Part VII

I am writing a series of essays on the difficult scientific questions from the Hebrew Scriptures Book of Job to assess how much we have learned over the past 5,000 years.

Job lived somewhere east of the Euphrates River about 3000 BC, or maybe even before the Great Deluge, 25,000 years ago. He posed a series of very difficult questions, at least for the time, but my main point is that many are still difficult.

Question: Do you know the way to death or its gates? Do you know its doors? Job 38:17

The technical answer is “No” and remains so. It’s interesting that Job did not answer with the Sumerian myths he surely knew.

Since World War II medical science and technology have made enormous strides, worldwide, with positive impact on general health. Several of my previous Morning News/ columns have touched on these issues: Aging, June 31, 2018; aspirin impact, Sept. 16, 2014 and general health care, July 10, 2013. The average American life expectancy has risen from 68 years in 1950 to 76 years today. Better cancer survival has been significant: since 1991 cancer mortality in the U.S. has fallen 27% with lung cancer falling 48%, breast cancer falling 41%, prostate cancer falling 51% and childhood cancers falling 47%. Many childhood cancers are now considered curable. Heart disease remains the most common cause of American deaths, but cardiac death rates have been declining about 2% per year for 20 years (this is about a 30% decline.) In 2016 the leading causes of death in the U.S. were heart disease, cancer, injury, respiratory, stroke, Alzheimer’s, diabetes, flu, kidney disease and suicide. Above data from the American Cancer Society, the American Heart Association and U.S. Bureau of Statistics.

End-of-life care has become a major American social, economic and political issue as heath care technology advances. The U.S. Center for Medicare and Medicaid Services (CMS, an agency of the U.S. Department of Health and Humans services) estimates that Medicare spends from 15% to 21% of its yearly budget on the 5% of beneficiaries who die within the year, and much of it is spent in the last three months of life. Mathematical modeling has not sharpened the data or made allocation any easier. Currently (2019) Medicare has a yearly budget of just over $700 billion covering about 60 million people. By the way, the average cost of a U.S. funeral in 2019 was $10,000; cremation may be cheaper, but usually not (50% of funerals are now cremations and growing). The U.S. funeral industry generated about $17 billion of revenue in 2019; there are about 19,000 funeral homes in the U.S. with 11,000 owned by what are called “large companies.”

Modern technology has been able to restore life to individuals who might have otherwise died, particularly after heart attacks and cold-water drownings. Some of these individuals recover remarkable mental acuity and some have been interviewed. Of course, there is no way to know if they have accurate memory of the “near death” experience or not. But many have reported either an “out of body experience” in which they are looking down on their bodies and the medical team at work on them, or they perceive a shaft of “white light” sometimes with a door as the light source; Hollywood and novelists have written about these experiences. Most likely, if not imagined, these experiences represent normal electrochemical effects of the temporary pause of brain blood flow.Getting back to Job’s question, there must in fact be some sort of road and gates to death. Ancient cultures before and after Job all assumed such to be the case. In fact, the idea of a river flowing to death or Hades goes way back in history. The ancient Sumerians (about 25,000 B.C.), Egyptians (about 3000 BC) and the Greeks (about 1600 B.C.) all believed such. These myths all had the idea of a river, lake or ocean as the path to death (or the underworld or Hades) with boat transport and a boatman: Sumer — River of Mother Hubur, boatman is Enki; Egypt — River Nile, boatman is Mahuf; Greece — River Styx, boatman is Charon; it is curious that in each myth the boatman needed some sort of payment. Sumer’s goddess Ishitar is supposed to have explored the pathway to Hades as later also did Gilgamesh. Not unexpectedly, Hinduism, probably the world’s oldest religion, now predominately thought to be from India, but probably originating long before the Great Deluge, is vague about death and an afterlife, preferring to believe in the possibility of human improvement over time or through reincarnation.

The Hebrew and Greek biblical Scriptures occasionally refer to the ancient stories of a pathway to Hades (Sheol or Gehanna) as historical misconceptions or in a poetic context. Most biblical references to the underworld, Hades, Heaven and the Lake of Fire, aside from the Hebrew Book of the Psalms, are in what the Greeks call the Biblical New Testament. In one New Testament parable, Hades is described to have some sort of division between the inhabitants. The Roman Catholic Church developed the idea of purgatory (akin to Hades) starting in about 1100 A.D., formalizing Purgatory in 1274 A.D. during the Second Council of Lyon. Durante di Alighieri degli Alighieri (Dante) started to write “The Divine Comedy” in 1300 (an epic poem written in three parts: Inferno, Purgatorio and Paradiso) that popularized a description of Hell, Purgatory and Paradise. It is not commonly appreciated that Dante’s epic work also contained some humor; he relegated Church officials, including some popes, he either did not like, or he thought were corrupt, to the lowest levels of Purgatory and Hell. One of the Protestant Reformation’s main causes was Martin Luther’s reaction against the commercial sale of indulgences (1517) to ease Purgatory, as marketed by Cardinal Johann Tetzel. The Protestants for the most part believe in salvation and an eventual heaven, achieved by the acceptance of the gift of grace and faith in the resurrected Jesus; in the modern era the Catholic Church, both West and East, have begun to move away from purgatory and slowly toward the Protestant position.

We do know death faces us all.

Dr. Stephen Imbeau and his wife, Shirley, moved to Florence on March 1, 1980. Arriving from Wisconsin, they were most surprised the next morning to see six inches of snow on the ground. Their three children were born and raised in Florence. Dr. Imbeau with Dr. Joseph Moyer opened the Allergy Asthma and Sinus Center in 1996, now one of the largest Allergy practices in South Carolina. You can reach him at

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