wishing to right what isn’t wrong

Three or more years ago, when I began to volunteer in palliative care, I found it most puzzling to be asked to attend to someone lying in bed, staring at the ceiling, breathing erratically, seemingly in another place, and showing no interest in my being there. What was I supposed to be doing? How could I be of service? What could I give to this patient? They didn’t seem to hear, see, or even notice my presence in the room. Might as well leave and find someone more open to my generous offering, I probably thought. And yet … I stayed and, over time, have learned about the importance of loving presence. 

Parker J. Palmer–Quaker, educator, and activist–speaks to this all-too-human desire to want to fix or certainly ameliorate another’s dilemma:

“‘When we sit sit with a dying person, we gain two critical insights into what it means to ‘be alone together.’ First, we realize that we must abandon the arrogance that often distorts our relationships–the arrogance of believing that we have the answer to the other person’s problems. When we sit with a dying person, we understand that what is before us is not a ‘problem to be solved’ but a mystery to be honored. As we find a way to stand respectfully on the edge of that mystery, we start to see that all our relationships would be deepened if we could play the fixer role less frequently.

“Second, when we sit with a dying person, we realize that we must overcome the fear that often distorts our relationships–the fear that causes us to turn away when the other reveals something too vexing, painful, or ugly to bear. Death may be all of this and more. And yet we hold the dying person in our gaze, our hearts, our prayers, knowing that it would be disrespectful to avert our eyes, that the only gift we have to offer in this moment is our undivided attention.”

source: Palmer, P.J. (2004). A hidden wholeness: the journey toward an undivided life. San Francisco: Jossey-Bass, p.61. 

the futility of grasping

Over and over, when sitting with someone near death, I notice how they hang on to ’what used to be.’ In one sense, looking back serves as a useful re-view of a life’s ups an downs, pleasures and pains, adventures and misadventures. Nothing wrong with that. What is troubling is that ’grasping’ keeps us from living what’s happening in real time, in this bed, at this bedside … now. Everything, including our own death, could come at any moment.

I am reminded of my own grasping and clinging: if only my Beloved would come back, I’d be truly happy; if only I didn’t have this nerve damage in my leg, I could run another half-marathon; if only I could still my mind, I wouldn’t be spending so much time fantasizing. And so on.

Ancient teachers remind us to practice dying every day, to let go of what’s gone, to realize the law of impermanence. So what the dying teach me is to let go now (and every moment) so that when the time comes for my body to give up, my mind will be clear and present. Seems a huge undertaking, and so it is. And the best time and place to begin is now.

“Grasping is the source of all our problems,” writes Sogyal Rinpoche, the Tibetan teacher, “Since impermanence to us spells anguish, we grasp on to things desperately; even though all things change. We are terrified of letting go, terrified, in fact, of living at all, since learning to live is learning to let go. And this is the tragedy and the irony of our struggle to hold on: Not only is it impossible, but it brings us the very pain we are seeking to avoid.”

source: Sogyal Rinpoche. (1995). Glimpse after glimpse: daily reflections on living and dying. HarperSanFrancisco, Feb.2. image: “Grasping” www.kinardist.com.

what the dying teach me

I have the privilege to observe how different people approach death. Many dwell in what used to be: pastimes, job, family, places of residence, the ups and downs of their lives. They also speak of hopes of going home, beating that tumour, seeing their grandchild graduate, and so on. Listening fills me with sadness because their charts indicate deteriorating health and death just around the corner.

 

Their stories remind me of my own habit of living in the past and future, replete with old mind-movies and various embellishments of my own fabrication. Gradually—and this takes effort and doesn’t always work—I am learning to catch my tripping into fantasy land. I am learning to see old stories for what they are … and to let them be. Not suppress or dismiss them and not giving them fresh energy.

 

What works for me is speaking to them directly: “Thank you for reminding me. Perhaps you have something to teach me. But you are from the past (or future), kept alive in my imagination. I prefer to open myself to whats right in front and ahead of me.” I don’t actually say all that but instead use short-hand whever I catch myself being absent. I say something like “thank you” or label what’s going on as “thinking,” “reminiscing,” or “fantasizing.” I then direct my attention to my breath. It helps when I place a hand just above the navel and silently note the natural rhythm of “rising … falling; rising … falling.” My attention—for a few moments at least—begins to rest in being alive: each out-breath an ending, each in-breath a beginning. Zen master Dogen Zenji (1200-1253) put it this way: 

“This life of one day is a life to rejoice in. Because of this, even through you live for just one day, if you can be awakened to the truth, that one day is vastly superior to an eternal life. … If this one day in the lifetime of a hundred years is lost, will you ever get your hands on it again?”

ending one journey

A busy day at the hospice; several patients with death “imminent.” Sat with one who kept wanting to climb out of bed, moaning aloud, seemingly unresponsive to my voice or touch. While assisting his nurse, I heard myself half-humming, half-singing “Silent Night,” imagining it a familiar soothing sound, repeating the same lines over and over, the only ones I could recall. Slowly sinking back into his pillows, his fixed grimace relaxed and wide-open eyes slowly shifted from stunned stare to watery gaze behind flickering lids.

As I stroked his hair and held his outstretched hand in mine, I spoke the names of his wife, daughter, and son and told him that he was loved … that it was OK to just be. Not sure he comprehended the details, but I believe that my tone and intentions served to reassure and calm him. Touched by this simple exchange, I felt love … for him, the nurse, his family. I too felt loved.

Drawing on the Tibetan tradition of preparing for death, Judith Lief writes:

“At the time of death, we are just at the very beginning of the journey that starts when this life is over and ends when our next life has begun. During the period when one body finishes and another body is not yet in the works, we are without our usual physical support system. The journey is disembodied, a mental-emotional journey very much like the journeys we take in our dreams.

“The person going through this particular journey is no longer dependent on the physical body and its parts–the heart, brain, feet, eyes, and ears. In this journey, hearing does not depend on having ears, seeing does not depend on having eyes, thinking and feeling do not depend on having functioning physical organs.

… “The moment of death is a profound experience of dissolution. It comes at the point when the elements holding our current existence together have dissolved and gone their separate ways. We have literally come apart.”

source: Lief, J.L. (2001. Making friends with death: a Buddhist guide to encountering mortality. Boston: Shambala, pp.24-25. see also: Sogyal Rinpoche. (2002). The Tibetan book of living and dying. Boston: Shambala.

God’s job

On Monday (see boundaries) I prayed with a hospice patient and his wife. I certainly didn’t enter their room to pray, nor is it my practice to pray. But pray I/we did and it was welcomed. Now I want to learn about the nature and purpose of prayer across faith practices. When asked about the power of prayer, Rabbi Harold Kushner explained:

The essence of prayer, as I understand it, is the cure for feeling alone. Martin Buber once said, “Jews don’t pray to God for anything. Jews pray to God for God.” For example, when I pray with a person who is in hospital, I explain that we’re not just praying for a miracle cure or good outcome to surgery. We are praying to for the presence of God. I don’t want patients to feel abandoned. I don’t want them to feel they are sick because God isn’t taking care of them. I don’t want them to think God has written them off.

I want patients to know that God is sending doctors, nurses, and researchers to help them with their illness. God is sending friends to sit with them and pray with them. I don’t want them ever to feel alone. To me, presence is the essence of prayer. That is what I have in mind when I pray.

I don’t pray for specifics. I don’t pray to win the lottery and I don’t pray for the good fortune or good health. I simply and openly pray for the presence of God because I am a different person when I feel I am in the presence of God. I behave differently. I stand straighter. I am more circumspect. I am braver. That’s all I ask for in prayer. [...]

Honestly, God’s job is not to make sick people healthy. That is the doctor’s job. God’s job is to make sick people brave.

Harold S. Kushner has served his congregation for 30 years and is now Rabbi Laureate of Temple Israel in Natick, NJ. His best-known book is When bad things happen to good people (2002).

source: Sacred Journeys: a journal of fellowship in prayer, April/May 2008, p.3-14.

boundaries

Spent a while in room 724 yesterday. Lying in bed and facing the ceiling is Bert*, with his eyes half-shut, skin clinging to jaw and skull, mouth open with lower teeth missing, breathing irregularly. Except for chest and head, his body is barely noticeable below the blanket, little more than a shadow.

 

Sibyl* stands in the middle of the room, looking lost, distraught. We connect quickly as she tells me of their life together, the worsening of his condition, bringing Bert to hospice “because I can not longer lift him;” thirty years caring for a disabled child; being at wit’s end. “I hope he’ll die soon, this is not quality of life,” and a little later “maybe I have another ten years to live; I’d like to go on a cruise before I die.”

 

As I listen, she weeps; we both do. Silly tissue papers all bunched up, too small to absorb the tears. She speaks of guilt, naturally: how could I wish him to die … but … it would be best for him. Am I being selfish? she wonders. Taking care of yourself is healthy and right, I offer.

 

We move to Bert’s bed, I touch his feet through the covers. “God willing, he won’t suffer much longer,” Sybil whispers. Instinctively, I take the cue and offer a prayer: “Dear God, keep an eye on Bert, make his pain go away and call him home. Please bless Sibyl and give her strength as she cares for him.” To which she adds, “and Peter as well.” Unaccustomed to praying, I listen as the words flow through me, tokens of comfort and reassurance. We remain standing a while longer, looking at her dying husband. “I feel a little better now, thank you!” says Sybil, “rich or poor, old or young, we’re all together.”  

 

Leaving the room my feet barely touch the ground, my heart overflows with joy. Turning down the hall way, the first person I meet receives my embrace. No boundaries. 

 

One of the classics in Mahayana Buddhism, The Way of the Bodhisattva, is a personal meditation in verse written in the 8th century by the Indian scholar Shantideva. At one point he says:   

All the joy the world contains,

Has come through wishing happiness for others.  

and a few lines later   

To free myself from harm

And others from their sufferings,

Let me give myself away,

And cherish others as I love myself. 

* names are fictitious; source: Shantideva. (Padmakara Translation Group). (1997). The way of the Bodhisattva. Boston: Shambala, 8-129, 132.

practicing humility

One of the people who interviewed me for the job (see footnote to yesterday’s post) said that she’d been impressed by my humour and humility. Here’s what my mind made of that: on the ego level it said, Thanks for the compliment. I’m glad you liked what you saw; for seeing something in me to recommend that I’d be hired. On the spiritual level it said, Yes, that’s how I’d like to be perceived (some day). I’m surprised and grateful that those qualities are apparent to strangers (albeit a sophisticated one in this instance).

Humility is a virtue that can be difficult to describe because of its paradoxical nature: claiming authority about humility and claiming that one is humble each suggest a lack of humility. Google reveals that humility is seen as an essential virtue in many faith traditions:

 

·  According to Chinese Zen master Li Yuansong, enlightenment can come only after humility, the wisdom of realizing one’s own ignorance, insignificance and lowliness, without which one cannot see the truth.

·  Guru Granth Sahib, the great book of Sikhism (p. 152), holds that “modesty, humility and intuitive understanding are my mother-in-law and father-in-law.” See also my post of March 28.

·  Bernard of Clairvaux (1099-1143) defines humility as “a virtue by which a man knows himself as he truly is.”

·  The Bible depicts humility as making us fit recipients of grace: “God opposes the proud but gives grace to the humble” (James 4:6).

·  Moses’ greatest virtue was humility (Num. xii. 3). At first he resists the mission to free his people because he mistrusts his ability. But once he accepts it, he does so with courage and energy.

 

As with Moses, so it is with me. Awed by the complexity of hospice work, I rise to the challenge without fear. It feels right for me to be here … to humbly serve all who entrust us with the last moments of their lives.

 

sources: BibleGateway.com; www.jewishencyclopedia.com; www.newadvent.org;

image: members/fortunecity.com.

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listening as worship

Walking down the hallway this morning, I caught a glimpse of someone lying in bed reading the paper. The room looked dim, blinds lowered almost to the windowsill. I took a few more steps and, without further thinking, turned around, knocked and entered. The patient, call him Mr. Grant, lowered the paper and with a smile of surprise coached me to raise the blinds just do. What made you stop by? he wanted to know, oxygen mask askew, bright eyes piercing out from under bushy white brows. It looked a bit dark for reading, I explained.

Seemingly without segue, he spoke of three sons who are looking after him, cutting the grass at the house while he’s away, one fixing the shower, the other arranging for daily visits from a home care worker to make his breakfast and peel a few spuds for supper. And how he’d tavelled to Hawaii with his wife of 52 years and how doctors had told her to get back home because she had skin cancer. And how his hearing aid stopped working and had been sent for repairs and how his hearing was gone in one and below 40% in the other ear. And why had I stopped by? And would I come and visit him at home, ring the bell (best come around the back), seven blocks from the shopping centre, in a house bought back in ‘62 for less than three thousand, and guess show much it’s worth today!

Where’s this going, asked a tiny voice in my head; not important, said the other: just listen. This man is telling you a story. It matters little whether you understand the details. Listen to the sound, the music, the emphasis in his telling. “True listening brings us in touch even with that which is unsaid and unsayable,” writes John O’Donohue.

Close to dying, his wife long gone, sons nearby or imagined, hearing shot, breathing a pain. What was important at that moment? Martin Heidegger says that true listening is worship. Here was Mr. Grant (pro)claiming fragments of his life and I was his witness. Nothing else mattered.

Today was the third day in the new role as interim Coordinator of Spiritual Care at Victoria Hospice. 

stephen & ondrea could use our help

You may have heard that Stephen and Ondrea Levine are facing significant financial difficulty. Ondrea has Leukemia and the costs of her insurance and treatment have depleted their savings. Stephen’s health is not the best and he is too frail to travel or teach. Good friends have set up a fund to assist them, and a number of us are reaching out to our communities to ask for support.

Stephen & Ondrea’s generosity seems boundless. For three years, they ran a 24-hour-a-day, seven-day-a-week free phone line for those dying or in need of support. They sat bedside with hundreds of people with AIDS, cancer and other illnesses. Over the past 30 years their teaching and books have brought solace and support to thousands. They inspired many of us in the hospice movement to care for the spirit as well as the body. They showed us a way to embrace another person’s suffering as our own. Now is our opportunity to offer our prayers and financial assistance.

Some Levine book titles you may recognize: (1982) Who dies? An investigation of conscious living and conscious dying; (1987) Healing into life and death; (1991) Guided meditations, explorations, and healings;  (1997) A year to live: how to live this year as if it were your last.

Ways to help: Please forward a link to this page to those in your hospice, healthcare institution, community or spiritual organizations. You are welcome to include this information in blogs and newsletters that might reach those who wish to be of support.

To donate on-line: click Levine Fund at Bread for the Journey. Bread for the Journey has generously offered to manage the fund with 100% of your donation going to the Levine Fund.  Or phone: (415) 383-4600 with a credit card number.