Where do we go when we die?

A recent online survey showed that more than one-third of us think that once we die, we end up in some kind of merit-based afterlife, like Heaven or Hell. Another 29 percent figure we go nowhere—we’re just dead.

   Well, yes and no. No matter where you think you’ll end up in the long run, you’re definitely going somewhere. In fact, our bodies—and maybe our souls—go on quite a journey from the time we flatline to the time we hit our final resting place. Depending on who you are, how you die, when you die and what you believe, your “life” after death is a veritable choose-your-own-adventure.

   Let’s say you’re a young, healthy, upper-
middle-class suburbanite who prematurely buys the farm in a car wreck. You’ll likely be heading to the medical examiner’s table for an autopsy. Perhaps you’re an old person who kicks it in your sleep. You’ll probably skip the M.E. and wind up in your $1,500 grave site, firmly ensconced in your $2,500 coffin—if you bargained, that is. Or maybe you were poor and black in the early part of the 20th century. You could have come to rest under
an unmarked stone in an unknown graveyard somewhere in Albemarle.

   Heaven or hell? We don’t know. The only thing we can say for sure is that it’s smart to hedge your bets. Build up good karma points, wear your seat belt, prepay your funeral costs and make the best out of every day.


Meet the medical examiner
Nobody makes an appointment for the
cold, hard slab

Most of us find our way to the morgue. No longer alive but not yet returned to dust, in the morgue we are simply a “body,” chilled to ward off decay until the story of our demise can be told.

   The task of piecing our story together falls to medical examiners and pathologists who perform autopsies—the study of corpses to determine cause of death. Sometimes the answer is tragically obvious, as when police discover a lifeless teenager near a wrecked motorcycle.

   Other times, death is a mystery that medical examiners try to unravel with scalpels, bone saws and microscopes. The sleuthing element is compelling, and indeed a spate of television shows (“CSI,” “Cold Case”) cast medical examiners as Sherlock Holmeses in lab coats, always managing to find the right answer in 60 minutes or less.

   Local medical examiner Deborah Chute says the shows heighten people’s interest in her job, which she hastens to add is nothing like TV. The lesson she takes home is not one about the wonders of technology, but the frailty of human life.

   “I drive a lot more carefully,” says Chute, a 28-year-old who is finishing her second year of residency in pathology at UVA Medical School. “I’m more aware of all the things that can happen.”

   Chute volunteers as one of two local medical examiners for Charlottesville and Albemarle County. It means she sometimes gets paged in the middle of the night to establish an official cause of death, and sign death certificates. To figure out why someone died, Chute sometimes draws blood to test for toxins, or checks out medical history to look for clues.

   Chute does not solve crimes. That task falls to the Office of the Chief Medical Examiner in Richmond. If a person dies violently, if he dies suddenly despite apparent health, if the death is suspicious or occurs in police custody, Chute must refer the body to the Chief Medical Examiner, Dr. Marcella Fierro.

   Fierro is a something of a celebrity in the world of forensic pathology. She inspired novelist Patricia Cornwell’s character Kay Scarpetta, a plucky, crime-solving forensic pathologist who has starred in a series of best-selling thrillers. (The author worked as a computer analyst in Fierro’s office during the 1980s.)

   The majority of bodies who end up in Fierro’s morgue got there by accident. In 2003, the most recent year for which data is available, Fierro’s office investigated 5,821 deaths statewide. Accidental deaths accounted for 40 percent of the total; 37 percent died of natural causes, 8 percent were murdered and 14 percent committed suicide. In Charlottesville that year, 83 of 127 deaths were accidental; in Albemarle, 26 of 53 people died by accident.

   Despite the public interest in busting the bad guys with Hollywood-style forensics, when Fierro talks about her job, she speaks of helping families adjust to the sudden loss of a loved one.

   “When folks come to us, there has been no goodbye,” says Fierro. “Families are devastated. They haven’t had the opportunity to resolve whatever issues they have.

   “Families want to know what happened to their person. Why did they really die? How long did it take? Did they suffer? Is there an inheritable disease? If those questions aren’t answered, they don’t get to a point where they can grieve effectively,” she says.

   To answer those questions, medical examiners look for physical clues. For example, dead heart tissue or clogged arteries can be signs of heart failure. If police find someone dead of a gunshot wound to the chest, the medical examiner might look at how much blood accumulated in the chest—if there’s a lot, the examiner knows the person survived for a while after being shot.

   “Families are never the same” following an unexpected death, she says. There is no closure; the best that can happen is that families go through the grieving process, so that eventually people can remember their dead without pain.

   How we die says something about how we live. According to state medical examiner records, the largest single cause of accidental deaths is car crashes; the largest single cause of natural deaths is heart disease. Not surprising, perhaps, for a culture addicted to automobiles and fast food.

   Chute says her friends sometimes wonder how she copes with regular encounters with death; she says her spiritual beliefs help. “I feel like they’ve moved on to a better place,” she says.

   “In medical school, you learn how to deal with tough situations,” Chute says. “Telling someone they have brain cancer is more difficult than seeing a dead body.”

   It’s frustrating, Chute says, to see cases where something as simple as a smoke detector or a motorcycle helmet could have saved a life. In Fierro’s office, examiners confront not only the random and foolish nature of some deaths, but they must also face the reality of human evil. She says she doesn’t understand how people watch death, destruction and cruelty for entertainment.

   “The real thing is not entertaining,” says Fierro.

   Asked how the job has affected her, Fierro echoes Chute in saying it has made her more cautious.

   “When my kids started driving, they had so many rules it drove them nuts,” says Fierro. “Well, alright, I’m overprotective, but each day is a gift. None of the people who came to my office made an appointment.”—John Borgmeyer


Grave matters
Uncovering the
forgotten burial sites of the poor

Most of our bodies go into the ground for a final resting place. Unfortunately, some of those resting places aren’t so restful—especially if you’re poor or black.

   Off Doctor’s Crossing near Stony Point there’s an unassuming patch of land on which grows a rose bush and a wild cherry tree. A chain-link fence covered in honeysuckle and sassafras used to separate the land from the unpaved road. Last year a logging truck knocked it over. Dirt piled up against the fence and pushed it back—into a row of easy-to-miss headstones.

   Joseph and Nelly Blue lie under the only inscribed stone on the plot. When they died in 1978 they were buried in the unnamed graveyard at the crossroads of Brook Mill Lane and Doctor’s Crossing; parallel lines of 15 unmarked stones—a few of them indistinguishable from regular rocks—hint at more bodies. Following the truck incident last year, road grading ate away at the small buffer separating gravestones from the thoroughfare and pushed the markers forward, as though in defeat.

   The road “just keeps coming this way,” says Bill Klem, a retiree who recently came aboard to take care of the land where his friends, the Blues, are buried. For 20 years, no one really looked after this falling-down place. Klem remains in a battle to win back precious inches for the dead here.

   Klem knows how hard it is to perpetuate a memory. Like others who step forward to care for a graveyard, Klem says he’ll be cremated.

   As does Dr. Lynn Rainville, a UVA professor of archeology and cemetery expert. More than a collection of holes for dead bodies, she says, cemeteries are museums. She’s spent hundreds of hours metaphorically digging up 60 different local cemeteries—she calls it a “hobby.” Mapping local cemeteries is key, she says, because work crews sometimes don’t know they are in a graveyard until a backhoe blade hits a coffin.

   Slave cemeteries are especially difficult to preserve because the graves are typically marked by fieldstones, maybe a foot high and almost never inscribed. Most sources document slavery in economic terms, showing what a slave cost or how many calories she ate. A graveyard offers a first-person reminder that these were people, not things, with real lives and bodies.

   Rainville collects information about graveyards on a website, the African American Cemeteries in Albemarle County Project (www.virginia.edu/woodson/ projects/aacac), housed by the Carter G. Woodson Institute at UVA. It preserves the history of common folks.

   “Five percent of human history is the elites,” she says, “the Thomas Jeffersons. Ninety-five percent of history is farmers, enslaved communities,” she says. Her project gives voice to those quieter histories.

   Ted Delaney also works at resurrecting history. At UVA, he researched the Daughters of Zion cemetery at First and Oak streets. Most people thought it was a segregated section of the Oakwood Cemetery. Even the name had been lost.

   In truth, the area was really a separate cemetery for elite blacks established as a statement of independence by the Daughters of Zion in 1873. Like Masons or Elks, Daughters of Zion offered benefits equivalent to modern life insurance: burial costs, a grave plot, and the apparently false security that they could care for a site far into the future. By 1950 the cemetery was pretty much abandoned.

   Delaney compares a good cemetery to a fine library. He is now the archivist at the Old City Cemetery in Lynchburg. Even a blank grave marker holds a wealth of information hidden in its material and form. “Granite was most popular from 1900 to 1950,” Delaney says. “You can date a certain cherub within five years of when it was carved.”

   Delaney thinks he’ll be cremated too. “It is a constant struggle to maintain immortality,” he says dryly, “especially when it comes to cemeteries.”—Lacey Phillabaum


Karma chameleons
For Buddhists, life keeps going and going and going…

Some of us go right back to living. If you’re a Buddhist, don’t expect to get much rest when you die. Buddhists believe in cyclic rebirth. And you won’t get by on your good looks or big bank account—good karma, the ticket to a good rebirth, is racked up by humanitarian actions.

   We can count loads of Charlottesville residents in the ranks of the quest for good karma. Thanks to a premier Tibetan rare book collection at UVA as well as world-famous abbots like Geshe Jampel Thardo at the Jefferson Tibetan Society, the Charlottesville Buddhist community has swelled since the 1960s. With about a quarter of Virginia’s Buddhism centers based in Charlottesville, local Buddhists have found a haven in Virginia to flex their karmic muscles and mull over what happens next.

   Buddhists don’t believe in a one-of-a-kind soul that crosses between this life and the next. According to Dr. Sandy Newhouse, the Buddhist representative to the UVA Hospital Interfaith Committee and a practicing psychologist, it’s the consciousness that transfers after death. “The death process goes on past the point where the heart stops beating—it’s not just the physical death,” she says.

   Buddhists believe it can take up to three days for the consciousness to leave the body. Over the three days, Buddhists continue to pray for and communicate with the dead to boost their chances for a good rebirth. If the consciousness leaves the body through the crown of the head or upper areas, it is believed that the dead will go onto to a higher karmic place. But watch out if the consciousness leaves through the lower areas—it could mean a karmic demotion (your consciousness can be forced into animal realms—where you become, say, a squirrel—or sent to a place of great suffering).

   After the consciousness bows out, Buddhists allow families to determine funeral specifics. Traditionally, Tibetans cremate the dead since it’s generally believed Buddha himself was cremated. Monks and nuns are often at funerals to lead prayers as families offer songs and thoughts about the dead. While some Buddhists might don black for a funeral, ceremonies celebrate rather than mourn the dead because everything is always changing in Buddhism—the end of one life is the beginning of another.

   According to the Buddhist tradition, it can take up to 49 days for the consciousness to find someplace new to hang its hat. Some Buddhists believe that during this time (bardo) the dead see the events of their life and long for a new body. The awareness of death pushes the consciousness into the third bardo—the final stage in rebirth.

   In Buddhism, practicing death is nearly as important as death itself. Buddhists are expected to spend time meditating about the death process—their fears, the physical sensations, entering a new realm—to lessen any anxiety that could complicate the death process. The more peaceful the mind is at the time of death, the better the rebirth will be. Some Buddhists do yoga that represents the sequential death process. It’s not that they’re emotional masochists—for Buddhists, realizing the temporary nature of life motivates believers to be more compassionate to others.

   Newhouse, co-founder of the Jefferson Tibetan Society, has practiced Buddhism for 30 years after converting at age 19. In her 10-plus years with the Interfaith Committee, she remembers one elderly man who seemed “blocked” from death. She says that the man was paralyzed by his fear of death. After she and several Tibetan monks visited with the man and prayed with him, he died a day or two later. She credits the prayers with pacifying his mind so that he could move on.

   The rebirth of consciousness can happen countless times for Buddhists—it continues until a person can control where he or she is reborn. On the road to liberation, Buddhists develop their capacity to help other people. As Newhouse puts it, “Just like anything in our lives, the more you practice something, the better you get at it.”—Jocelyn Guest



Paying the piper
At the funeral home, the dollars and cents add up after your death

You go six feet under, and if you’re not careful your family goes 6K in the hole. You may rest in peace, but your relatives are uneasy if they’ve been left with the decisions—and maybe the cost—of planning your last hurrah.

   According to Mark Ascoli of Hill and Wood Funeral Service on Market Street, the average funeral costs $7,500. That includes a service, and the embalming and preparation of your body, as well as a casket. If you opt for solid bronze on the latter, however, expect to pay $7,000 for the casket alone. Add on another $1,400 or so for a casket container, burial site and headstone at the cemetery, and cremation never sounded better. The cost for a no-frills cremation, complete with cardboard box for your burnt remains? $1,780.

   Dying is all too easy, but paying for it can be hard. Plan in advance, tell your family your wishes, and prepay what you can.

   As you aim to get the costs squared away, you’ll be faced with decisions. Doris McClenny, funeral director at McClenny Funeral Services on Henry Avenue, says many of them concern your personal style.

   Die-hard Wahoos, for instance, might want to spend eternity locked in the UVA casket, an option from high-end coffin designer Whitelight. (The company also makes a casket for NASCAR fans inscribed with the words, “The race is over.”) Being encased in the blue-and-orange box is like riding in a bumper sticker-plastered, pom pom-waving, football party-tailgating SUV to the Promised Land. And it will cost you $2,995. If you opt to enclose the thing in a concrete box for weatherproofing, add an additional $750 to $7,000. (Weatherproofing? Hello, you’re dead. Weather is not an issue.)

   Maybe this tally gets you thinking that you’ll leave the matter of your remains to the government. After all, you gave them plenty while you were around, didn’t you? Think again. The City’s Social Services Department will spend merely $650 to $800 to cremate you, and that’s only if the responsible party proves unable to pay
for it.

   Which brings us to Ronald Reagan. You might consider the $5,000 to $7,500 cost of a funeral to be excessive, but how do you feel knowing that taxpayers spent $400 million to memorialize and bury the former president? What’s that? You could keel over from the shock? No problem,
as long as you’ve made the proper arrangements with the funeral director.—Sarah Cox

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