Tag: Death Meditation

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How I learned to talk about death and dying

First step: Acknowledge it, together

By Steven Petrow

A serious illness is many things — terrifying, painful, life-altering. The prospect of losing a loved one, or your own life, becomes an unspeakable agony. It’s also isolating in a way I never could have imagined. I’ve been the one in that sickbed, and I’ve also done some time sitting beside it. I wouldn’t wish either experience on anyone.

Lately, however, I’ve been thinking about what memoirist Meghan O’Rourke has called “the long goodbye” and trying to focus on the one gift it does give us: the gift of time. Time to plan, but mostly time to unearth and process our feelings. And then, if we’re fortunate, to be able to share these deep-seated fears with those we love.

This is not easy. When my mother learned she had lung cancer several years ago, we both turned to humor to help absorb the meaning of her diagnosis and to deflect the pain. One afternoon, many months before she died, Mom said with a wry smile, “I think I’m really dying.” To which I replied, “You mean today? Because I’m going to the market, so if you really think so, I won’t shop for you.” “That’s hilarious,” Mom countered, a hungry smile now on her face. “What’s for dinner?” Very adroitly, pretty much reflexively, we had avoided the elephant in the room.

Mom’s health deteriorated over the next several weeks. Again, she raised the question of her death, but now without the smile. “Will dying be painful?” she asked. In that moment, I knew I needed to confront my own feelings about her mortality and not sidestep the conversation with facile banter.

I took Mom’s hand in mine and said, “Don’t worry, it won’t be painful.” I told her hospice had provided a “comfort kit,” which contained medications for restlessness, confusion, anxiety, sleeplessness, constipation and, of course, pain management. I could feel Mom’s hand relax. Finally, she said, with a palpable sense of relief, “Thank you.”

In the weeks after that, we began a new chapter. I hadn’t realized how much effort had gone into my denial. I thought about the many times I had said, “if you die …,” which denied what we both knew was inevitable. After I dropped the subjunctive and began to talk about when she died, a barrier was eliminated. She knew. I knew. Now, we knew together.

I don’t think Mom suffered in her final days. After she became “unresponsive” (considered part of “active dying”) I returned to that comfort kit at the direction of a nurse. I removed the liquid morphine and gently squeezed one drop, then a second into her mouth. When the end came a few hours later, my sister, brother and I sat on her hospital bed, holding hands with each other and our mother as she died. What a gift, I thought, as we helped her to let go honestly, openly, and — most importantly — together.

Three decades earlier, when I was newly in remission from my own cancer, I had so many worries — about recurrence, additional treatments, more surgery. But at its core the fear was always about dying, which I never acknowledged, which meant no opening for others to broach the topic. I tried hard to keep those anxieties buried away, mostly by taking anti-anxiety medications. I’d pop a Klonopin and for four hours I’d be “fine,” as I often repeated. Still, I felt detached from others, even myself, but in my mind, that was better than feeling. Or worse: talking about feelings with others.

I chose to be alone.

Every time when I returned to the hospital for follow-up labs and scans, I’d medicate. But drugs, it turns out, can do only so much. I’d still taste the fear in my throat, or notice the shallowness of my breathing. A few times I vomited — spontaneously — the associations too strong. No matter how hard I tried, I could not effectively lock away that demon, that fear.

Then I decided to volunteer at the cancer hospital that had given me so much, sharing my cancer “experience” with patients, which invariably included discussions of fear. I realized how helpful these conversations — about hair and weight loss, recurrence and remission, life and death — were to the patients I met in the hospital, either newly diagnosed or undergoing treatment. But these talks changed me, too.

For far too long, my fears had been caged inside me, dense and dark. Laura Wallace, a licensed clinical social worker whose practice focuses on transitions and loss, explained that acknowledging feelings of “loss and longing,” while deeply painful, is a much better alternative than anger, addiction and anxiety. Or denial.

Releasing these fears — into the rooms where I had these conversations, into the air outside the hospital when I would walk away — was liberating. Imagine a vial filled with dark blue worry. Release a drop into a small cup of water and it colors the water. Release another drop, this one into a gallon bucket, and it becomes nearly impossible to detect. By acknowledging and sharing my fears openly, I let them go and they began to dissolve. Eventually, I stopped taking those anti-anxiety medications.

In her recent memoir, “Going There,” journalist Katie Couric, whose husband died of colon cancer in 1998 at age 42, tells of feeling trapped between a rock and a hard place. “I was so worried about letting go of hope because I didn’t want Jay to spend whatever time he had left just waiting to die,” she wrote. “I think it takes extraordinary courage to be able to face death, and I think I was too scared, honestly.”

Couric’s words reverberated with me, especially as I’ve tried to take the lessons learned from my mother’s death, and my own illness: How to be present. How to balance today with tomorrow. How to find the courage to embrace what’s so often unspeakable.

A longtime friend, Barry Owen, succeeded in all three ways.

At 66, he revealed his pancreatic cancer diagnosis in a blog post. He knew, as did his husband, Dan, the unforgiving prognosis. (Stage IV pancreatic cancer has a five-year survival rate of 1 percent, according to Johns Hopkins Medicine.) “I have no illusions about this disease,” Barry wrote on his Caring Bridge blog, which was read by about 30 of his closest friends, including his two brothers.

Three months after his diagnosis, Barry pushed open the door to a conversation about dying. “Dan and I are starting to talk about planning, planning for my death,” he wrote. “This is not easy to write about.”

It was not easy to read about, either. But we joined the conversation with Barry and Dan, I hope, supporting them if not sharing their pain.

Barry did well enough for a while — long enough to celebrate his 67th birthday, to make a farewell tour to friends, and to enjoy the winter holidays. By spring, all that had changed. Eleven months after diagnosis, one of his caregivers posted the sentence everyone expected, yet dreaded. “So, yes, he is dying.” We understood. Barry’s followers made that final journey together with him.

During those final days I thought of “The Mary Tyler Moore Show,” one of Barry’s favorites, specifically the final scene where Mary, Rhoda, Lou, Ted and all the rest huddle, and walk offstage together, as one. It’s a tear-jerker, for sure.

We leaned in, through the Caring Bridge site. One friend acknowledged the heartbreak of losing Barry. His brother, Jamie, posted: “We all know the inevitable result, but it doesn’t keep me from becoming emotional every day.” I wrote that I’d burst into tears upon reading the news, but that I felt so deeply connected to his friends. Amid all this, a friend reminded us that Barry’s mantra had always been “Only connect,” which to him spoke to the importance of our relationships to help defeat “the isolation” — as novelist E.M. Forster put it — that keeps us apart.

I felt privileged to be among all these beautiful souls, so in touch with their feelings and able to express them. I thought then — as I do now — how rare this gift is. When Barry died, we held onto one another, tightly albeit it virtually. One friend posted, “Although I only know a few of all the friends around Barry, I feel part of you and share your grief.” Another wrote, “How terrible our loss.”

Complete Article ↪HERE↩!

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Loyal dog and veteran pass away within hours of each other

A dog’s loyalty to its owner is unshakeable. Even during the toughest times, they will remain by their human’s side.

By iHeartDogs.com

Gunner, an 11-year-old lab, was an extremely loyal pooch.

He has never left Daniel Hove’s side. Everywhere his human went, he was there. They turned out to be hunting buddies and best friends, too.

When Daniel received his pancreatic cancer diagnosis, Gunner was with him.

Even though he was a big dog, he’d go to Daniel and the two would cuddle up together. They’d spend an entire day like that.

“They were best buddies till the end. They were hunting buddies, they went everywhere together,” Daniel’s daughter, Heather Nicoletti, said in an interview Kare 11.

The Air Force veteran and his dog were literally inseparable.

Eventually, though, Gunner fell ill.

This was a bit expected, as the family noticed how incredibly in sync the two were.Daniel’s daughter, Heather, shared that she and her family more or less based their expectations of her dad’s daily health off of his dog.

“My dad was unresponsive, the dog was unresponsive. So once we saw how the dog was doing–he wasn’t moving much anymore, not doing well– we knew, it was coming.”

One day, Gunner grew listless.

His arms began to swell and he fell more ill. At that point, Heather knew that it was time to say goodbye to her dad’s dog.

She called the clinic she used to work at. When she got there, they put her dad’s long-beloved dog to sleep. He was right there beside him as he passed.

Within just an hour and a half, Daniel was gone too.

Knowing what happened to Gunner, the family couldn’t help but feel that the loving veteran would be gone soon as well. They did everything together, after all.

“Gunner could not be without my dad. I think he chose to go with him,” Heather continued.

However, they didn’t expect them to pass away within such a short time of each other. Losing both of them within the span of 90 minutes dealt a heavy blow to the ones that Gunner and Daniel left behind.

The family was devastated.

It’s always so sad to say goodbye to someone close to your heart. For Heather, she took comfort in the fact that her father never really had to say goodbye to his devoted, loving, and loyal dog.

In a sense, his passing couldn’t have gone any better. He wouldn’t be making the trip to the afterlife alone. His best friend was now with him even into eternity.

Now, Daniel and Gunner get to be together forever, pain-free.

In that sense, at least, the family was able to spare them from the pain of saying goodbye to each other.

“I had said I don’t know what’s going to be more traumatic for him. To try to take him away to end–to put him to sleep– to end his suffering, or if you let him live through dad dying. I think either way it’s going to kill him. We knew they were going to go together. We just didn’t know it was going to be hours apart,” -Heather shared.

Complete Article ↪HERE↩!

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Dignity therapy

— Making a patient’s last words count

Guided conversations with terminally ill people are popular with patients, families and doctors who’ve experienced them. But are they truly beneficial? Researchers are looking beneath the anecdotal appeal.

by Lola Butcher

In the mid-1990s, psychiatrist Harvey Max Chochinov and his colleagues were researching depression and anxiety in patients approaching the end of their lives when they became curious about this question: Why do some dying people wish for death and contemplate suicide while others, burdened with similar symptoms, experience serenity and a will to live right up to their last days?

Over the next decade, Chochinov’s team at the University of Manitoba in Canada developed a therapy designed to reduce depression, desire for death and suicidal thoughts at the end of life. Dignity therapy, as it is called, involves a guided conversation with a trained therapist to allow dying people to speak about the things that matter most to them.

“It is a conversation that we invite people into, to allow them to say the things they would want said before they are no longer in a position to be able to say it themselves,” Chochinov says.

Dignity therapy is little known to the general public but it has captivated end-of-life researchers around the world. Studies have yet to pin down exactly what benefits it confers, but research keeps confirming one thing: Patients, families and clinicians love it.

These end-of-life conversations are important, says Deborah Carr, a sociologist at Boston University who studies well-being in the last stages of life and explored the topic in the 2019Annual Review of Sociology.

A key need of people who know they are dying is tending to relationships with people who are important to them. This includes “being able to communicate their wishes to family and ensuring that their loved ones are able to say goodbye without regret,” she says.

And the closer we get to death, the more we need to understand what our lives have amounted to, says Kenneth J. Doka, senior vice president for grief programs for Hospice Foundation of America.

“As people reach the end of life, they want to look back and say, ‘My life counted. My life mattered. My life had value, had some importance,’ in whatever way they define it,” Doka says. “I think dignity therapy speaks to that need to find meaning in life and does it in a very structured and very successful way.”

A dignified ending

Chochinov’s search to understand why some people feel despair at the end of life while others do not led him to countries like Belgium, the Netherlands and Luxembourg, where euthanasia and assisted suicide have long been legal. There he learned that the most common reason people gave for seeking assisted suicide was loss of dignity.

To learn more, Chochinov and his colleagues asked 213 terminal cancer patients to rate their sense of dignity on a seven-point scale. Nearly half reported a loss of dignity to some degree, and 7.5 percent identified loss of dignity as a significant concern. Patients in this latter group were much more likely to report pain, desire for death, anxiety and depression than those who reported little or no loss of dignity.

Dignity at the end of life means different things to different people, but in interviews with 50 terminally ill patients, Chochinov and his colleagues found that one of the most common answers related to a dying person’s perception of how they were seen by others.

“Dignity is about being deserving of honour, respect or esteem,” Chochinov says. “Patients who felt a lost sense of dignity oftentimes perceived that others didn’t see them as somebody who had a continued sense of worth.”

Dignity therapy is tailored to enhance this sense of worth. In a session, a therapist — typically a clinician or social worker — carefully leads the patient through a series of nine questions (see graphic) that help a person express how their life has been worthwhile.

“It’s not like a recipe, that you can just read out these nine questions and then call it dignity therapy,” Chochinov says. “We train therapists so that we can help them guide people through a very organic kind of conversation.”

The session typically lasts around an hour. About half is spent gathering biographical highlights, and the other half focuses on what Chochinov calls the “more wisdom-laden” thoughts that the patient wants to share.

A few days later, the patient receives an edited draft for review. “There’s an ethos of immediacy — your words matter, you matter,” he says. “They can edit it and they can sign off on it to say, ‘That is what I want as part of my legacy.’”

But does it work?

Miguel Julião, a physician in Lisbon, Portugal, specialises in helping patients who have difficult symptoms, which is why he was asked one day a few years ago to see a patient suffering with unbearable pain.

“The minute I got into his room, he told me ‘I would like you to help me die soon,’” Julião says. “I told him, ‘I don’t agree with euthanasia and I don’t do it, but I would like to know about you as a person and what you are most proud of in your life.’”

In the next few minutes, Julião learned about the man’s pride in raising “two good human beings” and stories of their life as a family. And he received an invitation to return for more conversations, which continued until the man died a month later.

The encounter prompted Julião, who was pursuing his doctorate at the time, to pivot his research and focus squarely on dignity therapy. He has had lots of company. Chochinov estimates that nearly 100 peer-reviewed research papers, and at least four in-depth analyses — “systematic reviews” of the accumulated science — have been published so far, and more studies are ongoing. The largest study yet, of 560 patients treated at six sites across the country, is now being conducted by Diana Wilkie, a nursing professor at the University of Florida, and colleagues.

Wilkie also helped conduct the first systematic review, published in 2015, which came up with a conundrum. When all studies were viewed together, the evidence that dignity therapy reduced desire for death was lacking. “The findings have been mixed,” she says. “In the smaller studies, you see benefit sometimes and sometimes not; in the larger studies, not.”

The most definitive study— Chochinov’s original clinical trial, completed by 326 adults in Canada, the United States and Australia who were expected to live six months or less — found that the therapy did not mitigate “outright distress such as depression, desire for death or suicidality,” although it provided other benefits, including an improved quality of life and a change in how the patients’ family regarded and appreciated them. A few years later, however, Julião conducted a much smaller trial in Portugal in which dignity therapy did reduce demoralisation, desire for death, depression and anxiety.

Julião thinks that the different outcomes reflect differences in the patient groups: His study focused on people experiencing high levels of distress, while Chochinov’s did not. But Julião also notes that his study was small, with only 80 participants.

“We still need more evidence,” he says. “But, on the other hand, you see a high interest among clinicians, because they see it work in daily practice.”

Positive and negative results also may depend upon how studies measure “success.” Scott Irwin, a psychiatrist at Cedars-Sinai Cancer in Los Angeles, worked at a San Diego hospice that introduced dignity therapy in 2009.

“It was absolutely worthwhile — no question,” Irwin says. “Not only did the patients love it, but the nurses loved it and got to know their patients better. It was sort of a transformative experience for patients and the care team.”

Indeed, Wilkie’s literature review reported “overwhelming acceptability, rare for any medical intervention.” Patients seem to get something out of it, even if that “something” isn’t captured by measures like reduced desire for death. In one study of 100 terminally ill patients who received dignity therapy, 91 percent reported feeling satisfied or highly satisfied; in another, 93 percent gave high ratings of satisfaction.

In Portugal, family members of dying individuals have prompted Julião to develop new uses for the therapy. He and Chochinov first adapted the interview to be appropriate for adolescents. More recently, two individuals told Julião they regretted that their loved ones had died without receiving dignity therapy, prompting the researchers to create a posthumous therapy for surviving friends and family members.

In a study of this interview protocol for survivors, “we have wonderful, wonderful comments from people saying, ‘It’s like I’m here with him or with her,’” Julião says. Doing dignity therapy posthumously could be useful in helping families deal with bereavement, he says — an idea he’d like to test.

Barriers to use

But for all its appeal, few patients actually receive dignity therapy. Though the tool is well-known among clinicians and social workers who specialise in caring for seriously ill patients, it is not routinely available in the US, Doka says.

A primary barrier is time. The therapy session is designed to last just one hour, but in Irwin’s experience at the hospice, patients were often too tired or pain-ridden to get through the entire interview in one session. On average, a therapist met with a patient four times. And the interview then had to be edited by someone trained to create a concise narrative that is true to the patient’s perspective and sensitive in dealing with any comments that might be painful for loved ones to read.

Julião says he transcribes each patient’s interview himself and also edits it into the legacy document. The entire process typically takes about eight days; he suspects this is why he is one of only two people who provide dignity therapy in Portugal. He says he has enthusiastic responses from clinicians and social workers attending the lectures and workshops he has conducted since 2011. “But they don’t do it clinically because it’s hard for clinicians to dedicate so much time to this.”

Dignity therapy is most widely available in Winnipeg, its birthplace, where all clinicians at Cancer Care Manitoba, the organisation that provides cancer services in the province, have been trained in the protocol. If a patient expresses interest, or a clinician thinks a patient might be interested, a referral is made to one of the therapists, among them Chochinov.

“And then I see them, either in their hospital bed or more typically at their home,” he says.

A few months ago, he spent about an hour with a dying woman. She told him about her proudest accomplishments and shared some guidance for her loved ones.

A few days after he delivered a transcript of the conversation, the woman thanked him by email for their discussion and for the document that “will give my family something to treasure.”

“Dignity therapy is part of the bridge from here to there, from living my life fully to what remains at the end,” she wrote. “Thank you for helping me to tell this story.”

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What “Shared Death Experiences” Are

& Why We Need To Discuss Them

By William Peters, MFT

As an end-of-life therapist and researcher, I have long known that American culture has an uneasy relationship with death. We have been taught to “fear” death and dying. Fitness regimens, diets, and cosmetic procedures tout themselves as being able to “turn back the clock.” Medicine is even more uncomfortable with life’s end: Beating death is often presented as the ultimate goal. Aggressive measures to prolong life are viewed as a testament to our love for another person.

This relentless effort to fend off death is confounding when one considers that opinion polls consistently find that the majority of Americans believe in a benevolent afterlife. It would appear that the public interest in the mysteries that surround life’s end is far more extensive than our institutions would suggest.

Why we don’t feel comfortable discussing shared death experiences.

Much of my work centers on the transition from life to death, specifically “shared death experiences” where the living report a connection with the deceased around the time of their death. I’ve overwhelmingly found that this connection involves a clear sense that their loved one has moved on to a better place. In more than 50% of the cases that I have studied, experiencers even report accompanying their friend or loved one part way on their journey out of earthly life.

Knowledge of this transition space is an open secret in palliative and hospice care. We know that many terminally ill patients also report being aware of or seeing deceased family members, friends, and even pets, in the room with them, coming to help usher them out of this world. Some shared death experiencers also see or sense these figures as well.

Yet, again and again, shared death experiencers tell me that they feel uneasy discussing this subject with their health care and spiritual care providers. Their concern is valid, as one study found that 80% of patients who had sensed the presence of a deceased and shared it with their therapist felt dissatisfied with their counselors’ responses. They either did not feel understood, or they felt dismissed.

It wasn’t always this way.

One of the earliest written works on end-of-life care is the medieval text Ars Moriendi or “Art of Dying,” which was utilized in Catholic monasteries in Europe. Not only does it contain information on prayers, music, and pain remedies, as well as guidance on managing mental and emotional distress among the dying, but it is surprisingly ecumenical, drawing guidance from Catholic, Celtic, Jewish, and even Islamic traditions. Its underlying message is that dying is a spiritual experience and that it is possible to die well and be comforted. However, in our own era, there has been a strong reluctance to discuss what makes a good death or to openly explore what happens to us when we die.

In our own era, there has been a strong reluctance to discuss what makes a good death.

Speaking of her own shared death experience, Stephanie, a woman in Washington, D.C., whose husband died of aggressive cancer, recalled traveling with him into an incredibly bright, white light. She said, “There was no pain, no hurt. It was peaceful,” adding, “It felt as if I were going back to something I already knew.” But her own clergy shut down any conversation, and “that deflated me terribly,” she said. Finally, an oncologist told her that he’d had a similar experience. He told her this, however, after closing the office door and stating he would never share his experience with anyone else.

I believe that these hushed discussions could be the very things we need to help both the dying and the bereaved. Listening to and examining stories of individuals who have had shared death experiences can offer us another framework in which to process and accept death.

Consider the story of Carl, a California man whose father died of heart failure in Massachusetts. He experienced an overpowering sensation of being next to his father, saying “I could feel it in my bones and my cells that my dad was there with me.” While the experience did not end his grief, it changed his perspective. “I miss my dad,” he told me, adding, “and I wish I could call him up and be with him and spend time with him. I grieved and was sad, but it doesn’t feel like a tragedy. It feels like he is in the place he needs to be.”

Indeed, of the nearly 1,000 cases I have studied, 87% of the people interviewed report that their experience has convinced them that there is a benevolent afterlife. Nearly 70% said their shared death experience has positively affected their grief, and more than 50% said that it has removed their own fears around death and dying.

The takeaway.

In the last two years, the pandemic has resulted in a wave of death among people we know and love. Perhaps now, together, we can start a new conversation—one that is willing to include the voices of shared death experiencers. With their heartwarming stories, we may be able to transform our relationship with death from one of resistance and fear to that of acceptance, ease, and wonder of this great mystery that we will all one day embark on.

Complete Article ↪HERE↩!

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I’m a rabbi and I helped my father end his life

By Rabbi Rachel Timoner

“Promise me you will help me die.”

My father was 92 years old. He had congestive heart failure and COPD. He was living on oxygen and a dozen medications that had kept him alive since a debilitating stroke paralyzed him forty years ago. Last year, when his doctors told him that he was dying in a matter of weeks, or months, he urgently, desperately needed to end his life on his own terms.

My phone would ring in my Brooklyn apartment.

“Dad?”

“You have to help me die today, Rachel. I need to die today, please.”

“I can’t help you die today, Dad.”

“Rachel, please, you have to help me.”

This is how it went, day after day, sometimes several times a day, until my brother realized that in California, where they live, it was legal for my father to choose to end his own life.

And that is how I found myself at my father’s bedside in Los Angeles, supporting him as he took his own life, as his daughter and as his rabbi.

Judaism holds life sacred. In Genesis, when creating humans, G-d sees that it is very good. G-d creates us in G-d’s own image and breathes life into human beings, giving human life supreme value. The Mishnah teaches that saving one life is like saving an entire world. Pikuach nefesh (saving a life) supersedes all other mitzvot, except those forbidding murder, adultery, and idolatry. This love of life is the foundation of Jewish ethics and has led our tradition to stand firmly against any action that would lead to death.

Thus we read in the “Comprehensive Guide to Medical Halakha,” published in 1990 by Abraham S. Abraham:

“One may not hasten a death, even that of a patient who is suffering greatly and for whom there is no hope of a cure, even if the patient asks that this be done. To shorten the life of a person, even a life of agony and suffering, is forbidden.”

And in “Modern Medicine and Jewish Ethics” by Fred Rosner in 1991:

“Any positive act designed to hasten the death of the patient is equated with murder in Jewish law …. only the Creator, who bestows the gift of life, may relieve man of that life, even when it has become a burden rather than a blessing.”

I am a rabbi. I know well Judaism’s ban on euthanasia. But when I understood that my father would take his own life, I knew without a doubt that I would be by his side. He had soldiered on in this life for 92 years, uncomplaining, to be there for us and for his grandchildren. Now he wanted to leave the world, and all I could do was honor his wishes.

As this became my father’s story, I began to inquire more deeply into our tradition and found voices questioning this consensus in Jewish law. For example, Rabbi Leonard Kravitz argues that the story of the torturous death of Rabbi Hananiah at the hands of the Romans, which is usually read as a proof-text for the ban on euthanasia, can equally be read to make the case that hastening death when death is inevitable is an act of mercy. Rabbi Kravitz argues that Jews who are terminally ill and suffering should be able to choose a mitah yafah, a good death, which Rashi defines as sheyamut maher, that they should die quickly, particularly given that the Talmud prescribes this kind of death for criminals who will be executed by the court. If criminals deserve a good death, a death in which they are spared long, slow agony and suffering, Rabbi Kravitz argues, shouldn’t those who’ve committed no crime be allowed to choose this as well?

I raise this now in this public forum because my sister has made a film about my father’s death called “Last Flight Home,” and her film is premiering at the Sundance Film Festival today. In the film, viewers will see me, acting as a daughter and also a rabbi, loving and supporting my father as he ends his own life. I am aware that this will be upsetting and even offensive to many in the Jewish community. I do not wish to create controversy on this issue, and I would not have chosen to make this film. I would not have chosen for my father’s death to be viewed by the public at all, and I would not have chosen to champion this issue. But I have cared for others who desperately wished for this choice at the end of their lives, and I think it might be time for the Jewish people to reconsider our views on this important matter.

March 3rd will be my father’s first yahrzeit. May his memory forever be a blessing.

Complete Article ↪HERE↩!

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What a terminal cancer diagnosis is teaching this neuroscientist about the human mind

David J. Linden, a neuroscientist, writes in The Atlantic about how facing the end of his life is teaching him about the human mind.

By Scott Tong

Neuroscientist David J. Linden is dying.

But the impending end of his life doesn’t mean he’s done learning about the human mind just yet. Linden was recently diagnosed with terminal cancer. In a piece in The Atlantic, he writes: “I may be dying, but I’m still a science nerd.”

During a routine echocardiogram, doctors noticed something sticking up next to Linden’s heart that they thought was a hiatal hernia or a benign growth called a teratoma, he says. After the tumor was removed, a biopsy found it was a form of malignant cancer called synovial sarcoma that had grown into the wall of his heart — making it impossible to remove.

One way the biomedical researcher at Johns Hopkins University School of Medicine processes his diagnosis is by nerding out about it. His doctors showed him photos of his tumor and heart surgery to his excitement.

“It is empowering to be a nerd about something really grim, meaning my own terminal cancer,” he says. “But I think the more interesting thing is what it has led me to think about the human mind.”

After his diagnosis, he writes that feelings of anger about his shortened time came alongside gratitude for his love, relationships and career in neuroscience.

The fact that the human brain can occupy two mental states at once may be obvious for most people, Linden says, but it took his diagnosis for him to realize it.

In neuroscience, researchers believe people have a specific mental state at a given moment: sleepy or alert, exploring or pulling back.

“In truth, you can occupy more than one cognitive state at once, even if these states at first blush would seem to be contradictory,” he says, “like in my case, are gratitude and anger.”

Linden writes that there is no objective human experience: “All that we perceive and feel is colored by expectation, comparison and circumstance.” One example of this is people’s relative conception of time.

Time drags on while you wait in line at the Department of Motor Vehicles, he says, but it flies when you’re having a beer and conversation with a friend.

“All of our human perception is constructed. There is no objective experience in the world,” he says. “It’s all colored by our mood and our expectations.”

The concept of five years can feel different depending on where you are in life, he writes. One might think five years has a fundamental value that can’t change, but he knows that’s not the case.

“If someone had told me before my diagnosis that I had five years left to live, I would have been feeling deeply cheated and offended,” Linden says. “But now, with my prognosis of six to 18 months of life to live, the idea of five more years seems like an impossible gift.”

The human brain isn’t wired to comprehend our own death — that we will someday no longer exist, he says.

Linden can practically deal with his impending death by finalizing his will, getting his finances in order and writing recommendations for his trainees to help further their careers after he’s gone. But he finds himself failing to “deeply engage” with the idea of a world without him, he says.

“My mind skitters over the surface of this, and I don’t think that’s a personal failing,” he says. “I think it is telling us something about being human.”

When Linden entered the neuroscience field 43 years ago, he learned that the brain is reactive: Humans use their senses to make decisions about the world around them. One recent advancement in the field is the knowledge that the brain is always active and predicting the near future.

The brain spends a lot of time trying to figure out if other people are friends or enemies, or whether hunger is approaching, he says.

“The idea that the brain is constantly working to predict the near future presupposes that there will be a near future,” he says. “And I think in this way, our brains are hard-wired to have a problem with truly engaging with our own demise.”

Linden has been pondering questions about immortality and how our inability to engage with our own deaths has influenced human history in the form of religion. Almost all of the world’s major religions believe in an afterlife, reincarnation or some form of an “immortal soul” that lives beyond the demise of the body, he says.

“What I suspect is … that this is a result of the fact that our brains are hardwired to continuously predict the future and thereby to make it very difficult for us to imagine ourselves gone,” he says. “I think that this is the way this manifests in the species, the way it manifests societally.”

Considering the extent of religion’s impact on human society, it’s “astonishing” to think about how much this one aspect of the brain has molded humanity, he says.

Taking a step back and observing the human mind in this way gives Linden comfort in his final days.

“To me, thinking about the way my own impending death informs me about the human mind is a way for me to take control of my situation — to feel a sense of agency — rather than just being passive and borne along by this medical problem,” he says. “I feel that it’s given me a way to engage, to think to the end. And that’s an enormous gift.”

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What I Learned About Death From 7 Religious Scholars, 1 Atheist and My Father

By George Yancy

Just a few days before my father died in 2014, I asked him a question some might find insensitive or inappropriate:

“So, what are your thoughts now about dying?”

We were in the hospital. My father had not spoken much at all that day. He was under the influence of painkillers and had begun the active stage of dying.

He mustered all of his energy to give me his answer. “It’s too complex,” he said.

They were his final spoken words to me before he died. I had anticipated something more pensive, something more drawn-out. But they were consistent with our mutual grappling with the meaning of death. Until the very end, he spoke with honesty, courage and wisdom.

I have known many who have taken the mystery out of death through a kind of sociological matter-of-factness: “We all will die at some point. Tell me something I don’t know.” I suspect that many of these same people have also taken the mystery out of being alive, out of the fact that we exist: “But of course I exist; I’m right here, aren’t I?”

Confronting the reality of death and trying to understand its uncanny nature is part of what I do as a philosopher and as a human being. My father, while not a professional philosopher, loved wisdom and had the gift of gab. Our many conversations over the years touched on the existence of God, the meaning of love and, yes, the fact of death.

In retrospect, my father and I refused to allow death to have the final word without first, metaphorically, staring it in the face. We were both rebelling against the ways in which so many hide from facing the fact that consciousness, as we know it, will stop — poof!

We know the fact of death is inescapable, and it has been especially so for the nearly two-year pandemic. As we begin another year, I am astonished again and again to realize that more than 800,000 irreplaceable people have died from Covid-19 in the United States; worldwide, the number is over five million. When we hear about those numbers, it is important that we become attuned to actual deaths, the cessation of millions of consciousnesses, stopped just like that. This is not just about how people have died but also that they have died.

My father and I, like the philosopher Soren Kierkegaard, came to view death as “by no means something in general.” We understood that death is about me, him and you. But what we in fact were learning about was dying, not death. Dying is a process; we get to count the days, but for me to die, there is no conscious self who recognizes that I’m gone or that I was even here. So, yes, death, as my father put it, is too complex.

It was in February of 2020 that I wrote the introduction to a series of interviews that I would subsequently conduct for The Times’s philosophy series The Stone, called Conversations on Death, with religious scholars from a variety of faiths. While my initial aim had little to do with grappling with the deaths caused by Covid-19 (like most, I had no idea just how devastating the virus would be), it soon became hard to ignore. As the interviews appeared, I heard from readers who said that reading them helped them cope with their losses during the pandemic. I would like to think that it was partly the probing of the meaning of death, the refusal to look away, that was helpful. What had begun as a philosophical inquiry became a balm for some.

While each scholar articulated a different interpretation of what happens after we die, it was not long before our conversations on death turned to matters of life, on the importance of what we do on this side of the grave. Death is loss, each scholar seemed to say, but it also illuminates and transforms life and serves as a guide for the living.

The Buddhist scholar Dadul Namgyal stressed the importance of letting go of habits of self-obsession and attitudes of self-importance. Moulie Vidas, a scholar of Judaism, placed more emphasis on Judaism’s intellectual and spiritual energy. Karen Teel, a Roman Catholic, emphasized her interest in working toward making our world more just. The Jainism scholar Pankaj Jain underscored that it is on this side of the veil of death that one attempts to completely purify the soul through absolute nonviolence. Brook Ziporyn, a scholar of Taoism, stressed the importance of embracing this life as constant change, being able to let go, of allowing, as he says, every new situation to “deliver to us its own new form as a new good.” Leor Halevi, a historian of Islam, told me that an imam would stress the importance of paying debts, giving to charity and prayer. And Jacob Kehinde Olupona, a scholar of the Yoruba religion, explained that “humans are enjoined to do well in life so that when death eventually comes, one can be remembered for one’s good deeds.” The atheist philosopher Todd May placed importance on seeking to live our lives along two paths simultaneously — both looking forward and living fully in the present.

The sheer variety of these religious insights raised the possibility that there are no absolute answers — the questions are “too complex”— and that life, as William Shakespeare’s Macbeth says, is “a tale told by an idiot, full of sound and fury, signifying nothing.” Yet there is so much to learn, paradoxically, about what is unknowable.

Perhaps we should think of death in terms of the parable of the blind men and the elephant. Just as the blind men who come to know the elephant by touching only certain parts of it, our views of death, religious or not, are limited, marked by context, culture, explicit and implicit metaphysical sensibilities, values and vocabularies. The elephant evades full description. But with death, there doesn’t seem to be anything to touch. There is just the fact that we die.

Yet as human beings, we yearn to make sense of that about which we may not be able to capture in full. In this case, perhaps each religious worldview touches something or is touched by something beyond the grave, something that is beyond our descriptive limits.

Perhaps, for me, it is just too hard to let go, and so I refuse to accept that there is nothing after death. This attachment, which can function as a form of refusal, is familiar to all of us. The recent death of my dear friend bell hooks painfully demonstrates this. Why would I want to let go of our wonderful and caring relationship and our stimulating and witty conversations? I’m reminded, though, that my father’s last words regarding the meaning of death being too complex leave me facing a beautiful question mark.

My father was also a lover of Kahlil Gibran’s “The Prophet.” He would quote sections from it verbatim. I wasn’t there when my father stopped breathing, but I wish that I could have spoken these lines by Gibran as he left us: “And what is it to cease breathing, but to free the breath from its restless tides, that it may rise and expand and seek God unencumbered?”

In this past year of profound loss and grief, it is hard to find comfort. No matter how many philosophers or theologians seek the answers, the meaning of death remains a mystery. And yet silence in the face of this mystery is not an option for me, as it wasn’t for my father, perhaps because we know that, while we may find solace in our rituals, it is also in the seeking that we must persist.

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