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photo by ryan orange

The Story of Death is the Story of Women

… and They Want to Bring Back “The Good Death”

Mortician and bestselling author Caitlin Doughty

Mortician and bestselling author Caitlin Doughty approaches death with both humor and sensitivity, making the taboo topic accessible to many. Her advocacy centers on the corpse, which has “served as a vessel for feeling, ritual, and grief, for thousands of years of human history,” she says. photo by ryan orange

On a summer day in 2014, guests arrived at Mitch Metzner and Gabriel Gelbart’s home surrounded by the natural beauty of Topanga, an area nestled in the Santa Monica Mountains that has a reputation as a bohemian haven for Los Angeles artists. The couple had purchased the property with the intention of turning it into a residential hospice where people could spend their final days in a peaceful and supportive environment. A few weeks before, guests had come to celebrate the pair’s marriage, but today they came to attend Gelbart’s funeral.

Sarah Chavez

Sarah Chavez is the executive director of the Order of the Good Death and co-founder of feminist site Death & the Maiden. Twitter: @sarah_calavera.

Gelbart died suddenly of a heart attack, leaving a community of family and friends shocked and reeling with grief. Now they had come together to say goodbye. “It was stunningly beautiful and agonizingly sad,” says Olivia Bareham, a former geriatric nursing and hospice assistant who organized the funeral. “A collision of heaven and Earth.”

Gelbart’s body was brought home, to be washed and wrapped in a golden shroud by Bareham and Metzner. For Metzner, caring for his husband’s body was a natural continuation of the love and care Metzner provided him in life, allowing for a “healing journey through grief that the funeral industry wants to deny us,” he explained. For the next three days, mourners could spend time with Gelbart at the couple’s home.

Bareham has long sought to ease some of the fear and suffering surrounding death and dying that she observed among her patients and their families. In 2005 she founded Los Angeles-based The Sacred Crossings Institute for Conscious Dying, where she educates and empowers families to care for their deceased loved ones and create home funerals like the one she created for Gelbart.

Throughout the couple’s house, Bareham and friends provided a variety of activities for mourners, including the opportunity to decorate the casket with art supplies, or inscribe river rocks that would be used to build a memorial wall on the property. With this funeral, Bareham created a way for people to be truly present, bearing witness to the end of a life, and a space to process the enormity of their thoughts and emotions. Friends played music; dogs wandered among the bereaved, offering comfort. Food, drink, and collective pain were shared among all. For Metzner it was “one of the most profound and beautiful experiences of my life.”

This is not your typical American funeral, though.

From the Editor

The Death Issue

“When I learned that my first issue as editorial director of YES! would be on death, I cringed a bit. No one likes to think about death, much less talk about it. In fact, death might be more taboo to discuss than even sex or money. A recent survey found that only about a third of people had discussed making wills with their partners, or their wishes concerning their funerals. It’s almost as though we believe that dying doesn’t actually happen. At least not to us.

Cover of YES! Issue 91

The fact is, death is a universal certainty. Yet most Americans’ interactions with it are limited to times of crisis. In a culture that’s obsessed with prolonging life, death is seen as a failure — dark and depressing, macabre and morose. Death is the stuff of thrillers and sad poems.

This issue disrupts the silence around the D-word. It invites us to explore “a good death” — how to prepare ourselves and heal loved ones while we are still in the living world, how to die with grace and dignity, and how to make plans for the disposition of our bodies in a way that underscores our place in the ecosystem and nurtures the planet.

Since working on this issue, I’ve learned that being open about death can actually calm our fears. For the first time, I’ve talked to my parents and dear friends (even Generation Z’ers!) about their own plans. I, for one, would like to be turned into fertilizer for a tree under which people can read and picnic. That sounds pretty darned wonderful to me.

With these pages, our hope is that you might think differently not only about dying, but also about living. As I settle into my role at YES!, I’d like to learn about your hopes and dreams for the magazine and, well, the world. Perhaps there’s no better way to kick off that conversation than with the topic of death. Send your thoughts to [email protected] or post about your #GoodDeath on social.

Happy reading and living/dying, all!

Return to the story

Bareham is just one of many women who are disrupting the death paradigm by challenging our traditional funerary practices and advocating for transparency, eco-friendly options, and family involvement. While White patriarchy has spent the past hundred years shutting the doors and pulling the curtain — obfuscating and profiting from one of life’s most significant milestones — modern women are questioning whom our current system is serving and telling the funeral industry that its time is up.

Make no mistake, the future of death is a feminist one.

Feminist death advocates argue that the $20 billion funeral industry thrives on our society’s reluctance to face, or even think about, death. Although our fear of death is nothing new, our modern denial of death is.

Our current unfamiliarity with natural death has become more informed by horror tropes — including the dead returning to haunt us, or corpses suddenly reanimating to grasp at the living — than by facts. According to Ernest Becker, author of the Pulitzer Prize-winning book The Denial of Death, awareness of our mortality haunts us and motivates us. Becker argues that our actions are motivated by this fear, and in a desperate effort to mitigate our existential terror of ceasing to exist, we seek out distractions. We engage in what he calls “immortality projects” that help us establish legacies that will live on after we are dead, often through our work or by having children.

Due to this fear, and the established systems that shield us from healthy engagement with death, we’ve become death- and grief-illiterate. As a result, we have industry-led funerals that leave little room for meaningful family involvement and require costly products and services that are often unnecessary and can negatively impact the environment.

The median cost of a funeral today is $8,500. The Consumer Price Index for All Urban Consumers recorded a 227.1% increase from 1986 to 2017 — almost double the price increase for all other consumer items. As a result, funerals have become a luxury that many families struggle to afford, leaving some in “funeral poverty” to pay for them. Some states offer assistance, like Michigan’s Burial Services program, which offers up to $455 for a memorial service and cremation payable directly to a funeral director. Such social assistance programs to help with funeral costs vary widely from state to state, but generally cover only a portion of fees. For those without the financial means to pay, responsibility falls to the state, which typically cremates remains or donates the bodies to medical schools.

In contrast, according to the National Home Funeral Alliance, people can expect to pay about $200 for a home funeral, saving thousands of dollars. This amount usually includes dry ice to keep the body cold, gas and permit fees, and a container for the body — such as a simple pine or cardboard coffin — as well as a permit fee for transportation and copies of the death certificate. Costs for final disposition are additional: Direct cremation rings in at $600–$1,100, and burial varies greatly depending on personal preference.

It isn’t just the industry’s financial costs that are staggering; it’s the environmental ones, too.

Most modern funerals begin with embalming — the practice of injecting toxic chemicals into the body to delay the decomposition process. Embalming is not required by law, yet we place embalming fluid containing more than 827,000 gallons of toxic chemicals into the earth annually.

In cemeteries, embalmed bodies are placed in caskets, which use up to 20 million board feet of hardwood and 64,500 tons of steel each year to produce. All of this material is then placed inside concrete vaults to make it easier to maintain cemetery landscaping. And while cremation is more economical, a single cremation consumes as much energy as a 500-mile car journey and emits pollutants like mercury, carbon monoxide, and sulfur dioxide into the air.

For Metzner, caring for his husband’s body was a natural continuation of the love and care Metzner provided him in life.
YES! Photo by Federica Armstrong
Gabriel Gelbart's body was brought home to be washed and wrapped in a golden shroud

Gabriel Gelbart’s body was brought home to be washed and wrapped in a golden shroud by his husband and Los Angeles death midwife Olivia Bareham of Sacred Crossings.

YES! Photo by Federica Armstrong
For three days, mourners spent time with Gelbart's body at the couple's home

For three days, mourners spent time with Gelbart’s body at the couple’s home, decorating the casket and inscribing river rocks that would be used to build a memorial wall on the property. Photos from Sacred Crossings

Life might end with death, but the drain on resources doesn’t. Opting for standard burial means you are also expecting to be provided with “perpetual care” — an industry term to denote the expectation that your grave will be tended to, well, forever. This means lifetimes of land and water use, pesticides, and labor to keep the surrounding landscape manicured and attractive.

In other words: We’ve been taking a natural process that unites all living things and making it altogether unnatural.

The corpse has become a vessel for our death anxieties, a stark reminder of our inevitable future. We spend billions of dollars on anti-aging products because aging reminds us of our own mortality. Even in death our denial continues as we opt to appear “lifelike” and seal bodies away in caskets that promise to “protect” us from decomposition.

Is it any wonder many of us are somewhat relieved that the funeral industry is there to help us deny death just a little bit longer?

Currently, most of us die in busy hospitals or nursing homes, often in the company of strangers. Funeral homes quickly remove our dead and perform those final physical acts of care in preparing the body. We then go through the motions of performing sterile rituals — devoid of meaning — forced to sum up the significance of a human life during the brief couple of hours the funeral home or church has been rented to us. And in a person’s final moments they are again abandoned to strangers, who will either bury them deep in the earth or, like the mythic Charon, ferry them into the flames.

We can do better for our loved ones. In fact, we have done better.

A little more than a century ago we died at home. Our bodies were lovingly washed and dressed for burial by our kin. Funerals were individual- and community-centered — and women were typically at the helm of the process.

left double quoteOur recent cultural shift to ignoring or immediately disposing of our dead takes us further away from the reality of death and dying.” — Bestselling author Caitlin Doughty

Prior to the Civil War, “The Good Death” was an extension of ars moriendi, “The Art of Dying,” a Christian concept dating back to the 15th century. Dying a good death was a universally shared concept that was integral to life, which played out at home, where the dying individual was supported through this important passage by family and friends. It was believed that a dying person, poised on the threshold of heaven, could impart divine wisdom and provide reassurance that in the afterlife all would be reunited in a place free from the pains and sorrows of earthly life.

Then the war came.

Americans greatly underestimated the scale and duration of the Civil War, initially believing it would resolve quickly and with little bloodshed. Instead, according to historian David Blight, it left a culture of death and mourning beyond imagination. Families were forced to contend with the fact that their loved ones were dying far from home, alone on battlefields without the comforts provided by The Good Death.

For those who could afford it, modern embalming was introduced as a solution to temporarily preserve soldiers’ bodies for the long journey home. Embalmers would chase after battles, setting up camp and often propping up real embalmed bodies outside their tents, like storefront mannequins, to advertise their services. A demand for costly cast-iron caskets to transport bodies gave rise to another new venture.

The transition of embalming from wartime necessity to mainstream practice can be traced back to President Abraham Lincoln, whose body was embalmed and placed on a funeral train that toured 180 cities. The tour was a phenomenon, with mourners lining up for hours to catch a glimpse of the body. Lincoln’s embrace of embalming secured its place in American culture.

YES! Photo by Federica Armstrong
Modern embalming was introduced as a solution to temporarily preserve Civil War soldiers' bodies

Modern embalming was introduced as a solution to temporarily preserve Civil War soldiers’ bodies, which were far from home. Embalmers set up camp near battlefields. Photos from library of congress and Getty

Now that industrious men had found a way to make death profitable, they did so with zeal and ushered in the modern funeral industry. New enterprises to fashionably accessorize death with elaborate caskets, hearses, and mourning clothing emerged, followed by the relatively new roles of funeral director and embalmer.

The funeral and medical industry paralleled each other in numerous ways by “professionalizing” themselves. They opened schools, embraced new technology, and took advantage of false narratives to position themselves as guardians of public health and safety that alone would restore dignity to the processes of birth and death.

While the funeral industry pushed the myth that a corpse was dangerous and needed to be sanitized through embalming, physicians targeted midwives, whom they labeled “barbaric.” In 1911 one obstetrics professor went so far as to describe midwives as “dirty, ignorant, untrained” and an evil that must be controlled.

Death became a specialized profession solely for men — one that employed the “science” of embalming, a service that separated them from the duties that had previously fallen to women, who were removed from the process.

The next big shift in our modern deathways occurred in 1912 when door-to-door salesman Hubert Eaton arrived in Los Angeles with the goal of creating a cemetery and mortuary completely devoid of “signs of earthly death.” That’s right: a cemetery and funeral home without death. Eaton was a devout Christian who believed cemeteries should reinforce the idea of eternal life.

Eaton essentially rebranded death by using language and aesthetics that were comforting and even glamorous. The cemetery was now designated a “park.” Mortuary “slumber rooms” were decorated to evoke the feel of a Hollywood starlet’s boudoir, draped with pink satin and lush velvet. Speakers piped in the merry sounds of birdsong and species of trees that lost their leaves were banned as symbolic reminders of death. Traditional headstones were replaced with flat markers, set low in the sod so views of the lush lawns would not be inconvenienced by reminders that corpses lay in repose six feet under.

Forest Lawn in Los Angeles was the first to combine a cemetery, mortuary, chapels, and florist under one roof. Convenience, the powerful appeal of being the premier choice for celebrity weddings and funerals, and clever marketing that sold consumers an idyllic Hollywood ending became the industry standard — but death and life are far more complicated.

This commodification of death has resulted in one of the most profound and transformational events of our lives being mediated and staged through two industries — medical and funeral — that were initially created to financially and socially benefit men.



Women have fought for control over their bodies for centuries, in life and now in death, as modern women work to subvert patriarchal systems and once again take up the mantle of The Good Death. While the media’s ubiquitious “wellness” trends and discussions of living healthier lifestyles rarely mention death, the women whose stories follow are a small example of a growing movement to help Americans die well.

Death Cafes

Death cafes are informal, public gatherings for people to discuss all things death, with the hope that those discussions will help them to live better lives. According to the Death Cafe website, 8,848 cafes have been hosted since 2011. The cafes are overwhelmingly hosted by women, like Milwaukee resident Shantell Riley, whose son died from gun violence. After observing a lack of support and communication surrounding loss, she was compelled to become a host. Conversations are guided by the attendees themselves. “We laugh, we cry, but, most importantly, we talk,” Riley says. “It is exciting when you hear about how these conversations influence them and the impact it has on living their lives.”


Most of the 40 million people in the U.S. acting as caregivers for aging family members identify as women. “The U.S. health care system can be incredibly difficult to navigate,” says Aisha Adkins, who in 2017 founded Atlanta-based organization Our Turn 2 Care to fill the gaps. The organization provides information and resources and helps connect marginalized millennial caregivers to each other. “Initially, Our Turn 2 Care was a response to the fear and isolation I felt as a young Black woman,” Adkins says. “Not only was I unprepared to provide the unique medical support my family now needed, I was also unable to plan for my own future.”

Dying Well

In a profession that often views death as a failure — that which is to be avoided — doctors have reported that talking about dying, both with patients and among colleagues, is challenging. Too often the focus is on sustaining life, which frequently comes at great physical, emotional, and financial costs. A palliative care specialist, Dr. Sunita Puri wrote That Good Night: Life and Medicine in the Eleventh Hour, a book to help doctors and patients focus on quality of life in lieu of employing extraordinary measures that only prolong suffering for both the individual and their loved ones.

Puri encourages people not to shy away from talking about death, as it will help to clarify a plan that will augment happiness, comfort, and the things that are most meaningful to a patient in their final days.

Death Doulas

The largest sector of the female-led death revolution is death doulas, women who are reclaiming their role at the deathbed. The International End of Life Doula Association offers training programs that regularly sell out and have trained over 2,000 people in just under three years. Death doulas are “trained professionals with expertise and skills in supporting the dying person and the network of family, loved ones, and friends, to maintain the desired quality of life during the active dying process,” says Seattle-based death doula Lashanna Williams.

Rest in Peace

Eco-friendly options are gaining ground, including green burial and aquamation. The latter “uses gentle water flow, temperature, and alkalinity to accelerate our ecosystem’s natural method of decomposing organic matter,” providing the same result as flame cremation, says Darci Bernard, co-owner of an aquamation facility for pets in Seattle.

It should come as no surprise that the biggest opponents of aquamation have been men, including casket-makers, conservative politicians, and religious figures.

Another option currently making headlines after becoming legalized in Washington state is recomposition. Katrina Spade is the founder of Recompose, a public-benefit corporation developing a natural alternative to conventional cremation and burial. Similar to composting, recomposition gently transforms bodies into soil, which is then returned to families who can use it to grow trees or nourish gardens, creating new life through death.

Rethinking the Funeral Home

Bestselling author Caitlin Doughty has been revealing what goes on behind closed doors at funeral homes in her popular YouTube series, “Ask a Mortician” and a podcast, which she co-hosts with me. She approaches death with both humor and sensitivity, making the taboo topic accessible to many.

The heart of Doughty’s advocacy centers on the corpse, which has “served as a vessel for feeling, ritual, and grief, for thousands of years of human history,” she says. “Our recent cultural shift to ignoring or immediately disposing of our dead takes us further away from the reality of death and dying and prevents us from forming a healthy relationship with our own mortality.”

As both Doughty and photographer Paul Koudounaris have observed during their travels to document death practices around the world, the aversion Americans have toward death and corpses is not common elsewhere. Where we’ve created a hard boundary between ourselves and death, for most of the world a softer line exists, creating space for the living to work through their grief, begin to comprehend death, and come to terms with the fact that the bonds we’ve established with others do not dissipate at the moment of death.

In the U.S. we’ve handed over this sacred space surrounding the corpse to the funeral industry. The women reclaiming this space are acting in resistance.

It is clear that our society’s current denial of death is not working. What would our culture look like if we instead met the most mysterious, painful, and transformational aspect of our lives with compassion and clarity?

With women leading the way, we can create a future of death care that will improve not only how future generations die, but how they live. This is a legacy, and a feminist one at that, for which we can all be proud.

Sarah Chavez

Sarah Chavez is the executive director of the Order of the Good Death and co-founder of feminist site Death & the Maiden. Twitter: @sarah_calavera.


Bring Back a Visible Mourning Culture I needed others to see me — to acknowledge my grief.

engraving from La Mode Illustree, 1888

engraving from La Mode Illustree, 1888. De Agostini Editorial / Getty

Reader, he died.

I’ve devoted my career to death. As a scholar of Victorian disease, I think about death nearly every day, but this did not protect me from the sucker punch of loss. Neither did his slow, prolonged decline, nor my slow, growing awareness of his coming end, like a roller-coaster inching to the crest of a hurtling drop.

It hit me as I cradled my dog’s dead body: I was 32, a specialist in death, and I’d never seen a corpse before this moment. Even as my animalistic cries mingled with actual animal cries in the veterinarian’s office, the scholar in me awoke. How had I never seen a corpse? It struck me as I stroked his soft, velvet ears, no longer responsive to my love, that this separation from death — pervasive in modern society — is actually culturally and historically unprecedented.

Evidence of rituals associated with death is ancient — burials of modern humans date back about 30,000 years, a testament to the very human need for a physical means of coping with loss. Jewish communities sit Shiva. At funerals, mourners also tear pieces of their clothing to mark the permanent rift left in the fabric of their lives. In Croatia, going into mourning is still standard. But in America and much of Western Europe, we’ve scrubbed society clean of anything that bespeaks death. We tend to see ourselves as beyond the pale of infectious disease, and we have developed an entire funeral industry to cart away death so we don’t have to see it. Yet, by privileging ourselves with this social sanitation that offers a fantasy of life free from death, we have, in fact, robbed ourselves of any means of coping with it.

Caught in a vortex of loss, I felt profoundly the productive communal purpose of Victorian mourning culture. Victorian novelists often refer to mourning culture with wry disdain. I can appreciate their critique: After all, you were expected to go into mourning for your husband whether you were desperately in love with him or whether he was an abusive sadist. But in doing away with what can seem like fussy external markers of a deeply personal state, we’ve thrown the baby out with the bathwater.

Expected to teach my classes on Victorian culture and live my life with the stoic professionalism of the unbereaved, I felt lost after his death. I needed others to see me — to acknowledge my grief. Somehow that eased the nauseating feeling that my loss of something tangible was itself intangible. So, with the existential defiance of the bereft, I went into Victorian mourning. I wore black clothes and jet jewelry for weeks, comforted by their mute message: “Here stands loss … unalterable, unutterable loss.” In 2019, though, my mourning cues were indecipherable. How I wished, in that black hole of clawing grief, that they were readable signs calling for community support when I didn’t have strength to ask for it.

I wore black clothes and jet jewelry for weeks, comforted by their mute message: “Here stands loss, unalterable, unutterable loss.”

Victorian mourning culture was as complex as modern-day weddings. Bodies stayed in the family home for extended periods, giving families time to make sense of the same bodies they had always known, now lifeless. Black clothes were standard for up to two years, depending on the relationship with the deceased, after which muted purples and grays were permissible. Death literally colored daily life. After a flu epidemic in 1890, the streets were seas of black and purple foot traffic. Everything from jewelry to stationery to vehicles were marked with mourning symbols, communicating to correspondents and passersby that death had touched the writer of that letter, the person in this carriage. Families hired public mourners to walk with them to the cemetery, a means of asking for community witness to the expansive, enormous, all-consuming nature of private loss. They took one last photograph of their departed, and often clipped hair from their heads to braid into jewelry.

Today, my students often find these practices revolting, but they make sense to me. Ritual pads desperation. It gives us something to hold on to, literally and figuratively, a presence to mark an absence that feels like it will swallow us whole. I too clipped a lock of his hair and stored it away in an envelope to be sent to the few people who still practice the art of weaving Victorian hair jewelry for mourners. It’s not off-putting to me, because it was him — a cherished life connected to mine. It’s the last remaining vestige of his DNA — why wouldn’t I hoard it greedily when I’ve been deprived of every other part of his presence?

At a wedding recently, six months after his death, I found one of his hairs on my dress, death clinging to life at a celebration of love. What is more beautiful than this? This loss, this life, this love, all there together, among a crowd of unwitting wedding guests. I let the strand of hair go, watching as it drifted in the wind. This was another ritual concoction of mine in a world that gave me no structure for my grief, and I used it to wish for a world that did.

Friends at the End

Death doulas’ caregiving is an ancient practice. They are there to ease our dying, making death as natural and without fear and trauma as possible.

Vivette Jeffries-Logan, left, and Omisade Burney-Scott are death doulas.

Vivette Jeffries-Logan, left, and Omisade Burney-Scott are death doulas. They perform sacraments of soothing and release drawn from their West African and Indigenous spiritual traditions. YES! Photo by Madeline Gray

Vivette Jeffries-Logan and Omisade Burney-Scott are friends for life — and collaborators in death. Three years ago when a mutual friend realized she wouldn’t survive pancreatic cancer, the two central North Carolina women were within the circle of friends she summoned.

Cynthia Greenlee

Cynthia Greenlee, Ph.D., is a writer, editor, and historian based in North Carolina. Twitter: @CynthiaGreenlee.

Over the course of about three months, the women stayed at Cynthia Brown’s side, as the community activist and one-time Durham City Council member went about the process of dying.

They rubbed her head, kept a watchful eye on her pain, and helped her decipher doctorspeak. And when her spirits appeared to lag, they’d tell her jokes and sing at her bedside.

This, Jeffries-Logan says, was a good death: “If I can help someone at the end of life heal and be clear, I will. There are some things we are required to do alone, but we are not isolated. We are community people. What happens to my nation happens to me. What happens to me happens to my nation.”

Jeffries-Logan and Burney-Scott are death doulas; their form of caregiving is both old and new. The ancient Greek word “doula,” meaning “woman servant” or “slave,” was repurposed in the 1960s to describe birth workers who offer encouragement, back rubs, and other assistance during childbirth.

These days, end-of-life doulas, sometimes called death midwives, are an emerging profession in the growing death positivity movement, which urges a paradigm shift for thinking and talking about death as natural and not inherently traumatic.

They provide nonmedical support to help ease the final transition for the terminally ill. But it’s not merely about that culminating moment, “The End.” They help the dying and their loved ones navigate death with all its “before and afters” — including sickness, acceptance, finding resources for all the legal housekeeping, funeral planning, and bereavement.

For Burney-Scott and Jeffries-Logan, it’s the highest calling.

Sisters in ritual, they performed sacraments of soothing and release drawn from their West African and Indigenous spiritual traditions. Burney-Scott is African American and was initiated in the West African Ife religious practice, and Jeffries-Logan is a member of the Occaneechi Band of the Saponi Nation, a tribe rooted in the North Carolina Piedmont region.

Being a death doula “is not fun. But it’s an honor,” says Burney-Scott, a healer and longtime advocate who most recently worked as a reproductive justice organizer in North Carolina.

She stumbled into the practice when her mother’s dear friend, a hospice nurse, showed Burney-Scott what to do at her mother’s passing. “I didn’t want to do it,” she says. “The thing I feared most, from when I was a little girl and even when my mom was healthy, was losing my mother. She was that mom that all my friends would talk to, the mom who could let you know [you] were the most special person in the world even when she was yelling at you to do your laundry.”

Near the end, her mother made her retrieve a manila envelope containing her will, insurance information, deeds — the bureaucracy of death. But without ever using the word “doula,” her friend guided Burney-Scott in ushering out of this world the woman who had brought her into it.

“Aunt Cora” encouraged Burney-Scott to whisper her love in her mother’s ear, to hold her hand, play music, and to be present in “an organic practice.” One day, when her mother struggled to breathe, Cora assured Burney-Scott that she didn’t need to fetch doctors — that nothing was wrong. “She’s leaving,” Cora told her, a simple statement that’s also a tenet of end-of-life care: Death can’t be controlled, but you can prepare for some aspects of it.

Because there is no universal or official training, no licensing and no regulation, there is no official estimate of how many death doulas operate in this country.

But death and dying are constant. And beyond the eulogies and coffins, there’s a clear and growing need for death-related services. The number of Medicare-approved home- and hospital-based hospices, for example, rose from barely 30 to slightly more than 3,400 between 1984 and 2009. A decade later, more than 4,500 exist, according to the Centers for Medicare & Medicaid Services.

Vivette Jeffries-Logan, a citizen of the Occaneechi Band of the Saponi Nation, stands at the re-creation of her ancestors' village site in Hillsborough, North Carolina.

Vivette Jeffries-Logan, a citizen of the Occaneechi Band of the Saponi Nation, stands at the re-creation of her ancestors’ village site in Hillsborough, North Carolina. She spent eight years studying with elders. yes! Photo by madeline gray

Groups such as the International End-of-Life Doula Association and others train and certify doulas, providing hands-on experience, like a practicum. Still, many death doulas enter the field as Burney-Scott did, pressed into duty by a family member’s passing. Few can make it into a full-time, paying job. Others have a background in the clergy or are people of faith, are volunteers involved in work with the sick and shut-in, or are shamans or healers.

Still others start end-of-life doulaing because they are nurses, midwives, or health care professionals who, through experience, have come to know that end of life is more than just what happens to your body.

Merilynne Rush, a nurse and home-birth midwife, co-founded Lifespan Doulas, an organization that trains and certifies end-of-life doulas. In three years, she says, the group has trained 200 people. She sees the need to educate and vet death doulas even while she thinks that community-trained doulas are valuable and necessary.

“There are so many people who are called in their communities [to do this] that no one should tell them they can’t,” Rush says. “I’d never be able to go into every community. That’s one reason for never having any kind of regulation that imposes a state-sanctioned structure that says you are in or out.

“At the same time, when you are working within a medical organization, they need to know you are OK and there are some standards,” she adds. “Training should never be mandatory, but optional.”

A diversity consultant who focuses on Native communities and trauma, Jeffries-Logan distrusts what she believes is a move toward professionalization.

Her death doula work is grounded in Indigenous customs, and communicating with the ancestors does not happen through curricula. Heeding a call from her ancestors, she did a traveling ceremony, designed to pave a deceased person’s road to the afterlife, for an infant relative who died before he turned a year old. As part of a common tribal custom, she won’t speak the name of the deceased aloud for a year; to do so could keep the spirit tied to its temporal life — now a thing of the past — and distract it from the arduous journey to the ancestors.

Neither she nor Burney-Scott takes money for what they do. Rather, they extend their services to family and friends based on existing connections and an understanding that death is cultural and clinical. “It’s not like I was going to roll up and do this with just anyone. I don’t do shallow-ass relationships,” Jeffries-Logan says.

She questions what happens when the training moves out of informal community pedagogy and into a classroom.

“Who’s the certifying body? Who has the funds to pay for services?” she asks. She thinks of formalizing death doula work in the same vein as yoga, an Indian spiritual system that has been co-opted from communities of color and networks of caring to be dominated by White instructors who teach a fraction — the poses, the breathing — of the whole for pay.

So she stroked the soles of Brown’s feet — which got cooler and cooler as death approached — not to bring back sensation, but to help untether her from this earth.

Both women know that communities of color lag in accessing end-of-life care — whether due to cultural beliefs, experience and well-founded fear of racism in medical settings, lack of insurance or financial resources, or misconceptions about what’s available.

For example, Black people represented 8% of those receiving Medicare-funded hospice benefits in 2017, compared to 82% for White people.

In many Southern Black communities, people won’t talk about death, Burney-Scott offers. “There is truth in our mouth. You can manifest things with your word. Don’t talk about death [lest] you invite it in.”

That goes for other communities, as well. A 2010 study comparing Latino immigrant to White cancer caregivers found that the Latinos were surprised and even disturbed by transparent talk about death in hospice pamphlets and consultations.

Furthermore, Rush says that generally when death is imminent, “most people are overwhelmed and don’t know where to turn. They don’t even know that they can get hospice earlier. And even then, they may have a nurse come in for a few hours or an aide, but they aren’t there all the time. People have to rely on their community and network.”

And that’s just what Cynthia Brown did once she accepted that she wasn’t going to beat cancer, calling on the women her family members sometimes referred to as “Cynthia’s girls.”

“She invited us into the process from the very beginning. We swung into action on the logistical things: running errands, taking her to appointments, making meals,” Burney-Scott says.

“And then she said, ‘I want to cut my hair.’ She had 12 braids left. Each one of us cut two braids. Then, she called and said, ‘Hey, will you come over and help me write my memorial?”

She summoned Jeffries-Logan and another friend to help her assemble and bless her ancestors’ altar. With trademark precision and humor, she even planned who would cook at her funeral repast or meal: not her many loving White friends; she didn’t trust their chops in the kitchen.

Her death doulas and friends, in turn, called on each other, their own histories of loss, and their ancestors to help guide Brown through her own departure.

And when the end came, the friends all rolled to the hospital one last time. Burney-Scott donned her trademark white head wrap and packed a bag with crystals and Florida water, a citrusy blend believed to have calming properties.

Jeffries-Logan carried tobacco as an offering; red cedar to represent blood and life force; water from the Eno River, which courses through her tribal nation’s territory; and a ceremonial turtle rattle, used by tribes in special ceremonies.

“Cynthia fed me, I laid up on her couch, we carpooled to anti-racism trainings around the state,” Jeffries-Logan says, her eyes moist and a catch in her voice. “And when we did a ritual for my mother [who died from Alzheimer’s disease] in the ocean, Cynthia told me, since she had lost her parents at a young age and had to be like a mother to her younger siblings, she knew what it was like to be a motherless child. I was going to do whatever I could for her.”

She didn’t want her beloved sister-friend “scratching and clawing to stay here.” So she stroked the soles of Brown’s feet — which got cooler and cooler as death approached — not to bring back sensation, but to help untether her from this earth.

When Brown took her last breath, Burney-Scott’s and Jeffries-Logan’s hands were among those resting on her body. It was a fitting end: a social death for a community advocate who told her friends, “You continue to fight the good fight, and you have to promise me that you won’t leave anyone behind.”

Cynthia Greenlee

Cynthia Greenlee, Ph.D., is a writer, editor, and historian based in North Carolina. Twitter: @CynthiaGreenlee.

Making Room for Spirits Among the Living

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Making Room for Spirits graphic story No. 1

Making Room for Spirits graphic story No. 2

Return to Nature

Green burials go beyond not polluting or wasting. It’s about people needing and caring for land, conducting life-affirming activities there — including death.

In March, Stiles Najac buried her partner, Souleymane Ouattara, at the Rhinebeck natural cemetery

In March, Stiles Najac buried her partner, Souleymane Ouattara, at the Rhinebeck natural cemetery and looked forward to returning with their baby son, Zana, to picnic in the woods near his dad. yes! photo by meredith heuer

Initially, the cemetery in Rhinebeck, New York, appears conventional: businesslike granite squares placed in rows, flags and silk flowers sticking up here and there, grass mowed tight all around. In one corner, however, a walking path roped off from vehicles invites visitors to stroll into the woods. The area looks wild, but it turns out to be part of the cemetery. A hardwood sign marks it the “Natural Burial Ground.” Cherry, beech, and locust trees stretch tall. Ferns cover the ground. The sweetness of phlox, a purple wildflower, wafts in the air. The lawn portion suddenly looks as contrived as a golf course.

“It’s stark, isn’t it?” Suzanne Kelly, the cemetery’s administrator, says of the contrast. On a spring day, she’s taking us on a tour of the natural section she helped establish in 2014. We step in and she starts describing the deer, wild turkeys, and songbirds that pass through (and also warns us about a poison ivy patch). About 100 yards in, we start to see mounds and a few small fieldstones, some engraved with simple words like “Dear Nature, Thank You, Evelyn.” These 10 acres have been permanently set aside for bodies to be buried without the chemical embalming, nonbiodegradable caskets, or concrete vaults that often accompany the modern American way of death.

Kelly is a thoughtful Gen X academic-turned-garlic-farmer-turned-green-burial activist and expert. She remembers first feeling disconnected from standard funerals when her father died in 2000. She stared at the vinyl carpet covering his deep concrete vault and wondered what all the trappings of her dad’s Catholic service were for. “The idea of ‘dust to dust’ seemed to be missing,” she remembers. “Even though we were standing at the grave saying those words, we were not living those words.”

After moving back to the Hudson Valley in 2002, Kelly joined Rhinebeck’s cemetery advisory committee. She hoped to create options for people who wanted highly personal burials that connected to the earth. Since then, Kelly has positioned the Rhinebeck natural burial ground at the forefront of a growing international movement to reclaim death by bringing back burial traditions that are more environmentally friendly, more personalized, and more connected to place.

In 2015, Kelly wrote Greening Death, the definitive book on the grassroots efforts behind the movement. “The impetus has been to make death more environmentally minded, less resource-intensive, and less polluting,” she says. “And to tie us back to the land.”

While Stiles Najac buried her partner in March, she found that the Rhinebeck ground gave her an unexpected peace. Najac was nine months pregnant with their son when her partner, Souleymane Ouattara, died by suicide last fall. Six months of bureaucratic complications followed before Najac could lay him to rest. (A medical examiner stored Ouattara’s body in a cooler, a common preservation method before natural burials.) Ouattara was an Ivory Coast native, and his Muslim family wanted Islamic “dust to dust” burial traditions, which typically eschew vaults.

So on a crisp day, Ouattara’s friends and family traversed the burial ground’s muddy lane to a chosen spot in the sun. They lowered his body into the ground using straps. “It added another level of connection,” Najac says. “People actually returned him to the earth.” As sunlight flickered through the branches, each mourner had a chance to speak. Ouattara’s uncle had plainly felt the stigma of a family suicide. As the service went on, Najac watched his demeanor change. His nephew was still beloved.

Afterward, though lunch was waiting, everybody lingered. “We were nestled in the trees, which create warmth on even the coldest day,” Najac remembers. “I had that feeling of comfort and acceptance. This was nature’s home.” She plans to bring their exuberant baby son, Zana, to picnic in the woods with friends in the warmer months near his dad.

Since the Civil War, American death rituals have become increasingly elaborate, complete with artificial embalming, concrete vaults, and satin-lined metal caskets. But in 1963, writer Jessica Mitford’s witty exposé of the funeral industry, The American Way of Death, sold every copy the day it was published. (Spoiler: Plenty of material is wasted along the way, but lavishly buried bodies still decay, perhaps even more spectacularly than their pine-boxed counterparts.) The book changed the way Americans thought about funerals and contributed to the growth of cremation rates, from 2% then to more than 50% today.

[Cremation] isn’t as eco-friendly as many assume. Cremation relies on fossil fuels, produces about 150 pounds of CO2 per body, and releases mercury and other byproducts into the air. Burning one body is equivalent to driving 600 miles.

Still, cremation has limitations in both cost and impact. In 2017, the median cost of an American funeral with viewing and vault was $8,755, according to the National Funeral Directors Association. The median cost of a comparable cremation wasn’t dramatically less, at $6,260. In the age of climate change, environmental concerns have also prompted more people to cremate. For example, a conventional burial contributes to the production of about 230 pounds of CO2 equivalent, according to Sam Bar, quality assurance and manufacturing engineer at Green Burial Council, a California-based nonprofit that advocates for “environmentally sustainable, natural death care.” But burning isn’t as eco-friendly as many assume. Cremation relies on fossil fuels, produces about 150 pounds of CO2 per body, and releases mercury and other byproducts into the air. Burning one body is equivalent to driving 600 miles. And scattering “cremains” isn’t good for soil.

Then a couple decades ago, activists on both sides of the Atlantic came up with similar alternatives to the $20 billion funeral industry: What if we returned to burial practices that allowed bodies to decompose naturally? And what if lands could be preserved in the process? The author and social innovator Nicholas Albery helped establish “woodland burials” in the United Kingdom in 1994. The first similar but independently generated concept in the United States was Ramsey Creek Preserve, established in South Carolina in 1998. Billy and Kimberley Campbell are proud that it is now a dedicated Conservation Burial Ground, with a permanent land trust agreement. “Instead of wasting land, you’re actually protecting ecologically important land,” Billy says.

Whether next to a regular cemetery or on conserved land, there are now around 218 natural burial grounds in the U.S., up from around 100 just five years ago. The Green Burial Council certifies about one-third of them. (New Hampshire Funeral Resources, Education & Advocacy keeps a longer list that includes grounds not certified by the Green Burial Council, while other burial sites remain unreported.)

The Green Burial Council holds dual nonprofit status: a 501(c)(6) that certifies grounds and a 501(c)(3) that conducts education and outreach. The organization formed in response to the growing green burial movement and has since become the standard bearer of, and leading authority in, the U.S. movement. That’s no mean feat, given the divisions of purpose that have fragmented the nascent industry in the past. Lee Webster, director of the Green Burial Council’s education and outreach arm, says parts of the early movement were “very elitist,” and there is still a lot of confusion around terminology and standards.

Each year, burials in the U.S. use more than 827,000 gallons of dangerous chemicals and 1.6 million tons of concrete, materials that can be toxic to produce and damaging to the environment.

The Green Burial Council currently has three certification standards for green-burial grounds. Certified “hybrid cemeteries” are modern cemeteries that reserve space for burials without embalming or concrete vaults (each year, burials in the U.S. use more than 827,000 gallons of dangerous chemicals and 1.6 million tons of concrete, materials that can be toxic to produce and damaging to the environment). Certified “natural cemeteries” prohibit the use of vaults and toxic chemical embalming. And certified “conservation burial grounds” meet the other requirements of hybrid and natural cemeteries plus establish a land trust that holds a conservation easement, deed restriction, or other legally binding preservation of the land.

Webster spent three years on the Green Burial Council board through 2017 and returned earlier this year to help steer education and outreach. “Because of the myth people have been sold about vaults and caskets, we have to reeducate people on the safety of bodies being buried in the ground without all the furniture,” she says.

The Council updated its standards this spring to better align them with land trust and land management conservation practices. Establishing a land trust for a burial ground lends legitimacy to what’s still a niche movement, in addition to preserving the land and creating a potential revenue stream — crucial at a time when cemetery funding is short (in large part because increasing U.S. cremation rates have cut burial-plot revenues). As private and municipal-run burial grounds fill up, they can’t keep adding bodies, which means they have to dip into endowments to fund operations, Webster says. It’s not uncommon for a private cemetery to be abandoned when it runs out of money, at which point a nearby municipality often takes over, stretching funds even thinner.

To advocates like Webster, land conservation is the future of green burial. “The way it’s been approached has been to see it from a cemeterian’s point of view rather than a conservation point of view,” she says. “We’re going back now to encourage more land trusts to participate in this and understand how burial can be a conservation strategy.”

Others are going even further. In May, Washington became the first state to legalize body composting as an alternative to cremation or casket burial, a process pioneered by the Seattle-based company Recompose. Other companies offer still more unusual methods of handling human remains: You can have your body mummified, dissolved in water and lye, buried in a pod and planted with a tree, “promessed” (frozen, vibrated into dust, dehydrated, and reintegrated into soil), or put into the ground with a burial suit embroidered with mushroom-spore thread.

Webster believes that body composting and other methods of reintegrating human remains into the environment are “the answer” for urban settings, where burial space is increasingly scarce. So why keep advocating for natural burial grounds like the one in Rhinebeck? It’s the potential they hold for land conservation that’s exciting, she says, and remembrance ceremonies can become new ways to engage with the land. On the day we visited the Rhinebeck natural burial ground, two people bicycled on the pathway through the woods. Although they’d heard the site was a cemetery, they were using it as they’d use any public park.

left double quoteIt’s not just that we’re going to put people in the ground without concrete. It’s about the big picture and how it affects people, the way we relate to death but also the way we relate to each other in life.” — Lee Webster, director of the Green Burial Council’s education and outreach arm

“Conservation is about people needing and caring for land,” Webster says. “They’re going to conduct life-affirming activities: Getting married there, baptisms, confirmations, bird-watching, hiking, family picnics — all kinds of things are happening in these spaces because they’re conservation spaces first. That’s the value of it. It’s not just that we’re going to put people in the ground without concrete. It’s about the big picture and how it affects people, the way we relate to death but also the way we relate to each other in life.”

There is disagreement within the movement on how best to grow. The values driving green burial suggest there should be more conservation cemeteries, but to meet that standard usually requires starting a new cemetery rather than converting or hybridizing an existing one. That costs a lot of money and requires securing new land and going through a complicated zoning process. To date, the Green Burial Council has certified only six conservation cemeteries in the U.S., compared to 35 hybrid cemeteries.

Cynthia Beal, of the Natural Burial Company in Eugene, Oregon, is a vocal proponent for converting existing cemeteries to natural burial spaces. That averts the zoning issue and provides an educational opportunity for the community. “If you’re coming into a situation where the cemetery has been abandoned or poorly cared for and you make natural burial its new focus, you’re likely to have neighbors as advocates, happy to see the grounds renewed and the place cared for again,” Beal says. “Every cemetery is unique, telling its own stories of a community’s establishment and growth, and that history is also worthy of stewardship.”

Webster, for her part, is pragmatic about the challenge: While it would be great for more conservation cemeteries to come online, practices at local cemeteries should be improved in the meantime. That would also increase education and access. “A sense of place is critically important to this,” she says. “I’m not going to [be driven] 300 miles to be buried in a green cemetery. My family is going to associate me with here, where we lived.”

Even in places like Rhinebeck that build at least partly on existing cemetery infrastructure, establishing green-burial sites takes time. Ramsey Creek Preserve was easier, Kimberley Campbell says, because South Carolina didn’t bother regulating. “I called down to the funeral board and got a delightful secretary,” Kimberley remembers. “She said, ‘The cemetery board has shut down. … I think what you are doing sounds marvelous, and there is absolutely nothing to stop you.’” For Rhinebeck administrator Kelly, using municipal land didn’t require raising the $50,000 in trust for upkeep that is standard in many places. Still, it had to be planned, bid, surveyed, plotted, and certified, which took around five years.

The payoff of a natural burial ground can be big for a community. Gina Walker Fox, a Rhinebeck real estate agent, says she feels more comfortable with death for having bought a plot. (At 61, she recently asked a local quilter to sew her a raw-linen shroud, which she plans to embroider with a symbolic river.) Fox’s plot is near a blackcap raspberry bush she knows her adult children will want to visit. “That old way — where people pick berries, sit, visit, picnic — that speaks to me,” she says.

Kelly laughs when we ask where she’ll be buried. She hasn’t picked or purchased a spot yet. Even a green-burial activist can feel like she has plenty of time to live. “Once in a while,” she says, “I come by here and think I should probably get around to getting a plot.”


Black Funerals Are a Mood For African Americans, homegoings are the ultimate form of liberation.

The funerals — or homegoing celebrations, as they’re called in many Black communities — of Aretha Franklin and hip-hop artist Nipsey Hussle garnered millions of views from people across the globe via live television and viral online videos. They gave the world a glimpse of a tradition and ritual that until recently has mostly been witnessed from within African American communities.

Whether held at a small storefront church or one that seats thousands, as in Franklin’s, or at a stadium, as in Hussle’s, some things are constant: On display are flower-filled altars as the backdrop of the neatly casketed loved one, tear-jerking slideshows, the belting of Negro spirituals, odes to ancestors, sometimes West African drumming, liturgical dance selections and emotional reflections — oftentimes exceeding the two-minute time limit.

Black funerals are hands down the Blackest environment known to Black folks, where raw forms of Blackness are exercised — aesthetic, void of dress code, just “come as you are,” suited and booted, with colorful, elaborate hats, or oversized T-shirts honoring the deceased; celebration, gospel, grief, rage, repentance, the organ and its sonorous chords melded with guttural cords of the vocalist — it all goes down. For African Americans, the homegoing is the ultimate form of liberation. It is one of few Black spaces that has not been permeated with Whiteness.

Although, that was not always the case.

In her book To Serve the Living: Funeral Directors and the African American Way of Death, Suzanne E. Smith writes that during the Antebellum period, enslaved Africans were prohibited from performing funerals, much less practicing traditions that memorialized the dead.

This disallowance was due in part to the opportunities thought to be present when the enslaved gathered in numbers — that they’d escape captivity or plan a rebellion. It is also safe to assume enslavers simply lacked empathy and denied their “property” any sense of humanity. And if a slave owner felt benevolent toward enslaved mourners, funeral services were granted, albeit under supervision of an overseer or the enslaver himself. Such measures called for those enslaved to carry out funeral ceremonies in “hush harbors,” which were covert places where African religious practices were fused with Christianity — of course, unbeknownst to enslavers.

The American Civil War changed that. Black soldiers and civilians were relegated to recovering, embalming, and burying the dead bodies of other Black people, soldiers and civilians, and thus developed a vocational skill that would not only be profitable, but revered in Black communities.

And as funeralizing morphed into a viable profession in the Black community, Black embalmers, funeral directors, and morticians were shut out from the National Funeral Directors Association, moving them to form their own National Funeral Directors & Morticians Association. This led to African Americans being able to undertake and practice funeral services in our own way. Black funerals as we know them today emerged from those duties. Further segregation during Jim Crow and redlining helped them to thrive.

Homegoings are where Black folks perform Blackness with whole and unfettered reverence.

Once having been forced to abandon their ancestors’ traditions, Black people in America have revisited them.

Black funerals have thrived and continue to be void of Whiteness. Perhaps that is why they thrive.

Homegoings are where Black folks perform Blackness with whole and unfettered reverence. Benevolence and group economics are often at play because life insurance isn’t always part of the deal. Never mind the memorial Olympics — who bought the largest floral arrangement, or spoke the longest, cried the loudest, threw themselves at the casket. For each articulates love and loss in their own way wrapped in the finest African American vernacular. There’s no sight to see quite like witnessing estranged family members who fell out of fellowship unify out of respect for the decedent.

At Black services, blind rage may speak its truth to a room of sympathizers without the threat of dismissal, erasure, or harm. Black grief is tended by gingerly hands and hugs absent of hegemonic stereotypes and social pressures that demand strong womanness and hypermasculinity. Black funerals are a testament of rhythm and blues that fill chapels, soul that pours from organs, intonation wrapped around eulogies, final farewells at the close of the casket, and jubilance of breaking bread and celebrating Black life at the repast.

The Black funeral is a mood. It is radical Blackness and love at face value without the interruption of Whiteness.

Dead? Not dead? How families approach healing without certainty.


photos by Kevin Holtham

Daniel Pérez went missing Nov. 26, 2015, while attempting to cross the border into the United States.

Since 2015, Norma Pérez has been searching for her younger brother Daniel, one of thousands of migrants who’ve gone missing attempting to cross the border into the United States.

“His name is Daniel; he’s my little brother. He disappeared on Nov. 26, 2015. It’s been four years, and we haven’t heard anything about him. We contacted everyone,” says Pérez, who lives in the San Francisco Bay Area. “We don’t have much hope that one day he will appear. We’ve tried everything.”

Daniel was 18 when he went missing in 2015, making him 21 today. Pérez and her family, originally from Guanajuato, Mexico, started searching for Daniel immediately after he went missing, she says. Her father traveled to the border at Tijuana to file a missing-persons report.

“[Daniel] had returned to Mexico, but he couldn’t adapt. It was very difficult for him there,” Pérez says. “He couldn’t find work. He told me that he was going to try to cross the border that day. We didn’t know it would end like this with what happened to him.”

Families whose loved ones have gone missing experience what is known as ambiguous loss, a complex and often misunderstood type of grieving where coping is difficult because of its uncertainty. There are two types: The first occurs when someone is physically missing, as is the case with missing persons; and the second occurs when someone is physically present but psychologically missing, as is the case with dementia or addiction.

“Unfortunately, people jump too quickly to call it depression. It may be depression in some cases, but in all cases it’s sadness, and sadness is a normal reaction to an abnormal kind of loss,” says Pauline Boss, a researcher at the University of Minnesota Twin Cities who developed the theory of ambiguous loss.

Families experiencing it can get frozen in grief, especially if they are alone during the experience.

“Our society doesn’t know what to do with loss, and an ambiguous loss makes it even worse, so they stay away,” creating distance that becomes isolating for those experiencing it, Boss says.

Ambiguous loss is common for families whose relatives have disappeared while crossing the border. It’s also long been an issue in Indigenous communities, where women and girls go missing or are murdered at alarmingly high rates. In Canada, the crisis was declared a genocide after a two-year National Inquiry into the issue. In the U.S., Indigenous women experience violence at rates 10 times the national average, according to a 2018 report published by the Urban Indian Health Institute.

This violence isn’t new — it has occurred since colonization. As a result, Indigenous families have been experiencing ambiguous loss for generations.

“The thing that’s really important when we talk about Indigenous communities is that this kind of loss and grief isn’t just one or two generations old — it’s four, five, six, seven, eight generations old,” says Abigail Echo-Hawk, director of the Urban Indian Health Institute and co-author of the 2018 report. “When we think about the way that trauma is passed down from generation to generation, we absolutely have to be thinking about ambiguous loss and the grief that is perpetuating this generational trauma.”

Indigenous families face significantly more barriers that make the search for missing loved ones more difficult, including the indifference of law enforcement, which often fails to properly record or respond to missing-persons cases involving Indigenous women and girls. In 2016, there were 5,712 Indigenous women and girls reported missing in the U.S., but only 116 of them were filed in the National Missing and Unidentified Persons System, known as NamUs.

“As a result of institutional and structural racism, the data has not been gathered on the race and ethnicities of these women,” Echo-Hawk says. “It allows for an epidemic like we have to continue, and to continue to be unseen.”

Resilience has been the best option. Families experiencing the crisis have been coming together, supporting each other, holding searches, and working to prevent this from happening to others. That’s important, Boss says, because spending time with others experiencing the same type of ambiguous loss and taking action are helpful ways to cope with the pain.

Deborah Maytubee started the MMIW USA Facebook page in 2015 after losing two of her close friends. Since then, the page has grown into a full-blown family support network.

“Last year we brought four families together; three of them had never talked to another MMIW family before,” Maytubee says. “That was a precious thing to watch. When it gets talked about, it is a lot easier for everyone. It makes all the difference.”

The group helps Indigenous families across the U.S. search for missing loved ones and communicate with law enforcement. They also make sure families are able to meet their basic needs by helping with their heating and electric bills as they search and connect them with others experiencing the same situation.

left double quoteIt’s a daily struggle not to fall into sadness. Before Colibrí, the truth is that I did not know anyone well. There are many families experiencing this …” — Norma Pérez

After working with over 300 families with missing loved ones, MMIW USA launched Staying Sacred, a self-defense and awareness program in the Pacific Northwest for Indigenous girls ages 10 to 18. The group meets every month for a self-defense class followed by cultural lessons and discussions on human trafficking and how best to avoid dangerous situations. Most of the girls’ mothers participate in discussions, too.

“What we noticed about two months in was that this was really healing us too, to be able to help the kids avoid these things,” Maytubee says.

Back in the Bay Area, Pérez says she finally found support for coping with her grief. After finding the website for the Tucson, Arizona-based Colibrí Center for Human Rights, she called and gave staff information about Daniel’s disappearance. They then connected Pérez with her local comité, or group of families searching for missing loved ones.

“It’s a daily struggle not to fall into sadness,” Perez says. “Before Colibrí, the truth is that I did not know anyone well. There are many families experiencing this, but they’re not talking about it, I think mostly because of fear.”

The 17 members of her comité travel within the Bay Area to meet, share stories and coping strategies, make music, and seek justice. Colibrí has established four other comités in cities where they’ve received the highest number of reports: Tucson, Phoenix, Los Angeles, and New York City.

Family networks for relatives of desaparecidos have a long history in Latin America, especially in countries that have experienced the violence of civil wars, which often involve the U.S. government. But the groups Cofamide in El Salvador and Cofamipro in Honduras, both family networks created for and by families of disappeared migrants, were important models for Colibrí.

“In addition to the immense emotional difficulty [of ambiguous loss], each of these families is also navigating any number of forms of compounding disenfranchisement,” says Ben Clark, the family network director at Colibrí, “whether that’s documentation status, whether that’s socioeconomic, or these very logistical challenges like the inability to transfer property titles in Mexico for someone who’s disappeared but not confirmed deceased.”

The center launched the family network in 2016 and has created a space for families to be heard both within the network and by the public. And because they aren’t isolated in their suffering, many have been able to raise their voices together.

Colibrí sponsored Pérez and other families whose relatives have gone missing along the border to testify in Boulder, Colorado, before members of the Inter-American Commission on Human Rights. Other members started publishing a monthly zine.

“When I went to Boulder, I was able to meet families from Arizona. We could talk and support each other,” Pérez says, adding that there are plans for more networking between families in Latin America and the U.S.

“I’m sure it will be a very beautiful experience.”

7 Things People Forget to Do Before They Die

It’s never too soon.

photos by Kevin Holtham

Illustration by Anastasia Lembrik

Unless death is imminent, too many of us find the thought of it so frightening and vague that we prefer not to think about it. Kathy Kortes-Miller, author of Talking About Death Won’t Kill You, is a palliative care provider and a cancer survivor. She knows that by talking about death now, we can not only have a better death, but a better life.


Use the D-words.

Death, dying, and dead. Clear language rather than euphemisms like “passed away” or “transitioned” can help loved ones recognize end of life as a normal event and provide better support.


Ask your health care providers questions about death.

Even doctors can be uncomfortable having end-of-life conversations. But insist. “We need to empower ourselves as consumers of the health care system to engage in those conversations,” Kortes-Miller said.


Research for your death.

“Just like you’re preparing for a trip or going out and researching a car,” Kortes-Miller said. Ask yourself what your version of a “good death” looks like.


Take advantage of the little things.

Anyone diagnosed with a life-limiting or terminal illness knows that it makes everyday activities more important — a lesson everyone can take. “That goes into bringing the way we live into the way we die,” Kortes-Miller said. What simple pleasures can you incorporate into your end-of-life plan?


Let your loved ones know you’re going to lean on them for support when the time comes.

“Dying can be hard work for people,” Kortes-Miller said. According to the National Institute on Aging, dying often brings on depression or anxiety. Strong family and community ties can help ease stress and make for a more comfortable death.


Think about what kind of legacy you want to leave.

Kortes-Miller’s aunt wanted her funeral attendees to wear clown noses to remind friends and family of her sense of humor. How do you want your loved ones to remember you? What do you want your descendants to know, and how might that change the way you live your life?


Consider a different bucket list.

If you died suddenly, what have you left unsaid to people in your life? What do you want to have achieved? “Those are the things that can help as a guide to living,” Kortes-Miller said.

Photo Essay

I Am a Future Ancestor There is a larger purpose for healing.

photo illustration by josué rivas

photo illustrations by josué rivas

My father died when I was 7. He was tall, had a black mustache, and had a camera hanging from his neck. At least that’s how I remember him. To be clear, later when I became an adult, I found out he hadn’t actually died. Just disappeared from our lives. I thought he had died — from alcohol, stuck between his pain and his desire to be a good man. I began a healing process recently to better understand my role as a father of my own son, Tonatiuh. My son’s name means “the one that brings the light, the sun.” Digging deep into that trauma is difficult, but my traditional teachings as an Indigenous man tell me there is a larger purpose for my healing. Because all living and dead things are connected, my healing and being able to live well honors not just my ancestors, but also the future generations. For them I will be an ancestor to honor. Knowing this changes how I live my life.

photo illustration by josué rivas

photo illustration by josué rivas

photo illustration by josué rivas

photo illustration by josué rivas

photo illustration by josué rivas

photo illustration by josué rivas


“The End of What It Means to Be Human”

YES! Illustration by fran murphy

YES! Illustration by fran murphy

On a late spring day in seattle, I went for a walk in my neighborhood to enjoy the long-absent rays. But a thought intruded not long into my walk: I needed to pick up an N95 mask before the wildfires started and the hardware stores sold out. That’s what had happened the previous summer when, on a few occasions, smoke from wildfires in British Columbia and eastern Washington blew in and made the city’s air quality the worst of any major city worldwide. Calling this the “new normal” falls short; every year, new disastrous milestones are passed. Not only are human deaths per year expected to increase by at least a few hundred thousand, but 1 million animal and plant species will be at risk of extinction.

And there’s another kind of death that environmental activist and author Bill McKibben sees. The climate crisis also threatens the “human game,” he writes in his new book, Falter, “the sum total of culture and commerce and politics; of religion and sport and social life” — of everything humans have created. Thirty years after his first book framed climate change as a mainstream concern, McKibben assesses the scope and scale of the losses we face.

We talked about this existential death, where he still finds hope, and how to deal with loss this large.

Shannan Lenke Stoll: The tone of this new book is quite bleak. You spend a good portion describing gripping scenes of the death and destruction that’s already happening. Do we need to start being more honest about this crisis?

Bill McKibben: When we started, people said, “Maybe that’s too depressing a title because we’re already past 350 parts per million,” and so on. And I think otherwise. It’s like when you go to the doctor and the doctor tells you your cholesterol is too high: That’s when you finally pay some attention and begin to change. It strikes me that honesty is useful here.

If it was honesty without any hope then I wouldn’t have bothered writing the book. I’d just sit out on the porch and wait for the end to come. But there are things we can do. But we need to be honest about the scale and pace of the problems we face so that the scale and pace of our solutions have some hope of matching them.

Stoll: In terms of scale and pace, you describe how the losses that we’re facing are different from many other types of losses that we’ve faced before. But we have faced similarly existential crises before.

McKibben: Yes, and things that in many ways were harder to deal with. I mean, our grandparents and parents had to figure out how to deal with fascism in Europe in the last century. And that meant that they had to go kill people in large numbers and get killed themselves. And no one’s asking anyone to go kill somebody to solve climate change — just the opposite.

Stoll: What’s driving the inaction on the climate crisis, when those previous challenges were something that we were able to deal with?

McKibben: I think what’s driving the inaction is that, above all, there’s been a concerted effort of the fossil fuel industry. A 30-year campaign of deceit and denial and disinformation that fostered a completely phony debate about whether or not climate change was real, a debate both sides knew the answer to at the beginning — it’s just one of them was willing to lie. And that became the most consequential lie in history.

The alternate history on all of this is that in 1989 and ’88 after Jim Hansen testified that climate change was real, if the CEO of Exxon had gotten on the nightly news and said the same thing, no one would have accused him of being a climate alarmist. We just would have gotten to work. But we didn’t.

Stoll: What are the political and cultural conditions that made that possible? You describe an overarching ideology that arose at that time.

McKibben: The sense that — beginning in or really gaining ascendance in the ’80s under Reagan — that markets solve all worries and that, as Margaret Thatcher put it, there’s no such thing as society, there are only individuals. That kind of Ayn Randian [thought] made it very, very difficult to hold to account the people who were perpetrating that set of lies.

The answer [to that ideology] is human solidarity.

Stoll: Is there a particular loss that hits you especially hard? Because I live in the Pacific Northwest, for me it’s the loss of air quality due to wildfires.

McKibben: The loss of a reliable winter. That’s really, really hard on me. I love winter above all seasons, and it’s sad to see it shrinking and turning slushy. And the loss of a kind of sense of ease in the world around us is painful to me. As with climate change, we’ve seen things like Lyme disease spread, I see many, many people who are scared to let their kids go for a walk in the woods.

Stoll: The climate crisis isn’t all you write about in Falter. You also discuss technological acceleration, particularly with gene editing, CRISPR, and artificial intelligence. What’s the connection between the climate catastrophe and these technologies?

McKibben: I think that they’re also existential threats. You can make a case, and I try to, that they will mean the end of what it means to be human.

Movements are the great sign of hope. The fact that people are beginning to come together in numbers to stand up. I mean, the great dramas of human history often concerned the many and the small against the mighty and the few.

Stoll: You write about how, at its most extreme conclusion, this kind of technological acceleration is ultimately about beating death. You have a chapter about the literal search for the fountain of youth through technology. Could you say a little bit about that?

McKibben: Humans are the creature that knows they will die. That’s a big part of our psyche. And we’ve figured out ways to deal with it, religion being one of the most important and art another. But then these tech guys are so freaked out about it all that they’re willing to upend what it means to be human. If instead of being human, we’re just in a frictionless utopia, then there would be no need or place for [art and culture].

Stoll: When we publish this, the 2020 campaign will really be heating up. What’s the role of activists right now?

McKibben: Well, the first goal is not to get so enmeshed in the presidential campaign that it’s all we do for the next 18 months, because there’s other work that needs to go on.

Elections are important, but so is continued endless pressure on the fossil fuel industry, through things like divestment; so is the continuing opposition to new fossil fuel infrastructure and fights like the ones over Keystone and other pipelines that go on every day.

Stoll: A lot of the activism is coming from the people who are most impacted.

McKibben: That’s absolutely right. The climate fight’s led by frontline communities, by Indigenous communities, and it’s because they’ve faced the most trauma. The groups in America demographically that care most about climate change by far are African Americans and Latino Americans. And it’s because they’ve seen the damage that gets done.

Stoll: How do we build solidarity back into the political system such that people who are really benefiting right now join in?

McKibben: There are people who are never going to join this fight, and they need to be beaten. That’s part of what politics is about. That’s why we fight so hard against the fossil fuel industry. But there’s plenty of other people who have the compassion and empathy necessary to join with others in this fight. And so we need to bring them out of the woodwork wherever we can. That’s why it’s important that faith communities are involved in climate action now.

Stoll: One nugget from your book that I found helpful was a phrase that you used — “usefully naive outrage.” Could you describe what you mean by that?

McKibben: It doesn’t do much good for activists to be super cynical all the time. So, if great reporters discovered that Exxon’s been lying about climate change, it doesn’t do any good to say, “Oh, everybody would know that, of course, Exxon lies.” It’s much more useful to be — as one should be — outraged at those lies and communicate that outrage, that it’s not OK for important forces in our society to behave irresponsibly and immorally.

Stoll: Where do you see the greatest signs of hope?

McKibben: I think that, for me, movements are the great sign of hope. The fact that people are beginning to come together in numbers to stand up. I mean, the great dramas of human history often concerned the many and the small against the mighty and the few, you know, the Rebel Alliance against the Death Star. And that’s what we face when we face Exxon and Chevron and Shell and so on. And our only hope is to gather in numbers sufficient to change the zeitgeist, to change the sense of what’s normal and natural and obvious. And if we can do that, then we can win. It’s not easy, but there’s enough instances of it happening in our history to give it the best try one can.