Archive for April 17th, 2012

“How, then, do we know when a patient is giving up “too early” when we feel that a little fight on his part combined with the help of the medical profession could give him a chance to live longer?  How can we differentiate this from the stage of acceptance, when our wish to prolong his life often contradicts his wish to rest and die in peace?  If we are unable to differentiate these two stages we do more harm than good to our patients.”

~~Elisabeth Kubler-Ross, On Death and Dying


I know for many of us, it would be hard to hear that someone was “choosing” to not do everything in their power to stay alive… like, in some way they were making a choice to leave us. . .

But we forget, when a person has decided not to continue treatment, they have been and continue to grieve the loss of everything in life. . . the sight of crocuses popping out of the snow, the sunset through the tops of trees, the smell of their favorite food being cooked, the warmth of our hand in theirs.

It is a time of walking a strange balance, between accepting what is and being a continued advocate.

But, I think in the accepting of what is and being present to the now the person who is ill can make the decision to live in the now and have time with us than to continue treatment that might actually take them from us earlier.

It is a difficult time for everyone involved and yet, with open communication, it can be a time used to say what needs to be said, to spend the time we maybe didn’t have time for in the past, and to simply be together, focusing on our relationships rather than continuous trips to the doctors, hospital, etc.

I know many people who are especially early in their grief journey might disagree; they might want that person back more than any thing else in the world.  I appreciate that feeling.  I’m sure I’ve been there.  And I heard from patients who have expressed the wish that their family would just “let them go” and relax so that they could make the transition into active dying that they need to do.

Too often I heard stories around the clinical team meeting and from support group members that it was when the nurse came in to talk to family, or when the spouse fell asleep, or when they went to the chapel to pray or ran to get coffee that the person died.  At those moments, the bonds are slightly looser, their is more space in the relationship and the hold to each other is not so strong.

But to me that seems natural.  Totally engaged in a conversation with and just simply being with a friend and knowing it was time to leave, but not wanting to leave the safety, comfort, and love of the interaction.  And something happens… the phone rings, the kids come home, someone goes to make tea or use the washroom, and there is a a slight and temporary relaxing of the connection. . . and the invitation that it is okay to leave.

And some times, it takes great courage in those moments to move beyond the safety and warmth of the connection to venture out into the world and journey.

As we sit with someone who is living their dying and you have difficult moments, remember that they will not only be venturing from the safe comfort and love of your relationship and it has to be more bittersweet than anything in the world.  But it is also in our ability to have a soft and gentle touch that we can allow them to leave us with grace, dignity, and much less struggle and pain.


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Just read this link on Facebook and am deeply saddened for the Shambhala Community.  Raymond was the Asst Circulation Manager at Shambhala Sun and Bodhidharma Magazines.

Raymond had already been the victim of a hate crime once, for being an outspoken GLBT activist.  And yesterday he was murdered in Halifax.

Sadness washes over me as I read the loving tribute that his friends and colleagues have left as they begin to mourn.

I wish them comfort, safety, peace, compassion, and lovingkindness, all of the things that were robbed from Raymond as he was murdered.

May all of his communities stand stronger, wiser, and more tolerant for having known him and been touched by his life.

With profound sadness,


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“Compassion is the very heart and soul of awakening.  While meditation and reflection can make us more receptive to it, it cannot be contrived or manufactured.  When it erupts within us, it feels as though we have stumbled across it by chance.  And it can vanish just as suddenly as it appeared.  It is glimpsed in those moments when the barrier of self is lifted and individual existence is surrender to  the well-being of existence as a whole.  It becomes abundantly clear that we cannot attain awakening for ourselves:  we can only participate in the awakening of life.”

Stephen Batchelor, Buddhism Without Beliefs.

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“No matter how busy we are, we can bring simple contemplative elements into our caregiving practice that will help us to follow the dying person’s lead and to give no fear.  Sharing practice or prayer, silence and presence, with a dying person also services the caregiver’s well-being.  When you find yourself caught up in the events around you or in your own hope and fear, slow down.  Even stop.  Cultivate the habit of attending to the breath continually; use the breath to stabilize and concentrate the mind.”

~~ Roshi Joan Halifax, Being with Dying

No matter how long you practice, there are times that your breath gets caught… sometimes we find ourselves gasping, sometimes holding our breath… we forget how stabilizing our breath is and how it is the “stuff” of life.

I find myself at work, shoulders scrunched up, after counting data and updating excel spreadsheets for hours.  I realize several things…

I’ve not seen another human for a while.

I’ve not seen anything green for some time.

I’m slumped over and my heart is contracted.

I’m barely breathing.

At that time, I don’t need a chime to go off.  It’s too late and just the right time. It time to let my shoulders drop.  Let my heart open up.

Close my eyes… walk away from the graphs and spreadsheets and do something in like child’s pose or downward facing dog to bring myself back to my center.

It’s time to pick up one of the two Dharma books on my desk and read a sentence or two and remind myself that this moment is a gift.  It is the only thing that matters and I can let it pass by mindlessly or I can attend to it.

Knowing that we only have so many moments in each of our lifetimes, do we really want to let one go by without savoring it with a deep, slow breath?

As caregivers, we often forget ourselves … we’re not always 100% present to the one before us but maybe we are caught up in all of the tasks that are required… caregiving is hard work… but if spirituality is about chopping wood, carrying water, and washing dishes, than what a great gift caregiving is to us… to attend to “the baby buddha” that is within the person who we are caring for…

And if the person before us is a buddha, how do we want to meet the Buddha?  Too busy to say hello as we walk in the door?  Too busy looking for the pail to empty?  Or do we want to meet heart to heart, breath after breath, at the deepest level that we will allow ourselves and they will allow us to meet at?

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