When The Legacy is Suicide

The initial impact


When I was a child, my family was a strong, stoic clan. We valued fierce independence above all else.

Asking for help or seeking recognition was not acceptable.

Neither love nor grief was talked about or expressed.

Any acknowledgment of my academic achievements was housed in a joke or backhanded compliment. Mind you, I knew this jesting was how our family showed we cared, but I wanted more.

My father was accomplished in many areas. He was an author, store owner, expert on American Indian history and arts, political activist, humanitarian, editorial writer, illustrator, humorist and speaker. He set a high bar, but my goal was not only to reach it, but to break down the barriers to expressing love.

So as a 17-year-old high school senior, I came up with a plan.

In truth, it was a plan born more of need than generosity of spirit. But I hoped it would pay off for us all.

When I arrived in college in the fall, far away in Massachusetts, I would write a letter to my father. I would tell him what a role model he was.

I would tell him I was thankful for his support.

I would share my favorite memories of him.

And for the first time, I would tell him I loved him — on a piece of paper.

I wanted him to read it while I was safely a thousand miles away, just in case it didn’t garner the reaction I hoped for. It was a risk, but one I needed to take.

I hoped he would tell me he loved me in return.

But my plan was abruptly derailed on January 3, 1972 — the day my dad committed suicide.
heart-1936034__480 I fought to understand. But this didn’t make sense.

I recalled the many hours my father spoke with troubled men on the phone, talking them down from drunken misery, dissuading them from their suicidal thoughts and threats.

He told us suicide was selfish and even vengeful.

But my father was selfless, so how could his action make sense?

Once home, I walked numbly into my parent’s bedroom.

I looked up to see my father’s shirt hanging neatly over the chair. Something compelled me to check the pocket. It contained his carefully folded suicide note.

In short sentences he related that the vertigo attacks he suffered from were getting progressively worse and that he was “sorry for the inconvenience” of his action.

He directed that money be given to the university for the study of that “damnably depressing and debilitating disease.”

I love you hand written to a dead father

Credit: bemorewithless.com

No signature.

No final message to us.

No, “I love you.”

That was it? My stomach churned.

The paper felt cold in my hand.

I stared at the note for a long time, willing the strength to numb myself to the emotions that threatened to uproot the “Bahti family way of coping.”

I mustered strength to fulfill the expectation of being strong, silent.

Refusing to feel the need. Refusing to feel the pain.

I was a “Bahti”, afterall

I had to carry on my father’s legacy.

And so began my journey to understand and transform this unraveling event, and weave it into the legacy I choose for my own life.

Join me for part two of my story, Transforming the Legacy, next month.

About Tani:

Tani Bahti, RN, CT, CHPN, offers practical guidance to demystify the dying process. A RN since 1976, Tani has been working to empower families and healthcare professionals to enable the best end-of-life experience possible through education and the development of helpful tools and resources. The current Director of Pathways, Tani is also the author of “Dying to Know, Straight Talk About Death and Dying,” a book that SevenPonds considers one of the most helpful books on the subject available today. Founder Suzette Sherman says, “This is the book I will have at the bedside of my dying parents some day, hopefully a very long time from now.”


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Monday Hearts for Madalene

Page Hodel creates beautiful hearts as a tribute to enduring love
handmade heart of white and pink flowers

My love blossoms as spring nears

It’s an honor for SevenPonds to share with our readers the story of the Monday Hearts for Madalene project, a true account of the power of love in the midst of death.The project’s origins take us to 2005: the moment Page Hodel encountered Madalene Rodriguez and fell “instantly, dizzyingly in love with her.” The couple’s first meeting was electric, and Page felt inspired to do something unique for the woman who captured her heart. So, she began leaving handmade hearts – made from flowers, leaves, and other materials – on Madalene’s doorstep.  The hearts became a ritual, and they were there to greet Madalene as she left for work every Monday.

“To start her week with a visual reminder of our beautiful love.” Page Hodel

Just seven months later, Madalene was diagnosed with ovarian cancer and passed away on June 20th, 2006. But Page’s love for her hasn’t ceased, and she continues to make a heart for her every Monday in celebration of her life.

If you would like, you can also receive Page’s “Monday Hearts for Madalene” by emailing her at page.hodel@gmail.com with “subscribe” written as the subject. Images of the hearts can also be purchased  in her beautifully compiled book, Monday Hearts for Madelene. Please also visit her website and Facebook  page. A portion of all sales will go to the Women’s Cancer Resource Center in Oakland, California (www.wcrc.org). See more Monday Hearts for Madalene here.

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“We’re all born free and then taxed to death.”

Credit: usnews.com

Credit: usnews.com

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Is Alkaline Hydrolysis Better Than Cremation?

An interview with Philip Olson, Part One

Today, SevenPonds speaks with Philip Olson, an assistant professor of Science and Technology in Society at Virginia Tech. Olson researches bioethics and environmental ethics, analyzing society’s complex relationship with new technologies. He has a particular interest in the study of alkaline hydrolysis. Over the years, Olson has studied how receptive people are to this new technology. 

Warning: This post contains detailed information about how remains are processed. Reader discretion is advised. 

A portrait of professor Philip Olson

Credit: sts.vt.edu

Marissa Abruzzini: What made you want to study alkaline hydrolysis? 

Philip Olson: My mom, actually! I was visiting my parents one summer, and my mom told my dad about this article she’d read on alkaline hydrolysis. She said it was about dissolving human bodies and flushing them down the drain. It wasn’t very flattering. I thought, “I gotta see that.” It sounded like something my department would be interested in. I wanted to know how people are responding to this. Do they accept it, or think it’s strange? How is this gonna go over?

I guess I should step back for a moment. The reason why my mom was telling my dad about this article is because my dad is actually a funeral director. He operates a 90-year-old family business in Minnesota. I had no intention of doing that kind of work myself, so it’s funny that I now study funeral technologies.

Marissa: I bet that gives you a different perspective on the industry, too. 

Philip: I come at it from an interesting point of view. When I was growing up, the funeral business literally put food on the table.

Marissa: Can you describe the alkaline hydrolysis process? What does it involve exactly? 

Philip: First, you have a chamber that’s shaped like a cylinder. It has this wire mesh tray that slides out. The body is placed on this tray, and then the operator slides it into the cylinder and seals the door. The body can’t have anything on except pure leather or silk. These materials will hydrolyze along with the body, but things like polyester won’t. So most funeral directors will wrap the body in a silk body wrap.

A handful of white pieces of lye in a dish, commonly used in alkaline hydrolysis

Credit: Wikimedia.org
Sodium hydroxide, or lye, is used to dissolve bodies in alkaline hydrolysis.

Marissa: What makes them hydrolyze? 

Philip: It’s a mixture of water and alkali. The mixture is 95 percent water and 5 percent alkali (usually hydroxide or sodium hydroxide, AKA “lye”). That’s pumped into the cylinder and then heated.

Marissa: How long does it take to hydrolyze the body?

Philip: It depends on the amount of heat used, and the pressure. You need to get the fluid to heat beyond its boiling point for the process to work quickly. Most of the cylinders are pressurized to keep the water from fully boiling, and this speeds the hydrolysis process up. It only takes about two or three hours. But if the system isn’t pressurized, it can take as long as 12 hours.

One of the high-pressure system manufacturers actually makes submarines for the British Navy. It uses the same kind of high-pressure technology — some alkaline hydrolysis machines use actual submarine doors.

Marissa: Is the high-pressure system more expensive?

Philip: Oh yes. It costs about half a million dollars for the high-pressure machine, and about half that price for a low-pressure system.

Marissa: So what happens after the alkali and water is pumped into the cylinder? 

Philip: The body becomes liquefied. It looks a little bit like motor oil. This liquid has a very high pH, so you have to add an acid like carbon dioxide to the remaining liquid in order to make it neutral. They also cool the liquid down so that it can be sent to waste water management.

A waste water management facility, with tanks for processing waste, like alkaline hydrolysis remains

Credit: Wikimedia.org
Liquids are neutralized and sent to waste water management facilities for processing.

Marissa: Is it toxic? 

Philip: No, it’s not. Part of the controversy about alkaline hydrolysis is that this remaining liquid is processed by the same department that recycles drinking water. But the liquid is completely sterile and inert at this point. Everything is already broken down. There’s no DNA or RNA left because the heat and alkali has destroyed it.

Some experts claim that there aren’t any prions present either, and a few studies have backed this up. Prions are a problem in mad cow disease, and there is a human equivalent of that. Experts claim that the remaining liquid doesn’t have any prions, but I recently talked to a scientist at Virginia Tech who was skeptical. I’ll need to see more studies on that.

Marissa: What happens to the bones? They aren’t hydrolyzed, right? 

Philip: Right, you still have bone matter left over after you drain the liquid. The bones are wet, so they need to be dried. These bones are actually more brittle than cremated remains. And as in cremation, you’re not really getting “ashes.” In cremation, you burn the body away, and what you’re left with is bone and bone fragment, which you then grind into a powder. Alkaline hydrolysis is a similar process, except you use liquid instead of flames, and you get 20 percent more remains, on average. So you’ll need a bigger urn.

Marissa: I know that with cremation, your loved one’s remains are often mixed a little bit with others who were cremated in the same spot. Does this happen in alkaline hydrolysis? 

Philip: They call that “co-mingling,” yeah. There’s less co-mingling with alkaline hydrolysis. It’s inevitable that there will always be some.

Marissa: So you said that the bones need to be dried before they can go through the grinding process. How does that work?

Philip: How do you think it works? Take a guess!

Three clothes dryers sitting side-by-side, the same kind used to dry bones in alkaline hydrolysis

Credit: Wikimedia.org

Marissa: You can’t just leave them out. That’d be inefficient…I have no idea. 

Philip: Clothes dryer.

Marissa: No! Really?

Philip: Yes. They put bones on those shoe trays that you use to keep your sneakers from bouncing around, and they dry them in a regular clothes dryer. They don’t want to use it, but no one’s come up with a better solution yet. It’s fascinating to me, because so many people find this fact disturbing. There’s this boundary between industrial and domestic living spaces, and we try to keep those boundaries intact. And the idea that the same machine that dries your kids’ clothes is also drying bones creeps people out. Maybe it seems too casual? Or offensive to the body itself?

And that’s where people think of alkaline hydrolysis as controversial. We imagine we’re flushing our loved ones down the drain. In reality, nearly every funeral technology has one or two “creepy” aspects.

Please join us next week for Part Two of our interview with Philip Olson, where we talk about whether alkaline hydrolysis is environmentally-friendly. 

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“Kicking the Bucket List” Teaches Readers to Downsize

Gail Rubin makes life organization and end-of-life planning an easy process

If you’ve ever had a loved one die and had to sort through room after room of their life’s possessions, you know what a long, difficult process it can be. And if you’ve ever had to wade through your own living space because you’ve accumulated so much stuff, you know that’s hardly a pleasant experience either. Situations like these are what inspired Gail Rubin to write “Kicking the Bucket List: 100 Downsizing and Organizing Things to Do Before You Die.”

Cover of Kicking the Bucket ListGail Rubin is a certified thanatologist, a professional who educates people about end-of-life issues. She is also a certified celebrant, a role in which she “helps with funeral planning for those who don’t plan to die.” Rubin also hosts the TV/DVD series “A Good Goodbye.” In 2008, she fought a battle with breast cancer which led her to an even deeper awareness of her own mortality.

“Kicking the Bucket List” offers 100 brief, actionable suggestions for downsizing your property and making your final wishes known. Each idea offers a concise explanation, a website you can consult to take action or find more information, and a tongue-in-cheek picture. Some of her ideas are light-hearted. For instance, Rubin suggests getting a couple of kittens or a large dog to help with decluttering. They will knock all of your things down and break them anyway.

Other suggestions, like evaluating items for value, are more serious. Rubin understands how families pass ugly items from generation to generation because “it might be worth something someday.” Her philosophy? If it’s not worth anything now and you don’t like it, it goes!

This passage in the book reminded me of being a child and bouncing a ball in the house, even though my mother forbade it. I knocked over a lamp that had been a wedding present to my parents and broke it. My mom yelled at me, and of course I felt terrible. Years later, she told me that, while she was scolding me, she had to bite her lip to keep from laughing. It turned out she had hated that lamp from the moment she laid eyes on it, and was delighted to see it lying in pieces on the floor. So, don’t traumatize your kids. If you don’t like something, discreetly get rid of it.

Chart with the word plan shows how Kicking the Bucket List is a useful tool

Credit: industryweek.com

After Rubin has led her readers through a thorough decluttering, she discusses spelling out wishes about end-of-life care. She encourages the reader to think about what kind of service they would like to have, and who they would want to handle their money and property. She recommends checking all of these documents regularly to ensure that your wishes have not changed. For instance, you probably don’t want the ex-spouse who ran off with your secretary making your end-of-life decisions for you.

My only complaints about “Kicking the Bucket List” are small ones. First, most of the information Rubin provides is, if not common knowledge, then at least readily available. It’s the way she provides the information that makes the book a winner. Second — and Rubin acknowledges this problem herself — any book that links to as many online resources as “Kicking the Bucket List” is bound to run into a problem with dead links in a few years. Hopefully Rubin will keep an eye out for this and update as needed.

Overall, I found “Kicking the Bucket List” to be a clear, clever and interesting read. If you can bring yourself to actually perform the tasks suggested, your clean home and well-laid-out plans will make your loved ones’ grief that much easier to bear when your day arrives.

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Diabetes the No. 3 Cause of Death in US, Study Finds

Oftentimes diabetes is not listed as the underlying cause of death

Diabetes is now the third-leading cause of death in the United States, according to a new study from the University of Pennsylvania. The disease and its complications lead to roughly 12 percent of deaths in the nation, the study finds.

This number is much higher than medical professionals initially thought. Diabetes was the seventh leading cause of death in 2013, and in 2010 estimates for diabetes-related deaths was a mere 2.8 percent.

Bowl of sugar, blood sugar reader next to eachother symbolizing diabetesSamuel Preston, a professor of sociology at the University of Pennsylvania and one of the lead authors of the study, thinks that this should be a wake-up call. “Another way of saying that is if diabetes were eliminated as a disease process,” he says, “the number of deaths would decline by 12 percent.”

The reason for the seeming increase in deaths caused by the disease is because it isn’t listed as the underlying cause of death as often as it should be. “It’s difficult for a physician to say, ‘If this person didn’t have diabetes, he wouldn’t have died,’ but we are able to do that looking at national statistics,” says Preston. “When someone who died had multiple conditions, the certifier must choose one as the underlying cause of death. That choice is, to some extent, arbitrary.”

It is rare that people die directly from diabetes. They usually die from a condition that is caused by diabetes, whether it be heart disease, stroke, kidney disease, etc. Many times diabetes is not listed on the death certificate as the underlying cause.

Andrew Stokes, co-author of the study, notes that the main way scientists and researchers monitor population health in the United States and around the world is through mortality statistics. His research has led him to conclude that the under-reporting of diabetes as an underlying cause of death obscures the national health burden of the disease. “Our work aims to reveal that diabetes is a much more important cause than is appreciated,” Stokes says.

Research Methods

The researchers estimated the number of deaths attributable to diabetes using two representative samples of U.S. adults who were surveyed in the National Health and Nutrition Examination Survey (NHANES) and in the National Health Interview Survey (NHIS). The researchers then linked individuals from these surveys to their deaths reported in the National Death Index.Person with diabetes pricking their finger to test for blood sugar level

The NHIS provided researchers only with self-reported cases of the presence of the disease, whereas the NHANES contains data on both self-reports and individuals with high hemoglobin A1C levels, a biomarker which indicates presence of the disease. This is an important distinction to make, as “Drawing on both data sources provides a more comprehensive picture of the contribution of diabetes to deaths in the United States than using either source alone,” according to the report.

The research team found a “high degree of consistency” between the data sets. The proportion of deaths attributable to diabetes was 11.5 percent using the data from NHIS. Self-report data from NHANES showed a 11.7 percent proportion. The data set with the hemoglobin A1C marker from NHANES showed a proportion of deaths attributable to the disease at 11.8 percent. However, it was listed as the underlying cause of death in only 3.3 to 3.7 percent of the deaths.

Preston and Stokes believe that widespread focus and ramped up intervention are needed to address the issue of diabetes and its toll on the American population.

“We need something on a population scale,” Stokes says. “It’s a major issue.”

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