Category Archives: readings

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the sacred and profane of death and dying

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Book review of Katy Butler’s Knocking on Heaven’s Door: The Path to a Better Way of Death.

Katy Butler is a daughter, a writer, a life partner, a Buddhist. Mostly, Katy Butler is a daughter of whom more was asked by the medical system than should have been and more was expected of than could have been imagined by anyone as her father journeyed into his death.

This is the story of a family caught in the velocity of a medical momentum which erupts when someone enters the chaotic zone between a good life and good death. It is a heart-wrenching telling of what happens when we unwittingly place our trust in systems rather than people, in hope rather than clarity of thought. It is also a revealing, investigative and hard-nosed exposé of the death-preventing devices we hope would be life-sustaining. Butler invites us to journey with her to the realization that “(t)he honest, natural death is no longer the default pathway.” She begins by bringing us into her parents’ kitchen, sharing a cup of tea with her mother. This is a scene that can evoke memories of sweet poignancy of beginnings or endings; but here, here, there is a different evocation, a different prayer for an ending.

In  my role as a therapist, I have had the privilege to sit with spouses and adult children who were in the center of the turmoil of a loved one’s passing. The primary referral for “treatment” was triggered, they tell me, when they blurted out to their physician a wish that their loved one would die rather than continue to suffer. Typically, the physician panics and sees this as a pathological response to caregiving; some may even report this fearing the distraught spouse or child may act on those wishes. Butler explores with tremendous sensitivity this unspeakable longing for suffering to end without ever dropping into unnecessary angst or drama. But that is just the first three pages. The entire journey she takes with her mother and siblings is a wisdom trail from unknowing to being with not knowing, from waiting to bearing witness, from reacting to systemic demands to compassionate action.

The event line of the book is typical: her father has a stroke. In the usual process of rehabilitation treatment, decisions are made. It is not the decisions themselves but the revelation, through Butler’s skillful foreshadowing, that there are always unforeseeable consequences. And for many of those consequences, the mission of the medical industry often runs orthogonal to the values of the family and ethics of a supported death. The medical history of life-sustaining devices and interventions (surgeries, medication) is brilliantly interwoven into the narrative. Without taking us away from the unfolding tension, it makes us want to shout into the book “Oh, don’t do it! Don’t do it!”

But this is more than a story of one family’s tumultuous love for each other and their battle with the medical system. It is a cautionary tale for each of us, even if we think death is occupied with our future and not our present. It revealed for me that it is not about finding that right person to “pull the plug.” In fact, by the time it gets to that significant point, too many decisions have been made without full awareness and “pulling the plug” plays the smallest role in ending suffering. Butler writes tenderly, “Dying is hard on the dying. Death is hard on the living.”

Dying is not an acceptable topic of conversation. Still. Yet. Even. But converse on it we must because by looking away we only create a larger cauldron of suffering for those to whom we have entrusted our final moment – so wrongly believing it will only be that moment in which they will be called to act. Butler’s story carries this urgent message. We can honour the concept of dying as sacred but it can become a tragic process if we do not consider that getting to death itself can be a tainted and misguided journey.

It is worth mentioning that this book stands as an act of profound courage. It is brutally honest about the nature of relationships, searingly insightful in the potential of healing, and shines an intense light on our ignorance of what naively assume is a good death. For that alone, it is an important one to read.

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If you are interested in learning more about how to prepare and be with that honest death, here are some resources:

The Metta Institute offers training and workshops on end-of-life care as well as resources for practice.

The New York Zen Center for Contemplative Care offers grief and bereavement counselling, end-of-life programs, and meditations. Contemplative Care: A Film is an excellent resource.

Being With Dying Training at Upaya Institute is a rich program ranging in its training by Frank Ostaseki (Metta Institute), Laurie Leitch & Loree Sutton (Social Resilience Model), and Susan Bauer-Wu (Living with chronic illness).

The Canadian Palliative Hospice Care Association lists resources and programs for several professional groups (interestingly no psychologists), family caregivers, and volunteers.

The Quality End of Life Care Coalition of Canada document is a “Blueprint for Action – 2010-2020” to improve end-of-life care and ensure training and funding for Canadians.

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spirituality, ritual, and being a selectionist-buddhist

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Dad&Mum We had our first formal zazenkai today after a few years of hunkering down in formless practice. As formal as it gets, I suppose, given my tendency to laziness when it comes to form and ritual. Yet those moments of chanting and prostrations are a lovely dance we should all take part in if we are to learn to embody practice, to live vow.  And I felt it was important to honour the 7th day after my mother’s death.

Oh.  That’s my father and mother to the left.  They cut quite a dashing couple in the old days – which were actually the new days for them.  New days of hope that the British Occupation would bring them comfort and opportunity – which it did.  I think the picture is taken after WW II and around the time of Great Optimism.  They were both rising stars in the newly formed government, sometime after Aung San’s assassination and the military take over by Ne Win in 1963.  By then, they had learned to weave through the many political ups and downs including losing much of their acquired wealth when Ne Win demonetarized the Burmese kyat.  In fact, they had both retired and built their dream home only to have my father return to work when asked because, drawing from the rhythms of his poverty-ridden childhood,  he couldn’t imagine a world that didn’t need him or a family that ever had enough money to survive.

This was their legacy: work hard, do what’s necessary, never wonder if things could be better, make them better by waking up each morning and doing what is necessary.

Monk: What is the essence of your practice?
Basho: Whatever is needed

So today, we chanted the Honoring of the Bodhisattvas, lowered our bodies to the ground in gratitude for all the Bodhisattvas and Mahasattvas, the Stream of All Our Ancestors which now includes my parents and the parents of some of my friends whose mothers and fathers made their transition this week.

There’s a reluctance about the form of practice.  I feel it in myself even now after these years of lighting incense, bowing, prostrating, and stepping back before turning away from the altar.  As if somehow I would like this Buddhism to be something pure and separate from the religiosity of my childhood, the cathedrals and the black-frocked Christian European priests speaking to us poor Asians as if we were just south of a Neanderthal lineage.  And yet I resist the neo-spirituality I find that sucks in Buddhism as the panacea for and talisman against all sins past and future.

So yes, I’ve shopped my way around but in my defense it was only because of my ignorance of the many factions (I use that deliberately).  I grew up in a cultural Buddhism which had little to do with meditation and a lot to do with chanting at the pagodas, prostrating and feeding male monastics.  That said, a bit of buffet-surfing was to be expected and having (quickly) settled in Zen, I am quite content and even allow my Latin-Mass Catholic heritage to relish in the rise and fall of Namo Shakyamunaye Buddhaya.

Still, I have to say that meeting so many on this path who are caught in the confounding of being spiritual and being non-religious frustrates me.  Even more do claims to a Selectionist-Buddhism, as if that makes it more spiritual, annoy the heck out of me.    If there was one thing I learned standing my parents’ deathbed – even a decade apart – was that rituals don’t help ease the pain.  That’s not why we step into that space.  Rituals offer an opportunity to see how our mind grabs the nearest thing and makes it fuel.  That’s all.

And that’s likely the most important teaching we will ever receive whether it’s lifting a cup of coffee to our lips, checking the rear view mirror before backing out the driveway, packing our life’s belongings to cross an ocean, or bowing to the stream that awaits us as future ancestors.

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Note bene: Interestingly, I am reading Dispirited: How contemporary spirituality makes us stupid, selfish and unhappy by David Webster.  He has a fascinating thesis on spirituality having been hijacked by the New Age and the buffet mentality of seekers.  The book is good if somewhat problematic in being poorly edited, the occasional philosophical rant and difficulty with having to infer whether he’s talking about “authentic” or “let-me-look-spiritual”  spirituality.  But I’m liking it and, for the more philosophical among you, it may be worth the read.  (He actually does a great job of it on his blog post, Spiritual But Not Religious.)