Joan Halifax
Editor’s Note: Joan Halifax is an American Zen master who’s been a leader in developing a fearless, compassionate approach to caring for the dying. Drawing on Buddhist teachings, she trains healthcare professionals and other caregivers to develop a more mindful, open-hearted way of being present with the dying. The Zen teachings often speak of “not knowing,” of letting go of our fixed ideas. This becomes particularly important, Halifax explains, as we approach death.
When I was in graduate school I spent time in the hospital with an old woman who had breast cancer. Just before she died, she told me that you can never really know what dying is about until it is happening to you. Her eyes said even more than her words. All the stories she’d once told herself about the way she would die shattered against the reality of what her dying was really like.
Although we can become familiar with the physiology, psychology, and spirituality of dying, we cannot know death until it is happening to us. However, we can reconnoiter the territory. We can investigate the many little deaths and births we experience in daily life, exploring loss, change, and impermanence. We can try to stabilize our minds through spiritual practice. And we can listen to the stories we tell ourselves about death and perhaps loosen the knot that binds the stories to us by reaching deep inside each story to its very heart.
If we create the story that death is a tragedy and a defeat, for example, this might well color our experience of dying and our relationship with dying people. Or, instead, if we create a story of death as a great adventure, and it turns out that our mental and physical faculties are diminished and we are miserable as we approach death, we might wonder what happened to our so-called “good death.”
We don’t know how or when we will die–even as we are actually dying. Death, in all its aspects, is a mystery, and our stories might open the door to the unknown or help us to fool ourselves and those around us.
A young man with whom I worked felt he was ready to die and stopped taking his medications, with the idea that he would die a “noble” death a few days later. Even though we told him that the body dies in its own time and we could not predict what would happen, he found our counsel hard to accept, and he stuck to his story that he would die a quick and heroic death.
As the days passed and he did not die, this young man became more and more miserable. He had said valiant goodbyes to his family and friends, he was ready to die, and he did not want things to drag on.
Four months later his patience had been thoroughly tested, and he had none left. His death was not going to happen the way he wanted it to, and he felt his “story” had betrayed him. No amount of presence, support, love, and common sense could allay his anger, as he shifted into another story, this one focusing on him as a victim. He had lost control of his death, along with everything else in his life.
Those of us who were his caregivers had done our best to be there as he fought with frustration and physical pain. He was a young man who had always planned carefully and carried out his plans with commitment. Now this same energy had become an obstacle to living his dying. He had attended so-called good deaths of friends and expected his death to be like theirs. He had a definite idea of how things should be, and they were not working out that way. Finally, on what proved to be the morning of his death, after a difficult last struggle against the ideas that opposed his reality, he finally gave it all up.
Caring for this young man, I asked myself if there really is such a thing as a “good death.” I couldn’t call his death good or bad. He did it his way, and in retrospect, though it was at times hard for him and hard for us, it was an amazing journey. I had to respect his strange valor.
Each person dies in her or his own way. The young man, whose story I told above, from one point of view seemed to die too late. But was it too late? Did the shift in his story from hero to victim lead him to yet a third perspective, one that was free of bad and good, hero and victim?
As his final hours unfolded, everything seemed to drop away from him, including his suffering, including his story. He slipped beneath the wave of life and dove out of sight. In the end, I could not evaluate his journey. I simply felt love for my young friend, and over the years my respect for him has increased.
The concept of a good death can put unbearable pressure on dying people and caregivers, and can take us away from death’s mystery and the richness of not knowing. Our expectations of how someone should die can give rise to subtle or direct coerciveness. And no one wants to be judged for how well she dies.
“Death with dignity” is another concept that can become an obstacle to what is really happening. Dying can be very undignified. Often, it’s not dignified at all, with soiled bedclothes and sheets, bodily fluids and flailing, nudity and strange sexuality, confusion and rough language–all common enough in the course of dying. The stories we tell ourselves–good death, death with dignity–can be unfortunate fabrications that we use to try to protect ourselves against the sometimes raw and sometimes wondrous truth of dying.
Our practice of not-knowing points to an openness in perspective, an openness that is deeper than a story, deeper than our expectations, deeper than our wishes, deeper than our personality, deeper than cultural constructs. Being with dying gives us a precious opportunity to question all our stories, to drop the old harmful fabrications that no longer serve us.
