[river1951]

Gee, I only know a few hospice nurses who are religiously rigid. I think most of us have seen too many off the wall things to swallow the party line as it were. Consciousness itself is an intangible. I don't understand why we talk about end of life at all. I'm so tired of everyone being afraid to offend any non-believers that even though we intuitively know we go on, we can't say it because we're afraid someone will sue us.
Earth probably is full Michael, we just can't see them from this dimension!!

River

[earle58]

i don't know river.
i happen to think there are many religious folk out there.
what supports my hunch is the lack of response this entire thread has received.
while i try not to be presumptuous, i don't understand why there has been such little interaction in this thread and so, i'm led to believe that many are uncomfortable in their views of spirituality....which has been the focus, vs. religiousity.

leslie

[river1951]

Well, I can't explain it. Fool that I am, I actually thought lots of people would be talking about their patients and how they were able to help them resolve issues so they could have relax and be ready and not worry.
I never thought we'd be just the 4 of us talking to each other.
So, the question is open, whay aren't more of you guys in the discussion?
River

[BeExcellent]

Yes, to all. I think we need a separate thread on the spiritual aspect of a good death. Maybe this thread has just become too long and muddy for people to want to jump right in. I agree that every "midmorte" I have ever known has developed over time a strong personal spiritual beliefs. Many of us have found comfort and spiritual strength in our spiritual communities. But me having a strong spiritual conviction does not mean that I use THAT conviction to strength the pt and family. They can be helped to use their own spiritual strengths. One of the things I try to facilitate, if appropriate, is to have the family and friends start bringing in photographs of the pt. I start by noticing the photos in the home and then ask if there are photos of the pt as a teenage or a baby. What i am trying to do is show them that this dying part of the pt's life is such a small part of a rich life on earth. I love it when we have photos all over the pt room and laugh and cry at events. I know at some level tht dying pt is laughing and crying with us. What also happens is that inevitably some in the photos have since died themselves and folks can SEE that flow of life and start to part wht is happening in as part of that flow. Sad but not damaging.

[req_read]

Considering all possible responses to this thread, this is about the last one I would have expected. We have reached nearly 3,000 hits and have just 4 participants. I doubt that each of us 4 checked in 750 times apiece.

Puzzling as it may be, it does seem to reflect how people think about and deal with spirituality & religion… or perhaps I should say, don’t think about and deal with it. As I said in one of my books: About the only thing people are better at than procrastination is denial.

By the way Leslie, welcome back. I was worried about you.

In response to your post before last…

What I discovered when dealing with dying people is that after you cut through the religious outer covering you will eventually get to the core… or spiritual person. It is very much like the concept of the social façade. Indeed, the social façade and the religious façade are usually intertwined. And while there are vast differences in religions and religious doctrine, the human spiritual core is virtually universal.

It is sort of like language. There are hundreds and hundreds of different languages, but when you finish with all the interpretations it seems like people are all thinking similar thoughts.

Social workers like to study differences in religious doctrine and how that might affect outcomes. I always tried to cut through the veneer and get to the meat underneath.

Early on in dying process, when façades are still pretty much intact, the dying person still expresses learned responses. But as dying process progresses it (death itself) cuts through all the crap. I always viewed death as an ally in that regard. People could BS me… but not death. Death don’t take no crap off nobody! So I would wait… wait for death to do its magic and expose the core person. And what I found was, underneath the various layers of façade, the core is pure gold… spiritual gold. The various outer layers… the religious doctrine, the cultural background, the ethnic variations etc., etc. just add color… interesting color to be sure but nothing really substantive. It is like putting on colored glasses. Put on amber glasses and everything appears slightly yellow and contrasts are enhanced. Put on rose colored glasses and everything looks rosy. But the horizon… the overall view… is the same. Underneath our outer shell the core of who we are is universal. It is also beautiful!

There is so much going on in our world today that is driven by differences in religious doctrine. What I have seen in my dealings with the dying is that underneath there are no differences. So much of the suffering we see on the news is so tragic because it is so unnecessary.

Actually, when I think about it, the response to this thread accurately reflects the response by the general population to the study of dying process. There is no study of dying process in academia. I have said that several times in the course of this thread but now you can actually see it being played out; i.e. there is no response to an in-depth discussion of dying process in this thread… well, except for a handful of screwballs that is. And the really funny thing about it is… when people die they are forced to deal with it… think about it… face it… whether they like it or not. Death don’t take no crap off nobody. Until that time arrives however, people are inclined to leave it to the “experts”; e.g. the priests, shamans, ministers, clerics, mullahs, seers, et all. Then suddenly, when they themselves are dying, WHAM!!!! It dawns on them that this involves Me!

“What! ME?!?! I thought this just happened to other folks.”

The “experts” don’t die for you. You will have to tackle that on your own. If you’re lucky… and I mean really, REALLY lucky… there may be a midmorte in your immediate neighborhood… some screwball who actually thought about this stuff ahead of time… voluntarily… before being forced to.

Hey Excellent… that photo idea is clever. In sync with your notion of helping people to grasp the idea that their life on earth is but a small part of who they are I close (of course) with a quote.

Michael

Let us beware of saying that death is the opposite of life. The living being is only a species of the dead, and a very rare species.
Friedrich Nietzsche (1844–1900), German philosopher. The Gay Science, aph. 109 (rev. ed., 1887).

[earle58]

yes michael, people struggle through sev'l stages before all facades have banished and their souls are bared.
it's exhausting to die; truly alot of work.
yet what you perceive as spiritual, i perceive as vulnerability.
there is a gutteral wholeness right before leaving but i still don't think it is synonymous with spiritual awareness.
for me, those who have attained true spirituality, have come full circle.
various levels of awareness have already died and then reborn.
we are at fellowship w/the universe and its' multi-dimensional levels.
vulnerability otoh, is a sense of feeling exposed but not necessarily being aware.
the paradigm is, ironically, is while most are vulnerable, most are also detached.
there's a fragile affect w/o being affected.
there's a sense of awe w/o being uninspired.
while we remain physically here, we are mentally 'there'.
we are sensitized by touch but remain untouchable.
we are aware yet still feel lost; that is vulnerable.
it is when we feel aware and can find our way home, one has attained spiritual unity.
so while i do agree with your post contextually, my question still remains: how does one transcend their religious inclinations, and die w/o any preconceived barriers?
truly to the question at hand, how does one manage to have a good death?
what is a good death?
perhaps it is as unique as to the ones who are dying.
perhaps there really isn't a common concensus.
perhaps it really is about only managing the physical symptoms with pervasive clouding.
i know what would be good for me; not so sure about joe.
i'll let you know after we've talked.

leslie

[req_read]

Good morning Leslie…

I read your post last night but my brain could not handle it. Re-reading it this morning I’m doing better… I think.

You are making very good points. True spiritual awareness is not achieved by the simple expedient of dying, although the process certainly seems to lead in that direction. True spiritual awareness is so profound that we should be wary of using the term lightly.

Your use of the term vulnerable is, I think, apt. It is an accurate description of the state of mind… or perhaps, state of being… that often manifests in the latter stages of dying. It also implies that a willingness to be vulnerable expedites navigating the latter stages of dying process. Whereas resisting being vulnerable… fighting against the flow… generally results in angst, fear, unconsciousness etc.

I generally think of good death as one in which the person experiencing it goes with the flow so-to-speak… as opposed to fighting, kicking, screaming, denying, lashing out etc. And I don’t mean giving up… I mean gong into it willingly, with a sense of wonder and awe.

Your list of paradoxes makes a person stop and ponder; e.g. being vulnerable yet detached.

The Self seems to be multi-faceted. There is a part of the Self capable of detaching from and observing the Self. The Self can watch its Self. Perhaps that is the real Self observing the ego-driven Self… I don’t know. I only know that I have experienced it… and have heard it referred to as the “witness.”

As for your question: “how does one transcend their religious inclinations, and die w/o any preconceived barriers?”

Hm-m-m-m. Good question. The short version for my answer to that it- I don’t know. But let me share a couple of observations and ask if yours are similar.

I noticed, with a few different dying folks, that the religious training they received in childhood stuck… whether they wanted it to or not. A friend of mine calls herself a “recovering Catholic.” I have known some dying people who might be in that same category; i.e. were trained in the Catholic tradition but departed from it in their adulthood. However, while dying, the original training almost seemed to take over… to override the beliefs they worked at developing in adulthood. That is kind of a scary thought really… that you cannot undo whatever you happened to have been taught in childhood. Although it does seem to go along with other theories of growth & development; e.g. that what children are taught at an early age is difficult or impossible to un-teach at a later age.

I prefer to think we are capable of re-programming our Self... but have seen evidence to the contrary in some patients. To be perfectly frank, it scares the ___ out of me!

What have been your observations and what are your thoughts on this? (Leslie & everyone.)

Michael

[earle58]

i'm sorry it took so long for me to respond.
my schedule has been hectic as i've been working peds cases and i'm still not used to it.
so now, i'm trying to incorporate ways to get back on track.
dang michael, the short of it is, no, i don't think people are easily reprogrammed.
i agree with you in that whatever it is we are taught in early childhood, sticks w/us.
not the case for all of course: i was taught a myriad of emotionally and spiritually powerful concepts and i rejected every one of them.
but at the bedside, i see so many struggling with their faith and what it has imposed upon them at the end of their life.
if i could bring peace to that one aspect of dying, they'd be well on their way to what i perceive as a good death.
but the concept of God, Jesus Christ particularly, can and does impede the road to growth and self-discovery at the end, because of the aforementioned barriers i mentioned.
often, if the pt doesn't use their own pastor, i enlist one who isn't "by the Book" and converts religiousity to spirituality.
as a matter of fact, much emphasis has been put on the hiring of pastors, to try and ensure that there is a one-size-fits-most, no easy feat, i assure you.

anyway, i'm sorry but my brain isn't functioning fitfully but i felt inclined to respond to your post.
a 3yo with AIDS died today and the cries are still echoing in my mind.
i'm dreadfully distracted but in this little child's dying process, i had to ensure he was baptized, much to the chagrin of a family member, and there was much religious chaos throughout.
yet this case's experience has only served to fortify my thoughts as to the strife one's religion can create at the end of life.
if people (gen'lly speaking) could just draw from their resources within, much more would be at peace with the world.

leslie

[req_read]

Oh Leslie... you've been hurting... feeling a child's hurt.

As you know, perhaps THE most significant, culminating conclusion I have reached in my personal quest for truth is that all humans are connected… are, in fact, one. Sometimes we see and experience events in this world (the “world of folly”) that simultaneously reinforces and challenges this conclusion.

Our spirituality and our connection to other human beings is felt more than rationalized. Few cam deny feeling that connection when in the presence of a hurting child. When a child hurts we feel it… and we sense we are connected somehow. Our intellect cannot quite figure out how, but we feel it just the same, so the intellect wonders, “Hm-m-m-m… maybe there’s a connection here.”

The adults who cause the child’s pain are usually wound up in their own agendas, oblivious to the effects of their own acts… and we hope we are not connected to them.

But I sense that we are.

Being aware of the pain we cause (to ourselves and others) is key to self-awareness... to living consciously. Owning up to the pain we cause (sometimes with the best of intentions) is not easy.

When working in ICU one night, after all the patients had been tucked in & the lights were turned down, there suddenly came a yelling from Rm-2. “Hey! He-e-e-e-ey!!!.” It was not my patient but the other nurse & I both rushed in. There we saw the patient, an elderly gentleman, pulling on his catheter. Every time he yanked on the thing he would yell, “Hey!” We tried to explain that he was doing it himself… but of course he would have none of that. He was convinced his discomfort was due to the diabolical work of some malevolent other.

Similar scenes are common for nurses of course, but this one has stayed with me as a metaphor of human behavior. In a way we are all yanking on our own catheters… yelling and mad as hell… not realizing we are doing it to ourselves. Becoming aware… conscious… means facing up to the possibility that we may be doing it to ourselves. Only then do we begin to think, “Gee… maybe I should quit yanking on this hose.”

I recently heard a pundit on cable news refer to what he called, “the law of unintended consequences.”

We are inclined to focus on our good intentions while studiously ignoring the obvious effects of our acts. And even when someone brings the obvious effects of our acts to our attention we are inclined to blame instead of own… to make excuses and rationalizations instead of saying, “Woops! I think I made a booboo.” And when all else fails the ultimate blame-shifting technique is to justify our acts by quoting scripture. In that way we can shift the blame to God… the final repository of all blame.

Again I assert that self-awareness (looking within), as bitter a pill as it may be to swallow in the short run, yields better results in the long run.

Michael

[river1951]

Leslie- that is soo hard. I will hold you in my heart and thoughts.

I agree self awareness is the way to peace, but I see that for nearly everyone, self awareness is depressing, being human we are all horribly imperfect. Self awareness forces us to look at our own imperfections. How can we move on, when we've done such bad things? This can stand in the way of our patients moving on. It does not seem satisfactory to ask people to forgive themselves; most seem unwilling to accept imperfections, thuis denying their true nature. And I may add, making it difficult for them to pass through till the next phase.
At this risk of seeming too simplistic I believe helping our patients accept themsielves starts with our acceptance of them and believing what they say they need. If we are able to accept them as they are, I believe it makes it easier for them to share their needs, etc, etc. We have used ceremonies of forgiveness to assist patients at times. Does anyone else have other things they have found successful in assisting patients to accept themselves and their place on the wheel?
River