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heartmind, borrowed from Japanese kokoro, our buddha nature.
death among mammals
Three-month-old baby elephant “Lola” died a few days ago from a massive blood clot at the Munich Zoo. Returning from the veterinary hospital, her body was placed in the familiar enclosure so that her mother “Panang” and relatives could investigate. First the mother and then each member of the herd scanned the body with their trunks, sniffing and noting the absence of life. Once done, they turned to go about their normal routines. According to her caretaker, this instinctive ritual was necessary to determine that the little one was not lost (which would trigger a collective search), but dead.
I remember several deaths during my childhood (a grandmother, a neighbour, and a cousin) which involved viewing and touching of the body at home prior to transport to the cemetery. This experience imprinted the person’s departure on everyone’s awareness, stimulated reminiscences about the departed, and, more importantly, facilitated the letting-go and moving-on among the living. By contrast, the death of my mother (while I was still an infant) and that of my father (while we were estranged and living continents apart), did not allow for such rituals and may well have been the cause of prolonged and fitful grieving.
click on photos to enlarge
live or die
Further to yesterday’s post, here’s an anonymous entry on another blog by “JohnMND” who, at the point of his writing, was in the early stages of an illness similar to that of the man who died on Sunday. John writes (in part):
“I have recently been diagnosed with motor neurone disease [MND also known as ALS*]. What this means is I will slowly lose the use of my body as the muscles stop working and basically die. I have nearly lost the use of my arms. I can lift a cup of tea using both for a short while, but it will get worse and soon I wont be able to use them at all, although there is no knowing when that will happen. My right leg is starting to give me problems and I will eventually end up in a wheel chair. I will eventually be able to do nothing at all, not even swallow. Food will be fed into my gut by a tube. Someone will have to take me to the toilet and wipe my arse! Something I am not looking forward to at all, although I try to joke about this with my family; all of whom say they are here to help if I need it. My brain will function 100% so I will fully understand what is happening to me but I will probably lose any ability to communicate.
“Do I want to die? NO, at least not yet; the question is will I want to die sometime in the future before I get too bad?? Possibly, who knows. Imagine yourself in that position, would you want to live? Now put into the equation, I am 50 years of age, I have a wife and a young son aged 9. Do I want to see my son grow up and get married and have kids of his own? Obviously YES. Will I? Probably not. Do I want my wife to spend every living moment looking after me, NO. Do I want all the money and investments I have made for my sons future spent on me, NO. Otherwise all the time I spent away from them and all the chances I took to get this for my son was a waste of time. Do I think my son would rather I lived, YES. Do I think my son would want me to live as an object that cannot move, talk or communicate with him at all, probably not, why would he? I will basically be just a body in a chair that he walks by every day and talks to (if I am lucky) with no way of knowing what I would love to say back to him.
” … As for giving up or not being able to stand the pain as someone said. I won’t be in pain, I will just be lying, sitting, or whatever position I have been placed in. … I will have a fully functioning brain but will be able to do absolutely nothing! Try to imagine that for months on end, perhaps years … would you want to live? Of course at that stage I won’t be able to tell anyone what I want! I will feel pain, I will feel, hear and see everything. Will my wife and son suffer more watching me and spending their whole life looking after me than they would if I just died and they could try to get on with their lives … probably, at least that is what I think. It is not like I will be a good father or husband any more, I will just be the guy in the room on a chair that never talks or reacts to either of them.”
*Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND) and Lou Gehrig’s disease, is a rare disease in which degeneration of motor nerves leads to progressive weakness and wasting of muscles.
i’m glad he’s dead
A strange thing to say, but there it is. The patient I’ve been visiting for a while died yesterday. I just received a note inviting me to help organize a memorial service. My first reaction on hearing of his death was surprise (because he seemed so alert the last time we met) and then joy (as his suffering has come to an end). He’d been bedridden for almost two years, lying there with the curtains drawn, gradually loosing control of his muscles (limbs, tongue, eyelids, lungs), unable to speak coherently, more and more dependent and isolated. Four days ago we met for our last time, embracing each other with hands and forearms intertwined; his eyes glistening and wide open, a big smile as I arrived and when we parted.
At one point he asked (and it took three tries for me to make out the details), “How do Buddhists do funerals?” I explained a bit about various traditions, mostly Tibetans who have the most detailed protocol for the time before, during, and after death. “Do you want to talk about your funeral?” I asked. Nod. We agreed that I would come back this week with some readings and to continue the exploration.
Next to me, right now, sits a marvellous text by Christine Longaker*, a seasoned hospice worker and Tibetan Buddhist, from which I was going to read to him. “The Tibetan teachings,” she writes, “are based on a century-old wisdom tradition that reveals the deeper, spiritual dimension of life and death , and describes a very special hope we can find in death” (p. 26).
The Diamond Sutra has been chanted in the Mahayana tradition (which includes Zen) for over a millennium. Its most popular verse seems appropriate right now as it speaks to the impermanence of everything–
A star at dawn,
A bubble in a stream,
A flash of lightning in a summer cloud,
A flickering lamp,
A phantom, and a dream,
So is this fleeting world.
*Longaker, C. (1997). Facing death and finding hope: a guide to the emotional and spiritual care of the dying. New York: Broadway Books.
the plight of informal caregivers
Further to yesterday’s post: A recent study — summarized below – concluded that informal caregivers (e.g., friends, family) typically function without special training and that a significant minority have limited resources and high additional demands.
Changes in health care have shifted much cancer care to the home, with limited data to inform this transition. A great deal of clinical cancer care is delivered in the home by informal caregivers, who are often untrained. Caregivers’ circumstances vary widely, with many providing care despite low levels of resources and high levels of additional demands.
The study investigated the characteristics, care tasks, and needs of 677 informal caregivers of cancer patients. Over half of them (55%) cared for a patient with metastatic disease, severe co-morbidity, or undergoing current treatment. Besides assisting with activities of daily living, they provided cancer-specific care such as–
- watching for treatment side effects (68%),
- helping manage pain, nausea or fatigue (47%),
- administering medicine (34%),
- deciding whether to call a doctor (30%),
- deciding whether medicine was needed (29%),
- and changing bandages (19%).
However, half of caregivers reported not getting training perceived as necessary. In addition, 49% had jobs outside the home, 21% reported poor or fair health, and 21% provided unpaid care for other individuals. One in four reported low confidence in the quality of the care they provided.
source: van Ryn, M., et al. (2010) Objective burden, resources, and other stressors among informal cancer caregivers: a hidden quality issue? Psycho-Oncology, 20(1), 44-52. © 2010 John Wiley & Sons. image: in-homecareseattle.com
a friend in need
I just returned from meeting a friend whose mom is undergoing cancer treatment and whose daughter is waiting (waiting!) for surgery. I was struck by the inter-connectedness of these three women; also of their partners, friends, even co-workers. Everyone is experiencing their own fear and confusion; one person’s illness affects the next. I imagine the members of this system connected by a string, one to another. The moment one person tugs on their end, the tension is transmitted and felt by everyone in the network.
As my friend’s story unfolded, I sensed the immense weight on her shoulders. Her familiar role is changing day by day – from daughter and mother to caregiver, supporter, chauffeur, nurse, counsellor, advocate, and then some. I sensed confusing mix of emotions – anxiety, anger, frustration, helplessness — in response to an overwhelming situation.
My own tendency is to pull back when I hurt. I hide under the covers (as I did as a child) all the while hoping that someone will come to love me. Such a paradox: the very time we need loving kindness, we withdraw. In isolating ourselves, we isolate others. During my last bout with neuropathic pain I ended up lying on the stairs at home, screaming in agony. But did I phone someone? Did I take up friends’ offers to come to my aid? It finally took one person’s courage to barge into the home, to ignore my denials, and to bring the sustenance I so craved.
How then do I (do we) best support someone in need, especially when they say that all’s ”just fine”? How do we take care of ourselves by allowing others to care for us?
spring of hope, winter of despair
- what fun
My post of January 7 includes a list of activities which I hope will delay the inevitable shrinking of my cognitive functions. I’ve since begun to investigate the topic of aging and noticed that –
1. To get or be “old” is not a popular word. Just as we avoid “dying” by using such euphemisms as passed over, gone, passed on, deceased, no more, meeting one’s maker, ending the valiant fight, and expired, old people are described as aged, senior, frail, getting on, debilitated, golden/silver aged, senior citizens, geriatric, oldish, past their prime, over the hill, grizzled, infirm, and geezers. Preoccupied with being strong-young-healthy-handsome: society can bring itself to call the thing by its name.
2. Ageing or becoming old is easily seen as an illness to be treated with drugs, procedures, treatments, and “special care.” It’s not a cool state, neither desirable nor honourable. Advertisments rarely depict anyone older than 50, except perhaps for such products as step-in bathtubs, retirement living … and Rolex watches. Barely a hint of frailty. Checking a well-stocked book store today, most of the titles under gerontology spoke of staying young, beating old age, anti-aging workouts, and the secrets of optimal ageing. More avoidance.
3. Elder-care (another euphemism) takes place being closed doors, where old people, many separated from their loved-ones, are housed in special “facilities” assisted by underpaid “care aides” (often immigrant women with limited vocabulary) who perform such intimate acts as bathing, toileting, lifting, diapering, turning, and feeding.
Nothing in our experience and education has prepared us for this. And like death and dying, no topic will be less welcome the next time you meet a friend for coffee or sit down in the lunch room at work. So, what’s to be done?
This post’s title is borrowed from Charles Dickens’s “It was the best of times, it was the worst of times …”.
unexplainable
For now, this excerpt from “What is there beyond knowing” by © Mary Oliver in (2005) New and selected poems. Vol 2. Boston: Beacon Press, p. 20.
What I know
I could put in a pack
as if it were bread and cheese, and carry it
on one shoulder,
important and honourable, but so small!
While everything else continues, unexplained
and unexplainable. …
More soon.
along comes another disorder
Preliminary research suggests that Web addicts have brain changes similar to those hooked on drugs or alcohol. Experts in China scanned the brains of young web addicts and found disruption in the way their brains were wired up. There was evidence of disruption to connections in nerve fibres linking brain areas involved in emotions, decision making, and self-control.
See for yourself whether you might afflicted with Internet Addiction Disorder (IAD) by answering Yes or No to the diagnostic criteria below.
- Do you feel preoccupied with the Internet?
- Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction?
- Have you repeatedly made unsuccessful efforts to control, cut back or stop Internet use?
- Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?
- Do you stay online longer than intended?
- Have you jeopardized or risked the loss of a significant relationship, job, educational or career opportunity because of the Internet?
- Have you lied to family members, a therapist or others to conceal the extent of involvement with the Internet?
- Do you use the Internet as a way of escaping from problems or of relieving a distressed mood (e.g., feelings of helplessness, guilt, anxiety and depression)?
In the study, participants answering yes to questions 1 to 5 and at least one more answer were classed as suffering from Internet addiction disorder.
See also research on how social network sites (such as Facebook) may be changing people’s brains as well as their social life. Brain scans show a direct link between the number of Facebook friends a person has and the size of certain parts of their brain.
elders
Further to previous posts, these lines from Ram Dass:
“Unless we see ourselves as part of life’s continuity, whether we’re currently young or old, we will continue to view aging as something apart from the mainstream of culture, and the old as somehow other. In a non-traditional culture such as ours, dominated by technology, we value information far more than we do wisdom. But there is a difference between the two. Information involves the acquisition, organization, and dissemination of facts …. But wisdom involves another equally crucial function: the emptying and quieting of the mind, the application of the heart, and the alchemy of reason and feeling.”
♥
“This is our predicament, then: to regain our role as wise elders in a culture that has traditionally denied the need for wisdom, or the ability of old people to provide it … But it is futile to try to change the outside world without beginning with ourselves. … It is futile as well to look for our “selves” without understanding how the self is defined by our culture, and by what we consider reality to be.”
Ram Dass (2000). Still here: embracing aging, changing, and dying. New York: Riverhead Books, ch. 1.
getting older is not for me
Further to yesterday’s post. “Imagine being pushed out of an airplane without a parachute. It might take several minutes to hit the ground. The only moment of true physical pain is the last, and it is over in the blink of an eye. All the rest of the journey is free fall. You can spend the entire trip worrying about how much that last moment will hurt, screaming as you go. Or, if your Buddhist practice is very good, you can enjoy the feeling of the wind through your hair. How do you want to go?”
Thus writes Seth Segall, former professor of psychology and long-time student of Buddhism. “What is there to be afraid of? It’s a natural process, the way things are. You can resist it if you like, but what’s the benefit in that? Or you can let go and experience life fully the way it is, without the story.”
Ah! there’s the rub: The ego is unable (unwilling) to imagine its own demise. We may talk about death, witness it in others, contemplate ours in private, but to welcome it as “the way it is” seems beyond reach. I have from time to time wished to be dead – but to die, either by my own hand or external causes, I can’t conceive. No wonder it’s taken me ages to write a Last Will and I have yet to mail the forms to donate my cadaver to the university; to be kept on ice and cut into pieces by students.
And so it is with ageing. The last time someone asked my age I got it wrong, saying 67 when in fact it was 68½. Walking past a seniors’ centre, I see it as a place for people with white hair, but not for me. Seeing my naked body in the mirror or on a bathroom scale makes me look the other way — that can’t be me!
This, I believe, is a pivotal step towards acceptance: to face and name the beast.