Friday, July 03, 2020

From the Palliative/Spiritual Care Bookshelf

This evening I continue my series that draws from the insights contained in the many books on palliative and/or spiritual care that I have on my shelf at work. My work, since September 2018, is that of a palliative care interfaith chaplain at a hospital just north of the Twin Cities.

In this second installment I share an excerpt from Being with Dying: Cultivating Compassion and Fearlessness in the Presence of Death by Joan Halifax. (For the first installment in this series, click here.)

Sometimes all a loved one dying a difficult death needs is permission to leave, and the knowledge that they have been loved. Prayers, practices of devotion, and blessings from teachers, relatives, and friends can be helpful in transforming the atmosphere [for this giving and receiving to occur]. One friend’s father struggled in active dying until she told him, “Death is safe; death is safe,” quoting conscious pioneer Ram Dass. Her father clung to the phrase like a lifeline and repeated it until his last breath, using it as a raft to carry him to the other shore.

Another caregiver used the Lord’s Prayer as her raft, during the night-long vigil she kept by the bedside of her mother. I myself have floated on the Heart Sutra, chanting it softly under my breath. And how often have we heard family members encourage their dying relative, “Move toward the light,” “It is all right to die,” “We are here with you,” “You are loved and can let go,” or even, simply, “Thank you for all you have done for us.” In my father’s final hours, I could only thank him repeatedly for all he had done for me and for so many. Simple gratitude can hold our hands tightly in the very darkest moments, if we can manage to stay upright in the storm.

To illustrate surrender in dying, Henri Nouwen used the story of a trapeze artist who told a secret: that the important person to watch is the one who catches the other, not the one who jumps from the trapeze into the arms of the catcher. “The catcher,” said Nouwen, “is the real star. . . . [T]he flyer does nothing and the catcher does everything. . . . The flyer must trust, with outstretched arms, and his catcher will be there for him.” I think also of Christ’s dying words, in the Gospel of Luke: “Father, into your hands I commend my spirit.” Prayers and good words can carry us across, but there is a moment when we must leap, trusting the other side will catch and hold us safely.

We need to learn to stay with suffering without trying to change it or fix it. Only when we are able to be present for our own suffering are we able to be present for the suffering of others, and the difficulties they may encounter in dying. The practice of insight meditation, in which we watch the ebb and flow of mental activity, is a good way to cultivate this ability. With gentle precision and honesty, we stay with our experience through foul weather and clear skies. Seeing the mental weather go through its changes gives us some sense of the nature and cause of our suffering and also of the possibility that, at the very ground of our being, we are all free from suffering.

. . . When we cultivate our ability to be present, we train our hearts to open to suffering, transforming it into well-being and offering our own natural mercy. We’re asked to invite suffering into our being and let it break open the armor of our heart. The tender spaciousness that arises awakens selfless warmth and compassion. We cannot help but send our love and kindness to the one who is suffering, be it others or ourselves.

It is both true that suffering exists, and that some deaths are challenging – and it is also true that beings can be free of suffering and that death can be natural and simple. When I sit with a dying person, I must perceive both of these dimensions together. I must look from a place in myself that includes suffering but that is bigger than suffering. I must look from a heart that is so big that it is open to everything, including freedom from suffering. Can I see her struggling to die and her great heart as well? Can I see his true nature, who he really is, deeper than the story?

I sat once with a woman who felt completely defeated by her critical dying mother. From her mother’s point of view, she could do nothing right. The heaviness of failure shrank her body until it seemed small and defended. I shared with her how much effort it took to let go of my own expectations. This woman wanted her mother’s death to be “good” and her work to be easy. But in the end, her practice was to let go, again and again, of her expectations, her desire to flee, and her sense of despair. This required diligence, perseverance, and a pretty good sense of humor. But before she could start to let go of her own suffering, she also had to accept that it was completely real.

Ultimately, to help others, we must relate with kindness toward our own rage, helplessness, and frustration, our doubt, bitterness, and fear. We must get in touch with the obstacles that prevent us from understanding and caring. Through accepting our own suffering, we can begin to be with others in a more open, kind, and understanding way. We learn not to reject difficult situations or people. Rather, we meet them exactly where they are.

This is the basis for our work with the dying. We cannot prevent death from happening, or make it easier for the dying one to accept it. We can learn to meet it and find mercy in it. Cultivate the detail and craft of this practice. It can be done on every breath that you take, every breath that you give. Our own difficult personal experiences become the bridge leading us to compassion and to giving no fear when the ones we love are struggling with difficult deaths. This is what the old teachers mean by their saying “riding the waves of birth and death.”


See also the previous Wild Reed posts:
From the Palliative/Spiritual Care Bookshelf (Part I)
Chaplaincy: A Ministry of Welcome
Interfaith Chaplaincy: Meeting People Where They're At
Spirituality and the Healthcare Setting
World Hospice and Palliative Care Day
Resilience and Hope
The Calm Before the Storm
George Yancy on the “Unspoken Reality of Death”
Arthur Kleinman on the “Soul of Care”

Related Off-site Links:
In Pandemic, Health Care Chaplains Address an “Existential and Spiritual Crisis” – Alejandra Molina (Religion News Service, March 20, 2020).
Hospital Chaplains Bring Hope and Solace to COVID-19 Patients and Staff – Lulu Garcia-Navarro (NPR News, March 29, 2020).
It's Time to Get Serious About End-of-Life Care for High-Risk Coronavirus Patients – Jessica Gold and Shoshana Ungerleider (TIME, March 30, 2020).
Learning to Cope With the Pandemic From Palliative Care Patients – Rob A. Ruff (, May 8, 2020).
Our Crash Course in Being Mortal – Ira Byock (Goop, May 2020).

Images: Michael J. Bayly.

No comments: