A major new oral history from the Pulitzer Prize-winner, dealing with the universal experience of death. At the age of 88, Studs Terkel has turned to the ultimate human experience, that of death and the possibility of life afterward. Death is the one experience we all share but cannot know. In Studs Terkel's powerful new book, Will the Circle Be Unbroken? a wide range of people address that final experience and its impact on the present in which we live. In talking about the ultimate and unknowable culmination of our lives, these people give voice to their deepest beliefs and hopes, reflecting on the lives they have led and what still lies before them. The result is a book that may well be Terkel's most popular, a universal and deeply moving account of death and religion. This is the first time Terkel addresses the whole realm of religious belief and of expectations of an afterlife, including reincarnation. Interviewing a fascinating variety of people, he is able to come up with an extraordinary range of experience and of belief, all of which prove far more complex than Terkel anticipated. In the tradition of his books Working and Coming of Age, Studs Terkel addresses an issue bound up with all of our lives, yet rarely discussed on its own terms. From a Hiroshima survivor to an AIDS caseworker, from a death-row parolee to a woman who emerged from a two-year coma, these interviewees find an eloquence and grace in dealing with a topic many of us have yet to discuss openly and freely. Terkel also interviews the vast array of people who confront death in their everyday lives, whether as policemen, firemen, emergency health workers, doctors, or nurses. Many of the most moving interviews deal with AIDS, and how the disease has devastated whole communities and forced people to face death at the young ages we associate with centuries past. In a stunning capstone to his extraordinary career, Terkel introduces to us the variety of our reactions to life's ultimate experience. "My works had all been concerned with life and its uncertainties rather than death and its indubitable certainty. But what about the one experience none of us had, yet all of us will have: death? We, as a matter of course, only reflect on death, voice hope and fear, when a dear one is near death, or out of it. Why not speak of it while we're in the flower of good health? How can we envision our life, the one we now experience, unless we recognize that it is finite? In listening to these testimonies, this book is about life and its pricelessness, and of a vision, inchoate though it be, of a better one down here as well as, possibly, up there."From the Introduction

Chapter One

Doctors

Dr. Joseph Messer

Chief of cardiology at Rush--St. Luke's--Presbyterian Hospital in Chicago. Former chairman of the Board of Governors of the American College of Cardiologists.

I was born in 1931. Watertown, South Dakota, is thirty miles west of the Minnesota border. I lived there until I left to go to college in 1949.

    Dad was an undertaker. It had been the family profession for five generations: all the way back to cabinetmakers in Maine. They were the ministers, the circuit riders who marked the trees for molasses. This was the 1600s ... Their interest in wood led them to become cabinetmakers.

    In small towns, the furniture business and the undertaking business were the same people. My father's father, going back several generations, had been in this business. My dad left it, being more interested in banking and finance. It was while traveling through Watertown that he ran into the town banker, who offered him a job. He married the banker's daughter. An interesting coincidence: my mother's side of the family were in the funeral business. My father gave up his banking interests and ended up in the funeral part of it. So I was raised as an undertaker's son.

    We used to play in the chapel where the services were held, run up and down the aisles. I loved to play the piano. When I was about ten, eleven, my dad got a Hammond organ for the funeral chapel--I loved to play that. I was always admonished that I had to play somber music. A few times I would accompany my father--he had a beautiful voice--when he sang the old hymns at funerals.

    By the time I was ten, I was working there after school, taking care of the hearses, the limousines. I attended a lot of funerals and, in time, I drove the coaches and the ambulances. In those smaller towns, the funeral directors ran the ambulances because the hearses were convertible. This was before the days of paramedics.

    I grew up with grief, though I didn't experience it because I wasn't part of the grieving families. Having people die was a part of the life that I lived. I remember the enormous respect my father had for the deceased--he insisted that anyone in the funeral home share that respect. That was one of the important influences in my life. I remember going with my father to farmhouses where people had died. I would help with what we called "removals." He was on one end of the stretcher and I would be at the other end. I would watch my father interact with the relatives of the deceased, who were in grief. He treated people of all economic and social classes the same. I'm sure that watching him with people under stress, more than any other lesson, helped me become a good doctor--I hope ...

    I don't believe that I really felt grief until the boy who lived across the street was killed in World War II. I was about eleven, twelve. He was a wonderful young man. When we learned that he had been killed, it really struck home. It's my first memory of true grieving.

    My father's real goal in life was to be a physician. He actually started to go to medical school, but had to drop out because his father contracted tuberculosis--not an uncommon disease in those days. That's what led him into business, supporting the family. He clearly had great respect for physicians.

    I think he has lived out that desire vicariously to some extent because my brother and I became physicians; he's four years older. We were learning the bones of the body when we were six. I knew every bone in the body when I was seven or eight. He had all sorts of medical textbooks. He would teach me about blood vessels and veins and arteries. I saw him embalm many times. Preservative chemicals infused in order to replace the blood lost so that the remains could be preserved.

    My brother and I were really programmed to be doctors. It turns out that my daughter, my dad's granddaughter, is a physician. [ Laughs softly ] I tried not to unduly influence her--I didn't program her.

    My father was clearly trying to influence our career choices. I arrived at college with blinders on. There was only one thing I was going to do and that was to be a doctor. I probably missed out on some other things I might have been interested in ...

    Our major medical influence, our citadel, was the Mayo Clinic. That's where everyone from South Dakota went when they were seriously ill. I made innumerable ambulance trips for my dad from Watertown to Mayo. Lots of long-distance driving, about 375 miles. My dad was very interested in handicapped children. He had the dream that my brother, now deceased, and I would have the Messer Clinic, modeled after Mayo.

    My brother was in the army toward the very end of World War II. He had heard of a place on the East Coast called Harvard--it was just a name to us in Watertown. We were going to go to the University of Minnesota, of course. But my brother decided on Harvard, much to my father's dismay. My mother said, "If he wants to go there, let him." I went to Harvard College, too. I stayed there for medical school, for my residency, and for my fellowship in cardiology.

    After that, I worked at Wright Patterson Air Force Base. This was in the days of the astronauts--doing studies to get them up into space. Sputnik had gone up, and we were in a race with the Russians. I worked on human centrifuge--gravity and G-force. We would spin people around. That's how you simulated the tremendous G-forces of a rocket. It was a wonderful experience.

    I went back to the Boston City Hospital, one of my favorite institutions in cardiology. Then I came here to Chicago, to be chief of cardiology at Rush.

    During the first eighteen years or so of my life, I looked at death as an objective event that occurs--I didn't get very emotionally involved. Now, at this end of my life, the other end of my life, I react very personally to the deaths of my patients ... I sometimes become emotionally involved. I always seek out the families and talk with them and console them and give them my condolences. I'm very much helped by the memory of my father dealing with families in the funeral business. I don't deal with my patients' families as though I were an undertaker, but that ability to be empathetic, to share their feelings--I think it's because I watched my father do it.

    As I watch my own colleagues respond to death in their patients, I see quite a variety of responses. A certain ability to separate yourself emotionally from the environment that surrounds a sick and dying patient is important in order to maintain objectivity, to make intelligent decisions about the patient's care. I think you have to be able to separate yourself in that sense from your patients in order to be a good doctor. In some of us that ability is taken to an extreme. If you become caught up ... that's why we don't take care of our own families, the emotional problem of dealing with illness in your own loved ones. Perhaps it's a defense mechanism so that we don't get embroiled. Sometimes it's absolutely heart-wrenching to see what happens to sick people. If you allow yourself to be subject to that kind of emotional trauma over and over and over again, it becomes a very damaging thing. There has to be a certain amount of insulation--but I think there can still be compassion.

    A lot of it is experience. I was blessed in having the experience of watching a true master dealing with grief, my father, and maintaining that necessary separation--he had to do his business, he had to take care of the needs of that family. Dealing with death is a third-rail issue in the United States. We don't talk about death and dying as a societal problem, but it's going to become more and more of one ...

    It's a very delicate issue for many people--it probably conjures up all kinds of fear and anxiety in terms of their own mortality. But we need to do a better job of talking about it, thinking about it, preparing for it. As a result of that, I think the physician-patient relationship will be broadened.

    Often when patients die, we know that it's inevitable. We know the condition they have is incurable, and there's no self-doubt. It's always "could we have done better in the process of dying, in caring for the patient?" But, in some cases, you always wonder: there was a fork in the road in our decisions about a patient--surgery, no surgery. Surgery, we know there are certain risks but greater benefits. No surgery, lesser risks but lesser benefits. "Should we have turned the other way?" Now, knowing the outcome ... The retrospectascope--it's a wonderful tool to learn with, but it's a vicious mean tool to punish with when you look back and say, "We should have gone this way or that way." Of course we use it all the time in medicine and as well we should. You look back at how can we do it better next time--that's the whole basis of the postmortem examination.

    When it came to Ida, I had about ten different feelings. One was tremendous grief about her death, because I had enormous respect and affection for her. One was a sense of remorse: Had we made the wrong decisions in terms of recommending this particular course of therapy? Going back and doing a retrospect analysis. Did we overlook anything? What had gone wrong? One was: How am I going to confront you? I had learned that I was the one who was going to be telling you she had passed away. How am I going to break the news to you and your son? What words am I going to use? What's going to be your reaction? How are we going to interact in that terribly difficult period in your life and in my life? How can I help you after I've done that? What are the next steps? That's why I was so grateful to see that your son was there, that you had people with you.

    A physician must be honest in dealing with a patient. If the patient senses a lack of integrity, it'll undermine the whole process. At times being honest means bringing bad news. What I try to do--I'm sure I could do it better--is to tell the patient what the facts are. Then to do my very best to point out that there are ways of dealing with this problem. It may be a palliative type of thing: we're not going to cure it, but we're going to lessen the impact. I truly believe that virtually every diagnosis we deal with today holds the hope of some breakthrough in the foreseeable future. I like to bring that to my patients' attention. Right now we may not have a treatment or a cure for disease X, but so much is happening in the field ...

    My son had Hodgkin's disease--it's a cancer of the lymph nodes. When we learned that, I was devastated . The wonderful physician who took care of him pointed out to me that things are changing so quickly in this field that you should have hope--and she was right! He's now seven or eight years after being treated and no evidence of recurrence. The number-one thing when you're dealing with an incurable disease is to give the patient a sense of hope without being dishonest.

    Grief and guilt are threatening subjects, more so as we get older ... Because we're getting nearer and nearer to our own mortality.

    I think it's become more of a problem as our nation has become more secular. I noticed as a child, from experiences with my dad, how much of a role religion plays in dealing with this issue--the belief in the life hereafter, salvation and redemption, that sort of thing ... The sermons given at funerals, the masses, the expectation of something beyond--these things sustained the grieving family through this terrible period.

    My father was very religious, Methodist. He was a regular churchgoer and did all the things that religious people in small communities do in terms of contributions and the like. But his real religious expression was in the way he lived his life.

    I raised my children in a religious environment because I'm convinced unless you have experienced this as a child, you cannot recapture a religious belief as an adult. But my science background makes it difficult for me to accept some of the assumptions of organized religion. My experience with some organized religions makes me doubt that they are truly religious in terms of their compassion and their concern for human beings and the needs of human beings. I doubt that there's a hereafter--and that's probably the first time I've ever said that. [ Laughs ] But it would be nice if there were. Though I can imagine the enormous complexities if there is a hereafter and all my ancestors are up there!

    I think of people who have lost a loved one, as I have--my first wife died ten years ago--and then later remarry. How is that going to work out if we're all up there together with two wives? Maybe the Mormons were right. [ Laughs ] I don't mean to be disrespectful ... But it does seem a little difficult to put together from a scientific, rational basis that there is a hereafter. I guess I don't really care. I think the important issue is the way we conduct our lives while we're here, and the impact we have on other people while we're here. And if it helps some people to think there's a reward in the hereafter for being good, Calvinism or the Judeo-Christian ethic, so be it. The motivation isn't as important to me as the solace it gives survivors.

    I've always had an internal gut reaction against cremation. My initial experiences with it as the undertaker's son were emotionally repulsive. I don't know if I've ever gotten over that. When my wife passed away, my children felt very strongly cremation was the appropriate thing, and that my wife had actually told them that's what she wanted. She and I never discussed it ... I don't know that I've really decided what I would want. I'll leave that to my survivors.

    I think that we need to take a more active role in deciding about our own terminal care. If you haven't been able to talk about death and dying with your children, you've left them completely in the dark as to what you would like to have done. Most of us aren't able to do that in the last few months of our lives. Everyone has the right to a graceful death. Unfortunately, we don't have people die at home anymore, partly because there is this reluctance to engage in the process of dying. Many families don't want a sick person in the bedroom, dying.

    Last week, I attended a play, O'Neill's Desire Under the Elms . There was talk in that play of the parlor, which no one had entered since the wife's body was laid out there. From that point on, the parlor was never used by the family. That's why often it's called a funeral parlor, as it was in the old days. The service would be in the church, but the remains would be taken back to the home, and the viewing, the wake would be there.

    The issue of dying is a very sensitive one in our country. I think it's caused a lot of emotional stress, a lot of financial problems for people who haven't planned in advance. It's placed a lot of unnecessary burden on families because they don't know what the wishes of the parent might have been.

    When I was a kid my mother said, "There's certain things, Joseph, you don't talk about in polite company. You don't talk about politics, you don't talk about religion, you don't talk about sex." She never said death, but I would add that--because there's a fear that you're going to touch a sensitive raw surface on the other person, that you're going to remind them of a recent death or stimulate their anxiety and fear about their own illness. I don't mean that's the next thing, but I think it is a topic that needs to be discussed so that we can get our fears and our anxieties out in front of us, take a look at them, and then begin to deal with them.

Excerpted from Will the Circle Be Unbroken? by Studs Terkel. Copyright © 2001 by Studs Terkel. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.