Why is it so difficult to die?

I wish this were an easy answer, but unfortunately there are countless reasons why people have so much trouble dying. There are a few things that I am fairly certain about and that I have found that resonate with patients and family members. More often than not I find that people really DO have a difficulty with dying. Whether it be fear, denial, anxiety, or just avoidance, there is an underlying difficulty with dying.

Many people aren’t so much afraid of being dead, as they are of dying. I say this with intention, and I offer this to patients, in order to make a distinction. I have read in numerous places that it is best to think of living until we are dead. If we don’t then we could get depressed or think that our life is over as soon as we admit to dying. Think about it this way. “Dying,” an active tense word, is very different from the words like “dead” (adjective) and “be killed” (passive tense). There is no passive tense of “dying.” It is active, and so there for something we DO. It is something we live in, participate in, and include others in. So how do people want to go about their dying time? This is a good question to ask of people and to reflect on ourselves. We don’t just live until we are dead. These are the people who want to go out in their sleep or want to end their lives prematurely. There is no active participation in their dying there.

For many, unlike our ancestors, being around death and dying can be a very foreign experience. It used to be that loved ones would die at home attended to by family members in the upstairs bedroom. Now it is so often in a hospital or nursing home behind closed doors. The announcement comes from the RN or the doctor and the family comes in after a person has died. So many are not familiar with the signs of dying. They think a dying person may be on the road to improvement when they wake from days of sleeping and not eating and want to tell stories. These moments of clarity are often part of the dying process. Dying also is a very personal experience, different for each person, and something that each person can only go through once. If a dying person doesn’t share what it is like with their loved ones, they offer little of help to the next generation when it is their turn. But people are afraid of causing too much hardship to their loved ones by talking about it too much.

Dying in the hospital is very difficult because health care professionals are trained to cure, to heal, and to “fix.” In and of itself, this is not a bad thing at all. But when it comes to dying, there is no “fixing.” I have heard doctors say that having a palliative care team meet with a family is “giving up too early.” I have seen many many times doctors and nurses shy away from using the “D word” with families when the writing was clearly on the wall. Many will say a person who is accepting their dying is “giving up” or someone who is feeling sad about saying good bye is “depressed.” Too, too often do doctors trying treatment after treatment until a patient, who wants to die at home ends up unconscious while still hoping along with their family that they are going to “pull through.” Or a patient holds off  going home on hospice because a doctor or social worker feels trying out rehab first might be good, only to die the next day at the nursing home. I tell patients if they want to be an active participant in their dying experience, join hospice while they still have the capacity to choose for themselves.

If we can just begin to see how much death is a part of life. Dying is not a “bad” thing. It is a beautiful, sacred, natural thing. Not to say it is a “good” thing either. It just is. It is part of what happens to all healthy, mature, and connected to the earth beings. Going from living to dead is going around this natural process. As Stephen Jenkinson wonders, “How connected is someone to their life when they have to be told they are dying?”

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How does one process one’s grief?

My wife asked me the other day, “How does a person process grief?” You’d think that as a chaplain, walking beside and with those who are grieving, I would have had an answer in that moment. Maybe because it was the last, lingering thought before sleeping and I was further along than she, or maybe because there is just no easy answer to a question like this… it goes to say, I didn’t have anything satisfying to give in return.

Maybe the question didn’t sit with me. How do I process grief? Is this different than asking, how do I grieve? I really don’t think it is a matter of processing grief as much as just grieving. Processing is talking about it, writing about it, thinking about it, sharing it, and moving through it. With processing, though, it is always something outside, something that is different than us.

I grieve every day. I grieve when I am with someone who has lost a loved one. I grieve when I hear someone say, “They didn’t tell me chemo was going to be this way. I should have had the operation.” I grieve when I see the wretched state of political debates, of violence, of abuse of our planet. I grieve so much and often that there is a weight I carry that never goes away. I pray for peace and mercy for our Earth and for the humans and the non-humans who live on it. God have mercy.

And yet, I never wish that I could remain naive of all this. I never wish for this weight to go away. It’s like saying, “Breathing is just too much work. I’d rather not do it for an hour or two.” When we learn how to grieve (not learn how to process grief) we grieve even when we are not conscious we are grieving. We become a person who grieves. There is a compassion and a union that happens there. It is a development of the person, something we have to learn and allow ourselves to grow into. Perhaps we begin by remembering that grief is not a bad thing, and it is not a good thing either, it is just a thing. It is a hard thing, yes, but so is waking up when we have been asleep for too long. It is painful, but so is exercising when our muscles atrophy. Perhaps our grief ability has been atrophied by a world that continues to tell us that grief is a bad thing that must be moved through, processed, and healed from. There is no healing from grief.

To be rooted to the land you walk upon

It means something to be where you are from. And not just your family, not just your culture, or your religion or your country… It means something unequivically significant to be an occupier of the land you live upon. I am quite certain that most do not have this sensibility, at least not consciously but perhaps when really pressed, would affirm how important it is to them.

What I am getting at is an extra level down into a deeper sense of one’s place in this world, one’s sense of self, one’s spiritual life, and one’s connection with all that is.

There is meaning to the old saying, “You are what you eat.” In a quite literal sense, our bodies our composed of the food and water that goes into us. What other way is there? This is why, when we lived in Oregon, we drank our water, straight from the land, straight from the spring. No filter, no chemicals. And food… Where is your body connected to if your food comes from thousands of miles away or is processed to the extent that it can only be called, as Michael Pollen terms it, “edible food-like substances.”

So it means something very literally in regard to our physical make-up. But what does it mean to be from the Fox Valley in WI? To have grown up on a farm and lived there your whole life? As a chaplain, living in one of the most “homegrown” cities in the country, it means something to talk to my patients about where they are from and wehter their parents grew up here too. For a person living in city and never having left, to never found one’s self in green space, with one’s hands in the dirt or toes in the sand… This means something to that person. Maybe an ungroundedness or a sense of nature as “enemy.”

There is a profound teaching in observing the greatest tai chi masters (watch a video of one on YouTube). Where do they draw this life force from that allows them to move people without even touching them or to be unmovable themselves?

Readiness in dying

In my work in the hospital, dying is such a common theme. Something about being in the hospital, whether one has a terminal illness or not, brings about questions of one’s mortality and readiness to die. It really is amazing that something that people think about so often, or resist with such stubbornness is such an avoided subject by many medical professionals. I have been in so many conversations with medical teams, families, and patients talking about end of life, comfort care, and palliative care where the words “death” and “dying” are never mentioned. Why the awkwardness, why the fear? I think there is definitely something going with the doctors and nurses that I will address in other posts, but I would start with what I have been offering patients and family members these days.

I think there are three areas people become ready to go about their dying: their mind, their heart, and their body. Often times, especially when someone is younger and dying of cancer, their body might be saying, “It’s time,” but in their heart and mind, thinking and emotionally, they are far from ready. They have things to do, kids and grand kids to spend more time with, fears of the unknown that they hold on to. This so often makes for a lot of suffering. They pursue extreme treatment, their family members get alongside their efforts for more time, and doctors very readily do everything can to keep someone alive. But their body is saying it’s time.

The other, and perhaps less common situation, is when someone’s body is strong and in their heart and mind they really want to die. I see this with women and men in their 90’s who have no one left. Their parents died half a century ago, their spouses have died, some of their children have died, and all their friends have died. They ask me to pray that they would die soon. And yet they keep on living. I think this is getting to be more and more common with so many life-extending practices that we have now. This is a different kind of suffering, and I see doctors and nurses responding often with, “This patient is depressed.” I often remind patients (and staff) that wanting to die is not necessarily being “depressed.” It is not always “giving up.” Assuming this desire as such, minimizes the experience.

So ideally, our heart, mind, and body would be in sync when it comes to our dying time. How do we as those who may or may not be dying get to this place? Stephen Jenkinson writes that someone must be very out of touch with their life if they have to be told that they are dying. If we are paying attention and unafraid, we will know. The body has a wisdom of its own and knows when it has had enough. We would also do well to begin contemplating our dying and preparing for it as soon as possible. Why not now? I will tell patients it’s never too early to begin thinking about how we want our dying time to be. If only we can include our loved ones in this conversation, wondering and dreaming with them, recognizing that it is a part of life, not a bad thing. And one of the greatest gifts we can offer our children and grand children is a gracious and honest look at death so they have something to hold on to when it is their turn. This is a sacred thing to pass on. It is legacy. It is holy. And in this act we will be remembered.

Death defines me

The title should perhaps read, Death (Re)defines Me and Us. As a chaplain, and perhaps more specifically, as a human with my particular “Soulcraft,” I think about death daily. It happens to be my road in life to walk alongside those who are dying, wonder with them what death asks of them and of us, and to seek to understand death as best I can. As Stephen Jenkinson teaches, if we didn’t have death, we wouldn’t have life as we experience it. Our appreciation for a flower is very much affected by the knowledge that this particular flower will not be here forever. Our appreciation of the summer is only in the context that summer will change into fall and then into winter. Death does not have to equal trauma, death does not have to equal “giving up,” and death does not have to equal bad. Death IS real and we all will come to our time when it is our time.

My body will nourish the earth one day. I will become the literal compost of new and becoming life.

The difficulty of describing how this lands in my life is palpable. Living and dying is such an individual experience. Each of us has our own take… and to assume I know what it is like for another is ludicrous.And yet, we are so connected. So connected. We as humans have done the earth wrong in a million different ways by forgetting this, by living as if our living and dying is not part of the bigger thing.

For me, I want my to be as aware of my dying as possible. I will tell any who will listen (and perhaps some who won’t) what it is like and how it is to die. Especially my children, and those who I am blessed to elder in their growing and learning. Perhaps one of the greatest gifts I can leave behind is what it is like to go through this particularly individual and uncharted territory, so that when they go through their dying time, they might remember one who has been there before.

I forget sometimes, in any given moment, that I might not be alive in the next moment. Unlikely, perhaps, but things can change in an instant and we do ourselves and others we are blessed to journey with, a deep service to remember this. Life and death, both are good and beautiful things. As Richard Rohr says, “Everything belongs.”

My body will nourish the earth one day. I will become the literal compost of new and becoming life. This is where I belong in the circle of life. The earth gives me life and one day I will give her life. What does this do to us to feel this? To know it deep in our bones as we walk this land? In the depth of our lungs as we breath into our being? To eat our food, each plant and animal having had to die to sustain us?

Spiritual Direction and reflections on Spirituality

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