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May 24, 2024 18 mins

George Noory and death doula Alua Arthur discuss why people need to reexamine the dying process, the importance of making healthcare arrangements before the final moments, and how contemplating death can help you live a more authentic, fulfilling life.

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Speaker 1 (00:00):
Now here's a highlight from Coast to Coast am on iHeartRadio.

Speaker 2 (00:05):
And welcome back to Coast to Coast George Nori with
you as the most visible death dula working in America today,
and we'll tell you what that means in a moment.
Alewa Arthur is a seeker or recovering attorney and the
founder of Going with Grace, a death duela training and
end of life planning organization. She has spent thousands of
hours with folks as they contemplate their mortality, when regrets,

(00:30):
secret joys, hidden affairs, and dim realities are finally revealed aloud.
Her website is Going with Grace dot com. Her latest
book is Briefly Perfectly Human. Hellua, welcome to the program.

Speaker 3 (00:44):
Thank you so much for having me.

Speaker 2 (00:45):
Looking forward to this fascinating now I know. Dulham is
a person who assists women who are having babies. But
you're a death dula. What is that?

Speaker 3 (00:57):
It's the same thing, but just on the other side,
if you can have it so. Essentially, a death doula
is a supportive person who does all of the non
medical and holistic Karen support of the dying person and
the circle of support through the entire process. And when
I say dying person, I mean anybody who has come
into awareness of their mortality. So we can also work

(01:19):
with healthy people when they want to do some comprehensive
end of life planning or work through their fears of death.
When people know what it is that they're going to
be dying of or they have a diagnosis, we can
support them in creating the most ideal death for themselves
under the circumstances. And then after a death, we can
help family members wrap up affairs of their loved one's life.
We're doing all the emotional, spiritual, and practical support of

(01:42):
dying essentially.

Speaker 2 (01:44):
How did you get involved in this?

Speaker 3 (01:47):
Well, quite a process, you know. Not many people choose
to go into death work. Rather they say that deathwork
chooses you. About eleven years ago, I was practicing law
at the Legal Aid Foundation of Los Angeles in domestic
violence and Consumer Economic Development department. And I grew really
terribly depressed, clinically depressed, and I took a medical leave

(02:09):
of absence where I went to Cuba, and I met
a fellow traveler on the bus who had uterine cancer.
We spent a lot of time talking about her life
and then her death. We spent fourteen hours on that
bus ride together, and during that ride it became abundantly
clear to me that she didn't have very many people
to be in a conversation about mortality with, because when

(02:31):
she would mention death since she was ill, people would
tell her to focus on hope or healing instead. And
I can understand that impulse, and yet it meant that
she was alone in her questions and her considerations around dying.
It made me really sad that she was so alone
in it, and also to open my eyes to the
power of our mortality to help us get clear on

(02:51):
the type of life that we want to lead. When
I came back from Cuba, my brother in law became sick,
Peter Saint John was his name, and I got to
support him through the last two months of his life.
And I saw firsthand, partially what I'd witnessed in Cuba
with this beautiful, strange, right now friend on the bus,
but the reality for thousands of people in the medical

(03:13):
care system who are dying from illness, My heart.

Speaker 2 (03:16):
What got you so depressed in the first place?

Speaker 3 (03:19):
What got me?

Speaker 2 (03:19):
What was the question so depressed in the first place?

Speaker 3 (03:23):
Well, I think I was living a life that was
inauthentic to me. I'd been trying to squeeze myself into
this perfect little lawyer box, knowing that it wasn't really
a fit for my personality. I got really run down
by the system, kept butting up against the systems of
oppression that seemed to keep the people in the positions
that they were in, and there seemed to be no
hope for healing or recovery or getting out of the system.

(03:46):
And also I just wasn't able to use the parts
of myself that I really value, like my sensitivity and
my pension for the absurd, and wanting to play around
in the murky interesting parts of human existence and not
just tick boxes on forms and argue in court about
what was right. I wanted to argue about what was
just and said.

Speaker 2 (04:05):
I got the emails from a lot of high school
friends last week because one of our high school friends
passed away, and it kind of looks at your own
mortality when people that are your age go. But how
many people really understand the dying process of all?

Speaker 3 (04:26):
Not a lot of people. Certainly you don't have to
learn until you're in it yourself or somebody that you
care for deeply and you are probably doing some caregiving
for are in it. And then you learn far more
than you ever wanted to. You learn the signs of dying,
all about the medicines and how they're administered, and how
to talk to doctors rather, how to get your questions

(04:48):
answered or not. You learn about hospital gowns and how
much the cough drop costs. And you learn so much
about the process that is quite overwhelming when you're also
dealing with the heavily most toll of the potential of
somebody's death. So it's intense.

Speaker 2 (05:04):
What does society get wrong about the dying process?

Speaker 3 (05:07):
Oh boy, where do I begin? Well, for starters, we've
learned so much about the dying process from the media,
and I think many of us have this vision of
somebody who looks like they did much when they were healthy,
who is laying on this bed hooked up to some machines,
and they're maybe talking and laughing and maybe eating, and

(05:29):
then they get kind of quiet, and then they cross
their arms over their chests and then they drift off
to whatever comes next, if anything at all. But the
reality is a much more involved and intense process, and
that and dying off when happens really in a nonlinear fashion.
I'd say, where folks are grappling with the ups and

(05:51):
downs of illness and of grief as they are leaving
behind everybody that they've ever known and loved, and we
are weaving the that we love. Who's dying.

Speaker 2 (06:02):
My mother's going to be ninety five next week. Wow,
And she talks about death and what it is. But
I think when she talks about it, it gives her
a better understanding of living her current life more fully.

Speaker 3 (06:15):
What do you think I think your mom's got it
down in her ninety five years. She certainly picked up
something really powerful she did, and that's yeah, that's available
to all of us all the time. We don't have
to be elderly or dealing with the serious illness to
get to the point where we can start thinking about
our death and use it to inform how we live currently.

Speaker 2 (06:35):
What's the proper way of end of life planning.

Speaker 3 (06:39):
There's a number of things that we really need to
keep in mind. I'd say any place that somebody finds
the entry is a great place to begin. But there
are a few key things that we really need to
keep in mind when preparing for the end of life.
For starters, everybody, everybody, everybody should complete an advance directive.
That's a document that's made up of two parts. A
medical power of a turn me somebody who can make

(07:01):
your decisions for you in the event that you can't,
and a document that lays out your desires for life
support and how you want to be treated at the
end of life. These are wildly important documents that everybody
over the age of eighteen should be considering and filling
out and having big conversations about, because it's the people
that we love that really need to know these decisions
that we're making.

Speaker 2 (07:22):
I've given my two daughters and son that kind of document,
and I basically said, I don't want to be on
the licenustaining support on and on and on and on.
Pull the plug.

Speaker 3 (07:37):
Yeah, thank you for that. I think your children will
appreciate it at some point, and me, as a death doula,
definitely appreciates it. So thanks for doing that. Well.

Speaker 2 (07:45):
At least that way, they don't have to make that decision.

Speaker 3 (07:49):
Exactly when they're in the midst of a really emotionally
dense time. There's so much going on, you know, when
it's nearing the end of your life, and provided, let's
say one of these documents comes into play, your desires
already laid out, and while the situation may not look
like something that you could have imagined beforehand, they at
least have a set of principles through which to view

(08:11):
their decision, or through which to make it. That's wildly supportive.
Thank you, Thank you.

Speaker 2 (08:16):
Tell me about the title of your book, Briefly Perfectly Human.

Speaker 3 (08:20):
Well, the title was a hard fought one. The book
had been done for a while and I just con't
figure out what to call it. And I was thinking
about how all of us live these very brief lives.
When we're in them and they feel like they're going
on for forever. We all understand that our time here
is finite in some capacity, whether or not we're aware
to that fact. The Perfectly Portioned seems to be really

(08:42):
keen on us viewing our lives without thinking about what
they should have been, but rather exactly what they were.
I find that many people, as they get close to
the end of their lives, have to reconcile the life
that they thought that they should have had or could
have had with the one that they actually have is
to invite us all to think of our lives as

(09:02):
we live them as absolutely perfect as they were, And
of course the human part just hearkens back to the
idea that none of us know what we're doing. Really,
we're all on this really weird why ride, and we
have a whole host of human emotions and experiences, and
we're all doing our best to try to figure it
out as we go along.

Speaker 2 (09:23):
How often have you been at the bedside of the dying.

Speaker 3 (09:26):
A bunch at this point. It's kind of hard to say,
because there's certainly been clients that have you know, had
me Johnny with them for years, and some that I
talked to a few days before they die, So it's
been quite a few at this point.

Speaker 2 (09:44):
Explain to us of Uchanalua what should like to die?
I mean, what process did they go through?

Speaker 3 (09:52):
Well, George, I wish I knew that, But since I'm
still here in this body talking, not facing serious illness myself,
it's hard to say. Yet. I can point to some
signs that I've witnessed that make it look as though
dying is approaching, which is that the dying person often
disengages from the world around them, they may fall unconscious,

(10:14):
or they may go very quiet. They sleep for a
long periods of time, their skin starts to change appearance.
It's called modeling of the skin. When it creates this
like web like appearance that can be seen on both
fair people and darker skinned people. The tips of their
nose and fingertips toes might turn like a bluish hue

(10:38):
urine output gets much darker. The body starts to shink
in is the best way I can describe it. Where
As a body is either holding onto fluid or ridding
itself with it, these a body starts to take on
an appearance that is not much like the person when
they were vital and healthy, but rather it looks so

(11:00):
like dying is occurring. There's the best way I can
describe it. That's what I've been able to witness. I
notice also that people often before they get to the
point where they're unconscious, really start to think of their
lives in the big picture and start to that process
of reconciliation that I was talking about earlier.

Speaker 2 (11:17):
Are they uncomfortable? Is it uncomfortable for them? The dying process?

Speaker 3 (11:25):
It can be, And gratefully we have hospices that are
spectacular at handling pain and offering medication for any physical
symptoms that are uncomfortable. But I'd also say that it
can be emotionally uncomfortable as well. And recognizing that you're
soon leaving the only place that you've known with your
conscious mind at least, and the only place you've ever

(11:48):
really lived, it can be difficult. For sure.

Speaker 2 (11:50):
Do you believe in the hereafter?

Speaker 3 (11:53):
I'm not sure. I spent a lot of time thinking
about it and talking about it with my clients to
get them clear on what their ideas are. My job
is to remain as neutral as possible for their experience
so that I can help them get clear on what
they believe, because they will soon find out.

Speaker 2 (12:08):
What is the strangest visitation you've witnessed?

Speaker 3 (12:13):
Where visitation?

Speaker 2 (12:15):
Yeah, where maybe something is on the other side. Did
you ever see anything that might help convince you that
it exists?

Speaker 3 (12:25):
I can't take convinced, but I have seen folks. Well,
there's one client I want to tell you a story about.
She had had dementia for quite a few years. I've
been journeying with her for a couple of years at
the time this happened, and she had stopped using sentences.
She wasn't even really saying words anymore. She's using more
syllables and sounds when she spoke. And she had a

(12:47):
respiratory event and was bedridden from that point forward. One
day her daughter stepped out of the room and it
was just her and Eye for a moment. She had
been asleep, and she you know, started to raise her
torso up off the bed and started grabbing at something,
trying to hold onto something up up in the ceiling.

(13:08):
And she says in forwards and sentences that I could understand, Hubert,
help me, Hubert, help me. You know, I can't do this.
Hubert help me. And I thought, oh, that's interesting. But
she's laid back down and then you know, went back
to sleep. When her daughter came back, I told her
what her mother had said. And the daughter was shocked

(13:31):
because Hubert was her mom's boyfriend that had died in
a motorcycle accident when she was seventeen. Yeah, daughter had
never met Hubert before. And also as mom was speaking,
you know, she had this very teenage coy girl thing
about her, like help me. You know, I don't know
how to do this. It was it was a you know,

(13:52):
nobody knows what it could be there, either hallucinations or
a link to another dimension that those of us that
don't carry that gift can't see and can't reach.

Speaker 2 (14:02):
What is amazing? What's it like to die in your sleep?

Speaker 3 (14:07):
I think that might be kind of cool for most people.

Speaker 2 (14:10):
That's the best way to go.

Speaker 3 (14:12):
I think you think that would be your ideal?

Speaker 2 (14:15):
Yes, yeah, I.

Speaker 3 (14:17):
Think there'd probably be a good death for very many
people to not be conscious to what's happening. And yet
some people really want to live their deaths. They want
to be present for it the entire time and see
it going away and eyes open to whatever might be coming,
if there's anything.

Speaker 2 (14:38):
Assuming there's another side, I assume if you die in
your sleep, let's listen to these two scenarios. If you
die in your sleep, your soul kind of like moves
out of the body and you just kind of look
at yourself and you move on. I would think, what
do you think possible?

Speaker 3 (14:58):
Yeah, you wake up elsewhere if at.

Speaker 2 (15:00):
All, without any pain or anything. You just go.

Speaker 3 (15:04):
Yeah, you just go and maybe wake up someplaceful again.

Speaker 2 (15:08):
I mean, I'm in no rush, but I think that's
the ideal way to go.

Speaker 3 (15:12):
Yeah, do you have an age in mind.

Speaker 2 (15:15):
One hundred and fifty.

Speaker 3 (15:17):
Oh, well, that sounds painful. That's the way to do it, okay,
I wish that for you.

Speaker 2 (15:24):
Are you on call most of the time.

Speaker 3 (15:26):
I am on call a lot, especially as dying appears
to be imminent. But for you know, I spend probably
about half my time working with end of life planning clients,
healthy people that want to get their affairs in order
and do the comprehensive end of life planning past just
the medical decision making and into more care and comfort

(15:49):
and their body and their services and their possessions and
things of that sort. So about half the time I'm
working with those folks, and about the other half the
time I'm working with somebody who have and illness that
knows that dying will be occurring at some point in
the not so distant future and wants to wrap up
their affairs or be present for the things that may

(16:11):
still be undone in their lives.

Speaker 2 (16:13):
How many people pass alua and they don't tie up their.

Speaker 3 (16:17):
Affairs, many, very very many, very many. I like to
think that my work is encouraging people to get present
to their mortality now, so they can start not only
living the lives that they can eventually feel comfortable dying from.
But also they handle a lot of the practical matters
so that the people that they love aren't then trying

(16:39):
to go to bureaucracy and get things done when they
are in the midst of deep grief. That sounds really
cruel to me.

Speaker 2 (16:46):
Generally, what's a funeral cost with a casket and all that.

Speaker 3 (16:50):
It really depends on where you are, but it could
be about twelve to twenty thousand dollars.

Speaker 2 (16:56):
A lot of people might not have that kind of
money available. But what do they do? What does the
living do when a loved one dies like that?

Speaker 3 (17:06):
A lot of people go into debt, put it on
credit cards. They have a lot of folks I think,
have ideas about how to honor the person that they
love to diet and so they you know, they want
to send them off in the samsiest casket with oak,
even though they're just going to be sitting in the box,
deep in the ground in a concrete vault for a while.

(17:29):
So people end up the matching a lot of debt
to try to create these burials of funerals for people
that they cared about. When the person who died may
not want that at all, which is why it's really
really important to start having the conversations about what it
is that you want so your loved ones don't have
to incur that cost.

Speaker 2 (17:47):
Do you do you assist them with that?

Speaker 3 (17:50):
Yes. One of the things I really enjoy is to
sit next to somebody as they are going through what
the funeral might cost. You talk to them very clearly
about what it is that they're signing up for and
recognize either the importance of it to them or the
person who died, or not at all, so that they
can help save costs.

Speaker 1 (18:10):
Listen to more Coast to Coast am every weeknight at
one a m. Eastern and go to Coast to coastam
dot com for more

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