Picture the scene: a series of feet tapping, hips swaying, arms held aloft to an upbeat disco track. Not what you might expect in a hospice for the chronically and terminally ill. But this collective joy of gathering together and finding respite and relief in music is the rhythmic beating heart of Amy Hardie’s Seven Songs for a Long Life, a profoundly life-affirming documentary about death.
What we get to witness is the revolutionary power, not only of community – the Strathcarron Hospice in Denny offers pain management and end of life care to a wide array of patients – but also of music itself. A space of illness and loss is suddenly transformed, bodies wracked by pain or dulled by medication become playful again, and what emerges taps into something at once both deeply human and soaringly transcendent.
While Western culture seems to have fashioned a rough guide to grief, with mass-produced ‘Sympathy’ cards for the bereaved and an agreed-upon etiquette for funerals, there is still a strong sense of taboo around the process of dying itself. Our reluctance to confront mortality head-on ensures we keep the topic resolutely off-stage, out of sight and out of mind. Hardie, through her documentary, challenges this sidelining of one of life’s most central questions, venturing into the private space of the dying, focusing in on what most of us work so hard to ignore.
At first she’s unwelcome, with patients initially unwilling to talk on camera. But then along comes Tosh, charismatic and sharp-suited with a gruff sense of humour and a dapper line in hats, and a chance conversation about his memories of winning a singing contest in his youth. Crooning Rat Pack hits direct to camera, duetting with the 94-year-old Betty, Tosh seems to unblock something in the others, and soon enough the patients who shied away from the lens become the ones who seek it out, singing unaccompanied with startling openness. Rather than an intrusion, Hardie’s silent observations provide an empathetic audience, drawing each person into song or into the articulation of things previously unspoken.
The association of music and death is enduring – Scottish laments, funeral dirges, ululations or New Orleans jazz parades – and yet here, it is the dying, rather than mourners, who are expressing themselves through song. While illness and pain slowly strip away the individual’s independence and autonomy, patients can still choose and perform their own soundtrack, not in some version of televised competitions, but in an honest and open voicing of self that brings the patients out of isolation and into an improvised harmony.. As Mandy, one of the palliative care nurses puts it: ‘I think singing really lets you know a person…They’re singing more and more, for themselves and for each other.’
Crucially, Hardie captures the full range of experiences – rage, sorrow, humour, fear – avoiding siding with either the maudlin or the heroic. Emphasising the day-to-day negotiations each person makes with their pain, she tracks their attempts to keep some small-scale sense of normality ticking over in their daily routines – shopping, haircuts, skating with a child – so that we gradually get an intimate feel for the domestic and demystified settings of a terminal illness.
While death is inevitable, its timing – even after a terminal diagnosis – is radically uncertain: Julie is given just months to live following a diagnosis of stage IV Hodgkin’s lymphoma, yet is alive two years later; Dorene battles with the intense pain of bone marrow cancer, undergoes stem cell therapy and finds release through music, but remains acutely aware how likely it is to return; Iain watches his own body slowly start to disobey him as his Multiple Sclerosis gets progressively worse.
Hardie remains present with the reality before her: Nicola’s physical decline and pain levels are particularly gut-wrenching, the fragility of the human body uncompromisingly exposed on screen. The refusal to avert the gaze is once again felt not as an intrusion, but as a tender way of bearing witness, of honouring Nicola’s bravery as she keeps confronting her illness with the love and support of her family. As Mandy says, there is no magic formula, just the courage to stay with the experience: ‘You can’t fix it...You really just listen... and listen properly.’
Whilst acknowledging the mental toll of this uncertainty – with depression, isolation, disconnection and fear all openly expressed – there is also a sense of hope and resilience, unexpected joys as well as painful losses, the strength of love that endures the worst of times. As Hardie says later, questions and thoughts around death and terminal illnesses are pertinent for the whole spectrum of mental conditions. The qualities that the patients of Strathcarron have to discover in themselves, combined with the support they receive from staff, enable them to ‘grow their own strategy’.
Songs allow them to revisit the past, as when Alicia recalls her first dance with her late husband, or to prepare memories for the future, Nicola videoing a duet with her daughter. Through singing, patients learn to manage their fears, readying themselves and their loved ones for ‘their best death’, whatever that may be.
As Hardie points out after the screening, there appears to be an increasing mismatch in Western culture, between the rapid advance of medical technology in prolonging life and our own limited emotional intelligence concerning its end. Death, she says, has become a ‘medicalised event… it’s something that goes wrong behind the green curtain’. Rather than in previous times, where death was seen as a moment that gave life meaning, a scene to be planned and choreographed, it seems now that we push it out of our line of sight, unable or unwilling to contemplate it directly.
As to the manner of our dying, many of us choose to ignore what might happen until it’s too late. According to a report by Hospice UK, of the 500,000 of us who die each year, 82% want to die at home, whereas in fact over half will die in hospital. And, as Jim, the indefatigable fundraiser at Strathcarron points out, while the hospice is partly funded by the NHS, it requires £10,000 in additional funding every single day to survive.
Things do appear to be changing, however, as with the proliferation of Death Cafes, where people can gather to talk about death and dying over tea and cake, or the work of Dying Matters. Yet all this is something that demands a certain emotional bravery that is often hard to source in a culture where even the outward signs of ageing are taboo, never mind the actual processes and experiences of dying.
In some Buddhist traditions, meditators reflect on death and impermanence, not out of morbid curiosity, but as a means of addressing fear and attachment and of avoiding regret. At the end of the screening, Hardie invites the audience to do precisely this, asking people to pair off and ask each other four questions, honing in on personal values and how a terminal diagnosis might impact ways of living.
Acknowledging the extreme difficulty of facing up to the loss of loved ones, she urges us to think carefully about our own death, so that, by clearly setting out our wishes, we might gift this clarity to our family, relieving them of the difficulty of working it out for themselves. Facing up to death and dying is not simply a question of taking leave of those who remain, of saying goodbye or tying up loose ends, but also an important reminder of how we want to live.
by Clare Blackburne
Full film listings for the 10th Scottish Mental Health Arts and Film Festival can be found here.