Wednesday, August 30, 2017

The 'Primum Non Nocere' Principle

Nancy Carter Pennington & Lawrence H. Staples

If you like fiction, you might try the obituary page. While it’s not great fiction, it definitely is fiction, although it lacks drama. Clearly missing are many of the literary elements that produce dramatic impact: contradictions, point and counterpoint, the play of opposites, and change of pace, to name a few. Instead, obituaries tend to be linear and one-sidedly positive. Rarely revealed are the dark and shadowy sides of the decedent. After the initial glow of a gushing obituary has faded, we may begin to feel some discomfort. We may begin to compare the radiant claims of virtue and good character revealed publicly in the obituary with what we know privately about ourselves, what we conceal inside. We see that our private view of what’s inside us doesn’t compare very favorably with the very public lauding of another’s sterling qualities, the polished part they showed the outside world. Of course, we can only guess at what the interior truth about their lives may have been. But if we assume they were really anything like their obituary claims, we may feel bad about ourselves, perhaps even depressed.

There is a very powerful taboo against criticizing the deceased. We remember a patient whose mother called to let him know his paternal grandmother had died. His mother talked about what a wonderful person his grandmother, her mother-in-law, had been. At some point, our patient stopped his mother and said, “Mom, stop it. You know grandmother could be a real bitch and often treated you like dirt. Are you forgetting when she called you ‘K street trash’ to your face or accused you of being the hussy who married dad for money and security?” His mother couldn’t bring herself to criticize his grandmother except to add, “Well, maybe she wasn’t perfect.”

Our patient’s conversation with his mother exemplifies the taboo. To speak ill of the dead feels somehow blasphemous. It violates some more-or-less unconscious, sacred boundary. We worry we’ll be punished, as if we’d taken God’s name in vain.

We can wonder why talking about someone’s dark side in an obituary is so taboo. After all, they are dead. Perhaps the answer has something to do with our need to love and be loved. For example, if an important challenge of love is being able to accept and tolerate others as they are and ourselves as we are, perhaps the death of another allows us to love in ways we couldn’t when the other person was alive. And, since we also have similar dark qualities, our willingness to overlook someone’s faults after their death could help edge us along the road to accepting ourselves.