Joan Halifax —
A Midwife to the Dying

The Terri Schiavo case earlier this year raised ethical and medical issues that remain with us today. But missing in that debate was a real attention to the quality and the meaning of death. Joan Halifax tells us what she's learned and how she lives differently after three decades accompanying others to the final boundary of human life.

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is a medical anthropologist, Buddhist teacher, and founder of the Project on Being with Dying.

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My wife, Regina, and I appreciate your show. We especially found Joan Halifax helpful in teaching about death. In June, Regina was diagnosed with lung cancer which has spread into her lymph nodes. We pray that she has a long time left to live. Her diagnosis has spawned a deap spiritual search.

I was a run-away Catholic until we found 79-year-old Father John Clay of St. Stanislaus parish in St. Paul. Father Clay teaches us about love. His homilies are always about love, which is a very helpful guide when facing death. One nun said that listening to Father Clay is what she imagines listening to Jesus would be like. Father Clay's sermons are really theology lessons about love. His teachings are very similar to Buddhism in that he points to what we can do within ourselves. Regarding traditional Catholic teachings, Father Clay counsels to look at what they are "pointing towards" rather than taking them literally. He directly challenges the Church's teaching against gay people.

Your program on death did not touch on a question I have long wondered about. All of us would like to experience death in a meaningful way, as so beautifully described on your program. What happens, however, when the person dying is no longer the person they once were — when Alzeimers or severe brain damage, as in the Schiavo case, has robbed them of any semblance of their true self?

This touches on the question: there must be such a thing as the death of the self (or "soul"), as distinct from the death of the body. How can one mark and pay adequate tribute to this kind of death? My husband and I would like to thank you for your wonderful program, which is both thought-provoking and inspiring. We look forward to it every Sunday morning, and even put our Sunday papers aside to give it our full attention!

Thank you for the great program and interview with Joan Halifax. It was so sensitive and insightful into that great mystery. Kathleen Dowling Singh is another woman with comparable experience. Her book, The Grace in Dying, is also wonderful. Thank you again.

As a hospital worker, I had to find my faith quickly, or the death and suffering would tear me down emotionally. Now I see death as neither good or bad, only as normal and as natural as birth. So often I encounter patients or their family who believe death is the worst thing that could happen to someone. This is absolutely not true, and anyone with true faith would know not to fear death absolutely as so many do.

What bothers me most in the hospital is seeing people sacrifice privacy, dignity, their estate, and pain-free happy living for fear of death, all the while praying for a few more days of miserable living. It seems so contradictory. I will miss my loved ones who pass before me, and I will miss this world when it is my turn to go. However, I do believe in God, and in an afterlife, so I fear not. What is it in our culture that fosters this horrible fear, even in people who say they have faith?

I have a dear friend who cannot accept death and dying. As a Hospice nurse, I spent many hours if not days trying to explain to her how important it was to "be there" when a person dies. One day, as an exercise to better understand our job with Hospice, the entire staff came together and was told each person must write a poem that had a special meaning for us as individuals. The following poem is a result of that exercise, and why I continue to be there when people die, and I will be there when my friend dies.

She Wants to Know
She says she does not understand death.
Why was I brought into this world
To struggle, suffer, then die?
If that is all there is, then why bother
Being born at all?

She wants to know the purpose of death.
If it has no purpose,
Why must I die?
Why can't I continue on,
Doing good for people, helping people?

She wants to know who decided there would be death.
I don't believe God thought up death.
Why should I die because of Adam and Eve?
I did not eat the apple,
So why do I have to pay for their sins?

She says she is not afraid to die.
I will die if someone can explain why.
I will die if there is a purpose I can understand.
Since I can do none of these,
I believe death is not something in which I can partake.

Hi Kathleen. It's more than a year since you emailed "On Being" after Joan Halifax's interview. On Being is not on air in my region, and I have only recently started to listen to it online. As a Hospice nurse it is possible my late response might still be of use to you.
The creation myth of the Hawaiian people, from their traditional pre-Christian religion, has much too offer.
I do not know if it was God or the Gods, and I do not know if they made one human couple first or a group (I have more research to do, myself), but the first humans, like God or the Gods, were immortal. Woman or Women said to God or the Gods, "I want children," and the response was; "There isn't any room." So Woman or Women said, "I will die that there will be room for my children." They lived on small islands, after all.
Their insights, enriched by modern science, make much sense on the small island planet Earth. Here on small island Earth the human population keeps increasing and all the living animal populations which we eat are shrinking. Were we immortal having children might become illegal. . . in order that those who remain might continue to eat.
There is a sense in which single celled life does not die of old age. By splitting, a single cell isn't a parent that has had a child; which of the two new cells is the parent and which is the child? It has cloned itself; it has created itself into identical twins. There is sense in which the very first single celled blue algae, the first life on Earth that stuck, is still alive, and is 3 billion years old. The mixing of DNA in sexual reproduction is an immeasurable aid to evolution.
These are two extremely valuable reasons to celebrate death. It makes room for children, and it makes evolution into many life forms possible.
I'm a meditation teacher. These questions are of concern to me in my work life, too.
Perhaps you got lots of answers to your email to the On Being blog. I do not expect a reply from you, but would welcome one should you choose to respond. If you do email me put something about the On Being blog in the header. I get lots of spam and delete things without much thought when I don't recognize the sender.
Either way; many thanks to you for the good work you do in the world.

Thank you for your thought-provoking and moving discussion on death with Joan Halifax. As a pediatrician and a participant in several workshops with Dr. Rachel Remen, MD, I've pondered this topic a lot, and Halifax gave me even more mystery and hope than I had already experienced. You may want to consider a discussion between Ms. Halifax and Dr. Remen as you had between Rabbi Schulweis and Khaled Abou El Fadl. It would allow Krista to explore this important topic in even more depth with two innovative compassionate thinkers at once, and no doubt even more insights would arise.

My 43-year marriage to a Holocaust survivor has been an extraordinary experience. He is 91; I am 70. Now he suffers from mouth cancer. I am a former nurse and registered X-ray technician who also witnessed death and dying up close and personal. Each case was different both for the person and for me. I've come to realize that the relationship dictates our feelings. Actions and reactions are framed within mental, physical, emotional, and psychological conditions. A sincere belief that nothing is lost in nature gives comfort to heart and soul.

Years ago we made out a living will but recently my beloved called our three grown daughters together to talk about an ethical will. Issues were brought up that startled me. Ultimately it proved helpful. He left us with a question. What would they say at your funeral? Yes, "God laughs while man makes plans" but without a "road map" what is your life and who are you? This society separates itself by age and by illness. Suffering is part of life. Can an ethical will change our attitude? It did for our family.

I'm a night nurse on a surgical floor of a large county hospital. I left work this morning with tears and sad thoughts after learning that a favorite patient, recently diagnosed with cancer, lay in her room close to death, refusing all but palliative care and having accepted her coming death, with her family at her bedside. I caught the tail end of your segment featuring Ms. Halifax and was in time to hear her relate the story of being with a particular woman at the time of her death, singing "Swing Low, Sweet Chariot" and breathing with her to her dying breath. It was lovely and sad and was just what I needed to hear.

I'm very glad that Joan Halifax acknowledged the mystery surrounding death and dying and the sanctity of life. My concern as a mother of a fantastic 17-year-old young woman who happens to have been born with a disability is that we are careful not to judge quality of life based on our presumptions about other people. Often able-bodied people assume that because a person can't do certain things for themselves that they are a burden. In fact, it's an honor to care for another person and it's an honor to be cared for. After all, isn't that part of our lesson here on earth? To connect with compassion? To love one another?

People who live with severe disabilities are often left out of this discussion, and many of them have a very interesting perspective. I know people who live and work every day who need a ventilator to live. They tell me that they are happy to be alive. I know many people who live happy productive lives who, before they became disabled, may have said or thought, "I wouldn't want to live that way." But they have adjusted and still find many ways to contribute to the lives of others around them. I saw a documentary about the life of a writer who lived in an iron lung because he had polio. He said that he had thought he would want to kill himself if he had to live that way. But when he found himself actually in the situation, he discovered that he was comfortable in the iron lung and actually felt safe there.

Doctors are fallible and can't predict the future. We will never understand why we are here and how our presence affects those around us. When I was pregnant, the doctor who told me I was carrying a baby with a birth defect painted a very bleak picture of my life and hers. I cried. I prayed. I read all of the medical books. I worried that perhaps I wouldn't be able to love her. I worried about her being ostracized during her childhood. What I hadn't anticipated is what an absolutely joyful and transformative experience it would be to become a mother of this child. She has always been empathetic, outgoing, understanding, intelligent, and extremely spiritual. She has expanded my ability to love and has opened the door to my meeting many many incredible people who I might not have taken the time to get to know simply because they are different or disabled. Let's be careful and not lump people with disabilities in this "end of life" "dying with dignity discussion."

The fact is, we didn't really know what Terri Schiavo's wishes were. We never did find out how she became so severely disabled. And not having spent time with her, we don't know how she contributed to the lives of those around her after she became disabled. Let's be careful about the end of life decisions we make before we get to the end of our lives. Perhaps in the end of life, learning to allow someone to care for us, would be learning to be loved. Perhaps the person caring for us would be learning and expanding their ability to love. The truth is we don't know and won't know until we get there. Thank you for your very thoughtful and provocative show.

I am a regular listener to WNYC and came across Speaking of Faith today featuring Ms. Halifax and her experience with end-of-life issues. I, too, recently lost my father and experienced death in the peaceful surroundings of the Hospice of Austin, Texas and those lovely ladies who provided much needed and appreciated support during a very hard and trying time. Although his stay was short, the whole experience gave me such a new and hopeful prospective on death and dying. As Ms. Halifax mentioned, it IS a part of life. It helps if the person, like my father, dies peacefully of course. But it should not be feared and I feel so very grateful that I was able to experience death as a positive and natural thing. Another phase to life.

With Father's Day tomorrow, I was glad to hear such calm and reassuring words from Ms. Halifax as I contemplate my father's life and death. And I hope to hear more discussions of this type in the future. It is good that people are discussing life AND death in the same context. For, in death, one's life should be celebrated!

What a powerful show — I wanted more and more. Would you do a PBS program on this subject? Your program was so well constructed and gathered together so many diverse and meaningful voices. I have an incurable heart disease to which we are now turning to experimental modalities. I also suffer greatly with chronic fatigue and fibromyalgia. I am around the clock on two different narcotics to cope with the pain: oxycodone and a fentantyl patch. My death is not imminent but certain. I have 15 family members who have died of heart-related diseases in the last two generations that I know of; my father was 40 and my mother was 56. Both died of sudden cardiac failure. My wife, a year after the first year of heart attacks (there have been maybe eight or more), decided to leave me not wanting to be with a sick man any longer. She had the "grace" to inform me she filed for divorce while I was in the hospital getting one of my five stents opened up again.

I have long been acquainted with the voices of Victor Frankl and Mary Oliver (she and Jan Graham are particular favorites of mine who delve into the mystery of this life and the next). I am a member of the Church of Jesus Christ of Latter-day Saints and so my understanding of death does not make it fearful to me. In fact there have been many days in the past almost three years that I would have welcomed it having been in the ICU/hospital 15 times, 15 angioplasties/angiograms. The pain is what I fear and the dehumanization of the hospital experience. My material possessions have all been taken. I welcome what and who I will greet as I pass through this life into the next — what is there is NOT a dark cabin to. In fact, at LDS funerals we bring our children. We want them to understand that this life is not the beginning nor the end. We do not shrink from death. That does not mean we do not mourn — we do — but we are not bereft of comfort although we are just as saddened as anyone by the loss — our loss not the person who died.

So why have I written this comment? Because I am amazed that no matter what the spiritual background or not it seems on this subject that for those who have worked closely with the dying (I also greatly admire Elizabeth Kubler-Ross) seem to find more commonality in the experience both for the dying and those offering care. I greatly respect and admire their care and compassion. And I was touched by this carefully crafted program that dealt with this — one of the great questions and mysteries of life — with such delicacy and touching beauty. Thank you! You have been a boon and a comfort on a couple of very difficult days.

Love your shows