Why We've Lost the Plot on Death and What It's Costing Us
Rose Sexton is an end-of-life doula, nurse, mother, performer, mover of mountains, and author based in Victoria, Australia. Throughout a nursing career spanning more than four decades, she has been drawn to those facing life's biggest transitions, supporting people in this sacred space. She has recently published her dual-voice memoir "The Bird and the Bee" (Balboa Press, October 2026).
We plan obsessively for weddings, careers, and retirement, yet the one thing guaranteed to happen to every single one of us gets nothing but silence. After forty years as a palliative care nurse, I've watched that silence extract a devastating price. Here's what we've lost, and why it's time to start talking.
How we used to do it
It wasn't always like this. We used to know what to do. When someone died, you'd send little Jimmy out to knock on the doors and tell the neighbourhood. Food would arrive. You'd clear the parlour table for laying out the body, and friends and family would gather to cook and cry and pray and laugh and sing and hug. The grave would be dug, the prayers would be said, and the whole community carried the burden of it together.
Dying was done at home too. The wisdom of what to expect, what it looks and sounds like when someone is leaving, was absorbed simply by growing up. You sat by the bedside of your grandparents, your aunts and uncles, sometimes siblings, and you learned. Death was understood as a normal part of ordinary life.
It's curious, isn't it? We spend our lives planning for the big events. Weddings. Birthday parties. Babies. Careers. Retirement. Vacations. We plan in minute detail for all of it, and yet when it comes to the one thing we know is absolutely, positively going to happen to every single one of us, it's crickets.
Where it all went wrong
With the dawn of the 1900s, the funeral industry arrived and quietly took the whole thing off our hands. Modern medicine followed, convincing us, with the very best of intentions, that death is a healthcare issue. A problem to be solved. A tragedy. A failure of the patient, or the treatment, or the system.
We are not all entitled to die in our sleep at eighty-five. But somewhere along the way, we started acting as though we are.
The excuses are creative, I'll give us that:
"If I talk about it, I'll make it happen."
"That's too morbid, I'll make everyone sad."
"I'm never going to die."
My personal favourite:
"I eat really well."
Which brings me to a meme doing the rounds lately. A headstone in a cemetery. The inscription reads: I ate all that kale for nothing.
Despite all our collective best efforts to strain and strive for eternal life, we have never managed to get the mortality rate below 100 percent. Not once. Something for you to ponder.
The cost of pretending
I'm a palliative care nurse and an end-of-life doula. I've sat with a lot of dying people, and with a lot of people who love dying people. What I've watched, over and over again, is the cost of this pretending.
Death is not the opposite of life. It's the opposite of birth. It's the next transition, as embedded in our humanity as any other, and we have collectively decided to pretend it isn't there until it absolutely cannot be ignored. The result is that we have, as a culture, systematically pushed death and dying into the shadows. We become very interested in the floor whenever anyone mentions it, change the subject, or suddenly need something from a different aisle of the supermarket when we spot the newly grieving widow coming towards us.
People who arrive at the end of their lives having never thought about it, never talked about it, never made a plan, or had a single honest conversation have more than likely not said the things that needed saying. They haven't had the conversations that mattered, and then there's no time.
The people who love them haven't either. They don't know what they don't know. They don't know what they're entitled to, what's available, what they should be asking for. So they bob around in the ocean of doctors' appointments, treatments, and ill health, not knowing who to turn to, making decisions under enormous pressure with little support.
What gets me, every time, is that this is all so preventable. Not the dying. The dying is happening regardless. But the isolation. The panic of it. The things left unsaid.
Herd immunity for death
Getting conversations going about death and dying helps loosen up the resistance to it. I think of it as a kind of herd immunity. If enough people start opening up about it, we reach a kind of event horizon where death and dying and grief and loss become normal conversations. I do like to mix my metaphors, but sometimes it really helps! The kind that can happen around the kitchen table, at the pub, at the school gate. Before anyone is sick. While there's still time to say what we actually mean.
Bill Walsh was a guitarist, armchair philosopher, and my soulmate. He had melanoma twice, and he spent years thinking and writing and talking about death long before it became urgently personal. His line was this: death enchantment brings life enhancement. The more honestly you sit with your own mortality, the richer and more present your living becomes.
What happens when we look
We are not promised anything more than the present moment. Awareness of our impermanence, when we let it in rather than slam the door on it, doesn't shrink life, it can often do the opposite. It changes our priorities and what we say to the people who matter. What we stop putting off until some imaginary later that may or may not arrive.
Death literacy is not about becoming morbid. It's not about spending your weekends contemplating headstones, though if the kale one speaks to you, then go for it.
It's about having the conversation. The one most of us have been avoiding. The one that might, as it turns out, change everything. Not just how we die, but how we live.
This is the first in a series of articles drawn from my memoir The Bird and Bee (Balboa Press, 2026). In the next piece, I'll introduce you to Bill and let him speak for himself.
If this landed for you, the book goes much deeper. You can order The Bird and Bee here.
Read more from Rose Sexton
Rose Sexton, End-of-Life Doula, Registered Nurse & Author
Rose Sexton is a palliative care nurse, end-of-life doula, and author based in Victoria, Australia. Throughout a nursing career spanning more than forty years, she has been drawn to those facing life's biggest transitions. The Bird and Bee (Balboa Press, October 2026) is her debut memoir, a dual-voice account of walking with her soulmate Bill, guitarist and philosopher, through his final journey.
