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Category Archives: dying

ask a simple question

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I went to a residential training program a while ago. When I first spied the quantity of chairs in our class room (150, in fact) I began to fret: how can we have meaningful exchanges in such large a crowd. Little did I know.

During our first assembly the teacher asked us to reflect on what had brought us: “Why are you here?” He then passed around four microphones and invited comments. After a few responses he changed the question to “Why are you really here?”

Unsure of what to say, I nevertheless reached for a passing mic. The reason I’m here is to learn new skills, to be able to offer this training to … halfway through my earnest declaration, the teacher expanded the question once more: “Why are you really really here?”

After five years in end-of-life care I want to shift to being alive. Directly from my heart, bypassing reason and expectations, the voice of truth. In an instant, I felt as if the burden of and self-imposed penance for ‘being with dying’ had been lifted — replaced by fresh air to fill my longues.

“Always the beautiful answer who asks a more beautiful question,” writes e. e. cummings.

What would you say if asked, “What do you want to do? … and then … “What do you really really want to do with your life?”


the courage to grieve [no more]

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There’s one row on my bookshelf that I haven’t touched for some time. It sits prominently at eye level, affording easy access to any one of 60-or-so titles. Time has come to move them all a little lower. My interest has shifted.

“Grief is preoccupying and depleting,” writes Judy Tatelbaum,

Emotionally, grief is a mixture of raw feelings such as sorrow, anguish, anger, regret, longing, fear, and deprivation. Grief may be experienced physically as exhaustion, emptiness, tension, sleeplessness, or loss of appetite.

Grief sat at the top of my existence for several years, intense and multifaceted, affecting my emotions, my body, my entire life. It does so no more! Its place has been taken by quiet joy as I awake each morning.

Grief is the wound that needs attention in order to heal. … It takes courage to grieve. It takes courage to feel our pain and to face the unfamiliar. It also takes courage to grieve in a society that mistakenly values restraint, where we risk the rejection of others by being open or different.

I didn’t feel all that courageous when I sat out to grieve. Six or seven years ago, I was drawn to volunteer in the palliative care at a small hospital. A tumultuous love affair ripped open a life-time of unhealed wounds. Travelling back and forth to San Francisco I trained in end-of-life care and wept through most of the classes.

Teaching a workshop on “mindfulness at the bedside” led to paid hospice work. Dying, death, loss, anguish, and tears became my daily sustenance. After work I’d come home exhausted, collapsing into restoring sleep. Back the next day, I’d relish the ever-present pain — the comfort of being with people who thought grief was normal. We’d weep together, laugh, hug, and carry on. I thought I’d come to the top of my hill, that it didn’t get any better. Eighteen months later, that job ended. Shoved out the door, abandoned once more. A pain-filled year ensued, what HM The Queen would call an annus horibilis: selling home after 21 years, giving away books and furniture, bicycle-meets-Volvo accident with soft-tissue trauma, broken bones, neuropathic pain, walking stick, pain meds, more tears, touching bottom.

All that’s come and gone. The heart grows stronger and love returns. Love for self, for another, for this morning of pale spring sunshine. The plum-tree is in bloom, the neighbour’s pugs are barking at a truck a thousand times their size, and it’s time to go for breakfast.

source: Tatelbaum, J. (1980). The courage to grieve. New York: Harper & Row, pp. 7-8

practicing with everyday distress

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Zen teacher Hogen Bays — along with Chozen Bays — has been my spiritual guide and co-abott of Great Vow Zen Monastery for ten years. He writes: 

“There is so much in the news that reminds me of the first noble observation of Buddhism: that there are problems, serious problems everywhere. From the giant catastrophes such as the earthquake in Japan, the violence in Libya and the 450,000 people displaced by civil war in the Ivory Coast to one family’s struggles with illness and joblessness. Everywhere we turn we are reminded that no one is safe from difficulty and distress. It is almost impossible not to become anxious when we look honestly at the possible disruptions and challenges that we are facing and may have to face. What hope do we have? How can we live? What can we rely upon?

One thing is certain, that when confronted with life’s very real challenges, knowing theories about timeless wisdom is no help. When we are laying in bed at night and overwhelming anxiety wells up in our hearts, knowing how we ‘should’ respond does not help. When we are hungry even world class photos of food are not filling. Rocked by trauma, how we are ‘supposed’ to feel, what we ‘should’ understand, what we ‘think’ we know, is of little support. A real catastrophe washes away all our hopes, dreams, shoulds and oughts.

For me, this is when spiritual practice becomes extremely compelling. Usually, our spiritual and psychological lives revolve around how to be more happy, effective or successful. But when we know death is coming (and a lot sooner than we hoped) there are more urgent questions: “What is it that is alive right here?” “Where can I turn for help?” “What is real right now?” “Who is the one who is suffering?” “What is the truth that is always present?” When we are compelled to ask these questions no one else’s answers are of any use. What we have read, believe or been told will not do!  We must know for ourselves!

Of course, writing about this matter requires words and so it seems that these questions are intellectual and require thinking. These questions are like the finger pointing at the moon. The words only direct our attention to what is more intimate than words. What is more intimate than words is our direct experience. It is not a particular experience. We naturally meet crises with an intense aliveness, a compelling demand from deep inside us to look at what is real. It may present as anxiety, or numbness, anger, deep depression, or curiosity, but whatever our experience our attention is caught. It is our deepest life saying, “pay attention!”

This is what we can always take refuge in – the compelling experience of being alive. This experience is the essence of all seeing, hearing and feeling. It permeates all body, emotions and thought. In fact everything that comes forward whether we regard it as magnificent or dreadful comes from the same source. No matter what comes towards us or from within us, this is our ultimate refuge.

This attention to the source of life is a refuge available at all times, in every place. But we must practice and recognize it. Initially we have to learn to turn our attention away from our thoughts and conceptual mind. We let the churning of our minds still, like allowing the mud to settle so we can see the water. But, then we turn our awareness to seeing both mud and water, to seeing thought and the space in which it is held. We experience life and creation, death and destruction and the space in which they are held. We see ourselves respond completely to each changing condition. And whether our responses are skillful or unskillful they are all held in the dreamlike nature of our own life. This is the essence of practice. This is refuge.”


end-of-live care training

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As a 2006 graduate of the year-long Metta Institute program, I encourage you to attend the six-day Cultivating Presence Retreat, August 12-17 in San Rafael CA. 

Under the leadership of Frank Ostaseski and Ange Stephens, MA, MFT, the faculty comprises Angeles Arrien, PhD; Zoketsu Norman Fischer, Charles Garfield, PhD, Frances Vaughan, PhD, Ram Dass (via teleconferencing), and Guest Teachers. They’re competent, compassionate, and dedicated to experiential learning.

The program blends contemplative practices with pragmatic tools to offer a unique training experience. Metta Institute has an integrated approach to the emotional, psychological and spiritual dimensions of the dying experience that goes well beyond conventional medical models.

Great teachers, good food, restful environment and 50 CEUs for healthcare providers. Please give it your careful consideration. The attached poster has the details.


everything’s guaranteed (to die)

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Someone’s father died recently and another’s dear friend ended her life unexpectedly. Talking with them both reminded me of my own experiences with loss. With a simple flip of the coin, life becomes death. The moment we enter the world the clock starts counting down the hours until we die. It’s a fact.

We celebrate the cyclical comings and goings all around us — first day of spring, midsummer, and autumn; first day of school, mid-term, graduation; birthdays, weddings, and retirement parties. Each marks a milestone along the path from birth to death. We celebrate the “happy” events, but avoid the “sad” ones. We don’t much talk about the latter and so they come as a shock, leaving us to cope alone as others awkwardly step aside, lest they be infected.

“The cup’s already broken” goes that old Zen saying. Everything we know and cherish comes with a built-in guarantee of impermanence. Nothing lasts. Why then are we, educated and intelligent beings that we are, so surprised when death comes knocking?


“for death”

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A friend writes that “I too am completely overwhelmed by the devastation in Japan. My middle son lives there and thankfully he and his girlfriend are safe. My heart aches for all those poor unfortunates.” Several zen-related blogs report on Japanese friends and teachers, all well amid the horror.

News from Japan numbs my comprehension of Nature’s relentless power and man’s loss of control over atomic powers. Opening my heart to all who suffer, I copy these words by the late John O’Donohue:

From the moment you were born,
Your death has walked beside you.
Though it seldom shows its face,
You still feel its empty touch
When fear invades your life,
Or what you love is lost
Or inner damage is incurred.

That you would gather yourself
And decide carefully
How you now can live
The live you would love
To look back on
From your deathbed.

How can we, from a place of relative safety, express gratitude and love to others. How might I reach out to someone in need and share the abundance of my being? May the horror of others’ loss be a reminder to live each moment in full awareness and appreciation. May I turn to others with kindness. May I give thanks for all that is given and taken. May all beings be free from fear.

image: REUTERS/Lee Jae-Won. text: Excerpt from “for death” in: O’Donohue, J. (2008). To bless the space between us. New York: Doubleday, p. 72.


stunned by tsunami

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I was a day late in hearing about the disaster in Japan; that’s what you get for shunning TV and newspaper headlines. Now I’m in shock. What do you say or do in the face of such a catastrophy? Nothing, really — but turn inward, be silent, feel helpless … and notice your compassionate heart open towards far-way strangers. 

Looking out the window I imagine, for a quick moment, what it might be like if mud were to fill our little street, cars fly through the air, the house tip sideways and crack open, precious stuff disappear, and connections be disrupted to friends and neighbours. What would be left? What is there for you and me, when everything’s stripped away, when uncertainty descends, when our awareness is propelled towards the brink of unknowing?

It is indeed like that–
and I have never noticed
dew on grass.

image: REUTERS. Smoke rises in the distance behind destroyed houses in Kesennuma City in Miyagi Prefecture in northeastern Japan. text: poem by Kangyo in: Hoffmann, Y. (1998). (ed). Japanese death poems written by Zen monks and haiku poets on the verge of death. Tokyo/Vermont: Tuttle, p. 213.