In Extremis: Ernest Becker's Last Days in the Hospital
Shortly before his death to colon cancer in 1974, author of "The Denial of Death" Ernest Becker granted writer-philosopher Sam Keen an interview in his hospital room.
I am lying in a hospital bed dying and I am putting everything I have got into this interview, as though it were really important, right?
On a rainy February morning in Vancouver, Canada, writer Sam Keen walked into the hospital room with a set of interview questions for the author of the (not yet) Pulitzer-Prize-winning book The Denial of Death, Ernest Becker.
Becker had refused medication on this day to maintain a clear head for their anticipated high-minded dialogue, and thus suffered through the interview with pain and fatigue. As Keen entered the room, Becker greeted him, saying “Now you are catching me In Extremis. You will see how this philosophy dies.”
The things I appreciated most reading through Keen’s conversation with Becker (which appeared in Psychology Today in March of 1974, only a few days after Becker’s death) were the small human moments between these two men, Becker’s nurse, and their lofty ideas.
It would have been easy (perhaps recommended by modern journalistic standards) for Keen and his editors to cut these moments out of his recounting. Like when Becker pauses his analysis of the philosopher, Otto Rank to ask his nurse for ice chips “to suck on”. A request I am all too familiar with from my days in the infusion center. Something about the ice chips in a hospital hits different.
The whole conversation is heavily emotional with discussions ranging from the beauty of creation, to the Nixon administration and women’s liberation, to the motivations of evil and war. But with all this reaffirming of Becker’s life’s work and his incredibly knowledgable recall of schools of philosophy and psychology, the conversation can often seem too heady to grasp the viscera of the task at hand: mainly, Becker (through waves of fatigue) taking a long look at a future that exists without him and the inalterable to-do list of the past.
In my mind’s eye I was in the hospital room too. Maybe I was even Becker himself-laying in a hospital bed with my own personal psycho-analyst by my side begging me to stop intellectualizing my feelings and instead, to give myself the permission to feel them.
Despite all his training and preparation on the study of death, there is one moment in the conversation where the steel trap of Becker’s intellectual might loosens and we glimpse at the center a dying man saddened by the prospect of missing the release of the interview and anxious about the afterlife.
It’s funny, I have been working for 15 years with an obsessiveness to develop these ideas, dropping one book after another into the void and carrying on with some kind of confidence that the stuff was good. And just now, these last years, people are starting to take an interest in my work.
Sitting here talking to you like this makes me very wistful that I won’t be around to see these things. It is the creature who wants more experience, another 10 years, another five, another four, another three. I think, gee, all these things going on and I won’t be a part of it. I am not saying I won’t see them, that there aren’t other dimensions in existence but at least I will be out of this game and it makes me feel very wistful.
It is to my surprise that the interview ends right there. Keen remarks at the time, shares a brandy toast with Becker, and then leaves the room. It seems almost cruel to end this conversation so abruptly and then leave the “wistful” Becker alone with his nurse.
It is not documented by anyone publicly what happened next. Realistically, If I had to guess: Becker fell asleep, consumed by fatigue and his nurse resumed his medication schedule. In my hypothetical, I do wonder what Becker was feeling as he fell asleep after such an intense conversation.
Despite his exploration of heroics in the mundane, was he filled with an untempered excitement that someone was finally taking an interest in his work? Did he ever unconsciously slip into that denial of death he spent his whole career articulating – daydreaming about reading his article in Psychology Today? It’s not for any of us to know for sure. One unexplored area I yearn for in this interview is Becker’s thoughts on his illness, (not his death) as it relates to his life’s work. By the time Becker’s doctors caught the colon cancer growing within him, it was too late to cure him. So for Becker, cancer was the end of his life and a time for him to put all his death-acceptance philosophy into practice as an individual.
For many other people, cancer is a hair-pin turn in their life that’s messy, complicated, and painful, but ultimately not the end. As quickly as the shroud of cancer-treatment descends on your life, it vanishes and you’re released back into your enclosure for enrichment time. As Becker articulated: in a world set-up to deny death and mortality, how can you come so close to dying and then resume? With a body that doesn’t function the way it used to and a society fundamentally immobilized in it’s understanding of illness and disability.
For me, accepting the prospect of my death was less complicated than accepting the repercussions of my survivorship – a philosophy that left many people in my social circle concerned and confused. In the religious canon, death is a transformation, sometimes a transcendence, but illness on the pathway to death doesn’t share the same celestial interpretations.
One of my biggest sources of confusion early in my diagnosis was the sudden separation of my mind, my body, and the cancer growing within me. A schism between three things that in recent memory were considered as one – a separation that suddenly seemed obvious to everyone around me, but that I was still catching up to. Cancer’s relationship with my body was a parasitic one, yes, but it still was my body. Could I hate it with the passion that was matched by my community shouting “fuck cancer”? Could I interpret it as an invader in my sanctuary? As a harbinger of suffering?
I remember the moment I first laid eyes on the cancer itself in a dark ultrasound room. The malignancy that threatened my life was a small dark void in an undulating sea of black and white tissue, and I could only hate it as much as I hated myself.
After reading the interview, I often wonder how Becker interpreted his own cancer. Cynically? as an interloper in his career? Ambivalently? As a closing cadence to an inevitable fate?
Keen: Is it accidental that you became fascinated with the question of death and wrote The Denial of Death and then became ill? Was the fascination a kind of premonition?
Becker: No. That book was finished a full year before I became sick. I came upon the idea of the denial of death strictly from the logical imperatives of all my other work. I discovered that this was the idea that tied up the whole thing. It was primarily my discovery of the work of Otto Rank that showed me that the fear of life and the fear of death are the main-springs of human activity. Hi Nurse, am I still alive?
Nurse: You’re still alive.
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