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Photo Illustration/The Globe and Mail. Based on Rogier Van der Weyden, The Descent from the Cross (1435), Prado Museum

Brandy Schillace is the editor-in-chief for BMJ’s Medical Humanities Journal, the author of two books, including Death’s Summer Coat: What the History of Death and Dying Teaches Us About Life and Living. She won a 2019 Arthur P. Sloan Science Foundation award.

The immediate family washed his body, grown weak and frail from the ravages of cancer, and dressed him in a pale blue suit. Then, as the sun set, they prepared to sit up and watch over the dead. Imagine this small group of mourners, ringed around the wasted form, in a quiet time of care. Imagine, too, the next day, when mourners sang old hymns shoulder to shoulder, leaned into weeping embraces, and joined together to strew earth on a just-lowered coffin.

In its mixture of old and new, the death of my grandfather offered up a familiar type of grief-work. It invoked ritual, our human need to perform the stages of death and grief, and it worked in communal ways to unite mourners physically and spiritually in an act of closure.

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And yet today, shared rituals – even ones as simple but meaningful as my grandfather’s wake – may not be permitted.

As concern over the pandemic of COVID-19 increases, religious institutions and funeral homes have been ordered to halt gatherings for the purpose of “social distancing,” a means of limiting the person-to-person spread of contagion. Last week in Belgium, families were alerted that funerals would be cancelled just 24 hours beforehand. At Islamic centres across the United States, changes to the ceremonial washing of the deceased have been enacted for health reasons; in Ireland, mourners have been told that they cannot kiss the bodies of the dead. And these obstacles are just for deaths unrelated to the virus itself: In Italy, funeral homes refused to collect the body of a coronavirus victim for more than 36 hours, while in Jamaica, the health ministry announced it was looking for the attendees of the funeral for the woman who was the country’s first confirmed case so that they could be tested.

North Americans’ lives have had to readjust too, now that the coronavirus has taken hold. In the U.S., the Centers for Disease Control and Prevention advised the National Funeral Directors Association on Tuesday that only a small number of mourners should be physically present, complemented by online streams. In Canada, funeral services have been postponed in Montreal and Winnipeg, among other cities; in Alberta, as part of a provincial state of emergency, gatherings larger than 50 people, including weddings and funerals, have been cancelled. In Ontario, funeral homes have been exempted from a similar emergency order, but individual churches and other venues have been placing their own limits on a case-by-case basis.

Bergamo, Italy, March 16: Cemetery and funeral-agency workers wear protective masks while transporting the coffin of a person who died of COVID-19. Burials were being conducted at the rate of about one every half-hour.

Flavio Lo Scalzo/Reuters

A worker sprays disinfectant at Al Akbar mosque in Surabaya, Indonesia, on March 17 to guard against contamination by the novel coronavirus.

Trisnadi/The Associated Press

Grief is personal, intimate, crushing. The tether bonding another life to ours has snapped and there is no going back to revisit old joys or old wounds; we can dial the number, but it doesn’t connect. Feeling raw and often shattered, we nevertheless have decisions to make, people to contact, events to plan. In light of the present crisis, there are even more questions and frightening realities to grapple with. Is it safe to gather in grief, as humans have been doing for centuries? Is it ethical to invite others to do the same?

As health-care officials urge us to change our behaviours – to stay inside, cancel travel plans and avoid gatherings – we’ve had to endure deep inconveniences around our lives. But how, in this time of pandemic, are we meant to act in death? What happens when our deeply human need to gather and console collides with the reality of a pandemic and the medical imperative to flatten the curve of infection?

Expecting one’s own death, after all, is part of what makes us human. In most cultures, through most of human history, we have had a spiritual sense of continuity – of life and rebirth. In ancient Egypt, incredible preparations were made for the journey into the underworld; in the Greco-Roman traditions, coins must be placed near or in the body, so the spirit can offer it for safe passage over the River Styx. Fijians at the turn of the century believed battles must be fought and won to attain the afterlife, while modern Tibetan Buddhists believe we re-enter the cycle of life through death itself.

From prehistory, we have been both communal and narrative creatures, longing for the means to share with each other the great privilege and burden of what it means to know our mortality. Coming together in ritual offered a chance to make sense of death; we may wrestle with our grief, but we need not face it alone. This is what makes the gathering of mourners such an important and healing practice.

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A 14th-century illustration shows Dutch flagellants scourging themselves during the Black Death, a Europe-wide outbreak of bubonic plague.

PHOTOS.COM

The hopeful news is that, while the coronavirus is novel, the story of evolving our means of grief in the face of upheaval is not.

In 1348, Giovanni Boccaccio wrote his own eyewitness account of the Black Death in Florence, explaining that in the decade-long period in which the devastating bubonic plague is estimated to have killed more than half of Europe’s population, many rituals had to be abandoned. In Europe at the time, a priest was necessary to say last rites over the dead, but with no understanding of how the plague was spread, the clergy had also been infected. Death practice had to change, and quickly; the Ars Moriendi, or The Art of Dying, gave everyday people stewardship over death, dying and even last rites, allowing people to perform them without the church. In short, the Western approach to death was remade into an individualized, non-hierarchical experience.

Often referred to as the “Great Mortality,” the plague’s social upheaval forced grieving practices to change. The same may be said of a far more recent mass tragedy: the massacres in Cambodia by the Pol Pot-led Khmer Rouge. Between 1975 and 1979, an estimated million people were murdered in the so-called Killing Fields and thrown into mass graves, and so grieving for individuals through the usual rituals of Cambodians, which included singing prayers over the body, was effectively impossible. To cope with their loss, new rituals were created, ones that allowed items belonging to the deceased to stand in for their presence; retroactive funeral blessings were given months and even years later. This resilience and creativity in the face of tragedy should give us hope: Grief in the time of coronavirus can evolve as well.

Skulls are displayed in 2006 at the Choeung Ek memorial, on the outskirts of the Cambodian capital of Phnom Penh. The 'killing fields' site houses the skulls of more than 8,000 victims of the Khmer Rouge regime.

David Longstreath/The Associated Press

It has not been said enough: The world will be different after this pandemic. But that doesn’t mean it will all be for the worse.

Among the young and the healthy, facing down the reality of one’s own death is usually a distant and somewhat vague proposition; in the developed world, relatively few people under the age of 30 typically address the inevitable unknown of death. What the present pandemic has created, then, is a new reality where even in grieving for a loss we are forced to think much harder about our own vulnerabilities, no matter our age – but also of our neighbours, our friends, our families and our communities.

We take each other too often for granted. With enforced social distance, everyday communal interactions – a handshake, a shared laugh, even the subtle pressure of shoulders as we stand on trains and in queues – will be noticeable in their very absence. But in losing this nearness, we may learn appreciation and imagine new possibilities for mutual support. Can we imagine new rituals with which to support the bereaved, too?

A tribute to Dr. Li Wenliang, the Chinese opthalmologist whose early warnings about COVID-19 were unheeded and even suppressed, stands at the UCLA campus in Westwood, Calif., on Feb. 15. Since Dr. Li's death from COVID-19, images he shared on social media in his final days have been on display at memorials around the world.

MARK RALSTON/AFP via Getty Images

That work has already been under way, even if stumblingly.

When Facebook memorials first emerged, many worried about the toll of monitoring, preserving, or protecting a loved one’s online activity. As of 2013, Facebook had more than 30 million accounts set as “deceased,” and the Facebook app If I Die posthumously posted to friends on certain dates. The practice deeply unsettled many, who felt that their loved ones didn’t die once, but repeatedly, as sorrow punctuated these unsolicited messages. However, Facebook has since added new applications that allowed the grief contact for legacy pages to create a “tributes” section, which has come to function almost as a group-therapy chat room for mourners to share memories.

Similarly, the Death Café movement, started in London by Jon Underwood in 2013, offers online spaces to meet and discuss mortality, often utilizing video conferencing so community may be seen as well as heard. And long before the coronavirus became a threat, funeral directors and several private companies were experimenting with online, live-streamed funerals for long-distance mourners. It’s worth exploring what such practices could mean now and in future – not just for social distancing, but for those who cannot access the necessary collective support in any other way.

Indeed, while long-distance practices are now required as a means of protecting the immunosuppressed and elderly and for slowing the spread of disease, devoting more resources toward evolving virtual aspects of grief have other far-reaching benefits. After all, those with disabilities, chronic illness or mental illness, as well as those with fiscal and geographic limitations, struggle to attain access to communal support, even in the best of times. In addition to forcing us to see death and grief in new ways, the coronavirus pandemic may also bring to light just how much we take mobility and access to physical participation for granted.

We can never fully express or reproduce the raw pain of loss, but by use of the virtual – of social media, online memorials, even live-streamed funerals – we can translate individual loss into a narrative that others can share, link to and take comfort in. It becomes a communal event that can be conveyed not just to those in our immediate circle, but to our far-flung friends across the globe, for the central and perpetual reason that a grief that is shareable also becomes bearable.

In these uncertain times, perhaps experiencing our grief at a distance can help us remember all others in isolation, and to offer them a virtual bridge of community support. Perhaps in rethinking communal mourning, we can remake the world into one that’s more welcoming for all of us.

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Undertakers unload a coffin out of a hearse at the Bergamo cemetery on March 16.

PIERO CRUCIATTI/AFP via Getty Images


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