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"This Mind of Dying"

by Christian Wiman from "Every Riven Thing"

Pertinent Posts from the On Being Blog

We heard from so many people asking about the StoryCorps audio of Annie and Danny Perasa who ended this week's show. Here's an extended, animated short of the lovely couple talking about love and dying. An absolutely moving five minutes.

On my first day as a chaplain at Calvary Hospital, a palliative care facility in the Bronx — a place where every patient was near death — I was overwhelmed.

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The first Buddhist chaplaincy training program in the U.S. is featured in this beautiful short film about end of life care.

Great sayings and photos from Walter Breuning, who died this year in Montana at the age of 114.

The poet Elizabeth Alexander once asked, “What if the mightiest word is love?”

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A moving visual reflection on memory and relationships, absence and loss, and on the frail, tender love between family members.

Bedridden with an incurable illness, writer Paul Martin on navigating paths of pain and difficulty, and the depth and mystery of joy.

This TEDtalk by branding guru Stacey Kramer is three minutes long and inspirational in its brevity and its punch.

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(photo: Meredith Farmer/Flickr, cc by-nc-sa 2.0)

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Beautiful show. It made me think that being able to participate in the process of helping a loved one through this stage of existence helps relatives/friends/caregivers to eventually feel good about the event despite how difficult it might have been. In a way, participating becomes a blessing for the caregiver. I then thought about people whose loved ones die suddenly, tragically, alone, i.e., not "well" in the sense defined here? I know that was not the focus of this show, but the discussion made me wonder about the suffering for the living that comes with not able to be there, to help, to make things better. What is the healing balm (if any) for living with the feeling that you were not able to say I Love You, I Forgive You, Please Forgive me... that you had no chance to say Good Bye....
Thank you for this amazing show that pushes us to dig deeper within and without.

My late husband's oncologist recommended this podcast to me, I have not listened to it yet, but I know as my 38 year old husband was near the end of his battle with cancer it was my hope to surround him with love in his last days. He was so blessed to have so many visitors, including 4 different priests in those last days. One time he was even able to put his hands together and pray. That gave me a peace that I will never be able to explain in words. A peace that I knew he was ready and that God was ready to receive him. Also, a peace that while I was losing him on this Earth, he would always be a part of me and our children and that I would one day reunite with him for eternity.
While I was scared to lose him I never looked at his impending death as something to hide from, I faced it head on the entire time, because I know we all face it at some point and it does not do any good to be scared or tried to hide from it. Of course it is not what I wanted, I would much rather have him here healthy and helping me raise our 4 beautiful children, but I knew that was not to be and I wanted him to know, I was there, holding his hand, loving him, standing with him, until he took his last breath. I can only hope that when my time comes that I face it with the same brave face and welcoming heart as he did. For his strength and courage in those last days made me grow to love him even more.

Dr Ira starts with this quote “Death is a developmental stage in life”. What a profound statement and concept. So easy to say and understand, yet so difficult to accept and execute. In the end death is the final stage we can obtain from life and one that we will all face. We should be looking at death as a failure of the body and medicine, but not a failure of the mind and spirit. Another great quote is “We’re all going to be dead a long time, why rush it?” I busted out laughing at this quote because is hits home; it goes straight to the heart of the issue. We all die and we stay that way for a long, long time. We are all born with the will to survive and when we die, it’s personal because we are the only ones who experience it. I hope I can live my life for the living and not worry about death because if I only worry about death then I have missed life.

This show about Dr. Ira and his work on main streaming the idea behind death as being an embraceable life process and not one of failure of the body or medicine is a huge step for our society to accept.

Back decades ago, hospice wasn't even heard of. There were very few places that a person could die comfortably and without the feeling of abandonment. Dr. Ira worked on brining this old age way of thinking that death was a failure of the body and modern medicine and instead being a moment in life where one could reflect, rejoice and embrace the process before them.

I felt this is what is the ultimate goal in life; to die and be with your creator. That is the promise they give you no matter what you believe in. And if a person is spiritual, then the death process should be one of rejoicing and not of sorrow. But putting our human emotions in line with this idea is not only uncomfortable for the dying, but also for the living souls beside them.

We as a society have ingrained the importance of the physical world. We hang on to what we know and see. And even if we believe that there is happiness beyond, we still have sorrow of leaving our worldly things behind.

Unfortunately death has been a part of my life (as I'm sure a lot of can say) a little more than I would have liked it to this point. I've seen some family members on hospice care and it is not an easy thing to watch your loved ones go through their last phase of life. I also find myself telling myself to hold the time I get with my loved ones more sacred, to really take the time and make it a point to enjoy the time I have with them. Spend more time saying "thank you" or "I love you" so those people know how you feel instead of it just being interpreted because you are family. Unfortunately, and I have gotten better over the years at doing so, but I do find myself just going day by day not making it a point to make sure others know that I care. It is important that at that point when someone we love goes over that great divide we do not hold regrets for the time we did not spend with that person, or that we did not do a better job to show we care.

I think everyone can agree, but what this podcast cast was pointing out is that when something bad comes along, like a diagnosis, what really matters comes out and all that stuff on your iphone or blackberry takes a backseat (or anything else in the world). This is definitely true. When someone you care about so much is diagnosed or has something life threatening to them, nothing else in the world matters. All you want is more time with them, and for them to be okay. As the podcast states though, death is a part of life. Wanting more time is also a double edged sword too in a way; of course we are going to want more time, but we also really need to cherish this time so when death approaches our loved ones we know we spent all the time we could cherishing the moments we had.

Unfortunately death has been a part of my life (as I'm sure a lot of can say) a little more than I would have liked it to this point. I've seen some family members on hospice care and it is not an easy thing to watch your loved ones go through their last phase of life. I also find myself telling myself to hold the time I get with my loved ones more sacred, to really take the time and make it a point to enjoy the time I have with them. Spend more time saying Thank you or I love you so those people know how you feel instead of it just being interpreted because you are family. Unfortunately, and I have gotten better over the years at doing so, but I do find myself just going day by day not making it a point to make sure others know that I care.

I think we all can agree to this, but what this podcast cast was pointing out is that when something bad comes along, like a diagnosis, what really matters comes out and all that stuff on your iphone or blackberry takes a backseat (or anything else in the world). This is definitely true. When someone you care about so much is diagnosed or has something life threatening to them, nothing else in the world matters. All you want is more time with them, and for them to be okay. As the podcast states though, death is a part of life. Wanting more time is also a double edged sword too in a way; of course we are going to want more time, but we also really need to cherish this time so when death approaches our loved ones we know we spent all the time we could cherishing the moments we had.

Listening to this broadcast by Ira Byock on Contemplating Mortality was very touching. Having dealt with the death of my own mother a few years ago I can sincerely say that I wish I had heard this message prior to her end of life experience. So much is and can be done to prevent death that it still comes as a shock to people, even though death is one of the only "givens" in life.

His statement about death not being medical but personal is a wonderful way to look at the process. He also said that it's a "personal experience with serious medical needs". Coming to terms with mortality, whether it is our own or that of a loved one can be a traumatic experience. By embracing Dr. Byock's methods I think many people could travel through the process of death much easier.

I listerned to the podcast '' Contemplating mortality'' and found it very interesting. I was really impressed by the words,ideas and thoughts of Dr. Ira. Death is one of the subjects that we tend to avoid even inevitable situations. I believe that Dr.Ira has a honarable and compassionate message to offer to humanity in general. I understood from the interview that death is not something easy we look forward to in times quiet introspection and self-assertion. No matter what I have done or who I was in this life,the moment, a time will eventually come when I will have to come to terms with the inevitable fact that I'm going to die.

One of the most interesting point was that there is no perfect example of a perfect relation in the history of our planet. We have hurt feelings and make mistakes inthis thing called life. Naturally,people will fight and grip tightly to life and all we have known,learned,experienced and loved. I personally think that people will benefit most from a society that is well educated,medical community and a spiritual community . I think that there could not be anything more compassionate and more supportive than the group of people I mentioned above. The most impressive part of this interview to me was how Dr.Ira's Ideas are applicable to every human being. When I look at human life and what separates us and makes us different, only chidbirth and death stands out as events that never get affected by their significance experiences,standards and circumstances of the human society. Lastly, I learnt that, death can be very horrifying but Dr.Ira reminds us that it doesn't have to be.

Ira Byock is a prof of medicine at Dartmouth University and discusses "dying well". They talked about a lot and most of it was worthy of being mentioned in here, so I'll start by just listing the notes I took while listening:

Death is a failure of the body and medicine

In the 70's, hospice care was a social, counter cultural movement, it was not the norm.

Treat dying as a developmental time, a time of value in human life. Most of us have "medicalized" the end of life.

We should all attempt to "die well".

4 things that matter most - states of being:

Please forgive me
I forgive you
Thank you
I love you

It's easiest to say these when near the end of life or when there was a close call, like a car accident, because we are in the right frame of mind where none of the past matters.

Life threatening illness, injury makes buddhists of us all, we no longer feel immortal, it brings to light how our relationships are most important to us.

Love is stronger than death, death cannot take away love.

We have an unbelievable will to live, humans at the time of death are: vulnerable yet confident, insignificant yet meaningful, really the most real of any time in our lives.

Medical advances at some point work against the concept of dying well, as we're nowhere near making people immortal. Rather than being mentally and spiritually prepared and in a good state of mind, we hope or expect a cure to keep us living.

I really enjoyed listening to this. I would recommend anyone going through or who has a family member going through a serious illness to listen to this. What Byock talks about seems so simple and logical, yet put into real practice can seem so unattainable. He explains his views in a manner that makes the topic of dying almost calming, if that's possible. Having a father who has been battling (and winning thus far) stage IV lung cancer for the past 5 years, listening to this really added a calming perspective to dying and serious illness.

I found this discussion very interesting and I am glad I listened to Dr. Ira Byock's views on death. It is true that sometimes we can lose sight in the remarkable value we call life. Death is an experiences that is a profound value of life. We should not assume that its only about suffering or avoidance because it is a personal event that can be a transformative experience. Death can be a growing experience that can make us stronger.

Human development is a lifelong process which continues with death. Of course we do not want people to die, especially our loved ones, but death is an extreme moment in life where we are shaken free to express ourselves ultimately. The notion that life is coming to an end can be a powerful realization in one's self. A life threatening incident, as Dr. Ira said, turns us into "Budhists" and shows us how important we really are to each other.

The will to live is inherent in humans. We wish to defy death when we can. "We are utterly vulnerable and yet unshakably confident; Utterly insignificant and infinently meaningful". But even medicine, which used to be directed solely towards healing, now is also directed to ease the death process. I agree with what he says are the four sentences that is used easiest when dealing with death: Please forgive me. I forgive you. Thank you. I love you.

I would like to say that I have had my own experiences with the death of loved ones, and each one has changed me and molded me, essentially, to who I am today and what I strive to do. Death is definately an eye-opener.

When my mother passed away we had such good spiritual support from her nurses and CNAs. It was amazing to be around all those nurses aids and have their support in my mother's final hours. I am glad I was able to start my career to be a CNA, like them, and provide that same support.

I listened to this podcast for one of my college courses I am taking. I thoroughly enjoyed listening to this podcast as it gave me a sense of relief or calm regarding dying.

Throughout the pod cast, Ira goes back to the statement "dying well", He explains this does not mean that you are well but rather you are content and accepting. To allow bygones to be bygones and accept the fact that death is part of life. He likes to consider death as a form of human development. From losing someone close, we experience many different things. From anger to sadness we learn to cope with the aftermath of losing a loved one. At the same time, the person who is experiencing death goes through the same emotions but can also die well. Ira brought up the notion that death has become more medicalized. We rely heavily on medicine to "save" us from the inevitable. (My words not his). He is all for medicine and helping save people's lives if possible but he also said that we need space between medicine and dying. A question that came to my mind was, can medicine get in the way of dying? Do we intentionally attempt to prolong one's life for the sake of not losing them?

The thing I found most interesting that Ira Byock brought up was what he called the four states of beings or four things that matter most. He best explained this using an example of being in an accident or nearly in an accident that should have taken life. You are more apt and open to picking up your phone and calling a loved one - the words easily come out and bring on a new meaning. The four states of being are: "Please forgive me", "I forgive you", "Thank you", and "I love you". The more I thought about these simple statements, the more I could see how they bring on a new meaning when faced with terminal illness or being on a death bed. You want to create a calm sense or peace; allow yourself to accept what is going on. At first I struggled with this. When someone dies suddenly you do not get a chance to say things you want to say or things that should have been said a long time ago. How do you cope with losing someone so suddenly? Do you ponder the should have, could have, would have? How do you get to tell them you love them or ask for their forgiveness? When it comes to someone who is able to prepare for death, you have the chance to speak these words. One of the last things Ira said in the interview was, "Listen to the inner life of people dying." He correlates this with the spiritual being. He speaks briefly of humans being simply beings lost in the black of space. We as humans seem to appear inherently spiritual as Ira states. If death is upon, take it with gratitude not with fear or anger. Death is something we cannot avoid. Although I am sure it is extremely scary and hard to imagine the fact that we should not be angry upon death but remember the good times in life and be grateful for the life you got a chance to live.

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is former director of Palliative Medicine at Dartmouth-Hitchcock Medical Center and a Professor at Dartmouth Medical School. His books include Dying Well and The Best Care Possible.

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Host/Producer: Krista Tippett

Senior Editor: Trent Gilliss

Technical Director/Producer: Chris Heagle

Senior Producer: Lily Percy