by Robert Wilkinson
It is a fact of life that we all have bodies that die, and with that our feelings and minds as well. Except for the Masters of Yoga whose consciousness transcends the sickness, old age, and death that the Buddha offered as our ultimate fate, we all confront our mortality at some point in our lives. (And even Masters confront the mortality of our loved ones.) Today I offer you two remarkable statements on this difficult but universal subject, one a documentary on the remarkable Ram Dass, the other an article by a physician doing "end of life" care.
I suppose the reason these impacted me in such a personal way is that I am of the generation whose parents are still alive, but aging quicker than they ever have before. It seems that with age many things are accelerated, requiring that we not take certain things for granted as we did when we were younger.
While my parents are still able to take care of their lives and all they require, I know of many who are struggling with the deep feelings that result when trying to assist their sick and/or dying parent(s). Besides the family dynamics that always seem to intrude in the process of care-giving, there are the limitations of time, or money, or availability of therapeutic resources, or the energy to balance one's own life while caring for another. This post offers no cures for these dilemmas, but we shall explore two powerful approaches to the problems of aging and our mortality.
I recently had the pleasure of viewing "Fierce Grace," a compelling biography of Ram Dass. Once and still a Spiritual Icon for a generation, he was a noted psychologist and Harvard professor who found his way to his Guru in India which changed his life forever. I had the privilege of hanging with him back when I did events to raise big bucks for his Seva Foundation, a worthy endeavor helping thousands in miraculous ways. He had a stroke a few years ago and so doesn't tour much any more, but this documentary makes it clear that his heart is still as big as the Sun.
Since he's someone who really is as genuinely human AND consciously spiritual as it gets, I wholeheartedly recommend viewing this film, or revisiting it if you've already seen it. It's powerful, poignant, compelling, and ultimately uplifting. It demonstrates that regardless of how our bodies may fail us, we can embrace BEING our Higher Consciousness in ways that transcend the suffering of the body.
The other theme I offer you today is a written piece via the Washington Post. It is deeply moving in its own way, just as real as "Fierce Grace" but focusing on those who are not Ram Dass, and the problems and issues of being an adult caregiver to an elderly parent who is on their way out. The article by Craig Bowron, a physician in Minneapolis, is titled The Dying of the Light - The Drawn-Out Indignities of The American Way of Death, and is as strong a piece as I've ever read. Here's a part of it:
... never before in history has it been so hard to fulfill our final earthly task: dying. It used to be that people were "visited" by death. With nothing to fight it, we simply accepted it and grieved. Today, thanks to myriad medications and interventions that have been created to improve our health and prolong our lives, dying has become a difficult and often excruciatingly slow process....
.... Staring at his 230 pounds stretching the length of the bed, I wonder how difficult it must be to care for him. To transfer him to a toilet or a chair requires the use of a Hoyer lift, a gigantic sling that's wrapped around the patient and attached to a mobile mini-crane. Fully suspended, he looks like a massive baby being delivered by a giant stork. The contortions and gymnastics of getting him slung up and moved must drive him wild with arthritic pain.
Though I reviewed the patient's chart before going into his room, I can't recall seeing what nursing facility he had come from. So I ask the nurse. She tells me, unbelievably, that he has come from his home, where his son cares for him. Later in the day I place a call to this Clark Kent, this Superman in disguise.
The son answers with soft echoes of his father's Louisiana brogue, and I ask him how in the world he manages to take care of his dad. He replies that for one, it's all he does, a full-time job, and moreover, his experiences in Vietnam numbed him to some of the intimacies of caring for another human being. "Once you've shoved some guy's guts back into his stomach, you know, you can get used to the rest of it," he says.
He tells me that his father is wearing out and that it's hard to watch. The arthritis has become quite painful, and sometimes his dad just weeps. Some nights he needs a couple of Vicodin to be able to sleep through the pain. The old man is also spending a lot more time thinking about his wife, who passed away before him. His son thinks he may be ready to die....
From later in the article:
To be clear: Everyone dies. There are no life-saving medications, only life-prolonging ones. To say that anyone chooses to die is, in most situations, a misstatement of the facts. But medical advances have created at least the facade of choice. It appears as if death has made a counter-offer and that the responsibility is now ours.
In today's world, an elderly person or their family must "choose," for example, between dialysis and death, or a feeding tube and death. Those can be very simple choices when you're 40 and critically ill; they can be agonizing when you're 80 and the bad days outnumber the good days two to one.
It's not hard to identify one of these difficult cases in the hospital. Among the patient-care team -- nurses, physicians, nursing assistants, physical and occupational therapists, etc. -- there is often a palpable sense of "What in the world are we doing to this patient?" That's "to" and not "for." We all stagger under the weight of feeling complicit in a patient's torture, but often it's the nurses who bear most of that burden, physically and emotionally. As a nurse on a dialysis floor told me, "They'll tell us things that they won't tell the family or their physician. They'll say, 'I don't want to have any more dialysis. I'm tired of it,' but they won't admit that to anyone else."
This sense of complicity is what makes taking care of these kinds of patients the toughest thing I do. A fellow physician told me, "I feel like I am participating in something immoral." Another asked, "Whatever happened to that 'do no harm' business?"
If we can be honest and admit that we have no choice about dying, then the only thing we do have a say in are the circumstances. Like many nursing home patients, Dorothy was on the cholesterol-lowering medication Lipitor. Why? So that she wouldn't die of a heart attack or a stroke. But don't we all die of something?
Everyone wants to grow old and die in his or her sleep, but the truth is that most of us will die in pieces. Most will be nibbled to death by piranhas, and the piranhas of senescence are wearing some very dull dentures. It can be a torturously slow process, with an undeniable end, and our instinct shouldn't be to prolong it. If you were to walk by a Tilt-A-Whirl loaded with elderly riders and notice that all of them were dizzy to the point of vomiting, wouldn't your instinct be to turn the ride off? Or at the very least slow it down? Mercy calls for it.
This isn't about euthanasia. It's not about spiraling health care costs. It's about the gift of life -- and death. It is about living life and death with dignity, and letting go.
There are other very powerful insights in the article, so I recommend you read the whole thing. The author has even included his email address in case you want to write him.
"Fierce Grace" and "The Dying of the Light" may be uplifting or discouraging, but they definitely open doors for our consideration as we too get old. How we live, and how we die, are two of the most important issues we have as human beings. It is our job to determine the most lovingly wise, and wisely loving, ways to do both of these.
Copyright © 2009 Robert Wilkinson