The Death Doula

LES SILLARS, HOST: From WORLD Radio, this is Doubletake. I’m Les Sillars.

LAUREL MARR: When I was in my late 30s, I went back to work after having been a stay at home mom …

Laurel Marr is a Christian woman in her mid 40s. She’s about five foot four with brown hair and bright green eyes.

LAUREL: And I went to work in a church.

Calvary Episcopal Church in New York City, New York. The job was parish administrator.

MUSIC: Profound Diary

MARR: … And one of the questions they asked me in my interview was, “How do you feel about cremated remains on your desk?” And I was like, “What?” And sure enough, there were often times that I did have an urn of cremated remains on my desk, because we had a funeral that afternoon.

Having human ashes on your desk might seem a bit creepy. Laurel was OK with it.

MARR:: I grew up in a family with a father who was a physician and death was a pretty normal discussion in my home. I saw my grandparents when they were dead. And so it was always just, you know, a normal thing for me.

Over the next few years Laurel often helped the rector of Calvary Episcopal with funeral planning. She worked with the families of the deceased. And she went to visit sick parishioners. She had a good bedside manner for that kind of work.

MARR: I wanted to be a nurse when I was younger, but then my life went in a different direction.

In 2019, she landed another job at All Angels Episcopal church because she had organized a funeral there and they were impressed. The priest introduced Laurel to the concept of a “death doula.” Laurel had no idea what that was. The priest wasn’t exactly clear about it either.

MARR: She said, “I don’t know much about it. But it’s kind of an up and coming trend. I think you should look into it. And see if there’s, you know, a space for a Christian to be in this role.”

Laurel came to find out that “doula” is a Greek word meaning servant or slave. “Birth doulas” have been around for decades. They help women through pregnancy and delivery. A “death doula” is a woman who serves those who are about to die. Kind of like an end-of-life coach.

MUSIC: The Slow March

Anthropologist Ernest Becker famously argued that people live their lives desperately trying to avoid or ignore their own mortality. He claimed that the primary purpose of human civilization itself is “The Denial of Death.” That was the title of his 1973 Pulitzer Prize-winning book. He wrote, “The idea of death, the fear of it, haunts the human animal like nothing else.”

But Ecclesiastes tells us that there’s a time to be born and a time to die. We control neither the day of our birth nor the day of our death. And only rarely do we ask, “What does it mean to die well?”

Today on Doubletake, the story of a death doula. A woman patrolling the line between life and death. Trying to be there for people about to cross that line. So they’re not alone. So they die well.

Here’s Emma Perley with our story.

EMMA PERLEY: After Laurel heard about death doulas she took a training course. It covered a wide range of topics. How to deal with legal issues. Refining her bedside manner. She was also stationed with real families for authentic experiences. Three months later she received a private death doula certificate from Doulagivers Institute.

Laurel’s first client was referred by a friend in New York City. A successful businesswoman. She told Laurel that her cleaning lady, a woman named Angeline from South Africa, was very ill. Angeline had been with her for eight years. Could Laurel come help?

MARR: he said, “She basically raised my children for me while she was around my house cleaning, and I owe her so much—I want her to have the best death possible . . . There’s no one here who’s a Christian and we’re choosing you because of your faith.”

The woman who hired Laurel to take care of Angeline was Jewish. Angeline herself was a Pentecostal Christian. Angeline’s cousin Faith Memani says she was a sweet person with a hopeful attitude.

FAITH MEMANI: She had, like, big beautiful eyes, a huge smile always.

And she loved fashion.

MEMANI: She was like a diva, like, her hair would always be done.

Angeline had moved to the U.S. in 2006. She worked as a cleaner and eventually married a Jamaican man. They had a little girl named Melanie. But the marriage fell apart and they divorced. If Angeline was sad about it, Faith says, she never showed it. She was always looking out for other people.

MEMANI: If we’d go shopping, she would not shop for herself. She’d look for things that would fit me.

MUSIC: Ackarina

In 2021 Angeline was diagnosed with late-stage colon cancer. It had metastasized to her spine. Her doctors said she only had two weeks to a month to live. Her daughter Melanie was eight years old. And she had no one to look after her.

In the 1800s Angeline’s predicament would have been unusual in this country. Families typically lived close together and cared for the sick and elderly in their homes until they passed.

Family members commonly washed and dressed a relative who had died. They would lay the body on a table, sometimes in a coffin, and the funeral service was basically an open house. For a few days, anyone in the community could come by to see the body. Pay their respects. Maybe sit with the family for a while. Afterward they’d bury their loved one either in the family graveyard or a local cemetery.

That’s no longer the case.

In the 1970s, terminally ill patients were neglected, both physically and mentally. People generally died in hospitals or nursing homes. Nurses nicknamed them “hopeless patients.”

BARBARA KARNES: Americans are not taking care of their dying well. They are putting him at the end of the hospital hall. And that’s kind of it.

This is Barbara Karnes. Fifty years ago, she joined a growing movement toward taking proper care of terminally ill people. Hospices provided the time-intensive support and comfort that regular nurses were too busy to provide. The idea was that no one should be alone at the end. Barbara originally started as a volunteer with a nursing degree at a hospice, then became a primary care nurse for five years.

KARNES: Those five years of working with direct patient care, all of my patients died. That taught me more than anything, because there wasn’t anything out there on how people died.

Barbara didn’t view dying people as a burden on hospital staff. She didn’t see them from a detached medical viewpoint. Instead, she saw them as children of God.

KARNES: I didn’t bring any preconceived ideas on how people die. I learned by being with them, they were my teachers. Dying is not a medical event. Dying is an emotional, communal event.

Barbara worked during the AIDS epidemic in the 1990s. Very little was known about the disease. Researchers later discovered that AIDS is spread mainly through infected blood. But at the time people worried that it was very contagious. Barbara took care of a young woman with a sickly two year-old son.

MUSIC: Smoke (alt version 3)

Her husband had already died of AIDS. And the little boy was considered “failure to thrive,” meaning that he wouldn’t survive.

KARNES: He was just gorgeous. Almost like you can see through him. He just had a light about him.

His mother died and Barbara kept in touch with the family. The little boy’s grandparents started taking care of him. Two years later, they called Barbara and said that he was dying too.

KARNES: In the weeks before he died, he ran around and he told everyone he was going to take a trip. He said, ‘I can’t live with you anymore. I’m gonna go live with my parents.’

The little boy also had AIDS. He had contracted it in utero from his mother.

KARNES: When he was dying, we held him, rocked him. And he was so beautiful. He was so beautiful.

So the disease claimed the whole family.

A few years later, in 1994, Barbara started teaching classes on end-of-life care. She wrote a booklet called Gone From My Sight that detailed the process of dying, either from old age or disease.

KARNES: People don’t die like they do in the movies. And yet, that's what people think.

The booklet showed the reality of death. It described how people sleep more, eat less, and generally decline in the last few months before death. Barbara wrote it based on her own experience with terminal patients. She noticed they all followed the same general pattern.

KARNES: What I saw was that part of my job was to not just take care of the patient, but to support and guide the family and significant others.

But fear is never truly gone.

KARNES: No matter what your belief system is, everyone is going to be afraid to some degree, when it comes time to die. We’re facing the unknown.

Barbara doesn’t think there are good deaths or bad deaths, only people who are more terrified than others. Some people let go quickly and peacefully, while others hold on.

KARNES: We go through labor to get into this world. And we go through labor to leave it. Some of us can get out of our bodies easier than others.

Since Barbara’s time in hospice care, the medical system has absorbed hospices into its bureaucracy. Hospices have become increasingly regulated. As a hospice nurse, Barbara often stayed all night with a family and patient. She had to be there at the end. Nobody knew when death would arrive. But that individual care became less practical and much more expensive as hospices standardized care and wages.

MUSIC: Georgetown Tea

So Barbara became an early proponent of “end of life doulas.” What we’re calling “death doulas.” Privately-certified helpers who walk you through the last weeks or months of your life. They’ll come to your home or facility. Work with family, doctors, and nurses to provide individual support and comfort. To help you pass peacefully.

KARNES: We’re helping grandma die at home again.

So, what does dying in a hospital really look like? How is it so different than dying at home?

KATHRYN BUTLER: So my name is Dr. Kathryn Butler. I am a retired trauma and critical care surgeon.

Kathryn worked in surgical critical care at Massachusetts General Hospital for years. She saw firsthand how end of life care is often a medical event. Not a communal one.

BUTLER: In the medicalization of death, over the last 100 years, we’ve seen a dramatic shift where it’s no longer something with which we’re familiar. And, for example, 100 years ago, 80% of people died in the home. Now that statistic is down to 30%.

Patients spend months in cancer wards, fighting for their lives. Families practically live in the hospital. But outside of the hospital room, people don’t really think about death. Not unless they have to.

BUTLER: There’s this real removal of death from everyday experience.

Kathryn says it’s partly why there’s so much anguish that comes with death. People don’t prepare. Nobody knows, really, what to do when it comes to the hard questions.

BUTLER: Seventy-five percent of us can't speak at the end of life.

In the ICU, patients are often put on ventilators or intubated. They’re invasive treatment options that usually only prolong life. They don’t help the patient fully recover. And these procedures render the person voiceless. So the family has to decide what to do. Do they prolong life . . . or end suffering? Kathryn says that’s where situations get ugly.

BUTLER: The more we talk about it, the better prepared we are to love the people for whom we’re making decisions. And also, so we can love our kin and those making the decisions for us when we can’t speak.

But according to Kathryn, the healthcare industry has made a lot of advances in recent years. Hospice care is readily available. More people are dying at home today than they were twenty years ago. And people are becoming aware of things like living wills and Advanced Directives.

MUSIC: Zen Cycle

The first training programs for death doulas appeared in the mid-2000s. About a decade later the doula industry got some helpful media coverage, including a 2015 piece in The New York Times. And then the COVID pandemic prompted another spike in interest in death.

The National End-of-Life Doula Alliance now claims about 1,300 doulas as members. That’s up from only 200 in 2019. The University of Vermont’s online doula certification program tripled recently to about 600 students, according to TIME Magazine. And many more private organizations offer certifications.

Doulas are basically filling a role that hospice used to handle. A lot of them have very personal stories about why they chose to help people who are dying. Laurel is one of those people. And this is how she helped Angeline.

MARR: Her hair was done, she had big braids, and she had big nails.

Before Laurel first walked into the hospital room, she thought Angeline would look sickly. After all, she did have late stage colon cancer. And she had just gotten off a plane from South Africa the day before.

MARR: She wanted to see her family, she’d been given the terminal diagnosis.

Now, Angeline was laying in a hospital bed in New York City with the knowledge that she would be dead in two to four weeks.

MUSIC: Messages From the Sky

MARR: I showed up and I think she was kind of just waking up, she was already on pain medication. And at that point, she was still able to get out of bed and sit up.

Laurel expected the worst when she walked through the door. But Angeline didn’t look sickly at all.

MARR: And her skin was perfect. And she was just gorgeous. And I was, I was amazed. And she had these really big eyes. And they were like, white and vibrant and clear.

When Laurel said she was a Christian doula and had come to be with her, Angeline visibly relaxed.

MARR: She looked at me, and I mean, we’re looking at each other, two mothers who were the same age. And she’s like, “I am so scared to die.”

They began to talk about her fears. Angeline talked about how Melanie was growing up and Angeline wouldn’t be there. She would never see the milestones.

MARR: She was really sweet. She was a big girl, like, mature for her age. She looks just like her mom. And, and you can really see that she’s her, her mom’s daughter.

Laurel began staying with Angeline. Her cousin Faith came to visit and the two women sat at Angeline’s bedside. They told stories and laughed together. They rubbed Angeline’s legs and feet.

MARR: Her pain was really intense in her legs, because of, with the spine and all the nerves and all of that.

They talked about what Angeline wanted her life to be like. Before the cancer. When Faith had come to the States in 2016, they had envisioned what they wanted to do. How they wanted to be a family. Faith always saw Angeline as the strong one.

MEMANI: Growing up watching her, among all of us, she was the brave one. And so the dynamic had changed. I was the one who was giving encouragement instead of receiving it from her.

MUSIC: Sad Song

Both Angeline and Faith struggled to come to grips with the fact that God had not healed her. In South Africa, spiritual healing is common, especially in Pentecostal churches. When Angeline traveled to South Africa, she underwent healing rituals from her pastor.

MEMANI: I was confident that she was going to be healed and everything.

Many are skeptical of whether divine healing happens anymore. But it was a big part of Angeline’s faith. And she felt like she suddenly had to face reality.

MARR: She was on a lot of morphine. So really, I only got a few good days with her. And during those days, we talked a lot about, you know, what it meant that God had not healed her physically.

Angeline hadn’t planned for her death at all. It was too late for her to go back home and receive hospice care. Laurel sat by her bedside constantly. Sometimes she walked into the hallway of the cancer ward and saw people doing laps. Fighting to beat cancer. But now Angeline couldn’t even get out of bed. And every day she became more scared.

Laurel became a death doula when the practice started making headlines. A 2013 viral tweet from Caitlin Doughty, a young and hip L.A. mortician, set the stage. It said: “Why are there a zillion websites and references to being sex positive and nothing for being death positive?” Her tweet started what’s known as the “death positivity” movement. Caitlin explained it on her YouTube channel:

CAITLIN DOUGHTY: Being death positive is saying, hey, we want to improve our culture. We want to have more eco-friendly death practices, we want to have better conversations around death, and nobody has to hide that.

Caitlin’s channel has almost 2 million subscribers. They’re attracted to the blunt and humorous way she talks about death, burial, cremation, and so on.

MUSIC: Time and Again

The Death Positivity movement didn’t just appear out of nowhere. It was the result of several cultural movements over the last 60 years.

Elizabeth Kübler-Ross transformed people’s view of death with her 1960 book, "On Death and Dying." She was the first to write about the 5 stages of grief.

ELIZABETH KÜBLER-ROSS: in our society, we all have become great experts on how to keep people alive. But these still do not train enough people to take care of the total patient-of their emotional, spiritual, other kind of needs and that causes the big problem.

In the early ‘70s, Ernest Becker wrote "The Denial of Death." And it had a dim view of humanity. He wrote that the sooner man realizes his death is inevitable, the sooner he realizes that he has no special cosmic place in the universe.

Then in the ‘90s, the Green Burial movement began. People started clamoring for eco-friendly burials in tranquil, sunlight-dappled forests. Home burials made a trendy comeback.

In recent decades cremation has become increasingly popular. Body burning was a pagan ritual used by the Romans. In the early church era, Christians typically buried their dead as a way to stand apart. It’s not that the Bible says anything about cremation one way or another. But early Christians wanted to affirm their belief in a bodily resurrection.

Since 2016, cremation rates actually surpass burial rates in the U.S. It’s cheaper, more efficient. But other options are available to fit your personality.

MUSIC: Perplexing Peepshow

For example, artist Jae Rhim Lee came up with the idea to turn bodies into food for fungi.

JAE RHIM LEE: The Infinity Burial Project, an alternative burial system that uses mushrooms to decompose and clean toxins and bodies . . . a burial suit infused with mushroom spores, the mushroom death suit.

You can also have your cremated remains compressed into a diamond.

REUTERS: Industry insiders are noticing shifts in how Americans honor the passing of loved ones. Many more are choosing cremation than ever before. And some are even turning those ashes into precious gems.

Then, of course, there are death cafes. People gather together and talk about death over a hot cup of tea. It’s supposed to raise awareness and prompt people to plan for the end.

ALY DICKINSON: So you’ve come here today to start doing your advanced planning for end of life?

Reporter Leah Green from The Guardian went to learn what it’s all about. Here’s a snippet of her conversation with a death doula named Aly Dickinson.

DICKINSON: What is it that you want? Who would you like to speak for you if you can’t speak for yourself? And then what do you want to happen after you die? Should we talk about funerals . . . cremation or burial?

LEAH GREEN: I think I’d be buried …

And these types of conversations sometimes happen on a much larger scale.

MUSIC: Strange Banana

Last October I attended a Death Expo in Elon, North Carolina.

I sat in the back row of a dark conference room while a video about natural burials played. The room was filled with elderly people and a couple of curious university students.

Sara Williams bounced up to the front of the room to speak. She’s the president of the National Home Funeral Alliance. Her husband joined her at the front. Together they started drawing names out of a basket for a raffle. A woman named Nancy won this prize.

SARA WILLIAMS HUSBAND: Brad Little from Carolina Quality Caskets has a miniature casket wine bottle holder. Now unfortunately it’s empty—I’d say we should have put wine in it and we just crack that sucker open after lunch.

The atmosphere was surprisingly cheery. Everyone seemed eager to learn. Quick to laugh.

The next group trooped onstage with guitars and mics. They were the Threshold Singers of the Triangle, a volunteer choir that sings to people on their deathbeds.

THRESHOLD SINGERS OF THE TRIANGLE: Water in the well, all is well. Seen and unseen, no more forgotten, there is water in the well, all is well.

These types of choirs are found in almost every state in the U.S.

Then came a panel called “Dishin’ With the Death Doulas.” This is Jane:

JANE: You’re there to hold space for the dying person. You’re not there to take on their journey. You’re not there to take on their suffering.

And Dana chipped in:

DANA: A doula can be a really helpful presence to get some perspective and to honor that the way you’re feeling is absolutely a normal response to either dying or losing someone that you love deeply.

Dana said seeing her parents die gave her perspective about her own mortality when she herself was diagnosed with an illness. The panel saw doula-ing as a sort of charitable gift to dying people.

JANE: I just feel that this service is so important. I need to make it accessible to everyone.

We broke for lunch and filed downstairs to the gym. Vendors set up folding tables to display merchandise and burial brochures. I wandered through the array of death accessories.

A table of custom burial shrouds had stacks of business cards reading, Remains to Be Seen Burial Shrouds. Someone had a hearse parked out back for tours.

People asked what I was doing there. I guess I stuck out like a sore thumb—I was one among two or three who was under the age of 60.

MUSIC: Dipping into the South

A hospital chaplain named John Connor said most people carry around a lot of regret. A lot of bitterness from broken relationships. He calls it the “end of life crisis.”

JOHN CONNOR: All of those things that most of us carry around, just because we’re normal people.

John often officiates services for people who have no one else to do it. And secular people start to get spiritual toward the end, he says.

CONNOR: We provide that spiritual care according to what gives them meaning and value and purpose.

MUSIC: Mindless Philosopher

After lunch came the death panel. Literally. The three panelists described the options available after you die. Eric Bester is a funeral director. He brought aquamation, or alkaline hydrolysis, to North Carolina in 2018. Here’s Eric.

ERIC BESTER: Some folks joke and say it’s like one last day at the spa.

Aquamation is like cremation but it uses hot water and potassium rather than fire. The alkalinity reduces the body down to its skeletal remains.

BESTER: So the skeleton becomes your ash or powder . . . a lot of folks don't realize that, it’s funny, a lot of people think that we’re going to give them a bucket of water back at the end.

Using a kind of blender, he pulverizes the dried skeleton into a fine powder. Not ash. You even get 20% more powdered remains of your loved ones back than if they had been cremated. This is supposed to be a selling point.

BESTER: My contractor in Wilmington . . . last fall, when I pulled into the parking lot, he comes out the door and he's a true beach bum—stringy hair, shriveled up tan skin. He comes out the door and he says, ‘Eric, why smoke when you can soak?’

Next up was Dianne Person to discuss donating your body for medical research. She’s the Founding Director for Elon University’s Anatomical Gift Program.

DIANNE PERSON: The Anatomical Gift program is a first person consent program so, no next of kin donations, neighbor can’t donate another neighbor …

Finally, a lady named Anne talked about her “natural burial” site in North Carolina. Natural burial is in part a reaction against the funeral industry. Natural burial enthusiasts charge that funeral homes try to sell bereaved families pointless and expensive products and services. From embalming to ornate wooden caskets.

ANNE: My grandmother and my husband’s parents were buried in better furniture than they ever had.

Natural burial is just what it sounds like. A body—which has not been embalmed—is buried in a biodegradable casket in a forest. It’s sort of ecclesiastical: from dust you came and to dust you shall return. Organic. No preservatives.

ANNE: No embalming. Because who does that serve? It doesn’t serve your body.

As the Expo finished up, I managed to catch Sara in the hallway. She’s in her 60s with short blond hair, large glasses, and a big smile. Sara describes herself as having been “obsessed with death” from an early age. She’s certified to perform marriages through American Marriage Ministries. Its website promises that you can “become a minister online now”! She likes to joke that she can marry you and bury you.

SARA WILLIAMS: I’m a cocktail party downer. “Here she comes! Go the other way! She’s gonna talk about death!” I’m like, “Get over here, have you done your Advanced Directive yet?” I mean, and you have to laugh about it.

I asked Sara what she had already planned in preparation for her death. She wants to have a natural burial. Her shroud hangs in the closet at home.

WILLIAMS:When you’re ahead of the game, think of the gift to your family when you die.

Sara isn’t a Christian. She thinks that death will be a peaceful transition into some kind of afterlife. She referenced the movie Ghost. The plot centers around a banker played by Patrick Swayze.

Swayze gets murdered, and then comes back as, you guessed it, a ghost. He spends the rest of the film trying to save his girlfriend from the same fate.

MUSIC: Unchained Melody

WILLIAMS: I’ve seen it 80 times . . . but there’s that last scene where he tells her, I mean, he's dead, but he comes back that one time and he says, “you just can’t imagine the love that’s waiting.”

EMMA PERLEY: Is that how you imagine it?

WILLIAMS: Yeah, yeah . . .

GHOST: It’s amazing, Molly. The love inside. You take it with you . . . see ya.

MOLLY: See ya.

I saw lots of people at the Expo trying to control how they died. Sure you can plan for how you want to die. What you want to happen to your body. But nobody gets to decide whether they die. It occurred to me that some people are trying to control too much. Refusing to accept the reality of what’s happening to them.

Back to Laurel Marr, our death doula. At one point in Laurel’s life, too much control almost killed her. She grew up in a Christian household, but she struggled with the idea of mercy. Specifically God’s mercy toward her. Laurel felt what she called the “shame of being a sinner.”

MARR: As early as age nine, I was already beginning to have some issues with my body.

Part of why Laurel took to the role of death doula so readily is that she understands what it feels like to die. Slowly.

MARR: By 15, I was fully anorexic.

Her body dysmorphia told her she was fat. She went from 124 lbs to 88 lbs in a year. She was 5-foot-three.

MARR: And then by 22, I was fully bulimic, and then through marriage, pregnancies, raising children . . . eating disorders fully encompassed every area of my life.

She got married in 2002, when she was 25.

MARR: Everything I did, I was in control of it. I mean, when you're in control of your food and your exercise, you control everybody.

MUSIC: If I Kiss You Where It Hurts

By the time she was 36, Laurel’s bone density was so low that she couldn’t even walk around her block anymore. Her doctor found she had osteopenia. Her bones were brittle and weak. And she was on the way to getting osteoporosis.

And that’s when she hit rock bottom. For years she had fought for control. She wanted to be perfect. To be worthy of God’s love.

MARR: The absolute disgust in myself and the shame, being ashamed. I remember thinking, like, look what I’ve done to myself.

But the trip to the doctor’s office forced her to face the facts. The question was, literally, did she want to live or die?

MARR: I had a perception of God as a taskmaster. One who was like, be perfect, be perfect, be perfect. And by the time I had moved through recovery to a certain point, it was like, oh, God’s actually a God of grace.

My eating disorders, like, sure it manifests itself in starvation, throwing up, over exercise, but really what was beneath it was, I’m gonna have my own way . . .

Control is part of facing death. That’s why we feel fear when we face the unknown. We can’t let go of the control we want to have over how we die. That’s why there are Death Expos and death cafes. People want to be prepared.

But there’s only so much we can do for ourselves. At some point, we need more than preparation. We need faith. And hope. We want to die well, if we can. And that means giving up control.

MUSIC: Ocean of Longevity

MICHAEL WITTMER: I’ve been a professor of theology at Grand Rapids Theological Seminary, which is part of Cornerstone University since 1996.

About ten years ago Michael Wittmer had a midlife crisis. He didn’t go crazy and buy a bunch of sports cars. Michael just suddenly realized his life was halfway over. He started thinking about it. A lot.

WITTMER: I’m kind of a melancholy person, I think.

At one point, he drove to Traverse City, Michigan. The city is nestled around Grand Traverse Bay on Lake Michigan. The coast is lined with golden sand and bright blue water.

WITTMER: It’s the most beautiful spot. It’s a secret. Don’t ever—don’t tell many people.

Sorry Michael.

Sitting near the waters, he reflected on the end of his life. He started reading Christian books about death, and he noticed something was wrong. They glossed over the reality of fear. They talked about death, but not the process of “getting dead.” So Michael set out to write a book himself. He called it The Last Enemy.

In his research he found that people used to care about dying well. It was a big, communal event.

WITTMER:In the past, and the Middle Ages, death was preparation to meet God. Now, death is just a matter of existential angst. I think in a modern secular culture, we have a flattened ontology—we think this life is all there is. So people’s best death is to die in your sleep, unaware and just kind of fade off into oblivion and just fade to black.

That probably sounds really familiar to you and me. If death sneaks up on us, we don’t have to face the fear. We can pretend we’re still in control.

Michael thinks we should be more aware of our death than that. Death has power.

WITTMER: First Corinthians 15:26, Paul calls death the last enemy.

In Revelation, God throws Satan into the lake of fire in hell. Before death. Death is the last thing to go. Literally. And that means something.

WITTMER: If we minimize death, if we say it’s no big deal, then we also just minimize Jesus, because Jesus came to conquer death. And if the enemy that he conquered is no big deal, neither is he. So I want to make much of death.

Michael says the same goes for the body after we die. Our culture today views our bodies as a machine. Pick what you want to do with it because in the end, it doesn’t matter. It just turns to dust anyways. The death positive movement is really all about becoming one with the earth again. Aquamation. Human composting. Natural burial. They’re all about returning to nature forever.

But Michael points out that our bodies are meant for resurrection. Bodies do matter. How we treat our bodies after death does matter. What we do with them reflects what we believe is going to happen to them.

WITTMER: This body will rise again. The Christian hope is not that I get replaced. It’s that I get redeemed, restored.

Michael says fear is real, but it doesn’t have to take over. As Christians, we can have peace. But fear isn’t unimportant either. It’s more like a balancing act. Like walking a tightrope.  Michael spoke as a pastor at a couple of Christian funerals that just got plain weird. One was a bizarre sort of celebration.

WITTMER: Her day of her death, they called it her betrothal day, like the day that she married Jesus . . . like, oh, that’s just, it’s kind of sick.

Michael said he heard of another funeral where a father walked his daughter in her casket up the aisle. As if he was giving her dead body away to marry Jesus.

WITTMER: I do think we get in really weird strange territory when even Christians try and make death and the funeral a celebration. And no one buys it. Come on.

The temptation to try and paint over the reality of death is pretty prevalent in our culture. We’re replacing funerals with “Celebrations of Life.” We put our blinders on and ignore the reality of death. That it comes for all of us.

WITTMER: When someone dies, we grieve, we lament, we don’t ever minimize it. But we also say this ain’t over. Death has not won.

There’s nothing wrong with moving on or having positive memories for a loved one. But Michael says there’s a temptation to never face our own grief. And to never prepare for our own death.

WITTMER: So I think our culture encourages people not to reflect deeply about these things. Jesus, life, ultimate matters. And so when they’re forced to, they're just not ready.

Not everyone has a choice in how they die. But we do have a choice in how we live.

MUSIC: Dreaming of Tomorrow

When Michael was at Calvin Theological Seminary in Michigan, he got a call in the middle of the night. A woman he knew was dying of bone cancer. Her husband called Michael.

WITTMER: He said, “Come over, I think Jan, she may not make the night.”

Michael rushed over to their house. Jan was lying on the couch. And Michael wasn’t sure what to say. What could he say?

WITTMER: She said, Mike, how do I do this? I've never died before. And I don’t know what . . . I just mumbled something really stupid. But then I think God, I think he gave me the words. I said, “Jan, you don't do this. Right? You've walked with Christ for more than 70 years.” You just rest. This is why you're a believer for this night. And you let him carry you home. I think that’s, that’s the good death.

Laurel Marr wasn’t exactly thinking about the definition of a good death. She just knew that Angeline was dying. And Laurel was constantly at her bedside.

MARR: It’s hard to hold on to dignity when you don’t have privacy. The end is really coming.

At one point, a woman knocked on the door.

MARR: She came by and was like, Would you guys like me to come in for music therapy? and we were like . . . music therapy? And she like, like, wheeled in her keyboard. And she had like, a binder. And I don't know, I mean, I thought it was gonna be like, pretty cheesy. And she had a little headset on. She was like, What do you want me to sing? And we're like, well, Angeline, what do you want? What do you want her to sing? And she was like, Amazing Grace.

MUSIC: Amazing Grace Keyboard

The woman had a pretty plain voice. Angeline laid in the bed, propped up on pillows, listening. And she started to cry.

MARR: I had brought her daughter, at the gift store of the hospital, this little teddy bear. For Angeline to give to her, but Angeline loved it . . . and she was holding that there. And just the tears . . . you know the words: Amazing Grace, How Sweet the Sound.

The brown stuffed teddy bear held a heart that said ‘I Love You.’ Angeline held onto it like a child.

Angeline relied on Laurel to bring her to the bathroom, to talk to her when she could, to help her with whatever she needed. They read Psalms together out of Laurel’s Book of Common Prayer. Angeline’s ex husband visited to make amends.

And they talked about organizing the funeral. Angeline said she wanted to be cremated. So Laurel got in touch with her pastor in South Africa and they planned everything.

Only a day before the end, her pastor from her home church prayed healing prayers over her. He called her other pastor in South Africa on Facetime, and he joined in too.

MARR: I remember they were praying for her and saying in the name of Jesus get up and walk in all these, like real charismatic, healing prayers.

As the pastors were praying, Laurel anointed Angeline with olive oil.

MARR: I did take on more of a priestly role than I had anticipated, but you know, doulas are not like, intended to be priests by any means. That being said, you can really function as the hands of Christ.

Angeline slipped deeper into a death coma. Her breathing became more labored. She couldn’t speak. Laurel and the pastors prayed for hours.

On Monday, January 25th, Laurel went home around 10 pm when visiting hours were over. Angeline had stopped swallowing, which was a clear sign to everyone that she might not make it through the night. At 3 a.m., Laurel got a text that woke her up. It was the woman who had hired Laurel. Angeline’s employer. She wrote: “The hospital just called. Angeline’s gone” with a heart emoji. Laurel cried.

After Angeline died, Laurel went to her funeral at Heavenly Temple Church of God in Christ, a Pentecostal church in New Jersey.

MARR: And it was a wonderful funeral. It was absolutely wonderful, was so colorful, and they had the dancers.

Faith took Melanie into her home. Angeline’s ashes were sent to her family in South Africa. After it all settled down, Laurel just missed Angeline’s presence. They had had less than 10 days together, but Laurel felt her loss.

MARR: I really came to cherish her, you know, I got enough time with her to see—like when she was coherent—wow, what a wonderful woman like, I would have wanted to be her friend.

Faith misses her too.

MEMANI: Like in our church, a lot of people respected her. A lot of people loved her because she gave love. When she walked into the room, the first thing you saw was her smile.

Laurel told Angeline all the time that she didn’t have to be afraid for Melanie. Angeline had to trust God to take care of her after she was gone. She had to give up control. And it’s not the end for Angeline either. Here’s Michael again.

WITTMER: I think it’s important for Christians to distinguish the intermediate state: when you die, your soul goes through with Jesus. Praise God. But the ultimate destiny is what happens after that. The return of Christ, resurrection, restoration.

MUSIC: With Grace

This is how doulas help people die well. Helping them through the pain. Preparing them for the end. For Laurel, it’s just being there, as a Christian doula, to help them give up control. And orient them towards Christ.

MARR: I do feel fulfilled. But here's the interesting thing is that I don’t do it to go feel fulfilled, you know, I don’t, and I do it, because I really don’t think I have that much say about it.

Laurel now lives in Charlottesville, Virginia. She moved there a few years ago after her father died. She’s been a death doula for four years now, and she recently started her own doula training program called Convene Communities.

MARR: But I can say that there’s a verse in scripture that talks about, you know, Christ going ahead of us, and preparing our steps, right.

Laurel thinks her own experience with eating disorders equipped her for this type of work. When too much control became a barrier to living well.

MARR: Well, we thought we were in control, but we’re not really in control. Because we can’t muster up anything to be able to continue on that path. And we’ve been separated from it by our own choices. And our only choice now is to trust in God.

LES SILLARS: Emma Perley reported and wrote this episode of Doubletake. Produced with the help of the creative team at WORLD Radio. I’m Les Sillars.

Next time, on Doubletake.

MARZIYEH AMIRIZADEH: My name is Marziyeh Amirizadeh and I’m originally from Iran.

They told me, “You’re not here because of your car documents. You’re here because of your Christian faith. And because we, our guards noticed that you were giving Bibles to people.”

The day that they transferred us to Evin Prison. Honestly, first of all I was, I had so much fear, I knew that, you know, that's a notorious prison.

And at that time, we were so scared.

Thanks for listening to Doubletake. Go ahead and give us a positive review and start following us. Check out some of our other episodes as well. If you’re so inclined, share this on social media and give us a shoutout. Thanks. We’ll see you next time.

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