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Lions Roar : November 2017
In 1987, Ostaseski helped found the Zen Hospice Project, the first Buddhist hospice in North America. “We were dedicated to people who had no support systems,” he says. “They had cancer or AIDS or an addiction or multiple mental issues. They were on the margins of society. In the beginning, we worked on the street, and later had a physical hospice and long-term care facility.” Hospice care at the time was mostly a medically-driven model offering some emotional and psychological support. “One thing that was different about Zen Hospice was that all the caregivers, staff, and volunteers had a spiritual practice. So they could bring in calm stability, emotional availability, mind- fulness, and fearlessness developed in practice,” says Ostaseski. “But we didn’t teach people to meditate, nor did we impose our ideas about death and dying. We created a beautiful and receptive environment in which the residents felt loved and supported, and where they were free to explore who they were and what they believed.” The Zen Hospice Project became a model for other Bud- dhist-inspired care facilities. It provided volunteers for the Maitri Hospice, which was started by Issan Dorsey, a drag per- former, former drug addict, and abbot of the Hartford Street Zen Center. Maitri Hospice provided care for gay men dying of AIDS, including Issan Dorsey himself in 1990. Ostaseski has continued his work as a leader in end-of-life care, and in 2004 he founded the Metta Institute to provide education on spirituality in dying. In his recent book, The Five Invitations, he offers the living what he’s learned at the bedside of thousands of people as they died. He distils the wisdom of the deathbed into five invitations to be fully present in life: 1. Don’t wait. 2. Welcome everything; push away nothing. 3. Bring your whole self to the experience. 4. Find the place of rest in the middle of things. 5. Cultivate “don’t know” mind. Ostaseski has learned that the activities of caregiving are quite ordinary. He writes, “You make soup, give a back rub, change soiled sheets, help with medications, listen to a lifetime of stories lived and now ending, show up as a calm and loving presence. Nothing special. Just simple human kindness, really.” Yet Ostaseski has also discovered that participating in these ordinary activities can lead to a profound awareness of your own death. “Whether we are the ones making the beds or the ones confined to it,” he writes, “we have to confront the uncer- tain nature of this life. We become aware of the fundamental truth that everything comes and goes: every thought, every lovemaking, every life. When I’m sitting with someone who’s dying or their family member, I’m always looking at my own relationship to death and at my own fear. Otherwise, in what I say to the other person, they will know I’m just guessing, and they will sniff out my mortality.” Ostaseski is not romantic about dying. “It is hard work,” he writes. “Maybe the hardest work we will ever do in this life.” What he has discovered makes a good death, whatever that means individually, is the willingness to live in the deeper dimensions of what it means to be human. Ostaseski says there are four elements to be considered when helping a person to die well: • Mastery: having someone who can help manage pain • Meaning: having someone who can help sort out what has value in life • Mystery: letting go of meaning and entering the land of unanswerable questions • Mindfulness: being present with every aspect of every state of being. “When we only die with death as a medical event, we sell death short,” Ostaseski writes. “We rob it of its holy significance. In caring for each other, we must attend to both task and rela- tionship. Without a relationship to each other and the realiza- tion of intrinsic values, purpose, meaning, and spiritual growth, there is a loss of soul. We split off the secular from the secret.” Ostaseski says he has seen positive changes in end-of-life care over the decades, including a willingness to talk about death and more choices available for how people can die. “We’re starting to deal with the whole process, the whole human being, the whole process of dying,” Ostaseski says. “Bud- dhism’s not enough and medical care’s not enough. But we are finding ways of integrating and blending these models.” Spiritual Care: Joan Halifax As a faculty member of the University of Miami School of Medicine in 1970, Joan Halifax decided there had to be a better way to die. Frank Ostaseski has distilled the wisdom he’s gleaned from caring for thousands of people who are dying into five invitations to live more fully. PHOTOBYA.RAJAHORNSTEIN LION’S ROAR | NOVEMBER 2017 58