Pets on pot: is medical marijuana giving sick animals a necessary dose of relief?

As owners tout benefits and usage in compassionate care, the battle for legalization mirrors humans’ own medical marijuana fight in 1990s California

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Bernie
The Georgiadis’s dog, Bernie, who hasn’t had a seizure in four months.

Bernie, a 130-pound Swiss mountain dog, began having grand mal seizures when he was six months old. About once a week he would violently convulse, foam at the mouth, and urinate on himself for several minutes before recovering an or so hour later. The medication he was given seriously disoriented him, was harmful to his liver and for the most part didn’t work.

At the end of their rope, Bernie’s parents decided to put him on a pet supplement derived from cannabis. Gradually, his seizures became less severe and less frequent, before disappearing altogether.

Despite a large amount of promising anecdotal evidence like Bernie’s story, and a growing industry of cannabis-based pet products, many people have a hard time taking medical marijuana for pets seriously.

“It sounds ridiculous, until you experience it yourself,” said Bernie’s owner, Anthony Georgiadis, who says his dog hasn’t had a seizure in four months.

Living in Florida, where medical marijuana is illegal, Georgiadis orders Bernie’s supplement online from a California company called Treatibles. He is allowed to do this because Treatibles products are derived from legal hemp and contain little to no THC (the intoxicating ingredient in marijuana).

Many pet products are not made from hemp, though, but rather straight marijuana containing trace amounts of THC. So anyone wanting these products for their animal’s chronic pain, anxiety, inflammation, appetite stimulation, or epilepsy have to live in a state where medical marijuana is legal – and even then, they need to have a prescription for themselves just to enter a dispensary.

Last year, Tick Segerblom, a Nevada state senator, introduced a bill to create a medical marijuana registry for pets.

“They thought it was a joke,” Segerblom said of his senate colleagues. “It was the talk of the country for a while.”

“Look at this moron!” Dennis Miller screamed on the O’Reilly Factor, deriding the senator’s bill, calling it “the end of culture as we know it”.

“I have fish at home that want medical marijuana,” O’Reilly joked. “I’m not exactly sure how to deliver that to them, because if you put the cigarette in there it all gets wet.”

Despite the public ridicule, Segerblom said, he had been looking forward to the issue being debated in a hearing, but that hearing never happened. In the end, he said, “it went to a committee headed by a person who hates marijuana, and he made sure that it died”.

Amanda Reiman, manager of marijuana law at the Drug Policy Alliance, said that today’s battle over animal medical marijuana mirrors the clash over human medical marijuana in 1990s California.

“When we first started talking about the idea of using marijuana as a medicine, people laughed about it,” she said. “But they’ve come around, because when you know someone who was helped by cannabis it’s not funny anymore.”

n 2013, Reiman’s cat, Monkey, was diagnosed with terminal intestinal cancer. The chemotherapy and medication caused Monkey to lose her appetite, not sleep and become lethargic. The situation reminded Reiman of the countless scenarios she’d encountered with humans after a decade of working in medical marijuana, so she decided to mix a very small amount of cannabis oil in Monkey’s food.

Monkey
In 2013, Reiman’s cat, Monkey, was diagnosed with cancer.

“It brought her energy back, she was eating and playing – she was actually acting healthier than she had been before she was diagnosed with cancer,” Reiman said. “I knew it wasn’t a cure for her, and in the end she passed away several months later. But I really do feel it gave her a quality of life at the end; instead of just fading away, she stayed strong right up until the end.”

Veterinarians caution against pet owners taking matters into their own hands, because finding the correct dose can be tricky. While many pet medicines are just human drugs in different doses, the weight ratios between humans and animals can make it easy to accidentally give your pet an overdose. And pets overdosing on cannabis is already a serious problem in states where marijuana is legal.

001As with children, it’s common for pets to stumble upon a high potency marijuana edible, eat it, and become incredibly ill and intoxicated.

“We’ve seen some serious poisonings of animals [from marijuana] and even a couple of deaths,” says the medical director at the ASPCA Animal Poison Control Center, Dr Tina Wismer.

When it comes to pet meds, Wismer says it’s not uncommon for a human medication to be applied to animals purely on the basis of anecdotal evidence. She believes more studies need to be done on the therapeutic use of cannabis on animals to find the right dose.

Dr Sarah Brandon, a veterinarian and cofounder of Canna Companion, a hemp-based pet supplement company, says that over the last 18 years, she has administered cannabis to more than 4,000 animals, and is currently analyzing data before offering it to the medical community.

“Right now, veterinarians have no guidance on this,” she says. “There’s a lot of fear out there, and they are scared to come out and recommend [cannabis]. A veterinarian can recommend a hemp-based product as a supplement, but they cannot encourage them to use marijuana.”

Dan Goldfarb, owner of Seattle-based Canna-Pet, describes the differences between hemp and marijuana: “It’s like dog breeds: you can have a chihuahua or a great dane, both of which are dogs but are bred to exude very different characteristics.”

Canna-Pet, Treatibles and Canna Companion are all strictly hemp-based, so they are allowed to sell their products outside of marijuana dispensaries – even online to states where marijuana is illegal – without the need of a prescription. This also affords them deniability when people like Dennis Miller say they just want to get their pet stoned. But there are a handful of companies who use straight marijuana in their pet products, who say that hemp is too limited.

“We’ve seen better results with a little THC,” says Alison Ettel, founder of Treat Well, who has been using cannabis on a variety of animals for ten years and was recently invited to treat seals at the Marine Animal Center in Sausalito, California. She says that hemp works for some ailments like anxiety, but doesn’t contain a number of medicinal properties that marijuana does, like appetite stimulation, and that hemp can be harmful to an animal with a compromised immune system. “We believe hemp can have more negative effects than positive.”

Ettel adds that while her products contain psychoactive properties, if used in the right dosage in proportion to the animal’s size, there is no reason they should ever become intoxicated by it.

Brian Walker’s California company, Making You Better Brands, offers a marijuana based doggie shampoo for pain relief (along with similar products for horses). Walker says that the marijuana is never activated with heat, a process necessary for making the plant psychoactive.

But his company is still regulated like any other in the cannabis industry, meaning pet owners can only buy it in a dispensary with a (human) prescription, and can’t take it out of state. Walker said the lack of information available about the differences between hemp, active cannabis and inactive cannabis has prevented acceptance among veterinarians of medical marijuana.

“They picture a dog eating a brownie and being high for two days,” he said. “But with non-active cannabis they’re not going to get high – they’re going to get well.”

 Complete Article HERE!

Spiritual care at the end of life can add purpose and help maintain identity

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Spiritual care

In Australian nursing homes, older people are increasingly frail and being admitted to care later than they used to be. More than half of residents suffer from depression, yet psychiatrists and psychologists aren’t easily accessible, and pastoral or spiritual care is only available in a subset of homes.

Depression at the end of life is often associated with loss of meaning. Research shows people who suffer from such loss die earlier than those who maintain purpose. This can be helped by nurturing the “spirit” – a term that in this setting means more than an ethereal concept of the soul. Rather, spiritual care is an umbrella term for structures and processes that give someone meaning and purpose.

Caring for the spirit has strength in evidence. Spiritual care helps people cope in grief, crisis and ill health, and increases their ability to recover and keep living. It also has positive impacts on behaviour and emotional well-being, including for those with dementia.

Feeling hopeless

Many people have feelings of hopelessness when their physical, mental and social functions are diminished. A 95-year-old man may wonder if it’s worth going on living when his wife is dead, his children don’t visit anymore and he’s unable to do many things without help.

The suffering experienced in such situations can be understood in terms of threatening one’s “intactness” and mourning what has been lost, including self-identity.

Nursing home residents are increasingly frail and more than half experience depression.
Nursing home residents are increasingly frail and more than half experience depression.

Fear is also common among those facing death, but the particular nature of the fear is often unique. Some may be afraid of suffocating; others of ghosts. Some may even fear meeting their dead mother-in-law again.

What plagues people the most though is the thought of dying alone or being abandoned (though a significant minority express a preference to die alone). Anxiety about dying usually increases after losing a loved one.

But such losses can be transcended by encouraging people to pursue their own purpose for as long as they can; in other words, by caring for the spirit.

What is spiritual care?

Spiritual care has religious overtones that make it an uncomfortable concept in a secular health system. But such care can be useful for all – religious and non-religious – and can be provided by carers, psychologists and pastoral specialists alike.

Spirituality can be defined as “the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred”. Perhaps the Japanese term “ikigai” – meaning that which gives life significance or provides a reason to get up in the morning – most closely encompasses spirituality in the context of spiritual care.

Guidelines for spiritual care in government organisations, provided by the National Health Services in Scotland and Wales, note that it starts with encouraging human contact in a compassionate relationship and moves in whatever direction need requires. Spiritual needs are therefore met through tailoring components of care to the person’s background and wishes.

Spiritual care can involve having your dog nearby or being surrounded by your favourite sports team regalia.
Spiritual care can involve having your dog nearby or being surrounded by your favourite sports team regalia.

For instance, one person requested that her favourite football team regalia be placed around her room as she was dying. Another wanted her dog to stay with her in her last hours. Supporting these facets of identity can facilitate meaning and transcend the losses and anxiety associated with dying.

Spiritual care can include a spiritual assessment, for which a number of tools are available that clarify, for instance, a person’s value systems. Such assessments would be reviewed regularly as a person’s condition and spiritual needs can change.

Some people may seek religion as they near the end of their lives, or after a traumatic event, while others who have had lifelong relationships with a church can abandon their faith at this stage.

Other components of spiritual care can include allowing people to access and recount their life story; getting to know them, being present with them, understanding what is sacred to them and helping them to connect with it; and mindfulness and meditation. For those who seek out religious rituals, spiritual care can include reading scripture and praying.

Spiritual care in the health system

Psychologists or pastoral care practitioners may only visit residential homes infrequently because of cost or scarce resources. To receive successful spiritual care, a person living in a residential home needs to develop a trusting relationship with their carer.

For those who seek out religious rituals, spiritual care can include reading scripture and praying.
For those who seek out religious rituals, spiritual care can include reading scripture and praying.

This can best be done through a buddy system so frail residents can get to know an individual staff member rather than being looked after by the usual revolving door of staff.

Our reductionist health care model is not set up to support people in this way. Slowing down to address existential questions does not easily reconcile with frontline staff’s poverty of time. But health care settings around the world, including Scotland and Wales, the United States and the Netherlands, are starting to acknowledge the importance of spiritual care by issuing guidelines in this area.

In Australia, comprehensive spiritual care guidelines for aged care are being piloted in residential and home care organisations in early 2016.

People with chronic mental illness, the elderly, the frail and the disabled have the right to comprehensive health care despite their needs often being complex, time-consuming and expensive.

Finding meaning at all stages of life, including during the process of dying, is a challenging concept. It seems easier to get death over with as quickly as possible. But the development of new spiritual care guidelines brings us one step closer to supporting a meaningful existence right up to death.

Complete Article HERE!

Everything dies and it’s best we learn to live with that

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Everything dies and it’s best we learn to live with that

Fear of dying – or death anxiety – is often considered to be one of the most common fears. Interestingly though, neither of the two widely used diagnostic psychiatric manuals, DSM-5 or ICD-10, has a specific listing for death anxiety.

Death is related in the manuals to a number of anxiety disordersincluding specific phobias, social anxiety, panic disorder, agoraphobia, post-traumatic stress disorder and obsessive compulsive disorder. Although many psychologists will argue that these fears are proxies for the larger fear of death.

Existential therapy directly targets death and the meaning of life. It’s practised by psychiatrist Irvin Yalom, a pioneer in understanding fear of death and how to treat it in therapy. He has written a popular book on the subject called Staring at the Sun: Overcoming the Terror of Death. Existential therapy is one way of treating death anxiety but no matter what psychological approach is used, the underlying theme is generally the same: acceptance.

What’s so frightening about death?

All life has death in common, yet it’s striking how little we actually talk about it. In Western cultures at least, the concept can be too much even to consider. But from a clinical psychology perspective, the more we avoid a topic, situation, thought or emotion, the greater the fear of it can become and the more we want to avoid it. A vicious cycle.

Fear of the unknown is one of the specific fears around death.
Fear of the unknown is one of the specific fears around death.

If presented with a client who has death anxiety, we would ask them to tell us exactly what they fear about death. Yalom once asked a client what bothered him most. The client replied, “The next five billion years with my absence.”

Yalom then asked, “Were you bothered by your absence during the last five billion years?”

The specific death fear will be different for everyone, but it can often be categorised into one of four areas: loss of self or someone else; loss of control; fear of the unknown – what will happen after death (nothingness, heaven, hell); and pain and suffering of dying.

Yalom suggests psychologists speak about death directly and early in therapy. The psychologist should find out when the client first became aware of death, who he discussed it with, how the adults in his life responded to his questions and whether his attitudes about death had changed over time.

Once we understand the client’s relationship to death, there are several approaches to help manage the associated anxiety. These include existential therapy, cognitive-behaviour therapy, acceptance and commitment therapy and compassion-focused therapy.

How to treat death anxiety

In one of the first studies to examine death anxiety directly, cognitive-behaviour therapy (CBT), was found to be successful in treating it in those suffering from hypochondria. The strategies used included exposure (going to a funeral), relaxation strategies (breathing) and creating flexible thoughts around death, such as recognising that fearing death is normal.

Some researchers argue that CBT should include strategies that explore the probability of life events – such as calculating the chances of your parents’ meeting and having you. Such techniques can shift our perspective from a negative fear of dying to a positive realisation we are lucky to experience life at all.

We must learn to accept death. It’s not going away.
We must learn to accept death. It’s not going away.

Existential therapy has been shown very useful in treating death anxiety. It focuses on ultimate existential concerns such as isolation. For instance, we have a deep need to belong and having family and friends means, in some way, we live on after death.

Treatment is directed at finding meaning and purpose in life, increasing psychological and social support, building relationships with friends and family and improving coping skills to manage anxiety in daily life.

In compassion focused therapy (CFT), the client is encouraged to descend into the reality of human experience. That means realising we only have about 25,000 to 30,000 days of life. Suffering is normalised and the emphasis is on the fact that the trajectory of life is the same for everyone: we come into this world, grow and flourish and then decay and die.

CFT discusses how the human brain has the fantastic ability to imagine and question our very existence – as far as we know a uniquely human quality. We will then say to clients: “Did you design your brain to have that capacity?” Of course the answer is a resounding no.

So we work on the principle that it is not the client’s fault they have death anxiety but that we must work with our brains so they don’t paralyse our ability to live now.

In CFT we will sometimes use the phrase, “Our brains were designed for survival not happiness”. Strategies arising form this include guided discovery (slowing down and giving clients opportunities to make their own insights) and soothing rhythm breathing.

Although subtly different in approach these therapies have a similar underlying theme. Death is something we must learn to accept. The key for us in the context of death anxiety is how we get out of our minds and into our life.

Some tips that could help

If you struggle with death anxiety, please consider seeing a psychologist. But for now, here are three tips that might be helpful.question existence

  1. Normalise the experience: We have tricky brains that allow us to question our existence. This is not your fault but is how the human brain was designed. It is perfectly normal to have a fear of death; you are not alone in this struggle.
  2. Breathe: When you notice anxiety entering your body and mind, try to engage in some soothing breathing to help slow down your mind and physiological response.
  3. Write your own eulogy as if you’re looking back over a long life: Pretend it is your funeral and you have to give the eulogy. What would you write? What would you have wanted your life to be about? This might provide some meaning and purpose for how to live your life now.

Complete Article HERE!

Here’s what people in their 90s really think about death

By JANE FLEMING

old-age-lead

Across the developed world more people are living longer, which of course means more get to be extremely old by the time they die. Nearly half of all deaths in the United Kingdom are in people aged 85 or older, up from only one in five just 25 years ago.

Dying in older age can mean a different sort of death, such as becoming gradually frailer in both body and mind and developing numerous health problems over many years. Where years after retirement were previously considered just old age, a longer life span means the later years now include variation reflected in labels such as younger old and older old.

Our previous research showed people who are over 90 when they die need more support with daily life in their last year than even those who die in their late 80s. In the United Kingdom, around 85% of those dying aged 90 or older were so disabled as to need assistance in basic self care activities. Only 59% of those between 85 and 89 at death had this level of disability.

This knowledge has implications for planning support for life and death in different care settings. But what do we know about what the older old (95 plus) people actually want when it comes to decisions about their care as they approach the end of their lives?

HOW THE OLDER OLD FEEL ABOUT DYING

The oldest and frailest in our society are becoming less visible as many who need the most support, such as those with dementia, are either in care homes or less able to get out and about. But their voices are crucial to shaping end-of-life care services.

In our latest research, we had conversations about care experiences and preferences with 33 women and men aged at least 95, some over 100, and 39 of their relatives or carers. Of these, 88% were women, 86% were widowed and 42% lived in care homes.

Death was part of life for many of the older people who often said they were taking each day as it comes and not worrying too much about tomorrow. “It is only day-from-day when you get to 97,” said one woman. Most felt ready to die and some even welcomed it: “I just say I’m the lady-in-waiting, waiting to go,” said one.

Others were more desperate in their desire to reach the end. “I wish I could snuff it. I’m only in the way,” was a typical sentiment in those who felt they were a nuisance. Others begged not to be left to live until they were a hundred, saying there was no point to keeping them alive.

Most were concerned about the impact on those left behind: “The only thing I’m worried about is my sister. I hope that she’ll be not sad and be able to come to terms with it.”

The dying process itself was the cause of most worries. A peaceful and painless death, preferably during sleep, was a common ideal. Interviewees mainly preferred to be made comfortable rather than have treatment, wishing to avoid going into hospital.

We found families’ understanding of their relative’s preferences only occasionally incorrect (just twice). For instance, one person said they wanted to have treatment for as long as they could, while their family member believed they would prefer palliative care. This highlights the importance of trying to talk options through with the older person rather than assuming their family knows their views.

We found most discussed end-of-life preferences willingly and many mentioned previous talk about death was uncommon, often only alluded to or couched in humour. A minority weren’t interested in these discussions.

WE NEED TO TALK WITH THE OLDER OLD

It’s rare to hear from people in their tenth or eleventh decade but there are some studies that have explored the views of the younger old. Most often these have concentrated on care home residents and occasionally on those living at home.

A literature review conducted in Sweden in 2013 found a total of 33 studies across the world that explored views of death and dying among older people, although very few of these sought the views of the older old.

A 2002 study found older people in Ghana looked forward to death, seeing it as a welcome visitor that would bring peace and rest after a strenuous life. And a 2013 study in the Netherlands showed many people changed their preferences on how they wanted to die as their care needs changed.

A recent review examined older people’s attitudes towards advance care plans and preferences for when to start such discussions. It identified 24 studies, mainly from the United States and with younger old age ranges. The results showed that while a minority shirked from end-of-life care discussion, most would welcome them but were rarely given the opportunity.

These studies support our findings on older people’s willingness to discuss often taboo topics, their acceptance of impending death, and their concerns around what the dying process would bring: increasing dependence, being a burden and the impact of their own death on those left behind.

To plan services to best support rising numbers of people dying at increasingly older ages in different settings, we need to understand their priorities as they near the end of life.

Complete Article HERE!

Meet the Woman Who Cared for Hundreds of Abandoned Gay Men Dying of AIDS

By David Koon

ruth-burks

“Who knew there’d come a time when people didn’t want to bury their children?” says Ruth Cocker Burks.

Between 1984 and the mid-1990s, before better HIV drugs effectively rendered her obsolete, Ruth Coker Burks cared for hundreds of dying people, many of them gay men who had been abandoned by their families. She buried more than three dozen of them herself, after their families refused to claim their bodies. For many of those people, she is now the only person who knows the location of their graves.

It started in 1984, in a hospital hallway. Ruth Coker Burks was 25 and a young mother when she went to University Hospital in Little Rock, Ark., to help care for a friend who had cancer. Her friend eventually went through five surgeries, Burks said, so she spent a lot of time that year parked in hospitals. That’s where she was the day she noticed the door, one with “a big, red bag” over it. It was a patient’s room. “I would watch the nurses draw straws to see who would go in and check on him. It’d be: ‘Best two out of three,’ and then they’d say, ‘Can we draw again?’ ”

She knew what it probably was, even though it was early enough in the epidemic for the disease to be called GRID — gay-related immune deficiency — instead of AIDS. She had a gay cousin in Hawaii and had asked him about the stories of a gay plague after seeing a report on the news. He’d told her, “That’s just the leather guys in San Francisco. It’s not us. Don’t worry.” Still, in her concern for him, she’d read everything she could find about the disease over the previous months, hoping he was right.

Whether because of curiosity or — as she believes today — some higher power moving her, Burks eventually disregarded the warnings on the red door and snuck into the room. In the bed was a skeletal young man, wasted away to less than 100 pounds. He told her he wanted to see his mother before he died.

“I walked out and [the nurses] said, ‘You didn’t go in that room, did you?’” Burks recalled. “I said, ‘Well, yeah. He wants his mother.’ They laughed. They said, ‘Honey, his mother’s not coming. He’s been here six weeks. Nobody’s coming.’”

Unwilling to take no for an answer, Burks wrangled a number for the young man’s mother out of one of the nurses, then called. She was able to speak for only a moment before the woman on the line hung up on her.

“I called her back,” Burks said. “I said, ‘If you hang up on me again, I will put your son’s obituary in your hometown newspaper and I will list his cause of death.’ Then I had her attention.”

Her son was a sinner, the woman told Burks. She didn’t know what was wrong with him and didn’t care. She wouldn’t come, as he was already dead to her as far as she was concerned. She said she wouldn’t even claim his body when he died. It was a curse Burks would hear again and again over the next decade: sure judgment and yawning hellfire, abandonment on a platter of scripture. Burks estimates she worked with more than 1,000 people dying of AIDS over the years. Of those, she said, only a handful of families didn’t turn their backs on their loved ones.

Burks hung up the phone, trying to decide what she should tell the dying man. “I went back in his room,” she said, “and when I walked in, he said, ‘Oh, momma. I knew you’d come,’ and then he lifted his hand. And what was I going to do? So I took his hand. I said, ‘I’m here, honey. I’m here.’”

Burks pulled a chair to his bedside, talked to him, and held his hand. She bathed his face with a cloth and told him she was there. “I stayed with him for 13 hours while he took his last breaths on Earth,” she said.

Since at least the late 1880s, Burks’s kin have been buried in Files Cemetery, a half-acre of red dirt on top of a hill in Hot Springs, Ark. When Burks was a girl, she said, her mother got in a final, epic row with Burks’s uncle. To make sure he and his branch of the family tree would never lie in the same dirt as the rest of them, Burks said, her mother quietly bought every available grave space in the cemetery: 262 plots. They visited the cemetery most Sundays after church when she was young, Burks said, and her mother would often sarcastically remark on her holdings, looking out over the cemetery and telling her daughter, “Someday, all of this is going to be yours.”

“I always wondered what I was going to do with a cemetery,” she said. “Who knew there’d come a time when people didn’t want to bury their children?”

Files Cemetery is where Burks buried the ashes of the man she’d seen die, after a second call to his mother confirmed she wanted nothing to do with him, even in death. “No one wanted him,” she said, “and I told him in those long 13 hours that I would take him to my beautiful little cemetery, where my daddy and grandparents were buried, and they would watch out over him.”

Burks had to contract with a funeral home in Pine Bluff, some 70 miles away, for the cremation. It was the closest funeral home she could find that would even touch the body. She paid for the cremation out of her savings.

The ashes were returned to her in a cardboard box. She went to a friend at Dryden Pottery in Hot Springs, who gave her a chipped cookie jar for an urn. Then she went to Files Cemetery and used a pair of posthole diggers to excavate a hole in the middle of her father’s grave.

“I knew that Daddy would love that about me,” she said, “and I knew that I would be able to find him if I ever needed to find him.” She put the urn in the hole and covered it over. She prayed over the grave, and it was done.

Over the next few years, as she became one of the go-to people in the state when it came to caring for those dying with AIDS, Burks would bury more than 40 people in chipped cookie jars in Files Cemetery. Most of them were gay men whose families would not even claim their ashes.

“My daughter would go with me,” Burks said. “She had a little spade, and I had posthole diggers. I’d dig the hole, and she would help me. I’d bury them, and we’d have a do-it-yourself funeral. I couldn’t get a priest or a preacher. No one would even say anything over their graves.”

She believes the number is 43, but she isn’t sure. Somewhere in her attic, in a box, among the dozens of yellowed day planners she calls her Books of the Dead filled with the appointments, setbacks, and medications of people 30 years gone, there is a list of names.

keeping-the-flame

Burks always made a last effort to reach out to families before she put the urns in the ground. “I tried every time,” she said. “They hung up on me. They cussed me out. They prayed like I was a demon on the phone and they had to get me off — prayed while they were on the phone. Just crazy. Just ridiculous.”

After she cared for the dying man at University Hospital, people started calling Burks, asking for her help. “They just started coming,” she said. “Word got out that there was this kind of wacko woman in Hot Springs who wasn’t afraid. They would tell them, ‘Just go to her. Don’t come to me. Here’s the name and number. Go.’…I was their hospice. Their gay friends were their hospice. Their companions were their hospice.”

Before long, she was getting referrals from rural hospitals all over the state. Financing her work through donations and sometimes out of her own pocket, she’d take patients to their appointments, help them get assistance when they could no longer work, help them get their medicines, and try to cheer them up when the depression was dark as a pit. She said many pharmacies wouldn’t handle prescriptions for AIDS drugs like AZT, and there was fear among even those who would.

She soon stockpiled what she called an “underground pharmacy” in her house. “I didn’t have any narcotics, but I had AZT, I had antibiotics,” she said. “People would die and leave me all of their medicines. I kept it because somebody else might not have any.”

Burks said the financial help given to patients — from burial expenses to medications to rent for those unable to work — couldn’t have happened without the support of the gay clubs around the state, particularly Little Rock’s Discovery. “They would twirl up a drag show on Saturday night and here’d come the money,” she said. “That’s how we’d buy medicine, that’s how we’d pay rent. If it hadn’t been for the drag queens, I don’t know what we would have done.”

Burks’s stories from that time border on nightmarish, with her watching one person after another waste away before her eyes. She would sometimes go to three funerals a day in the early years, including the funerals of many people she’d befriended while they fought the disease. Many of her memories seem to have blurred together into a kind of terrible shade. Others are told with perfect, minute clarity.

There was the man whose family insisted he be baptized in a creek in October, three days before he died, to wash away the sin of being gay; whose mother pressed a spoonful of oatmeal to his lips, pleading, “Roger, eat. Please eat, Roger. Please, please, please,” until Burks gently took the spoon and bowl from her; who died at 6 foot 6 and 75 pounds; whose aunts came to his parents’ house after the funeral in plastic suits and yellow gloves to double-bag his clothes and scrub everything, even the ceiling fan, with bleach.

She recalled the odd sensation of sitting with dying people while they filled out their own death certificates, because Burks knew she wouldn’t be able to call on their families for the required information. “We’d sit and fill it out together,” she said. “Can you imagine filling out your death certificate before you die? But I didn’t have that information. I wouldn’t have their mother’s maiden name or this, that, or the other. So I’d get a pizza and we’d have pizza and fill out the death certificate.”

Billy is the one who hit her hardest and the one she remembers most clearly of all. He was one of the youngest she ever cared for, a female impersonator in his early 20s. He was beautiful, she said, perfect and fine-boned. She still has one of Billy’s dresses in her closet up in the city of Rogers: a tiny, flame-red designer number, intricate as an orchid.

As Billy’s health declined, Burks accompanied him to the mall in Little Rock as he quit his job at a store there. Afterward, she said, he wept, Burks holding the frail young man as shoppers streamed around them. “He broke down just sobbing in the middle of the mall,” she said. “I just stood there and held him until he quit sobbing. People were looking and pointing and all that, but I couldn’t care less.”

Once, a few weeks before Billy died — he weighed only 55 pounds, the lightest she ever saw, light as a feather, so light that she was able to lift his body from the bed with just her forearms —  Burks had taken Billy to an appointment in Little Rock. Afterward, they were driving around aimlessly, trying to get his spirits up. She often felt like crying in those days, she said, but she couldn’t let herself. She had to be strong for them.

“He was so depressed. It was horrible,” she said. “We were driving by the zoo, and somebody was riding an elephant. He goes, ‘You know, I’ve never ridden an elephant.’ I said, ‘Well, we’ll fix that.’” And she turned the car around. Somewhere, in the boxes that hold all her terrible memories, there’s a picture of the two of them up on the back of the elephant, Ruth Coker Burks in her heels and dress, Billy with a rare smile.

When it was too much, she said, she’d go fishing. And it wasn’t all terrible. While Burks got to see the worst of people, she said, she was also privileged to see people at their best, caring for their partners and friends with selflessness, dignity, and grace. She said that’s why she’s been so happy to see gay marriage legalized all over the country.

“I watched these men take care of their companions and watch them die,” she said. “I’ve seen them go in and hold them up in the shower. They would hold them while I washed them. They would carry them back to the bed. We would dry them off and put lotion on them. They did that until the very end, knowing that they were going to be that person before long. Now, you tell me that’s not love and devotion? I don’t know a lot of straight people who would do that.”

Ruth Coker Burks had a stroke five years ago, early enough in her life that she can’t help but believe that the stress of the bad old days had something to do with it. After the stroke, she had to relearn everything: to talk, to feed herself, to read and write. It’s probably a miracle she’s not buried in Files Cemetery herself.

After better drugs, education, understanding, and treatment made her work obsolete, she moved to Florida for several years, where she worked as a funeral director and a fishing guide. When Bill Clinton was elected president, she served as a White House consultant on AIDS education.

A few years ago, she moved to Rogers to be closer to her grandchildren. In 2013, she went to bat for three foster children who were removed from the elementary school at nearby Pea Ridge after administrators heard that one of them might be HIV-positive. Burks said she couldn’t believe she was still dealing with the same knee-jerk fears in the 21st century.

The work she and others did in the 1980s and 1990s has mostly been forgotten, partly because so many of those she knew back then have died. She’s not the only one who did that work, but she’s one of the few who survived. And so she has become the keeper of memory.

Before she’s gone, she said, she’d like to see a memorial erected in Files Cemetery. Something to tell people the story. A plaque. A stone. A listing of the names of the unremembered dead who lie there.

“Someday,” she said, “I’d love to get a monument that says: This is what happened. In 1984, it started. They just kept coming and coming. And they knew they would be remembered, loved, and taken care of, and that someone would say a kind word over them when they died.”

Complete Article HERE!

12 LIFE LESSONS FROM A MAN WHO HAS SEEN 12000 DEATHS

By

Bhairav Nath Shukla
Bhairav Nath Shukla

Rooted in the hearts of many Hindus is the belief that if you breathe your last in Kashi (Varanasi) you attain what is popularly known as ‘Kashi Labh’ or ‘the fruit of Kashi’—moksh or “release from the cycle of rebirth impelled by the law of karma”.

Kashi Labh Mukti Bhawan in Varanasi is one of the three guesthouses in the city where people check in to die. The other two are Mumukshu Bhawan and Ganga Labh Bhawan. Established in 1908, Mukti Bhawan is well-known within the city and outside.

Bhairav Nath Shukla has been the Manager of Mukti Bhawan for 44 years. He has seen the rich and the poor take refuge in the guesthouse in their final days as they await death and hope to find peace. Shukla hopes with and for them. He sits on the wooden bench in the courtyard, against the red brick wall and shares with me 12 recurring life lessons from the 12000 deaths he has witnessed in his experience as the manager of Mukti Bhawan:

1. Resolve all conflicts before you go

Shukla recounts the story of Shri Ram Sagar Mishr, a Sanskrit scholar of his times. Mishr was the eldest of six brothers and was closest to the youngest one. Years ago an ugly argument between the two brothers led to a wall to partition the house.

In his final days, Mishr walked to the guesthouse carrying his little paan case and asked to keep room no. 3 reserved for him. He was sure he will pass away on the 16th day from his arrival. On the 14th day he said, “Ask my estranged brother of 40 years to come see me. This bitterness makes my heart heavy. I am anxious to resolve every conflict.”

A letter was sent out. On the 16th day when the youngest brother arrived, Mishr held his hand and asked to bring down the wall dividing the house. He asked his brother for forgiveness. Both brothers wept and mid sentence, Mishr stopped speaking. His face became calm. He was gone in a moment.

Shukla has seen this story replay in many forms over the years. “People carry so much baggage, unnecessarily, all through their life only wanting to drop it at the very end of their journey. The trick lies not in not having conflicts but in resolving them as soon as one can,” says Shukla.

2. Simplicity is the truth of life

“People stop eating indulgent food when they know they are going to go. The understanding that dawns on many people in their final days is that they should’ve lived a simple life. They regret that the most,” says Shukla.

A simple life, as he explains, can be attained by spending less. We spend more to accumulate more and thus create more need. To find contentment in less is the secret to having more.

3. Filter out people’s bad traits

Shukla maintains that every person has shades of good and bad. But instead of dismissing “bad” people outrightly, we must seek out their good qualities. Harbouring bitterness for certain people comes from concentrating on their negatives. If you focus on the good qualities though, you spend that time getting to know them better or, maybe even, loving them.

4. Be willing to seek help from others

To know and do everything by yourself might feel empowering but it limits one from absorbing what others have learnt. Shukla believes we must help others, but more importantly, have the courage to seek help when we’re in need.

Every person in the world knows more than us in some respect. And their knowledge can help us, only if we’re open to it.

He recounts the incident of an old woman being admitted on a rainy day back in the 80s. The people who got her there left her without filling the inquiry form. A few hours later, the police came to trace the relatives of the old lady who, they said, were runaway Naxalites. Shukla pretended to not know nothing. The police left. When the lady’s relatives returned next morning, Shukla asked the leader uninhibitedly, “When you can kill 5-8 people yourself why didn’t you simply shoot your Nani and cremate her yourself? Why did you make me lie and feel ashamed?” The grandson fell to his knees and pleaded for forgiveness saying no one amongst them is capable of helping his religious grandmother attain salvation. He respects that, and is the reason why he brought her to Mukti Bhawan.

5. Find beauty in simple things

Mukti Bhavan plays soulful bhajans and devotional songs three times a day. “Some people”, he says, “stop and admire a note or the sound of the instruments as if they have never heard it before, even if they have. They pause to appreciate it and find beauty in it.”

But that’s not true of everyone, he adds. People who are too critical or too proud, are the ones who find it hard to find joy in small things because their minds are preoccupied with “seemingly” more important things.

6. Acceptance is liberation

Most people shirk away from accepting what they are going through. This constant denial breeds in them emotions that are highly dangerous. Only once you accept your situation is when you become free to decide what to do about it. Without acceptance you are always in the grey space.

When you are not in denial of a problem you have the strength to find a solution.

Indifference, avoidance, and denial of a certain truth, Shukla believes, cause anxiety; they develop a fear of that thing in the person. Instead, accept the situation so you are free to think what you want to do about it and how. Acceptance will liberate you and empower you.

7. Accepting everyone as the same makes service easier

The secret to Shukla’s unfazed dedication and determination towards his demanding job can be understood via this life lesson. He admits that life would’ve been difficult if he treated people who admit themselves to Mukti Bhavan differently, based on their caste, creed, colour, and social or economic status. Categorisation leads to complication and one ends up serving no one well. “The day you treat everyone the same is the day you breathe light and worry less about who might feel offended or not. Make your job easier,” he says.

8. If/When you find your purpose, do something about it

To have awareness about one’s calling is great, but only if you do something about it.

A lot of people, Shukla says, know their purpose but don’t do anything about realising it, making it come to life. Simply sitting on it is worse than not having a calling in the first place. Having a perspective towards your purpose will help you measure the time and effort you need to dedicate to it, while you’re caught up in what you think you can’t let go or escape. Take action on what truly matters.

9. Habits become values

Shukla recommends cultivating good habits to be able to house good values. And building good habits happens over time, with practice. “It’s like building a muscle; you have to keep at it everyday.”

Till one doesn’t consistently work towards being just or kind or truthful or honest or compassionate, every single time he is challenged, one cannot expect to have attained that quality.

10. Choose what you want to learn

In the vastness of the infinite amount of knowledge available to us it is easy to get lost and confused. “The key lesson here is to be mindful of choosing what you deeply feel will be of value to you,” he says. People might impose subjects and philosophies on you because it interests them and while you must acknowledge their suggestions, the wise thing to do is delve deeper into what rejoices your own heart and mind.

With a smile on his face Shukla says, “In the last days of their life a lot of people can’t speak, walk or communicate with others with as much ease as they could, earlier. So, they turn inwards. And start to remember the things that made their heart sing once, things that they cared to learn more about over the course of their life, which enriches their days now.”

11. You don’t break ties with people; you break ties with the thought they produce

You can seldom distance yourself from people you have truly loved or connected with in some way. However, in any relationship, along the way, certain mismatch of ideologies causes people to stop communicating. This never means you are no longer associated with that person. It simply means that you don’t associate with a dominant thought that person brings with him/her, and to avoid more conflict you move away. The divorce, Shukla affirms, is with the thought and never with the person. To understand that is to unburden yourself from being bitter and revengeful.

12. 10 percent of what you earn should be kept aside for dharma

Dharma, Shukla doesn’t define as something religious or spiritual. Instead, he says it is associated more with doing good for others and feeling responsible about that. A simple calculation according to him is to keep 10 percent of your income for goodwill.

Many people donate or do charitable acts towards the end of their life because death is hard on them. In their suffering, they begin to empathise with others’ suffering. He says those who have the companionship of loved ones, the blessings of unknown strangers, and an all-encompassing goodwill of people exit peacefully and gracefully. That is possible when you don’t cling on to everything you have, and leave some part of it for others.

Complete Article HERE!

Death Changes Everything. Time Changes Nothing

death-changes-everything

“Dost thou love life? Then do not squander time, for that is the stuff life is made of. “ —- Benjamin Franklin

By Hospice of the North Coast

Time is our greatest commodity, yet we often squander it. It’s not until we’re faced with the death of a loved one when we realize just how much time has passed away, and how much of our time we spent “being busy” instead of “being with” the people we love. We get so busy with our day-to-day lives, often time just trying to make ends meet, that we forget that the time we spend interacting with someone may very well be our last day with them.

When our minds are being so distracted, be it with work, or in Information Overload mode, it’s difficult to enjoy the moment we’re currently in. As they say, we’re not “in the here and now.” We dwell on the past, dream of the future and ignore the present.

It takes a lot of hard work, time and energy to reach a level of success — however you define success — that results in acquiring whatever possession you desire. Then we spend even more time and resources protecting our possessions.

What if we protected our time as diligently as we protect our possessions and lived as if we just found out we only a few months left? Would we spend more of our time with family, friends and loved ones? Or would we spend more time working, or texting and emailing those we hold dear instead of actually spending time with them? Would we procrastinate even more, or go visit a friend who has been feeling alone and isolated since h/her spouse passed away? Or go visit a family member in Hospice that you’ve been putting off due to your busy schedule.

How often have you said, “Life is too short for this (enter the first word that comes to mind)?” During those times, what was it that made you feel life is too short for you to be wasting your time on? A pointless argument? Being stuck in traffic? Being dragged into other people’s dramas? To some extent, you have to put up with things forced upon you by circumstances, such as being stuck in traffic because you really need the job you’re trying to ge to (or return home from), so quitting and relocating is not an option.

Some things that waste our precious time on are, unfortunately, necessary and inevitable. It’s the time-draining (and by extension, life-draining) events that we can absolutely avoid yet choose not to. A perfect example is the time we spend on social media sites and/or getting engaged in an online argument. Another example is always having your smartphone turned on so that you can immediately text and/or answer emails… even while you’re having lunch with a friend.

How you live affects how long you live. Keep a good watch over your time, and spend it wisely.

“So it is: we are not given a short life but we make it short, and we are not ill-supplied but wasteful of it… Life is long if you know how to use it.” — Seneca, Roman philosopher

Complete Article HERE!