The Dancing Skeletons

By John Harvey Negru

One of the more enchanting costumed Tibetan Buddhist dances involves a couple of jovial skeletons (citipati) who perform a jig that is, to me, vaguely reminiscent of Abbot and Costello in a vaudeville routine. Their grins are ear-to-ear, one holds a skull cup full of blood and the other holds a wand comprising a child’s spine and skull. Charming.

There are many images of these two clowns; it’s not a particularly obscure bit of tantric exotica. They’re just part of the entourage. They come on between the multi-octave throat singers and the more elaborately gowned Black Hat re-enactment or Yamantaka dance.

Clearly this is not an image of death that was part of the zeitgeist when and where I grew up as a nice Jewish boy, down the street from Leonard Cohen in Westmount, the English enclave in Montreal, Québec, a Canadian province still in the fading grip of the Catholic Church after the Quiet Revolution.

And yet, as I and my generation have grown older and older, we find ourselves with a ticket to the Greatest Show on Earth: our demise, like it or not. Leonard has already made his own curtain call.

These days, we have a cornucopia of narratives about how our end of life will go. And as you can imagine, each of us is pretty darn committed to finding the one that will bring the greatest peace of mind and no regrets.

As we have learned over the past year and a half, dying is a much more difficult passage than being dead. Tragically, many of us have found ourselves unprepared to deal with the passing of a loved one or recognizing that we ourselves are leaving lots of loose ends for those we love.

Linda Hochstetler. Photo by Kristina Ruddick. Image courtesy of the author
Linda Hochstetler.

The end of life is not something folks like to talk about, but it is our ultimate mystery. On another plane, it is also a tricky logistical path across a gameboard, with pitfalls such as dealing with hospital bureaucracy, filling in forms, searching for hospice care, making advanced care plans, and so much more.

I know several Canadian Buddhists who have served as death doulas. A few months ago, I was approached by a Buddhist social worker from Toronto, Linda Hochstetler, who has specialized in death work for many years in a variety of capacities. She explained that she had written an end-of-life guide and asked if I would be interested in publishing it. The short answer was yes and the book will be out this autumn.

It seemed worth interviewing her because I wanted to learn more about her perspective on the end of life, and to explore some of the themes she raises in her book but which were subsumed to the need to keep it practical for its intended Canadian audience. Here is a portion of our conversation.

Buddhistdoor Global: When we talk about death and dying, reversing the order of things, we make death the focus of our attention at the expense of understanding and working with the process of dying. In the best of all possible worlds, how would you change that?

Linda Hochstetler: I would spend much more time teaching about the dying process. Everyone should know the death process intimately before they graduate high school. The dying process is not really understood or taught anywhere. Not to adults and certainly not to kids. I would love it to be a part of school curricula. It’s too often avoided at all ages. Switching the order within the phrase dying and death allows us to really look at dying up close and to spend much more time and interest here, understanding this before we try to move on to death.

BDG: The pandemic has transformed our awareness of the fragility of life, our interbeing, and our relationships with old and young. In offering spiritual care to frontline healthcare workers, what do you see and how do you respond?

LH: Frontline healthcare workers are called to do their work because it matters to them. They want to be a part of a system that they approve of and where they feel they can make a difference. The pandemic has been challenging because many of the policies in healthcare were not in line with healthcare workers’ priorities. Healthcare workers were asked to work without PPE initially, and there were often staff shortages when staff were sick themselves or just stressed out. These situations were unfortunate because they pitted the workers against families, and even when the healthcare workers wanted to work together with families to provide good care to sick family members, they were unable to do so. We have been hearing that we’re all in the pandemic together, but too often our needs have been competing and we have not been able to work together well. Under these conditions, spiritual support is often considered to be superfluous and the easiest part to cut out. This is unfortunate, because it is our spirituality that is the core of our common humanity.

BDG: What is “a good death” and is this a goal we need to strive toward?

LH: A good death will differ for everyone. It is one that is in line with one’s values. It is also one that is the best in those circumstances from the options available. It is helpful to aim for a good death but not to cling too tightly to the idea, because sometimes things come up that are a surprise. It’s easier to say what is not a good death than what is a good death. What is not a good death is hanging on and slowing down death with the idea that it can be prevented. Attached to this is the idea that resisting death increases interventions at the end. Interventions create activity and distraction from the dying process, and often require professionals and hospital rules to take precedence over the dying process, which belongs to the dying person and their loved ones.

BDG: How is death work different from grief work?

LH: Death work is the honest seeing of the process of dying. It is witnessing the changes in the body, understanding how this affects the mind and ultimately our conversations and interactions with those remaining. Grief work is both the work of the dying person, who is letting go of this lifetime, and the work of the loved ones, who are releasing the dying person, and imaging a life without their loved one even while they are still alive. Very basically, death work has a greater focus on the body, while grief work has a greater focus on the mind and feelings. And both can happen both before and after the final breath.

BDG: The use of self is one of the benchmarks by which neophyte chaplains are evaluated in their CPE training. Yet the role of a spiritual caregiver demands the abandonment of self for the benefit of the patient or client. Since Buddhism negates the idea of a self, is there some special advantage a Buddhist approach can offer here?

LH: The use of self in a therapeutic sense begins with an awareness of self and an awareness of other. Buddhism negates the idea of a self—not in the sense that it doesn’t exist but that it is not inherently different from the other. Awareness training helps to hold this seeming dichotomy together. In this way, a Buddhist chaplain has the experience and training to see the patient or client as themselves and can more easily offer help from this perspective. They can go between their needs and their client’s needs seamlessly without needing to drop either side. Buddhist chaplains are way more comfortable with “both/and” situations.

BDG: When a loved one is dying, it is often the nexus for family conflict that can leave lasting scars. Of course, preventing such conflict is important, but when it has been unavoidable, what is the best way to repair the damage?

LH: Preventing family conflict around the death bed is so much easier than repairing it afterwards, so whenever possible, resources and time should be spent here. Making room for all loved ones to share in the dying process is best, even if that means making a schedule and taking turns in the care. However, when damage has occurred, it is best to find a neutral person—a chaplain or social worker—to speak with all sides individually and invite them to consider the wishes of the dying person. The dying person’s wishes should be of greatest importance, and ideally this priority can guide the overall decision-making.

BDG: How do Western Buddhist views of dying and death differ from those of Asian Buddhists? How are they the same?

LH: Buddhism is always a combined product of the scriptures/teaching and the local culture. As such, it is often hard to know what is influenced by Buddhism and what is influenced by culture. In many ways, there are fewer differences between Western and Asian Buddhists, and more differences between traditional Buddhist interpretations and modern options. For example, 50 years ago if someone was close to dying, they would be doing so at home and tended by family members into a natural death. Today, modern medicine presents many options for extending life and often these extensions are what is considered controversial. These options, which involve feeding and breathing tubes, are offered around the world. Taking someone off of life support, medical assistance in dying, or organ donations are all options that have come up in the last 50 years and were not even imaginable in the Buddhist scriptures or teaching, so much must be extrapolated from the culture on the rightness and wrongness of these choices. I think Western Buddhists and Asian Buddhists have much more in common than is often assumed and would do well to look at their similarities rather than their differences.

BDG: Briefly, what is the difference between palliative and hospice care, from a Buddhist perspective?

LH: There is no difference between palliative care and hospice care from a Buddhist perspective. In actuality, palliative care can involve a greater resistance when it includes death hidden from the community, but this doesn’t have to be so. Hospice care often occurs in locations—home or residential hospice—that allow for fewer rules regarding spiritual practices, but this is not inherently so.

BDG: What is the difference between spiritual care and psycho-spiritual therapy?

LH: Spiritual care emphasizes both the individual and the community aspect of spiritual practice. This might include formal practices such as prayer and chanting, with the support of spiritual leaders or lay chaplains or sangha members. Psycho-spiritual therapy often involves a relationship that works on individual ego work, often throughout one’s life. It includes explorations of where spiritual practices and aspirations fit into an individual’s life. Ideally, therapy is done long before the dying process so as to clear away energy for dying without also having the weight of previous relationships unresolved.

BDG: Is it possible to celebrate dying?

LH: Absolutely. Just like there are many challenges in one’s life, dying is a final one. Celebration comes from training for death and then completing it according to the training. As with many challenges, the focus doesn’t have to be on the exact result, but more in the effort in a particular direction. And the celebration of dying includes the celebration of living. Look at the whole life and see that dying is one more step of the life, and celebrate when it all hangs together consistently and as a whole.

Complete Article HERE!

Liberal Judaism, Modern Church join new Religious Alliance for Dignity in Dying

  • New group of interfaith leaders and laypeople following more than a dozen denominations call for change in law on assisted dying
  • Poll finds 53% people of faith felt religious leaders were wrong to campaign against last assisted dying bill, while just 22% felt it was right
  • Christian man who accompanied wife to Dignitas welcomes new Alliance

Liberal Judaism, a progressive strand of Judaism, and the Modern Church, an Anglican society promoting liberal Christian theology, are the latest faith organisations to join the new Religious Alliance for Dignity in Dying, a collection of multi-faith groups, leaders and laypeople calling for a change in the law on assisted dying. Lord Carey, the former Archbishop of Canterbury, has also joined the Alliance and the Chief Officer of the Unitarians has recognised the strong support among many of their members. The Alliance is also welcomed by a Christian man who accompanied his terminally ill wife to Dignitas in 2019 at her request.

The Religious Alliance for Dignity in Dying is formed of religious organisations, leaders and people who follow more than a dozen different denominations and who support a change in the law to enable terminally ill people the ability to determine how, when and where they die alongside high quality end of life care. This comes as a private member’s bill on assisted dying was introduced to the House of Lords last month by Baroness Meacher, Chair of Dignity in Dying, paving the way for the first debate on prospective legislation in Parliament for more than five years.

In a YouGov poll of 5,039 adults published yesterday, 53% of religious people felt it was wrong for religious leaders to actively campaign against an assisted dying bill that was debated in the House of Commons in 2015, with just 22% saying they felt it was right for them to do so.

Faith leaders including the Archbishop of Canterbury and the Archbishop of Westminster wrote to MPs in September 2015 to urge them to oppose the Second Reading of the assisted dying bill in the House of Commons. The bill was based on one introduced by Lord Falconer in 2014, which was supported by Peers both at Second Reading and at Committee Stage, where two opposition amendments were defeated by large margins. Unfortunately, the parliamentary session ended before it could progress further. Baroness Meacher’s bill, also based on Lord Falconer’s bill, was drawn seventh in the House of Lords private members’ ballot last month and a Second Reading is expected in the autumn.

A 2019 Populus poll found that approximately 80% of religious people (and 84% of the general public) support the change proposed in Baroness Meacher’s bill – namely that terminally ill, mentally competent adults in their final months would be able to request an assisted death, subject to approval from two independent doctors and a High Court judge.

Similar legislation has been in place in Oregon, USA for over 23 years, and has since been adopted by nine other American states plus the District of Columbia, three Australian states and New Zealand.

The Religious Alliance for Dignity in Dying brings together followers of the Church of England, Church of Scotland, Church of Wales, Catholicism, Baptism, Evangelism, Methodism, Unitarianism, United Reformed Church, Quakerism, Liberal Judaism, Reform Judaism and Sunni Islam.

Rabbi Charley Baginsky, Chief Executive of Liberal Judaism, said: “Liberal Judaism has a proud history of being at the forefront of progressive societal change, speaking up for much-needed liberal reforms with compassion at their heart. Much like votes for women or equal marriage – rights which now seem unchallengeable – assisted dying is a right we are proud to champion for people nearing the end of their life.”

Rabbi Danny Rich, Liberal Judaism rabbi with responsibility for hospital and prison chaplaincy and former Chief Executive of Liberal Judaism, said: “I have long been an advocate of the right of terminally ill individuals, subject to appropriate safeguards, to decide the manner and timing of their own deaths. Twenty-seven years ago my own great uncle, suffering with inoperable cancer, ended his own life with help from a relative. That dying people are still forced to contemplate dying by suicide as an alternative to a traumatic or prolonged death by their disease is shameful. I add my voice to the growing number calling for true choice and control at the end of life.”

Alan Race, Chair of the Modern Church, said: “Christians place high value on human dignity and compassion and believe we should relieve suffering where possible. We welcome medical intervention in order to relieve pain, especially when suffering becomes unbearable. Relationship with God is a freely chosen commitment and this means that we do not leave it to God to determine the time of death. Trusting in God’s unlimited compassion therefore includes the desire to relieve unbearable suffering at the end of life. In practical terms, granting permission for assisted dying often has the effect of releasing renewed spirituality for living a more fulfilled life prior to death itself.” 

Lord Carey, former Archbishop of Canterbury, said: “For too long we have turned a blind eye to the suffering inflicted on terminally ill people by the ban on assisted dying. Compassion, a central tenet of the Christian faith, should not be a crime, and yet under the current law it is treated as such. I believe a change to the law is urgently needed to enable our dying citizens the ability to go as they wish. To my mind, this is the moral, and the Christian, thing to do.”

Liz Slade, Chief Officer of the Unitarians, said: “The Unitarian movement voted in 2013 on the issue of assisted dying; in our recognition of the worth the dignity of all people and their freedom to believe as their consciences dictate, members voted to support the principle that individuals should have the right to seek support for assisted dying in certain circumstances, and that legislation should respect this choice and allow them compassionate assistance without fear of prosecution of anyone involved. Many Unitarians are passionately in favour of a change in the law, while recognising the need to allow a diversity of voices to be considered on this important moral issue.”

Rabbi Dr Jonathan Romain, Chair of the Religious Alliance for Dignity in Dying, said: “This new Alliance is a truly multi-faith rallying call for a compassionate, safeguarded law on assisted dying for the UK.

“In the 60 years since the blanket ban has been in place, medical advances have done wonders in prolonging life, but this often means prolonging the dying process too, causing suffering that may be beyond the reach of palliative care. Religious teaching evolves to deal with the challenges of modern life, so too should the options we offer people when they reach the end of it. That we continue to deny our dying citizens a choice that is now available in states and nations around the world is morally indefensible. It’s time to have a national debate on assisted dying that respects all views while recognising the strong support among religious people.”

Len Taphouse, 81, a former lecturer in engineering and father of three from Hornchurch, is a member of the Church of England and welcomes the new Religious Alliance for Dignity in Dying. Len accompanied his wife of 55 years, Stella, to die at Dignitas in Switzerland at her request in August 2019. Stella was terminally ill with Parkinson’s disease and breast cancer, and in previous years had been diagnosed with cancer of the womb and skin.

Len said: “I was brought up as a regular church-goer, and in 2014 Stella and I renewed our vows 50 years later in the very same church we got married in. Neither of us found our faith a barrier to supporting Stella’s decision, quite the opposite. But this option should have been available here at home. Stella should not have had to spend £11,000 and my daughters and I should not have had to break the law and risk prosecution to accompany her in her final moments. It’s time the law was changed so that people like Stella can die as they wish in this country, surrounded by those they love, in their own bed.”

Tom Davies, Director of Campaigns and Communications at Dignity in Dying, said: “Medical organisations are increasingly recognising the range of views among their members, with doctors accepting that whatever their personal opinion they cannot deny their dying patients the choices they want. Religious organisations and faith leaders are now doing the same, recognising the support for change among their congregations and putting the choice and autonomy of those at the end of life before doctrine.

“With an assisted dying bill in the House of Lords, the Health Secretary commissioning data on suicides by terminally ill people, Scotland due to consult on potential legislation and Jersey conducting a citizen’s jury on the subject, it is essential that parliamentarians across the British Isles understand that the vast majority of the pubic, with faith and without, want change.”

Complete Article HERE!

The Secret to Happiness?

Thinking About Death.

In an excerpt from his new book, journalist Michael Easter travels to Bhutan to learn about how confronting death head-on can lead to a more fulfilled life

By Michael Easter

In his new book, The Comfort Crisis, Michael Easter investigates the connection between modern comforts and conveniences and some of our most pressing problems, like heart disease, diabetes, depression, and a sense of purposelessness. Turns out, engaging with a handful of evolutionary discomforts can dramatically improve our mental, physical, and spiritual wellbeing. One of those fruitful discomforts? Thinking about dying.

Death has always been the most uncomfortable fact of life. And as modern medicine, comforts, and conveniences have given us more years, we’ve seemingly become less and less comfortable with life’s only guarantee. Roughly seven out of ten Westerners say they feel uncomfortable with death. Only half of people over 65 have considered how they want to die.

After someone dies we’re encouraged to stay busy to take our mind off it. A dead person’s body is immediately covered and sent to a mortician where it is prepared to look as youthful and alive as possible before one final, hour-long viewing, after which it is dropped into the ground of a perfectly manicured cemetery.

But new research is showing that death awareness is good for us. For example, scientists at the University of Kentucky had one group of people think about a painful visit to the dentist and the other contemplate their death. The death thinkers afterward said they were more happy and fulfilled in life. The scientists concluded, “death is a psychologically threatening fact, but when people contemplate it, apparently the automatic system begins to search for happy thoughts.”

The country of Bhutan has made it part of its national curriculum to think about death anywhere from one to three times daily. The understanding that we’re all going to die is hammered into Bhutan’s collective conscience, and death is part of everyday life. Ashes of the dead are mixed with clay and molded into small pyramids, called tsa tsas, and placed along heavily trafficked areas like roadsides, in window sills, and public squares and parks. Bhutanese arts often center around death; paintings of vultures picking the flesh from corpses, dances that reenact dying. Funerals are a 21-day event where the dead body “lives” in its house before being slowly cremated over fragrant juniper trees in front of hundreds of friends and relatives.

All of this death is doing anything but bumming out the Bhutanese. Despite being ranked the 134th most developed nation on earth, extensive studies conducted by Japanese researchers have found that Bhutan is among the world’s 20 happiest countries. But what you probably don’t know is how morbidity contributes to their feelings of happiness. And neither did I.


After four flights across 48 hours, 14 time zones, and 9,465 miles, I stepped off an aging 737 onto a runway 7,333 feet above sea level at Bhutan’s Paro International Airport. THE thin air filled my lungs as the sun illuminated the surrounding snow-capped Himalayan foothills. I was there to find out how Bhutan’s uncomfortable intimacy with death might improve my life—and maybe yours too.

I’d arranged to meet with a host of characters, including government leaders who study happiness in Bhutan. But the most compelling men I met with were both leaders in the Buddhist faith.

The first was Khenpo Phuntsho Tashi. He knows as much about death as a living human can. He’s one of Bhutan’s leading Buddhist thinkers, and he’s found a niche in the study of death and dying. The Khenpo is the author of a 250-page book called “The Fine Art of Living and Manifesting a Peaceful Death.” And unlike many of Bhutan’s monks, the Khenpo is intimately familiar with what ails people in the West. Before he dedicated himself to his spiritual practice he lived in Atlanta, with a girlfriend who was the Dalai Lama’s translator. He, I thought, would be able to get to the heart and consequences of the West’s fear of death.

My boots kicked up a low-hanging dust as the Khenpo’s cliff-side shack came into view. It was wooden, tin-roofed, and in the shadow of Dakarpo. Dakarpo is an ancient Buddhist monastery built on an outcropping that overlooks the Shaba valley. Fifteen or so people walked clockwise around the white, fortress-like monastery. They chanted as they carefully stepped around its rocky terrain. Bhutanese mythology says a person will be cleared of all of his or her sins by circumventing the Dakarpo 108 times. Each lap takes roughly 25 minutes. The full 108 takes most pilgrims about four full days, a relatively small fee for absolute absolution.

The scent of burning incense crawled into my nose as I peeled back the heavy orange embroidered silk drape leading into the Khenpo’s room. Light was entering the room through a hazy window, catching smoke. It obscured a small altar anchored by a three-foot statue of the Buddha. Around it were smaller Buddhist statues, photographs, and burning sticks of champa. Through the smoke I saw the profile of a face. It was the Khenpo.

“Welcome,” said the Khenpo, his voice a heavily accented butter. I bowed and sat. “You want to talk about death?”

I nodded. “Hmmmm,” he said. His chest slowly rose and fell in the silence.

“You Americans are usually ignorant,” he said, using a word often seen as an insult in the United States, but that by definition means “lacking awareness.” In Bhutan and other Buddhist countries, “ignorance” is the rough English translation of “Avidyā.” That’s a Sanskrit word that means having a misunderstanding of the true nature of your reality and the truth of your impermanence. “Most Americans are unaware of how good you have it, and so many of you are miserable and chasing the wrong things.

“You act like life is fulfilling a checklist. ‘I need to get a good wife or husband, then I get a good car, then I get a good house, then I get a promotion, then I get a better car and a better house and I make a name for myself and then …’” he rattled off more accomplishments that fulfill the American Dream. “But this plan will never materialize perfectly. And even if it does, then what? You don’t settle, you add more items to the checklist. It is the nature of desire to get one thing and immediately want the next thing, and this cycle of accomplishment and acquisitions won’t necessarily make you happy—if you have ten pairs of shoes you want 11 pairs.”

The Khenpo then pointed out that by pursuing this checklist, we’re often forced into acts that take us away from that higher reality and happiness. He was echoing a sentiment shared among many leaders in the tradition of Vajrayana Buddhism. Sogral Rinpoche in his 1992 work The Tibetan Book of Living and Dying called this checklist phenomenon “Western laziness.” It consists of “cramming our lives with compulsive activity, so that there is no time at all to confront the real issues … If we look into our lives, we will see clearly how many unimportant tasks, so-called ‘responsibilities’ accumulate to fill them up … Going on as we do, obsessively trying to improve our conditions, can become an end in itself and a pointless distraction.”

The average American works 47 hours a week. Our entrepreneurs and “productivity gurus” preach that a “grind” and “shut up and work harder” mentality is the secret to satisfaction. This upset in our work/life balance—or, perhaps, our problem integrating our work into our life and not the other way around—factors into why other research has shown that America is, in fact, less happy than it was decades ago.

“So this checklist plan does not make you truly happy. Then what?” said the Khenpo. He was silent. Left it open for me to ponder.

“I don’t know. I’m an ignorant American,” I said and smiled.

“Then you could be happier!” he responded with a chuckle. “Whereas if you understand this cycle and nature of mind and you prioritize mindfulness then everything will be ok. Even if you don’t become rich. Fine, you’re mindful. Even if you don’t get a perfect wife? Fine, you’re mindful.”

Ah, yes. “Mindfulness.” That squishy, what-the-fuck-does-that-even-mean word that’s so hot in America today but has, in fact, been a part of Eastern traditions since before Christ. It’s roughly defined as purposefully paying attention to what’s happening in the present moment without judgment, according to Jon Kabat Zinn, a profes-sor at the University of Massachusetts Medical School and pioneer of mindfulness in the Western world. In other words, it’s being aware of what’s going on upstairs.

The Khenpo made mindfulness sound akin to jamming a stick into the spokes of the checklist and developing a state of okayness. In other words, whether I’m rich or poor or famous or a nobody, I should avoid becoming caught up in the narratives my mind spits out and just accept the direction of things. This will help me go beyond the checklist and be just fine.

The woman who took me through the cleansing ritual entered the room. She placed a plate of sliced cucumbers and mandarin wedges on the floor between the Khenpo and me. “All organic!,” he said and grabbed a spear of cucumber. It crunched as he bit into it.

“Well, the Bhutanese, we also have ignorance, anger, and attachment. We have the same problems of the checklist. But I think less. This is because we apply what we call mindfulness of the body. We remember that everyone is dying right now,” said the Khenpo. “Everyone will die. You are not singled out. Do you know this? To not think of death and not prepare for it … this is the root of ignorance.”

Pretend you are walking along a trail, he explained, and there is a cliff in 500 yards. The catch: The cliff is death and we will all walk off it. “Buddha died. Jesus died. You will die. I will die. I would like to die on that bed,” said the Khenpo, pointing to a twin mattress on the floor.

“Don’t you want to know that there’s a cliff?” he asked. Because only then can we change our course. We could take a more scenic route, notice the beauty of the trail before it ends, say the things we truly want to say to the people we’re walking it with.

“When you start to understand that death is coming, that the cliff is coming, you see things differently. You change your mental course—you naturally become more compassionate and mindful,” said the Khenpo. “But Americans, they don’t want to hear about the cliff. They don’t think about death. After a funeral, they want to get their mind off the death and just eat cake. The Bhutanese, they want to know about the cliff and they will be happy to talk about death and ruin the cake eating.”

“So remember,” he continued. He was able to sustain the perfect upright lotus position while I was slumping and couldn’t feel my legs. “We are all dying right now. To develop this mindfulness of death you have to think of Mitakpa.”

“Mitakpa?” I asked.

“Yes,” he said. “Mitakpa.”

Before I could probe the Khenpo on Mitakpa—what it is and what it might be able to do—his time was up and I was back in Dorji’s hatchback. We were like bouncy balls in the seats as gravity aggressively pulled the car over all the rocks and ruts that once thwarted us. As we descended I asked, “Dorji, what is mitakpa?” He looked at me and shook his head. “Mi-tak-pa,” I said.

“Oh. Mitakpa,” he replied, pronouncing the word less like an ignorant American. “Takpa ‘permanent,’” he said. “Mi ‘no.’ Mitakpa ‘no permanent.’”

I began to ask him to explain further, but a Bhutanese traffic jam interrupted me. A herd of seven bulls and cows ambled up the one-lane road. Dorji pressed into the brake to slow the car to a crawl. The half-ton animals lazily parted around us. Their bells clanked as they slid down the length of the hatchback.

The next day, I headed into an apartment in the city of Thimpu to meet Lama Damcho Gyeltshen. He doesn’t ponder death in any abstract sense—he experiences it every day. He’s the head Lama at the Jigme Dorji Wangchuck National Referral Hospital, the main hospital in Bhutan. It’s there that he councils the dying. After the Khenpo elucidated the problem and hinted at some solution, the Lama, I figured, might be able to expand.

The Lama was sitting on a platform that was covered in silk meditation pads. He hopped off of it as we entered. He and I shook hands and did a lot of smiling and nodding. He was bald, short, and doughy, with wire-framed glasses. His bright white smile popped against his blaze orange robes. He sat back atop the platform, in the lotus, while Jigme and I sat on the floor. Jigme explained what I was there to talk about. Death, dying, and the Bhutanese death complex.

“Well first I’d like to thank you for coming and reminding me of death because it is important for the mind,” said the Lama. His words, naturally, set me up to ask why.

“When people come into my hospital there is a chance they leave,” he said. “But there is also a high chance they do not leave. My job is to help people prepare for death. I have found that the people who have not thought about death are the ones who have regrets on their deathbeds. Because they have not used a necessary tool that could have made them live a fuller life.” An American study conducted across various hospitals like the Yale Cancer Center, Dana -Farber Cancer Institute, and Massachusetts General Hospital supports this notion. It found that dying patients who had open conversations about their death experienced better quality of life in the weeks and months leading to their passing, as judged by their family members and nurse practitioners.

“The mind is afflicted with many delusions. But they come down to three,” continued the Lama. “And those are greed, anger, and ignorance. When your mind is not taken care of these three things have an advantage. The dying people I council … they suddenly do not care about getting famous, or their car or watch, or working more. They don’t care about the things that once angered them.” In other words: When a person realizes death is imminent, their checklist and everyday bullshit becomes irrelevant and their mind begins to center on that which makes it happy. Research from Australia found that the top regrets of the dying include not living in the moment, working too often, and living a life the person thinks they should rather than one they truly want to.

“Whereas those who have thought of their death and prepared for it,” said the Lama, “they do not have those regrets. Because they have often not fallen so much into those delusions. They have lived in the moment. Maybe they have accomplished a lot. Maybe they have not. But regardless it has not affected their happiness as much …” He expanded on this phenomenon, explaining that a sort of cosmic psychic shift often occurs in the dying. It brings them closer to the things that matter in the end. A living person who thinks of dying will, yes, initially face mental discomfort, but they’ll emerge on the other side having stolen a bit of this end-of-life magic.

“What is mitakpa?” I asked. “Someone told me it translates to ‘no permanent…’”

“Close. Mitakpa is impermanence,” said the Lama. He raised an arm and finger, like a professor making a point. “Impermanence, impermanence, impermanence.” This, he said, is the cornerstone of Buddhist teachings. Nothing lasts and, therefore, nothing can be held onto. By trying to hold on to that which is changing, like our life itself, we ultimately end up suffering. Buddha’s final words were on impermanence, a reminder that all things die. “All things change. Whatever is born is subject to decay…” he said. “All individual things pass away.”

“It’s important to preserve this precious understanding of mitakpa in your mind. It will significantly contribute to your happiness,” said the Lama. He echoed the Khenpo’s sentiment. He explained that not thinking of mitakpa often leads a person to believe that “things will be better when I do X.” Or with a false sense of permanence that causes a person to put off the things they truly want to do because “I can do that when I retire.”

“But when you understand that nothing is permanent you cannot help but follow a better, happier path,” he said. “It calms your mind. You tend not to get overly excited, angry, or critical. With this principle, people interact with others and it improves their relationships. They become more grateful and gratuitous. Because they realize all their material goods and status will not matter in the end.” And not just in Bhutan. A study in Psychological Science discovered that people who thought about their death were more likely to show concern for people around them. They did things like donating time, money, and even their blood to blood banks.

“How often should I be thinking about mitakpa?” I asked.

“You must think of mitakpa three times each day. Once in the morning, once in the afternoon, and once in the evening. You must be curious about your death. You must understand you don’t know how you will die or where you will die. Just that you will die. And that death can come at any time,” he said. “The ancient monks would remind themselves of this every time they left their meditation cave. I, too, remind myself of this every time I walk out my front door.”

We talked for a half-hour more about death and his work at the hospital. Then it was time for me to leave.

“Remember,” said the Lama as we were saying goodbye. “Death can come at any time. Any time.”


The next day I spent the morning hiking five steep miles to Paro Taksang, “The Tiger’s Nest,” a sacred 15th-century Buddhist monastery built in the traditional Bhutanese Dzong style. The monastery sits at 10,240 feet above sea level and clings to a cliff like a reptile on a vertical wall. It’s the location where in the eighth century Padmasambhava, a man considered the “Second Buddha,” meditated in a tiger-filled cave for three years, three months, three weeks, three days, and three hours.

I’d come to see the monastery’s famous artwork, much of which depicts death. It holds various images and statues of, for example, Mahakala, a protector god whose crown is ringed with skulls and whose sash is strung with severed heads. His Sanskrit name translates to “beyond time” or, more simply, “death.”

As I exited the monastery and put my shoes back on, Dorji, my driver (Bhutanese law requires all tourists to hire a guide and a driver … my guide had conked out due to the altitude), hurriedly approached me. “Someone sick,” he said in his broken English. He pointed up the trail, to a set of steep stairs cut from a cliff that lead up to a small meditation hut next to a waterfall. Towards the top of the steps, a group of people huddled. They were all wearing either traditional Bhutanese ghos or monk robes. Dorji jogged towards the group. I followed. As I quickly stepped up the thin stairs I could see feet hanging from the edge of the steps.

A monk—bald head, thin glasses, maroon robes—was down on the steps, unconscious. I recalled some basic emergency wilderness training I took and checked his spine for signs of fracture. Nothing. A general understanding arose within the group. The man needed to be moved to flat ground so he could be airlifted out.

The stairs were too steep and thin for a group carry. So we carefully propped the monk onto the back of the largest driver, who hoofed him down the steps. With the help of the group, he laid the monk onto a flat grass patch along the cliffside trail.

The monk’s eyes were rolled back as if he was scrutinizing the brain above them. “I’m going to do CPR,” I slowly told the group. They only partially understood me. As I knelt in front of him two tiny women, a mother and daughter who were both doctors in Hong Kong, were suddenly at my side. They were hiking to the monastery when they walked into this scene.

They pressed their fingers to the man’s neck to check vitals and agreed that CPR was needed. These two were surely better trained. But I was the only person with any training who was also large enough to optimally execute CPR on the 200-pound monk.

I tore open his robe, revealing a gold t-shirt. I dug my knees into the dirt, overlapped my hands, and placed the heel of my right hand on the monk’s sternum. Then I began hammering into his chest; 100 beats a minute as the daughter doctor began a timer.

I was unsure of the cultural implications of giving a monk mouth-to-mouth. So the younger Hong Kong doctor quickly instructed one of the other monks, a woman, on how to do it. She breathed into him, repeatedly pushing air into his lungs. Then I was back to compressing his chest.

“Time is 10:26,” said the daughter. A crowd had formed around us, and a driver who was on the phone stepped into the group. “Helicopter cannot come,” he told us. There was nowhere to land, and the cliffs were too close for an airlift.

The daughter checked the monk’s vitals. She shook her head. I continued pressing. Pressing, pressing, as hard as I could, thinking that if I could push hard enough it might kickstart his heart. We hit the fifteen-minute mark. His face was distant. “20 minutes 11 seconds,” said the doctor. “You can stop.” He was gone.

Here was a man who just minutes ago had hiked five steep miles. And he was joking and laughing and talking with friends along the way. Death can come at any time.

Complete Article HERE!

Plague & Prayer

— In the Midst of Pandemic Life, Religion is a Mixed Blessing

By

The coronavirus pandemic has now ravaged the globe for more than a year. It has brought with it myriad difficulties; despite the fact that many have been spared from the virus itself, no one has been immune to its economic and social consequences. This dimension of the pandemic’s impact has unmistakably revealed the disproportionate distribution of privilege and hardship in societies around the world, drawing much-needed attention to the ways in which COVID-19 has been experienced very differently by racialized and ethnic minorities, the socioeconomically disadvantaged, and women.

But despite the factual relevance of race, gender, and socioeconomic status, these not the only factors with the potential to complicate pandemic life for people. In the Western world, where religion no longer plays a central role in public life, not much attention is paid to the experience of religious communities. Yet, faith has proven to have a powerful role in shaping pandemic life for believers worldwide, and while it has been a comfort to many, it is arguably a mixed blessing.  

Risks and rewards 

Given the communal aspect of most faiths, many believers have found themselves facing a difficult choice between honouring their sense of religious duty and following public health guidelines to protect their health and safety. Obviously, the degree to which this has become a reality for religious believers varies based on different religious customs regarding congregation, but, having to choose between one’s faith and, potentially, one’s life is no easy decision.

In some cases, religious communities have found ways to adapt to restrictions by holding faith services online. Religious researchers have noted that roughly two-thirds of practicing Christians in the United States are attending virtual church services during the pandemic. However, they also recorded a decline in religious participation among the same group: approximately one in three practicing Christians have stopped attending church during COVID-19. Some of those who continue to worship practices struggle with the inadequacy of online services, but nonetheless express a drive to “keep going.”

However, practitioners of certain other faiths — particularly Islam and Judaism — have, in many cases, struggled with an incompatibility between their religious practices and social distancing requirements. Measures implemented in response to the coronavirus have deeply disrupted Muslim rituals surrounding death and burial rites. Likewise, social distancing regulations conflict with many practices central to (ultra-)Orthodox Jewish life. In Orthodox communities in New York and Israel, devout Jews have defied gathering restrictions in order to attend the enormous wedding and funeral ceremonies that represent a foundational part of their culture and heritage. Attendance at such gatherings is, for many, both “a religious and personal duty.” 

Orthodox Jewish communities have been hit particularly hard by COVID-19, and many have struggled to reconcile the congregation-centred aspects of their faith and culture with public health guidelines. “Man walking beside red wall photo

A UK study showed that coronavirus death rates were highest among Muslims, followed by those who identified as Jewish, Hindu, or Sikh. Christians had a significantly lower risk, while non-religious individuals had the lowest death rate of all surveyed groups. The researchers noted that these risk disparities could be largely attributed to differences in geographical location, socioeconomic status, and demographic and ethnic factors already linked to higher risk of COVID-19 mortality, and that these considerations could not provide a complete explanatory picture. It seems possible that differences in faith practices could perhaps play at least a minor role. Religious communities whose traditions tend to require mass gatherings could conceivably be more vulnerable to contagion and death.

Furthermore, there’s yet another risk — that of prejudice and division. The perception among the rest of society that members of religious communities are selfishly endangering others by defying restrictions in order to perform rites and duties of faith can breed resentment and deepen social divides. In New York, the government’s handling of the pandemic has largely failed to show sensitivity to the particular needs of the insular Orthodox Jewish communities there, deepening their distrust in civic administration. Efforts by these groups to uphold religious obligations and community life in spite of the pandemic has led to clashes with local government and resentment from fellow citizens. Meanwhile, in India, an outbreak of the virus at an Islamic religious conference in 2020 was followed by an outbreak of Islamophobia. Muslims became the increasingly ostracized targets of fake news claiming they were actively attempting to spread COVID-19. 

Yet, although religion has demonstrated the potential to complicate the pandemic life of its adherents in these various ways, it also brings courage and comfort to many in facing the hardships that the coronavirus has brought. For example, many religious Buddhist communities in Southeast Asia are turning to rituals, magical rites, prayer, and talismans to protect themselves against the virus. Turning to faith-based methods in combination with public health guidelines has provided comfort and relief from anxiety in the midst of the pandemic: for millions, faith can assuage fear and inspire hope and courage. There is also increasing research that supports the idea that faith can have powerful, positive effects on health, especially mental health.

Furthermore, while some like Esau McCaulley lament the loss of community and the irreplaceable experience of in-person worship, others voice enthusiasm for virtual services. A Lutheran pastor replied to McCaulley in The New York Times by pointing out that online worship can indeed provide a sense of unity and community, with the power to alleviate the isolation and loneliness most of the world currently finds itself in. Another reader celebrated the increased attendance her synagogue experienced after switching to online services. For some, the effort to find their version of divinity even in the absence of a tangible community may strengthen and deepen their sense of devotion both to their faith and to their fellow believers.

The responsibility of faith leaders

Given the ways in which religion can have an enormous impact on pandemic life, it’s clear that faith leaders have a lot of power and responsibility in terms of the guidance they offer to their followers during this troubled time.

Where religious leaders misuse their power, society at large suffers as a result. For instance, some evangelical ministers in the United States have established a reputation for denying or downplaying crucial information about the virus, encouraging their followers to put their faith in God rather than in scientific and medical experts, and refusing to suspend in-person services while denigrating those who have done so in compliance with social distancing guidelines. In-person religious gatherings can turn into super-spreader events, infecting not just religious believers, but also other members of society they may come into contact with afterwards.

The Dalai Lama is among the religious leaders who have shared messages of hope, compassion, and unity during the pandemic. “The Dalai Lama speaks at the NIH

However, other faith leaders around the world– including the Dalai Lama and Pope Francis— have demonstrated an understanding of the responsibility that rests on their shoulders, and have shared uplifting messages of courage, hope, and compassion with their followers while also praising medical workers and encouraging their communities to be patient, heed guidelines, get vaccinated, and listen to science. An interfaith conference of religious leaders in Indonesia demonstrated a heartening logic of cooperation in the face of challenges and awareness of faith’s powerful impact on society’s experience of pandemic life. While almost everyone has recognized the vital role played by political, scientific, and medical authorities as the world struggles to tackle the virus, perhaps we should also acknowledge that similarly, religious authorities have a significant impact. The messages they send to their followers play a role in determining whether and how the faithful will adapt their worship to comply with public health guidelines. Thus, while faith has a hand in how believers suffer and overcome the hardships of navigating an isolated world, it also affects public health, as the choices religious congregations make have far-reaching effects beyond their own communities. In one way or another, faith has the potential to affect believers and non-believers alike at this fraught moment in human history.

Complete Article HERE!

3 biggest regrets people have at the end of life

Hospice chaplain shares common regrets she hears from people who have less than six months to live.

By A. Pawlowski

Sitting at the bedside of dying patients, Tenzin Kiyosaki sees every day how regrets can haunt people at the end of life.

The former Buddhist nun works as an interfaith hospice chaplain for Torrance Memorial Medical Center in the South Bay area of Los Angeles, tending to the spiritual and emotional needs of people who have less than six months to live, and listening to their concerns.

When her brother, “Rich Dad Poor Dad” author Robert Kiyosaki, asked her what the dying talk about, she mentioned some of the common concerns she heard over and over. Kiyosaki shares them in her new book, “The Three Regrets: Inspirational Stories and Practical Advice for Love and Forgiveness at Life’s End.”

It’s also a nudge for younger, healthier people to take action to resolve or prevent regrets now.

Kiyosaki wants people to remember that death doesn’t only come to the old.

Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart. — Steve Jobs

No one knows when their time is up, whether because of an accident or illness.

Life is impermanent not only for you, but your family, friends and loved ones. Kiyosaki’s own mother passed away suddenly at 49, leaving the family in shock.

“Understanding that death can come at any time can help you see how precious life is and how to really get on with our ambitions and our dreams, and to be kind to each other,” Kiyosaki, 72, told TODAY.

“We should clear the regrets now and go for our dreams rather than just hanging on to regrets that take up a lot of mental and emotional space.”

I did not live my life of dreams.

One patient always wanted to travel the world, but never did. “She felt like, ‘I never got out of here, I never got to do what I really wanted to do,’” Kiyosaki said.

For others, the “what if” regrets might center around never taking a chance on starting a business, applying for a dream job abroad or moving to a new city.

Kiyosaki urged people to examine whether they’re neglecting or putting off their dreams and if so, to turn it around and go for them now — it’s not too late. One terminally-ill woman she knew flew to Europe by herself despite all the obstacles in her way.

I did not share my love.

Many end-of-life patients are frustrated that they haven’t been able to share what’s really in their heart and say what they needed to say to their loved ones. For some, that might be “I love you.” For others, just being able to acknowledge, “I was absent, I was cruel, I was unavailable,” can transform a family and allow it to heal.

“I just feel like it’s important for people to see that they don’t have to live their whole life this way,” Kiyosaki said.

“Don’t fade away from life without saying what you need to say,” she writes in her book. “Find ways to say ‘I love you’ and express your love every day.”

I did not forgive.

This is perhaps the biggest regret many people have at the end. Old wounds and unfinished business rise to the surface, but holding on to past grievances hurts us, Kiyosaki writes, citing a quote from Buddha: “Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else — you are the one who gets burned.”

The power of forgiveness is a gift you give to yourself.

Kiyosaki recommends an exercise: Imagine you have one year left to live. Who would you call? What would you do and say to be at peace? Do it now.

“If you just clear the regrets, you have so much more open heart and receptivity to the world,” Kiyosaki said. “Let’s turn it around and enjoy our lives because they are impermanent — we’re all going to face end of life.”

Complete Article HERE!

‘I will hold their hands’

— Chaplains give terminal COVID patients a chance to say goodbye

By Will Peebles

Two days after a parade-less St. Patrick’s Day in Savannah last year, Mayor Van Johnson declared a local state of emergency because of COVID-19. The next day, March 20, the Georgia Department of Public Health reported the first two cases of COVID-19 in Chatham County. In the year since, Chatham County has lost more than 350 people to the virus. This article is one in a series that examines how individuals have dealt with a year-long crisis and have helped pull the community through the pandemic.

Rachel Greiner remembers when the reality of COVID-19 truly hit home for her.

In June, Greiner, the director of Memorial Health University Medical Center’s Pastoral Care team, found herself making arrangements for a mother and daughter, both sick in the hospital with COVID.

The daughter, the more serious case, was on the hospital’s COVID intensive care unitfloor.

She was dying.

Her mother was on the floor above her, reserved for patients sick enough to be in the hospital, but not yet sick enough to require ICU care.

Greiner and her staff of chaplains worked to get the mother into her daughter’s room. They were together until her final breath, a powerful, truly human moment — a final goodbye.

“And it was, of course, a sacred time, very beautiful that the hospital worked in order to get this woman down to be with her daughter,” Greiner said. “And while that was happening, my phone was ringing, and it must have rang six times.”

While Greiner was making sure a mother could be there with her dying daughter, her own children’s daycare was calling. She stepped out, in full personal protective equipment, to return the missed calls.

The daycare told her one of the teachers contracted COVID, and was calling to tell Greiner her children had been exposed.

“Now, that’s so commonplace I would roll my eyes if they called me and told me that today, but at that juncture, literally standing at the deathbed of someone with COVID-19, hearing that my children had been exposed to it — that was probably the moment that I was like okay, this is really real now,” Greiner said.

As a chaplain, Greiner deals with heart-wrenching situations on a daily basis. And for the last year, there has been no shortage of difficult work.

It’s a misunderstood profession, Greiner said. She and her team provide spiritual care to patients in the hospital, but it isn’t a single religion — in fact, it’s not inherently religious at all.

“We call it a ministry of presence. Sure, a lot of the things that we do are religious in nature. People want to pray. And they ask, and of course, we say yes,” Greiner said. “But we don’t come in the room demanding that you bow your heads and pray with us.”

If a person is in the ICU at Memorial Health, they’re going to see a chaplain at least once during their stay. But COVID, as it so often does, complicates things.

Early on in the pandemic, Memorial turned an entire medical ICU into an ICU specifically for COVID patients. Nurses were sending their children to live with grandparents to avoid possible spread.

Chaplains are in charge of facilitating patient visits. Sometimes those visits are virtual — they hold an iPad with family members on video chat. Not long ago, Greiner did a call with 48 people as they said goodbye to a family matriarch.

But it’s not the same.

“There’s no substituting what it would be for these patients to hold the hands of their spouses or their children. But in their stead, I will hold their hands and hold the iPad over them so that their loved ones can say goodbye,” Greiner said. “And my hope is that as they are transitioning from this place to the next, that that’s what they’re hearing: the love pouring out of their family’s voices coming through the iPad to them.”

For in-person visits in the COVID ICU, adults get one visitor. For kids, it’s two.

But when they’re moved to end-of-life care, that number is expanded to five.

That’s a tough restriction for some families. Only two people can go to be with their dying loved one for 30 minutes at a time.

“Let’s say it’s a spouse, they’ve been married 50 years, they have six kids. Well, they only have four more spots left, so they have to pick their four favorite children. And then of those four, only one of them can stay with dad while mom dies,” Greiner said. “I understand the reasoning behind it. But it is no less difficult to explain over and over again, and to empathize and say how sorry you are that you can’t get everybody in.”

It can be exhausting, but Greiner’s job doesn’t stop there. Her pastoral team members aren’t the only ones putting in emotional work day after day: the nurses, doctors and staff at Memorial are in the thick of the pandemic, as well.

Greiner said while her job is patient-oriented by nature, a lot of her work involves caring for her coworkers, as well. She coordinates with Memorial’s Nurse Manager Amber Schieber to host Muffins, Moments and More, a get-together at the hospital where the staff leans on each other for support, talking through situations that affected them, Schieber said.

In the breakroom is a prayer, written by Greiner, framed by Schieber.

“Rachel has really been a rock for us during this pandemic. She’s so wonderful. She’s been there for our patients and the families and the staff,” Schieber said. ”If COVID has taught us anything, it’s to really lean on your family and your support system. And Rachel has absolutely been that for us.”

“I tell everyone, it is so important to establish a counselor of some sort, especially when you work in health care,” Greiner said. “You can’t care for other people if you’re not caring for yourself.”

For Greiner, self-care is paramount. It can take the form of a monthly check-in with a therapist or a pep talk from her family. Sometimes, it’s as simple as getting out of the house to go to her happy place: the beach.

“I have a family that supports me, my husband knows if I say it’s time to go to the beach, then it’s time to go to the beach,” Greiner said.

The emotional toll of her job is enormous, and it has been especially so for the last year. But day-in and day-out, she facilitates these sacred end-of-life rituals — these final goodbyes — for those most touched by the tragedy of COVID.

“It is difficult, but it’s also very humbling. I think that the ground we stand on at that point is very sacred, and it’s an honor to stand on it with these people and to help bridge the gap from wherever their families are to that room where they can’t be,” Greiner said. “To hold their hands and stroke their faces and tell them it’s going to be okay as they leave, it is an honor.”

Complete Article HERE!

Growing My Faith in the Face of Death

I spent a lifetime counseling others before my diagnosis. Will I be able to take my own advice?

By Timothy Keller

I have spent a good part of my life talking with people about the role of faith in the face of imminent death. Since I became an ordained Presbyterian minister in 1975, I have sat at countless bedsides, and occasionally even watched someone take their final breath. I recently wrote a small book, On Death, relating a lot of what I say to people in such times. But when, a little more than a month after that book was published, I was diagnosed with pancreatic cancer, I was still caught unprepared.

On the way home from a conference of Asian Christians in Kuala Lumpur in February 2020, I developed an intestinal infection. A scan at the hospital showed what looked like enlarged lymph nodes in my abdomen: No cause for concern, but come back in three months just to check. My book was published. And then, while all of us in New York City were trying to protect ourselves from COVID-19, I learned that I already had an agent of death growing inside me.

I spent a few harrowing minutes looking online at the dire survival statistics for pancreatic cancer, and caught a glimpse of On Death on a table nearby. I didn’t dare open it to read what I’d written.

My wife, Kathy, and I spent much time in tears and disbelief. We were both turning 70, but felt strong, clear-minded, and capable of nearly all the things we have done for the past 50 years. “I thought we’d feel a lot older when we got to this age,” Kathy said. We had plenty of plans and lots of comforts, especially our children and grandchildren. We expected some illness to come and take us when we felt really old. But not now, not yet. This couldn’t be; what was God doing to us? The Bible, and especially the Psalms, gave voice to our feelings: “Why, O Lord, do you stand far off?” “Wake up, O Lord. Why are you sleeping?” “How long, O Lord? Will you forget me forever?”

A significant number of believers in God find their faith shaken or destroyed when they learn that they will die at a time and in a way that seems unfair to them. Before my diagnosis, I had seen this in people of many faiths. One woman with cancer told me years ago, “I’m not a believer anymore—that doesn’t work for me. I can’t believe in a personal God who would do something like this to me.” Cancer killed her God.

What would happen to me? I felt like a surgeon who was suddenly on the operating table. Would I be able to take my own advice?

One of the first things I learned was that religious faith does not automatically provide solace in times of crisis. A belief in God and an afterlife does not become spontaneously comforting and existentially strengthening. Despite my rational, conscious acknowledgment that I would die someday, the shattering reality of a fatal diagnosis provoked a remarkably strong psychological denial of mortality. Instead of acting on Dylan Thomas’s advice to “rage, rage against the dying of the light,” I found myself thinking, What? No! I can’t die. That happens to others, but not to me. When I said these outrageous words out loud, I realized that this delusion had been the actual operating principle of my heart.

The cultural anthropologist Ernest Becker argued that the denial of death dominates our culture, but even if he was right that modern life has heightened this denial, it has always been with us. As the 16th-century Protestant theologian John Calvin wrote, “We undertake all things as if we were establishing immortality for ourselves on earth. If we see a dead body, we may philosophize briefly about the fleeting nature of life, but the moment we turn away from the sight the thought of our own perpetuity remains fixed in our minds.” Death is an abstraction to us, something technically true but unimaginable as a personal reality.

For the same reason, our beliefs about God and an afterlife, if we have them, are often abstractions as well. If we don’t accept the reality of death, we don’t need these beliefs to be anything other than mental assents. A feigned battle in a play or a movie requires only stage props. But as death, the last enemy, became real to my heart, I realized that my beliefs would have to become just as real to my heart, or I wouldn’t be able to get through the day. Theoretical ideas about God’s love and the future resurrection had to become life-gripping truths, or be discarded as useless.

I’ve watched many others partake of this denial of death and then struggle when their convictions evaporate, and not just among the religious. I spent time as a pastor with sick and dying people whose religious faith was nominal or nonexistent. Many had a set of beliefs about the universe, even if they went largely unacknowledged—that the material world came into being on its own and that there is no supernatural world we go to after death. Death, in this view, is simply nonexistence, and therefore, as the writer Julian Barnes has argued, nothing to be frightened of. These ideas are items of faith that can’t be proved, and people use them as Barnes does, to stave off fear of death. But I’ve found that nonreligious people who think such secular beliefs will be comforting often find that they crumple when confronted by the real thing.

So when the certainty of your mortality and death finally breaks through, is there a way to face it without debilitating fear? Is there a way to spend the time you have left growing into greater grace, love, and wisdom? I believe there is, but it requires both intellectual and emotional engagement: head work and heart work.

I use the terms head and heart to mean reasoning and feeling, adapting to the modern view that these two things are independent faculties. The Hebrew scriptures, however, see the heart as the seat of the mind, will, and emotions. Proverbs says, “As he thinketh in his heart, so is he.” In other words, rational conviction and experience might change my mind, but the shift would not be complete until it took root in my heart. And so I set out to reexamine my convictions and to strengthen my faith, so that it might prove more than a match for death.

Paul Brand, an orthopedic surgeon, spent the first part of his medical career in India and the last part of his career in the U.S. “In the United States … I encountered a society that seeks to avoid pain at all costs,” he wrote in his recent memoir. “Patients lived at a greater comfort level than any I had previously treated, but they seemed far less equipped to handle suffering and far more traumatized by it.”

Why is it that people in prosperous, modern societies seem to struggle so much with the existence of evil, suffering, and death? In his book A Secular Age, the philosopher Charles Taylor wrote that while humans have always struggled with the ways and justice of God, until quite recently no one had concluded that suffering made the existence of God implausible. For millennia, people held a strong belief in their own inadequacy or sinfulness, and did not hold the modern assumption that we all deserve a comfortable life. Moreover, Taylor has argued, we have become so confident in our powers of logic that if we cannot imagine any good reason that suffering exists, we assume there can’t be one.

But if there is a God great enough to merit your anger over the suffering you witness or endure, then there is a God great enough to have reasons for allowing it that you can’t detect. It is not logical to believe in an infinite God and still be convinced that you can tally the sums of good and evil as he does, or to grow angry that he doesn’t always see things your way. Taylor’s point is that people say their suffering makes faith in God impossible—but it is in fact their overconfidence in themselves and their abilities that sets them up for anger, fear, and confusion.

When I got my cancer diagnosis, I had to look not only at my professed beliefs, which align with historical Protestant orthodoxy, but also at my actual understanding of God. Had it been shaped by my culture? Had I been slipping unconsciously into the supposition that God lived for me rather than I for him, that life should go well for me, that I knew better than God does how things should go? The answer was yes—to some degree. I found that to embrace God’s greatness, to say “Thy will be done,” was painful at first and then, perhaps counterintuitively, profoundly liberating. To assume that God is as small and finite as we are may feel freeing—but it offers no remedy for anger.

Another area of head work for me had to do with Jesus’s resurrection. Ironically, I had already begun working on a book about Easter. Before cancer, the resurrection had been a mostly theoretical issue for me—but not now. I’m familiar with the common charge that any belief in an afterlife is mere wish fulfillment without grounding in fact—and that belief in Jesus is in the same category as faith in the Flying Spaghetti Monster. But over the past 20 years, I’ve been drawn to the work of the British biblical scholar N. T. Wright, who mounts a historical case for Jesus’s bodily resurrection.

I returned to his material now, with greater skepticism than I had previously applied. I didn’t want to be taken in. But as I reread his arguments, they seemed even more formidable and fair to me than they had in the past. They gave me a place to get my footing. Still, I needed more than mental assent to believe in the resurrection.

The heart work came in as I struggled to bridge the gap between an abstract belief and one that touches the imagination. As the early American philosopher Jonathan Edwards argued, it is one thing to believe with certainty that honey is sweet, perhaps through the universal testimony of trusted people, but it is another to actually taste the sweetness of honey. The sense of the honey’s sweetness on the tongue brings a fuller knowledge of honey than any rational deduction. In the same way, it is one thing to believe in a God who has attributes such as love, power, and wisdom; it is another to sense the reality of that God in your heart. The Bible is filled with sensory language. We are not only to believe that God is good but also to “taste” his goodness, the psalmist tells us; not just to believe that God is glorious and powerful but also to “see” it with “the eyes of the heart,” it says in Ephesians.

On December 6, 1273, Thomas Aquinas stopped writing his monumental Summa Theologiae. When asked why by his friend Reginald, he replied that he had had a beatific experience of God that made all his theology “seem like straw” by comparison. That was no repudiation of his theology, but Thomas had seen the difference between the map of God and God himself, and a very great difference it was. While I cannot claim that any of my experiences of God in the past several months have been “beatific,” they have been deeper and sweeter than I have known before.

My path to this has involved three disciplines.

The first was to immerse myself in the Psalms to be sure that I wasn’t encountering a God I had made up myself. Any God I make up will be less troubling and offensive, to be sure, but then how can such a God contradict me when my heart says that there’s no hope, or that I’m worthless? The Psalms show me a God maddening in his complexity, but this difficult deity comes across as a real being, not one any human would have conjured. Through the Psalms, I grew in confidence that I was before “him with whom we have to do.”

The second discipline was something that earlier writers like Edwards called spiritual “soliloquy.” You see it in Psalms 42 and 103, where the psalmist says, “Why are you cast down, O my soul?” and “Bless the Lord, O my soul. And forget not all his benefits.” The authors are addressing neither God nor their readers but their own souls, their selves. They are not so much listening to their hearts as talking to them. They are interrogating them and reminding them about God. They are taking truths about God and pressing them down deep into their hearts until they catch fire there.

I had to look hard at my deepest trusts, my strongest loves and fears, and bring them into contact with God. Sometimes—not always, or even usually—this leads, as the poet George Herbert wrote, to “a kind of tune … softness, and peace, and joy, and love, and bliss, exalted manna … heaven in the ordinary.” But even though most days’ hour of Bible reading, meditation, soliloquy, and prayer doesn’t yield this kind of music, the reality of God and his promises grew on me. My imagination became more able to visualize the resurrection and rest my heart in it.

Most particularly for me as a Christian, Jesus’s costly love, death, and resurrection had become not just something I believed and filed away, but a hope that sustained me all day. I pray this prayer daily. Occasionally it electrifies, but ultimately it always calms:

And as I lay down in sleep and rose this morning only by your grace, keep me in the joyful, lively remembrance that whatever happens, I will someday know my final rising, because Jesus Christ lay down in death for me, and rose for my justification.

As this spiritual reality grows, what are the effects on how I live? One of the most difficult results to explain is what happened to my joys and fears. Since my diagnosis, Kathy and I have come to see that the more we tried to make a heaven out of this world—the more we grounded our comfort and security in it—the less we were able to enjoy it.

Kathy finds deep consolation and rest in the familiar, comforting places where we vacation. Some of them are shacks with bare light bulbs on wires, but they are her Sehnsucht locations—the spaces for which she longs. My pseudo-salvations are professional goals and accomplishments—another book, a new ministry project, another milestone at the church. For these reasons we found that when we got to the end of a vacation at the beach, our responses were both opposite and yet strangely the same.

Kathy would begin to mourn the need to depart almost as soon as she arrived, which made it impossible for her to fully enjoy herself. She would fantasize about handcuffing herself to the porch railing and refusing to budge. I, however, would always chafe and be eager to get back to work. I spent much of the time at the beach brainstorming and writing out plans. Neither of us learned to savor the moment, and so we never came home refreshed.  

A short, green Jedi Master’s words applied to me perfectly: “All his life has he looked away to the future, the horizon. Never his mind on where he was.” Kathy and I should have known better. We did know better. When we turn good things into ultimate things, when we make them our greatest consolations and loves, they will necessarily disappoint us bitterly. “Thou hast made us for thyself,” Augustine said in his most famous sentence, “and our hearts are restless until they find their rest in Thee.” The 18th-century hymn writer John Newton depicted God as saying to the human soul, “These inward trials I employ from pride and self to set thee free, and break thy schemes of earthly joy that thou would find thine all in me.”

To our surprise and encouragement, Kathy and I have discovered that the less we attempt to make this world into a heaven, the more we are able to enjoy it.

No longer are we burdening it with demands impossible for it to fulfill. We have found that the simplest things—from sun on the water and flowers in the vase to our own embraces, sex, and conversation—bring more joy than ever. This has taken us by surprise.

This change was not an overnight revolution. As God’s reality dawns more on my heart, slowly and painfully and through many tears, the simplest pleasures of this world have become sources of daily happiness. It is only as I have become, for lack of a better term, more heavenly minded that I can see the material world for the astonishingly good divine gift that it is.

I can sincerely say, without any sentimentality or exaggeration, that I’ve never been happier in my life, that I’ve never had more days filled with comfort. But it is equally true that I’ve never had so many days of grief. One of our dearest friends lost her husband to cancer six years ago. Even now, she says, she might seem fine, and then out of nowhere some reminder or thought will sideswipe her and cripple her with sorrow.

Yes. But I have come to be grateful for those sideswipes, because they remind me to reorient myself to the convictions of my head and the processes of my heart. When I take time to remember how to deal with my fears and savor my joys, the consolations are stronger and sweeter than ever.

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