‘We can’t escape it’: death doula Alua Arthur on her age-old profession

TThere is little about Alua Arthur that exudes the deadly or morbid. The 45-year-old Los Angeles native has a bright, gap-toothed smile, a penchant for citrus-colored nail polish and a tendency to laugh before finishing a sentence.

But not long ago, she was working in legal aid and struggling with depression. She took frequent breaks to travel the world, attending music festivals, visiting friends and enjoying short-lived romances with fellow seekers. While backpacking in Cuba, she boarded a bus and sat next to a woman her age who revealed she had been diagnosed with uterine cancer. What followed was an hours-long conversation that rocked her world off its axis.

“It was strangely intimate, comfortable and hilarious,” Arthur said. “There was such an ease in our new friendship that allowed us to journey into the depths together and discuss our fears and hopes.” Not long after she returned home, her brother-in-law died of cancer, and she threw herself into caring for him, her sister and her then four-year-old niece.

Within a few months, she followed her gut and enrolled in a training program to become a death doula, an end-of-life care worker who helps people manage their affairs and feel more comfortable when faced with the inevitable. The work may include providing companionship, discussing clients’ feelings about estranged friends and family members, and helping them look back on their lives and identify the moments they are proud of, as well as those they regret of having. It’s a calling that Arthur, who grew up in Colorado as the daughter of political refugees from Ghana, describes in her compelling memoir, Briefly Perfectly Human.

There is a festive atmosphere in the book. After all, the downside of thinking about death all day long is that we remember how fleeting life is and enjoy the mere act of living, as well as the people and natural beauty that surrounds us. Arthur, whose company, Go with gracehas trained more than 2,500 death professionals in 17 countries, spoke to The Guardian about her end-of-life work.

The death doula seems to be gaining popularity, following in the footsteps of the birth doula. Do you feel like we’ll hear about death doulas more and more?

The death doula is very old, because as long as people are alive, they have been dying, and others have supported them in their death. But the profession and its formality are on the rise in the modern world. It is similar to birth doulas in the concept and in the work we do: we care for each other and celebrate each other. But there is now a Fortune 500 company that has a doula death benefit as part of their benefits program, where employees receive compensation if they seek the help of a doula for someone they consider family. They can help support someone’s death and receive compensation. Isn’t that pretty radical?

You talk a lot in your book about the difference between empathy and compassion. Can you walk me through that?

I have been very empathetic all my life. I feel things very deeply. And I feel like I feel things on behalf of other people, but also what I feel for them are things that I’ve made up in my head about what the experience is like. And if I do that while someone is dying, it’s really dangerous, because I don’t know what it’s like to die. I can imagine it all I want, but I don’t know what it’s like, and that can be really problematic. This may be a bit rude, but I feel like empathetic people, sometimes we’re quite self-aggrandizing somehow. What we need to do when we work with dying people is to practice clear compassion, which says: I don’t know what you’re experiencing, but I’m sad. I’m here with you, and I’m riding with you.

What does a typical week in your work life look like?

I’m not seeing any clients at the moment, I’m way too busy. These days I focus on raising public awareness about the way we die, in hopes of helping more people get support as they die, and frankly, helping more death doulas find clients. But when I visited clients, I probably only had one client whose death seemed imminent, and then several clients who wanted to plan their end of life. And I would also do death meditations, give workshops and help healthy people with end-of-life planning, and help someone who has a serious illness.

So don’t all your clients count as end-of-life patients?

Many clients are people who carry a lot of fear of death with them. There was one customer I talked to for maybe two years. His mother had died and his anxiety had gone through the roof after she died. And so once a week for almost two years he sat and talked about where the fear of death showed up in his life that week, and we worked through it. I gave tips and tricks and we did exercises. There was a young woman, she was 22 years old and her parents were in their fifties. But she just thought it would be wise to do end-of-life planning and I thought, oh, cool. Let’s do it.

There is a trend in our culture to fetishize the “birth story,” but people hesitate to talk about death, let alone the “death story.””.

We want to pretend this isn’t happening. And yet it happens every day, all around us. Not just in nature, but there is probably someone a few doors down from home who knows someone who is dying. And we have no skills to talk about our experience. We make no room for sadness.

But I feel like it’s starting to change. For example, this television series Limitless, with Chris Hemsworth. In one of the episodes he explores the limits of his physical body. Even though the previous episodes were all about how he could live longer and better, an entire episode thinks about death.

Our world is miserable with biohackers trying to prevent death.

We cannot escape it. That’s kind of the point. People work so hard to come up with all these solutions and somehow try to deny it. But by denying it, they make it more real. For example, why not just spend time talking about your fear of death?

In your book you are not silent about your battle with depression. How does that affect your work?

Well, for starters, my life before death care was just kind of a mess. There was no direction, no goal, but there was plenty of adventure. I was the lawyer working at Legal Aid who was broke and saddled with debt. Before death care, I was always looking for something – you know, something that made me feel alive. I sought out great adventures, traveled to faraway places, ate different foods. I used to go to Burning Man, but not lately. I think part of me has always been looking for top experiences in life. That part of me lends itself very, very easily to the care of death, because a large part of my relationship with death is anchoring myself in this body of this life for the time being and filling it up as much as possible.

What is the most important question people ask you when they are dying?

They always ask what the meaning of it all is. And I don’t know! I know the locs, the dark skin, and the jewelry might make people think I talk to other beings all the time, that I’m mystical. But I don’t know anything.

Two of my friends recently lost their parents and I’m having trouble writing letters to them. Do you have any advice?

Sometimes the right thing to do is just show up and say, “This is really hard, but I don’t know what to say, but just know that I care about you. Just know that I know this happened. I don’t know what you’re experiencing. And this is awkward, but I want you to know that I’m here and I care about you. And then you’ll probably get a thank you, and if they want to talk about the person they lost, they will, and if they want to talk about the Kardashians, they will.

How does your current work influence the way you live now?

I think I’m giving myself a lot more grace for the mistakes I make and my sadness, my fear and my doubt, and the extra pounds I carry around. I give myself much more freedom to enjoy food. Whereas before I was so worried about being skinny and exercising, and now I’m like, fuck it, like I’m so grateful for this body that carries me across the earth. Plus, I love chocolate cake.