1장
When Death Becomes Your Greatest Teacher
What would you do if you knew you were going to die soon? Not in some abstract future, but soon enough that you need to make decisions now? This question haunts the pages of Alua Arthur's transformative memoir "Briefly, Perfectly Human." As a death doula who has guided hundreds through their final transitions, Arthur doesn't just theorize about mortality-she lives intimately with it. Her work has garnered attention from Oprah Winfrey, who featured her on the "Super Soul Sunday" series, and her perspective has influenced contemporary conversations about death in America. Through her organization Going with Grace, Arthur has trained thousands in end-of-life care, bringing compassionate death practices into mainstream consciousness during a time when our society desperately needs to heal its relationship with mortality.
2장
The Taxi That Changed Everything
I nearly got hit by a taxi in Trinidad, Cuba-a moment that would have been comical if it hadn't been so terrifying. As I dodged the vehicle, my mind raced with oddly specific concerns: dying in a foreign country, the shame it would bring my Ghanaian family, and my mother's inevitable disapproval of my underwear choice. This near-death experience interrupted my journey to return a red scrunchie to Yesenia, a local woman I'd befriended while jogging.
At the bus station afterward, I met Jessica, a German woman with a red quill pen tattoo who helped stall the bus for me. As we traveled together, she revealed something that changed everything: she had uterine cancer and was seeing the world before she died. Unlike her friends and family who avoided discussing death, I asked her direct questions about dying. Our conversation sparked something profound in me.
"When you look at yourself on your deathbed, who do you see?" I asked her.
This question led Jessica to realize she wanted to write a book about her travels. Watching her excitedly scribble in her notebook, I contemplated my own mortality for the first time at age thirty-four. I envisioned the Alua I wanted to be when my time came-someone who had lived fully, without regrets.
Years later, I understand that without this "coincidental" encounter, I might be dead-not physically, but crushed under the weight of an inauthentic life. Meeting Jessica, who embraced life fully despite her illness, showed me that awareness of mortality doesn't diminish life but makes it bloom wildly. While society shuns death conversations, embracing our mortality is perhaps the only thing truly within our control.
3장
The Body Always Wins
Our bodies tell our life stories through every line, scar, and wrinkle. As a death doula, I've witnessed countless bodies transform from vibrant vessels to empty matter in a single breath. I've seen how Jonathan's furrowed brow revealed his skeptical astronomer's nature, Elizabeth's smile lines showed her dancer's joy, and Ernst's jowls displayed his perpetual disapproval.
My own body-tall, melanated, strong-featured-arrived in Ghana in 1978 weighing ten pounds, celebrated as a healthy "bofti" child before moving to America where my body suddenly became something to fear and fix. Now I've found harmony with my physical self, decorating it boldly with locs, jewelry, and bright colors, taking up space wherever I go.
Despite aging-losing collagen, gaining cellulite, developing lines-I recognize my body as my most trustworthy companion, performing billions of tasks without thanks. The body alerts us to danger with goosebumps (what I call "juicebumps"), heals our wounds, and ultimately, always wins. Until science finds a workaround, our bodies will age and die. This isn't pessimism-it's reality.
The body's inevitable decline becomes particularly poignant in my work. I've held hands that once built houses but now struggle to hold a spoon. I've watched brilliant minds that solved complex equations become confused by simple questions. I've witnessed strong legs that ran marathons become unable to support their owner's weight. The body always wins this game we're playing, and acknowledging this truth is the first step toward making peace with our mortality.
4장
When Death Comes Knocking Early
My earliest memory is escaping death during Ghana's 1981 military coup. At three years old, I recall disconnected images: my father's sweaty hand rushing me down seven flights of stairs, car doors flung open, people panicking. My father, Dr. Appianda Arthur, was a prominent government official under President Limann, whose administration was being violently overthrown by J.J. Rawlings.
After seeking refuge at my uncle's house, my father eventually surrendered rather than risk capture and spent five months in prison. My pregnant mother took us to Bethesda, Maryland, finding community at First Baptist Church. My father eventually escaped Ghana with help from farmers and fishermen, joining us in Maryland as a political refugee.
This early brush with mortality shaped me profoundly, but nothing prepared me for losing my brother-in-law Peter to cancer. When Peter said he was tired, I wish I'd understood he meant life-tired. Ready-to-die tired. Those were the last words he ever said to me before slipping into unconsciousness and dying three days later.
Peter's diagnosis with Stage 4 Burkitt's lymphoma felt like a meteor headed our way, shattering any illusion that the world is just. During his final months, I became the first person I "doula'd" before knowing what it was-providing support not just to him but to everyone in his orbit. I fielded four-year-old Lael's inquisitive questions about death, balanced honesty with comfort, and wished we'd had more guidance-someone to tell us how to talk to children about death, how to approach burial decisions, or just to reassure us that our experience was normal.
For three days and nights, we sat vigil by Peter's bedside as he labored out of this world. Christmas music played, as it was his favorite holiday. Around 3 AM on December 11, 2013, four days before his forty-fourth birthday, Peter breathed his last. The room filled with deafening stillness until my sister Bozoma pierced it with a sharp whimper. Her husband and father of her children was gone.
After Peter's death, I couldn't focus on basic tasks. The dining room table became littered with colorful sticky notes full of questions with no answers-contacting credit card companies, cataloguing online accounts, figuring out what to do with his clothes. I desperately wished for someone knowledgeable and compassionate to help us navigate this maze of death duties. This experience of isolation in grief fueled my anger at a society that understands the universality of death but does nothing to support those left behind. My anger eventually transformed into purpose-if there wasn't someone I could call for help, I could become that person for others.
5장
The Birth of Compassion
My journey toward understanding death and empathy began early in my life. When I was twelve, my father woke me at 4 a.m. for an adventure-a trip to a rural Denver farm to get fresh meat. While he surveyed chickens, I heard desperate bleating in the distance. When a loud blast silenced the cries, I burst into tears, devastated by the goat's death. Unable to reconcile the animal's fear with eating its flesh, I declared myself vegetarian on the spot. This experience revealed my overwhelming empathy-a quality that would both guide and challenge me throughout my life.
At eleven, I became preoccupied with Ryan White, a hemophiliac boy who contracted HIV/AIDS through a blood transfusion and fought against discrimination. I couldn't understand why he was treated differently because of something his body did. My heartbreak over his situation eventually sparked righteousness that flared into activism.
But empathy without boundaries can be destructive. During my first year of law school, I worked at South Brooklyn Legal Services in the HIV/AIDS Unit, where I met Natasha, a twenty-six-year-old Black woman with AIDS who seemed remarkably similar to me. I overextended myself helping her beyond my professional duties. My supervisor Cynthia eventually gave me life-changing advice: "Well, Alua, it's not you."
I had collapsed the space between myself and Natasha, conflating our experiences. This taught me the crucial difference between empathy and compassion. Empathy says "I know what you're going through," while compassion acknowledges "I might not understand exactly, but I'm curious and I'm here with you." This distinction became fundamental to my death doula work, where imposing our perspective on others is counterproductive. The most healing approach is to show up and shut up-acknowledge the situation, then follow the grieving person's lead.
I learned this lesson again with Akua, a client with terminal cancer. When I first met her, she wasn't ready to discuss death. Rather than forcing her to confront it, I respected her timeline. When I returned weeks later, she had accepted her approaching death and planned it meticulously-surrounded by purple flowers, Nils Frahm's music, chakra-closing rituals, and her loved ones. Had we forced her to confront death earlier, she might never have reached this powerful self-acceptance.
6장
Becoming Death's Companion
After Peter's death, I followed my grief-fueled curiosity about death. My therapist connected me with Sacred Crossings, where I attended an Introduction to Death Midwifery course led by Olivia Bareham. Despite being younger than most participants, I found my people-others drawn to that "inky, dense, indescribable moment in human life." I completed the Death Midwifery Program in 2014, flying in from wherever I was temporarily living to attend weekend sessions, while devouring books on death.
To build my practice, I worked part-time at an alternative funeral home, volunteered at hospice, helped build a social model hospice home, and got licensed to sell life insurance. I formalized Going with Grace in 2015 after a Vipassana meditation retreat where the business structure came to me. Though my first attempts at marketing were awkward-retrieving discarded brochures from trash cans to reuse them-I eventually got my first client through a referral.
Six years into my business, I met Justina, a famous self-help guru with just twelve days left to live. Her glamorous home matched her reputation-fur rugs, Swarovski crystals, Pomeranians with dedicated walkers, and a white throne with gold upholstery. At our first meeting, she sat surrounded by fifteen adoring visitors, her hair curled, lipstick perfect. Despite her cheerful welcome, I sensed sadness behind her bright blue eyes.
By my second visit a week later, everything had changed. The lipstick and visitors were gone, replaced by frustration and heaviness. "No one understands," she repeated through tears. Though surrounded by people, she felt profoundly alone facing mortality. She confessed her misery, her desire to die quickly after two years of disease, and her wish to have only six people present at her death.
When she began actively dying, dozens of uninvited people showed up, turning her death into a spectacle with people flinging themselves on her body. I struggled to protect her intimate space while honoring her wishes. After her passing, I facilitated her chosen friends washing her body with lavender water. On my drive home, I broke down crying, feeling I'd failed her. Only after processing with my students days later did I realize I had done what mattered most-serving Justina's needs and holding her hand as she died surrounded by her closest friends.
7장
Death Doesn't Discriminate, But Society Does
I begin working with Nancy, a ninety-six-year-old former librarian with Alzheimer's, in June 2016. During one visit, I find her uncharacteristically agitated, stuffing torn newspaper into her wheelchair pockets. Spotting Zsa Zsa Gabor's obituary, I attempt to redirect her energy. Initially, Nancy recognizes the actress, but then suddenly asks with disgust if Gabor is Black, before turning her laser eyes on me and demanding, "Wait, are you Black?" Her accusatory tone leaves me speechless. Of course I am Black-Black as fuck. It's core to my identity, though technically I'm Ghanaian, not African American.
Nancy's racist outburst reveals how inequities follow us into death. I'm exasperated when people call death "the great equalizer"-while we all die, we die of different causes at different rates in different ways. Death reflects social power dynamics-white women outlive Black women, men die earlier than women, straight people outlive queer folks, and poor people die earlier than wealthy ones.
These facts matter in deathcare, where failing to acknowledge privilege and bias can further marginalize communities at their most vulnerable moments. The fake colorblindness in wellness spaces ("I don't see color") has infected the death community too, erasing my identity and history. If someone claims not to see my Blackness, they're refusing to see me in all my glory.
As a child, I had little concept of race. Moving from California to Nairobi at age six, I judged people by their generosity, not skin color. But at Rosslyn Academy, predominantly white, I first encountered racism when selected to play drums in music class and heard whispers: "Why her?" "She's Black." "Can she even play drums?" Later in Colorado Springs, I was called "jungle bunny," "African booty scratcher," and "monkey" in my first week of sixth grade.
Being an outsider prepared me for death work-the dying are outsiders too, on their way out while the rest remain. The system isn't set up for us to win-it shows in how we live and how we die. Acknowledging our unique humanity is the best way to achieve that elusive good death, based on who we were as individuals, not as a monolith.
8장
Love in the Face of Mortality
Falling in love feels like tripping over yourself-one of life's messy adventures and greatest joys. It creates a paralyzing fear of death as we become aware of our mortality and our beloved's. Despite teasing from friends about my tendency to declare love easily, my declarations have always been real. Love doesn't look like just one thing-some find it in brief encounters, others in long-term relationships. However you find genuine love, you should take it and give it, because eventually we all die.
I met Kip at a Hollywood gas station after graduating law school. Six-two, dark-skinned, with locs down his back and intriguing piercings, this eighth-grade English teacher was also a musician and sneakerhead. Despite our differences-his Christian homebody nature versus my spiritual explorer tendencies-he proposed on the 105 freeway. Three months after our Costa Rica elopement, discovering he didn't use flat sheets triggered an existential crisis about compromise and identity loss.
That flat sheet discovery spiraled into existential questions about what parts of myself I'd have to sacrifice for marriage. Six months after our beach ceremony, we separated. The breakup was excruciating-my organs seemingly shutting down as I confronted internalized failure. Now, fifteen years later, Kip and I remain good friends. The man he became wasn't mine to keep, nor I his-yet the risk of loving is always heartbreak, whether through separation or death.
I've seen this play out with clients like Elena and Mike. After Mike died from ALS, Elena struggled to adapt to life without someone to care for. For almost two years, her entire existence focused on Mike's care-now she had no spreadsheets to update, nothing to control. Less than a year after his death, Elena died of a heart attack. I believe she died of a broken heart, with nothing left to live for.
In my work as a death doula, I offer clients a practice called "finding your feet" to help ground them in the present moment. When someone is focused on the past or worried about the future, I encourage them to bring attention to their feet-through a warm foot bath or simply placing bare feet on the earth-to invite themselves into the moment where they can affirm: "Today, I am here."
9장
Fighting the Wrong Battles
On my first day as a "real" lawyer at the Legal Aid Foundation of Los Angeles, I stared at my frosted-glass door with "Alua Arthur Attorney" in adhesive letters. I tested if the letters could be removed, relieved they weren't permanent-already sensing I didn't want to be a lawyer, a truth that would take nine exhausting years to fully face. My body knew it all along.
Starting in the government benefits unit, I advocated for people who'd lost access to essential benefits. I immediately struggled with the regular office schedule. After only a year, I grew disgusted seeing how the government treated poor people, mostly Black and Brown clients who would lose benefits for accidentally earning slightly over the cap. I transferred to family law doing domestic violence work, but eventually the cycle of paperwork and seeing clients repeatedly seeking protection from the same abusers wore me down.
Desperate to save myself, I switched roles again to community economic development, cutting my hours to part-time-a perverse decision for a single woman lawyer with no financial safety net. To fight the creeping rot inside me, I'd bike nine miles to work with headphones blaring, swimming in endorphins to counteract the dread.
I distracted myself endlessly, running from the pain of not knowing why I was doing my work, trying to patch together a meaningful life. Why was I struggling when everyone else seemed to have it figured out?
Unlike me, Jordan, a twenty-seven-year-old actor client, seemed to have a different problem-an intense fear of death that manifested as anxiety about unlikely catastrophes. Despite therapy and medications, his fears persisted. Through a death meditation I guided him through, Jordan realized his fear wasn't of death itself but of the dying process and potential pain. This fear had ballooned into avoiding anything potentially dangerous-roller coasters, bridges, motorcycles-despite longing for these experiences.
I explained that most people die from disease, not accidents, which account for only 6% of deaths. Jordan realized he'd been running from pain rather than toward pleasure, avoiding life to avoid death: "Don't do stunts, you'll get hurt. Don't open your heart, it will break. Don't love, you will grieve. Don't live, you will die."
This avoidance is a common response to our fear of death, manifesting as perfectionism, workaholism, addiction, or endless distraction. But what I've seen in my work is that avoidance only works temporarily-eventually, we must face what we're running from.
10장
Finding Your True Self Before It's Too Late
Sometimes, we're blessed with unexpected guardian figures who name the very truth we're desperately avoiding. For me, this person was Silvia Argueta, a senior attorney at Legal Aid. During my tortured tenure there, she became both mentor and close friend.
In our first meeting, she cut straight to the heart of my struggle with a direct question that unnerved me: "Why are you a lawyer?"
I couldn't admit I'd become a lawyer because I was a "gifted" child expected to do big things, because it sounded good, and I wanted to make my family proud. I'd taken the path of least resistance despite the torture of law school and the California Bar Exam. I was a hexagon-shaped peg trying to fit into a lawyer-sized hole, and Silvia saw right through me.
Throughout nine years at Legal Aid, I shopped for drab "lawyer" clothes trying to fit in-heather-gray suits and pinstripes instead of orange Alexander McQueen skirts or mudcloth capes. As a young Black woman, I felt I had to look the part to be taken seriously, but these clothes didn't fit the real me.
I've always felt like a zebra-Black in America, African with Black people, American in Ghana. No matter where I went, I didn't fit in. My wardrobe started changing naturally-grays and blacks replaced vibrant colors. The spark faded from my life. I was slowly killing myself, shrinking my joy for a life I didn't buy into.
Now as a death doula, I help clients feel like authentic versions of themselves-something I missed for so long. When we can't give the dying exactly what they want, we focus on the spirit of the request. While I might adjust flower choices when certain blooms aren't available, I will go to war for a client who's being misgendered or deadnamed at death. Too often, parts of a person get erased because biological family doesn't support them or because aspects were kept secret. But we bury the whole person.
If we could honor everyone for exactly who they were in life, we could break down barriers that separate us from our complex humanity. And if in life we could live out loud with our authentic identities, we could shine light on parts others choose to hate.
11장
When Depression Meets Mortality
Eight months before my life fell apart, I returned to work after a desert trip to find a voicemail from Silvia, now Legal Aid's executive director. Budget cuts meant I'd have to work full-time at the Self-Help Center in Inglewood Courthouse-eliminating the only part of my job that still nourished me: client contact.
I'd been crying more frequently lately, expressing all emotions through tears. Within three therapy sessions, I was diagnosed with dysthymia-persistent mild depression-which I dismissed as situational. Three months later, this was upgraded to major depression, which I still denied.
My six months at the Self-Help Center (which I called "The Dungeon") were barely survivable. I spent days in a windowless basement office and nights alone drinking wine and smoking hash spliffs to numb my thoughts. Every morning I woke crying, dragged myself into the shower, and could barely dress myself. My apartment deteriorated into chaos-dirty dishes everywhere, decaying vegetables in the fridge, windows perpetually closed.
I withdrew from friends, embarrassed by my broken state. Though my life had once appeared successful from outside-meaningful work, travel, social life-something enormous was missing. At thirty-four, I was still waiting for my life to begin, shocked to realize this empty shell was my reality.
For my final week at The Dungeon, I used vacation time to attend Burning Man festival. I found unexpected magic there. At Burning Man, curiosity rekindled. I wondered about the elaborate structures, outlandish costumes, and most importantly-who were these people so comfortable in their skin? I realized they weren't freaks; society simply didn't match their ideals. The problem wasn't me-it was society.
Driving back to Los Angeles, I received a voicemail that Legal Aid needed me at The Dungeon for another three to six months. "I'm never stepping foot in that place again. I'll die if I do," I told my friends. Having glimpsed what life could be, I couldn't go back.
12장
The Courage to Face the Unknown
If I could ask one question of the Creator or whatever force knows all, I'd simply ask: Why? Why the heartache, depression, pain, insecurity, uncertainty, life itself, and death? The "why" of life becomes especially potent when facing death.
When I meet Leslie, a sixty-seven-year-old woman with terminal lung disease, she wastes no time with her first jarring question: "What does dying feel like?" I'm stunned-in all my years, no one has asked this so directly. I admit I don't know from personal experience. Undeterred, she crosses out the question in her notebook and asks what happens after death. Again, I explain I can't know for certain.
The five W questions we learn in school-who, what, when, where, why-fail us when applied to death. Everyone dies. Death is the cessation of bodily functions. When and where remain unknown until the moment arrives. And why we die has stumped religions and philosophers forever.
Death drives us into the discomfort of "I don't know," which explains why many cling to what they think they can control. Getting comfortable with this uncertainty has humbled me in my work. I can't take away clients' discomfort or provide certainty-I can only be present as they create their own answers while surrendering to the unknown.
This same principle applies to life itself. When we open ourselves to the discomfort of not knowing, we find where all the juice lies. Certainty makes us rigid and stagnant. Embracing uncertainty opens us to the magic of what may be-a place of boundless potential where anything is possible.
I think about my death almost daily-sometimes from near-misses, sometimes from witnessing others die, sometimes because my entire life leads to that mystifying moment. Though none of us knows what follows death, we can choose anticipation over dread, adding sensory richness to our vision of dying.
The myth of "having it all"-perfect career, abs, children, home, spouse, eyebrows-is just a myth. Humans are imperfect, and we all eventually weaken and die. Many reach life's end still ruminating on what they were "supposed" to do, making peace with this phantom guidebook only when it's too late. While living, we can create a life we feel comfortable dying from, untangling ourselves from others' expectations.
Life doesn't guarantee Hollywood endings with neat bows. It can be tangled, torturous, and surprising. All we know is that everything ends. Our death denial makes us behave like we'll live forever, but we don't have forever to create the life we want. So make the banana bread, scream into pillows, take naps, eat cake, forgive yourself, apologize to those you've hurt, tell your truth, tell people you love them. Do whatever you must to reconcile your life with your death-today.
