I have been honored to be present with many people towards the end of their life and learned so much from each of them. I have learned that while many of us wish to die at home, that sometimes is not possible, or even optimal for the comfort of the dying or their families.
In my experience what matters most is our alertness to the situation and the quality of our presence. Though death is a solo journey it does not need to be lonely. We can be a comfort. We can cradle each other in powerful ways, dispelling loneliness and fear.
Our Presence, our thoughtful actions and the moments of intimacy that we share can create an oasis of quiet in the midst of noise, carve out a landscape of peace in raw or discordant places and shape a mysterious beauty that is independent of external conditions.
I share these brief recollections to honor different aspects of the final journey of each of these women and have changed their names to respect their privacy.
Ruby’s long white hair was cut short so it wouldn’t tangle as she lay in the hospital bed. Her bright blue eyes were closed but her eyelids flickered when family members discussed calves and fields, goats and rodeos and her fingers flailed briefly at her bed sheets; as if she were a diver, trying to reach the surface of the water.
Nurses and hospital staff stopped by to see Ruby and her neighbors told tales of the people she had healed--people with diabetes, or bullet wounds, broken bones or child fever. Sometimes Ruby moaned and tossed. Her granddaughter bathed her forehead, murmuring into her ear.
At the end of Ruby’s life she was encircled by six women. We watched as each breath left her mouth and waited, our own breath suspended with hers, until her lungs swelled and drew in air again. The pauses between Ruby’s exhalations and inhalations grew longer and longer. Finally she left us with a long, soft sigh, her breath passing into the air like a pebble dropped into still water, its ripples gradually fading until the water's surface bears no trace of the stone. Ruby was 89 when she died. Her death, in 1989, was the first that I attended.
Sita was only 32 yrs. old when she died of breast cancer. I visited her often during the last year of her life. Sometimes we played cards. Sita usually won. We talked and cried and laughed; and talked some more. One day the hospice nurses advised Sita’s family that she was close to death. She had not had anything to eat or drink eaten for days and she had not spoken or opened her eyes. The family began its their traditional preparations. Her brother was called so he would be ready to cut his hair and fast. A local restaurant was called to prepare traditional foods for when the family broke its fast and flowers were gathered. Sita’s beautiful saris were laid out and a harmonium player was contacted to play chants for her through the night.
But three days later Sita was sitting up in her bed playing solitaire when I came to visit. She was upset with her family and she was afraid. “Did you think I was dying too,” she asked again and again. “Are they all waiting for me to die? Are they just tired of me being so sick for so long."
A month passed and Sita lay quietly in her bed, her shining black hair spread over her pillow. Her mother brushed her hair. She oiled her feet, her legs, her hands. She washed Sita’s body with a damp cloth and changed her clothes. Later, as I offered her sips of cool water through a straw, Sita turned her head on the pillow and looked at me. “I am dying, Rose,” she said, “I’m dying.” I looked into her face, meeting her dark and honest eyes. I knew that only the truth would serve. “I know, Sita, I know. We’re here with you,” I answered softly.
Sita’s husband stood on the opposite side of her bed. He grabbed her hand in his,
“Don't die, don’t leave me. Don’t die.” he cried. Sita turned her head quickly and comforted him as the dying so often do, “Don’t worry, Mahesh, I am not dying. I will not die.”
Emily died of pneumonia in her early 60’s. It was the disease she prayed for to spare her from the slow deterioration that the progression of her chronic illness would cause. Because of her chronic disease Emily was very aware that she did not have much time. She desperately wanted to be reconciled with her daughter and did mend that relationship as best she could. In the months before she died Emily became bedridden and almost blind.
Because she was such a skilled planner and organizer I suggested Emily work on her funeral plans. She chose green silk pajamas to wear and decided on the flowers that we would lay upon her open casket. She created her own memorial cards and a CD of her favorite music to play at her memorial service and wrote instructions about the food to serve.
During the last hours of her life Emily was in ICU, attended by friends and family. She had wanted Buddhist prayers whispered in her ear, and they were. Her oxygen was slowly withdrawn, as she had requested in her Advance Directives. When her caregiver of 10 years came to her beside and whispered the Catholic prayers Emily had grown up with into her ear Emily exhaled once and slipped away.
Joselyn had lung cancer. She was in her 50’s when she died. Two weeks before her death she attended a retreat on contemplative practices for dying. Joselyn invited her closest friends and family to visit her after the retreat. For several days in a row, as daylight faded she sat up on the edge of her bed and rang a mindfulness bell to begin and end the short sitting mediation she wanted to share with those around her. On the third day she died peacefully, just after midnight.
Ellen was an artist. In her 40’s she was the victim of a crushing car accident that left her in a coma for a week. Friends and family visited; recalling her many talents and her brilliant, curious mind. Some of us sang to her, others stayed quietly at her beside. Friends gave Ellen's husband a place to stay during the long days of his vigil and they feed him on many levels, bringing him food, sharing stories, tears and laughter and taking turns being at Ellen's bedside as he made the necessary and difficult decision to remove her life support. Ellen's body was washed and tended ritually by the Jewish Burial group, the Chevrah Kedesha, and she was buried by her loved ones.
Ruby, Emily and Ellen died in the hospital, surrounded by friends and caregivers. Joselyn died in bed at her sister’s home and Sita died at home too, early on a Saturday morning, and the women of her family strung a necklace of marigolds and calendula for her to wear while another woman chanted and played the harmonium.
There are so many ways to die.
What do we do when we encounter what many call the Great Mystery? Stumbling over our feelings and fears, we want to be of comfort, but perhaps we do not know what form that comfort might take. Often we wish we could stop death simply by refusing to acknowledge it.
There are no magic words, no one way we should act. But we can bring a quality of presence to those who are dying, a presence that can offer spacious companionship to them and to their family and friends. A presence that acknowledges our shared humanity and our timeless and unending connection. A presence that gives no fear.