Are legally guiding bindings. They come as a living will or a power of attorney for health care about what medical procedures you might want at the end of life. That is what an advanced directive is. It helps you manage death. Ok. 1900, you just i. There was you just die. There was almost nothing a doctor could do for you. Today, many people die after a decision is made to withhold or withdraw a lifesustaining treatment. One of those is cpr, you all know what that is. Tube feeding is what we will talk about monday. Chemo, transfusions, these are the kind of things that two thirds of americans say, i am done, i dont want that anymore, then they finally die. The picture looks like this. Will fall over dead or get hit by a ups truck. The other two thirds will have to make a decision. Its these its this last third that is in particular. They need advanced directive. The Competent Group can make those decisions themselves. They are awake, they are competent and able to participate. For this other group, they might have advanced dementia, or they may be sedated seriously and cannot dissipate. Cannot participate. That is why he get those advanced directives. Deciding what a person can get, given what their wishes are. These documents are legal in every single state, and have been since 1990. We are coming up on 30 years. It is not a new idea. 90 of americans take advanced inc. Advanced think advanced Care Planning is a good idea. But only 37 actually complete these documents. Many of them are not well completed. They are half done. They are wrong. A lot of mistakes are made. Actually talkople to members of their family. They say, why would i care whether you talk to members of your family . This legal document is legal only in a theoretical sense. Right . Taj, if you are married and you have something in your document and you dont tell your spouse can override what you want. Say you dont want cpr. When it comes time for them to when it comes time for that dnr and, you have a your spouse could say, im not ready to let him go, i want to keep going. Even though you have written a document, it was not with your spouse. You have to talk to your spouse and make sure she understands that this is what you really want. Raise your hand if you are an organ donor. Keep your hand up if you told your parents about this. Excellent. Great. Hands down. Do you know why this is important . Because if you do get hit by that ups truck, and you are essentially braindead and they go to your parents and they say your son, your daughter is an organ donor, they will ask them. Or,hey say, i cannot do it, i dont think its a good idea, they wont take the organs. Even though it is legally binding, and in pennsylvania the Organ Donation law says they can take your organs without asking, but they never do. They dont want to get sued by your parents. With it. Say the heck as a result, six people die every singled a in this country because they do not have a sufficient supply of organs. Often times there are plenty organs out there, but the loved ones say they cannot do it. Thats why this conversation is kind of important. Since nobody dubs this does this, or only a third of people do it and dont talk to their family about it, this is where taj comes in. They care patients law and what they get at the end of life. Sometimes its because they did not do a document. Sometimes they did it and did not tell anybody, than the family comes in and changes everything. There are a lot of problems with that. Is, why ismber one it that even though two thirds of americans will die a managed death, advanced directives are legal in every state, 90 think it is a good idea but most people dont do it . Whatost people dont get they want. This is 30 years and still people dont get what they want. Riddle number two, quality of death. This is something you saw last monday. Perannual Health Spending person, per year at the 12 most developed countries in the world. You dont see the United States that is numbere one. It is 10,224 one year ago, per person, per year. Its more than twice the mean of all the other countries. We know thatage, the United States spends a lot on health care. Here is something else. Those same 12 countries, here is your Life Expectancy. Its best in japan and goes down to the u. K. At 82. 81, then United States is 79. We spend twice the means and people are dying earlier here. Not only are they dying earlier oh, there is one other thing. What do the seven countries have in common . Slovenia,a, chile, lebanon, and cuba . Said that . Who said that . They all rank higher in Life Expectancy. We are lower than most countries. We are lower than cuba, nothing against cuba, but its a little out of sorts. 2010 2010 is the most recent year they have this massive, hundreds of thousands of records they have look through and found out what symptoms have at the end of life. Moderate to severe pain. Its the thing that most of us worry about. Hospice and, Palliative Care physicians can tell you they can manage all but 2 of pain. There is no reason to be in pain say they aree 52 in moderate to severe pain at the end of life. Its worse than it was in 1998, so we are going backwards. Same with oppression, 57 . That thingir hunger, where you caught your breath and you cannot get your breath and it is a scary thing. Anorexia, inability to take in food and keep it down. Nausea. The only thing we get better at is frequent vomiting, and that is not a big deal. Only 12 have it. End ofing on the quality care is the survey done by the economist intelligence. They have all of the standards, they go through and you can see the top to endoflife quality care countries in the world are australia and the u. K. That means they go in and ask people who suffer from the symptoms, did you get what you want . Are you satisfied with your care . U. K. Is number one. Australia is number two. We are way off to the right. All those countries that spend less than us are ahead of us, except for france and canada. Why is it that even though the u. S. Spends more on health care and we have a really low Life Expectancy compared to other countries, and endoflife care is getting worse. Riddle number three, endoflife care training. This is a short one. Here is the top 10 medical schools in the world. We are proud to say that the the 10. Tates has 8 of u. K. And canada have a couple of them. Australia and u. K. Are number one and number two, then we are all the way down f14. 14. Own at we have good schools but they are not teaching much about and of life care. Why is it that eight of the top 10 schools are here, but if we are so good, why do we do such a bad job at this . This is your data. The data you went and collected, asking students. We had 313 responses at 9 00 this morning. The curb looks like the United States. I thought it would be shifted to the right, but you guys were peg on what the United States. Most people are in support, about a quarter of you in the middle, and very few of you on the other side. Only 14 feel badly about this idea. This is what it looks like in the United States. About two thirds. Between two thirds and three quarters over the course of the last 20 years say that physician aid in dying is ok. But, that red bar is the number of people who live in a state where they can take advantage of physicianassisted death. Its only 18 , even though a vast majority of americans have, over the course of time, supported these ideas. California, colorado, hawaii, d. C. And vermont. Montana by court ruling. They are in that cluster of states. Here is your last riddle, why is it that even though support for assisted suicide remain strong, you only got seven out of 50 states, 18 of the population covered . Our for riddles. Advanced directives, bad. Quality of death, bad. And of life care training, thats bad. Then finally, physician aid in dying is bad. History can help us answer these questions. You will help me answer these questions too when we get to that point. When we try to figure out why it is we are here, sometimes if we look back into history we can figure things out. Number one, scientism. This is one you will help us out with in a couple of slides. A culture that puts unwarranted case, medicalthis technology. There are other examples. Asks istion scientism why pass laws about death when medicine is so full of miracles . Miracle and scientism, that language of religion seeps in here on purpose. Because faith, miracle, religion and scientism all kind of go together. 1700. We are going back into history. Very little doctors could do and they had almost no formal training. There were no medical schools in the 1700s. You read a couple of books. It was not until well into the 1800s that you could get an official law degree. Most people were selftaught. One of the biggest things they did back then was bleeding. They thought that blood was causing your problems. They would open your vein up and start draining blood out, hoping it would cure you. Here is a quote by a physician that you know this physicians name. You know his name and you walk by him every day. Who would that be . You walk by this physician everyday. Who . No. He is standing out here, you walk by him today. Dr. Benjamin rush. Out by his quote, plead pales in full force. To bleed people. Dont know why, but that was his being. He is the father of bleeding. His practices carried on into and lead to no end of problems. Here is one guy that had a problem in 1799. George washington gets on his horse and it is cold and raining and he is writing through this riding through this terrible storm and he has a bad throw. Anthropologists have looked back at the records and symptoms and they decided that he probably had a case of strep throat. Doctorminal, but his decided to bleed him. The average person has one and a quarter gallons of blood in the body. Tor took five pints. Over he bled over half his blood supply. This is not good. This is one reason people had no faith in doctors because they were likely to kill you. Now in the 1800s of medicine shows. These are like circus events were people Start Talking about crazy things that they can do. One of them they used to use was pultering hostesses stouses. Of thingts some kind that you lay on the belly and your skin swells up. It was supposed to help. It never helped anybody but they sold a lot of them. We choose. Leeches. Sometimes they open your main to bleed you veins to bleed you and sometimes they used leeches. The text here says swedish leeches. We are constantly receiving fresh healthy swedish and hungarian leeches. Which we can sell at the lowest marketplace market price. This is very, very common. Snake oil. Who has ever heard of that . That phrase, that term. Everybody, right . You never heard of snake oil . Really . Snake oil,. You never heard this term, Snake Oil Salesman . No. With hoefler i grew up this term. I see a lot of people around the room shaking their heads. Snake oil was something you would say. It was a phrase to describe something that did not work. They actually sold it back then as an elixir to help people. Snake dung. I dont know what it looks like, but they would go follow snakes and get their stuff. Crowe vomit was a big one. Toyou could get a crow vomit and feed it to someone, this was supposed to help them. The little bottles out of somebody stroke store. Its arsenic pills. We know its not a good thing to take right now, but it was common back then. Induced vomiting. They would stick the end of a knife, not the sharp end, the back end into your throat and induce vomiting by setting off that choking reflex. This is what i like, narcotics. Narcotics. This is for kids. It says, soothing syrup for children during nursing periods. In terry, canker sore mouth and banishes pain dysentery, canker sore mouth and banishes pain. There is cocaine in this. Im sure it handles pain, but it may not be a good thing for teething children. Enemas. One of my favorites. This is an actual drawing from a textbook of how to build an enema. An enema inducing scene. What was put up there . Tobacco smoke. Urine. Thats good. Coffee enemas, on common. Then, olive oil. Why these things . I dont know. There are medical textbooks from the 1800s. The most common was tobacco smoke and coffee second. I have not read that much about urine and olive oil. Comes outhis, this the british journal september 4, 1868. Port wine as a substitute of transfusion of blood and coast in case of postpartum hemorrhage. Port wine. You know where the saying comes from, bottoms up. I cannot help myself. This is how bad medicine was. Medicine was so bad that a often times misdiagnosed death. From time to time they would exhume a body, they would recover a ring, what you would see is claw marks on the top of the coffin. Word of this spread through the country to the point where this guy came up with a patent for a coffin that, once it got buried, it had a string leading up to a bell. If you werent really dead and you were in the coffin and woke up, you could ring the bell and hope somebody would hear it. Thats nuts. The guy got a patent for that because there was a problem. Ok, here is a question. What do all these people have in common . Think about that for a second. What do they all have in common . Obviously that is not da vinci. That is a picture. He painted that picture. Heres what they have in common. Life expectancy for all of those people was about 35 years. Back to recorded time, well into the bcs, people lived about 35 years. 35. 34, that was the limit. It did not mean you hit 35 and fell over, but that was the average age people died. Here we go. 4 hundred, six hundred, 800, right up to 1800s, then you see a dip off. That is just before 1900. It went from 35 to 36. Big deal. See what happens in 1900 to 2000. It goes hundred years straight up. 75. 75. In 100 years, when no advances had been made for thousands of years previous. , who you recognize, he is 72. Does that mean he will die at 75 . What do you think his average Life Expectancy is . He made it to 72. Any ideas . Thats it. Donald will live to 85. Mean he will get to 85 and fall over, he could fall over tomorrow or live to 90. Someone who is 72 lives to 85. This is incredible stuff. Since 1900, Life Expectancy increased 2. 5 days for every week. By every four months you at another year. If you could get a year for year than you would never die. That would be good. I dont think we will get there, but the point is, that is a pretty dramatic change. Something else that was happening in this time period. Now we will start in 1900. Both my grandmothers, and all of their siblings, and everybody they ever knew were all born at home. All born atme home. They were born at the end of the 1800s. In 1900 only 5 of babies were born in a hospital. 7 87 . Now they are going to start delivering by csection. Then in the next 40 years, csection kicks off. Right now we are in the 99 range. That islf of that 1 not born in the hospital, they get born in a cab on the way. Whoe is a half a percent chooses to have their children at home with a midwife, or whatever. But medicine has medicalized birth to the point where it is uncommon not to be in the hospital. Are bornf three babies with a very significant medical procedure called cesarean section. How did we get here . Who knows who that is . Any guesses . Famous nurse. Who is the most famous nurse in the world . Second most famous nurse . Come on. Famous nurse. Florence, florence nightingale. Florence nightingale, she was the one who tipped this curve up like this. Antiseptic conditions. That means wash her hands. Doctors did not wash their hands in the 1860s to 1870s. They would go from patient to patient and never wash their hands. The signs are everywhere. Clean hands see lives. Thank you florence mango. Florence nightingale. Becauseed so many lives people stopped transmitting Infectious Diseases from one person to another. A really big deal. The second thing that happens, right around 1900 you gets xray, eeg, vaccine, transfusions and the birth of the modern hospital. Before 1900 there was not a modern hospital. Hospital existed, but it was not for poor people. If you were sick, you were at home. If you did not have family you would go to a hospital. It was more of a poor house. Why . Because the doctors were not washing their hands. 30 of some people in some hospitals would not die for a year. 16 of the staff would die per year because they all get each other sick. It is not really a good place to be. The reason why the hospital comes along is the xray machine. Xray machine is a big machine, very expensive, and doctors cannot afford it. One doctor could not afford an xray machine, but they said we will get together. Who will have it . I want to at my place, no we will have it at my place. We will put it in a commonplace. Thats the first hospital. Telephones come along, now you can call. Doctors stopped traveling out to patients and start centralizing. It changes the face of medicine. This is another big one. Antibiotics. Now we are in the 1920s. The leading cause of death in the 1900s, infectious disease. Many of us would have died already. I would have died half a dozen times because i got some infectious disease. I got pneumonia, i got tetanus, no i did not have tetanus. But some kind of really bad infection, if you did not treat it, you would get a fever and die. Penicillin and all these things come along around 1920s, 1930s, huge. Now we are up to the 1960s. Cpr,plants, pacemakers, cpr is a big technology. You go and pump somebodys chest. The whole concept that you could start somebodys heart with compressions like that was a new idea in the 1960s. M. R. I. , to feeding. Tube feeding. Physical idea of getting a tube into the stomach, you had to have small plastic tubes. Plastic technology did not come until the 1960s. Then csection. They start csection in the 1930s, but they take off in the 1960s. We are up with ctg therapy. Now have 3d visualization for doing surgeries, and so forth. History explanation number one, for, trainwhy plan for, or pass laws about death when medicines miracles. What other areas of the world is their technology that kind of blinds us and we blindly may be believe that everything is going to be ok . Yes, sir . They came in for a lecture about global warming. Global warming affects the environment as we know today. As technology increases, so does the pollution in the air. Humans put their blind faith in technology when we see it fail. [indiscernible] prof. Hoefler the poor case with the young people suing the government, not being more cognizant are models that would help the environment. They wouldrnible] drive electric cars. We have cars that take gas and set of electric cars because we dont have that option. Not every gas station has a charging station. Prof. Hoefler any other ones . Social media. I talked about social media and the internet and people putting their blind faith in believing what they read in the internet. Altered the view and shape the way people think about certain ideas or topics. People dont always get the full story and well just believe. Hatever they see not everything you find on the internet is true or accurate, same thing with the media. Prof. Hoefler that is a good one. You had one. People arernible] told that it could be dangerous. People dont realize that social media [indiscernible]. About smart phones. Almost everyone has a smart phone. No one knows how they could be affected by it, or they affected could have in the long run. Younger and younger generations are exposed to it earlier. Can do andthings it we dont question it. Prof. Hoefler what do you call those little scooters . Those little electric scooters. Bird, yeah. I was out in santa monica. I got on one of those things and i just trusted. Oldw old people im not i saw old people get on these things and im like, it must be fine. I swiped at my card and got on, two weeks later i find out first of all, i have terrible people were signing up to maintain these things by watching youtube videos. They are really unreliable. There have been a number of deaths. Emergency rooms all around the country are banding together to petition municipalities to limit these things, or to eliminate them because they are inherently dangerous. When i saw this thing i said, cool. Works good, got on it, easy, it must be ok and its not. Yeah, its just kind of interesting that its part of our culture. The culture is a function of our history. It is the change from, could not do anything and probably urge , all my god, it is going oh my god, it is going straight up. This gets back to the idea that we believe tv. Were you talking about believing . Whos conspiracy theorists talking about social media . Who did that one . Cpr attempt, believing what you see on tv. I have a picture here of a hospital, but this is people who go down on the street. 75 survive when its really only 40. About half. Don you have people who arrest in the hospital, two thirds of them survive on tv, and we believe that, even though only 15 survive to leave the hospital. Its not so good. Heres the real scientism. People, 65 and older, 25 think they have a 90 chance of survival. 81 think they have a 50 chance of survival. But, if you are old and you have cancer and you are in the icu, your chances of survival are about 1 . If you are old, in the icu, with cancer, on a ventilator to help you breathe, and on medication to help thin out your blood, its essentially zero. Inhave all this faith technology, but this is the thing, it is not wellplaced. I will show you a picture. Who likes baseball . Ok. Are you good with recognizing faces . Ok. We will see in a second. Cryonics is where you freeze the future hopes of, at some point, they were figure out what killed you, they will bring you back. You can get it for 28,000 or 35,000. They have different plans. This guy. Ted williams. Ted williams is frozen. He is in 2 pieces. They took his hat off and thats in one place, desk his head off and up to one place, and his body somewhere else. Ideaought it was a good and thought his will family should do it. They were not into it. Family alls right, ok. This is kind of where we are at. Its almost like doctors can fix your age. Came back good, ic 57 and id like to get that down a little bit. Scientism is a culture that puts unwarranted faith in medical Tech Knowledge he technology. Its this dramatic change starting in 1900 when nobody trusted a doctor, to the point now where you have believed it has become a faith. We have other examples. Real, of death is not need not be dealt with. Back into history. 1800s, the United States is an agricultural society. Charleston was one of the biggest cities back then. York, philadelphia, baltimore, only a couple thousand people. Most people lived out in the country. What did that mean . They lived on farms. When you live on farms you live around animals. When you live around animals you see them born and you see them die. King, but seem lion this is like the cycle of life. Its right there in front of you. You see it all day long. You have animals living, youve got animals dying, and we have family members dying. This is a picture of the waltons. Does anybody know this Television Show . Probably not. It was a show that ran for 20 or 15 years when i was growing up, but this is the multi generational family all living under one roof. The important thing here is that it was very common back in back then. Whose dream is it to live with your parents after graduation . Whos dreaming of that dream . No, that is not a good dream. Thats a badgering. We call that bad dream. We call that a nightmare. Who has grandparents living with them right now . One, two. Back then the answer would be where else would they live . Grandparents dont live by themselves. The point of multi generational families is, when grandma and grandpa died, they die at home die, they die at home. You are connected to death in that way. This is what dying was like back in the 1800s. Like i said, hospitals not come around until 1900s. The only people that went to hospitals were people without a family. Everybody else died at home. Probably 95 of americans died at home up until after the civil war. Who has heard that term deathwatch. Nobody has heard this word . Ok. Deathwatch is sitting by somebody who is dying. Being present. Being there with them. You dont want them to die alone. Deathwatch was something that families did. Everybody in the family participated. Right down to the littlest of jokes. Going back to the waltons picture, all those kids would be participating in the deathwatch. So when grandma got old and frail and cotton ammonia, the thelest pneumonia, littlest of children would sit next to grandma and take shifts. People knew what death would like. This is a little harder to understand, but after the person past you would sit there with them for 24 to 48 hours. Why . Why would you sit with that person after they have died for 24 to 48 hours . Give me some ideas. Any ideas . Body . T next to a dead they might not actually be dead. Prof. Hoefler bingo, thats number one. Remember the worry about people getting buried alive. Few people have stethoscopes back then, and there were the stories of people being buried alive. You just wanted to make sure this person was really dead. Give me another one. About ifyou worried you have a dead body up in the bedroom . On a farm . Animals. You have varmints. You have to sit there to shoo away the mice and the bigger mice, that we call rats. There was also the superstition. Who wants to be wandering around in your house with a dead person of their. Deathwatch before, deathwatch after. The kids take part in that. They would sit right there. Everybody had to pitch in and do their part. Everyone was involved. The wake would take place at home. Why wouldnt you call a funeral director . They did not have them back then . Prof. Hoefler they did not have Funeral Directors, he did not have phones. So they would have to yell i guess. What was the name of the room you would hold your wake . Any ideas . Colder. Cold room. Which cold room . [indiscernible] prof. Hoefler i never heard of that. Any other ideas . Where do you go now . The funeral home or the funeral parlor . Prof. Hoefler parlor. They met with these parlors. They would wake the body in the house. The parlor. Thats why when Funeral Directors started industrializing their process, they called it a funeral parlor. They took the word from the name of the house and use that to indicate what would happen there. The body would be prepared by the family. What does that mean . That means they would wash the body, they would dress grandma, they would get her all fixed up and then take her down to the wake. Now you have people who are death. Ely in touch with they see it in the cycle of life. They are sitting next to people who died. They know what it looks like, they know what it smells like, they know what it feels like. It is a tactile thing. Its really a part of their life. Then they would build the casket. You can order a casket on amazon mel amazon now. That then there was no casket makers. It was not until after the civil war that people started commercially selling caskets. You build the caskets, you build the grave, then the grave site would be in the backyard. There were no cemeteries. The thing is, you would look out your window and see the graves of people who had passed. The point is, you were really in touch with death. Lets go up to the great depression. This guy in the middle, his name is john boyd. But if that character gets to 32 years old, what are his losses going to be . You will lose both of his grandparents, and he is probably going to lose both his parents. And hes probably going to lose three of his five siblings. 32, he has lost seven people really close to him. You would be very unfortunate if that happened to be you. When i got to 32 my number was one. My grandfather. For aery, very common 32yearold to never have lost somebody in their immediate family. I am trying to describe a system, or a social, cultural history of the 1900s were this was very rare. Death trajectory. Blessing on this point, eight days. That means you get sick on sunday, youre dead on monday of the next week. It was often times pneumonia. The leading cause of death in 1900 was infectious disease. Othernia, stomach flu, kinds of bacterial infection. Thats what killed people, and they killed them pretty quickly. There is no managing death. It happens, you cannot call a doctor because they will try to bleed you out. Death is rare today. Death trajectory is now measured in years. Most people die three and a half years after they were diagnosed with the thing that killed them. Ok. Plenty of people live 20 years. Path. Ust a flight not tos a lot of reason worry. A 32yearold man not have lost a loved one. In hospitals die or nursing homes. You dont see it. You do not see a death anymore, it happens someplace else. You get a call in the morning that grandma died last night. Deathwatch at home. The family does not build the casket. The wake is done in the funeral home. In the funeral parlor. Here is another quick question. What do we call the parlor room now . When you build a house you dont put a parlor in it. Any ideas . The living room. Kind of interesting. Parter, death parlor, now we have the living room. That you would set a room aside, mostly just to care for dead people. That is pretty profound. Then when that moves out, you create a living room. Society,rban suburban less than 2 live on farms anymore. We dont see the cycle of life. Right . We hide it. I had a student a couple of years ago, we were talking about this and she got a little weepy. I said, whats the matter . She said, i had a dog, bosco, had this dog for years, went to college, came home at christmas and i wanted to see my family, but i wanted to see bosco so bad. The dog stood there and looked at her. It was not bosco. Bosco had died and the family tried to buy a new dog that looked like bosco because they did not want her to be upset. She was so upset. The point is, they were worried died, so to 27 other animals. Its just a lot different now. We are all trying to shield each other from death. Multigenerational families are rare. Manyve two here, but how are grandparents . How many grandparents . Just one. Whole threea generations there. But today mom and dad live and die someplace else. Where will they die . It is true, a lot of people get older and move to florida. Infant mortality rate, one lasting care, 30 and in 1760. One out of three babies would die. It just drops, and drops, and drops, and drops up until today when it is like for 10th of 1 . 1800s, it wasthe not uncommon to have five or six children any chance of losing one of them. Today you have two children or less, 1. 6 i think is the average, and you have a one and 250 chance of losing that child. It is an awfully rare occasion. 1900s, hospitals have special elevators. Hearse pull upa to a hospital. They dont pull up to the front. Any new hospital will have a special entrance in the back. They have a special elevator. They have special gurneys. People in the hospital dont want to see you wheeling a dead person out. They have false bottom gurneys and they throw a sheet over, then they take it out the back elevator down, then they wheel it in and the thing is gone. Then how different that is sitting next to your grandmother or grandfather while they are in their last days. They have special elevators, Funeral Directors. This is a good word. Body. Repare the nick, you talked about this, didnt you . You know what im talking about . Wash them, the dress them, and they do their makeup, they do their hair, they will do my hair. It woman, they will have a hairdresser come in and they will do it. They will apply makeup. You get laid out like you are sleeping. They put a pillow there, like, what is that . Its all about staging sleep. Have to make this look like a big sleep. This is not. This is not death. How you walk in and everything is laid out. There is music out, there is music playing, then you have to dig the grave. No. The grave has been dug. What did they do with the dirt . Have you ever seen that green carpet they put over the dirt . Why . They dont want you to see the dirt because the dirt might be too upsetting for us. Nobody wants to see the backhoe. They take tobacco behind someplace the backhoe out behind someplace else. Carsal directors says, here, people part here, lining everybody up, you go in this car, you go in that car, this is all taking carried of taking care of. You know the most common question Funeral Directors get . The most common question is, what do i say . You walk up to the funeral director before you meet the family. Think about this, funeral direction directors run like a movie. Makeup, give people their lines, got the soundtrack, choreography, the whole thing. Thats why i put the funeral director on the chair. The point is, everything is taking care of. We dont have to even mess with this. In california they have a wake. Some of the funeral parlors have wakes were you can drive up. They have cameras inside. Its almost like you are going to a driveup atm, you look in the camera and you say what you want and go. A lot of them you can participate by webcam. We are a long wave from death and where we were. That is why woody allen says, im not afraid of death, i just dont want to be there when it happens to me. I showed you this comment that end street this the other day, dead end street. This is the quiz i was waiting for. What do you send someone when they are having a wedding . Congratulations on your wedding. Birthday card . Happy birthday card. How about graduate . This will happen to you eventually. Yes, congratulations, happy graduation. And then when you die . Death card. Deepesthave here, sympathy. Our thoughts are with you. Sorry to hear your news. Praying for you and your loss. This next one i really like, i dont understand but, welcome home. You will have to help me with that. Have death care a word for death cards. They are called sympathy c ards. Because death is very scary. We have a euphemism for it. Here is one thing i want to share with you. It was a dutch film in 1988. In the best film of the year dutch lynn, netherlands. Here is the plot and 20 seconds. The top,haracters on boyfriend and girlfriend, the guy down below is as bad as can be. He kidnaps a girl. That guy spends the home will be trying to find them. He is sending all kinds of taunting messages. She is here, shes there, do you want to see her . Finally it ends up in the cemetery. There is the cemetery. The good guy in the middle goes to the bad guy and says, where is she, where is she. He goes, she is buried alive. The shovel is over there, did her up. E starts digging the guy is just any manner watching him digging. He finally gets his girlfriend and she is alive gasping for breath. The bad guy gets a shovel and waxed the guy on the head. He falls in with his girlfriend, he shovels the dirt on him and thats the end of the movie. It got best movie. They brought it to the United States, they will die, im sorry. Youre not going to watch that anyways because its in dutch. They bring it to the United States, they translated. You know these guys appear, he has a big beard, whos on top . Jeff bridges. I dont know the woman, but Kiefer Sutherland is the bag i. They won the movie the same way as spoorloos does and what do americans do . We dont want to see that movie because the good guys die. So, in the vanishing, sorry, heres your spoiler. At the very end Kiefer Sutherland gets up, jeff ridges bangs kiefer on the head, the girl gets out and they covered kiefer up. We cant deal with it. The really interesting thing i was thinking about was, look at the poster on the left. The poster on the left is of a bang,ittle girl, then, they killer. A the right is the evil guy, kind gets you going, but the evil guy will not win, not in the United States. The evil guy dies in the United States. Good people win. We are a little different in this way, the denial of death. I pulled some of the data, or some of the pictures you got. Fountain of youth in the United States, the everchanging as this of antiaging. Botox, age defying jack black, never heard of him, new twist on antiaging, i dont know what that is, some kind of cream. Fight sagging. I dont know its sagging but you can find it with loreal. Superpower. Does this remind you of the crazy stuff we saw in the 1800s. None of this stuff really works, i dont think. Then you get your plastic surgery, you got your London Hospital therapy. I think they just stick you in a refrigerator. Really weird. You can go on amazon, collagen face moisturizer. These two women, are they really the same . Come on. , who had the video . Yree is no way the the same. I dont in any case, heres the only one that used the dword. Im sure the marketing usertment was going, do we it . I dont know. You just never see that. To i will give 50, 50 anybody who can find me a sympathy card that uses the dword. Death, dying, anything any d, you heard it here. I gotta pay up, right . So cheat death. And then this one. Kind of stuck out at me. 2,000 for a bottle of cream . Know, man. People will go to any lengths. 488 milliliters, so i guess maybe its worth it. I dont know. Yours, this was carly, i think. Was it . Yeah. So heres a Service Called perpetuate some blood and hair from your pet and maybe call in pet somewhere down the road. Yeah. Talk about not wanting to give in. This is just really culturally strange. So history, explanation number two, denial. Real. That death is not need not be dealt with. So summarizing, advance care del in every state legal in every state but we dont do it. Getting what they want, end of life. Get physicianassisted suicide. For care. Ranked ranked number 14 for training. We spend all of this money, and dont get much for it. Why . Be explained by scienism andcepts, denial. It. Ink thats thank you, guys [cheering] you can watch lectures in history every weekend on American History tv. Take you inside College Classrooms to learn about topics americanrom the revolution to 9 11. P. M. Andturday at 8 midnight eastern on cspan 3. This weekend, on american artifacts, world war ii reenactor frederick describes divisionsinfantry role in the june 6, 1944 dday armysn at the u. S. Heritage days in pennsylvania. Heres a preview. My name is jered frederick. History. Structor of im also a reenactor with the furious World War Ii History group. At Army Heritage days in carlisle, pennsylvania. This event, it is a major complex. Heritagee on the army trail. One can find reenactors, living historians from all different time periods, ranging from the 17th century up to the present. Group, though, is here this weekend to discuss the 75th normandyry of the invasion, which is taking place this summer. Certainlyught it fitting to commemorate that event. These oldting on umpires uniforms, wearing old equipment, it certainly gives us a better perspective and appreciation of what the greatest generation went through. If we can impart even a small passersby andt to families who come visit this place, we feel weve done a job. Y good the unit that we portray is the Fourth Infantry Division. Sometimest thats overshadowed in the realm of World War Ii History. Nonetheless, it was one of the spearhead units involved in the normandy invasion. The firste of amphibious troops. They waded ashore on utah beach. Unbeknownst to many of them at actually, they had landed on the wrong sector. They had landed about a half offcourse and there is a little bit of uncertainty, thatps hesitation as who exactly they should do, but commander,ivision Theodore Roosevelt jr. , son of the president , the oldest american participate in the defiantly,aid very were gonna start the war right here. And indeed, that is what they did. They carried the fight inland, into the normandy countryside, where they really began to tally up casualties. The unit fault all throughout mainland europe. They were the First American troops into paris. They were the First American troops into germany. But unfortunately, it inflicted a very grim toll. Entiretyin its throughout the war suffered about 250 casualties. Perpetualjust a stream of wounded, killed, and then their replacements, and sometimes replacements after that were being killed and wounded as well. So it was an absolutely devastating affair, but many of the men in the unit had the firm they needed to do this, because there was really no other choice. Of stopping price fascism and its spread. Wrlas many world war i veterans to world war ii very day,ay to this its something that had to be done. 75 years later, thats something believe in. Irmly thank you, gentlemen. Thank you learn more about the Fourth Infantry Division and their role on dday, sunday at 6 p. M. And 10 p. M. Eastern on american artifacts. Explore our nations past, here on American History t. V. The International Spy museum moved to a newly constructed building in washington, d. C. , with double the space of its previous location. Next, on American History t. V. , the Opening Ceremony with maltz, themilton International Spy museums asnding chair, as well