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Ars Moriendi

Article  in  Qualitative Inquiry · December 2013

DOI: 10.1177/1077800413508541

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Grace Ann Giorgio

University of Illinois, Urbana-Champaign
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ARS  MORIENDI  

Ars  Moriendi  

Grace  Giorgio,  Ph.D.  

Department  of  Communication  

University  of  Illinois  at  Urbana-­‐Champaign  

702  S.  Wright  Street  MC-­‐456  

Urbana,  IL  61801  

giorgio@illinois.edu  

January  31,  2013  

 
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ARS  MORIENDI  

Abstract  

As  a  short  story  “Ars  Moriendi,”  the  art  of  dying,  pays  tribute  to  how  social  science  and  its  methods  such  
as  autoethnography  can  enhance  our  understanding  of  life  and  death.  Contrasting  the  limited  medical  
technologies  of  the  past  with  the  abilities  of  the  present,  this  story  once  told  to  me  by  my  father,  an  
oncologist/hematologist,  captures  the  human  element  in  the  act  of  dying.  Often,  our  culture  works  
diligently  to  treat  death  an  obstacle  to  overcome,  not  something  to  embrace  when  its  time  has  come.  
“Ars  Moriendi”  also  pays  tribute  to  my  father  and  to  the  many  medical  professionals  who  aim  to  
preserve  life,  and  yet  understand  that  death  also  needs  to  be  accepted,  artfully.    

 
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 “Autoethnography  helps  us  come  to  know  how  we  want  to  live  and  how  we  want  to  die.”  
Art  Bochner,  International  Congress  for  Qualitative  Inquiry,  May  2012.  

The  pain  running  through  the  remains  of  my  body—modulated  by  a  steady  stream  of  morphine  pouring  
into  my  left  arm,  tells  me  I  am  still  alive.  I  see  nothing  but  hear  the  mumblings  of  voices  familiar  and  
strange,  the  tone  of  fear  ringing  in  the  spaces  between  us.  I  feel  the  space,  a  heaviness  bearing  down  
upon  me,  like  sandbags  placed  on  my  arms  and  legs  so  I  won’t  float  away.  Space  encompasses  my  every  
cell—I  cannot  move,  my  breathing  is  labored,  my  mind  captured  in  the  moments  of  waiting.  It  smells  in  
here—like  a  washed  out  septic  tank,  and  dead  birds.  Oh,  how  I  remember  the  birds—each  night  we’d  sit  
on  the  porch  with  the  cats,  whose  ears  twisted  like  sonar  receptors  to  the  mocking  birds  and  brown  
thrush’s  calls.    Television  for  cats,  and  me  and  Myrna  sipping  wine,  and  enjoying  the  evening  breath—
cool  soft  breezes  –  and  then  a  sudden  shift  in  wind  and  the  pig  farm  would  make  a  brief  appearance,  a  
chance  to  go  inside  and  see  if  anyone  had  called.    

Those  nights  are  long  gone,  so  banal  and  ordinary,  and  yet  what  I  remember  most  about  living.  Now  it  is  
twilight–an  interstice  between  life  and  death.    I  never  signed  the  living  will  I  promised  myself.  I  never  
talked  about  what  I  wanted  should  I  become  a  vegetable.  Months  of  chemo,  months  of  prayer,  months  
of  experimental  drugs,  and  a  walker,  and  catheter,  and  too  many  emergency  visits  to  the  hospital.  

I  am  dying,  but  no  one  wants  to  let  me  go.  I  want  to  go.  It  is  time  but  I  cannot  tell  them.  I  am  silenced  in  
my  smothered  breath.  My  mind,  overly  active  as  always,  keeps  asking:  How  much  is  this  costing?  What  
will  be  left?  Why  won’t  the  doctors  tell  Myrna  it’s  over?  I’m  gone.  

Doctors,  I  was  never  afraid  of  doctors.  They  put  their  pants  on  one  leg  at  time  just  like  the  rest  of  us.  
And  they  belch  and  fart  and  have  sex.  My  mother  always  said  doctors  had  an  inherent  god  complex.  She  
feared  doctors.  You  always  knew  when  she  had  an  appointment  coming  up  because  her  voice  would  
deepen  with  a  deliberative  slurring  as  if  she  were  holding  onto  the  moments  that  separated  her  from  
the  dreaded  visit.  Then  her  nervousness  would  scramble  up  her  arms  to  her  neck—she’d  wrap  her  hand  
over  her  face  and  down  her  throat,  a  nervous  tick  that  got  better  once  she  got  the  proper  medication.  
Once  I  had  to  take  her  to  the  hospital  for  a  blood  pressure  reading—the  nurse  had  forgotten  to  take  it  
the  day  before  and  so  for  Mother  it  was  another  day  back  into  the  cold  corridors  of  stale  hallways  
holding  runaway  gurneys.  Oh,  that  was  a  bad  drive  and  didn’t  help  her  blood  pressure  one  iota.  Boy,  she  
hated  doctors—mostly  because  she  said  they  always  got  it  wrong.  Maybe  I  should  have  been  more  like  
her,  developing  those  ticks  and  taking  blood  pressure  medicine  instead  of  listening  for  these  months—
these  dreadful  months  of  hope  and  denial,  of  clinging  to  Myrna,  when  I  should  have  just  said  stop.  But  I  
didn’t  see  this  coming.    I  planned  a  peaceful  death  at  home,  in  Myrna’s  arms.  I  am  ready  for  her  arms  to  
put  me  to  rest.  

But  I  trusted  the  docs—for  good  reason,  first  they  had  all  sorts  of  promising  news  about  new  cancer  
drugs.  I  was  in  great  shape  for  my  age—many  of  lesser  health  and  build  had  kicked  this  beast  before.  
And  the  chemo—even  after  the  third  try,  my  scalp  rubbed  raw  and  pimpled  with  burns,  my  wrists  and  
ankles  weakened  into  wobbly  toothpicks.  And  I  liked  the  doctors.  I  wanted  them  to  like  me  back.  They  
were  so  earnest  in  their  desire  to  help  us.  Now,  I  do  know  their  voices—the  ones  with  us  from  the  
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beginning  anyway,  but  there  are  others  whose  voices  I  cannot  identify.  I  just  know  I  am  getting  the  best  
care  the  medical  world  has  to  offer.    Much  better  than  what  was  available  fifty    years  ago...fifty    years  
ago.  

A  young  doc—Italian,  small  build  and  trim,  moved  like  a  penguin  on  diet  pills,  fast  and  anxious.    Dr.  G  
defied  my  mother’s  belief  system.  He  was  not  a  god.  He  had  to  ask  permission  of  his  supervisor,  the  
head  doc,  before  changing  Elizabeth’s  medication.  I  never  told  Myrna  the  whole  story.  She  knows  about  
Elizabeth.  On  our  second  date,  I  told  her  the  story:  that  I  had  not  been  ready  to  meet  a  girl,  but  
Benjamin  insisted.  He  had  a  new  girl  himself  after  Shirley  broke  up  with  him  so  cruelly,  dumped  him  in  
the  dumpster  like  a  dead  mouse,  but  he  rebounded  agilely.  Wasn’t  going  to  let  some  dame  ruin  his  
manliness—he  went  straight  out,  ready  to  conquer  the  world.  We  were  working  men—our  high  school  
diplomas  good  enough  for  us  to  get  good  paying  jobs  at  the  plant.  His  new  interest  would  not  go  out  
alone—did  I  mention  we  were  Mormons?—if  he  wanted  to  see  her  it  had  to  be  a  double  date.  He  knew  
just  the  right  guy  for  it,  me,  the  nice  guy  who  sang  in  choir  and  ran  the  fuel  station.  I  knew  of  Elizabeth  
from  church,  but  it  was  a  large  one,  filled  with  many  pretty  girls.    

We  picked  the  girls  up  in  Benjamin’s  Plymouth,  a  smooth,  forest-­‐green,  bodacious  body  with  cream  
lined  fins,  matching  off-­‐white  leather  interior,  and  no  seat  belts  back  then.  That  was  fun  for  us.  When  
we  went  around  a  bend  your  girl  would  slide  into  your  lap—her  satin  dress  and  stockings  so  slippery!  
Sometimes  Benjamin  and  I  did  it  on  purpose—that  is  take  wild  turns  just  to  get  a  good  fun  laugh.  We  
were  innocent  though.  With  the  exception  of  a  good  night  kiss  on  the  cheek,  leather  sliding  was  as  close  
as  we  got  to  necking  until  engagement  rings  landed  on  fingers.  

Elizabeth  was  stunning  that  first  night.  I  thought  I  was  only  doing  my  buddy  a  favor—joining  him  on  a  
double  date  so  he  could  get  over  that  bitch.  Yes,  Mormons  swear  on  occasion  even  the  pious  ones  like  
me  back  then.  She  came  out  of  her  house  wearing  a  pink  tunic-­‐like  dress—silky  and  smooth  around  the  
waist.  Her  red  hair  piled  high  on  her  head—I  later  learned  it  was  a  hair  piece,  a  deception  I  never  
minded  and  even  complied  with  once  she  was  in  the  hospital  herself.  We  went  for  ice  cream  and  a  
movie  that  night.    I  don’t  recall  much  about  Benjamin’s  girl—she  was  pretty  for  sure,  but  I  could  not  take  
my  eyes  off  of  Elizabeth.  I  believed  I  had  found  the  girl  I  would  marry.  Six  months  later,  we  were  
engaged.  

Just  when  life  gives  you  its  finest  gifts,  the  devil  comes  out  to  take  them  away.  Elizabeth  and  I  hadn’t  
been  engaged  for  three  months  when  she  started  feeling  ill.  Her  face  lost  color  and  her  weight  dropped  
precipitously.  After  weeks  of  tests,  she  was  sent  to  the  oncologist,  a  hematologist,  a  resident  in  Salt  
Lake,  Dr.  G.  who  solemnly  told  us  it  was  cancer,  leukemia,  a  rare  and  incurable  form—one  that  Dr.  G  
understood  well  from  his  graduate  work  in  the  East  Coast.    Dr.  G  was  a  smart  guy.  Unlike  the  other  docs,  
he  had  an  M.D.  and  a  Ph.D.  He  was  young,  knowledgeable,  and  studious.  He  admitted  Elizabeth  to  the  
hospital  that  week  where  more  tests  could  be  done  and  her  situation  monitored.  I  visited  her  every  day,  
all  day—her  condition  worsening  by  the  moment.  Even  though  we  weren’t  married,  Dr.  G  consulted  
with  me  privately,  telling  me  soberly  that  Elizabeth  had  very  few  weeks  to  live.  There  is  nothing  we  can  
do,  he  said.  Back  then  there  was  nothing  docs  could  do,  but  now,  they  do  everything:  tests,  
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experimental  drugs;  multiple  chemo  sessions.  The  doc  encouraged  me  to  visit  every  day.  He  told  me  she  
improved  at  least  on  the  surface  during  the  visits.  

One  day  I  drove  up  in  a  new  car.  I  had  saved  my  money  for  the  house  Elizabeth  and  I  would  own,  but  
couldn’t  imagine  living  in  a  house  alone.  I  used  the  money  for  a  down  payment  on  a  convertible,  a  
sporty  red  MG  Midget—an  original.  You  had  to  roll  down  the  windows  to  open  the  doors  from  inside.  If  
Elizabeth  couldn’t  have  a  home,  a  family,  and  me,  I  could  at  least  take  her  for  a  drive  in  our  car.  And  she  
would  know  it  was  hers.  I  walked  into  the  doc’s  office  and  asked  where  I  could  find  him.  He  was  making  
rounds.  I  found  him  on  the  second  floor  in  the  children’s  unit.    

Doc,  I  asked,  I  have  a  special  favor  to  ask  of  you.      

Sure,  sure,  Earnest,  what  can  I  do  for  you?    

Doc,  I  bought  a  convertible  and  I  want  to  take  my  girl  for  a  spin.  Can  you  release  her?    

The  doc’s  eyes  sparkled  with  the  excitement  that  comes  from  making  decisions  about  such  unexpected  
requests.  I  pulled  him  to  the  window  and  showed  him  the  car.  Dr.  G  was  impressed,  I  could  tell,  by  how  
long  he  stayed  at  the  window.  

Nice  car.  

Elizabeth  would  love  to  take  a  ride,  I  said.    

Doc  placed  his  hand  on  my  shoulder  and  said  very  kindly,  I  think  that  is  a  very  good  idea.    I’ll  release  her  
when  I  finish  the  rounds.  Go  get  her  some  flowers  and  pack  a  picnic.  I’ll  have  a  nurse  get  her  dressed.    

In  an  hour  I  walked  into  her  room  and  found  her  in  the  same  pink  dress  that  she  wore  on  our  first  date.  
That  double  date.    She  was  still  pretty,  pretty  in  pink,  though  her  skin  so  sheer  I  could  see  her  blood  
vessels  and  the  texture  of  her  cheekbones.  

We  took  a  spin.  I  drove  her  to  the  lake,  where  we  unpacked  our  lunch  and  sipped  grape  juice  and  held  
hands.  She  asked  me  if  I  would  swim  for  her.  She  could  not  do  that  but  she  wanted  to  take  pleasure  in  
the  water  if  vicariously  through  me.  I  took  off  my  suit  behind  a  tree  and  emerged  in  my  long  underwear,  
ready  to  take  a  dive.  Before  me  she  lay  naked  on  the  checkered  blanket;  her  once  plump  breasts  that  I  
had  never  seen,  never  touched,  resting  on  her  chest—her  long  thin  legs  stretched  out,  her  delicate  feet  
revealing  red  toenail  polish.  Elizabeth  had  beautiful  feet.    

She  reached  her  arms  for  me  and  asked  me  to  make  love  to  her—she  wanted  to  know  me  carnally;  she  
wanted  to  know  what  love  felt  like  on  her  skin.  

Not  to  worry,  she  said,  if  I  get  pregnant  I  won’t  live  long  enough  to  have  the  baby.    

I  removed  the  last  of  my  modest  clothing,  drawing  a  puckered  smile  from  her  lips.  I  sat  next  to  her  and  
kissed  her,  on  her  cheek,  her  forehead;  her  hands.  When  she  opened  her  mouth  to  mine,  my  
nervousness  disappeared  and  I  poured  my  body  and  soul  into  hers.  We  did  not  make  it  back  to  the  
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hospital  until  nightfall.  I  tucked  her  in  that  night  and  slept  by  her  side  on  a  chair.  In  the  morning  she  was  
gone.  

That’s  the  part  I  never  told  Myrna—I  feared  she’d  think  I  loved  Elizabeth  more  than  her—but  it  was  not  
more,  just  different.  Like  the  medical  care  back  then—that  love  was  innocent  and  untested.  That  care  let  
the  dying  die.  Dr.  G  knew  Elizabeth  had  little  time  left.  When  he  saw  the  little  MG,  he  knew  I  was  hoping  
to  make  love  to  her.  And  when  we  came  back,  he  was  still  there  even  though  his  shift  should  have  been  
over.  Tinkering  around  the  nurse’s  station,  he  smiled  at  us  as  we  walked  in.    

After  the  funeral,  I  asked  to  see  him.  When  we  spoke  he  said,  “My  supervisor  said  we  did  the  right  thing  
for  her.”  We  shook  hands  and  departed  somberly.  I  like  doctors,  even  these  ones,  though  I  wish  I  could  
talk  to  them  like  I  could  with  Dr.  G.  

Tears  fill  my  eyes—eyes  that  only  see  the  past.  My  ears,  though,  hear  the  frantic  voices  filling  the  room.    

Please  God,  tell  them  to  let  me  go.  I  am  ready  to  die.            

Epilogue    

Autoethnography,  the  rendering  our  lived  experiences—words  spoken  and  unspoken,  emotions  
expressed  and  forbidden—into  stories,  allows  for  meaning-­‐making.  Art  Bochner  asks:  Why  does  the  
story  matter?  Social  science,  he  suggests,  shows  us  how  science  and  its  technologies  make  our  lifespans  
easier;  he  further  argues  that  social  science  and  its  methods  such  as  autoethnography  can  help  us  make  
sense  of  dying.  “Ars  Moriendi”  pays  tribute  to  these  ideas,  showing  medical  technology,  despite  its  
amazing  abilities,  making  death  quite  difficult  in  contrast  to  a  time  when  medical  outcomes  were  
limited,  too  often  with  tragedy  and  loss  of  young  life.  

“Ars  Moriendi”  also  pays  tribute  to  my  father,  Dr.  G,  an  oncologist/hematologist,  who  after  a  childhood  
hunting  trip  in  which  he  killed  a  squirrel,  realized  he  wanted  to  preserve  life,  not  end  it.  A  few  years  ago,  
he  told  me  the  story  of  “a  case  I’ll  never  forget.  I  had  a  patient,  a  woman;  young,  mid-­‐twenties  with  full  
leukemia.  She  was  going  to  die  and  I  knew  this.  My  supervisor  knew  this.  Her  fiancé  knew,  too.  There  
was  nothing  we  could  do  for  her.  These  days  we  could  have  done  something;  young  people  aren’t  dying  
so  easily,  as  we  have  some  wonderful  drugs  and  treatments,  but  back  then,  fifty  years  ago—a  young  
person  would  just  as  easily  die  as  be  diagnosed.”  

Not  long  after  my  father  told  me  this  story,  I  came  across  a  moving  New  Yorker  piece  on  the  lost  art  of  
dying,  “Letting  Go”  (2010)  in  which  the  Atul  Gawande,  a  medical  doctor,  contemplates  how  our  current  
medical  system  with  its  experimental  drugs  and  high-­‐tech  equipment  denies  many  of  us  peaceful,  even  
artful  deaths.  The  article  contrasts  the  standard  and  ingrained  scientific  approach  of  preserving  life  no  
matter  the  costs  with  the  less  accepted  but  more  humane  treatment  of  hospice  care.  Painting  a  picture  
of  death  rites  denied,  Gawande  writes  of  “ars  moriendi,”  the  art  of  dying,  “For  all  but  our  most  recent  
history,  dying  was  a  typically  brief  process”  and  “used  to  be  accompanied  by  a  prescribed  set  of  
customs…Reaffirming  one’s  faith,  repenting  one’s  sins,  letting  go  of  one’s  worldly  possessions  and  
desires  were  crucial,  and  guides  provided  families  with  prayers  and  questions  for  the  dying  in  order  to  
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ARS  MORIENDI  

put  them  in  the  right  frame  of  mind  during  their  final  hours.  Last  words  came  to  hold  a  particular  place  
of  reverence”  (2010,  pg.  39).    

Death  as  a  process  was  acknowledged  and  accepted  as  a  part  of  the  life  cycle,  not  something  to  be  
resisted  when  the  inevitable  became  so  painful  that  the  dying  still  clung  to  life  with  false  hope.  Given  
our  medical  technology  and  the  specialized  training  of  our  medical  professionals,  our  culture  works  
diligently  to  treat  death  as  an  obstacle  to  overcome,  not  as  something  to  embrace  when  its  time  has  
come.  In  our  efforts  to  overcome  the  inevitable,  hope,  possibly  better  described  as  “uncertainty,”  guides  
us.  While  hope  feeds  the  spirit,  it  can  deceive.  Centuries  of  experience,  tradition,  and  language  about  
our  mortality  lost,  we  have  created  a  new  difficulty  for  human  kind:  How  to  die.  We  die  only  once.      

Autoethnographic  writing,  I  believe,  allows  us  to  capture  the  essence  of  lived  experience,  including  the  
lost  art  of  dying.  According  to  Bochner,  when  social  science  aspires  for  truth,  emotional  dialogue  and  
collaborations  concerned  with  better  living  and  not  just  science  produce  better  understandings  and  
compassion.  In  autoethnography,  the  truth  exists  between  the  storyteller  and  the  reader;  together  we  
can  face  up  to  life’s  challenges,  to  speak  to  our  fellow  sufferers.  Reflection  is  at  the  heart  of  
autoethnography;  we  tell  stories  of  trouble  and  in  need  of  understanding,  such  as  how  do  we  die  artfully  
in  a  world  of  science  that  aims  to  prolong  life  when  life  is  no  longer  able  to  persist  on  its  own.  

See:  

Gawande,  A.  (Aug  2,  2010).  Letting  go:  Rethinking  the  end-­‐of-­‐life-­‐treatment.  New  Yorker.  

http://well.blogs.nytimes.com/2012/06/18/mapping-­‐your-­‐end-­‐of-­‐life-­‐choices/?src=me&ref=general  

   

         

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