The death doula: ‘We live in a death-phobic society’

A cheery chat about death? It sounds incongruous doesn’t it? Death is tragic, traumatic, it’s a wrenched ending: something to be feared or ignored until it makes its presence felt. We use euphemisms: gone to a better place, passed away, moved on. That’s until it touches you, and then it threatens, engulfs, overwhelms. Covid has brought death closer. It’s there in the relentless statistics, an online counter, the curve of a graph, a needle flickering up into the red zone.

Ruth McGill has a different idea about death. The actress and singer is also a death doula. “It’s sort of a new label,” she tells me via Zoom from where she’s currently living in Ardara, Co Donegal. “Soul midwife is another term I’ve heard, but it’s so much more.”

In this, McGill has been inspired by her aunt, Phyllida Anam-Áire, author of the Celtic Book of Dying. Aunt Phil, as McGill calls her, worked with Elizabeth Kübler Ross, the Swiss-American psychiatrist who developed the idea of the five stages of grief and death (denial, anger, bargaining, depression, and acceptance). At age 15, Aunt Phil helped McGill sit with her dying grandfather. “That was my first experience of watching with the dying. It was profound, and not at all scary. I was welcomed there. My aunt created the space where it was natural.”

A generation or so ago, this would have been the norm in Ireland, but things have changed. Death has been medicalised, hospitalised and also narrativised. We have funeral homes, where the dead are taken, then returned to us, often in strange make-up. Removed from its place as a natural process of life, we adopt beliefs from TV and movies, in which the stories leading up to, and around a death, can be as artificial as those of Hollywood romance.

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If I was expecting our conversation to be grim, it turns out to be quite the opposite. Poignant at times, it is also full of laughter. Like the time when we’re wondering about what it all means, and McGill’s Siri chimes in (and no, there was no useful answer from the great beyond). A singer with The Evertides, and an actress who has appeared in films and TV (The Clinic, Love/Hate, What Richard Did) and on stage (Furniture, Jimmy’s Hall, The Dead, Alice in Funderland), McGill has been spending lockdown in Donegal with her father.

“This room,” she says, gesturing to the green-painted space behind her Zoom screen, “it’s my favourite. It’s full of my mother. These are the things she loved.” I look to see candlesticks, ornaments, a pair of lamps, pictures in frames, a china teapot: the collected items of a life. And I start to wonder what, from the background in my own Zoom, would have any meaning to people packing up my house were I to suddenly – and here I was going to use a euphemism – but no, let’s be blunt: die?

‘Is she gone?’

There is a nasty pair of cactus-shaped vases that I like because I remember the day I got them, when I hadn’t realised I was coming down with pneumonia in Arizona. There’s a jug that came from my mum. A candlestick badly mended with sugru . . . Maybe legacy is about something other than the material things we leave behind.

“The child in me,” says McGill, “still wonders, is she gone? Where is she? But the other part of me finds an expansiveness of Mum, of her person. Who she was feels like it’s in the air, in the flowers, in the things she was in to. Of course, that depends on your relationship with the person . . .” she adds, laughing at the thought of someone you really didn’t like suddenly being everywhere.

Thanks to her Aunt Phil, McGill felt she got to say a proper goodbye to her mum, who died from cancer 14 years ago. This leads on to talk of the afterlife. Does she believe in one? For some, an acceptance of death could be made perhaps a little easier by holding to the idea of it being God’s will.

“I’m not sure if I like the idea of being looked down on, watched,” she says. I tell her that I’d had this vague idea that the dead stop watching when you turn the lights off, which makes us both laugh again. “I don’t know,” she says, more seriously, “because I haven’t died yet. But I do think there is the love thing: that you’re leaving someone with endless amounts of love, that feeling, from my mum’s perspective, has never left me”

So what does a death doula do? According to McGill, who worked with Red Tent Doula (redtentduolas.co.uk) as part of her learning for the role, it depends on the person themselves. Essentially it’s all about conversation, although it’s also about listening and silence. The role of a death doula is not a medical role, but they can enable someone to have better conversations with doctors and other healthcare professionals by helping the person to unravel what it is they want to say and do and find the sense of agency to communicate it.

Through expert listening, they can help you to decide where you might like to die – at home, in a hospice. They can help you to have conversations with family or loved ones, which when grief is already at play can become fraught and loaded. By that token, McGill may also be contacted by a family member, who is finding things difficult from their side.

Lonely process

And it’s not just the “where” of it all. A death doula can help you think, and talk about the how. For anyone who has been led to believe that death is a lonely process, a death doula can rebalance the focus. By creating space to face something we are taught by society to ignore, McGill can help people to decide what they want, before, during and after death, by looking at what is right for them. They can help you to face fears, and come to accept what is one of the most natural processes of all. It is very open – as McGill says, “People want to know how to take the right steps, but there are no right steps.” Of course Covid has taken home and care home visits off the agenda for now, but they will come back.

“We had a gathering in Sligo,” she says of her training. “We looked at rituals and ways to celebrate our ancestors, especially ones around their deaths, and their babies’ deaths. There were a lot of baby deaths. You know that ungrieved grief? There was a lot of keening.”

She stresses that it’s neither a medical nor a psychotherapeutical role. “It’s more about emotional support. It’s a holding space, I’m holding space for what is, allowing it to be okay to say the things that are on your mind, or to be a container for the difficult things that get out. And it is difficult, if you’ve never spoken or thought about your own death.”

Today, as women particularly are bombarded with anti-ageing messaging, and science delves into trying to undo the processes of death, some people do manage to avoid all thoughts of its inevitability. “We live in a death-phobic society,” agrees McGill. “Some people really do have an idea of ‘no, it’s not going to happen to me’.” But when something happens that brings it closer, the unprepared mind can find it even more devastating.

Sometimes a person who is dying makes contact, sometimes it’s a family member or friend. “I think we did this kind of thing for each other before. It’s not a new thing, but we’re not in the practice of it any more.”

She widens her eyes at the idea and at the memory of rural wakes experienced as a child. A friend once reminded me that as we age we get the faces we deserve. McGill’s face is open, kind, with a strong and mobile beauty, but compassion too. Ruth: the name, meaning compassion and pity, is apt.

Energetic act

Before lockdown, McGill was holding Death Cafes, most recently at Dublin's First Draft Cafe in Portobello. "There were about 22 people in this small cafe," she says wonderingly at what felt normal pre-Covid. "It was incredible," she continues, talking about the in-person subtleties we're all missing, about how Zoom takes away the sense of what the body is saying, even as it gives us the chance to view one another. "There was a lot of silence," she says. "Just holding space, letting things land, letting it be okay. If all I ever do as a death doula is have and open up conversations, even that would be enough."

Talking with Ruth, I become intrigued about dying in a way that previously would have required great courage. There’s something about her that inspires both confidence and confidences. She agrees that there’s a lot of drama overlaying the idea of death. “It’s almost like people take it as the worst thing – the last-breath thing. But the body’s process of death takes a long time. It depends on what the illness is, of course, but when does the dying begin? It’s an energetic act. There’s something taking hold, and there are things the body knows. You need less water. The skin comes back. It feels like a sacred thing to watch.”

So, should you find you need one, how do you find a death doula? I joke that maybe it’s like the A-Team, you find them when you need them. “Through Facebook,” she says, prosaically, which feels very strange. “Or through my website. It usually tends to be a more personal set of recommendations.”

Talk of death inevitably leads to ideas of what is a life well-lived? We ponder the meaning of work and worth. How hard it has been, as Covid has eroded careers, and with them swathes of people’s sense of self. “That comes back to the regrets of the dying,” McGill says. “It’s all related, how we limit and define ourselves by outside things.” We’re also caught between the drive to make, learn, achieve and do; and the quieter desires for contentment, peace and simply being. That’s a tougher one to solve, we agree, and remark upon how the finest meditative minds have sat on mountains for millennia wrestling with it.

“It’s enough that it’s even questioned,” says McGill sagely. She describes how her acting, singing and voice coach work all tie in, in that they are about using your body – and listening to it, using your energy to find your voice, to connect with people, and helping them to find their own voices too. “I couldn’t exactly call it a job,” she says. “I also find it very difficult to call acting a job. It is vocational, it is what you get back from giving space to people to have a conversation. I think that would be a lovely legacy to have had.”

Find Ruth McGill at theholdingspace.ie