An Ordinary Dying

This topic seemed a natural segue from last week’s newsletter This Could Be My Last Breath.

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We’re sitting on our comfy couch—two sets of feet perched on the multi-colored ottoman, a snoring pooch sprawled next to my wife. We’re watching the eighth and final episode of the HULU series Dying For Sex.

Sally turns to me. “I don’t think I’ve ever seen this on TV before.”

The “this” Sally referred to wasn’t the sex—though there was lots of it and definitely some “haven’t seen that on TV before” moments. She was talking about the dying—specifically the dying process, described.

Dying For Sex is loosely based on a real person and a real story, originally introduced to the world as a podcast of the same name.

Molly, a forty-something woman—a survivor of an mis/late-diagnosed breast cancer a decade before—learns the cancer has metastasized to her bones, brain and liver. There’s no cure or remission in her future—but there are treatments to attempt to manage symptoms and give her as much time.

With the support of her best friend Nikki and palliative care specialist Sonya, Molly embarks on a sexual exploration with the goal of experiencing an orgasm with another person. Ultimately, she seeks to answer the question: what turns her on? It’s an exploration shaped, in part, by Molly’s physical symptoms, childhood sexual abuse and the passage of time.

I found the series laugh-out-loud funny, sad, eye-opening, sexy, harrowing, beautiful, uncomfortable and enlarging. I think about it a lot, particularly the powerful and deep acting performances.

The scene Sally referred to—“I don’t think I’ve ever seen this on TV before.” It’s when Amy the hospice nurse (played by the great Paula Pell) asks “who would like to hear about what happens when you’re dying?

Getting the go ahead from Molly, Amy describes with a kind of holy amazement what Molly’s last four to six weeks would likely be like.

[The transcript that follows is my effort. So, not official and under 100% accurate.]

Amy the Hospice Nurse: So as you’re filling out those forms, who would like to hear about what happens when you are dying?

Molly raises hand.

That’s good enough for me.

Death is not a mystery. It is not a medical disaster. It is a bodily process. Like giving birth or like going to the bathroom or coughing. (Whispering) Having an orgasm. Cause your body knows what to do. Your body knows how to die. How cool is that?

Ok. Here’s what to expect.

In the last month of your life you’re gonna to stop getting out of bed.

You’re gonna to eat and drink a lot less and you’re gonna to sleep a lot more.

Now, delirium is very common, and some people say they get this feeling like time stops being real.

Is that something that you’ve been feeling?

Molly: Yes!

Yes. OK. Two to three weeks out you’re gonna need help with all daily activities.

But my favorite part of the dying process—

Nikki: Amy!

Amy: I know, I’ve been talked to about my enthusiasm.
I should dial it back, sorry.

Nikki: It doesn’t work for me right now.

Amy: Should I keep going?

Molly: Yeah, but would you hold my hand?

Your body knows what’s coming and it goes into a state of ketosis which decreases hunger and pain. And it increases the sense of euphoria.

And when you start active dying …

Molly: What’s active dying?

Oh, active dying is a sacred time. At least it use to be, and still is in some parts of the world.

It’s the moment when you’re very close to death and your body starts shutting down.

….

In active dying, you won’t be fully conscious. And your jaw muscles will relax. Your breathing changes. And there might be a gurgling in the back of your throat caused by something, unfortunately, called “terminal secretions.”

[laughter]

I know.

And when you are very close to death, your breathing goes into a cycle of deep, slow breaths and long pauses. And then eventually there is a breath out that is not followed by a breath in.

And that’s it.

… …

And at a certain time if you’re just feeling too weak or, you know, too much pain or you’re just done, you can talk to me about sedating you but then you’ll be unconscious.

… …

(Excitedly) Wait, I forgot to tell you about the rally.

The last week of life, some people experience what’s called the rally. And it’s this just surge of energy and mental clarify. So, enjoy the rally.

Just know that you’re another step closer to death, okay?

Molly: I fucking love your vibe, Amy. You’re nuts, man!

Dying for Sex, Episode 8, “It’s Not That Serious”
Writing credit: Kim Rosenstock

In its first week, Dying for Sex made the top ten most streamed shows in the US. That’s a lot of Americans watching the final episode and, possibly, learning—with such specificity—about ordinary human dying.

Dying for Sex is, of course, a fiction.

Though Amy’s monologue is accurate,¹ I’m not sure any hospital or hospice room is actually that large. There’s a scene when Nikki is on hold with an insurance company on Molly’s behalf, but anyone who has been that person knows the calls and follow-ups are legion. They just don’t make for interesting television.

One hundred years ago, most people would have experienced someone dying in the home. Medical and pharmaceutical progress (vaccines! huzzah!) have extended many lives. And the medicalization of death means that many—most?—Americans haven’t experienced ordinary dying. We are, understandably, often afraid of what we don’t know.

Merrimack River. Concord, New Hampshire. Last night, May 14, 2025

If you’ve read Marking What Matters’ origin story, you know that part of my life’s—and this newsletter’s—exploration is about sidling up next to dying and death. It’s a path born out of my young, large, inchoate fears about my mother’s illness and possible death. Things that are unwieldy and not-understandable to a young person can, in adulthood, be looked at it and turned over, explored and integrated. That’s the theory!

So I’m interested in what ordinary dying looks like.

I think there’s value in gaining that “lost wisdom”, as Kathryn Mannix, MD calls it, for ourselves and for the people we love.

If we understand what a person’s dying might look like—sound like—perhaps we’ll have less fear.
Perhaps we’ll increase the odds of being more emotionally present and responsive to the moment.
Perhaps our presence at the bedside of dying person will help others find their way to something similar.

Amy’s monologue in the last Dying for Sex episode reminded me of Kathryn Mannix’s 2022 Tedx talk—so I’m sharing it here.

I found her words and her telling both illuminating, comforting and deeply human. My hope is that it offers something similar to you.

The video is about 15 minutes long. If you prefer to read her words, there’s a transcript available on the website. Click on the “Read Transcript” box just below the video’s lower right corner.

As always, please continue the conversation in the comment section below.

If you saw Dying for Sex, how did you experience it? Is there anything about Kathryn Mannix’s talk that spoke to you or surprised you? If you’ve been a witness to a person’s dying—whether as a family, friend or in your work—how do these two descriptions relate to your experiences? And, of course, please offer whatever you want to share from your own experience.

Thanks for reading—I appreciate it.

Until next week,

Rachel

1. Additionally, in the last days of life, along with delirium, agitation is also possible. This could be a restlessness or a twitchiness.