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The Lost Art of Dying
Cover of The Lost Art of Dying
The Lost Art of Dying
Reviving Forgotten Wisdom
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A Columbia University physician comes across a popular medieval text on dying well written after the horror of the Black Plague and discovers ancient wisdom for rethinking death and gaining insight today on how we can learn the lost art of dying well in this wise, clear-eyed book that is as compelling and soulful as Being Mortal, When Breath Becomes Air, and Smoke Gets in Your Eyes.

As a specialist in both medical ethics and the treatment of older patients, Dr. L. S. Dugdale knows a great deal about the end of life. Far too many of us die poorly, she argues. Our culture has overly medicalized death: dying is often institutional and sterile, prolonged by unnecessary resuscitations and other intrusive interventions. We are not going gently into that good night—our reliance on modern medicine can actually prolong suffering and strip us of our dignity. Yet our lives do not have to end this way.

Centuries ago, in the wake of the Black Plague, a text was published offering advice to help the living prepare for a good death. Written during the late Middle Ages, ars moriendi—The Art of Dying—made clear that to die well, one first had to live well and described what practices best help us prepare. When Dugdale discovered this Medieval book, it was a revelation. Inspired by its holistic approach to the final stage we must all one day face, she draws from this forgotten work, combining its wisdom with the knowledge she has gleaned from her long medical career. The Lost Art of Dying is a twenty-first century ars moriendi, filled with much-needed insight and thoughtful guidance that will change our perceptions. By recovering our sense of finitude, confronting our fears, accepting how our bodies age, developing meaningful rituals, and involving our communities in end-of-life care, we can discover what it means to both live and die well. And like the original ars moriendi, The Lost Art of Dying includes nine black-and-white drawings from artist Michael W. Dugger.

Dr. Dugdale offers a hopeful perspective on death and dying as she shows us how to adapt the wisdom from the past to our lives today. The Lost Art of Dying is a vital, affecting book that reconsiders death, death culture, and how we can transform how we live each day, including our last.

A Columbia University physician comes across a popular medieval text on dying well written after the horror of the Black Plague and discovers ancient wisdom for rethinking death and gaining insight today on how we can learn the lost art of dying well in this wise, clear-eyed book that is as compelling and soulful as Being Mortal, When Breath Becomes Air, and Smoke Gets in Your Eyes.

As a specialist in both medical ethics and the treatment of older patients, Dr. L. S. Dugdale knows a great deal about the end of life. Far too many of us die poorly, she argues. Our culture has overly medicalized death: dying is often institutional and sterile, prolonged by unnecessary resuscitations and other intrusive interventions. We are not going gently into that good night—our reliance on modern medicine can actually prolong suffering and strip us of our dignity. Yet our lives do not have to end this way.

Centuries ago, in the wake of the Black Plague, a text was published offering advice to help the living prepare for a good death. Written during the late Middle Ages, ars moriendi—The Art of Dying—made clear that to die well, one first had to live well and described what practices best help us prepare. When Dugdale discovered this Medieval book, it was a revelation. Inspired by its holistic approach to the final stage we must all one day face, she draws from this forgotten work, combining its wisdom with the knowledge she has gleaned from her long medical career. The Lost Art of Dying is a twenty-first century ars moriendi, filled with much-needed insight and thoughtful guidance that will change our perceptions. By recovering our sense of finitude, confronting our fears, accepting how our bodies age, developing meaningful rituals, and involving our communities in end-of-life care, we can discover what it means to both live and die well. And like the original ars moriendi, The Lost Art of Dying includes nine black-and-white drawings from artist Michael W. Dugger.

Dr. Dugdale offers a hopeful perspective on death and dying as she shows us how to adapt the wisdom from the past to our lives today. The Lost Art of Dying is a vital, affecting book that reconsiders death, death culture, and how we can transform how we live each day, including our last.

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About the Author-
  • Lydia Dugdale MD, MAR, is associate professor of medicine and director of the Center for Clinical Medical Ethics at Columbia University. Prior to her 2019 move to Columbia, she was Associate Director of the Program for Biomedical Ethics and founding Co-Director of the Program for Medicine, Spirituality, and Religion at Yale School of Medicine. She is an internal medicine primary care doctor and medical ethicist. Her first book, Dying in the Twenty-First Century (MIT Press, 2015), provides the theoretical grounding for this current book. She lives with her husband and daughters in New York City.

Reviews-
  • Publisher's Weekly

    Starred review from April 20, 2020
    In this probing analysis, Dugdale (Dying in the Twenty-First Century), director of Columbia University’s Center for Clinical Medical Ethics, considers how to change the current “death-denying” culture to help readers become more comfortable with death. She challenges the assumptions and habits that lead to a preponderance of medicalized hospital deaths, calling for a personal acceptance of mortality and a revival of community support for the dying, particularly support of those who would otherwise die alone. Sparing no details, Dugdale pulls readers into the ethical conundrums that doctors face with a gripping story of the night she resuscitated an elderly man three times before he died, following the wishes of his children to spare him more pain. Dugdale paints a picture of the medical “conveyor belt” that leads to one treatment after another, often without examining the wisdom or consequences of these actions. She also laments the lack of cultural practices that help people prepare for death, such as the Ars moriendi (Latin for the art of dying) literature of medieval Europe, which emphasized the importance of living well in order to die well. Dugdale discusses the wide variety of responses people have to near-death experiences (despite the expectation of it being a transformative event, many people report feeling or thinking nothing at all), and urges readers to think twice about hospitalization and resuscitation, especially for the frail. This illuminating and thought-provoking book will convince many readers to reexamine their assumptions about death and dying.

  • Kirkus

    May 1, 2020
    A physician draws wisdom from a late medieval text to transform our thoughts and fears about dying. When a terminal patient's life is prolonged with desperate medical procedures, that individual's final moments may be sadly compromised. Yet reliance on modern medical interventions has become increasingly common in our culture. As Dugdale, the director of Columbia University's Center for Clinical Medical Ethics, writes, "in failing to die well, we fail to live well." Beginning with a case study example, the author relates how woeful such a failure can be. The patient was an elderly man approaching the end of a lengthy battle with cancer, and no one in his family was prepared to acknowledge his approaching death, insisting that every effort be made to keep him alive. In his final hours, he suffered through several unnecessary resuscitations, resulting in a long, painful death. Such examples led Dugdale to seek out a more compassionate alternative. In her studies, she was inspired by the holistically grounded approach to dying examined in ars moriendi ("the art of dying"), a 15th-century text that contains intriguing reflections on death as an essential aspect of living requiring careful preparation. "Although more than six hundred years have passed, I have been repeatedly struck by the need for a similar handbook today," writes Dugdale. "That's why I wrote this book. Although some of the original ars moriendi content is less relevant to the diverse and global twenty-first century, it nevertheless offers rich wisdom on how we might die well." Throughout the book, Dugdale balances her clinical experience with an openly holistic mindfulness, and she thoughtfully expands on the relevant lessons of ars moriendi: acknowledging our human finitude, or what it means to be mortal; embracing a meaningful community; facing a fear of death; and giving consideration to the decision of whether to die at home or in a hospital or other setting. A wise and reassuring guide for confronting death.

    COPYRIGHT(2020) Kirkus Reviews, ALL RIGHTS RESERVED.

  • Library Journal

    May 1, 2020

    In her many years of practice, Columbia University physician Dugdale has seen a lot of death, and here she rails against the overly medicalized way of dying, which is prolonged by unnecessary resuscitations and other intrusive interventions. Instead, she guides readers toward taking a holistic approach to this final stage by accepting the finitude of life, developing meaningful rituals, and involving their communities in end-of-life care. The overarching theme of the book is that to die well, one must live well, and that living well entails determining what ultimately matters and going through each day with purpose. VERDICT A readable and inspiring manual for living one's days fully and dying well.--Deborah Bigelow, Director Emerita, Leonia P.L., NJ

    Copyright 2020 Library Journal, LLC Used with permission.

  • Mary Pipher, author of Women Rowing North "In this profound and compassionate book about death and its nearness, Dugdale demystifies one of the essential mysteries of our time."
  • Siddhartha Mukherjee, the Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene "Sensitive, informed by clinical experience, rich in the wisdom of the past, L. S. Dugdale has written a riveting book about life's hardest truth—death. A must read for all of us as we face our mortality."
  • Abraham Nussbaum, MD, author of The Finest Traditions of My Calling "Dugdale guides readers toward taking a holistic approach to this final stage by accepting the finitude of life, developing meaningful rituals, and involving their communities in end-of-life care. The overarching theme is that to die well, one must live well. . . . A readable and inspiring manual."
  • Raymond Barfield, MD, PhD, professor of pediatrics and Christian philosophy, Duke University "In this fascinating, timely, and important book Dugdale draws us into the transformative wisdom of the art of dying. In so doing she reimagines a world where death is not simply an oppressive shadow to be avoided but an important step on the road to life in all its fullness."
  • James Martin, SJ, author of The Jesuit Guide and Jesus: A Pilgrimage "Like Atul Gawande and Paul Kalanithi, Dugdale writes fluently about dying from clinical experience. What sets her book apart is that she writes wise words everyone needs to hear as they live. When I lay dying, I hope I will have a doctor like Dr. Dugdale at the bedside."
  • Publisher's Weekly (starred review) "The Lost Art of Dying brilliantly combines medical experience and humanistic tradition to show not only how we should prepare for death and why we must, but also that it is an essential part of the art of living well."
  • Arthur C. Brooks, author of Love Your Enemies and professor at the Harvard Kennedy School Lydia Dugdale's The Lost Art of Dying proves that there is often nothing more relevant to our present cultural moment than the wisdom of the past—in this instance, on the subject of how to face death. The book is based on a great deal of painstaking scholarship but is written in the most accessible style. It will not only be of enormous help to people facing their own death or the death of a loved one, but also to professionals in various fields who attend the dying.
  • Jeffrey Sonnenfeld, Senior Associate Dean, Yale School of Management "Kudos to Dugdale's The Lost Art of Dying for being honest, refreshing, and useful. As a physician who has experienced many deaths, she helps us think about the meaning of our lives and about how to have a good death. I recommend this book to all who are mortal."
  • Victoria Sweet, MD, PhD, author of God's Hotel and Slow Medicine "At this fraught moment, Dugdale's work could not feel more uncanny and necessary."
  • Christian Wiman, author of My Bright Abyss "I'm adding this book about dying to my collection of treasured guides to living well. Filling me with illuminating, compelling, and consoling hope, this book, more than any other I have read, reveals how to rediscover the lost art of dying. Read it. Then read it again and again."
  • Timothy Keller, NYT Bestselling Author, Pastor Emeritus, Redeemer Presbyterian Church, New York City.  "In this important new book, Dugdale asks why it is so difficult for patients and families to accept terminal diagnoses and for all of us to recognize our finitude. The solution, Dugdale proposes, is for us to learn about dying now, as part of our living. And she is right."
  • Dr. Mark Siegler, Lindy Bergman Distinguished Service Professor of Medicine and Surgery at the University of Chicago and coauthor of Clinical Ethics "In this extraordinary book Dugdale applies both her clinical experience and her deep insights into a centuries-old approach to help dying patients live well and die well. Although I was an early student of Elisabeth Kübler-Ross, Dugdale's book has provided me with new insights that I will apply immediately."
  • R. R. Reno, editor of First Things  "Want a better life? Then think about your death, starting with Lydia Dugdale's The Lost Art of Dying. Dugdale shows that death should be courageously confronted. In so doing, we not only conquer our fear, but also understand the reason for our lives."
  • James Rhodes, PhD, professor emeritus of Medieval Studies at Southern Connecticut State University "One of the most avoided questions in life is also one of the most important: what is it like to die? It's a question we will all encounter, no matter what our beliefs about the afterlife. And you will find no more compassionate and knowledgeable guide than Dr. Dugdale, who has accompanied many people on this journey. Her new book is a great gift to all of us who will die or face death, which is to say, all of us."
  • Rita Ferrone, contributing writer and columnist, Commonweal magazine "Dugdale patiently and respectfully unveils the reality that many in our world die poorly. Drawing on Medieval wisdom on dying well, she teases out lessons...
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