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Lions Roar : November 2009
SHAMBHALA SUN NoveMBer 2009 27 ImagIne you’re preparIng for a trip to a foreign country and you’re limited to taking only what can be carried in a backpack. your decisions on what to take and what to leave behind will determine the quality of your experience. Too many items and the weight will be burdensome. not enough of the right ones and you might be forced to neglect some ba- sic needs. We make decisions of this type regularly. Take what’s important, leave behind what isn’t. But we tend to be oblivious to the importance of these decisions for the most momentous journey of our life—our death. as a bedside hospice volun- teer, I’ve found that the ideas and emotions people carry with them through life often determine the quality of their death. I remember my patient Joyce saying, “Dying is such hard work.” For months, her physical condition had been declin- ing steadily, so I assumed she was referring to her pulmonary problems. But then she said, “I’m not talking about what’s hap- pening to my body.” pointing to her head, she continued, “The hard work is what’s happening here.” For most people, this work falls into four categories: the difficulty of simplifying the present, forgiving the thoughtlessness of others, wanting desperately to be forgiven, and letting go of dreams that will never be fulfilled. Simplifying I’ve seen many patients experience a stimulus overload as they get closer to dying. The Ceo of a multinational company had difficulty deciding what he’d have for breakfast and a carpen- ter who built houses couldn’t complete easy manual tasks. For patients with dementia or other neurological problems, difficul- ties like these are organically based. But for people such as the Ceo and carpenter, I believe the hard work of dying involves an The Hard Work of Dying Simplifying, forgiving, and letting go—Stan GoldberG on working toward a good death. information-processing prob- lem: too many issues and not enough time to come to terms with them. patients some- times limit the number of visitors who come to see them in order to help with this over- load. others cut back on or eliminate lifelong interests, or decide not to talk about highly emotional issues. anne, a well- known poet, chose a unique way of simplifying her life: she gave herself a going-away party. She invited friends to her hospice facility, and after everyone had told her how their lives were changed by knowing her, anne called each person individually to her side. She whispered to each person and then gave them a single sheet of paper on which one of her poems was written. When all were given away, she said, “now, I’m ready to die.” When anne described the party to me, I asked if she could recite one of her poems. With a smile she said, “I can’t. I don’t own them anymore.” Offering Forgiveness The pain people experience from their past often follows them into death. This was true of marie. I visited her weekly for five months, and every visit began and ended with her telling me the story of her co-workers’ cruelty. She spoke with such emotion you’d think it had been a recent event, rather than something that had occurred more than fifty years before. For marie, the in- ability to forgive the unskillful acts and words of others made the time leading up to her death emotionally difficult. But for some people, such as ned, it’s never too late to forgive. I started visiting ned almost daily after he expressed a fear of dying alone and asked me to be with him when it happened. Sometimes I visited for only a few minutes when he was heavily medicated, yet still showed no signs of actively dying. at other phoToByB.FreSTeDT