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Somatosphere Presents

a book forum on
Robert Desjarlais

subject to

death

life and loss in a buddhist world

Contributions from
Anand Pandian
Johns Hopkins University
Karma Gyaltsen Lama
Sarah Pinto
Tufts University
Summar Saad
Wayne State University
Marsha Hurst
Columbia University

with a response from


Robert Desjarlais
Sarah Lawrence College
edited by
Todd Meyers
New York University, Shanghai

Somatosphere Presents
A Book Forum on

Subject to Death:
Life and Loss in a Buddhist World
by Robert Desjarlais
University of Chicago Press
2016, 304 pages
Contributions from:

Anand Pandian
Johns Hopkins University

Karma Gyaltsen Lama


Sarah Pinto
Tufts University

Summar Saad
Wayne State University

Marsha Hurst
Columbia University
with a response from

Robert Desjarlais
Sarah Lawrence College

Edited by

Todd Meyers
New York University, Shanghai

Robert Desjarlaiss Subject to Death is like stepping onto a train already in motion. Its
momentum isn't fierce but theres no time to ease in from its first pages, as readers we find
ourselves in the midst of death and life and loss as they take and are given form. At the risk
of overusing the term, there is great care in this book, and the five commentaries that follow
are reflections of this care, not owing to an expected attitude or comportment towards life
and death, but attending to what is required by the invitation Desjarlais makes to readers,
made between author and subject and reader, as we are brought into a conversation rather
than relegated only to eavesdrop. It is a great honor to present this forum on Robert
Desjarlais's Subject to Death.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
http://somatosphere.net/2016/09/book-forum-robersubject-to-death.html

Living with Dying


ANAND PANDIAN
Associate Professor, Anthropology, Johns Hopkins University

I SAW MY GRANDFATHER in Madurai, India, for the last time in January 2014. He was already
gone somehow; I could tell when I got there. Where was the him in him, I found myself
asking. Wed written a book together about his life, published it in two languages. But his
smiles now were distant and vacant, and what he mostly wanted to say to me was this: Lets
talk later. Ayya, who had survived the plague and two cancers, an indigent childhood and
the Second World War, trembled now with a fright of death, which seemed to approach and
recede in waves. One evening he announced he would die at 5:45. He sat and waited. Then he
said it would come in two minutes. Then it passed, and he played two hands of cards with a
granddaughter. One night it drew so close, this feeling of an imminent death, that my father
sent me to the pharmacy down the road for a few vials of morphine to ease my grandfather's
journey. At the counter, I could barely breathe, keep my own composure from cracking. But
that night too, Ayya survived, and many more that year, lingering at the blessed heart of a
circle of attentive relations and caretakers. Care for the dying and the bereaved, and try to
provide for a good and properly social death, Robert Desjarlais might say. Accompany the
dying in their last moments. Make them feel less frightened and alone. Try to make the
death a calm and comfortable one (53).
The measured and deliberate voice that utters these words is, in fact, one of the most
powerful elements of this remarkable book, Subject to Death. Whose voice is it? Does it belong
to Desjarlais? In their mood and syntax, such terse imperatives, opening each section of each
chapter, are profoundly unlike the remainder of the books prose. They enter directly into
what Desjarlais calls Hyolmo ordinary death philosophy (18), a poiesis of cessation, the
calm and careful making of unmaking that marks experience of death in this Buddhist
lifeworld. How does a person relate the stories of other peoples deaths...without words
dancing on the remnants of their lives? Desjarlais asks (30). These imperative fragments
offer one crucial means of traversing this moral impasse, allowing the book to assume the
intimate voice of a companion. Unlike the Tibetan Bardo Thedol, which teaches the dying how
to die, these moments of counsel in the book, strung throughout the text almost like prayer
beads, teach the living how to live with death, how to navigate the dying of those who are
passing on. With humility and grace, the author invites his readers to share in the
intersubjective responsibility felt by the Hyolmo, a responsibility to help prepare others and
their kin for a good death. For indeed, as Desjarlais writes in a spirit of radical and openended kinship, loss nicks at all of us (18).

Somatosphere | September 2016

Book Forum: Subject to Death by Robert Desjarlais

I read this book during a summer month in the United States pulsing with outrage over
the deaths of Alton Sterling and Philando Castile, over police officers killed in Dallas and in
Baton Rouge, over the apparent impossibility of doing anything with a national populace
armed to the gills with assault weapons, other than to invest law enforcement with ever
more deadly hardware. I reached this books final pages here in Baltimore on the day that all
charges were dropped against the officers involved in the April 2015 death of Freddie Grey, a
death ruled a homicide by the state medical examiners office. In a deeply moving postscript
on the devastating 2015 earthquake in Nepal, Subject to Death touches on the problem of
police brutality in the United States and the turmoil last year in Baltimore. As I read of
Desjarlais and his American Hyolmo interlocutors grappling with the paralyzing torrent of
images that broadcast news of the quake, I couldnt help but think of the shaky and grainy
video clips of untimely death we glimpse so often now in the United States, from bodycams,
online newsfeeds, and the cellphones of bystanders. Can a good death occur during a time
of disaster? Desjarlais asks, lingering on the ghostly apparitions of the familiar flickering
from such images. He rightly cautions us against seeking closure and redemption in such
times, for disaster inhabits the shadows between clear forms, such that each experience of
death endures in its liminality, multiple, recurrent, unsettled" (248, 249, 259). In such
circumstances, this sensitive and courageous book teaches us that what is most important is
less the promise of a good death than the possibility of a good life imagined anew, a life
willing to abide with the sheer uncertainty of death, unafraid to countenance those most
unsettling moments when the world would appear to dissolve.
Online at: http://somatosphere.net/forumpost/living-with-dying

Anand Pandian teaches anthropology at Johns Hopkins University. His most recent book, Reel World:
An Anthropology of Creation, was the focus of a Somatosphere Book Forum in December 2015.

Somatosphere | September 2016

Book Forum: Subject to Death by Robert Desjarlais

Insiders Note
KARMA GYALTSEN LAMA

PROBABLY THE MOST SIMPLISTIC statement on death, needing no elaboration, would be


that each and every being has to die sooner or later. For a common Hyolmo individual,
these words extend themselves from being a mere statement to something carrying a deeper
message. This message serves as a reason for, or rather a reminder of, the importance of
becoming a good human being in this life as a step towards securing a good rebirth in the
next life. This notion, which forms the very basis of the Buddhist principle of impermanence
and karmic interdependence, finds root in Hyolmo lives as a natural component. Although
death occurs at the end of a life, it is actually not that isolated; its dimensions and
implications are far-reaching in a persons everyday events, in his or her relation to others,
and in ones cultural and social engagements throughout life.
Subject to Death is Robert Desjarlaiss close observation of the organic relation of living
and dying present in the Hyolmo society. The stories and conversations in which he engages
converge around Hyolmo ideas of living a meaningful life, carrying out good moral deeds,
hoping for a peaceful good ending when it happens, and wishing for a good rebirth in the
next life (or lives). Bobs discussion in the Prelude, under the section Poiesis in Life and
Death, strikes me as the gist of the subject. Hyolmo life, at least in terms of aspirations, is so
much about creating desirable conditions to affect the relation between life and death.
For a western reader, Subject to Death is an anthropologists informed narration and
discussion of a possibly striking foreign culture. For those like me, from within the Hyolmo
community, it is a sophisticated perspective on our lives, from an angle different from our
own.
During the course of his prolonged work on this book, Bob mentions feeling tensely at
one point that he was having too many thoughts about death; he longed to be soon done
with the work. As a western anthropologist who had not been involved so closely with the
subject, trying to get into it as deeply as he did, this sentiment may well be natural. The
experience of seeing a corpse being cremated on wooden pyre, observing people in the sheer
distress of mourning, witnessing the extensive funeral rites, interviewing so many people,
and then eventually trying to piece together all of those foreign experiences in a larger
picture this understandably should be no fun, if not daunting.
From an early age, I have witnessed many deaths and have taken part in funerals and
cremation rites as have others of my age in our community. Time and again, we have
listened to Lamas (teachers) teach about impermanence, karma, rebirth, compassion and so
forth. For us, then, death is a familiar subject since childhood. It is nothing to shy away
Somatosphere | September 2016

Book Forum: Subject to Death by Robert Desjarlais

from. Death is woven into the cultural fabric of life. When you look at a death singularly, in
an isolated manner, it will seem to cause immense distress, grief and a sense of loss for
anyone. However, when you see it in this larger fabric it indeed serves as a mirror of life,
as teachers put it. It offers a point to reflect on our life and karma, our actions that will
influence our future.
The devastating earthquake last year in Nepal that Bob mentions at the end of the book
badly hit the entire Hyolmo region. Although there were only a few human casualties in
Hyolmo, so many lives were lost in other parts of the country. This is an important reminder
to the impermanent and unpredictable nature of life. The help and support that poured in
from around the world in the aftermath of the earthquake shows humanity unfolding with
love and compassion in times of such tragedy. From a Hyolmo Buddhist perspective, this
implies a great karma of those involved, with or without any conscious association with the
notion. Karma offers so much hope for the future!

Online at: http://somatosphere.net/forumpost/insiders-note

Karma Gyaltsen Lama is an artist from Hyolmo.

Somatosphere | September 2016

Book Forum: Subject to Death by Robert Desjarlais

You are here.


SARAH PINTO
Associate Professor, Anthropology, Tufts University

Take up the ethnography as you might a conversation. Read a sentence. Read it again.
Finish the paragraph, or the chapter, then go back to a phrase that snagged your
attention. It will have changed. Take up that transformation. Know that you are reading
with a community of others.
Consider the way the chapters are pulsed with gentle, recipe-like directives. Find
yourself in the book, in the invitations to act, to notice what those acts are doing to you
and those around you, and to feel what might be created in those actions. Notice that you
are here. You always were.
ROBERT DESJARLAIS BOOK, Subject to Death, about Hyolmo rituals of, for, and by the dying, is
punctuated with sentences in the second-person. The tone is softly instructional. The verb
tense is command. But the fact, underlying the directive, is that these sentences are for you.
So much ethnography is written as though first and third person are not only our only
authorial options, but are the structure for all discussion of ethnographic creativity and its
ethical limits. When we talk about ethnographic experimentation, we are often talking about
the use of first-person. What do we learn from the presence of the I? Is the imaginary of an
omniscient narrator preferable to the imposition of a personal narrative? The use of the
second person in just the way it appears here reminds us how small, and tired, is a
conversation about the politics of knowledge organized around the contrast between first
and third persons.
In Subject to Death, second person commands contain the substance of ritual and the
shape of its relationship to human agency. They are at once specific and vague, open-ended
(we are all their subject) and a call into readerly intimacy. What Desjarlais calls the
epistemology of khoi? of where?, uncertainty, and openness is enacted in these
moments that are initially a surprise, later, a comfort (217). Through them, his writing
demonstrates a willingness to move through uncertainty without getting stuck in it. That
is, Subject to Deaths embrace of uncertainty does not signal a rejection of interpretation, but
is a reminder of its momentary quality.
There is something to be said about what Hyolmo death rituals do. And there is also
something to be said about the way they undo the permanence of that understanding. In
many ways, this book is less an anthropology of impermanence than a statement of
anthropology as impermanence, a Buddhist record of dissolution that returns, by way of the

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Book Forum: Subject to Death by Robert Desjarlais

end of absolutes, to the pressing potential of the conventional and passing. The secondperson pushes against the mistake of nihilism that might come from mishandling the
Buddhist principle of no-self and, similarly, from post-modern invocations of selves as
performance and the relative nature of truths.
Do this now, because it matters, here, for now.
Desjarlais first book, Body and Emotion (1992), an account of soul loss and the healing
rituals of Hyolmo shamans, offers the reader an example of the visceral nature of
transformation. Chants have shape, sound, and feel. Their sensory qualities are entwined
with the symbolic potential of their words. One poem hinges on the repeated phrase, You
are HERE, summoning the soul back into the presence of the afflicted person through the
sensory force of voice and meaning.
I have read this chant aloud to my Medical Anthropology class since 2005, sometimes
ending a lecture with it. I love this session, and look forward to it every time I teach the
course. I have never heard a shaman speak these words, and I do not have any idea what
they should sound like. I make my own play with sound and the pleasures of discomforting
dislocation from context. My voice rises in volume and deepens as I move through the
phrases. Your parents are HERE. I land more and more heavily on the words in all caps. You
are HERE. I let go of the professorially protective veil of irony. Sometimes students squirm.
Sometimes some of them laugh. Always, one or two or three look shocked, involved,
confused, excited. Sometimes I let them leave in silence after the final syllable. Sometimes I
get teacherly again and give myself, or one of them, the final word.
Notice, too, all that is being undone. Find the names you know, the ideas that are
reassuring and familiar. Find and feel relief at the play of the general, the clarity of the
way cultural praxis is something recognizable. Then, dismantle those conventions, that relief.
Imagine an effigy of cultural knowledge, in which the undoing of cultural certainty with
ideas like performance and politics is replaced with a different, more pleasingly
paradoxical undoing: the undoing that comes with the certainty of dissolution. Notice that
you are, also, not here. You never were.
Several years ago, when Bob was writing Subject to Death, I was in London. Something
terrible had just happened, and I was alone, angry, and at a loss in the truest sense of the
phrase. Part of the issue was that, for about two days I did not know where my daughter was.
That is a longer story. She was safe and fine, and while I would not be told where she was, I
knew that was true. But I was a mess, with nothing to do but wait. And walk. I walked, and
walked, and walked, and walked. It was mid-summer and the days were long, sunny, and
warm. I clutched a paper map, and looked at it every thirty seconds. For some reason, the
Hyolmo chant came into my head. I got lost in confusing streets. I found my way. I got lost
again. I found my way.
The first night, I went back to the flat where I was staying. I emailed my friend, Bob. I
said that that chapter of Body and Emotion, that poem, would not leave my head. I said I felt

Somatosphere | September 2016

Book Forum: Subject to Death by Robert Desjarlais

like I was making myself into a human map of khoi? Where? Evie khoi? Ama
khoi? I told him how much it hurt.
Bob wrote back a few hours later. He had rewritten the Hyolmo chant, replacing its key
symbols with the landmarks of my life my street, my home, my cat, my daughter
replacing the Hyolmo mapping of location in the face of soul-loss with my lifes own terrain.
You are HERE. You are HERE.
Bob writes, in the opening pages of his new book, I have come to perceive a world
where people learn from an early age that life is characterized by a tense and ever-shifting
play between presence and absence, fullness and emptiness (3). The balance of the sentence
the relationship between ethnographic truth and truth truth remains vague, as this point
of distinction does beautifully in so much of Bobs writing. Is the point of difference
what makes the ethnography ethnography that people perceive from an early age
something like a natural fact (one that people in other places may never learn)? Or is it that
people perceive as all people do a specific, cultural truth from an early age?
But Bob often works in the space of sensation, in which it becomes clear that this a
false dichotomy. What we encounter in Subject to Death, in the hand gesture of an uncle
telling a young boy, gently, that his mother Ama is, like everything, here, not here, is
something other than either the absolute truth of the absence that undergirds presence or
the relative truth of a cultural form that says absence undergirds presence. What we find in
instructions for how to act, feel, and understand rituals of dying are strands of sense (6).
The tentative, open-ended way the Hyolmo die is at once a cultural repertoire and a
metonym for knowing more generally, for asking and for telling in the way of the
ethnographer. This is a technical matter as much as anything; the dying can take up, in the
company of others and with their help, the technique of ceasing to be a self, the minute and
momentous techn of dissolution.
Invite a reader into a moment of engagement that undoes itself. Practice a technique of
creating and undoing the security of knowing an other; show the possibility for care at that
juncture of presence and absence, absolute and relative truth.
Bob Desjarlais asks (to slightly paraphrase) if anthropologizing might help one learn
how to die (19). In Subject to Death, there is more to ethnography than the telling of an idea
or the deep narration of a way of living. There is in the intimacy of its invitation to you a
conviction about the ability of our imperfect technologies of knowing and writing to
embody, engender, establish not just an idea about something but a form of being/doing
knowledge, of being/doing together.
There is dissolution; there is absence and the inevitable fire of immolation. There is the
at once relative and absolute truth of Here, now gone. There is also, as part of that contract,
the healing power of momentary presence. There is not here, but there is also here. There is
this gift we give each other.

Somatosphere | September 2016

Book Forum: Subject to Death by Robert Desjarlais

Online at: http://somatosphere.net/forumpost/you-are-here

Sarah Pinto is Associate Professor of Anthropology at Tufts University, and author of Where There Is
No Midwife: Birth and Loss in Rural India (Berghahn Books, 2008), and Daughters of Parvati:
Women and Madness in Contemporary India (University of Pennsylvania Press, 2014).

Somatosphere | September 2016

Book Forum: Subject to Death by Robert Desjarlais

10

Life in Death
SUMMAR SAAD
Ph.D. student, Medical Anthropology, Wayne State University

TO READ SUBJECT TO DEATH is to embark on an intimate journey of dying; one in which you
will find yourself confronted with thoughts of your own mortality and the frailty of human
existence. Beautifully written and arranged, it is filled with the rawest of human emotions
and the sort of existential questions we find ourselves asking when our world crumbles in
the face of loss. With the perfect balance of ethnographic vignettes woven through
photographic images and deeply personal reflections, Robert Desjarlais offers a fresh
perspective on the contingent nature of life and personhood through the analytic frame
of poiesis; the creative potential that lies at the heart of human action, thought, memory, and
relationships. In this way, Subject to Death is as much an ethnography of life as it is of death.
Beginning with the simple anecdotal account of ama khoi? where a young boy is
teased about absence of his mother, Desjarlais traces the meaning of this utterance through
Hyolmo engagements in the world. From life on the verge of death to life after death in
Buddhist cosmology; from the dissolution of life to the creation and possibility of another, it
is through this utterance that we are exposed to the cultural logic that weaves through the
fabric of Hyolmo life. Here, now gone. Desjarlais returns full circle to this ethnographic
moment that has haunted him, posing a number of important questions about the nature of
these Hyolmo rituals: Why is it that the rites so incessantly invoke images of the deceased,
one after another, only to dissolve many of those same images within the next ritual
moment?... And in what ways, if any, do these funeral processes work to assuage or
transform the grief of those mourning a loss? How, in brief, does mourning proceed in a
Buddhist world" (306)?
The answers to these questions hold relevance far beyond Buddhist lifeworlds but what
applicability do they offer to the discipline as a whole? Or to answer the question Desjarlais
raises, can an anthropology of dying teach a consciousness, yours or mine, how to dissolve
into emptiness, and thus how to live" (31)? What are the stakes of such an anthropology? I
ask this because I often find, when I speak of my fieldwork and interests, a lurking
assumption that an anthropology of death is a morbid preoccupation with endings and that
it is meaningful only to those interested in death and dying. Desjarlaiss ethnography makes
the case that an anthropology of death, by virtue of its concern with the uncertainties,
mysteries, and limits of human experience, offers up far more than we have acknowledged;
that just as mourning rituals are necessary for the living, the theoretical insights of an
anthropology of death are essential to the project of anthropology as a whole.

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The chronicling of mourning rituals, however, is not something new in the


anthropology of death and dying. We have known from classics like Robert Hertzs Death and
the Right Hand that death is a social event and that mourning ceremonies and customs are as
much (if not more) for the living as they are for the dead. While Desjarlais certainly
demonstrates the ways in which Hyolmo funeral rites transform grief symbolically, there is
a functionalist flavor to the analysis that raises other questions. Ultimately when Desjarlais
asks how rituals work to transform grief, he is also asking a cognitive question. This, for me,
remains largely unexplored throughout the book. For as Maurice Bloch (2012) correctly
points out, anthropologists are involved in cognitive studies when they claim to tell us what
people are like (7). So what does it mean to make the claim that Hyolmo funeral rites
spur the cognition that appearances are empty of inherent existence, that clinging to lost
illusions is pointless (224)? And how might this differ from, say, a cognition in a world
where mourners are left to go to their grief alone (123)? The symbolism is but one layer of
many in the assemblage of practices unpacked for us and so the question remains: between
thought and ritual, where and how does the transformation of grief emerge?
Perhaps the most striking aspect of Desjarlais writing is the thoughtfulness that shines
through not only in his mode of questioning but through the structure and arrangement of
various themes. Each chapter ends with no definitive conclusion but rather dissolves
seamlessly into the next. I imagine this is reflective of the fact that Hyolmo rituals resist
closure, that they do not merely mark the end but also the beginning of something new. It
also speaks to the theme of impermanence and transformation within the discipline and the
creative possibilities in our labor and production of knowledge. Rupture comes with
creation. The pulse of life finds new channels" (75).
References
Bloch, M. (2012). Anthropology and the cognitive challenge. Cambridge University Press.
Hertz, R. (2013). Death and the right hand (Vol. 4). Routledge.
Online at: http://somatosphere.net/forumpost/life-in-death

Summar Saad is a PhD student in medical anthropology at Wayne State University where she is
currently in the planning stages of her dissertation project aiming to examine how various actors talk
and think about brain death in a clinical context. Her research interests include end-of-life issues,
personhood, cognition, and culturally-competent care.

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Book Forum: Subject to Death by Robert Desjarlais

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Making Death: A Narrative Medicine Exploration


MARSHA HURST
Lecturer, Narrative Medicine, Columbia University

When you come to one of the many moments in life where you must give an
account of yourself, provide a ledger of what you have been, and done, and
meant to the world, do not, I pray, discount that you filled a dying mans days
with a sated joy, a joy unknown to me in all my prior years, a joy that does not
hunger for more and more but rests, satisfied. In this time, right now, that is
an enormous thing.
--- Paul Kalanithi, When Breath Becomes Air, 2016, 199
PAUL KALANITHI APPEARED TO DIE of a disease out of his control: his life unfinished, his
career as a neurosurgeon on the verge of a launch that would not happen, his passion for
writing confined to a final memoir at age 37, and his fatherhood of eight months barely old
enough to crawl. And yet he tells us, his readers, that he has experienced a joy that rests,
satisfied. How can we understand this experience of dying? I turn to Subject to Death.
On one evening each year, Bob Desjarlais enters my classroom, taking a seat at the seminar
table, and opening himself up to the subject of death. This is a graduate course on
Narratives of Death, Living and Caring at the End of Life for students in the Narrative
Medicine program at Columbia University. For five years Bob, sometimes with his friend
Karma, has shared with us his research on the experience and meaning of being subject to
death in Hyolmo Buddhist society. For Narrative Medicine students clinicians, patients,
caregivers, advocates stories are what enable them to enter into the experience of another,
to be part of that weaving of selfhood through the terrains of illness, suffering, death, and
loss. They seek the competence to attend to others, to represent the suffering of others, and
to affiliate with those who are at the end of life (Charon, Chapter 7). Now, Subject to Death: Life
and Loss in a Buddhist World shares the personal stories told to Bob of dying, death, and
mourning in the family and the community.
In the seminar our attention is first drawn to the Hyolmo Buddhist concern with a good
death. Few of us in class see our desire for a good death as part of our hope for a good
rebirth, as the Hyolmo Buddhists do, but we, nevertheless, seek a good resolution of life at
the end of life. For 80 percent of Americans, a good death means dying in our home, yet only
20 percent of us manage to end our life at home (Stanford, 2016). Like the Hyolmo, we do not
want to die in the hospital with death mediated by technology, hovering between life and
death until the time to die is decided for us by institutional forces (citing Kaufman, 38). In

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the hospital, for Hyolmo people, dying is disrupted: Unable to die, a person is stuck
between lives. The temporality of a good death is obstructed (38). We discuss the definition
of death itself, which, medicalized, becomes a static measurement, stripped of the process of
dying.
The good death we seek the death my students seek for their patients, and for those
they love has a universality. Philippe Aris tells us that the tamed death dominated for
centuries, and today we will recognize its basic elements as desirable. A good death is still
one we can prepare for, perhaps sorrowfully, but with forgiveness for those who have
harmed us. Surrounded by family and friends, we would say farewell, ask for pardons, give
our blessings, and welcome a death without fear (Aris, 9-10). This tamed death feels much
like a good Hyolmo death. Shyi lu yhabu shyisin, he died in a good way of dying: not being a
burden on others, dying at home with family members, not dying in fear or longing. The
familiarity of these aspects of a good death is itself comforting.
Subject to Death asks us to think about this putting together of our dying by
considering poiesis: dying as a kind of creating or crafting. In Western terms there is a
dimension of controlling, of making our own, to dying. In 2000 a BMJ editorial on A Good
Death offered 12 principles of a good death that included multiple ways of retaining
control: over place of death, over pain, over who should accompany us during our dying,
over when to say goodbye, and over what wishes we want respected after our death.
Control, though, is a harsh word with a suggestion of exclusivity. The poiesis of cessation
is not something to be done alone. Among the Hyolmo, friends and family help fashion dying
by unmaking attachments (14). Semjha, we learn, is a matter of longing or desire (50). It
exists within a persons heartmind as a lingering interest in some aspect of the world.
Something has gone unsatisfied, unsated. Something remains apart from the self, something
unfulfilled in the dying persons life. It is best to die complete, and thus to end the state of
being. Ill die without any thoughts or feelings, says one woman (53).
With this poiesis of cessation in mind, the class can revisit Paul Hardings Tinkers
(2009), a novel in which both order and chaos inhabit the mind of George Washington Crosby
as he lives his last days at home, in the presence of family who come and go around him. For
eight days, as the clock winds down, the storied threads of Georges life twist and turn in an
order he could not control (18). As he lay on his deathbed, George wanted to see his father
again (21), the father who had left home when George was twelve. The fragments of
imagination and memory feel disconnected, but as with the clocks George painstakingly
repairs, the parts make a working whole. The last thing George remembered in his dying was
his fathers only visit when George himself was a young father, but that imagining was
enough to feel a completion. Semjha, the longing for resolution of a relationship severed,
was satisfied.
I also ask my students to think about Atul Gawandes book Being Mortal (2014). We
physicians, Gawande says, are taught to save lives, not how to tend to their demise (3).
Lacking a coherent view of how people might live successfully all the way to their very end,
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we have allowed our fates to be controlled by the imperatives of medicine, technology, and
strangers (9). Gawande goes in search of alternatives ways that physician, patient, and
family together craft a way of living and dying at the end of life. He learns to ask, What
makes life worth living when we are old and frail and unable to care for ourselves? (92). A
common thread in the responses he hears is autonomy, not the autonomy of acting alone,
but autonomy that enables us to fashion our life and our death, accepting the help we need
but continuing to keep shaping the story of [our] life in the world (146).
Most Americans never reflect on or discuss what gives meaning to life at the end of life,
and how they want to die. Even with new Medicare reimbursement, physicians still do not
talk to their patients about their wishes. Cardiologist Ravi Parikh, writing in the Washington
Post, told the story of his patient who insisted on having full code recorded in his chart,
which would result in having everything possible done to prolong his life should his heart
fail or breathing stop. The patient was a man close to 90, with a history of cardiac disease,
events, and treatment. Trying to convince the older man to change his code status to do
not resuscitate (DNR) was futile, but asking what was important to his patient during this
last period of his life led to a discussion of values, meaning, and priorities. Parikh learned
that the patient wanted full code so that he could stay alive to meet his new great
granddaughter, who would be flying to America from Ethiopia the next month. After the
family left, the patient changed his code status to DNR, and together doctor and patient
began to explore hospice care. Dying complete meant resolving this longing. Paul Kalanithi
(2016) wrote about his decision to have a baby knowing that he did not have long to live:
life isnt about avoiding suffering (143), but about a joy that does not hunger for more
(199).
Subject to Death lets us reflect on the poiesis of cessation in many of the narratives we
read in class, stories of dying and stories of caring. In each memoir of caregiving we read,
the selfhood of the dying and the selfhood of the caring struggle as they reach for a place in
which together they will be creating an ending. Donald Hall recounts in diary-like detail the
work he and his dying wife, Jane Kenyon, do when they come home to craft Janes death:
there are poems to be edited, people to call, a funeral to plan, pain to relieve, suffering to
sooth, and a lifeworld to complete. For the caregiver, crafting a good death is particularly
difficult when the loved one has dementia and dying is characterized by chaos (Frank,
1995), not completion. Can a family say, Shyi lu yhabu shyisin, he died in a good way of
dying (26), when the dying person is not mentally capable of accepting death? For the
caregiver, the ethics of care involved in helping a person to die well may remain
unsatisfied. There can be no co-crafting of a mindful death.
When I first asked Bob to share his work with us, I intended to enable students to
attend to the experience of dying and death in another culture as otherness. But what we
have all learned is a deeper and more complex attention, a kind of narrative humility, as
my colleague Sayantani DasGupta has suggested (2008). The Hyolmo stories we heard were
not objects to master but rather dynamic entities that we can approach and engage with
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(981). It is the connectedness of Hyolmo desire and experience with our own that enables my
students to also hear the differences.
Subject to Death teaches us narrative humility by inviting us to enter into the
experience of Bobs Hyolmo friends, their families, and their communities, to be open to
their stories. This has not been an easy book to write, we are told (241), and we know this
must be true. For students who are, or will be physicians, or other caregivers, death should
not be easy to write, and they appreciate the honesty. The personal struggle Bob experiences
as he writes this book is one they know: how to affiliate with those who have shared their
stories, and yet not be overwhelmed by the seductive aesthetics of death (239). The
physicians and future physicians in the classroom reflect on whether they will be able not
only to give care to the dying but to allow that experience to shape how [they] engage in
the world and relate to others (241).
References
Aries, P. (1974). Western attitudes toward death: from the middle ages to the present. Baltimore,
MD: Johns Hopkins University Press.
Charon, R. (2006). Narrative medicine: Honoring the stories of illness. Oxford, UK: Oxford
University Press.
DasGupta, S. (2008). Narrative humility, The Lancet, 371, 980-981.
Gawande, A. (2014). Being mortal: Medicine and what matters in the end. New York, NY:
Metropolitan Books.
Frank, A. (1995). The wounded storyteller: Body, illness, and ethics. Chicago, IL: U of Chicago
Press.
Hall, D. (2005). The best day the worst day: Life with Jane Kenyon. New York, NY: Houghton
Mifflin.
Harding, P. (2009). Tinkers. New York, NY: Bellevue Literary Press.
Kalanithi, P. (2016). When breath becomes air. New York, NY: Random House.
Levine, C. (2008, July 24). Married once, widowed twice, New York Times.
Parikh, R. (2016, April 18). When a doctor and patient disagree about care at the end of life.
Washington Post. [accessed 6/20/16]
Smith, R. (2000, 15 January). A good death: An important aim for health services and for us
all, BMJ, 320, 12930.
Stanford School of Medicine: Palliative Care. Where do Americans die? [accessed 6/19/2016]

Marsha Hurst teaches in the Narrative Medicine masters program at Columbia University and cochairs the University Seminar on Narrative, Health, and Social Justice. She is co-editor of Stories of
Illness and Healing: Women Write Their Bodies (Kent State University Press, 2007) and has
written on palliative care, end of life, and narrative.
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16

Writing Anew
ROBERT DESJARLAIS
Professor, Anthropology, Sarah Lawrence College

WRITING A BOOK is, in some ways, like performing a ritual. Most often, youre trying to get
something done, and fill a particular expanse with sense and transformative change. In
tinkering with certain aspects of the world, generating affects, you proceed carefully,
cautiously, sometimes with the air of an obsessive; youre trying to get it right, lest the gods
get offended and damage ensues. You might have a sense of what you wish to accomplish
through the effort, but it can be unclear what effects the rites produce, what traces linger, or
how the actions involved strike any perceivers. The engagements might release energies and
forces which, in principle, can affect aspects of the world in remarkable ways. They can also
work in terms that one never intended, or fall flat altogether. Ultimately, one faces a
horizon of emptiness and unknowing.
It is with this abiding sense of uncertain effects that I receive these terrifically
thoughtful reflections on Subject to Death. I read the texts with care, impressed with the
generosity of thought and spirit at hand.
Karma Gyaltsen Lamas Insiders Note is a welcome and perceptive commentary on
how the book might be read by someone from within the community which the book
considers, namely Hyolmo people of northcentral Nepal. Karma and I have known each
other since the late 1980s, when I was first conducting fieldwork among Hyolmo people. I
met Karma at a critical moment. He helped me in highly important ways to understand the
materials I had been collecting, and to translate and comprehend a number of Hyolmo
songs, prayers, and ritual practices. Since that youthful time, we have worked as friends and
colleagues on themes related to Hyolmo culture. Karma figures importantly in Subject to
Death, as he has in my previous writings on Hyolmo lives as an interlocutor, a subject of
Hyolmo life and knowledge, and a critical reader of my efforts to understand. His
commentary on Subject to Death touches on the way that a sustained dialogic engagement
between different lifeworlds can lead to insight, reflection, and novel, unexpected thought
catalyzing the happy traumatism that Levinas and Derrida spoke of, when one encounters
another and meets with an angle different from ones own, as Karma himself puts it. Once
again, I am struck with Karmas perceptive take on the matter at hand, namely the presence
and significance of death among the lives of the living. Death is woven into the cultural
fabric of life, he notes. Perhaps because of this, he and other Hyolmo people find that death
is a familiar subject, not to be shied away from. He thus finds the concerns conveyed by
the author while writing the book, about having come to think too intensely about death, as

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somewhat odd, a pattern evident in a society where death, admittedly, is often pushed aside,
or thrown out of everyday consciousness. In a sense, Karmas reading of the book entails an
astute anthropological reflection on the grounds of an anthropologists writings an
insiders on words from the outside. In reading his observations I encounter, once again, a
moment where a charge of difference uneven, fruitful difference comes to the fore in our
engagements with one another.
Marsha Hurst offers another plane of dialogue and difference in her reflection,
Making Death: A Narrative Medicine Exploration. For she reads the book primarily from
the perspective of someone who teaches students in the Narrative Medicine program at
Columbia University to comprehend the narrative dimensions of death in North America.
Many of these students are, or will be soon, physicians, directly involved in the care of
people at the end of their lives. In learning to regard death not solely in medical terms, but
as a profoundly human experience of cessation, parting, and transformative passage, these
physicians come to engage with dying and death beyond the procedures of technological
intervention. This education in the arts of dying is a highly important and timely one. In
drawing from her richly informed experience in such considerations, Marshas reading of
the book traces out several affinities between Hyolmo ways of dying and end of life
processes in a number of American settings from the pressing search for a good death to
the value of diminishing attachments and longing in ones final days to the quiet sense of
poiesis that can inform how people work to craft their deaths or the imminent passing of
loved ones. Along with the affinities she notes, she also points out how Hyolmo ways of
dying throw into relief the ways that death is often managed in highly medical contexts,
where strangers try to sustain a frail body, and where, more generally, people do not talk or
think much about how they would like to die. Again, its through an encounter with other
ways of living and dying that certain understandings take form. It has been within the
spirit of such an open-ended conversation that I have been visiting Marshas class on
Narrative Dying for several years now, often with Karma present, when possible. Each time
that class session is held on an autumn evening in Manhattan, and were sitting around a
table, discussing passages of the present book, something new emerges a novel thought or
perspective, a new strand of affinity or difference. Its through such engagements that
certain attitudes toward processes of living and dying might alter, in time.
Summar Saads valuable reflection underscores the idea that an anthropology of death
and dying can tell us a great deal about what it means to be alive more generally that an
anthropology of death speaks to so much more than direct considerations of funeral rites
and concepts of death. I think Summar is right to tease out the functionalist flavor in my
attempts to articulate the ways that death rituals among Hyolmo people work to transform
the bodies, consciousnesses, and karmic statuses of the dead and the living. It could be that
anthropologists face a kind of interpretive imperative when attending to the work of
rituals, for there is often a compulsion to try to make sense of the rites and explain their
presumed purposes and effects. With that said, I can only respond with uncertainty and
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hesitation to Summars pressing question, between thought and ritual, where and how does
the transformation of grief emerge? Its unclear to me, and to the Hyolmo people with
whom Ive worked, how the rites might actually transform grief, if they do at all. For one,
the rituals are largely understood to serve the needs of the recently deceased, who must
move on from their recently ended life and seek a rebirth or enlightenment altogether; any
effects or affects for the living are seen as secondary, at best, to the main purposes of the
rites. At the same time, the myriad actions and effects of the rituals are so diverse, and so
fleeting and transient, that its difficult, if not impossible, to develop a sustained sense of
how any transformations in emotion and cognition might actually occur. One can only chart
the pathways entailed in the ritual processes, and conceptualize, in tentative ways, through
a sketch of ritual movement, any possible transformations involved.
Each of the commentators has engaged with the book through the contexts and prisms
of their own circumstances in life, from intensive care wards in American hospitals to the
damaging earthquake in Nepal in April 2015 to killings and protests in Baltimore and
elsewhere. In his astute reflection, Anand Pandian reads the book in the aftermath of the
demise of his grandfather, the life of whom we learn of in Pandians fine, co-authored
book, Ayyas Account (Pandian and Mariappan, 2014). I have read this book of a life on several
occasions, with admiration and respect and fondness for the books main subject, whom I
never met, though I feel Ive come to know this person in some imagined, empathic fashion.
In reading Anands poignant words on his last meeting with his grandfather, in January
2014, my own life touches on this good mans passing, while knowing of the rich generativity
he brought to the world. The writing, the ledger, recurs. Anand also relates my own text to
the terrible, impossible violence he and others have faced in the United States in recent
months. He finds within the present book a language that speaks not only to the pathways of
a good death but, as well, the possibilities of a good life imagined anew. In death there is
life, anew.
Whose voice is it? asks Anand of the clusters of sentences that begin each section
of Subject to Death. He rightly alludes to the Tibetan Bardo Thedol, the so-called Tibetan Book
of the Dead, for it is indeed from the second-person linguistics of that sacred text that the
current book draws, in part. In the Bardo Thedol an unnamed narrator speaks to the reader or
anyone listening to the oral recitation of the text; for example:
Do not be afraid! All phenomenal existence is now arising as luminosities and
buddha-bodies. By recognizing all the present visionary experiences to be the natural
luminosity of your own intrinsic awareness, manifesting as lights and buddha-bodies,
you will dissolve inseparably within the lights and buddha-bodies, and buddhahood
will be attained (Dorje 2005:267).
Subject to Death likewise invokes a second-voice language, directed at the reader, from
an underdetermined narrative position, as if the words might guide the reader or make clear
what is at stake in the unfolding story of life and death:

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Reduce attachment, desire, and cravings when dying. Help the dying in this. Satiate
a dead persons longings for this world. If need be, create a fiction to appease a
restless mind (Desjarlais 2016:48).
Sarah Pinto also gives thought to the readerly effects provoked by the second-person
sentences, in her insightful and moving reflection. The tone is softly instructional. The very
tense is command. But the fact, underlying the directive, is that these sentences are for
you. She finds the second-person commands initially a surprise, later a comfort. That
phrasing reminds me of a set of exchanges Sarah and I once had on the language of the book.
As I remember it, I once showed a set of draft versions of the opening sections to Sarah, in
the summer of 2010, when we were both living in the Cambridge-Somerville area of
Massachusetts and helping each other with the books we were working on (for her own
recent work, see Pinto 2014). I asked Sarah what she thought of these second-person
statements that began each section. Theyre interesting, she answered (to paraphrase).
Theyre very direct. They speak right to the reader, to the you of the reader. Our
conversation moved on to other subjects, and I took in mind what she said. At some point
during that season of writing I decided to take out all of those second-person statements,
which Sarah noticed when she read a revised version of the book manuscript.
I see that you took out those second-person paragraphs, said Sarah, as I recall.
Yes, I did, I said. It seemed that the voice there was too strong, too direct toward the
reader, too much of a command, an assertion. And you were finding as much when you were
reading the earlier versions.
But I liked that voice, too. It was intriguing, different.
Sarah encouraged me to consider putting those statements back into the text. I did just
that, after giving the language further thought. In a subsequent reading, seasons later, Sarah
finds the text implies anthropology as impermanence; ethnographic knowing through
uncertainty. Sarah sees this in the language itself, in ways that I wasnt so consciously aware
when writing. I can say though that I wrote with care, in a spirit of intersubjective
responsibility, in trying to convey certain forms of living and relating. Personally,
professionally, I am committed to the idea that anthropologists need to work toward new
modes of writing and expression, to articulate syntaxes of life that might help us to
encounter the world in attentively dynamic ways, which can offer new forms of perception,
awareness, and potential action. A novel poetics of language and life needs to be cultivated.
Write imaginatively, imagine anew.
And so a book comes to be written from the engaged voices of others, through
countless perceptions, encounters, reflections, torsions. Sarah herself recalls some words I
once sent along to her, in the spirit of a ritual grounding, to help her find comfort and
reassurance, a momentary sense of HERE when it was proving difficult to find any presence
and contact in the dislocations of a foreign land. Reading her recollection of this exchange
brought back the memory of it in vivid ways, including the cafe in Northampton,
Massachusetts, where I wrote the words one summer afternoon. This, in itself, reminds me
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that anthropology is so much more than the production and reception of scholarly treatises
or the latest epistemological turn. Its a way of proceeding in the world, of relating and
connecting to others, learning from them, learning anew from friends, colleagues, and
students, exchanging ideas and forms of life, tracing affinities and difference, be it in Nepal,
New York, Baltimore, Detroit, or New England, in a spirit of care and relational support. This
is the radical and open-ended kinship that Anand speaks of. We write, ultimately, for one
another, and for the world at large. As such, I receive the gift of these reflections.
I write these words in Paris, France, while seated on the terrace of a brasserie in the
th
10 Arrondissement, close to Canal St. Martin, not far from where some of the bloody
attacks took place the night of 13 November, 2015. The memory of the deaths and terrible
damage here is ever-present, as if a shadow cast from the ground. Within this same expanse
of space and time one hears sounds of vital language, music, friendship, lives ongoing. Any
reflection on death is, within the same breath, a reflection on life.
References
Desjarlais, R. (2016). Subject to Death: Life and Loss in a Buddhist World. Chicago: University of
Chicago Press.
Dorje, G., trans., Graham Coleman with Thupten Jinpa, eds. (2005). The Tibetan Book of the
Dead: First Complete Translation. New York: Penguin.
Pandian, A. and M.P. Mariappan. (2014). Ayya's Accounts: A Ledger of Hope. Bloomington:
Indiana University Press.
Pinto, S. (2014). Daughters of Parvati: Women and Madness in Contemporary India. Philadelphia:
University of Pennsylvania Press.
Online at: http://somatosphere.net/forumpost/writing-anew

Robert Desjarlais is Professor of Anthropology at Sarah Lawrence College.

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Book Forum: Subject to Death by Robert Desjarlais