TEDMED Explores Death As Dinner Conversation

Death. It’s not typically considered polite dinner conversation, but it was the topic of choice at seven dinners with TEDMED delegates and an assortment of grandparents, parents, close friends, co-workers, children and strangers.

Let's Have Dinner and Talk About Death

The dinners are part of a new project, Let’s Have Dinner and Talk about Death, which encourages people to “discuss the beauty, mystery, fears, hopes, and challenges of end of life decision making” in a setting that is comfortable and comforting—over dinner.

Chef Michael Hebb, a TEDMED 2013 speaker and founder of the project, urges families to have these discussions now, rather than waiting for a critical, life-threatening situation when emotions are high and time is short.

A New Yorker article from 2010, one of the three pieces of pre-dinner “homework” for TEDMED dinner attendees, reported on a national Coping with Cancer study showing that terminally ill cancer patients who received intensive care had a substantially worse quality of life in their last week than those who received no such interventions.

Some studies have found that the missing ingredient that often stands between a patient and a quality end of life is simply talking about goals and ideas for what end of life should be like before the time comes.

Other recommended listening before the dinners included a poignant—sometimes funny, sometimes heart-wrenching—interview with comedian Tig Notaro, who broke all social mores and opened up a critical dialogue by sharing her experience losing her mother and receiving a fatal cancer diagnosis as part of a live comedy standup act.

To help that difficult discussion along, Hebb offered a framework for the discussion, which others could use to guide their talks with family as well:
  1. Start with a sense of gratitude. Think of someone who is no longer with us, and how they made a difference in your life.
  2. Share the most powerful end of life experience you have witnessed—whether from up close or afar.
  3. What do your final days look like? Who is with you? Where are you? (“Are you at home, are you in a hospital, are you on safari in Kenya aloft in a hot air balloon with vintage champagne on ice?”)

For more about the project, visit www.deathoverdinner.org and follow #deathoverdinner.

The dinners followed a moving set of talks at TEDMED all focused on opening up an honest dialogue about death. Charity Tillemann-Dick, an accomplished opera singer who happens to be on her third set of lungs, urged the crowd to find immortality, in a way, by giving new life at death — through organ donation

Pulitzer Prize-winning journalist and author of The Cost of Hope, Amanda Bennett, recounted her experience with her husband’s last weeks and months. She said she and her husband truly believed that despite his diagnosis of severe bowel disease, if they worked hard enough, conducted enough research and found the right treatments — that her husband would never have to die. But Bennett proposed that quest represents not denial, but a powerful form of hope. And just maybe that hope serves a critical purpose in the struggle to comprehend and survive, so to speak, death.

This cultural approach to resisting death may not be unique, but it’s also not universal. Anthropologist Kelli Swazey offered a glimpse into the culture of the Torajan tribesmen, who spend their entire lives preparing for their deaths. Their comfort with death is so complete that they continue to live with the dead bodies of their expired kin during a transitional period before they can raise the money for mandatory elaborate burial rituals.

Michael Hebb closed the evening by leading attendees in a toast to death, summoning a feeling of gratitude for those we have lost.

Let’s have dinner and talk about death.

How would you like to die?  How would you like to be remembered?  And what’s the best death you’ve ever seen?

It’s difficult thinking about these questions, let alone verbalizing answers. There are consequences, though, for trying to avoid the inevitable.  Some 70 percent of Americans say they would prefer to die at home, yet only 30 percent actually do.  Dying in a hospital, perhaps with unplanned or unwanted treatment, can be hugely expensive for patients’ families and for taxpayers: The Wall Street Journal reports that in 2009, the 1.6 million Medicare patients who died that year accounted for 22.3% of total hospital expenditures.

A new project, Let’s Have Dinner and Talk about Death, aims to give people the opportunity to broach what might be perhaps the toughest subject of all over a table rather than a hospital bed rail.  It’s built around the idea that mealtime discussions offer a convivial forum for participants to talk about, quite simply, how they would like to die.  Hopefully, expressing wishes out loud will lead to having an end-of-life plan in place with family and healthcare providers.

"How would you like to be remembered?"

The concept comes from chef Michael Hebb, a TEDMED 2013 speaker, and Scott Macklin, a Teaching Fellow and Associate Director at the University of Washington’s (UW) Digital Media program.  Hebb says humans have an innate urge to communicate over a meal.  “The table and the fire are where we first concentrated calories by cooking,” he says. “There is a safety and comfort among food and drink, and a sense that issues of gravity can be discussed.”

A web site devoted to the experience, www.deathoverdinner.org, which will be fully operational this summer, will share ideas for hosting dinners devoted to morbidity and will invite users to share their stories in its online community. It’s also the basis of a new UW course. The enterprise is a division of the non-profit Engage With Grace, and two TEDMED partners, Shirley Bergin and Jonathan Ellenthal, are advisors.

Michael Hebb

And what’s the ideal menu for such a dinner?  First, Hebb says, serve something you know how to cook. “Unless you are a culinary wizard, I wouldn’t suggest molecular gastronomy or any new kitchen terrain,” he says. “Make something that makes you happy, both to prepare and to eat.”

For more about the project, visit www.deathoverdinner.org and follow #deathoverdinner.