Issue 10 |

Making sense of final words: A book review of "Words at the Threshold" by Lisa Smartt

by on April 21, 2017

Book Review

Words at the Threshold: What We Say as We’re Nearing Death, by Lisa Smartt


Enigmatic. Nonsensical. Out of this world.

Perhaps these are the words you have heard others use to describe the language produced by a loved one nearing their final moments in life. It is not uncommon for confused caregivers to describe an increasing incomprehensibility in the language of the dying. With talks of visions, unfathomable and illogical expressions, and references to seemingly random concepts or events only they understand, the words of the dying are often so inexplicable that they may as well be speaking a completely different, constructed language of their own.

But what if these seemingly nonsensical expressions are, in fact, not a demonstration of deteriorating cognitive and linguistic ability, but a window into the experience of what it means to be dying and of the possibility of life after death? Is there a deeper meaning or order to the mysterious words of those who know that they have reached their final stage in life? And why is this supposed decline in lucidity nearly universal?

I’d pondered over these questions before encountering this book; questions which were perhaps better left unasked in a society where death is often a taboo topic. And when such questions are avoided for fear of ridicule or just a fear of the unknown, open sharing and healthy discussion on the apparent changes in the mental and linguistic clarity of loved ones before they pass on are often lacking, leaving many confused and searching for answers long after.

Launched on 15 March 2017, Words at the Threshold examines these questions and offers refreshing and often surprising insight on the world and language of those on the border of death. In this recent publication, author and linguist Lisa Smartt approaches the complex study of death and dying through the lens of language, marrying research in linguistics, psychology, palliative medicine, and neuroscience to illuminate our understandings of terminal illness and the cognitive processes behind it. Baffled and inspired by a personal experience of her father’s language change in the days leading to his passing, Smartt’s work is an analysis of her collection of over 1,500 English utterances from those on their deathbeds. It reveals profound trends in the very words often dismissed as manifestations of hallucination or cognitive decline.

Because humans are sense-making creatures, seemingly unintelligible language often goes unnoticed or disregarded by those who hear it, explains Smartt, but final words are significant as they deeply reflect who we are and what matters most to us. The words of the dying reveal a path of consciousness as they make sense of what is happening to them and their experiences. As this book uncovers, these often involve journeying into a world beyond the literal and present, where realities may be non-linear and transcend the logic of human knowledge and imagination.

What kind of language might you use to describe the experience of dying? For most, this is a completely new encounter and for which the listener has no reference point. It is, moreover, at this point where the perceptions of reality for listener and speaker diverge, and that experience transcends the descriptions literal language has to offer. When language, as we use it to describe our world, cannot convey something that goes beyond the five senses, perception can only be described imaginatively and figuratively. For example, talks by the dying of preparing for a great event or a journey, in the form of expressions like “I am getting ready for the big dance” or “He’s waiting to play golf with me. They need a fourth”, understandably make no sense to listeners.

However, as Smart explains, these are in fact common metaphors found in the attempt to use language ill-equipped to describe their liminal experiences. They are figures of speech which challenge our taken-for-granted conceptualisations of reality. By the end of the book, it is easy to see that the babbling of those at the final point in their lives are so much more than that, and that we have barely skimmed the surface in our efforts to discover and make sense of the previously unfathomable experiences and possibilities of the inevitable—death.

Smartt’s book is thus a culmination of systematic analyses on end-of-life communication. It uses examples from ordinary people, chronicling and elucidating the linguistic themes and patterns in the speech of those leaving this world behind. In so doing, her research not only opens up discussions on how we perceive dying, but also on how we think about living, and provides invaluable explanation and guidance on how “we ourselves can be both guides and tourists as we journey with those we love to the portal”.

While the experiences in her book were collected from the United States and Canada and focused on English, further exploration through drawing comparisons from other communities and languages would also be interesting and insightful in yielding a greater understanding of what it means to live and pass on, universally and culture-specifically. Nonetheless, Words at the Threshold has the potential for profound implications on the care of terminally ill patients and their loved ones, and is a wonderful, comprehensible, and sensitive starting point to a topic and experience that many, including myself, have found hard to approach.

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