In the movie, The Farewell, we’re introduced to Billi—a young Chinese-American woman who is conflicted when her family refuses to tell her terminally grandmother, Nai Nai, that she is dying of lung cancer. Wanting to honor her grandmother, Billi is inclined to reveal the truth to Nai Nai but is challenged by her family who says that within Eastern culture one’s life belongs to a whole; that it is the duty of the family to protect the ailing person even if it means withholding the truth. This fascinating movie enlightens viewers as it reminds us that how we deal, discuss and engage with death/dying is deeply influenced by our culture. We are called by this movie to consider how one’s culture greatly informs the way they approach issues of end-of-life care.
Below are stories from two of The Conversation Project’s team members. In their personal narratives, they share a few thoughts about how their ethnicity and culture has played a role in how they think of, engage with and discuss end-of-life.
Naomi’s Experience as a Haitian-American Woman
Mama Bo was ninety-six years old when she passed. Full of wit and cognition before she died, she told her daughters that she did not want any extensive measures taken if her health were to severely decline. When it did, her children honored her wishes by letting the rising and lowering of her chest slowly stop on its own.
My great-aunt’s death underscored a lot of things I already knew about my Haitian family: when it came to death, we did not really have a common agreement about how to grapple with it. There were members of our family who were irate that Mama Bo’s children didn’t do “everything they could” to extend her life (i.e. taking extra medical measures to elongate her days) and there were others who believed it was the right time to let go.
What I’ve repetitively seen in my family and within my community is overly aggressive treatment given to people who are clearly living on the brink of death. While my American purview is inclined to reprimand those who view this approach as reasonable, my Haitian roots humbly remind me of an island of people who do not have easy access to quality care or healthcare at all. So, those of us who are living in the States, when given the opportunity, tap into the what seems like an endless stream of healthcare interventions.
Similar to Billi in Farewell, I am sometimes conflicted by the way my community handles the issue of death. But I also recognize that my perspective is not to be exalted as it has been refined by my hyphened identity: Haitian-American (emphasize American). Beyond my personal experiences, there are that of other’s that greatly influence how they view death and dying.
Antonella’s Experience Within Her Filipino Community
When I think about Filipino culture, it is fundamentally about storytelling. Filipinos often live in a culture of shared experiences, which makes it easier to connect in community with fellow Filipinos around the world. I first learned to treasure storytelling from my parents, who often share stories about growing up in the Philippines. These stories were my connection with a place beyond what I knew and helped me understand what I valued in life.
My dad loves to tell stories in both Tagalog and English. The stories he tells me are rich in historical context and measured emotion that come from his unique experiences as a Filipino immigrant living in America. Although I can only understand his stories in English, I can tell how warm the Philippines has been in his heart and why it was important for me and my sister to grow up as culturally-aware Filipino-Americans.
So, when I wanted to talk to my dad about death and dying, I didn’t ask him directly about it because I know it wouldn’t be a simple answer. I know that many Filipinos traditionally believe in family harmony and a life as more than one’s own. In this case, I asked him what he thought of the movie The Farewell. My dad suggested that the central lie was a sensible choice: “They’re easing the burden for her. In the East, we value family harmony, and it’s assumed that the family should keep this in mind.”
He then tells me the story about his dad, my Lolo, who passed away when I was young. “I wasn’t able to physically be there for him,” he said. “But I could feel he was there when you woke up in the middle of the night and cried for a moment.” Filipinos are superstitious, and my dad believed that this moment was when my Lolo came to say goodbye.
This was the first of many conversations we had about something as complex as the end-of-life. I have come to understand the complexities of the Filipino experience as a result of diaspora, multigenerational differences, and multicultural influence. This makes considering what my family would want at the end-of-life seem complex, but it gives me a sense of how I have chosen to live: as a part of the Filipino community.
In my Filipino-American culture, the stories we share with each other help us understand the nuanced experiences among us. The impact of culture on one’s life looks different for everyone, but it is becoming more apparent that it is important for patients, providers, families, and communities to acknowledge the importance of cultural context.
We want to hear your story. Email us: how has your culture and/or ethnicity influence the way you approach the topic of death and dying? Send us your story and it will possibly be featured in our upcoming Culture Series.