Dying for an answer

A dam collapsed in Logan, WV, on this day in 1972, flooding a valley and killing 118 people. Another 4,000 were left homeless.

"What is the appropriate behavior for a man or a woman in the midst of this world, where each person is clinging to his piece of debris? What is the proper salutation between people as they pass each other in this flood?" -- Buddha. 

An article in the New Yorker some years back was entitled “Final Forms:What death certificates can tell us, and what they can’t.” What our death certificate can tell someone, unequivocally, is that we are, indeed, dead (not always a precondition for burial, in times gone by). What it cannot tell, with any finality, is why we die.

“Every dead body is a mystery,” said author Kathryn Schulz. “Death is an assassin with infinite aliases, and the question of what kills us is tremendously complex.” As with any other complex matter, we have developed a bureaucracy to address it–or to obfuscate it–and, by Schulz’s reckoning, “The atomic unit of that bureaucracy is the death certificate.” As a means to come to terms with our mortality, the death certificate is, in Schulz’s elegant phrase, “the saddest of diplomas, the most mysterious of passports.”

The death certificate stands for our notion that every death means something, and should be accounted for. It also represents our attempt to explain death, by documenting it.

Keeping track of the dead is a relatively new endeavor. The death certificate was an innovation of 16^th-century England, in the form of a document known as a Bill of Mortality. “Early states,” Schulz pointed out, “had neither the means nor the motive to track individual deaths–or, for that matter, Individual anything.”   

The motive arose in large part because of the Black Plague, which made death a public concern, and the means followed, as states began to mandate the recording of deaths.

With the rise of democracies, the death certificate took on the aspect of a personal ID. As Schulz noted, “The flip side of democracy is bureaucracy: if everyone counts, everyone must be counted.”

But the imperative to account for every death was marred, inevitably, by imprecision, where the cause of death was uncertain and those charged with the recording of deaths were overwhelmed or unqualified. Today the task of filling out death certificates is often foisted on medical interns or residents, and Schulz quoted one who compared it to “filling out your own taxes. Shouldn’t I be smart enough to know how to do this?” The comparison is an apt one: the official book on causes of mortality is as dreary and byzantine as the IRS tax manual, and lists over 8,000 ways to die.

Even when it is as accurate as mortal hands and minds can make it, the death certificate can still never answer the question, Why do we die? All we can do is guess, and say, as Schulz did, with cheerful resignation: “We die because we were born; because we are mortal; because that is, after all, life.”