In a sunny patch of grass in the middle of Indianapolis鈥 Crown Hill Cemetery, 45 people recently gathered around a large blackboard. The words 鈥淏efore I Die, I Want To 鈥︹ were stenciled on the board in bold white letters.
Sixty-two-year-old Tom Davis led us through the thousands of gravestones scattered across the cemetery. He鈥檇 been thinking about his life and death a lot in the previous few weeks, he told us. On March 22, he鈥檇 had a heart attack.
Davis said he originally planned to jot, 鈥淚 want to believe people care about me.鈥 But after his heart attack, he found he had something new to write: 鈥淚 want to see my grandkids grow up.鈥
Others at the event grabbed a piece of chalk to write down their dreams, too, including some whimsical ones: Hold a sloth. Visit an active volcano. Finally see Star Wars.
The cemetery tour was part of the city鈥檚 , held in mid-April 鈥 the first festival of its kind in the U.S. The was held in Cardiff, Wales, in 2013, and the idea has since spread to the U.K., and now to Indianapolis.
The purpose of each gathering is to get people thinking ahead 鈥 about topics like what they want to accomplish in their remaining days, end-of-life care, funeral arrangements, wills, organ donation, good deaths and bad 鈥 and to spark conversations.
鈥淭his is an opportunity to begin to change the culture, to make it possible for people to think about and talk about death so it鈥檚 not a mystery,鈥 said the festival鈥檚 organizer聽, a nurse ethicist at the Fairbanks Center for Medical Ethics in Indianapolis.
The festival included films, book discussions and death-related art. One exhibit at the聽 had on display 61 pairs of boots, representing the fallen soldiers from Indiana who died at age 21 or younger.
These festivals grew out of a larger movement that includes , salon-like discussions of death that are held in dozens of cities around the country, and 鈥 chalked lists of aspirational reflections that have now gone up in more than 1,000 neighborhoods around the world.
Sixty-one pairs of boots lined the walls at the Kurt Vonnegut Memorial Library to commemorate Indiana soldiers who died before their 22nd birthday. (Jake Harper/WFYI)
鈥淒eath has changed,鈥 Wocial said. 鈥淵ears ago people just died. Now death, in many cases, is an orchestrated event.鈥
Medicine has brought new ways to extend life, she said, forcing patients and families to make a lot of end-of-life decisions about things people may not have thought of in advance.
鈥淵ou鈥檙e probably not just going to drop dead one day,鈥 she said. 鈥淵ou or a family member will be faced with a decision: 鈥業 could have that surgery or this treatment.鈥 Who knew dying was so complicated?鈥
With that in mind, the festival organizers held a workshop on advance care planning, including how to write an , the document that tells physicians and hospitals what interventions, if any, you want them to make on your behalf if you鈥檙e terminally ill and can鈥檛 communicate your wishes. The document might also list a family member or friend you鈥檝e designated to make decisions for you if you become incapacitated.
鈥淚f you have thought about it when you鈥檙e not in the midst of a crisis, the crisis will be better,鈥 Wocial said. 鈥淕uaranteed.鈥
About a in the U.S. goes to end-of-life care. Bills that insurance doesn鈥檛 cover are usually left to the patients and their families to pay.
, a medical ethicist from Marian University who spoke at the festival, said advance directives can address these financial issues, too. 鈥淧eople themselves, in their advance directive will say, 鈥楲ook, I don鈥檛 want to drain my kids鈥 college savings or my wife鈥檚 retirement account, to go through one round of chemo when there鈥檚 only a 15 percent chance of remission. I鈥檓 not going to do that to them.鈥 鈥
The festival also included tour of a cremation facility in downtown Indianapolis. There are a lot of options for disposing of human ashes, it turns out. You can place them in a biodegradable urn, for example, have them blown into glass 鈥 even, for a price, turn them into a diamond.
鈥淚t鈥檚 not inexpensive,鈥 Eddie Beagles, vice president of Flanner and Buchanan, a chain of funeral homes in the Indianapolis area, told our tour group. 鈥淭he last time I looked into it for a family, it was about $10,000.鈥
A crematorium tour was part of the festival, too. Metal balls, pins, sockets and screws survive the fire of cremation. (Jake Harper/WFYI)
鈥淩eally, when it comes to cremation, there鈥檚 always somebody coming up with a million dollar idea,鈥 Beagles added. 鈥淚f you can think of it, they can do it.鈥
Beagles showed us a pile of detritus from cremated human remains. He picked up a hip replacement 鈥 a hollow metal ball 鈥 then dropped it back into the ashes.
I鈥檓 a health reporter, so I know a fair amount about the things that could kill me, or are already killing me. But watching this piece of metal that used to be inside a human be tossed back onto the heap gave me pause. I鈥檓 thinking about what I might write on a 鈥淏efore I Die鈥 wall. I still don鈥檛 know 鈥 there are many things to do before I go. But I鈥檓 thinking about it a lot harder now.
This story is part of a partnership that includes , and Kaiser Health News.