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To see yourself is to die, to die to all illusions.

Søren Kierkegaard

In his classic analysis of the concept of death in children, existential psychotherapist Irvin Yalom describes how youngsters protect themselves by anthropomorphizing death, treating it as if it were something separate from them and giving it a skeletal and ghostly human form. In a conversation with a therapist, Bobby, a four-year-old, says:

[B.] Death does wrong.

[T.] How does it do wrong?

[B.] Stabs you to death with a knife.

[T.] What is death?

[B.] A man.

[T.] What sort of man?

[B.] Death-man.

[T.] How do you know?

[B.] I saw him.¹

For the existentialist, our childhood fears of “death-man” persist deep into adulthood. Death-man is deteriorating; he is disabled, thin, and frail; he has translucent skin, yellowed and missing teeth, and a stale smell. We don’t want to be near death-man because he reminds us of where we are heading. When I was in cardiac rehab I saw many incarnations of death-man, and they terrified me. It was inconceivable that I was like them. But, back on campus a few weeks later, I realized that I was death-man. Although the external defibrillator I was wearing after my heart attack to protect me from cardiac arrest was largely concealed under my shirt, it was attached to a camera-sized box at my hip, with a black cord running up my side. It was unmistakably a medical device, and I felt the stigma. I was branded. When colleagues approached me, they would glance uneasily at the device and look at me with concern. What was especially disturbing is that some whom I considered close friends avoided me altogether or would simply smile and scurry away, uncomfortable with what I represented: shattered health, vulnerability, a reminder of death. These jarring experiences forced me to reflect on my obsession with youth, beauty, and strength and my negative views of old age and consider the fact that the pervasiveness of ageism in our culture may manifest itself unconsciously, as a way for us to protect ourselves from the awareness of our own mortality.

The ways in which we belittle and debase the elderly in contemporary society are shocking, especially considering that, at least in the United States, the fastest growing age group is made up of eighty-five- to ninety-four-year-olds.² The toxicity of ageism has become acutely visible during the coronavirus pandemic. We have witnessed a remarkably callous attitude toward older persons, as if their lives no longer had any productive value. The United Kingdom’s former political strategist Dominic Cummings remarked that the primary goal of the country’s response to the pandemic was to achieve “herd immunity, [to] protect the economy, and if that means some pensioners die, too bad.”³ And Dan Patrick, lieutenant governor of Texas, came under fire for claiming on a nightly news broadcast that, because older persons are no longer contributing members of society, they should be willing to sacrifice their lives for the sake of reopening the economy.⁴ These views reflect an attitude that conveys the impression that older persons are neither admired nor respected; they are expendable. And this attitude has become so normalized that it is rarely called into question. Our negative stance toward the elderly appears on the surface not as a subjective expression of bigotry or as a contingent historical quirk so much as an objective fact about the human condition. This is strange because, unlike other “isms” such as sexism or racism, ageism isn’t directed at an amorphous “other” with a different gender or skin tone, but at our own future self. Understood this way, ageism looks like a kind of self-hatred of who we will one day become, and this means that older persons today probably participated in the same negative stereotyping that they are now being subjected to. As Beauvoir puts it, “[w]e carry this ostracism so far that we even reach the point of turning it against ourselves: for in the old person that we must become, we refuse to recognize ourselves.”⁵ This, she says, is “astonishing, since every single member of the community must know that his future is in question.”⁶

But in previous eras older persons were not dismissed as incarnations of suffering, illness, and death. Indeed, growing old was viewed as a sign of grace, and mortality was more commonly associated with youth, with dying in childbirth, with injuries from battle, with executions, or with various vocational hazards. The old were regarded as fonts of vitality and wisdom. Their voices mattered because they embodied a deep understanding of the customs, myths, and rituals that held their communities together.⁷ This sense of respect and veneration helps us understand the words of the Stoic philosopher Seneca (4 BC–AD 65) in their proper cultural context: “Let us cherish and love old age, for it is full of pleasure if one knows how to use it … if God is pleased to add another day, we should welcome it with glad hearts.”⁸ Contrast Seneca’s reflections with the dehumanizing views we have today, when older adults are scorned and functionally removed from productive society, given over to the paternalizing control of medical experts, and warehoused in nursing homes and retirement communities. Beauvoir refers to this phenomenon as nothing less than a “failure of our entire civilization,”⁹ but the failure is not merely the byproduct of the unique sociohistorical forces of modern capitalism. The existentialist understands that the segregation of the elderly and the structural discriminations of ageism emerge out of something more insidious and primal: out of our collective fear of death.

Of all the existentialists, none was more haunted by death than Kierkegaard, whose name is homonymous with kirkegård, the Danish word for “graveyard.” In his brief life of forty-two years, he witnessed the deaths of his parents and of five of his seven siblings; and he had the prophetic belief that he, too, was fated to die at a young age.¹⁰ Kierkegaard was intimately familiar with the abyss that yawns and swirls beneath our lives and recognized this abyss as the wellspring of all our neuroses. He saw death as the ultimate concern, the fundamental given of our existence, and reminded his readers that, although death was certain, the time of death was uncertain; it could come for any of us at any moment. From the standpoint of this “uncertain certainty,” he introduced a pioneering distinction between “fear” (frygt) and “anxiety” (angst) that would later become axiomatic in the development of existential psychotherapy. He argued that fear always has an object; it is always of something, and these thing-like fears can be managed and controlled to some extent if we make efforts to avoid them. Anxiety, on the other hand, is a fear of nothing; it is fear of the annihilating chasm at the heart of the human condition. Anxiety reveals that there is nothing solid or stable that secures my existence, that I am lost, and that there is no underlying reason for me to be. And I cannot point to what it is that I am anxious about because I myself am the source of anxiety. Kierkegaard went on to show that most of our everyday fears manifest themselves as displaced anxiety, whereby the inchoate fear of my own nothingness is transferred onto a more manageable fear of something. My fear of divorce, of losing my job, or of my upcoming colonoscopy displaces and covers over what it is that I’m really afraid of. Kierkegaard believed that, when anxiety is displaced in this way, “the nothing which is the object of anxiety becomes as it were more and more a something.”¹¹

He goes on to argue that our cultural institutions and social practices are built in large part to repress this anxiety and to keep death hidden from us. Losing ourselves in these practices creates the illusion of well-being, that we are living a good life, that we are not lost, not in despair. In The Sickness unto Death, he writes:

Precisely by losing himself in this way, such a person has gained all that is required for going along superbly in business and social life, yes, for making a great success out of life. Far from anyone thinking him to be in despair, he is just what a human being ought to be. Naturally the world has generally no understanding of what is truly horrifying. The despair that not only does not cause any inconvenience in life but makes life convenient and comfortable is, naturally enough, in no way regarded as despair.¹²

But Kierkegaard believes that this “convenient and comfortable” life is itself the greatest form of despair; it is the despair of self-deception, of “not wanting to be oneself, of wanting to be rid of oneself.”¹³ And the myriad ways in which we lie to ourselves about death are all too familiar. We believe in the immortality of the soul and an afterlife. We have children, in the hope of living on in them after we’re gone. We accumulate wealth, publish books, and produce works of art that will leave a lasting mark. We obsess about fitness and diet and cosmetically alter our physical appearance in our efforts to stay young. We treat aging and death as medical problems that can be solved with new treatments and technologies. We believe in our own specialness: death may happen to others, but it can’t possibly happen to me. We even avoid using the word “death” altogether, because of the singular horror it evokes. In his famous story The Death of Ivan Ilych, the Russian novelist Leo Tolstoy captures this deep-seated avoidance through his titular character, a shallow everyman suddenly stricken with a terminal illness who is in such a state of denial that he can speak of death only from a detached, third-person standpoint, as a nameless “It” that stalks him. As the illness progresses, his futile attempts to depersonalize death become more desperate.

Ivan Ilych would turn his attention to it and try to drive the thought of it away, but without success. It would come and stand before him and look at him, and he would be horrified, and the light would die out of his eyes, and he would again begin asking himself whether It alone was true … He would go to his study, lie down, and again be alone with It: face to face with It. And nothing could be done with It except to look at it and shudder.¹⁴

Ivan Ilych is like all of us, clinging to familiar cultural norms and symbolic practices that shelter us from the terrifying mutability and impermanence of existence. They serve as character defenses that conceal death by creating the appearance that there is something stable, solid, and secure about our lives. Illness and old age are painful exercises in tearing those defenses down and in giving up on the illusion of control. Older persons are frightening to us precisely because they expose our own vulnerability, and we live in a state of denial by pushing them to the margins of our lives. When we mock older persons, we are drawing a clear distinction between “us” and “them.” In this way, the rampant ageism we experience today can be regarded as a manifestation of our society’s effort to deny and turn away from death. Even media images of so-called “successful aging” are often expressions of this denial, revolving as they do around tropes of autonomy, strength, and mobility. They generally betray the hard realities of growing old, of bodily pain and mental decline, of loss, of being confined to a wheelchair or nursing home. But, more importantly for the existentialist, they point to a deep despair founded on an unwillingness to be honest with ourselves. And Kierkegaard makes it clear that the masquerade is in vain; illness, disability, and death always catch up to us.

Do you not know that there comes a midnight hour when everyone has to throw off his mask? Do you believe that life will always let itself be mocked? Do you think you can slip away a little before midnight in order to avoid this? Or are you not terrified by it? I have seen men in real life who so long deceived themselves that at last their true nature could not reveal itself.¹⁵

It is clear that the midnight hour is coming, but here is the trick. For Kierkegaard, we should not recoil from death but earnestly turn toward it, welcome it, and work to integrate it into our lives. Death is our teacher. It is a reminder of our temporal nature, that our time is short, and that our lives cannot be delayed or postponed until tomorrow, next month, or next year. Rilke refers to this attitude as an affirmation of our existence, a state in which we don’t run away from death but befriend it, allowing it to “come very close and snuggle up to [us].”¹⁶

Believe me that death is a friend, maybe the only one who is never, never deterred by our actions and indecision … and this, you understand, not in the sentimental–romantic sense of a denial of life, of the opposite of life, but our friend especially then when we most passionately, most tremblingly affirm our being-here … Death is the real yes-sayer.”¹⁷

This attitude of affirmation and acceptance is what Kierkegaard means by “earnestness” (alvor). It is to live with a sense of seriousness about death, and it is this seriousness that gives our projects a sense of urgency, meaning, and value that they otherwise wouldn’t have if we continued to drift along in self-deception, thinking that our time was limitless. “Earnestness,” in Kierkegaard’s words, “becomes the living of each day as if it were the last and also the first in a long life, and the choosing of work that does not depend on whether one is granted a lifetime to complete it well or only a brief time to have begun it well.”¹⁸ When our own death is squarely in view, it enriches the fleeting moments of our lives, allowing us to become fully present to their depth and poignancy. This kind of person, for Kierkegaard, is outwardly unremarkable. In Fear and Trembling, he suggests an earnest man could easily be mistaken for a clerk, a shopkeeper, or a postman; there is nothing “aloof or superior” about him. What stands out, however, is that he seems to “take delight in everything he sees.”

He lives as carefree as a ne’er-do-well, and yet he buys up the acceptable time at the dearest price, for he does not do the least thing except by virtue of the absurd … Finiteness tastes to him just as good as to one who never knew anything higher.¹⁹

When Kierkegaard, writing for his nominally Lutheran readers in nineteenth-century Copenhagen, says that the earnest person lives “by virtue of the absurd,” he is making it clear that such a person recognizes the fundamental paradox of religious existence, that the divine is not to be found in some otherworldly realm; it is actually bound up in the temporal. It is the finite that has infinite significance. By soberly facing and accepting death, the true Christian experiences the divine in this life, and is able to “live joyfully and happily every instant,” seeing that each moment might be his or her last.²⁰ In this way the person recognizes an appalling truth about God: that “he wants you to die, to die unto the world,” because dying is a kind of freedom; it liberates us from trivial concerns and distractions and enables us to treasure the moments we have now rather than deferring life to some illusory future.²¹ The earnest person knows that we lie to ourselves when we think our happiness is always around the next corner, after the promotion, the wedding, the birth of the child, or the retirement. With death as our most uncertain certainty, all we have is this moment, and the moment is ambiguous; it is not just a cause for anxiety but a cause for joy as well. The German philosopher Martin Heidegger will later develop this idea in Being and Time, by writing: “along with the sober anxiety which brings us face to face with our individualized potentiality-for-being, there goes an unshakable joy in this possibility. In it, existence becomes free from the entertaining ‘distractions’ with which we busy ourselves.”²²

Oncologists and palliative care physicians have long been witnesses to this kind of personal transformation. They have treated terminally ill patients who were initially horrified at their diagnosis but eventually came to view it as liberating. In accepting death, their remaining days often lit up with a sense of urgency and deep meaning; the gravity of their condition pulled them away from frivolous quarrels and ego-driven concerns toward a feeling of gratitude for the short time that was left. Clinical psychologist Mary Pipher describes a conversation in which an oncologist tells one of his patients: “you are about to experience the most affirming era of your lifetime.”²³ Another patient, Kathy, who nearly died of kidney failure, echoes this sentiment, describing her own experience as an existential rebirth.

The first Kathy died during dialysis. She could not make it long in the face of death. A second Kathy had to be born. This is the Kathy that was born in the midst of death …

The first Kathy lived for trivia only. But the second Kathy—that’s me now. I am infatuated with life. Look at the beauty of the sky! It’s gorgeously blue! I go into a flower garden and every flower takes on such fabulous colors that I am dazzled by their beauty … One thing I do know, had I remained the first Kathy, I would have played away my whole life, and I would never have known what the real joy of living was all about. I had to face death eyeball to eyeball before I could live. I had to die in order to live.²⁴

Kathy has made what Kierkegaard calls a “leap” (Spring) into the absurd.²⁵ Through her dying to the world, the world has come back to her with a depth and an intensity that were missing before her diagnosis. For Kierkegaard, “dying is one of the most remarkable leaps” precisely because it shakes us out of our routinized drift, allows us to see what is really important, and awakens in us a sense of appreciation for simply being alive.²⁶ This may explain why many terminal patients have referred to their cancer diagnosis positively and, according to Irvin Yalom, sometimes describe it as the best thing that ever happened to them.²⁷ But we don’t need a terminal diagnosis to experience this transformation. We are already terminal, and when we move into the evening of life, the transformation may come more naturally.

This exposes one of the unsettling truths about the coronavirus pandemic. By bringing death clearly into view, it made us realize that we can no longer flee from it. As the world masked up and great cities shut down, as hospitals overflowed with the sick and dying, as we were reminded that a person died from the virus every thirty-three seconds, death ceased to be an impersonal or abstract event.²⁸ We are all waking up to our own finitude, grappling with the reality that it is now my life and my death that are at stake. B. J. Miller, a palliative care physician, describes the existential insights that the pandemic has brought to his own dying patients.

Earlier last week, I had a patient lean into her computer’s camera and whisper to me that she appreciates what the pandemic is doing for her: She has been living through the final stages of cancer for a while, only now her friends are more able to relate to her uncertainties, and that empathy is a balm. I’ve heard many, in hushed tones, say that these times are shaking them into clarity. That clarity may show up as unmitigated sorrow or discomfort, but that is honest and real, and it is itself a powerful sign of life.²⁹

The pandemic has pulled away the veil, reminding us how close we are to death at every moment and forcing us to confront the most uncertain certainty that we have spent most of our lives hiding from. It allows us to see, finally, what really matters: not the new car, the job title, or the petty grievance at work but the simple, fleeting delights in life that we ordinarily take for granted. As Oregon Senator Richard Neuberger wrote just months before he died of cancer,

Questions of prestige, of political success, of financial status, became all at once unimportant … In their stead has come a new appreciation of things I once took for granted—eating lunch with a friend, scratching Muffett’s ears and listening for his purrs, the company of my wife, reading a book in the quiet cone of my bed lamp at night … For the first time I think I’m actually savoring life.³⁰

When we are young and healthy, we are, in Kierkegaard’s words, often “too tenacious of life to die.”³¹ But this tenacious grip begins to loosen as we grow older and move closer to death; we begin to let go of the temporal and, by virtue of the absurd, the temporal comes back to us and is now illuminated in ways it never was before. Kierkegaard calls this a “double movement” (dobbeltbevaegelse), a movement whereby “every instant we see the sword hanging over the head” and are overcome not only with terror but with awe, as we marvel at the majesty and richness of the moment.³² John Leland noticed this deep wisdom in his study of the elderly. Jonas Mekas, one of the New Yorkers with whom Leland spent more than one year, was a ninety-two-year-old Lithuanian immigrant who survived the horrors of the Nazi concentration camps and lived with an unblinking acceptance of death and an awareness that the future was an illusion. He appeared to embrace Kierkegaard’s paradox, that the finite has infinite significance, that the eternal is not to be found in some supersensible realm but is right here, in the present. After experiencing so much loss in his long life, he describes the simple delights of the temporal that we assume will always be there for us, like eating a plate of grapes. “This plate is my Paradise,” he says. “I don’t want anything else—no country house, no car, no dacha, no life insurance, no riches. It’s this plate of grapes that I want. It’s this plate of grapes that makes me really happy. To eat my grapes and enjoy them and want nothing else—that is happiness, that’s what makes me happy.”³³

Jonas sees death-man in the mirror, but doesn’t recoil from what he sees. He has no illusions and embodies the Kierkegaardian spirit of earnestness. Jonas knows that the clock is ticking, but it is this knowledge that each fleeting moment could be his last, that this grape may be the last sweet thing he tastes, that gives meaning and clarity to his life. Kierkegaard describes this state as being “awakened” to who we are and to what we really care about; it is “to be wide awake and to think death … to think that all was over, that everything was lost along with life,” but to do so “in order to win everything in life.”³⁴ Awakened in this way, Jonas lives with a sense of urgency and vitality that is missing in folks half his age. In the winter of his life, he embodies the core truth of Kierkegaard’s philosophy: that “death in earnest gives life force as nothing else does; it makes one alert as nothing else does.”³⁵