Commusings: On Rethinking Death by Dr. Casey Means

Dear Commune Community,

Sitting behind all other fears is the fear of death.

For tens of thousands of years, we killed everything bigger than us, and for the last 150 years, we've attempted to kill everything smaller.

The paroxysms of anxiety that death elicits have led us to create myth upon myth, with bearded yet invisible patriarchs promising eternal life if we subscribe to a certain sexual guidebook (or else the cudgel falls!).

The fear of death has also led us to elongate our shelf-life. Even after we've passed away, we tend to inject ourselves with formaldehyde and store ourselves in insulated boxes.

But really, the only courteous thing to do is to do what Casey's mother did – which is to give back everything you've extracted in this glorious life. All of the carbon, oxygen, nitrogen, hydrogen, calcium, and phosphorus that somehow miraculously self-assembled into what was your life. It all goes back into the cycle of nature to feed the emergence of new life.

We are deeply fortunate to have Dr. Casey Means providing this week's Commusings essay. She has bent the arc of both my personal and professional life and I encourage you to dig in (for free) to her new Commune course, Optimize Your Metabolism.

Ready for queries at [email protected] and alive and kicking (for now) on Instagram at @jeffkrasno.

In love, include me,
Jeff 

• • •

On Rethinking Death
By Dr. Casey Means

Excerpted from her new book, Good Energy: The Surprising Connection Between Metabolism and Limitless Health

In medical school, I was taught that anything—no matter the cost, side effects, or societal toll—is justifiable to prevent death, even if it only is to squeak out a few more painful, vegetative days. The message patients receive from hospitals and pharma companies isn’t that “we are going to keep you healthy and help you have the best possible life”—it is that “we are going to keep you alive.”

For me, death was my greatest fear from childhood and into adulthood and the one I have had to address head-on to unpeel the layers shielding me from good energy. I have spent more of my life worrying about the ways I or my family could die than about any other issue. Death was the reason for my mind racing countless nights. Death is why I got into medicine.

A set of experiences with my mother beginning in early 2020 changed my perspective on worry—particularly about death—forever. Concerned about her rising glucose and cholesterol levels, I took her to Sedona for “Dr. Casey’s Bootcamp” of proven actions to improve metabolic health: extended fasting, cold plunging, exercise, morning sunrise hikes. It was a year before we’d discover her pancreatic cancer.

Having not eaten for three days and am on a ketone high. I felt euphoric as my mom and I looked at the towering Red Rock Mountains together. My mom and I had hiked to the top of a ridge in the dark for a full-moon drum circle that we’d heard about from a local art gallery, and she and I danced together in the moonlight with abandon.

Looking at the towering rocks, I couldn’t get the idea out of my head that the mountains and I were made of much the same thing. The atoms that make up my body have been on the earth since its creation some 4.6 billion years ago. And for a brief sliver of time, my mitochondria produce ATP to power the organization of these atoms into my tissues, organs, and ultimately me.

In Sedona, my mom and I talked about how the ideas of “self” and the finality of death were illusions. In reality, large portions of our bodies are dying on a regular basis—we each shed more than a pound of cells each day. Our cells make up to 88 percent of dust in our homes. In medical school, I looked at slivers of body parts on slides under the microscope and was surprised to see the full spectrum of life and death happening inside what seemed like an “adult” living body. But at the microscopic level, cells were dying, dividing, being born, aging at vastly different rates. At the cellular level, we die and are reborn trillions upon trillions of times in one “lifetime.” The discarded matter from our bodies returns to the earth and eventually creates new things. Fossil fuels, which supply 80 percent of the earth’s energy today, are nothing more than the remains of animals and plants that existed millions of years ago. We are literally powering our cars and homes with the atoms that made up our ancestors.

It is merely a limitation of our visual systems that we don’t see these innumerable reactions happening every second in our body and the constant creation and re-creation that makes up our world.

I speculated with my mom about whether the discarded pieces of myself would be taken up into a delicious piece of broccoli that feeds a child. Or maybe I would supply some carbons that will be pounded into a perfect diamond. Or maybe I will donate some atomic dust to a gust of wind that helps form mountain ranges that are yet to exist.

Probably all the above, plus other forms I can’t even conceive of.

The impact we have on others—the people we love, the people we mistreat, the people we teach, the people who read our writing—literally changes their biology and lives forever. As my mom and I danced and hugged under the moonlight, I thought about how this loving experience with her was literally changing the physical neural pathways and biology in my body through neurotransmitter and hormone release, reinforcing synapses, and transferring microbiomes to each other. My experience of her—and all people with whom I choose to interact— will physically encode itself in me.

On January 7, 2021, I received a FaceTime call from my mother while I was preparing dinner, tears streaming down her face as she told me that she was dying, that she had to leave me, and that she would not meet my future children. She relayed that she had learned earlier that day that her vague stomach pain had actually been widely metastatic stage 4 pancreatic cancer and she had softball-sized tumors all throughout her belly.

Over the next thirteen days—the final days of my mom’s consciousness, she received hundreds of letters about the impact she’d had on people’s lives. I will never forget the gratitude and poignant emotion on her face as she sat reading them, while outside on the porch overlooking the Pacific. Every note was from a human who’d been biochemically changed because of my mother’s impact on them. Just as we had talked about in Sedona, I could feel that she was fundamentally immortal due to her impact on everyone in her life and her energetic ripple effect in the universe, which every one of us is connected to and contributes to by our sheer existence. She was without fear as she held my hand and told me that she could feel her life force rapidly retreating.

Days after she died, we buried her in a natural cemetery along the coastline. How profound to lower her beautiful body into a small patch of dirt next to the endless expanse of the ocean. This woman—whom my brother and I had lived inside of, our source, who built my body and consciousness, who traveled the world, and who impacted thousands of people—disintegrated into the earth to feed the trees and flowers and mushrooms above her in an eternal cycle.

Worrying about the years her physical body existed on Earth seemed so irrelevant. All my years of anxiety about my mortality and the mortality of my family had been wasted energy. Death is uncontrollable and it is OK. I feel that because when I held my mother as she took last breath, she was OK. In her final waking moments, she whispered to me that we are here to protect the energy of the universe. That it all—the life, the death—was perfect.

Casey Means, MD, is a Stanford-trained physician and co-founder of Levels, a health technology company with the mission of reversing the world’s metabolic health crisis. Her book on metabolic health, Good Energy, comes out in May 2024 with Penguin Random House. She received her BA and MD from Stanford and has served on Stanford faculty. She trained in Head & Neck Surgery before leaving traditional medicine to devote her life to tackling the root cause of why Americans are sick.