One day last January I stopped by to visit my parents and found them in the dining room, sitting across the table from two men in ties and short-sleeve shirts. The table was spread with manila envelopes and ring binders. My father, 81 and unable to hear most conversations, was leaning forward, his hand cupped behind his left ear. My mother, who is 78 and suffers from Parkinson's disease, smiled at me uncertainly. After a moment's hesitation, she introduced the two strangers as representatives of a corporation specializing in "pre-need" funeral arrangements. Though my parents invited me to join them at the table, I excused myself and left.

I knew my mother had been worried for some time about arranging for their funerals. She has had that job on her hands several times in her life and wanted to spare me and my brother the emotional and physical exhaustion that usually attends such a task. So I figured my parents had arranged this meeting, and I didn't want to intrude. As I later learned, however, the salesmen had simply turned up at their door that afternoon.

The next day my parents proudly handed me the packet the salesmen had left with them, which included the contract they had signed with National Prearranged Services.

"It'll all be paid for," my father said with evident satisfaction. "No problem about price increases either. It's all locked in."

I expressed what I hoped was an appropriate amount of gratitude for their concern. But leafing through the packet, I found that most of the information had actually been supplied by my parents, data necessary for filling out their death certificates. The company had provided little besides the amount my parents had paid.

"Didn't they give you a list of services the policy provides?" I asked.

"They told us that would be coming later, from the local funeral home here," my mother said. That was the first time I asked myself why I hadn't taken a seat at the table that afternoon.

If I had read Jessica Mitford's The American Way of Death Revisited, a recently updated version of her 1963 bestseller, I wouldn't have hesitated. When the original version appeared in 1963, I had been too preoccupied with diapers and dissertations to actually read it, even though it was a hot bestseller.

It was one of those books like Rachel Carson's Silent Spring that quickly became a cultural phenomenon. The shock waves from its publication alerted even those who didn't read it to the excesses of the funeral trade.

Thus, I assumed that Mitford's expose had brought about significant changes and that Americans could no longer be gulled into paying for a final farewell outrageous both in premise and price. In fact, I harbored the vague impression that prepaid funeral plans had been invented precisely to circumvent impulse buying by grief-stricken families.

If you have been operating with the same blurry hope, forget it. The funeral industry has successfully ridden out the brief tempest of consumer outrage following Mitford's original book. In 1975, after repeated petitions from angry citizens, the Consumer Protection Bureau of the Federal Trade Commission did finally begin work on minimal guidelines for the industry. The unhappy history of that effort is chronicled in this new version.

The original FTC guidelines required that mortuaries itemize their services on billings and allow customers to choose which services they wished (embalming, use of a "slumber room" for viewing the body, renting the establishment's chapel for the funeral service, multiple transportation charges, "grief counseling") instead of accepting a package deal. Mortuary staff would also be required to quote prices over the phone, a practice they had adamantly resisted. Phone inquiries made comparison shopping easier, as well as allowed the bereaved to escape the full force of the industry's highly developed sales techniques. The new rules also required the cheapest caskets (never referred to as coffins by any self-respecting funeral director) be displayed along with the high-end models. And finally, funeral directors were enjoined from outright lying to customers, either about the legal requirements for embalming (nonexistent in many states) or by claiming that their "eternal sealer" caskets could actually preserve an embalmed corpse for more than a brief period.

These guidelines seemed simple and straightforward enough, even though a past president of the New York State Funeral Directors testified at the ftc hearing that the list was "a threat to the American way of life," and the trade organ Mortuary Management accused the FTC of "trying to force their agnostic, atheistic ways on God-fearing, traditional family-oriented America."

Despite their simplicity, it took ten years to adopt these guidelines, and constant pressure from the industry over the following decade has worn away whatever resolve the ftc had to protect funeral shoppers. Some of the requirements were dropped before the rule was ever adopted, and since 1996 funeral homes have once more been allowed to "bundle" their prices, meaning the customer pays for the whole enchilada—embalming, slumber room, mortuary chapel, hearse, flower car, family limo, and so on. Declining any of these services does not result in a lower bill, just a miffed mortician.

Funeral directors, it appears, consider death their rightful domain and yield place to no one, not even clergy, when it comes to advising the bereaved. Mitford quotes the trade publication National Funeral Service Journal, which named "religion, avarice, and a burning desire for social reform" as the industry's primary nemeses. "The minister is perhaps our most serious problem," the journal speculates, "but the one most easily solved." The clergy's chief sin lies in cautioning families about extravagant arrangement, though the growing trend toward holding funerals in churches also alarms the industry. The journal may have found it easy to outfox interfering clergy several decades ago, but they reckoned without today's Internet—and Fr. Henry Wasielewski, whose Web site (www.xroads.com/~funerals) provides exhaustive price comparisons of funerals, especially those offered by the new mortuary conglomerates that are rapidly buying up mom-and-pop funeral homes across America.

And what about the "pre-need" funeral plan I thought had grown out of the funeral-reform movement and that my parents hoped would save money as well as their children's sensibilities? As of 1997, only seven states protected buyers of these plans against default. While the corporation is collecting interest on the $15,000 my parents have already paid, it is not required to place that money in trust; morticians might simply use it to pay their operating costs during a lean year. Most states do not audit these funds.

My father's belief that "pre-need" plans are a hedge against inflation also appears doomed. Charges are routinely added to the package—for instance, fees for providing obituaries (written by the family) sent to newspapers (which do not charge for this public service). The most common and costly additions, however, occur when the mortuary claims it no longer carries the casket originally ordered. The bereaved finds herself in the very position the plan was purportedly designed to circumvent—making difficult choices while in an unsettled emotional state. No wonder the AARP has already issued a caveat to its members about purchasing such policies.

One would expect such bad news to make exceedingly dour reading, but the success of Mitford's book in the sixties was in large part due to its spirited satire, and her wit bites just as sharply in this version. In taking the funeral industry to task, she avoids the usual overearnest tone of the muckraker and instead approaches her subject like a stand-up comic. And, given the material supplied by her straight men, the morticians of America, it's hard to imagine how she could have addressed the topic otherwise. Consider, for example, an ad in the Practical Burial Footware catalogue for the "Fit-a-Fut Oxford," which comes in four colors and a choice of lace-up or elastic gore back. Or the "Expression" casket, unveiled at the 1996 convention of the National Funeral Directors Association: it boasts "a smooth surface with a special coating on which those who gather may write one last farewell to the departed"—the ultimate body cast. How can a writer resist such ready-made self-parody?

Of course, funerals have for centuries provided an occasion for humor. Shakespeare's gravedigger in Hamlet provides earthy comic relief. In Huckleberry Finn, Mark Twain devotes a lengthy diversion to the hilarious home burial of Peter Wilks, complete with a howling dog and a "skreeky" melodeon. In this century, "Digger" O'Dell, the lugubrious undertaker, became a regular on The Life of Riley radio show. And in 1965 the movie release of Evelyn Waugh's novel The Loved One lampooned Los Angeles's Forest Lawn Memorial Park, one of Mitford's own favorite targets. The finality of death and the solemnity it occasions often make ridiculous by contrast our bungling attempts at ceremony.

So how do we find that balance between denial and excess that truly honors the dead and consoles the bereft? Mitford provides less help here. Her tale is primarily cautionary—how to avoid the greed and gaucherie of the funeral industry. But what do we put in their place? However definite our theological convictions about the body and resurrection, patterns bequeathed to us by family tradition and the general culture also determine how we confront death—when it comes in the form of a corpse, not a concept.

My parents' funerals, for instance, will be complex occasions, pulling in a wide net of relatives, friends, and church members, some with quite definite expectations. Whose feelings and needs get priority? Moreover, my father has recently confided, after attending a friend's funeral held in his church sanctuary, that he found such a service preferable to the funeral home's chapel. My mother wants congregational singing instead of the audiotape the mortuary provides. Will I be able to make those alterations in their prepaid plan? How did this whole affair get so complicated?

DEATH DECORUM

Few things tell us more about a people than how they ritualize death. There is something sadly futile about the wizened mummies of the ancient Egyptian kings housed in their plundered pyramids; something at once stoic and scary about the Greek Hades, that dark underworld where the dead wander as shadows. And there is some shared mystery in the imagery of all those archetypal watercourses, from Acheron to the Jordan, over which we must cross to reach whatever lies beyond death.

The Jews, however, have provided us the sturdiest and most practical death rites in the Western world. Believing that the body has been a vessel containing the life-giving breath of God and bearing his image, the corpse must be treated with reverence. Though the Book of Numbers regards those who of necessity must handle a corpse as "unclean" for seven days, Jewish tradition considers kibbud hamet, or "honoring the deceased," as among the most meritorious of good works, for God himself, rabbinical writings point out, buried Moses. Within most Jewish communities the Chevrah Kaddisha, a guild that prepares the body for burial, performs its service without pay.

Traditional Judaism allows only earth burial, keeping to the Genesis prescription, "to dust you shall return." Ideally, this occurs within 24 hours of death (viz. Deut. 21:23) and includes all parts of the body, including blood, thus disallowing organ donation, embalming, and, except in extreme circumstances, autopsies. During the talmudic period, when wealthy families began to bury their dead with lavish display, rabbis decreed that all Jews must henceforth be buried only in plain white shrouds, though men could be draped with their prayer shawls as well. Today only simple wooden coffins are condoned in this country, and, in the State of Israel, everyone, including the assassinated prime minister, goes into the earth uncasketed, the point being to emphasize our equality, if not in life, at least in death and before God.

The behavior of the bereaved family is likewise well defined. Relatives symbolically rend their clothing. Members of the immediate family stay at home for seven days after a death, "sitting shivah," during which time they do not shave, wear make-up or leather shoes, or cut their hair. Friends come regularly to recite daily prayers (as they did with Mary and Martha after their brother Lazarus' death). For the rest of the month, mourners can return to work but must continue to abstain from music, parties, and haircuts. A lesser degree of mourning extends for the full year, during which they continue to recite the Kaddish, or prayer for the dead—though it contains no reference to death, but instead prays that God will soon establish his kingdom on earth. The novelist Herman Wouk attests to "the hypnotic power" of this ancient Aramaic text and "the emotional impact of speaking it together with others who have recently suffered death in the family."

In what originated in the fifteenth century but remains perhaps the most widely observed of Jewish practices today, family members continue to honor the memory of the lost loved one by reciting the Kaddish every year. Though Jewish thought has always differed about an afterlife (a bone of contention between the Pharisees and Sadducees in Jesus' day), all agree that the act of commemoration is crucial to their collective and spiritual lives.

DANCING WITH DEATH

Did Christianity alter Western ways of dealing with death? This is the central question of Paul Binski's book Medieval Death: Ritual and Representation. According to Binski, an art historian, the nascent Christian faith was "transgressive" precisely because it "placed a death at the centre of its drama of salvation," that is, Christ's death on the cross, his burial, and resurrected body—revealed first at the tomb. No one in the ancient world wanted much contact with corpses. The Jews may have considered them "unclean," Binski points out, but pagans believed they were "an abomination, abhorred by the Gods." In fact, by Roman law, only special heroes could be buried inside city walls.

Historians may find Binski's treatment of the ancient world a bit simplistic, though. Antigone, after all, risked her life to bury her rebel brother's body, and Spartan mothers expected their sons to return, if not as conquering heroes then as corpses borne aloft on their shields. Binski also misses several practices medieval Christians inherited directly from Judaism. Theologians, too, may fault Binski for focusing too narrowly on Christ's death while ignoring the impact of the Incarnation itself on Western categories of body and soul. Nevertheless, the central point of his book remains intriguing: Christianity fundamentally "resocialized" the dead, dissolving the boundaries between the living and the dead.

Binski maps those regions of the medieval mind that remain largely terra incognita to the modern world. He leads us from the catacombs, those subterranean graveyards where early Christians met to worship, to the great basilicas of Rome where bodies were kept, as Revelation 6:9 described, "under the altar." Such "demarginalizing" of the dead, Binski believes, eventually led to the later Christian practices of venerating relics and saying masses for the repose of one's deceased relatives.

The danse macabre, the popular theme of late-medieval murals, woodcuts, stone sculpture, and church panel paintings, depicted figures from all stations of life—kings, popes, artisans, peasants, and even children—compelled to join skeletons and cadavers in a vigorous jig. Sometimes enacted as at village pageants, the danse macabre was also performed as court masques, the courtiers dressing up as corpses from various strata of society. In a culture strictly structured by hierarchy, the dancing cadavers proved that Death was a true democracy.

Remnants of the Dance of Death survive today in our own Halloween, though scarcely anyone remembers that both the name and the observance began liturgically as All Hallows' Eve. We have tried to tame our secular version by turning it into a children's festival, even exchanging the traditional scary costumes of ghosts and goblins for the innocuous Snow White and Winnie-the-Pooh.

But death is persistent —despite our cultural denial. We may not suffer from the Black Death anymore, but we do have AIDS. And schoolyard massacres. And Rwandan rivers clogged with corpses. Television packages our own version of the danse macabre. And we still support the shrines and relics of our secular saints. Graceland claims as many visitors as Lourdes. And what medieval saint can rival the ten thousand tons of cellophane-wrapped flowers left at Kensington Palace for the lost princess?

IN THE COMPANY OF DEATH

For most of us, death comes not with violent dispatch but from slow disease and wasting. As the nation's life-expectancy levels rise, we face the added problem of slow, expensive, and lonely death. Originally asylums for the destitute dying, hospitals shifted their focus to healing following the enormous improvement in medicine during the nineteenth century. Whereas the medieval almshouse had practically as many chaplains on its staff as infirmarians, modern hosptials work very hard at keeping people alive and very little at comforting the dying.

Enter Cicely Saunders, a British nurse and "lady almoner" (now known as a medical social worker). Appalled that wounded veterans of World War II were left to face pain without morphine and death without companionship, she opened the first modern hospice in 1967, Saint Christopher's in south London.

Two years later, Elisabeth Kubler-Ross, the Swiss-born psychiatrist and pioneer in "thanatology," published On Death and Dying, which, like Mitford's earlier work, soon became a cultural referent, even for those who never read it. Kubler-Ross's five stages of dying gave people an instrument with which to dissect a subject more taboo than sex while also paving the way for the hospice movement in this country.

Welcomed by a public generally dissatisfied with a medical establishment it perceived as coldly clinical, hospice care has now become thoroughly acculturated in the United States. When Congress discovered that the nation's greatest medical costs are incurred during the last two weeks of a person's life—$200,000 on average—it voted to allow Medicare to pay for hospice services. The 1983 act declared that, after a doctor certifies that a patient has only six months to live, Medicare will pay 100 percent of the hospice bill and 95 percent of prescription drug charges.

At $90 a day, hospice care is one of the few bargains in American medicine today. Few hospices provide much in-patient care; most are essentially home health-care businesses with employees and volunteers trained in "palliative care," meaning their mission is to reduce pain in terminally ill patients. Many private insurers now include it in their coverage. And, in a rare end run around church-state issues, the congressional act also required that a chaplain be available to all patients under hospice care. Thus, ironically—or perhaps fittingly—the marketplace may be the agent that finally makes Americans face up to death—by bringing it home.

Still, in a culture as devoted to youth and physical perfection as ours, the cultural changes for which Mitford, Saunders, and Kubler-Ross were catalysts might have died out except for AIDS. In the 1980s, that almost mythical disease replaced the Vietnam War as our national icon for death. Since aids usually affects younger people who have strong feelings about how and with whom they spend their last days, the demand for hospice care increased.

Spurred by the memory of a friend who had died of AIDS, Marie de Hennezel, a French psychologist, joined the staff of a palliative-care unit at a Paris hospital in 1987. Intimate Death: How the Dying Teach Us How to Live, stories gleaned from her seven years there, became a bestseller in France and appears in its English edition with a foreword by Francois Mitterrand, written shortly before his death.

Hennezel's own preface begins with promising frankness:

I know that I will die one day, although I don't know how, or when. There's a place deep inside me where I know this.

I know I'll have to leave the people I love, unless, of course, they leave me first.

This deepest, most private awareness is, paradoxially, what binds me to every other human being. It's why everyman's death touches me. It allows me to penetrate to the heart of the only true question: So what does my life mean?

Every Christian, indeed every human being, ought to think precisely these thoughts—and fairly frequently. To ignore them reduces us to animals, who have no consciousness of their own end. Hennezel's book does not, to my mind, adequately answer that question. Like dozens of other such books currently available, it grows out of the author's need to recount those scenes that have gone closest to the bone of her life.

Nonetheless, instead of smugly dismissing such partial answers, Christians need to increase their attentiveness to whoever is asking these essential questions. The novelist John Cheever once asked, "How can a people who do not understand love hope to understand death, and who will sound the alarm?" If nothing else, books like Intimate Death sound the alarm.

Beyond that, such works also remind us of that irreducible residue of goodness in creation over which God himself exclaimed. I recently asked a friend who works at a hospice how people caring for dying relatives at home generally fare. "At first they're usually frightened," she said, "no doubt about it. But over time I've found they display great courage and compassion. They rise to the occasion." She thought a moment longer, then added, "It's undeniably difficult and demanding, but the word I most often hear to describe the experience is 'reward.' A great reward. Most of them say they wouldn't have missed it."

LOOKING DEATH IN THE FACE

Thanks to our rapidly advancing technology, we now must learn to negotiate that tricky area between ending life by euthanasia and extending it artifically. The National Hospice Organization officially supports neither legalizing voluntary euthanasia nor doctor-assisted suicide. It has recently reaffirmed its "commitment to the value of the end of life and to the philosophy that hospice care neither hastens nor postpones death." Would that churches planted such clearly marked signposts in this new territory we all must traverse sooner or later.

Our culture, unwilling to admit its mortality, has become obsessed with living forever. And Christians show very little immunity to the infection. So desperate is our culture's death grip on life that we seek out growth hormones, gene therapy, even cellular cloning in an effort to gain the only eternal life we can imagine. As the surgeon Sherwin B. Nuland points out in his book How We Die: Reflections on Life's Final Chapter, "There is a vanity in all this, and it demeans us. … When it is accepted that there are clearly defined limits to life, then life will be seen to have a symmetry as well. There is a framework of living into which all pleasures and accomplishments fit—and pain, too. … The fact that there is a limited right time to do the rewarding things in our lives is what creates the urgency to do them."

Last January I avoided sitting down at my parents' dining table with the two funeral salesmen. I regret that now. But events of much larger consequence than buying overpriced coffins lie ahead for my family. My mother is not going to get well. How and where will she spend her last months? How can we who love her ease and enrich them? What will we learn from the experience for our own dying? As Nuland says, "the right time to do the rewarding things" is limited. And I don't want to miss this reward.

Virginia Stem Owens is a novelist, essayist, and poet. In a forthcoming issue of BOOKS & CULTURE she will write about caring for aging parents.

Copyright © 1999 by the author or Christianity Today/Books & Culture Magazine. For reprint information call 630-260-6200 or e-mail bceditor@BooksAndCulture.com.