and showed organically rich soils were a darker colour than others.”

An anthropologist specialising in skull structure, Wescott collaborates with entomologists and microbiologists to learn more about decomposition. Among his collaborators is Javan, who has been busy analysing samples of cadaver soil collected from the facility in San Marcos.

Lately, Wescott has started using a micro-CT scanner to analyse the microscopic structure of the bones that are brought back to the lab from the San Marcos body farm. He also works with computer engineers and a pilot who operates a drone and uses it to take aerial photographs of the facility.

“We’re looking at the purging fluid that comes out of decomposing bodies,” he says. “I thought if farmers can spot organically rich fields, then maybe our little drone will pick up the cadaver decomposition islands, too.”

Furthermore, grave soil analysis may eventually provide another possible way of estimating time of death. A 2008 study of the biochemical changes that take place in a cadaver decomposition island showed that the soil concentration of lipid-phosphorous leaking from a cadaver peaks at around 40 days after death, whereas those of nitrogen and extractable phosphorous peak at 72 and 100 days, respectively. With a more detailed understanding of these processes, analyses of grave soil biochemistry could one day help forensic researchers to estimate how long ago a body was placed in a hidden grave.

Another reason why estimating time of death can be extremely difficult is because the stages of decomposition do not occur discretely, but often overlap, with several taking place simultaneously, and because the rate at which it proceeds can vary widely, depending largely on temperature. Once maggot migration has ended, the cadaver enters the last stages of decay, with just the bones, and perhaps some skin, remain. These final stages of decomposition, and the transition between them, are difficult to identify, because there are far fewer observable changes than at earlier stages.

In the relentless dry heat of the Texas summer, a body left to the elements will mummify rather than decompose fully. The skin will quickly loose all of its moisture, so that it remains clinging to the bones when the process is complete.

The speed of the chemical reactions involved doubles with every 10°C rise in temperature, so a cadaver will reach the advanced stage after 16 days at an average daily temperature of 25°C, and after 80 days at an average daily temperature of 5°C.

The ancient Egyptians knew this. In the pre-dynastic period, they wrapped their dead in linen and buried them directly in the sand. The heat inhibited the activity of microbes, while burial prevented insects from reaching the bodies, and so they were extremely well preserved. Later on, they began building increasingly elaborate tombs for the dead, in order to provide even better for their afterlife, but this had the opposite of the intended effect, hastening the decomposition process, and so they invented embalming and mummification.

Morticians study the ancient Egyptian embalming method to this day. The embalmer would first wash the body of the deceased with palm wine and Nile water, remove most of the internal organs through an incision made down the left-hand side, and pack them with natron, a naturally-occurring salt mixture found throughout the Nile valley. He would use a long hook to pull the brain out through the nostrils, then cover the entire with body with natron, and leave it to dry for forty days.

Initially, the dried organs were placed into canopic jars that were buried alongside the body; later, they were wrapped in linen and returned to the body. Finally, the body itself was wrapped in multiple layers of linen, in preparation for burial.

Skeletonized human remains at the San Marcos body farm

Skeletonised human remains near the entrance to the Forensic Anthropology Center at Texas State University in San Marcos, TX. Photograph: Mo Costandi

Living in a small town, Williams has worked on many people she knew, or even grew up with – friends who overdosed, committed suicide, or died texting at the wheel. And when her mother died four years ago, Williams did some work on her, too, adding the final touches by making up her face: “I always did her hair and make-up when she was alive, so I knew how to do it just right.”

She transfers John to the prep table, removes his clothes and positions him, then takes several small bottles of embalming fluid from a wall cupboard. The fluid contains a mixture of formaldehyde, methanol and other solvents; it temporarily preserves the body’s tissues by linking cellular proteins to each other and ‘fixing’ them into place. The fluid kills bacteria and prevents them from breaking down the proteins and using them as a food source.

Williams pours the bottles’ contents into the embalming machine. The fluid comes in an array of colours, each matching a different skin tone. Williams wipes the body with a wet sponge and makes a diagonal incision just above his left collarbone. She ‘raises’ the carotid artery and subclavian vein from the neck, ties them off with pieces of string, then pushes a cannula into the artery and small tweezers into the vein to open up the vessels.

Next, she switches the machine on, pumping embalming fluid into the carotid artery and around the body. As the fluid goes in, blood pours out of the incision, flowing down along the guttered edges of the sloped metal table and into a large sink. Meanwhile, she picks up one of his limbs to massage it gently. “It takes about an hour to remove all the blood from an average-sized person and replace it with embalming fluid,” Williams says. “Blood clots can slow it down, so massaging breaks them up and helps the flow of the embalming fluid.”

Once all the blood has been replaced, she pushes an aspirator into John’s abdomen and sucks the fluids out of the body cavity, together with any urine and faeces that might still be in there. Finally, she sews up the incisions, wipes the body down a second time, sets the facial features, and re-dresses it. John is now ready for his funeral.

Embalmed bodies eventually decompose too, but exactly when, and how long it takes, depends largely on how the embalming was done, the type of casket in which the body is placed, and how it is buried. Bodies are, after all, merely forms of energy, trapped in lumps of matter waiting to be released into the wider universe. In life, our bodies expend energy keeping their countless atoms locked in highly organized configurations, staying composed.

According to the laws of thermodynamics, energy cannot be created or destroyed, only converted from one form to another, and the amount of free energy always increases. In other words, things fall apart, converting their mass to energy while doing so. Decomposition is one final, morbid reminder that all matter in the universe must follow these fundamental laws. It breaks us down, equilibrating our bodily matter with its surroundings, and recycling it so that other living things can put it to use.

Ashes to ashes, dust to dust.

Re-Posted from an article in The Guardian by Mo Costandi

Life After Mom

Re-Posted from

November 2014 marked the two year anniversary of the day I lost my brave, wonderful mum to cancer. A day you never really think will happen. But it did. And she was gone. It was a very strange kind of anniversary, if you can call it that – I wasn’t sure whether to do something to acknowledge it, or to shut myself away and wallow in my own grief…instead I chose to just go to work and get on with the day, because I really didn’t know what else to do.

Back in October 2012, when we found out that mum’s cancer had returned and this time it was terminal, the overriding question I had was ‘how long?’.  Of course, no one can ever tell you exactly long but that’s the one thing that was burning in my brain. How long have you got left? How long before you leave me? They said she had an aggressive tumour in the psoas muscle (bottom of the back/hip), which in turn had blocked the function of the kidneys. She had an operation to have stents inserted to support the her kidneys, and they thought they had caught them in time, but just six short weeks later, she was gone.

Suzanne, aged about 7 or 8, with her Mum.

I think I started grieving for mum weeks before she passed – I don’t know why, perhaps it was my way of preparing to lose her. We never really spoke about what was coming in detail; she always told us that she had to deal with it in her own way and she was so strong and brave during those last weeks. What she did tell me was that although she didn’t like what was happening, she had made her peace with it and she wasn’t scared. But then that was mum all over; strong, practical and a fighter – when life dealt her a bad hand (and she’d had her fair share of struggles in the past), she dug deep, picked herself up and carried on. I guess in her eyes this was no different.

The weeks after she died were very strange – it was like living a semi-dream state, where your heart feels the awful reality of what’s just happened, but your head carries you on. I had an 18-month-old to think of, I had work to go back to and in a very surreal way, life just goes on. Christmas came and went, and we all went through the motions as a family, not really sure what else to do.

Just eight weeks after she passed, I found out I was pregnant with my youngest son. I have no doubt in my mind that he was a gift from her, the circle of life, one-in-one-out. So the first year of life without her went by in a haze of pregnancy and I gave birth to my beautiful angel baby just 11 months after losing my mum. It was such a bittersweet day and I wish with all my heart that she could have been there.

I thought I’d be a bit of a mess in the weeks after giving birth, hormones flying all over the place and grief rearing its ugly head with a vengeance, but to my surprise, I just got through it. I think I just battened down the hatches and got on with it (sound familiar?), because, quite frankly, what else can you do? Falling apart wasn’t an option.

So here I am, two-and-a-half years later and I think the magnitude of losing mum, having a baby and all of the milestones in-between are starting to sink in. My sense of loss and missing is more acute now than it was in those early days. My heart aches when I think of how much I want to tell her, to share with her and how desperately I wish she could meet her new grandson. I hate the fact that I can’t just pick up the phone and talk to her and ask for advice. I hate the fact that my sons won’t know how wonderful their nana was. And I hate the fact that I can never fully enjoy my own Mother’s Day with the boys, because it’s always tinged with sadness.

Suzanne and her Mum, approx. 2008

Of course there are so many thing that I’m grateful for too; that I got to have her as my mother for 32 years, that she taught me to be the person I am today, that she loved me unconditionally and I grew up knowing I was truly cherished and that I belonged. Something that I will make sure my sons know as they grow up too.

I don’t know if these things get easier, all I do know is that you have to slowly come to terms with living a new kind of normal. Things will never be the same without her in my life, but I have to believe she’s still here, watching over me and making sure everything will be alright. Grief is a strange beast, and often it will creep up and overwhelm you in the blink of an eye. Allowing yourself time to feel the pain and process your loss is important – and I’m only fully realising the extent of this two-and-a-half years on.

I wasn’t even sure whether or not to write this post initially, but I’m glad I did. I guess the point of it is to mark the fact that she lived and died – to talk about her out loud and remember that I still have a mother, she’s just not here right now.

Customizing a Loved One’s Burial

From Pink Caskets to Camouflage Casket Liners: Customizing a Loved One’s Burial

From Pink Caskets to Camouflage Casket Liners: Customizing a Loved One’s BurialWhen most people plan a traditional burial during funeral plans, they do it because there is comfort to be found in the familiar. The act of saying goodbye to a loved one is something that everyone goes through at some time or another, spanning generations and cultures and even socioeconomic status. No matter what the circumstances of your loss, knowing others have gone through the same funeral planning steps you have is a good way to put your grief into perspective.

Of course, that doesn’t mean you can’t personalize a funeral. Some of the best traditions are the ones we make ourselves, and customizing burial is easier than ever before thanks to retailers offering more options in casket colors, materials, and details. For example, pink caskets are growing in popularity among female burials (or may even be purchased as part of the breast cancer awareness campaign). Offered in everything from a delicate shell to a more vibrant shade of pink, caskets like these allow you to add a touch of color and whimsy to an otherwise bleak day.

Caskets like these come in a variety of colors and materials. Both hardwoods and stainless steel options can be tinted or finished with the color of your choosing, or they can come with specialty decals or other hardware that is unique to your loved one. These are especially lovely if you’ll be having a body viewing or casket viewing prior to the service.

Other Custom Casket Options

Not everyone wants to veer too far from tradition, and that’s okay. Pink caskets aren’t for everyone, and you can add color in the form of custom casket liners or pink casket flowers instead.

Send Funeral Flowers today

Casket liners (not to be confused with burial liners, which go around the casket underground) are the bedding on which your loved one rests inside the casket. Traditionally composed of white satin or taffeta, casket liners are easy to customize. Options range from camouflage or paisley fabric (for those who want to make a statement) to higher-end silks in a range of hues.

Casket flowers also provide you with a chance to add color and personalization. The spray of funeral flowers that sits atop the casket during viewing and/or burial can be chosen to match the colors of the casket and casket liner.

How to Find a Pink Casket and Other Unique Casket Features

Not every funeral home will carry a pink casket or options in casket liners in their showroom, so be sure and ask if you’re interested in this type of personalization. Most can special-order a casket to your specifications, and you can also shop online to find what you’re looking for.

According to funeral regulations in the United States, funeral homes are required to accept caskets from third-party vendors, so there is little limit to what you can choose when it comes to burying your loved one.

Re-posted from