Changing Ways of Death in Twentieth Century Australia: War, Medicine and the Funeral Business

By Pat Jalland, Sydney: UNSW Press, 2006, 410 pages, paperback, $39.95. Reviewed by Stephanie Bishop in the July 2006 issue.

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Amongst my most enduring childhood memories is one in which I have my small seven year old hand pushed deep into the blue china urn that housed my great grandmother's ashes. I was curious as to how her body came to resemble grey dust, leading my father to explain to me the process of cremation whilst I, excitedly, came upon small bits of bone that I pulled out of the urn as though they were minor trophies in a gothic lucky dip. I seem to remember my father and I marvelling at these tiny fragments together, wondering as to what part of the body they once belonged.

By the time she died my great grandmother had lived through two world wars and witnessed the magnitude of this public loss. But she had also benefited from medical advancements that allowed her to age well beyond the life expectancy of her parent's generation, and which raised new problems as to how, as a culture, we were to deal with the process of dying. Moreover, she had died at a time when death, after several decades of existing as a taboo subject, was once more becoming a topic openly discussed and debated.

It is this shift in our relationship to death and dying, which occurred between the first world war and the 1980s, that is the subject of Pat Jalland's new work Changing Ways of Death in Twentieth Century Australia. Continuing her award-winning research into Australian attitudes to death, Jalland focuses on how, as a culture, we have moved from a state of death denial to a greater acceptance of both dying and bereavement. Echoing the trajectory of what was my great grandmother's own life, Jalland's book illuminates this profound change recently undergone in Australia's emotional culture. For had my great grandmother died twenty years earlier, and had I been a child at that time, there is little chance that the scene with my hand in her ashes, whilst my father and I conversed about death as a truly strange thing, would have been permitted. For according to Jalland, between 1914 and the 1970's the primary response to death was one of denial -- an attitude that would not change significantly until the 1980's. Informed by the overwhelming loss suffered through the two world wars and the country's subsequent trend towards secularisation -- a shift which saw the relinquishment of the often public religious rituals associated with death -- the accepted response to death and dying became one that was constituted by suppression and the internalisation of private sorrow. Stoicism became the attitude assumed in the face of loss.

A denial of death was further confirmed, Jalland argues, through the major medical advancements that were witnessed in the twentieth century. For while increased medical knowledge resulted in a dramatic reduction of infant mortality, it also meant that the population as a whole was living to a far greater age. In this situation the most significant number of deaths were caused by degenerative diseases. This demographic shift marks a situation that is familiar to us now, whereby medicine's ability to prolong life has the disturbing effect of rendering death a failure of medical knowledge, and something that ought to be overcome. In an increasingly secular society, Jalland suggests, the knowledge of the doctor came to replace the will of God, creating a medicalisation, and a hospitalisation of death. In this instance, death became something relegated to a hospital ward where the best -- and, Jalland argues, an inherently modern notion of a 'good death' -- was thought to be one that occurred quickly, so that the person dying would be spared the knowledge of their own impending end. In Jalland's view, such technologically advanced medical practice results in a further denial of death by assuming death to be an alien experience -- as something separate from, and antithetical to, the experience of one's life.

Jalland's work is at its most moving and compelling however when she considers the public response to this over medicalisation through the rise of the euthanasia movement and the increasing interest in palliative care. While the goal of both euthanasia and palliative care is that of a dignified and peaceful death, Jalland sensitively traces the fine line between medicine's ability to inadvertently prolong the process of dying in spite of an intention to beneficially increase one's quantity of life. Avoiding a confrontation between these two 'sides', Jalland's work compassionately tends to the public's increasing need to openly discuss ways of dying, as well as the public anxiety that the rights and desires of the dying remain attended to.

However Jalland argues that it was only though large-scale public discussion and education that attitudes towards death began to change. The first such public discussions concerned the issue of urban graveyard relocation, and exhumation. But later, in 1977 with the Granville train disaster, this public discussion of death was to take on a far more urgent tone where media images both of the crash site, and of those who were grieving, incited a renewed awareness of the need for open expression of sorrow in response to loss. While the role played by the media in informing our attitudes and discussions of death is touched on only briefly here, it seems a compelling topic in itself and it would have been interesting to have heard more on its significance. One need only think of 9/11, or of the current embargo on showing footage of bodies being returned from the Iraq war, to sense the power yielded by the media in this realm.

Yet on the subject of this transition towards a culture open to the experience of dying and grief, Jalland argues that the role of psychologists -- now emphasising the importance of openly grieving -- were also a significant factor in this relatively recent shift. Instead of emphasising a stoic attitude, and the need to 'get over' the loss of a loved one, Jalland suggests that the dominant psychological trend that emerged in coincidence with the Granville train disaster and the Newcastle earthquake in 1989, was towards an acknowledgement of an ongoing relationship with the dead. Grief was no longer regarded as something that one completed and moved on from. Instead, it was seen to be a potentially enduring and life-long experience.

While I do not disagree with Jalland's point, if I have one criticism of the book it is the lack of attention given to psychological trends pertaining to practices of grieving. Fair enough -- it is intended as an historical account, and as such it can at times suffer from being overburdened by repetitive case studies, particularly in Jalland's discussion of war. But if Jalland is prepared to argue that contemporary practices of psychology were a large factor in changing our attitudes towards death in a recent sense, it would seem reasonable to ask what role psychology played in the earlier era of Jalland's study, particularly in relation to her consideration of bereavement practices during the first world war. It is perplexing, in this instance why, given Jalland's emphasis of grieving practices in the first half of the twentieth century, and especially in relation to the war, she does not mention Freud's seminal essays Mourning and Melancholia (1917) or On Transience (1915), which, while they insist that mourning is a finite labour, also counter the denial of death by emphasising the importance of grieving.

For it would seem that the transition in 'Australian' attitudes Jalland is describing -- in which mourning was first conceived as something a healthy individual overcame, and was only later acknowledged as an ongoing, if not endless process -- echoes Freud's own thinking between the period of 1915 and 1923, which shifted with the publication The Ego and the Id. One might be wary of Jalland's claim that it took until the 1980's for mourning to be acknowledged as ongoing, and not a symptom -- as Freud's earlier work suggested -- of pathological melancholia on the occasions where grieving continued without the bereaved finding consolation in a substitute object. Moreover, Jalland's argument that these attitudes to death were in any way inherently Australian remains unconvincing. For despite the book's title that suggests there may be something singular in the way death has been dealt with in Australia, this is a book that is largely concerned with universal processes of bereavement. It is about the difficulties of grieving, and about our individual fears of death as much as it is a book that is concerned with how we have avoided a discussion of death and how death itself has come to us in different historical guises over the course of the previous century -- be it by war, old age, or a lethal dose of morphine. It is a testament to Jalland's writing that she can provide such a vivid and moving account of historical practices and attitudes, whilst continuing to emphasise the need for ongoing discussion about death in our ethnically diverse and secular culture.

Citation

• Stephanie Bishop. 'Review: Changing Ways of Death in Twentieth Century Australia: War, Medicine and the Funeral Business by Pat Jalland' [online]. Network Review of Books (Perth, Australian Public Intellectual Network), July 2006. Availability: <please cite the web address here> ISSN 1833-0932. [accessed 18 June 2013].

Back Cover Blurb

• Death and bereavement come to us all. This is the first book to help us explain and understand their history across twentieth-century Australia. It draws aside the veil of silence that surrounded death for fifty years after 1918 -- characterised by denial, minimal ritual and private sorrow -- and explores the dramatic changes since the 1980s. Emotional and compelling, award-winning writer Pat Jalland's important book looks at the World Wars and the impact of medicine, with many stories drawn from letters and diaries. She also discusses cancer, euthanasia, palliative care, the funeral business, cemeteries and cremation.

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