What Is Death?

One of my patients died a couple of weeks ago from amyotrophic lateral sclerosis (ALS). He was a wonderful man, and I really loved having him as my patient, but I was always sad about the circumstances that made our paths cross. I remember the first time I explained the diagnosis to him, and his good-natured acceptance on that day and throughout his disease course was inspiring to me. From the very beginning he refused any kind of intervention aside from pain management, and he died a little over 2 years from the onset of his first symptom. At every clinic visit he made me laugh, and I will always remember the way he smiled in the face of death.

How could he smile in the face of death? Because he understood that death is not the end of life.

We have discussed the topic of death in several previous posts, but always in the context of some other topic. I want to hit it head on this time. What do Latter-day Saints believe about death, and how does this affect the way we live our lives?

Life is Universally Fatal

Mortality by CenturyI once attended a lecture given by a palliative care specialist who displayed a graph of mortality rates for the last few centuries, showing that every century has a 100% mortality rate. It is a stubborn fact of life that everyone dies sooner or later, and there is no getting out of this life without going through the process of death. (Yes, there are a handful of apparent exceptions in the ancient scriptures, but let’s dismiss those for now.)

Death refers to the total failure of all body functions. If your heart stops beating and blood circulation stops, then you are dead. This is the more familiar and intuitive of the two medical definitions of death. The second definition is death by neurologic criteria, more commonly known as brain death. Neurologists tend to think of all of the other organ systems as just an elaborate life support system for the brain, and I used to teach my medical students that the goal of all medicine is to keep the brain alive. When your brain is dead, then you are dead, whether or not your heart is still beating.

The Plan of Salvation

These are medical definitions of death, but let’s talk about a religious definition. To define death, we must first understand the nature of mortal life. Latter-day Saints believe that our individual spiritual existence began in the presence of God our Father before we came to live on earth. During our life on earth our spirits are paired with a physical body. The spirit is immortal and cannot die, so the spirit continues to live after the body dies. When I was teaching this concept as a missionary I sometimes used the analogy that our physical body is like a glove, and our spirit is like a hand. Without a hand inside the glove is limp and inanimate, but with the hand inside it can move and work. The body without its spirit is dead, but the spirit continues to live after the body dies.

Now let’s put death in its greater context. The schematic diagram of the Plan of Salvation shown here is typical of what you might find in one of our Sunday school classes or in a Family Home Evening lesson, but some things will be unfamiliar to other Christians. At a glance you can see that death is just one step in a longer process, which continues on to bigger and better things. Death is the end of mortal life, but a spiritual life continues on. This belief in life after death is shared by most religions, and faith in this principal is very comforting for those who die, and for their families and friends.Plan of Salvation

Latter-day Saints believe in a universal resurrection, meaning that every person will eventually be restored to their physical body just as Jesus rose from death after his three days in the tomb. Resurrection is the reuniting of the spirit and body together in a way that they can no longer be separated. The resurrected body is perfectly whole, without deformity, and is no longer vulnerable to disease or injury. At the time of the resurrection we will stand before the Lord to be judged. It comforts me to know that my final judgment will be made by someone who loves me so much that he sacrificed his life to save me from my sins.

Another thing which distinguishes ours from other Christian doctrines is the three degrees of glory in salvation. This is mentioned obliquely in the Bible (see John 14:2 and 1 Cor 15:40-42, for instance), but these passages are difficult to interpret without the additional insight from modern revelation. The Spirit World that follows Mortality is not our final destination. After the resurrection and judgment we will move on to kingdoms of glory, and Latter-day Saints believe in a near-universal salvation. Doctrine and Covenants section 76 recounts a vision given to Joseph Smith where he was shown these three degrees of glory in detail. We are saved by the grace of Christ, which allows us to repent of our sins. What distinguishes the degrees of glory from one another is how completely those in each kingdom accept and act upon the good news of the gospel.

Latter-day Saint Funerals

All smiles at a Latter-day Saint funeral.

People of other faiths who attend our funerals often remark on what a strange experience it is. At my Uncle Stewart’s funeral a couple of years ago there was an open-casket viewing right before the services began. I remember sitting across the room watching my grandmother and her three sisters smiling, talking, laughing, and cheerfully greeting extended family members and friends. Yes, it was a solemn occasion and there were tears shed, but the joy of Christ swallows up the sting of death when you have a sure knowledge that death is not the end of life. Uncle Stewart had fought the good fight and had overcome, so his funeral was a celebration of the goodness of his life. A Latter-day Saint funeral is more like a graduation than a final farewell. We knew that he had moved on to a better place, and was at peace. And we also knew that we would see him again, because families are forever.

Coming in for a Landing

Picture your life as an airplane flight: your birth is the take-off and your death is the landing. You have a flight plan, a destination, a cruising altitude, and a small packet of pretzels to eat along the way. The process of dying is like the descent, and our hope is to get the plane to the right altitude, velocity, and location to have a safe and smooth landing. We don’t want to crash-land in a fireball up in the mountains; we want to land on an airport runway at our destination.

Some flights have mechanical or other problems, and the flight plan needs to be altered for an emergency landing. This is like a terminal disease that hits us in the prime of life when we aren’t yet ready to die. One of my mentors would use an analogy like this in the ALS clinic when we started talking about the palliative care aspects of the disease. “This plane is coming down out of the sky,” he would say. “We want to help you have a smooth landing and not a crash landing.”

I have seen many cases of both types of landings. Some of the best ones I have seen were people who understood the greater purpose of life and who believed that death was not the end of their existence.

Having a knowledge of the Plan of Salvation changes the way I approach my work as a doctor. Death is less of a mystery to me, so I don’t have any inhibitions about bringing up the subject when it is appropriate to do so. Most patients are grateful to have an open discussion about end-of-life planning.

If you or someone you love is in the final descent, please have faith that good things await you on the other side. A loving Father in Heaven is waiting to greet you and welcome you back home.

Alan B. Sanderson, MD is a member of The Church of Jesus Christ of Latter-day Saints and is a practicing neurologist.

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