… This life is short. Somehow I am 45 years old. I feel 13, 17, 21, I feel timeless and ageless. Yet, when I look in the mirror, I’m sometimes surprised by what is looking back at me. I see signs of aging on my body. My knees hurt. My sleep is getting wonky. I have to pee a lot more than I used to. My body is changing, and one day I’m going to be in the process of dying, which means death will soon be awaiting me. I hope that I, and the reader you, reach the end of your life having lived the entire breadth of it. Get to your edges, because we are here for the tiniest amount of time. While we’re here, we have the opportunity to be actually alive, to feel wind on our skin and eat delicious food, make eye contact with people we love, meet fascinating people along the way, do work we feel proud of, be kind, be compassionate, and give ourselves grace to not match up to external ideas of who we should be, but rather just be exactly who we are. This life is short. As my dad always said, “Life is for the living.” Let’s live…
I had the pleasure of speaking with Alua Arthur, a trailblazer in the realm of end-of-life care, who has emerged as America’s most distinguished death doula, reshaping the conversation around mortality with a blend of empathy, humor, and wisdom. Born in Ghana in the late 1970s, Arthur’s early life was marked by upheaval and resilience. Her family’s flight from a coup d’état and subsequent political asylum in the United States laid the foundation for a life characterized by profound changes and a search for meaning.
After a successful but ultimately unsatisfying career in law, Arthur encountered a pivotal moment that steered her towards her life’s calling. A meeting with a young woman battling uterine cancer in Cuba, coupled with the personal loss of her brother-in-law to lymphoma, highlighted the profound isolation and lack of conversation surrounding death. These experiences propelled her to found Going with Grace, an organization dedicated to end-of-life planning and death doula training.
Arthur’s approach to death is both revolutionary and deeply human, advocating for open dialogue and preparation as tools for leading a more fulfilling life. Her work emphasizes that contemplating our mortality can unlock a deeper appreciation for the present, encouraging people to live more authentically and with purpose.
Set to release her debut memoir, “Briefly Perfectly Human: Making An Authentic Life By Getting Real About The End,” Arthur offers insights into her journey and the lessons learned from those she has guided through their final moments. The book promises to be a testament to her belief in the transformative power of facing our finitude, inviting readers to embrace life’s impermanence as a source of strength and clarity.
Arthur’s influence extends beyond her immediate practice. Her TED Talk, “Why Thinking About Death Helps You Live a Better Life,” has captivated over a million viewers, while her presence in media and at speaking engagements around the globe has spread her message far and wide. Esteemed for her unique perspective on life and death, she has garnered accolades from figures like Jodi Picoult and Glennon Doyle, who celebrate her work’s profound impact on our understanding of the human experience.
As Arthur’s memoir awaits its release, her journey from a childhood marked by displacement to becoming a guiding light in the conversation about death underscores a life dedicated to serving others. In embracing death, Alua Arthur teaches us how to live — not in the shadow of our ending but illuminated by the knowledge of our finite existence, urging us to live each moment with intention, grace, and authenticity.
Yitzi: Alua, it’s a delight and an honor to meet you. Before we dive in, our readers would love to first learn about your personal origin story. Can you share the story of your childhood and how you grew up?
The pleasure is all mine, Yitzi. I was born in Ghana in the late 70s. My parents had been in the United States for a while. My dad had been getting a PhD, and he was currently a lecturer at the University of Ghana when I was born. Then he became a member of parliament in the Ghanaian government under Dr. Hilla Liman.
That government was overthrown in a military coup three years after my birth when I had an additional sister. We hit the road after that. He went to prison and my mom, my sisters, and I eventually gained political asylum and came to the United States. When he was released from prison, he came to join us.
They both found Jesus when they were apart. So we traveled, spreading the word of God for years of my childhood.
Yitzi: So can you share with us the story of what brought you to this specific career path?
After about a decade practicing law at the Legal Aid Foundation of Los Angeles, I grew clinically depressed. I took a leave of absence where I went to Cuba, and there I met a young woman, a fellow traveler who had uterine cancer.
We talked a lot about her life. I asked her questions about her death. She gratefully came with me, and what we uncovered was that she hadn’t had anybody to talk to about her mortality. It was one of the first real conversations she was having about death, which made me really sad. I felt like it had to be incredibly isolating and lonely. But in that space together, I felt the most like myself that I’d felt in a long time.
Not long after that conversation with her, I started to think about how mortality helps give me an idea of who I want to be. I figured if I died from my disease of depression, which can be a life-limiting illness if left untreated, I didn’t like the life I’d lived so far. And I wanted to do something about it. So I did.
I didn’t mean to do death work in particular, but on that bus, I felt clear that I could be of service in this way. Then after I came back from Cuba, my brother-in-law, Peter Saint. John, became ill. Not long after that, he was dying, and I was devastated. I got to support him through the last two months of his life. That’s when I saw in real-time how different the work is than what I thought it would initially be, and also how encompassing it is.
Yitzi: That’s amazing. So how did you turn those experiences into a career, into a business?
I’m still figuring it out myself. But basically, I saw a need when I was with my sister. First, as my brother-in-law was dying, I wanted somebody there. They were asking me questions and sometimes looked to me for answers. I wish I had somebody else to look at because I was grieving myself. I was also losing my brother-in-law. I wanted to sleep the whole night long myself. Grief and death won’t let you, but it was such an isolating and lonely time. I wished there was somebody there with us. At that point, I would have paid anything.
Not long after he died, I was leaving my sister-in-law in New York and felt really sad for her because she was in the midst of profound grief herself. She didn’t have the tools to do what she needed because of grief. I wish there was somebody I could hire to help her wrap up the affairs of his life, sit and grieve with her, and all these things. Nobody was available. It didn’t exist. I thought, well, we can do this. We can offer it to other people.
Yitzi: Wow. So you probably have some fascinating experiences. I know you can’t share everything, but can you share with us a powerful story, a profound story that has occurred to you in the course of this career?
In my book, I talk a lot about and share client stories. One I really enjoy sharing is the story of Summer. She was young, 26, and had breast cancer, looking at the end of her life. She approached her death in a way that people decades her senior hadn’t quite come around to. She recognized this disease she’d been with for a while was going to kill her and had come into acceptance of that reality. It’s hard to accept death anyway, but she had at least come around to it. She touched me in a way. She was so young. It felt unfair, but that was her life story, her whole path.
Another client named Akua that I wrote about, her son called me and said she wanted to talk about her death. When I got to her house, she didn’t anymore. She thought she was going to live and had decided to live because in her prayer circle and prayer group, they told her she was still going to live. So she didn’t want to talk about death.
But what I was able to do was work with her to get clear on what she still wanted to experience in her life, which realistically is kind of the same thing anyway. Preparing people for death means how do you live the time you have left fully, and also get clear on what the most ideal death is for yourself under the circumstances. When I went back, she was ready. She had an ideal death for herself.
Yitzi: Have you ever had a near-death experience?
I almost got hit by a car when I was in Cuba. That really shocked me into the present moment. I didn’t think of it necessarily as a near-death experience at the time because the car didn’t actually hit me. I never lost consciousness, I never went toward the light, as they say, but it was a brush with death.
Yitzi: So, what exactly is the process of comforting someone before death? Does it entail keeping them company? Or does it involve more like describing what death is? Tell us what exactly the process involves?
The process of preparing for death, helping to prepare your client for death, looks like a lot of things. It looks like, for starters, getting clear on what you want to have happen to your body after you die, getting clear on who you want to make your decisions for you in the event that you can’t, getting clear on your desires for life support.
Telling people what you want done with your possessions. If you have children and the other parent is not available, then naming a guardian for your kids, a guardian for any adult disabled dependents you may have, a guardian for your pets — people always forget about their pets.
Hearing stories, telling stories, creating some context and meaning for your life in the way you feel most comfortable doing so. Just thinking about the value of your life, what you valued while you were living — those are the basic things to get prepared for death.
But there’s much deeper ones like reconciling your life for exactly what it was as opposed to what you thought you wanted it to be. Your relationships, understanding your suffering, recognizing who you were as opposed to who you thought you were supposed to be. Easy stuff.
But the need to leave peacefully really depends on the individual. For some, there is no desire to forgive. For some, there is no desire to apologize. For some, leaving peacefully means a blaze of glory. Just screw everybody and I’m out. And that’s their absolute authority to do so.
Yitzi: Is being a death doula similar to a birthing doula, that you’re on call 24 hours a day, you have to leave everything, drop whatever you’re doing?
Yeah, sometimes. But I’m not always there when somebody is dying, because I want to send the message that I trust them and their capacity to die. So I’m available by phone if they need me, but the caregivers got it. The body knows how to die. I’m quite available to people if they want me to be.
Yitzi: Which part of this unique work is the most challenging and what’s the most rewarding?
I think the most challenging part by far has been learning how to run a business. Being with dying people pales in comparison to taxes, job descriptions, and time management. That has nothing on capitalism, I’ll put it that way. Nothing.
The most rewarding part is the relationships I’ve gotten to foster because I get to meet people at their most intimate and vulnerable, and I’m not one for small talk anyway. We can get right in there, you know what I mean? I have loved teaching death doulas too. Getting to amplify the work in this way feels so good.
Yitzi: It’s been said that sometimes our mistakes can be our greatest teachers. Do you have a story of a humorous mistake you made when you were first starting and the lesson that you learned from it?
Let me tell you something I thought was a mistake and turned out not to be, but I like to talk about it.
Very early on, I was with a client, and her sister. She was dying. I was devastated for her and the sister was having a hard time. It was just a really emotionally dense space.
I’m a cryer. I cry joy, beauty, sadness, frustration — everything. At that moment, they were crying in pain and grief, and I cried with them. I got so overcome that I had to excuse myself. They were deep in their process, so I got myself together, came back into the room, and eventually, we wrapped up, and I went home.
I beat myself up so bad about that. I thought, “This is not my sister. This is not my death. Why did I make this about me?” It felt like I just shifted the whole dynamic of the situation. I felt awful for days. Then a couple of days later, I talked to the sister who thanked me. She was so grateful that I had been human because they were used to medical staff coming in, being clinical, and leaving.
I showed emotion in this emotional process, and she was grateful for it. I’ve since learned that my sensitivity is my greatest asset in this work. I wanted to shut that part off for a long time, certainly when I was practicing law. And it also made me so happy I wasn’t a lawyer anymore. No, thank you.
Yitzi: Is there a person who made a profound impact on your professional life? And if there is, can you share a story about that person?
I’d say the person that I started the company with. Eight or nine years ago, I had this idea to begin this death companioning business where we would do workshops to talk to people about their mortality. We’d help people plan for the end, and then we would be with them as they died. I also had the idea to start teaching, but that wasn’t going to be for a few years.
I shared this story with her — her name was Emerald Fields at the time, she’s now Emily Marquez. And she said, “Let’s do it.” If it wasn’t for her, I never would have. I was terrified. I didn’t know anything about business. I didn’t know how to begin. So without her, none of it would have been possible.
Yitzi: So you have so much impressive work. In addition to your book, what are some of the exciting projects that you’re working on now and where do you see yourself heading from here?
Today, actually, as soon as we’re done, I’m heading off to Lake Arrowhead. We have 40 students from around the globe joining us there to do a death doula training.
I’ve been training students now for about five years. We’ve trained about 2,500 students in 17 countries so far, and 40 of them are coming to Lake Arrowhead. They’ve packed their bags, asked someone to take care of their cats, and packed toiletries. It’s really exciting, so continuing to teach is one of my favorite, favorite things. I’m still really excited about that.
Also, anytime there’s an opportunity to talk to people about mortality, I’m jazzed. It happens all the time — on flights, in coffee shops, at the mechanic. Anytime “what do you do for work?” comes up, whoops, we just stepped on the line they didn’t mean to.
Yitzi: Okay, so until we learn how to clone you, there aren’t enough of you around to coach all the people that need comforting before they leave. And I think many people probably have relatives or close family members in that position. Would you be able to share five things that a person can do to act like you, to support people during the stages of passing away?
I would say, for starters, practice being present. Practice actually listening when somebody’s talking, paying attention to the words they’re using, how they’re using their body, how they’re situated in space. Practice presence in your own life as well.
Encourage the conversation. Encourage the difficult conversations.
I’d also say practice vulnerability and transparency. Part of the reason our society has such a hard time with death is that we shove it away into a closet. We pretend it’s not happening until it does. Then we grieve in our small communities. We don’t grieve at work, we’re not grieving publicly, we’re not grieving out loud, which further makes it seem like something bad or wrong that needs to be hidden.
Practicing vulnerability and transparency — “I’m having a hard day today. I feel sad. I’m lost.” All those things can go a long way to encouraging people into the conversation about where they’re at.
And make some checklists. Make checklists of the practical things you need to get done and say yes to life. Because we die, death gives life value and meaning. It’s finite. Without death, none of this would matter. We’d just go on for all eternity. Who gives a shit that you’re eating an orange if you can eat an infinite number of oranges? If you can look at an orange like the miracle it is, then you can appreciate life for the miracle it is and get to your death feeling comfortable with the life you’ve lived.
Yitzi: How about giving comfort to the survivors like the spouse or the children or parents?
Yeah, for starters, grief is hard. It’s not easy. Any day that you wake up and you keep living with grief is courageous. Really, really hard.
Talk to people in your life, tell them what you need if you can identify it. If you can’t identify it, you can say, “I’m hungry” or “I can’t think about food.” Then somebody else maybe can think about that, but we’ve got to practice speaking our needs or at least telling people that we can’t identify our needs so we can let somebody show up to support us.
Accept support. Accept support from the people that are willing. Be gentle with yourself, please be gentle with yourself. This is a life-altering process. Death is a life-altering event, and grief is a life-altering process. And there’ll be tomorrow.
Yitzi: Has it happened that a person is very afraid of death and somehow you’re able to calm them down?
Most of the people I work with have some awareness that death is coming. I think a lot of us carry a fear.
There’s a client that I wrote about who asked a lot of questions. She was looking outside of herself or somebody else to tell her how she should think or feel. Being present with her, actually listening to her, reflecting back what I was hearing ultimately helped her make some decisions and find value for herself.
Even though I do this work, I don’t have the hubris to suggest that I have a magic wand for anybody. Everybody’s journey with their existence is theirs. I just sit alongside as they walk that path.
Yitzi: Do you ever discuss the afterlife?
Not really. My clients do this all the time, and I’m always really curious about people’s ideas because they are wild. Somebody once told me she thought the afterlife would be going into the big eye in the sky. I thought this was like a metaphysical experience of “I”, the pronoun, but she actually meant an actual eye.
So does that mean she believed there was just something watching us all the time? We didn’t get to that before she wasn’t able to talk anymore.
Yeah, I see my job as being secular in nature, so I can support anybody who wants to be in conversation about their mortality.
Yitzi: Do you think that the healthcare system should incorporate more people like you?
Yes.
Yitzi: Let’s say you’re talking to a senator on the head of the committee that deals with health care. Can you make your best sales pitch?
My best pitch is that people are dying in ways across the country that do not serve them and ultimately cause a drain on our systems. Because you always have to talk to the senators about their money — I feel like they only care about the money and how efficiently the system is working.
The systems end up having a tremendous drain because people are not being adequately cared for and are grieving. People are in hospitals for a much longer time. They’re not receiving proper care at home. We’re using up hospital beds and spending millions of Medicare money. We have a shortage of caregivers and nurses. If we incorporated more death doulas into the medical care system, most of those problems would be alleviated.
Patients in the medical care system would receive a patient-focused, patient-centered approach to the end of their lives, thereby healing a lot of people’s relationships with death, grief, and loss. And save money. How’s that?
Yitzi: So as we wind to the end of our interview, what final thoughts or messages do you want to leave with our readers about embracing life and facing death?
This life is short. Somehow I am 45 years old. I feel 13, 17, 21, I feel timeless and ageless. Yet, when I look in the mirror, I’m sometimes surprised by what is looking back at me. I see signs of aging on my body. My knees hurt. My sleep is getting wonky. I have to pee a lot more than I used to. My body is changing, and one day I’m going to be in the process of dying, which means death will soon be awaiting me.
I hope that I, and the reader you, reach the end of your life having lived the entire breadth of it. Get to your edges, because we are here for the tiniest amount of time. While we’re here, we have the opportunity to be actually alive, to feel wind on our skin and eat delicious food, make eye contact with people we love, meet fascinating people along the way, do work we feel proud of, be kind, be compassionate, and give ourselves grace to not match up to external ideas of who we should be, but rather just be exactly who we are.
This life is short. As my dad always said, “Life is for the living.” Let’s live.
Yitzi: How can our readers continue to follow your work online? How can they purchase your book? How can they support you in any way possible? How do they engage in your programs?
Always find us on the internet. God bless the internet, right? The website is goingwithgrace.com. There you’ll find courses, retreats, meditations, and opportunities to engage in your mortality, learn how to be a death doula, and build skills in preparing for the end of life. The book is out, so please buy the book. And live.
Yitzi: Alua, it’s been a true delight to meet you and talk to you. Thank you for these thoughtful and wise insights, and I wish you continued success, good health, and blessings.
Thank you very much. If I come to Baltimore, I’m going to find you. I’ll send you an invitation.
Yitzi: I would love to come. I’d love to meet you in person.
Social Impact Authors: Why & How ‘Death Doula’ Alua Arthur Is Helping To Change Our World was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.