With a little help from my friends

“I was just sitting here thinking about what would be on my mind if I were in your place, facing my imminent death. I suppose I would be thinking about immortality, not in any conventional sense of that word, but more in terms of my legacy. I guess I’m really self-conscious, or maybe it’s vanity, I don’t know, but I think I’d be wondering about my contribution to this wounded world.”

My good friend Kim called me out of the blue. She asked if I would be available to consult with a couple of her friends, James and Rebecca. James is dying.

I didn’t know Rebecca or James personally, but I had heard a lot about them from my friend Kim. I talked to Rebecca briefly by phone and accepted an invitation to visit with them the very next day. When I arrived at their home, I found James very close to death. The scene was calm and, at first glance, everything seemed to be in order, but the tranquility was deceptive.

challenges aheadRebecca began by telling me that she thought something was wrong. “What do you mean, wrong?” I asked.

“I don’t know. I can’t put my finger on it exactly. James has been actively dying for weeks. Why is it taking so long? We’ve prepared for the end in the best way that each of us knows how, both psychologically and physically. Everyone has been extremely helpful. Hospice has been wonderful. But we never thought it would turn out to be such a marathon. We’ve been waiting and waiting for what seems like forever for the end but it doesn’t happen.”

She went on to say, “Don’t misunderstand, I’m not impatient for James to die, but there’s something unnerving about all of this that has us both on edge. It’s like standing at the airport fully packed for a long trip waiting to board a flight that never arrives. It’s been exhausting for the both of us. I can’t help but think we’ve overlooked something. I’ve quizzed James about it, but he doesn’t know what it could be either. That’s when Kim suggested we talk to you. We’re both afraid that our impatience and anxiety is going to disrupt the tranquility we’ve worked so hard to achieve. Can you help us?”

James confirmed what Rebecca told me. “Look at me! There’s nothing left that works, I can barely see anymore. It’s pathetic. I should have been dead by now. Even my hospice people are surprised that I’m lingering. I think I’ve been extremely patient so far, but this is ridiculous. I want this to be over, damnit. I don’t know how much more of this I can take.”

There was a blockage, no doubt about it. I could feel it all around me. Had they overlooked something important? I thought I’d better try and find out.

“James, is there anything left undone? Did your restaurant sell?”solutions

“Yeah, months ago. I’m satisfied that we’ve taken care of every last legal detail. I’ve even had two different lawyers sign off on the deal.”

“How about family; any unfinished business there?

“No, my parents are here, sisters and brothers have all been through here at one time or another. I’m feeling real good about all of my relationships.”

I was stumped. They appeared to have thought of everything. Nothing seemed out of place. So why did we all feel on edge? We sat quietly for a while and then I said, “You know, James, maybe it’s something metaphysical.”

“You mean like God and heaven and that sort of thing?”

“Yeah, in a roundabout sort of way. I was just sitting here thinking about what would be on my mind if I were in your place, facing my imminent death. I suppose I would be thinking about immortality, not in any conventional sense of that word, but more in terms of my legacy. I guess I’m really self-conscious, or maybe it’s vanity, I don’t know, but I think I’d be wondering about my contribution to this wounded world. Since I think about this a lot and I’m not sick, I’m sure that I’d be concerned about it as I lay dying. We’re not such different people, you and I. Do you ever wonder about the impact you’ve had on your world? Is any of this even making any sense?”

Silence. Then tears pooled in his eyes.

“You know, I’ve been a foodie all my life. When I moved to the Bay Area thirty years plus ago it was because it’s the center of the food world. All the world’s greatest cuisines come together here. It’s the culinary Mecca. This town really appreciates the creativity and art involved in cooking. I’ve had the good fortune to work with the best chefs in the world and, in turn, they’ve shared my table. I was good; I mean I was real good. And now that I’m dying, no one has asked me for my recipes. Was it all for nothing?”

I get by with a Little help from my friendsWe were all stunned by what we were hearing. Rebecca spoke first.

“Sweetheart, your friends would never think to ask you for your recipes. They all secretly covet them, of course, but asking for them would be out of the question. It would be kind of ghoulish, don’t you think? Like vultures hovering, waiting to pick over a carcass. And you have to admit that you haven’t been particularly forthcoming about any of this yourself.”

“Yeah, I know, but I’m dying. It’s different now. It’s my legacy, just like Richard said.”

Two days later a simple but elegant ritual had been prepared. Champagne was chilled, a couple of friends were called, and James directed Rebecca to fetch his treasure. Choking back tears of gratitude, he blessed us all.

“Thanks for making this such a great ride, you guys.”

As he said this, he handed each of us a memory stick, which held the booty. James entrusted us with his cookbook manuscript in the hopes that we would have it published after his death. He insisted that the title be: Food to Die For. We promised that we would do our best and thanked him for his trust and friendship.

I guess that took care of that, because seven hours later James was dead.

Holly’s Dilemma

“Can’t you see I’m starving? I have needs too, you know. For as much love as I get from you, I could be living on the moon. Are we ever going to resume our sex life? Because if I wanted to live like a nun I woulda joined a convent. Your sex aversion is making me sick.”

 

I want to introduce you to my friend, Holly, (not her real name). She is 43. She had a double mastectomy three years ago and has been cancer-free since. She’s a graphic artist, shares a home with her partner (now wife) of ten years, Jean, and their teenage daughter Annie.

black-woman-braidsA beautiful smile radiates from Holly’s full mocha-colored face. Oodles of thick jet-black braids spring from her head as from a fountain gone mad. She is forever brushing one or another of them from her face as she speaks. Her frequent laughter is like music, making her whole body dance and shake, but her levity masks a somberness and apprehension that is very troubling to her.

She tells me; “I often become consumed with worries about getting sick again. My fears can turn into a paralyzing dread that takes days and sometimes weeks to shake. I know that until I can accept the possibility of my own death, I’ll never be able to embrace all the great things that are right in front of me.”

Later in our conversation she says;

“Ok, so if ya wanna know the truth, I’m dealing with some big-time body issues. The mastectomy really scarred me psychologically as well as physically. I didn’t realize the dimensions of all of this until I had finished the chemo and radiation I was doing. For a good six months after the surgery, I was so sick from all that poison that the thought of sex of any kind made me nauseous. I didn’t even want to have Jean in the same bed with me. It was awful.

Over time the nausea diminished and I was able to resume some semblance of intimacy with Jean. We were able to be close and do some touching, like sitting on the couch holding hands while watching TV, just as long as it wasn’t sexual.

Then a couple of months ago, Jean and I had this big blowout. We were screaming and yelling about God only knows what when she finally blurts out; ‘Can’t you see I’m starving? I have needs too, you know. For as much intimacy as I get from you, I could be living on the moon. Are we ever going to resume our sex life? Because if I wanted to live like a nun I woulda joined a convent. Your sex aversion is making me sick.’

The intensity and ferocity of Jean’s outburst blew me away. I had completely forgotten about her needs. I know I still love her, of course, but after the surgery I didn’t feel whole. I didn’t feel like a woman, know what I mean?

When things simmered down a bit, I think Jean could tell she wounded me deeply, she said; ‘I’m doing this as much for you as I am for myself. You gotta deal with this, babe.’

Jean was right! I was starving too, but I was too afraid and ashamed to admit it. We’ve made some lame attempts to move past the status quo since then, but it’s still not like the old days.

My God, in the old days Jean and I were like wild women, letting it all hang out. Some of that was lesbian pride, but it was also a kind of in-your-face protest. We were both like; ‘These are my breasts, damnit! Get over it!’ I don’t see how I can ever regain that.

I mean, how can I make a gift of myself to someone if I’m not feeling much like I’m a treasure? I still have shame about losing my breasts. I’m not a whole person anymore.”

“Hold on there, Holly. Where did you lose your breasts, at the laundromat? You didn’t lose your breasts. You had cancer. They were surgically removed to save your life. There’s no shame in that! To think otherwise is self-defeating.

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Besides, it doesn’t sound like Jean thinks of you as damaged goods at all. You’re still attracted to her, right?

That’s what I thought. Well then, you’re just gonna have to let your love for one another heal you of your shame and self-doubt. You are no less a woman without your breasts. I wonder, have you ever taken the time to grieve the loss of your breasts? Could you go to Jean and ask her to hold you while you weep for what is no longer yours?

Your shame is indeed getting in the way of you reconnecting with Jean. But Jean is your life partner and this is part of life. Share it with her. Don’t try to carry this alone.”

Holly countered; “But I have this completely non-existent sex drive. The first couple of months after the chemo and radiation, I would have this weird feeling when Jean would try to be close to me. It was like being on a bad acid trip or something. I felt as though my body was there with her but I wasn’t. I felt nothing. My headspace was totally different from how it was before I got sick. I would lie there thinking, ‘Oh my God, what’s happening? Will I ever feel normal again? How many more opportunities will I have to be with Jean like this before I die? Why don’t I feel what I used to feel?”

I said, “Well, for one thing, you were fighting for your life back then, right? That’s bound to alter a person’s perceptions a bit, wouldn’t you say?

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Listen; can I suggest that you have a heart-to-heart talk with Jean about your concerns? Tell her what you are telling me. Just be sure that you have this conversation at some neutral time, not during an intimate moment. This way you could speak freely about what you are thinking and feeling without fear of Jean misinterpreting your comments as sexual rejection. How does that sound to you?”

“But what if I screw this up?” What if this somehow scars Jean for the rest of her life? I don’t what that to happen. I wouldn’t be able to forgive myself. I’m afraid something bad might happen and that’s why I’m frozen in place.”

“There are ways to overcome this stalemate, Holly. First, you need to reassure Jean that you are committed to working through this impasse with her. I think she needs some assurance that you haven’t given up. And in return you could ask her for her patience, because the process may be a slow one. One thing for sure, you’re gonna have to give her some sort of timeline; otherwise you may find yourself putting this off indefinitely. And that won’t do.

I recommend that the two of you begin to explore what is possible now in your sex life together. Avoid comparing what you are able to do now with how things were in the past. Keep the exploration simple and open-ended. And I suggest that you don’t create a goal to be achieved. That’s where most people in your situation go wrong. Keep you exploration moving forward, of course, but also try to keep it open-ended.

You guys might start with some cuddling and spoon breathing. Do you know what that is? It’s a great exercise! I highly recommend it.

Here’s what you do lay on your side next to one another like two spoons—Jean’s front to your back. Then try to match one another’s breathing pattern. First Jean will try to match your breathing pattern then you guys could switch position—your front to her back, and you could try to match her breathing pattern. This exercise can be done with or without clothing. You will be amazed at how comforting this will be for you both. It’s the ideal place to start rebuilding a sense of confidence about being physically together.

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As time goes on, your spoon breathing embraces could become more adventuresome. When you are feeling up to it, take one of Jean’s hands in one of your own hands and guide it over your body in a way that feels pleasurable and comfortable for you. You could show her the kind of stroke and pressure that is desirable for you. This will be a very effective way of reestablishing a threshold for what is possible between the two of you now as well as moving forward.

Guided-hand sensual touch like this can be expanded to include genitals if and when you ready. You could help educate Jean on how to pleasure you in a way that would allow you to be more of a passive recipient rather than an active participant in your lovemaking if that’s what you want.

I suspect that these two exercises will be a good place for you and Jean to start the non-verbal communication that is just as essential as having that chat that I mentioned earlier. The only other suggestions I have to offer are these: keep these exercises playful and honor your limits.

Maybe you could get back to me in a few weeks and let me know how it goes.”

The Good Life (and death)

“Let’s take a fresh look at our mortality, and let’s do so in an interactive and positive way. Let’s celebrate the concept that living well and dying well are one and the same thing. I’m not talking about adjusting deathbed pillows so that, as we die, we can strike heroic poses for the edification of onlookers. I’m talking about achieving a good death in the context of real dying–with all its unpredictability, disfigurement, pain, and sorrow.”

 

I presented a workshop to a group of seniors, at a senior center, north of Seattle awhile back. The workshop was titled, Managing Our Mortality. I like that title; if for no other reason than it doesn’t seem to spook folks into thinking doom and gloom as they consider the end of their life. Fact is, and this is a real curious thing, for most people the concept of their mortality is easier to handle than the concept of their death. Even though, let’s face it, they basically are one and the same thing. Such is the power of euphemisms.

At any rate, I began my presentation with some preliminary thoughts on the concept of living a good death. This is another favorite topic of mine. See an earlier posting of mine, Is Death The Enemy?  I am of the mind that a good life and a good death are one and the same thing, but this is a real hard sell for someone who is enjoying one’s life (especially one’s golden years) and who is not yet ready to go push up daises.

live in such a wayAll these workshops begin with a proclamation. “Let’s take a fresh look at our mortality, and let’s do so in an interactive and positive way. Let’s celebrate the concept that living well and dying well are one and the same thing. I’m not talking about adjusting deathbed pillows so that, as we die, we can strike heroic poses for the edification of onlookers. I’m talking about achieving a good death in the context of real dying–with all its unpredictability, disfigurement, pain, and sorrow.”

While I was saying this I was watching the body language of those gathered to hear me speak. I know this is a critical moment in the presentation. A swift rise in the anxiety level of just a few participants can be contagious to the whole group. I notice that there was a modest amount of lip pursing, clearing of throats, shifting in their seats, and crossing of arms. This signaled that some were ill at ease, but I thought I was ok with the majority so I pressed on. But just to be sure, I casually added that I deliver this very same message regardless of my audience—college kids, soccer moms, healing and helping professionals, what have you. This seemed to settle down my audience a bit. I guess they were reassured that I wasn’t singling them out for a special dose of reality just because they were of a certain age.

I was just about to move on to my next point when a nicely dressed woman with carefully coiffed platinum-colored hair meekly raised her hand with a question. I called on her. She said; “I don’t understand the concept of a good death. There’s nothing ‘good’ about death. Death is the end. I’m really enjoying my retirement, I’m involved with all sorts of creative things I never had time for when I was working and raising my family. I don’t relish the thought of all this coming to an end any time soon.”

There was a lot of nodding of heads in agreement. A man, further back in the room, who appeared to be well into his 70’s, stood up, with the aid of his cane, in anticipation that I would call on him. I pointed to him and asked, “Do you have a question?” “Yes I do! Actually it’s more of a statement.” I said, “Please continue.” “Well, seems to me that dying is hard enough. All this talk of a ‘good death’ sounds like you are layering on an expectation that we do it correctly. I take exception to that.”

Again, there’s more nodding of heads. And then there was a fair amount of whispered chatter too.

I could tell the anxiety level in the group was beginning to peak. Perhaps I misjudged my audience. I thought they were with me, but at least some of them were either resisting or confused by the concept of a good death. So I decide to circle back to see if I could head off their growing concern.

I addressed the man in the back of the room who was still standing and leaning slightly on his cane. “I think there has been some misunderstanding. When I use the term a ‘good death,’ I don’t mean to suggest that there’s a ‘proper’ way of dying. As you suggest, sir, dying is hard enough all by itself, I certainly don’t want to add performance anxiety to the mix. Is anyone else getting the impression that I’m talking about a ‘correct way’ to die?”

Some of the participants tentatively raise their hands.dying well

I quickly took stock of the situation. If a few people were bold enough to raise their hands, others must have been feeling the same way but were too timid to acknowledge it. I decided to approach this in different way. I asked; “If we were talking about living the good life, would any of you feel as if you needed to conform to some arbitrary notion of what the ‘good life’ is?” Most everyone shook their head. “I thought not! So why then, did you make that leap when I mentioned the concept of a ‘good death’?”

This stumped my audience.

I went on to say; “One of the reasons death is such a hot button issue for most of us is because we’ve isolated death way over at the extreme end of our life. I think that’s a mistake. For one thing, it makes death stick out like a sore thumb, when actually it is part and parcel of life. Death is embedded in life. Nothing is alive that will not die. In fact, more things die than will ever have a real life. Consider the infant that is stillborn. For that child birth and death occurred at the same moment. But just because you and I lived beyond that crucial period in our lives, doesn’t me we were in the clear, so to speak.

If the truth were told, the first breath we took once outside our mother’s womb set us on a trajectory toward the inevitable end of our life. And each of us is old enough to have witnessed the death of many people, some older and some younger; if not personally then by proxy. We’ve all seen the carnage of war, the ravages of disease, and we’ve known sudden and accidental death too. So, to my mind, every breath, between our first and our last, is both our living and our dying. That’s why I say that living well and dying well are one and the same thing.”

I let that settle for a bit before I continued.

“There’s a secret I want to pass on to you. It’ll seem pretty simple and self-evident once you’ve embraced it. And the secret is: we must learn to integrate death into life. Once we do that, death stops being this freakish, scary thing over there waiting for its chance to pounce. Death is actually beside us all along. No, that’s not right! Death is not beside us; it’s in us! We are our death in the same way we are our life.

When we live the ‘good life,’ however we choose to define that, we are also living our ‘good death.’ And that’s what I want to address today. If we want to insure that our death, in as much as we have control over it, be good and wise, then we have to be proactive. Just as we have been proactive in living our ‘good life,’ in as much as we have control over that.”

Before I moved on to my next topic I had one final thing to say about a good death. “If we fear death then, on some fundamental level, we fear ourselves. And nothing good, least of all a good life, will ever come of that.”

Who’s gonna tell the kids?

“People’s deepest fears about death and dying often spring straight from a traumatic childhood incident or misshapen belief about the end of life that was passed on to them when they were kids.”

In previous postings I’ve talked about how postponing any thoughtful consideration of our death till it’s too late, can have disastrous consequences for us in terms of preparing for the inevitable. I addressed how our death-denying culture provides precious few opportunities for us to deal healthily with our mortality before it comes crashing in on us.

Why is dealing with death so hard for us? Early childhood messages about death sure don’t help. Think spooks, skeletons, things that go bump in the night, and specter of hell and damnation. From a young age, most of us have had it drilled into our heads that we shouldn’t ask questions or even talk about death because it’s either inappropriate, it’ll bring bad luck, or worse, hasten death.01

How many times, as a child, did a relative, family friend, or even a beloved family pet simply disappear, never to be heard from or spoken of again? Or perhaps you were told that the absent loved one is now in heaven or asleep with the angels, the “D” word being avoided like Aunt Agnes’s infamous tuna surprise? Or maybe, when you were a kid, you were told that someone you knew had died, but that you wouldn’t be able to go to the funeral because that was no place for kids. And how much of the confusion, bewilderment, and unresolved grief from your childhood are you still carrying around with you today? Is it any wonder that, when faced with the prospect of our own death, we often feel like we’ve been ordered to belt out our swan song without ever having an opportunity to learn the tune.

In the first chapter of my book, The Amateur’s Guide To Death And Dying, I ask my readers to confront head-on the un-golden silence that surrounds the end of life. I invite them to consider the early messages they got about death and dying. I ask; how old were you when you first heard about or witnessed these things? What were the messages you picked up about death and dying from the movies or television? People often report that their deepest fears about death spring straight from a traumatic childhood incident or misshapen belief about the end of life that was passed on to them when they were kids. And, not surprisingly, most people report that they continue to carry these fears with them as adults.

I believe that’s criminal. I also believe that there is a better way to handle this delicate matter with young people than avoiding it, sidestepping it, or perpetuating a misconception. I believe we can break the vicious cycle of our culture’s death phobia by refusing to contaminate another generation with it. It would take a concerted effort, of course, and it would mean that we would have to resolve ourselves of our own fears first, but I believe it’s doable.

A good place to begin this effort is with the stories we read to and tell our children. Stories, both written and recited, become the basis of our children’s understanding of the world. Stories contribute to their language development as well as their critical thinking, and coping skills. Death and grief are particularly thorny subjects to communicate to children, not because our children are incapable of grasping the message, but because we, the adult storytellers, are often unprepared for, or uncomfortable with, the topics ourselves.

To address this problem, I developed a workshop titled: Exploring Death and Grief Through the Medium of the Children’s Story. In this workshop I help adults choose age specific messaging and images for their storytelling. I help them mold the basic concepts about death and bereavement into the arc of their story. And finally, I offer the workshop attendees tips on writing and illustrating their own story with the kids in their life.

By way of example, I share with my audience my latest children’s story, Longfellow And The Deep Hidden Woods. This is the story of Longfellow, the bravest and noblest wiener dog in the world. As my story begins, Longfellow is a puppy learning how to be a good friend to his human companions, old Henry and Henry’s nurse Miss O’weeza Tuffy. By the end of the story, Longfellow has grown old himself, but he is still ready for one final adventure. What happens in between throws a tender light on the difficult truths of loss and longing as well as on our greatest hopes. Curiously enough, all the adults who have read my story say they think it’s actually a book for adults. Maybe so! I can be really subversive like that.

longfellow square smallWriting and illustrating a children’s story with your kids can be an amazing bonding experience for both the adult and the child, but this is especially true when the topics are death and bereavement. It’s a project that will open the door to a life-long appreciation for and the affirmation of life, especially it’s final season. The discussion that will be part of your story-writing project will also help you reshape the coming generation’s perceptions about the end of life. It may also help you rethink the early message you received about death and dying when you were a kid.

My workshop ends with one proviso. I caution the adults in my workshop not to wait until there’s a pressing need for the story writing or telling. I encourage them to start now, before grandpa or the beloved family pet is dead. I suggest that they get a jump on this project right away. Because, if they do, it won’t appear to their kids like they are trying to play catch up when death comes calling. I mean think about it; we don’t hold off teaching young people arithmetic till they get their first job making change at the grocery or the fast food counter, right?

Try to imagine how writing a story about death and grief with your kids or grand kids will change the trajectory of their life in terms of their understanding of this fundamental fact of life. Imagine if someone asks your kids or grand kids, twenty or forty years from now, what their earliest memories about death and dying are. Surely they will think back fondly on the time they spent with you as you helped them understand the marvelous cycle of life.

Will this one exercise inoculate your kids or grand kids from all the culturally induced fears, apprehensions and superstitions that abound in our death-phobic society? Probably not! But as the old adage goes, an ounce of prevention is worth a pound of cure.

TIBETAN SKY BURIAL

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{Tibetan: བྱ་གཏོར་, w bya gtor}, lit. ”alms for the birds” is a funerary practice in the Chinese provinces of Tibet, Qinghai, and Inner Mongolia and in Mongolia proper wherein a human corpse is incised in certain locations and placed on a mountaintop, exposing it to the elements {mahabhuta} and animals – especially predatory birds. The locations of preparation and sky burial are understood in the Vajrayana traditions as charnel grounds.

 

The majority of Tibetans and many Mongolians adhere to Vajrayana Buddhism, which teaches the transmigration of spirits. There is no need to preserve the body, as it is now an empty vessel. Birds may eat it or nature may cause it to decompose.

 

The function of the sky burial is simply to dispose of the remains in as generous a way as possible {the source of the practice’s Tibetan name}. In much of Tibet and Qinghai, the ground is too hard and rocky to dig a grave, and, due to the scarcity of fuel and timber, sky burials were typically more practical than the traditional Buddhist practice of cremation. In the past, cremation was limited to high lamas and some other dignitaries, but modern technology and difficulties with sky burial have led to its increasing use by commoners.

 

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