Archive for the ‘Hospice’ Category


As I stood at the doorway to his room, it was as if he looked straight into my eyes.  His eyes were still open and blue as ever. I couldn’t quite tell if he had a smile on his face, but he looked peaceful. I felt heartened and found solace in this last expression of his. I also felt sadness that I would never encounter him in the hallways again nor would I be able to say, “Hi” to him. I will miss that.

Over the months, volunteering in hospice, there had been numerous struggles (tears, fear and anger) over what lie ahead for him. I tried in what seemed like an endless exercise in futility to provide some comfort to him during these months, to help him process his impending death. However, he fought me every inch, railed against his own understanding of his impending death and forced me to take him on his own terms, regardless of whatever agenda I had for him.  He was a skillful teacher for me. Over time, I abandoned this agenda of mine and let him take the lead. I often found myself serving his need to be distracted from his understandings of his impending death. It perplexed me at the time and forced me beyond my confined understanding of what I was doing as a hospice volunteer and my own understandings of death, that’s what made him such a good teacher for me.

In looking at my own remembrance of encountering death, I began to see the teaching. Trying to understand the experience of death, trying to wrap one’s head around it is an exercise in futility. We cannot know. If we make up something frightful about death we suffer more intensely. If we make up something pleasant about death we suffer less intensely. If we make up nothing about death, we suffer not.

Personally, I don’t remember dying almost 2 years ago and it’s almost as if it didn’t happen at all (see previous posts, “The Paradox of Death and Deathlessness”). In a way, it was much ado about nothing for me and yet for my rescuers and family, way too much happened. I can’t say it was much ado about nothing for them! My point is that death is a concept, an understanding, and concepts or understandings are not the thing itself. Whatever we think, whatever understanding we have, whatever label we give, tis not the thing itself. Then, there is the understanding of absence or oblivion which is really no different than any other kind of understanding, it just an understanding that parades itself as a nothing.

In the Zen tradition, there is a story of a monk that would carry a pail of water from a local stream to his humble abode nightly. This monk would admire deeply the reflection of the moon in this pail of water as he walked home. It seemed so beautiful to him. One night, as he walked home, the pail fell from his hand hit the ground and shattered. The water dispersed and the thirsty ground soaked it all up. No pail, no water, no reflection that he had gained such pleasure from. In his anguish he turned his head to cry into the sky, only to see the real moon, for the very first time shining bright in all its glory high in the night sky above! What a pale imitation the reflection of the moon in the pail of water was!


Our understandings are these reflections in a pail of water they encourage us to look beyond the understanding to the direct experience, but we are so enthralled with our understandings because we think that that understanding is all we have. We mistake that the absence of understanding is nothing in a while it is described as emptiness from the perspective of understanding, it’s absolutely not empty! The point of practice, be that meditation or inquiry, is to break the obsession with this “pail” understandings and to begin to perceive directly the non-conceptual wisdom.

All our understandings in this life, including our understanding of death, are “pail” understandings. They are pale versions of direct perceptions. What my teacher (in this hospice resident) here reminded me of, was that death need not be processed through our “pail” understanding. Whether our final months/moments here involve existential inquiry or living as if there is no death, matters not. I am reminded of the truly unimaginable ground of existence!

Whether I think I know what I’m doing, or not, in how I am serving hospice residents or living life in general, matters not. My job is to be present, open, and compassionate. It’s okay to make up frightful things about death. It’s okay to make up comforting things about death. It’s okay to make up neutral things about death. It’s okay not to think about death at all! It’s an awful lot of work to make all these things up and sometimes I can just feel lazy and let it all go! Besides, I don’t think that the universe really concerns itself much with our understandings. It seems to me that on an ultimate level, existence is perfect as it is and the universe is completely independent of any of our understandings or judgments, mine, his, or anyone else’s.


You, teacher, taught me this most pointedly as your lifeless body gazed into me and pierced my “pail” understandings of you, me, life, and death.  Thank you for the reminder that understanding is a virtual playground, feel free to play in the infinite number of pleasant and unpleasant creations and remember that they are unnecessarily confining! Go ahead and pretend that these “pail” understandings are in any way real, to your heart’s content if you must!  Ultimately, we must leave our confinement of pail understandings, this playground that we play in, and when we do we will never want to return to such limitation and confinement for it will seem like a prison to us.

In the meantime, play in them until you’re no longer interested.


Inside this new love, die.

Your way begins on the other side.

Become the sky.

Take an ax to the prison wall.

Escape. Walk out

like someone suddenly born into color.

Do it now.

You’re covered with thick cloud.

Slide out the side. Die,

and be quiet. Quietness is the surest sign

that you’ve died.

Your old life was a frantic running

from silence.

The speechless full moon comes out now.


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I come to hospice volunteering from an unusual angle in comparison to other volunteers. Most people who choose to do volunteer caregiving in hospice do so because they have been with a relative or loved one during their dying process and it has profoundly impacted them. I can certainly see why they would choose to volunteer. However, I come from the unusual experience of having been the one to die and for some unfathomable reason I was plucked from the jaws of death. I survived odds that no reasonable person would ever choose. Only 6.8% of people survive out-of-hospital sudden cardiac arrest in the US and only 3% survive without debilitating anoxic/hypoxic brain injury. Statistically, I really shouldn’t still be here.

During a conversation/training on the signs of approaching death, there was a discussion about unpleasant odors that are sometimes present and the bodily fluids that can cause them. I was abruptly reminded that night of an undignified part of my own death just over a year ago. In addition to going into convulsions due to oxygen deprivation, my bladder voided its contents into my shorts and onto the grass in front of everyone who was witnessing my death. I was not in control of this body. I was the one that was dying and apparently that’s what dying people do. It’s not the sort of thing that I like to think about because there is no dignity in pissing your pants while being completely unable to care for yourself. I know this all too intimately.

The conversation about this, during the training, had a level of humor and levity that was both understandable and a somewhat painful and jarring for me personally. I understand, respect, and will defend the value and use of humor as a way to help caregivers manage and be present for the difficult or even traumatic experiences of being with the dying. My paramedic rescuers taught me how important this sense of humor was to the preservation of their sanity as they went on emergency call after emergency call, day after day, year after year.

And yet the levity and humor also stung because that was me dying and it was me, pissing my pants during the process, as others were trying to care for me. There was nothing dignified in it. It was humbling and even somewhat humiliating. Maybe that’s why preserving the dignity of our hospice residents is so important to me. In this way, I may understand them like few people can. My hope in writing and sharing this is that it will help others to understand the role of humor as well as to empathize more deeply with those we serve.

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Sunday evening: I entered her room. Labored, inconsistent breathing, still body lying in bed, hands occasionally grasping. The grating drone and incongruous cadence of the announcers at a basketball game was blaring away on the TV in the background. Future measured in days, not weeks, they said. Hearing, one of the few senses left that connected her to everything beyond the boundary of her skin.

“It shouldn’t be like this” moved through my veins like icewater.

No, she didn’t watch sports when she was able to communicate her needs and I don’t know what she would find soothing, but I needed to do something. Reaching into the mystery with the only available question left, “What would I want to hear in my final days?” I remembered hearing about a harpist coming to provide soothing music to my aunt Sherry when she was close to death.

I will take a leap of faith and change the soundtrack, find something more soothing and relevant. My only wish? That it soothed. And that she felt someone cared enough to provide soothing. And then I just sat with her. I didn’t know what else to do but to simply be with her in the mystery of not knowing, the ultimate mystery of any existence.

Today: two and half days later, the news. Sadness at a life no longer available to the rest of us. Gratitude for the transformative power of love and the small unassuming Army (Angels) of compassion that wielded its transformative power in her last days here. I’m utterly blown away!

This is a little pocket of heaven on earth; a sacred waystation for those departing for home. It doesn’t matter, the story of their life. Each life is sacred, loved, and tended. Preparation for the journey.

How do I determine who is the care-giver and the receiver in all of this? Who is the teacher and who is the student? I think I’m in over my head and the best way possible here. What a poignant blessing!

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