Category: Preparing for Death

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Pa’s Smile

Jaimal Yogis’s dad explained his final wishes: “I’ve gotten so much from Buddhism for good living, I’m not going to pass up their tips for good dying.”

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The first and only time I bought dry ice, the grocery store clerk asked if I was going camping. “No,” I muttered, then managed to stop myself from saying it was for a body. The ice really was to lay my father’s corpse on.

An air force colonel who was skeptical of organized religion, my father, who we call Pa, wasn’t sure the Tibetan Buddhist tradition of leaving the dead undisturbed for three days was necessary. But, as he said after being diagnosed with late stage lung cancer, “I’ve gotten so much from Buddhism for good living, I’m not going to pass up their tips for good dying.”

As if summarizing Socrates in his famous pre-execution speech, Pa often said he had no idea where he was going. ‘If the lights go out, it’ll be a good rest,’ he’d say. ‘And if there’s more, it’ll be a great adventure.’

These three days are not unique to Tibetan, or more accurately, Vajrayana Buddhism. Irish wakes often last two or three days while a soul departs, and Jewish Midrashic texts say a soul hovers over the body for three days (or seven) until the body is buried. The idea behind the three days in Vajrayana Buddhism is that as the breath and heart stop, our gross level of consciousness dissolves but more subtle levels of consciousness remain in the body for up to about seventy-two hours. During that time the subtlest stream of consciousness is said to leave, a transition known to go more smoothly if the body can chill—in Pa’s case literally since under California law dead bodies have to be kept on ice.

“Otherwise they tend to smell like dead bodies,” our hospice nurse informed us.

“Right,” I nodded. “And where do we get the ice?”

“Grocery store.”

“Of course.”

As if summarizing Socrates in his famous pre-execution speech, Pa often said he had no idea where he was going. “If the lights go out, it’ll be a good rest,” he’d say. “And if there’s more, it’ll be a great adventure.” Still, he’d reasoned his way toward the three-day death plan. In addition to reading up on how Vajrayana Buddhists use strict tests to prove they’ve found reincarnations of former teachers, he’d read the work of doctors like Sam Parnia of NYU Langone Health. Dr. Parnia has meticulously catalogued data on people who’ve died clinically, sometimes for hours, before being resuscitated. These briefly dead folks often report vivid dreams after waking, sometimes ones in which they correctly recount what doctors had been saying—“Going to the game later?”—when the patients had no heartbeat. “That’s enough evidence for me,” Pa said. “Don’t poke or prod me for a few days.”

As the actual death part of the three-day death plan approached, we—his family—wondered if having Pa’s cold body steaming on carbon dioxide in the bedroom might intensify our grief. And might it be a little creepy? It turned out to be just the opposite.

Death leaves you in a dreamy shock. You don’t know if you should wail or drive all night to Mexico or finally get to writing your own will. When Pa stopped breathing on a warm summer evening, dressing him in his aloha shirt and favorite Christmas socks, then adorning his room with flowers, was just the beautiful busy work our reeling minds needed. Reading Jane Hirshfield’s “It Was Like This: You Were Happy,” a special request from Pa, while he was actually there in the room felt more heart opening than reading it again while scattering his ashes. And as we sat with Pa each of the three mornings while reading him The Tibetan Book of The Dead—a text meant to help us navigate the space between lives—it felt as if we were on a kind of spiritual tour bus with him, visiting the realms where awakened beings are born from lotuses and truths are whispered on the breeze.

Perhaps most surprising was how much the three-day death plan helped before death. As Pa was starting to show signs of getting close to the end, my sister Ciel and I asked if he would like to hear a Medicine Buddha ceremony that is often done for the sick and dying. “You don’t have to bother with that,” Pa said, continuing his usual stubborn quest to keep us from doting. But we argued that the ceremony would be a good warm-up for when he was down for the count and we were reading The Tibetan Book of the Dead, which Tibetans actually call The Great Liberation for Hearing in the Bardo. Since this made it sound like the reading was for us, Pa agreed.

We sat around his bed, switching back and forth between botching the Tibetan chanting and reading the English translation. The ceremony took about an hour, and we thought ­­Pa had slept through it. But at the end, he sat up with tears in his eyes. “I am so honored you did that for me,” he said. “And now I’m going to get up and see the sky one more time.”

“We’ll get the wheelchair,” Pa’s wife, Margaret, said reasonably.

“No,” he said, “I’m going to walk.”

Pa had already fallen behind the toilet in such a precarious position we’d needed the fire department to come dislodge him, and he’d been bedridden for days now. But charged up by the chanting, Pa managed to lumber slowly to the back porch, rasping with every breath.

We opened the door. Pa turned his face up bracingly to the blue. He looked so pale, I half expected him to croak right there. Instead, he then looked down at a few small stairs he would have to navigate in order to be fully outside. “Take me back,” he whispered. “I want an easy death. Not to fall off the damn steps.”

We laughed. Finding humor in the face of hardship was one of Pa’s great gifts. But we hadn’t heard zingers with gusto like this for a few weeks. And I think, in addition to the power of the ceremony itself, knowing that his family would be there for three full days—botching more Tibetan chants around him—was a great comfort, a lightening.

Philosophical aspects of the plan were helpful too. In hospice Pa occasionally felt unsure of where—even who—he was. One day he called himself King Henry and my aunt the queen. “You wouldn’t believe what’s happening,” he told me. “It’s like I’m disappearing.” This was scary, but Buddhist wisdom for conscious dying gave Pa a place to put his fears.

According to Vajrayana Buddhists, our gross consciousness is where we construct our version of reality through our senses. This construction is like a video game in our heads in which we are the most important character, the one whose suffering matters most, the one who should win all the gold coins because, as our senses (falsely) tell us, we exist separately from the rest of reality. The more we let go of this illusory separation from others, the more room there is to experience our true blissful and compassionate nature. Vajrayana Buddhist teachers say this true nature is most easily accessible at death because, as opposed to meditative glimpses beyond the veil, in death the gross levels of consciousness drop away automatically. So, when Pa was scared or disoriented, we could remind him that losing a mere idea of himself was not just natural, it was part of spiritual awakening.

In his last hours, Pa’s brow was furrowed and his body appeared tense. He looked like he was trying desperately to remember something. Ciel, Margaret, and I were taking turns sitting with him, and fittingly it was just when Margaret was singing him Nat King Cole’s, “When I Fall in Love,” a song they’d danced to on West Cliff Drive above the sea, that Pa finally let go. As he did, his brow smoothed completely, making him look instantly younger. A distinct half-smile appeared on his lips. A Buddha smile. And whether it was Pa’s newfound bliss, rigor mortis, or some combination of both, that smile remained perfectly serene for all three days.

Complete Article ↪HERE↩!

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The surprising benefits of contemplating your death

Now is the perfect time to face your fear of mortality. Here’s how.

By Sigal Samuel

Nikki Mirghafori has a fantastically unusual career. After getting a PhD in computer science, she’s spent three decades as an artificial intelligence researcher and scientific advisor to tech startups in Silicon Valley. She’s also spent a bunch of time in Myanmar, training with a Buddhist meditation master in the Theravada tradition. Now she teaches Buddhist meditation internationally, alongside her work as a scientist.

One of Mirghafori’s specialties is maranasati, which means mindfulness of death. Mortality might seem like a scary thing to contemplate — in fact, maybe you’re tempted to stop reading this right now — but that’s exactly why I’d say you should keep reading. Death is something we really don’t like to think or talk about, especially in the West. Yet our fear of mortality is what’s driving so much of our anxiety, especially during this pandemic.

Maybe it’s the prospect of your own mortality that scares you. Or maybe you’re like me, and thinking about the mortality of the people you love is really what’s hard to wrestle with.

Either way, I think now is actually a great time to face that fear, to get on intimate terms with it, so that we can learn how to reduce the suffering it brings into our lives.

I recently spoke with Mirghafori for Future Perfect’s limited-series podcast The Way Through, which is all about mining the world’s rich philosophical and spiritual traditions for guidance that can help us through these challenging times.

In our conversation, Mirghafori outlined the benefits of contemplating our mortality. She then walked me through some specific practices for developing mindfulness of death and working through the fear that can come up around that. Some of them are simple, like reciting a few key sentences each morning, and some of them are more … shall we say… intense.

I think they’re all fascinating ways that Buddhists have generated over the centuries to come to terms with the prospect of death rather than trying to escape it.

You can hear our full conversation in the podcast here. A partial transcript, edited for length and clarity, follows.

Sigal Samuel

You’ve worked in Silicon Valley and you still live near there, so I’m sure you’ve encountered the desire in certain tech circles to live forever. There are biohackers who are taking dozens of supplements every day. Some are getting young blood transfusions, trying to put young people’s blood in their veins to live longer. Some are having their bodies or brains preserved in liquid nitrogen, doing cryopreservation so they can be brought back to life one day. What is your feeling about all these efforts?

Nikki Mirghafori

It’s the quest for immortality and the denial of death. Part of it is natural. Human beings have done this for as long as we have been conscious of the fact that we are mortal.

A person who really put this well was Ernest Becker, the author of the seminal book The Denial of Death. I’d like to offer this quote from him:

This is the paradox. A human is out of nature and hopelessly in it. We are dual. Up in the stars and yet housed in a heart-pumping, breath-gasping body that once belonged to a fish and still carries the gill marks to prove it. A human is literally split in two. We have an awareness of our own splendid uniqueness in that we stick out of nature with a towering majesty, and yet we go back into the ground a few feet in order to blindly and dumbly rot and disappear forever. It is a terrifying dilemma to be in and to have to live with.

There is a whole field of research in psychology called terror management theory, which started from the work of Ernest Becker. This theory says that there’s a basic psychological conflict that arises from having, on the one hand, a self-preservation instinct, and on the other hand, that realization that death is inevitable.

This psychological conflict produces terror. And how human beings manage this terror is either by embracing cultural beliefs or symbolic systems as ways to counter this biological reality, or doing these various things — cryogenics, trying to find elixirs of life, taking lots of supplements or whatnot.

It’s nothing new. The ancient Egyptians almost 4,000 years ago, and ancient Chinese almost 2,000 years ago, both believed that death-defying technology was right around the corner. The zeitgeist is not so different. We think we are more advanced, but it comes from the same fear, same denial of death.

Sigal Samuel

It seems like in the West, we really have a bad case of that denial. I think we rarely talk about death or are willing to face up to the reality that we’re going to die. We seem to be wanting to always distract ourselves from it.

You are a Buddhist practitioner and you have a practice that is very much the opposite of that, which is mindfulness of death, or maranasati. You’ve done trainings and led retreats around this subject. But some people might say this is too morbid and depressing to think about. So before we actually delve into the mindfulness of death practices, could you entice us by telling us a few of the benefits of doing them?

Nikki Mirghafori

First and foremost, what I found for many people, myself included, is that facing the fact that I am not going to live forever really aligns my life with my values.

Most people suffer what’s called the misalignment problem, which is that we don’t quite live according to our values. There was a study that really highlighted this, by a team of scientists, including Nobel Prize winner Daniel Kahneman. They surveyed a group of women and compared how much satisfaction they derived from their daily activities. Among voluntary activities, you’d probably expect that people’s choices would roughly correlate to their satisfaction. You’re choosing to do it, so you’d think that you actually enjoy it.

Guess what? That wasn’t the case. The women reported deriving more satisfaction from prayer, worship, and meditation than from watching television. But the average respondent spent more than five times as long watching television than engaging in spiritual activities that they actually said they enjoyed more.

This is a misalignment problem. There’s a way we want to spend our time, but we don’t do that because we don’t have the sense that time is short, time is precious. And the way to systematically raise the sense of urgency — Buddhism calls it samvega, spiritual urgency — is to bring the scarcity of time front and center in one’s consciousness: I am going to die. This show is not going to go on forever. This is a party on death row.

Sigal Samuel

So the approach here is to bring to the forefront of our consciousness how precious our time is, by impressing upon our minds how scarce it is. And that helps align our life with our values.

Are there other benefits to practicing mindfulness of death?

Nikki Mirghafori

The second benefit is to live without fear of death for our own sake. That way, we don’t engage in typical escape activities. And it frees up a lot of psychic energy. We have more peace, more ease in our lives.

The third benefit is to live without fear of death for the sake of our loved ones. We can support others in their dying process. Usually the challenge of supporting a loved one is that we have a sense of grief for losing them, but a lot of that grief is actually that it’s bringing up fear of our own mortality. So if we have made peace with our own mortality, we can be fully present and support them in their process, which can be a huge gift.

My mom passed away two years ago. And for me, having done all of these practices, I could be with her by her deathbed, holding her hand and supporting her so that she could have a peaceful transition. She didn’t have to take care of me so much and console me. She could be at peace and take delight in this mysterious process that we just don’t know what it’s like. It might be beautiful, might be graceful. We don’t know — there might be nothing; there might be something.

Sigal Samuel

Now I feel sufficiently enticed to learn about the actual practices of mindfulness of death. Let’s start with one that seems simple: the Five Daily Reflections, sometimes called the Five Remembrances, that are often recited in Buddhist circles. Would you mind reciting those?

Nikki Mirghafori

Happy to. These are the Five Daily Reflections that the Buddha suggested people recite every day.

Just like everyone, I am of the nature to age. I have not gone beyond aging.

Just like everyone, I am of the nature to sicken. I have not gone beyond sickness.

Just like everyone, I am subjected to the results of my own actions. I am not free from these karmic effects.

Just like everyone, I am of the nature to die. I have not gone beyond dying.

Just like everyone, all that is mine, beloved and pleasing, will change, will become otherwise, will become separated from me.

Allow whatever arises to come up. It’s okay. These contemplations can bring a lot up. So just be with them as much as possible.

Sigal Samuel

I’ve done these reflections before, but every time I do them, I notice that some are much harder for me to absorb than others. The fourth one — I’m of the nature to die — does not terrify me. Maybe that’s weird, but that’s not the one that really scares me. The one that I find impossibly hard is the fifth one. Everyone that I love and everything that I love is of the nature to change and be separated from me.

It’s really the death or the separation from the people I love that I find much harder to face than the death of myself. Because if I’m going to die, you know, then I’ll be gone. There won’t be any me to miss things.

Nikki Mirghafori

Yes. So appreciate and make space for the one that really touches you.

Also I would say that with the fourth one, making peace with our own death, I’ve done the practice and sometimes I’m like yeah, sure, whatever. And then I’ve really stayed with it, and thought, “This could be my last breath.” When the practice really takes hold and becomes alight with fire, it’s like, “Oh, my God, I am going to die!” It really hits home.

Sigal Samuel

Just to clarify, this is a separate mindfulness of death practice, where you contemplate with every breath, “This could be my last inhale. This could be my last exhale.”

Nikki Mirghafori

Yes. And to bring the historical context into it: This particular teaching is what’s called maranasati. Marana is death in Pali, the language of the Buddha. Sati is mindfulness. The mindfulness of death sutra, that’s where the Buddha taught it, and it’s actually quite a lovely teaching.

The Buddha comes and asks the monks, “How are you practicing mindfulness of death?” And one of them says, “Well, I think I could die in a fortnight, in a couple weeks.” Another one of them says, “Well, I think I could die in 24 hours.” Or “Well, I could die at the end of this meal.” Or “Well, I could die at the end of this bite of food I’m eating.” And another one says, “Well, I could die at the end of this very breath.”

And the Buddha says, “Those of you who said, two weeks, 24 hours, whatever — you are practicing heedlessly. Those who said right at this breath, you are practicing heedfully, correctly. That is the practice.”

There are ways to really bring the sense of immediacy and urgency to all this. It’s not out of the question that there could be an aneurysm or that a meteor could just hit the Earth in this moment. Use visualizations; be creative.

Sigal Samuel

Another thing I find really helpful is remembering the idea of impermanence. Which, of course, is the theme of our whole conversation — that our whole life is impermanent — and that’s a very central Buddhist teaching. But also any emotion that I’m feeling is impermanent. So if I’m feeling an intense surge of fear as I do a practice, that’s impermanent, too.

Nikki Mirghafori

Yeah, I love that. When I teach impermanence, there are little impermanences that come and go, and then there is the big impermanence, which is your life! I’m chuckling because this is a case where impermanence is on your side. Impermanence is just a rule of how things run in this world. It’s impersonal. It’s just the way things are. But in our perspective, it’s either working for us or against us.

Sigal Samuel

Can you tell me about another kind of contemplation — the “corpse contemplation” or “charnel ground contemplation”? Charnel grounds are these places where, after people have died, their bodies are left to decay above ground, to rot in the open air. And Buddhist monks would go and observe them up close, right?

Nikki Mirghafori

Many monks do that, especially in Asia. In order to become more intimate with a sense of mortality, the practice is to go to the charnel ground and to actually see a corpse. And the contemplation is: My body, this alive body, is just like this body that is decaying. It’s in different stages of being a body, of decomposing.

A specific practice in the Buddhist canon is to contemplate a corpse in different stages of decay. This particular practice requires a sense of stability of mind. Do the other ones first. I only teach it on a retreat when there’s a container of safety, holding people and supporting them through it.

Sigal Samuel

I definitely have not yet worked myself up to doing corpse contemplation by looking at images of actual human corpses. But when I go for a walk, whenever I see a dead bird or squirrel or mouse that’s been run over in the road, I actually pause and take a minute to look at it. I’m trying to ease my way into this practice.

Nikki Mirghafori

Brilliant. Similarly, another informal practice I wanted to share is having a memento mori. Like a little skull, or those bracelets that are all skulls. I just drew on a little Post-It a skull and bones, and posted it on my computer monitor, so I would remember: Life is short. I’m going to die.

I’ve had various memento moris on my desk throughout the years, and I invite people to have them. They don’t have to be sophisticated. On a piece of paper, just write out, “Life is short” or “You are going to die” or “Traveler, tread lightly.” Whatever works for you to keep death in your perspective. And I think it’s good to switch memento moris around so that your mind doesn’t get used to seeing the same thing all the time.

Sigal Samuel

I’m glad you brought this up because I was going to say the corpse contemplation reminds me a lot of that memento mori tradition, which is a centuries-long tradition in Christianity. So many different religious traditions have emphasized the importance of meditating on our death and have devised ways like the memento mori to try to keep forcing the ego to recognize its looming demise.

Nikki Mirghafori

Yes. And I know that for me, I feel most alive and I feel happiest and I feel most connected with myself, when I’m aware of my death. If it happens for a day or two that it’s not in the forefront for whatever reason, I’m not as bright, as sharp, as alive. So I just love bringing it back. It enlivens me. It supports me to live more fully and hopefully die with more delight and joy and curiosity.

Sigal Samuel

I’m wondering if you can help me with something else. I mentioned earlier that I’m not really scared of my own death so much, but I am scared of the death of the people I love. And especially during the pandemic, I think that’s causing a lot of anxiety for me and probably a lot of others. We’re scared about the potential death of our grandparents, our parents, our friends. Is there a way to free ourselves of the overwhelming fear of their death?

Grief is a natural part of the process. However, it is complicated by our own seen and unseen fear of death. So I invite you to actually work with the practice of making peace with your own death. That’s what’s underlying it. Even if you think you’re not afraid of your own death, you probably are.

When people are really at peace with their own passing, there is a different perspective. There’s a different way of being with the fear or sadness of losing others. There is still a pain of loss, but it shifts.

Complete Article ↪HERE↩!

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Dying in Your Mother’s Arms

A palliative care doctor on finding a “good death” for children in the worst situations.

A palliative care doctor on finding a “good death” for children in the worst situations.

by John Beder

If losing a child to an illness is one of the worst things that can happen to a family, Dr. Nadia Tremonti has made it her mission to make it better.

It’s not easy. But as a pediatric palliative care physician, she works to ensure that terminally ill children receive quality end-of-life care. Palliative care is sometimes misunderstood to shorten life expectancy, but it’s a method that increases quality of life, improves symptom burden and decreases medical costs. We follow Dr. Tremonti in the short documentary above as she works to make death less medical and more human. In the process she asks a critical question: When a child is terminally ill, how can we make the end of life a better one?

Complete Article ↪HERE↩!

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How to Say Goodbye When Someone is Dying

By Dr. Lynn Webster

Once, a patient with chronic pain due to an immunodeficiency made an appointment with me to say goodbye. For years, he had received intravenous therapies for his infections, but they had all stopped working. His other doctors had already told him that nothing more could be done, and he had little time left to live. He came to let me know that he appreciated what we had done for him.

It was a surreal moment. The young man wasn’t in agony, and he seemed to be at peace with the inevitability of his death. However, I was caught unprepared. Since I wasn’t sure how to respond, I simply acknowledged his words with a “thank you.” We shook hands and he departed. That was the last time I saw him.

Last week, a colleague of mine sent out an email to a small number of his professional associates. He told us that he is very ill. Clearly, his implicit message was that he might never see us again. 

As I reflected on his message, I felt unprepared again. I wondered how I should respond. How would I say goodbye? Should I even broach the topic? This might be my only chance to let him know that I’d always considered him a mentor. But would he become despondent if I appeared to eulogize him? Would it be hurtful to express my sadness that we might never speak again?

I certainly didn’t want to add to his suffering. Perhaps I should ignore the gravity of his illness and focus on how I hoped he would recover soon.

But that would be dishonest. He is a physician, too, and always modeled treating his patients with empathy and compassion This was the part of his character that I felt most drawn to. He is a doctor who healed as much by listening to his patients than by any other therapy.

Asking the Right Questions

I decided to tell my friend what an important role model he has been for me, but I also had a question for him. Having treated many terminally ill patients, I have learned that most people who are dying have hopes for themselves, as well as the loved ones they are leaving behind. Therefore, I asked my physician friend whether he had any hopes he wanted to share with me. He told me he had two wishes.

“As I have been reflecting upon my personal and professional life, my first hope is that my presence really made a positive difference in people’s lives. That would be my legacy. The outpouring of affection, goodwill and positive comments that I have received from ex-patients, friends, family and colleagues has made it clear that I have succeeded in that,” he said.

My friend also expressed his hope for a change in our political situation. He mentioned the anger, frustration and hopelessness he feels watching American society fall into two warring ideological camps. His hope is that the young people of today will lead us into a better future.

Opportunities for Closure

COVID-19 has forced me to think about the reality that death can catch any of us by surprise.

As I write this, we are in the midst of a pandemic that has infected more than 17 million people and taken more than 680,000 lives worldwide. Many of the COVID-19 victims died alone and didn’t get a chance to say goodbye to their loved ones.

Even in ordinary times, most of us don’t get to say goodbye. We often deny the reality of death as life draws to a close. “You’ll feel better soon,” we say, either to make ourselves feel better or to avoid the topic. Even when we are allowed to be at the bedside of someone who is dying, we often lack the courage to convey our true feelings. Honesty can be too painful during those moments.

I remember saying goodbye to my dying father. Lying with him on his bed in his home, I asked my father if he was afraid. Many of us refrain from expressing grief at moments like that, because we worry that we might make the dying person feel worse. But I could not keep from crying.

In The Four Things That Matter Most, author Ira Byock, MD, identifies the messages he considers most important to communicate to loved ones near the end of life: “Please forgive me. I forgive you. Thank you. I love you.” Expressing these sentiments can help create a sense of mutual peace and completion.

Saying goodbye does not wish death on anyone. It acknowledges the richness of the relationship that has been. That is what I felt when I told my dad I loved him, which at the time was my way of saying goodbye. It is also how I felt when I brought closure to the relationship with my friend who emailed me.

Congressman John Lewis, the noted civil rights leader, expressed hope for the future in a New York Times op-ed published shortly after his July 17th death. He said, “Though I am gone, I urge you to answer the highest calling of your heart and stand up for what you truly believe.”

Perhaps we should consider following Lewis’s example. By daring to acknowledge what is happening and to say goodbye, we are bravely addressing the highest calling of our hearts. We also have the opportunity to honor all those who touched us and made us who we are.

Complete Article ↪HERE↩!

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Sacred Crossings

– Reclaiming the Lost Art of Death Midwifery and Healing Ritual of the Home Funeral

Death Midwifery returns death to its sacred place in the beauty, mystery and celebration of life. A Sacred Crossings Death Midwife shepherds individuals toward a conscious dying experience; guides loved ones in after-death care of the body; and empowers families to reclaim the healing ritual of a vigil and funeral at home. They offer compassionate support to individuals and their families from terminal diagnosis to final disposition.

“As a culture, we deny the natural process of aging and death,” remarked Olivia Bareham, founder of Sacred Crossings. “Learning how to die consciously with grace and acceptance is the greatest gift we can give ourselves and those we love.”

Many people are unaware that they have the legal right to care for their dead at home before burial or cremation. Sacred Crossings offers education and guidance to families who wish to create meaningful funerals at home. We teach them the ancient ritual of bathing, anointing and dressing the body, laying the body in honor for a 3-day vigil and decorating the cremation casket. Inter-faith ministerial services include near-death prayer/meditation vigils, grief support and funeral celebrant services.

Sacred Crossings founder Olivia Bareham is a death midwife, home funeral guide, ordained inter-faith minister and funeral celebrant. She is a member of the National Home Funeral Alliance http://www.homefuneralalliance.org and serves on the board of the Center for Conscious Creativity. Sacred Crossings is owned and operated by certified death midwives.

About Sacred Crossings:
Sacred Crossings is changing the culture of death and dying – through death education and an alternative funeral home. We offer an environmentally friendly option to traditional funeral industry practices and the opportunity for families to have a vigil and funeral at home. The Sacred Crossings Institute offers workshops and classes in conscious dying, home funerals, end-of-life planning, and a certificate program in The Art of Death Midwifery. The Sacred Crossings Funeral Home, owned and operated by certified death midwives, offers a full range of services including home funerals, cremation, conventional burial, green burial and full-body deep sea burial. For more information, contact Annemarie Osborne, publicist at 949.237.2906 or by email annemarieosborne7@gmail.com or Olivia Bareham at 310.968.2763 or olivia@sacredcrossings.com or visit http://www.sacredcrossings.com.

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“We pathologize the dead.”

Mortician Caitlin Doughty on funeral rituals and why death is often hidden away

Mortician, Caitlin Doughty.

by Jonathan Bastian

Some Native Americans have long believed that death is part of the natural cycle of life and many cultures believe the dead spirit continues to “walk on” implying the continuation of a journey rather than an end point with death. Funeral and burial rituals provide comfort and acceptance; death is embraced and revered instead of feared. What can be learned from these practices and rituals that would help make death more meaningful, and less frightening. Do rituals need to be religious to serve a purpose? KCRW’s Jonathan Bastian talks with Larry Sellers, a traditional practitioner and member of the Osage, Cherokee and Lakota tribes and Caitlin Doughty, a mortician and author of “From Here to Eternity; Traveling the World to Find the Good Death.”


The following interview excerpts have been abbreviated and edited for clarity. 

KCRW : We heard from BJ Miller, about how we, as a society, run from death and delay it. What have you experienced?

Caitlin Doughty:What I always find fascinating about the American way of death is how successfully we’ve hidden death. Dead bodies go to funeral homes or industrialized crematories. People who are dying are hidden away in hospitals or nursing homes. Even our animals are removed from view and taken to slaughterhouses, so we don’t even know where our meat comes from anymore. So never in history has there been a society that has so successfully hidden away death, and I think that’s caused innumerable problems.

Larry Sellers: Yes, for the most part, the masses have had this thing about being afraid of death; it’s not a part of their lives, so they hide it and then they make more out of it than what it really is. And in traditional cultures, there isn’t death, there’s only a change of worlds. That you go from this world, because the human spirit never dies and you go to another world. And the dominant culture here is to make everybody afraid of death. Whereas traditional peoples, we look at it as a part of that life cycle. And it’s the transition, the “crossing over,” that’s to be celebrated.

Traditionally many years ago, the way Osage people would bury those who have “crossed” was to put them in a sitting position facing East where the sun rises, so they could greet the morning. Then they would stack stones around them. As a society we believe the community and heritage comes first, so in death, you would be willing to sacrifice yourself, so that the people on Mother Earth can continue to survive.

What about the importance of ritual and ability to navigate this process?

Doughty: What I end up focusing on is the idea that engagement right after death, specifically engagement with the dead body itself is primal, it’s timeless and it can help your grief journey so much to be able to be present with the dead body and care for the dead body because that’s what humans have been doing for tens of thousands of years in all different cultures.

The fact that we pathologize the dead body, we’ve said it’s dangerous, it’s scary, it’s filled with bacteria, it’s probably decomposing, none of which are true. We’ve made the dead body something that can only be handled by professionals for quite a lot of money, as opposed to something that can be done in your community, by the person’s wife or by the person’s child.

In fact, if the family is involved with care for the dead body, it can completely transform how they feel about the death; they can feel empowered, they can feel connected and they can feel like they were there at the very end.

Also it doesn’t have to be religious. If you feel like you’re a modern secular American, without much of a connection to religiosity or that you’ve lost it. Ritual can a-religious, if you still believe in what you’re doing and you’re doing a physical action, you can still be powerful, important, and it can represent a transition.

Sellers:Being with that body and helping that body make that transition is so important. We’ve been affected by the US law from totally practicing our culture because we’re required in large part to encase our family members in a either a metal case or concrete casement rather than a natural burial. Only a few places around the country that allow for natural burials. So if you want a natural burial, you have to go there rather than be with your relatives here. Being around that body helps you process that transition. And it helps to see that person is taken well care of by the family members and the people who were important in that individual’s life.

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Why planning for death should start when we’re living

Dr. B.J. Miller.

by Jonathan Bastian

Death and dying are inevitable and a natural part of life’s cycle. The pandemic has brought the issue of our own mortality into sharp focus. Many people have died alone, away from family, and in the isolation unit of a hospital.  It’s not an option many would choose. Palliative care expert Dr. B.J. Miller talks with KCRW’s Jonathan Bastian about his experiences caring for those who are at the end of their lives. He says one of the big takeaways of this moment is that we should make preparations and think about our mortality when we are healthy.  

The following interview excerpts have been abbreviated and edited for clarity. 

KCRW: You’ve spent countless hours with folks that are nearing the end of their life. What do people want as they prepare to die?

B.J. Miller: Well, in general there’s a ton of individual variation. This is why the subject is so interesting and that’s where some of the joy is. For the most part people want to be at home when they die. And by home, most people mean not the hospital and not the nursing home. Dying at home is doable, especially with hospice. But again here, what I really think people mean is they want to die in familiar settings, where they’re comfortable surrounded by people they love, wherever they call home. In other words, to have a minimum of gear and machines propping them up. A lot of people find peace, in the realization that they are natural creatures and that death is a natural phenomenon. And the more they can touch into that nature, the more at peace they feel, as a rule. But some of us see ourselves as fighters and quote unquote, “when I go down, I go down swinging,” and the idea of an ICU death with desperate measures happening, is fitting, so to each their own.

But to answer your question, dying at home, dying in a more natural way, dying comfortably enough so that you can have time with people you care about. So you can think about anything you know, something besides your pain for a moment here and there. People want to be at peace with their loved ones.

The idea of closure is an invented notion. Nature doesn’t promise us closure except for the idea of birth and death. But a lot of us are just social creatures and are thinking about our legacy, what do we leave behind? So a lot of people say, I just want to make sure I’m not a burden to my family. I want to make sure my family is okay.

It makes sense because I think a lot of what’s dying is the ego and the more each of us can find a way to to love life outside of ourselves beyond ourselves, but inclusive of ourselves, the easier death is on us, the more readily we can, we can handle it.

As we navigate this pandemic, it highlights some of the breakdown in the healthcare system in dealing with death?

The last thing any of us wants to do is shame each other as we’re heading off the planet. But this is exactly why — whether it’s COVID, being hit by a bus, the idea of a sudden death, of suddenly being here and then not being here, that’s always possible — when we make this subject matter taboo — hard to talk about, and the healthcare system doesn’t make it any easier and doctors aren’t trained to talk about it — we end up kind of deferring the inevitable until it’s really too late.

So one of the takeaways right now is we should all be doing our advanced care planning, our wills, our healthcare proxy, the variable putting our affairs, we should all be thinking about our mortality, if only to make sure we are present for the life we have. These are lessons that have been in the population for eons but are easily forgotten because death is such an obnoxious topic, especially in modern society. But we can be swept away in an instant and it would be so helpful to have had these conversations with loved ones before and document our wishes, especially when we’re healthy because you just never know.

You worked at the Zen Hospice Center for a long time in San Francisco, is there a spiritual dimension that you are aware of being around death for so long?

You know, I don’t know what word I like, religion, faith, spirituality, they’re all importantly different. I believe that we are all connected not just person to person, but person to tree, person to chipmunk, person or whatever, that we’re all part of something that we can’t possibly fathom. And as smart as we are, there’s still so much we don’t know. So there’s got to be some deference to mystery, some deference to not knowing.

You can look at that void or that abyss or that mystery and project judgments or you can project a sort of a universal love. For me, I happen to believe that, in general, adjectives and qualifications are human invention. But one way or another, I look at that mystery, I feel all that connection and I see love. I see humility in all that we don’t know and yet are totally a part of.

You can imagine how much this comes up when you’re dealing with patients and families, friends, anybody at the end of life.  If I can sit with a patient and they’re in the throes of wondering what’s going to happen, maybe scared about what’s going to happen when they die, I often end up just talking with people about mystery and about not knowing and say, “Well, you know, I don’t know either, you know, I’ve been around death and dying for a lot of a lot of years and a lot of people and I still have no idea. And you know, isn’t that amazing?”

When I look up in the night sky, and I can see all these stars and light that’s hitting my eyes that left that source billions of years ago, empirically, there’s enough proof of connection among us or fascination around us. I’m coaxed into a faith that love is somewhere binding us. And even if it’s not the natural order, it’s certainly something that we inject and put love and meaning into this mystery.

And so sitting at the bedside, there’s a permissiveness at the end of life that I’ve come kind of addicted to, because if you’re with someone who’s only going to be around for a while, you can quickly go to the vulnerable place, you can quickly love someone without fear of Gosh, if I tell them, I love them, they’re gonna get expectations and you don’t have to talk yourself out of this very simple thing of loving someone.

So at the end of life, I don’t know what’s coming either but I’m gonna sit here with you and we’ll walk up to the edge of that abyss with you and I’m not going to go anywhere. And I’ll be thinking of you even after you’re gone and I love you, and we get to share this planet at the same time. Isn’t that amazing?

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