Susana Moreira Marques - A tender, lyrical and intimate meditation on death and bereavement, examining dispossession, the fury of grief and the end we all will face

Now and at the hour of our death

Susana Moreira Marques, Now and at the Hour of Our Death, Trans. by Julia Sanches, And Other Stories, 2015.

A nurse sleeps at the bedside of his dying patients; a wife deceives her husband by never telling him he has cancer; a bedridden man has to be hidden from his demented and amorous eighty-year-old wife. In her poignant and genre-busting debut, Susana Moreira Marques confronts us with our own mortality and inspires us to think about what is important. Accompanying a palliative care team, Moreira Marques travelled to Trás-os-Montes, a forgotten corner of northern Portugal, a rural area abandoned by the young. Crossing great distances where eagles circle over the roads, she visits villages where rural ways of life are disappearing. She listens to families facing death and gives us their stories in their words as well as through her own meditations. Brilliantly blending the immediacy of oral history with the sensibility of philosophical reportage, Moreira Marques’ book speaks about death in a fresh way.

"Raymond Carver once wrote about loving everything that increases me. This book increased me. It is fearless and luminous and full of grace; it travels to the edge of death and finds life there. Its attention to the particulars of love—between the ones who will go and the ones they will leave—is something close to sublime." - Leslie Jamison

"The writing of Susana Moreira Marques has the quiet intensity and the transformative power of poetry. She describes, in tender detail, the dying of people and the slow dying of a remote rural community, the one superimposed on the other. She does not judge or assume but listens and imagines and tries to understand not only those who are dying but also those around them and who try to care for them. She observes that it is perhaps harder to watch the dying of someone we love than it is to die ourselves … Good doctors pay real attention to the detail of dying and this book will help them to see and hear more. Marques pays tribute to the palliative care doctor who “will hold your hand as she chases away . . . fear.” Yet she also delivers a fierce warning to the more foolish and damaging aspirations of contemporary medicine." - Iona Heath

". Now and at the Hour of our Death is written with great compassion, and with the economy and precision usually reserved for poetry." - Gavin Francis

"Moreira Marques has the ability to evoke an entire lifespan in a few words or sentences, summoning an individual through a brief experience, event or gesture… Her great achievement is to situate dying so squarely within life itself. She liberates death and dying back into the messy business of living." Anne Karpf

"A brilliant book which pushes the boundaries, not only of literary reportage but of literary genres in general, to discuss that most intimate of moments: death. (…) Death isn’t good or bad, death is; and Susana Moreira Marques writes about it in her first book in a way that can only be done by great writers." - Isabel Lucas

"An extremely rare event: a book capable of creating its own form, inventing on the way a new literary genre." - José Mário Silva

"One of the best books ever written about the meaning of life’s end." - Ana Dias Ferreira

"Susana Moreira Marques has written a book you cannot categorise." - José Riço Direitinho

Now and at the Hour of our Death is part poetic travelogue, part oral history project, and part philosophical rumination on dying. Susana Moreira Marques travels with a palliative care team to a remote village in northern Portugal and speaks to both the dying and their families, capturing the stories of their lives and their attitudes towards their approaching death.
The first section of the book is made up of a series of short, impressionistic paragraphs which create a collage of nameless terminally ill people, the author’s thoughts about her own life during this newfound proximity to death, and scraps of her poetic musings. It serves to convey the mercurial nature of the author’s subject, circling around a part of human experience which, by definition, cannot be described.
What follows are three portraits: one of a terminally ill mother, another of an old couple, and the third of two sisters whose father has just passed away. The author shares her impressions of these people then they are given their own space to talk. Long conversations are transcribed replete with pauses in which articulation of certain feelings becomes impossible, situated as they are beyond words. The clichés with which we try to comfort ourselves when faced with death have to suffice.
The final section offers a short list of thoughts that the author has taken away from her experience and these are perspectives that the reader will likely want to share: “Live uninterruptedly, like nature”, “Share the corniest things you can remember with those closest to you”. Of course an acquaintance with death has to result in a greater appreciation of life, and Now and at the Hour of our Death is a welcome unsentimental but tender reminder. - Adam Ley-Lange

We might say that to be frank is to accept the negative consequences of truth. But there can be a guileless beauty in frankness which has little to do with terms as obtuse as positive or negative. Over the course of several months in 2011 Susana Moreira Marques visited gravely ill inhabitants of the rural Portuguese north as a journalist. This series of visits resulted in her first book, Now and at the hour of our death, translated from Portuguese by Julia Sanches and published by And Other Stories. In this text it is the journalist’s crime of living that enters her into quiet confrontation with her dying subjects: “I knock on the door of a man who knows he will die, hoping he’ll tell me how it feels to be a man who knows he will die.” The simplicity and intimacy of this request stretches so tautly that even the sparsest sentences hum. To ask a stranger how it feels to know that he is dying demands a frankness that is fearless.
Now and at the hour of our death has been coloured by surprise at the novelty of Moreira Marques’ approach. How can a book have borne a new form of writing about death, which is surely (along with every writer’s other favourite topic: love) one of the most enduring preoccupations of literature? One explanation is that the author, in this case, does not seek to conceptualise death, nor freight it with great forces of narrative symmetry which so frequently pummel and subdue the Reaper into a carnivalesque literary character or device. As Moreira Marques observes early on in the book: “there is little that is literary about death.” Instead, it is the quiet, physical banality of dying that she chooses to document; literature is in the service of death, rather than the other way around. If we cast our minds to life’s end at all then we would rather it were dramatic and meaningful and darkly metaphorical, to thrill through the voyeuristic veneer of broadsheet catastrophes and to punctuate the careful plotting of fiction – giving us a framework to live against and wrap our imaginations around. After all, it is far more difficult to wage war against a stateless, shapeless – and ultimately faceless – enemy.
On the discovery of his oesophageal cancer, Christopher Hitchens wrote memorably of his migration “from the country of the well across the stark frontier that marks off the land of malady”. In Now and at the hour of our death, such a place is given physical form in Trás-os-Montes (this translates literally, with strangely fitting connotations, as Behind-the-Mountains), a region in the verdant northeast of Portugal wreathed in rivers and speckled with shrinking villages. Geographically and culturally, Trás-os-Montes is the remotest area from the Portuguese capital, home to scores of aging communities and a slow-paced, seasonal way of life which is gradually disappearing. In noting this, Moreira Marques pins mortality firmly onto place, the monotony of the endless roads she takes to travel from Lisbon calling forth the metaphors: “ripe fruit falling from trees; paths cut off abruptly; and the journey itself, an age-old metaphor for life and for the end of life.” The stasis of these isolated villages comes to echo that of their terminally ill inhabitants, a rural culture almost slowing to a stop. Death and place have an uncanny way of bolstering one another as metaphor in the mind’s eye: the author associates death with the transmontano hills, the countless crosses lining the roadside, and the eagles circling overhead, leaving ghostly wingbeats between pages.
On arrival she sees the signs of death in people. There is the woman subjected to so many operations that she is left with scarring that gives her a strange, double-bellied silhouette. The shepherd who hopes to witness a vision of the Virgin with the fervency of a lottery ticket holder, believing that real miracles are reserved for the poor. The fifty-seven-year-old, scared of strangers, whose entire world is barely the breadth of a few streets. The abusive hunter who beats his wife all the way to the pearly gates – then leaves her dumbfounded when she is not taken first. “Make people into characters,” the author writes, in her intermittent jottings entitled ‘Survival Guide’, but “don’t stop crying over characters”.
The architecture of this slim volume is peculiar, and intriguing. The first thirty-odd pages include notes, sketches, fragments of poetry and aphorisms (translator Julia Sanches has aptly referred to them as ‘vignettes’) which herringbone together to produce a kind of intimate travelogue-mosaic. The central, lengthiest section is given over to ‘Portraits’, comprising Moreira Marques’ interviews with three sets of palliative care patients over the course of several visits. The author introduces each portrait, then gives her selected subjects their own platform in which to express themselves through long, italicised paragraphs of reported speech. These monologues/dialogues are poignant, raw and funny, all the more so for their unfussy pragmatism and the temporary change of narrative voice. One of these voices, Paula, describes the effect death has imposed upon her: “Life changes completely from one day to the next, and that’s when you realise that there’s no use fighting wars, there’s no use getting annoyed – life’s too short – and it changed my way of thinking, way of being…” Realisations which ought to read as trite seem to reveal another layer of meaning when vocalised in the context of these portraits, serving to ‘re-humanise’ sayings we have collectively bludgeoned into commonplaces.
There are gods in this narrative, too, but they are vacillating and unreliable. “Man is not God. Man is not God. Man is not God. Man is not […] We should be punished for thinking we can control everything, even death; for thinking that we can foresee it, and, who knows, maybe even avoid it.” Medicine has become the modern religion when it comes to dealing with dying; parallels recur between the palliative care team the writer accompanies to the area and the single-minded missionary activities of old. Bribes are silently promised to effigies of the Virgin outside operating theatres. Telephone calls asking for the deceased can feel, for the living, like an unearthly resurrection, jolting memories of a loved one into consciousness like a current of electricity through the muscles of a corpse. One of the triumphs of this book is that the author does not try to imbue death itself with unwarranted meaning, religious or otherwise, and yet observes so acutely the grief-stricken edges of the craters it creates in people’s lives. The hour of our death emphasises the communality of such an experience.
“We obsess over lasts as we do over firsts. Last days, last images, last words. We want signs.” George Lakoff and Mark Johnson gave us the seminal study of the extent to which language shapes our thoughts in Metaphors we live by; Susana Moreira Marques has, in turn, illuminated some of the metaphors we die by. Perhaps we continue to seek solace in the nebulous world of metaphor as a way in which to shape and to signpost our fears. Hitchens wrote his final notes on “living dyingly” just before his death in December 2011, a couple of months after Moreira Marques made her final visit to Trás-os-Montes. His resulting book, Mortality, was published in 2012, as was hers. Though exceptionally distinct, what these books share is a beautiful frankness about a subject which many would blanch at broaching, let alone record in such careful detail. To read Now and at the hour of our death is to better recognise the glitzy clichés and ragged euphemisms with which we dress up our mortality, and when to value or discard them. It is to embrace the fact that we are not gods. It is to define a good death. It is to “know you are a machine and not feel saddened but, rather, liberated by the thought”. It is to travel to the land of malady, and back again. - Laura Garmeson

“See me safe up,” Sir Thomas More is said to have told his executioner as he approached the scaffold on which he was to be beheaded. “And for my coming down, let me shift for myself.” By the sixteenth century, philosophers had long been obsessed with well-executed deaths. A few moments before drinking the hemlock that acquainted him with his, Socrates proffered an off-the-cuff, in extremis redefinition of his vocation: philosophy’s task, he said, is to prepare us “for death and dying,” and all our dalliances with truth come to naught unless they teach us how to die well. And how well Socrates died, marching up and down, discoursing about the immortality of the soul, laughing dry the tears of his well-meaning disciples and cracking jokes at the authorities’ expense. Classic Socrates, we might say. With this death and the words that preceded it, Socrates inaugurated a long-standing tradition where death is not simply another topic for philosophy, but its very life-force.
The following centuries saw many variations on this Socratic theme: both from a theoretical perspective, in the writings of philosophers, and (with varying degrees of success) from a practical perspective, in the deaths of those philosophers. To die “well,” then, with philosophy by one’s side, is to die wholly and unmistakably oneself, to “have a death of one’s own,” as Rilke’s Brigge put it two-and-half millennia later; it is to exercise autonomy to the last and to run headfirst, collar straight, laces tied to meet one’s maker.
These are truly lovely thoughts, but they lie.
When my nan, Kathleen, died of the cancer that she had plenty of time to become acquainted with, she did not, as far as I know, crack jokes. I don’t think that she was humourless. And when my aunt Deirdre died in her sleep, many, many years before anyone thought possible, we did not think that it was “classic Dee.” And when you die with dementia, as you probably will, in a bed that is not your own, your character stripped bare as the walls (read: curtains) that surround you, I would not dream of suggesting that you try harder to personalise proceedings.
Following Socrates’ lead, philosophy typically tries to understand death by bringing it under control—by making it an object of the will, a skill to be learned, maybe perfected. But death is shifty, always mirthlessly mocking our attempts to master it, always giving us the slip. Despite philosophy’s idealistic preoccupations it is matter, not mind, that has the last laugh. And when death comes—sooner or later it always does—today, advances in medical science mean that it usually comes slowly, beginning its work well in advance of completing it, leaving us radically disempowered and less, not more, like the selves that we were. (If you want to be disabused of the idea that there is some special skill involved in dying, visit a hospice.)
“We should be punished for thinking we can control everything, even death,” writes Portuguese journalist Susana Moreira Marques in her slim new volume Now and at the Hour of Our Death. Indeed, often we are. Socrates’ words do bear some truth; but in reality our death is never truly “ours,” is never something we “do.” How can we prepare ourselves “for death and dying” while avoiding this fantasy of control which may simply serve to increase the height from which we fall? Moreira Marques’s book—translated into sharp, spare English by Julia Sanches—provides more than a few clues. Systematically rejecting every rhetorical and psychological trick we typically use to make light of death or gain a foothold in it, Moreira Marques nonetheless avoids stumbling blindly into pessimism. By turning a journalist’s unblinking eye to the concrete realities of dying, she allows something fragile, utterly realistic and quietly affirming to come to the fore.
Now and at the Hour of Our Death is the result of the five months its author spent following a palliative care unit through a remote rural region of northeast Portugal called Trás-os-Montes (“behind the mountains”), a moribund but beautiful area “from which the children have disappeared.” During her stay, Moreira Marques spoke to the terminally ill and their families about life, death, and about what it’s like to exist in the twilight region behind the mountains which marks the border between the two—creating, from these meetings, a collage of portraits and transcripts, bookended with her own aphoristic sketches, reflections, and vignettes.
Strikingly, much of the book is given over to those who are themselves facing death. How do these ailing, dying people speak? In banalities, mostly. “Life changes completely from one day to the next . . . there’s no use getting annoyed—life’s too short,” says one; “Now I always think about how anything can happen, at any moment, so you’ve got to make the most of it,” another. In this context, though, you can hear the breath beneath these threadbare phrases, and this gives them a kind of misty beauty, a renewed urgency—like coins, worn away by repeated exchange, which once again bear human faces.
Moreira Marques is (sometimes painfully) honest about the shortcomings of the people whom she encounters. “The hunter who liked flowers also liked his wife to feel like his prey: frightened and cornered . . . The last time, using only his eyes, he had made his wife feel as if she should be the one to die first.” And, “He has stopped eating, which is perhaps another way of hurting her. Or, perhaps, in his dementia, he knows she has more than enough reason to poison him.” Death does not make saints of us—why would it?—and Moreira Marques feels no need to pretend it does, describing these characters full of tender contempt and writerly good grace. Neither does death provide the occasion for redemption, reconciliation, or revelation. “He died in bed having said no meaningful last words,” she writes of one man. For Moreira Marques, death is untimely and unseemly—always coming too soon or taking too long; always full of nasty surprises. “We obsess over lasts as we do over firsts. Last days, last images, last words. We want signs.” But often there is little that is meaningful in our last days, preoccupied as we are with the grim effort of dying: “Articulated beds, diapers, morphine, gaze, creams for cuts and abrasions, serum drips, tubes, needles.” “The sick suffer,” she writes, “and then have no strength left to think or to ask themselves . . . moral questions.”
Now and at the Hour of our Death bears no hint that anything spans the gap between life and death. Even love, far from surviving death, might not survive life. “She no longer asks about him,” she writes of a woman with dementia who, not so long ago, had refused to sleep apart from her husband, despite the advice of doctors, which resulted in him falling out of bed and seriously injuring himself. She has been “madly in love” with him for six-and-half decades, but now, “when asked . . . [she] answers she was never married. When he dies, she might not even realize and might not even cry.” Later, Moreira Marques describes another scene: a man playing guitar while his wife, many years his senior and with her memory ailing, taps along. He started playing the guitar again while she was in hospital, dying of leukemia. But against all the odds she survived; and now here she is, tapping. When he sings on the radio, he dedicates his songs to her. In a lesser work, the pathos of a story like this would be redeeming. For just a moment it would allow us to believe that some things last forever. But not here. Because now it is the husband, all those years younger, who faces death, and his wife who faces abandonment. And whatever happens, before too long one of them will die, and one of them will be alone; and then the solitary one will die too. This is inevitable; it just depends where we stop reading. Elsewhere a husband and wife both make the tragicomic confession that each selfishly hopes they’ll be granted the luxury of being the first to die—because life without the other would be unbearable.
Despite presenting these ugly realities denuded of beautifying lies, Moreira Marques’s book is not pessimistic; and she repudiates the repose of dwelling on these naked facts just as thoroughly as that of denying them. The ethic of this work seems to be the same as that which traverses Gillian Rose’s magisterial Love’s Work, written while she was in the throes of fatal ovarian cancer, “Keep your mind in hell, and despair not.” 
Like most books about death, Moreira Marques’s has much to teach us about life; and in the final chapter, which is only a few lines long, she braves to try to salvage a little wisdom from the wreckage. These cautious lines—which I will not quote, for they should be read last—are shot through with the sense that inevitably they will over- and understate what they wish to say; that words are both under- and over-equipped to deal with death, always saying too much, too little. Thus Moreira Marques’s conclusion has no pretensions of profundity, but is written instead in the mode of cliché confirmed and refined by experience.
Ultimately, for Moreira Marques, death marks the end with a full stop’s quiet insistence, and the book’s encounters take place in the space between the final letter and the full stop. But this interlude, she shows us, is anything but empty; in fact, like the area around a seabed hydrothermal vent, it is teeming with life lived furiously, and painfully, against the odds.
Instead of philosophy’s model of the solitary individual bravely facing his or her own death, Moreira Marques’s book gives us something much more precarious, realistic, and human: men and women—some professionals, others not—bravely facing the deaths of others and looking after them when they can no longer look after themselves. There “is little that is literary about death,” she writes. But if there is beauty in death, she shows us that it lives in the small, generous gestures performed by those who will one day perish for those who are already doing so. Now and at the Hour of our Death offers nothing as straightforward as despair or hope; instead, it describes those final moments and finds, amid the horror, a little beauty that isn’t separable from it. Moreira Marques shows us that to prepare oneself for “death and dying” does not mean to try to control what cannot be controlled, but to be ready for that inevitable moment when control will no longer be possible; that a “good” death isn’t one which is “one’s own,” but one that is shared with others. One could call this conclusion banal. It certainly seems modest compared to the pomp and grandeur of the heroic, philosophical death. But Susana Moreira Marques’s triumph is to show that it is precisely here, amid, rather than above “the pajamas, the diapers, the drool,” that fleeting glimmers of transcendence exist. By giving lie to the philosophy’s myth of mastery, while ushering us away from despair, she breathes new life into a topic that has long been marked by what had seemed like a terminal lifelessness. - Will Rees

Travel Notes About Death