Burials, Funerals, & Health

Stanton Shanedling: Good morning, everybody. Welcome to Health Chatter. Today's show is on burial, funerals, and health—three topics that are certainly connected. It can be a sad subject, or even a happy one, but we all deal with it, so we’ll get to that in a minute with our Health Chatter crew. We all have a lot of experiences to share. We have a great crew, including Maddy Levine-Wolf, Erin Collins, Diondra Howard, Matthew Campbell, Sheridan Nygard, and of course, Barry Baines, our medical advisor. Thanks to all of you. You're second to none.

By the way, all the research we do for our shows is available on our website at healthchatterpodcast.com. You can also listen to the podcasts there.

Also with us today is my great colleague Clarence Jones, who co-hosts the show and links us to a wonderful community health organization called Hueman Partnership, who sponsors Health Chatter for us. We greatly appreciate them and the work they do. You can check them out at huemanpartnership.org.

Stanton Shanedling: Thanks, everybody. Let’s dive into today’s subject: burial, funerals, and health. To start, I’ll ask for some personal reflections on this topic. Clarence, how about you share your personal thoughts on funerals, death, and burial?

Clarence Jones: Thanks, stan. I’m actually in the middle of this right now. I was just sharing with the group that I have a sister who needs a new heart and a kidney. Just yesterday, the family decided that she would go on hospice care, and that they would make her comfortable. So, I'm at that stage where we’re talking about funerals and death, but it’s also been necessitated by health issues. I just wanted to put that out there.

Stanton Shanedling: Yeah, we’ll circle back to that. I’m sorry you have to go through that.

Barry Baines: Yeah, I feel like I’m an orphan in a way. Both of my parents passed away many years ago, in 1990 and 1993. My in-laws have also passed. One thing that’s important to me is that even though your loved ones are gone, the relationship doesn't end. It's different, of course, because they're not physically present, but that relationship doesn't go away. I used to worry about forgetting them, but I've found ways to keep their memories alive. I carry their legacies with me, which helps me through the grief. Everyone grieves differently, and it never completely goes away. It's more about integrating that loss into your life.

A humorous story: even after my grandmother passed, my parents would still talk to her in their minds, asking, “What would Bubby do?” It’s like consulting them mentally. That connection remains important.

As a hospice medical director, I work with a lot of people who are facing death, which has sensitized me to the different ways people grieve. It’s not a one-size-fits-all process.

Stanton Shanedling: Great. Thanks for sharing that, Barry. Maddy, how about you?

Maddy Levine-Wolf: Sure. I lost both of my maternal grandparents—my grandmother about 15 years ago and my grandfather about 5 years ago. I’ve also lost a few family pets, which is a different kind of grief, but still deep. I’ve been thinking a lot about how to process my own grief while also supporting my family members as they navigate theirs. For example, when my grandmother passed, my mom lost both of her parents at a young age. My mom thinks about them every day, and I’ve had to learn how to support her through that while also processing my own grief. Grief is something that never fully goes away, but it can be managed in different ways. I'm looking forward to discussing different traditions around funerals and rituals today.

Stanton Shanedling: Thanks for sharing that, Maddy. Sheridan, how about you?

Sheridan Nygaard: Yeah, unfortunately, I have a lot of experience with death. Professionally, I work with older populations, including those in hospice, so I’m surrounded by death in my daily life. Personally, I've lost several loved ones, and I’ve talked about some of them in previous episodes, especially the organ donation episode. I would also like to note that organ donation and today's conversation are linked but distinct topics. One thing I’ve learned from all the losses I’ve experienced is that your perspective on death changes as you grow and have more life experiences. For instance, when I lost my grandmother to COVID, I couldn’t say goodbye, which made it especially hard. But I’ve learned a lot from the research we’ve done for this episode, and I’m looking forward to discussing it further. There’s so much to learn from different cultural perspectives on death and dying.

Stanton Shanedling: Yeah, the research was really interesting. We could probably do more than one show on this topic. My own personal experience is that my father passed away when I was very young. I think I might’ve mentioned this before, but when someone passes away, there's often someone who has to take charge of all the logistics—funeral arrangements, etc.—while the others are grieving in their own way. I was that person for my father. Two weeks after his death, I completely broke down emotionally. I realized that I never had the chance to fully process my grief at the time, and even today, I still grieve that I didn’t properly process it. I think a lot of people go through that when they’re the ones responsible for the logistics during a time of loss.

Stanton Shanedling: I never had a situation like that before. And so today, to this day, I'm still trying to figure that out.
One way I do that is I visit the cemetery where my father and mother are buried.

The other thing is—Maddie, you kind of alluded to this. For myself, I never met any of my grandparents. So then you ask the question, how do you link with them? And again, at least on my father's side, his parents are buried at the same cemetery. So when I visit him and his gravesite, I visit them too. There's that kind of linkage. I don’t know whether that’s part of the grieving process or whether that’s just part of your spiritual, soulful component, but that’s one thing I do, and there’s a personal story about it.

So there's a lot of stuff here. I’m going to start out with one that I think is kind of interesting, and it relates to cultural differences, maybe even religious differences. I recently went on a long road trip with my pooch, Murphy. Our first stop was at a National Monument Park called Effigy Mounds National Park. It’s north of Davenport, Iowa, in the cliffs overlooking the Mississippi River. Beautiful, dense forest, and beautiful vistas of the Mississippi River. I highly recommend a visit if you live close by.

At any rate, up in the middle of this forest are burial sites for American Indians who buried their people there. There are mounds in the middle of the forest. It's like a clearing all of a sudden—what the heck, there are no trees, and there are these mounds. This is where they buried their people, along with bears. When bears would die, they would bury them along with their loved ones. You stop and you look at that and say, "Wow!" Talk about culture or how people deal with death. Here’s how native Americans did it in that area of the country.

Let’s talk about this a little bit. You know, the culture of it all. Clarence, let’s start with you. In your background, I suppose you could link in your spiritual aspects, your religious aspects, and your health aspects. How is it that it's dealt with?

Clarence Jones: Yeah, I think one of the things... Thank you for that. And I want to tell all my other colleagues on this: Thank you very much for sharing, being willing to share. That was very important for me as well. But traditionally in my culture, it appears that showing signs of affection for the person who died, having good stories—even if they might not have been good stories about them, you have to figure out something good to say.

The other thing about it is wailing. Sometimes it appears that I’m going to say this, and I know people may not like me, but I’m going to say it anyway: People believe that the louder you wail, the more you love the person. And I always laugh at that because people be wailing and they didn’t even like the person they’re wailing about. But that’s part of the tradition sometimes. And I’m being totally honest about what I really think and what I really see. So I’m leaving it alone.

Stanton Shanedling: Yeah. Barry, how about you?

Barry Baines: I think the ritual traditions, how they relate to religion—being Jewish—I appreciate the ability to actually stretch out the grieving process. A lot of times when a person dies, there’s this pressure to get over it, and that actually creates a lot of health issues for people. In Judaism, with death, there’s this gathering of community to really help, and it stages the grief. That first week, in Judaism, is called the Shiva period, where you sit, cover your mirrors, and sit on hard stools when guests come. But most of that Shiva period is spent talking about the person who’s gone, remembering stories. Everybody who knew that person has a story, so you get this treasure trove of stories which provides a lot of comfort.

Then there’s the second phase, a month-long period called Shlosheem, where you stay away from celebrations and stay in mourning, gradually reintegrating into the community. The mourning period lasts a year, where you say a special prayer called the Kaddish. It’s a prayer of remembrance. The grieving period formally ends, though it never really ends. On the anniversary of the person’s death, they’re remembered. Interestingly, the anniversary of my mother’s death starts tonight, so I’ll be saying this prayer and lighting a candle. I like the more gradual reintegration back into the community rather than trying to compress your grieving, because everyone goes at their own pace. Even a year may not be enough, and it goes on longer than that, but the gradual reintroduction is key.

Stanton Shanedling: Yes, yeah. Hopefully.

Barry Baines: So those are the rituals I’ve been part of, and for me, they've always been very helpful.

Stanton Shanedling: Maddie, how about for you?

Maddy Levine-Wolf: Yeah, I’m also Jewish, so a lot of what Barry said is also how my family mourns and grieves, especially in the immediate aftermath of death. I always found the Shiva tradition relatively uplifting. In my family, the sitting Shiva period was always more of a celebration of life, which I think is really lovely. Also, I started working with a rabbi about a year ago to learn more about my own understanding of Judaism and to dive into my own spirituality. One thing we’re really focused on is unpacking mourning and death and mortality within Judaism. That’s obviously relevant to this episode. So just continuing to learn about how Judaism looks at life, death, and rituals after death.

Oh, I know this is going to interrupt it, but did anyone know that Clarence had to leave?

Stanton Shanedling: Oh, he did? Okay, so he wasn’t going to be on here for that long.

Maddy Levine-Wolf: Is that right?

Stanton Shanedling: Sheridan, you there?

Sheridan's iPhone: Yeah, I’m still here. Sorry. As long as we don’t need Clarence at this moment... For me, I am not religious. I would call myself more spiritual, but I don’t really know what that means. I’m currently in the process of trying to explore that for myself. My family is not very religious. We are not super in touch with our cultural roots, so every funeral has been different for me, based on preference. I think that’s an interesting thing about America—you can really find any kind of funeral or memorial service or celebration of life service today. I’ve gone to a tree-planting ceremony where somebody had their ashes made into a tree, and we planted that and everybody threw dirt onto the tree. It was really lovely. But I’ve also done the traditional funerals in a funeral home with open caskets.

One thing I’ve found beautiful is the breadth of different ways you can celebrate your life at the end. I’ve always thought it’s funny that we plan funerals and we never get to attend our own funeral. We never get to hear the beautiful things our loved ones say about us. I had this thought when I was 15: If I knew I was dying, I’d have my funeral with me still there. I think I’d force everybody to come and I’d want to hear all those things for myself. If they still wanted to do something after I’ve passed, sure. But I just think it’s funny how we say all these beautiful things and the person doesn’t get to hear them.

Maddy Levine-Wolf: Actually, sorry, I was just going to say really quick: I’ve seen that in movies, Sheridan, and I think for what we culturally do around death and loss, it’s kind of a radical idea. But I definitely hear you, and I think it’s a really interesting idea. I support you.

Sheridan's iPhone: Thank you. It’s definitely weird.

Stanton Shanedling: So here’s a couple of things that I think are important to bring out. Inevitably, you will go about doing your things in life, and then all of a sudden, you’ll hear from somebody who’ll come up and say, “Hey, did you hear that so-and-so passed away?” And it’s a little bit of a shock. You might not be real close to that person, You might not attend their funeral. and that might be it as far as how you deal with it, but it still hits you. and it causes us to be I will say human, more human, connected, maybe for that that moment in time. 

What I'd like to do is talk about what makes other people comfortable when somebody has passed away. For instance, I'll reflect on this. When my father passed away, I remember many people coming up to me and saying, "Sorry for your loss."

I remember thinking about that afterwards. It's well-intentioned, but I also remember one gentleman who was very, very close to my father. They were good friends. When we were doing Shiva after my father passed away, he came into the house and didn't say a word to me. He just put his hand on my shoulder. That was it.

To this day, that non-verbal reaction sticks with me. It's not that you have to say something or be compelled to say something—just your mere presence of support is meaningful and, in many ways, healthy for people.

The other thing I'd like to reflect on, and it ties into your thoughts, are eulogies. When you go to a funeral and listen to a eulogy—whether it's given by a minister, pastor, rabbi, or family members or friends—it really is a reflection on a point in time and history with the person who has passed away. For some, eulogies are very needed. They provide reason or purpose to the person's passing, especially if it was an unexpected death.

There's been a lot of great research for this episode, and I highly recommend that everyone check out the background research Sheridan put together. It’s really quite insightful. What we're dealing with here is health and grief—how we deal with grief. Barry, you made the point that everyone grieves differently. Some people get over it very quickly, and others hold on to it.

I’ll tell you this, and one thing you didn’t mention, Barry, was in Judaism, when someone passes away, particularly a mother or father, the rabbi historically would tear a piece of your clothing. Today, they give you a black ribbon to tear. It's symbolic of someone being torn from your life.

There are many things we do—flowers, lighting candles, tearing garments, putting flowers at a gravesite. In Jewish cemeteries, you might see people placing small stones on a gravestone, as a reminder that they've visited, and hopefully, this brings comfort to those who have passed away.

Let’s talk about symbols a little bit and the verbal things people say. Any thoughts on that, Barry, Sheridan, or Maddie?

Maddy Levine-Wolf: I think that the verbal part is always difficult. Even though I’ve experienced loss myself, it’s always just hard to know what the right thing to say is, even if you’ve supported someone through their own loss before. You never know what the right thing to say is. "I’m sorry for your loss" is kind of a standard, but you never want it to sound inauthentic, because it’s said so often.

So for me, I just try to tell the person, family member, or friend that I’m here for them, if they need anything. But it can be difficult because, like we’ve already talked about, everyone processes and grieves in different ways. It’s challenging. And if anyone knows the right thing to say, please tell me. There’s no one perfect thing that makes it better.

Barry Baines: I kind of agree with Maddie. There are some scripts about things to say, but I think the little story Stan told about just someone coming over and touching you shows that the comfort of presence is really powerful. People feel compelled to say something, but they’re also worried they won’t say the right thing. Often, just being there and touching the person says it all.

Something simple like "I’m sorry for your loss" can go a long way. And then, just hanging out or letting the griever initiate can also help. When we go to a funeral, we often bring a nugget of the experience we had with their loved one, and sharing that sometimes brings the most comfort. You hear stories you’ve never heard before, and that can be powerful.

I think simplicity is best—just being present, listening, and supporting.

Another point is that immediately after a loved one passes, a lot of people visit and provide support. That’s really helpful. But as time passes, those visits fade away, and the griever can feel isolated. It’s important to maintain a presence not just in the weeks immediately following, but also by checking in over time. This can be very helpful because people grieving often start to feel isolated, and that’s where medical issues like depression can come in. Grief is a normal response, but unresolved grief, when it lasts a long time, can lead to significant health issues.

Stanton Shanedling: Shocking death.

Barry Baines: Versus.

Stanton Shanedling: That's good.

Barry Baines: Versus expected, right?

Stanton Shanedling: Yeah. You know, somebody gets killed in a motor vehicle accident, or somebody gets shot, or an active service member gets killed in the line of duty. These are more shocking and perhaps more difficult to deal with.

But that's where truly family support, community support becomes very, very important.

One thing that Sheridan brought up in her research for this show is the costs of burying someone, you know, a funeral today. They aren’t cheap.

In Judaism, for instance, there’s the concept of "dust to dust," so often Jewish people are buried in a plain pine box—nothing extravagant at all as far as a casket is concerned. On the other hand, there are a lot of different caskets that people feel are important. So, there are a lot of costs, and to a certain extent, funeral costs are unexpected. I mean, you just don’t realize, then all of a sudden, you're hit with this. So, I recommend everybody read some of the background research here that gives a sense of it.

Another thing—maybe Sharon, you can reflect on this—is organ donation and body donation. For at least theoretical science purposes. Did anything hit you specifically about that when you were researching?

Sherds iPhone: Yeah, absolutely. So, this is actually something we could probably do an entire episode on—medical body donation. I would love to, and if people are interested, I’d be willing to do that. But I’d like to preface that organ donation is very different from medical body donation. Organ donation—you have to consent to this while you're still alive. You’d say so on your driver’s license or an advance directive, and you'd donate organs in certain situations, including skin and eyes, and other useful components to living people.

Now, when you die, and if for some reason you haven’t indicated exactly how you would want to be buried or cremated, and your family is kind of at a loss—and a lot of times families cannot afford the costs associated with a funeral service—that’s where medical body donation comes into play. There are several different types of organizations that do this. You can donate directly to universities, such as the University of Minnesota, where I work. You can donate your body directly to the university, which is one of the more regulated ways to donate to science.

There are also other organizations, and they come under several different names. There is a legal commercial market for the purchase and sale of cadavers, and even dismembered parts. The loved ones of the deceased make no profit from the remains of their loved ones. They basically sell the remains to a body broker, who collects cadavers, generally for free. The body brokers stand to make somewhere between $4,000 and $8,000, typically around $5,800 for selling a whole cadaver.

So picture this: Your loved one has just passed, you can’t afford a funeral, and someone approaches you with a free way to have them cremated and also use some of their body for science. There’s a contract you sign, which is highly legal, full of jargon and very confusing. You sign it because you don’t have a lot of other options, and then you find out later that your loved one’s body was not used for actual medical research. It was used for research anywhere—it could go to the military, or research companies that study things like knee implants. So you really have no idea where your loved one’s body is going after you sign this contract. You’re typically told it will be used for research and education, but there’s little oversight. People who’ve done exposés have found instances where bodies are being exploited. For example, in 2004, a body donated to Tulane University was shipped to a broker who then sent it to the army for landmine experiments.

For me, that would be devastating. It’s a gross misuse of exploitation, taking advantage of someone's grief and lack of resources. And this is unfortunately still going on. It happened in 2004, but there have been other similar cases, and it’s really concerning. But yeah, a lot of that came up in my research.

I want to make it very clear that this is extremely different from organ donation. We have an entire episode on organ donation, which, if you have any questions, go check that out. But it’s entirely different. Please try to keep them separate in your mind, as they are really distinct.

Stanton Shanedling: You know, I remember distinctly taking an anatomy course at the University of Minnesota, and I remember we were in a laboratory with cadavers. Our professor, before we even started, said, "No matter where you come from, what kind of culture or religion you have, these people have donated their bodies for us—for educational purposes and for you to become knowledgeable." And he said, "Before we ever get started, we’re taking a moment of silence just to thank them." And we did. And that was really powerful. It also caused us, when we were studying these particular cadavers, to do it carefully and with respect. It really stuck with me all these years.

Stanton Shanedling: Clarence, welcome back. I really want to get your overall thoughts on this topic of funeral and death. What hits your core? What have you learned in all your years that really affects you to this day?

Clarence Jones: I think what I really learned is that grief is universal. People experience it in a variety of ways, but it’s important that there’s support for people going through this process. One of the first things I noticed was that death and dying is a fundamental part of the human experience. At some point, all of us are going to be affected—whether we’re young or old, this issue is going to come up. So for me, the important thing is when this issue does come up, we need to have ways to support each other, but also skills and tools to help us get through it.

Stanton Shanedling: All right, everybody, round table. Last thoughts, Barry?

Barry Baines: I just want to quickly tie together a couple of things. One is the great research that Sheridan had done, which shows that funerals are expensive, and most people don't know about it. This is actually a plea for doing some pre-planning, as Clarence mentioned. As all of us know, taxes are inevitable, and so is death. We are all going to die. One of the greatest gifts you can leave for your family is to do some pre-planning about your funeral. This way, you can have a say beforehand—not just about the service, which is important, but also understanding the cost options that are available. It's extremely important to be aware of those things and have those conversations. If you're in hospice, those things are addressed upfront, but most people don’t go into hospice, so they don't have that ability to have those conversations. So, it’s about thinking ahead.

Also, in the funeral industry, green funerals are becoming more common. Sheridan mentioned something about a service with a tree and ashes, and more people are opting for these. Cremation has also become more common than traditional burials, largely because of cost. The funeral industry has begun to pivot to the importance of pre-funeral planning to help the family avoid the pressure of making all the decisions when they’re grieving. Pre-planning eases that pressure, which helps survivors make better decisions. So, my plea is to think about having those conversations and be proactive about pre-planning.

Stanton Shanedling: Yeah.

Stanton Shanedling: Maddie, last thoughts?

Sheridan's iPhone: I think Maddie wanted to skip her last thoughts. I just got that message.

Maddy Levine-Wolf: I guess it's not a big deal. I just don’t have articulate concluding thoughts, so I wanted to leave it to everyone else.

Stanton Shanedling: I have two things I'd like to quickly say. One is what I’ve realized over the years, after visiting cemeteries around the world, is the history. For instance, I recently went to Abraham Lincoln’s boyhood home in Northern Tennessee, and his mother is buried there. She was 35 years old when she passed away, and I couldn’t help but stop in front of her gravestone. The thought that came to my mind was, “I hope you really realize how significant your son was in the lives of many people in the United States—something you couldn’t have foreseen at 35.”

The last thing I want to do is read something that Sheridan provided from her great research. The word "funeral" was first used in the 1300s. It's believed that Geoffrey Chaucer, often considered the father of the English language, was the first to use the word in writing. It appeared in his middle English work The Knight’s Tale, published in 1386, marking the first known written use of the word "funeral."

With that, that’s the end of our show today. Our next show will be on health and safety, so tune into that. In the meantime, everyone, keep health Chatting away.