A View From The Edge (Part II)

Posted by Dia in Living and Dying and tagged with change, Depression, facing fear, Life, Surprise, the natural world February 25, 2011

“Lunar Eclipse” by Lorin Kline (my son)

(Last week in Part I I described the forces that drove me high into the mountains for a three-day rendezvous with my deepest fears. This is the continuing excerpt from the book, Chapter 5. Dia)

While the list of things scaring me was varied and long, when I arrived at my campsite I discovered one fear in particular standing head and shoulders above the rest. More than all else, hands down, the prospect of the sun setting terrified me.

There was something so final about it. I was all alone. Cal had chosen a spot about five miles away and there was no way to communicate with him, no satellite phone or flare or even matches with which to build a signal fire. The trailhead where we’d left the truck was only a two-hour hike away, but without a flashlight I was unable to traverse the steeply forested, snow-slick, north side of the mountain I was on in the dark. If I panicked I had no weapon to wave wildly at the night, no back door, no safety-net. Once darkness fell I’d move beyond the reach of any help and for the next eight hours or so, whatever came into my circle I’d have to face.

Which is exactly what I’d intended of course. Back home it seemed like such a good idea.

Struggling to control the impulse for white-eyed, foaming flight I forced myself to sit down on my sleeping bag facing west. I called on the desperation that had driven me up there in the first place and made myself watch, eyes unaverted, as the sun dropped towards the peaks, observed as the light around me faded and thinned—and in the process discovered something surprising.

You may not know this but it turns out night doesn’t fall. It rises. Shadows start at the bottom, puddling and pooling in the hollows and roots like water and then filling things up from there. Initially, I was suspicious as I watched the darkness climbing out of the valley towards me, enveloping each boulder, bush and bare spot in its path. But eventually some subconscious, nightmare expectation in my mind relaxed and I realized there wouldn’t be any eerie wailing or flapping of leathery wings, nothing with foul breath descending on me from above and behind. The big, bad dark was not coming to get me after all. On the contrary, as the night shadow rose higher the world grew hushed and peaceful, feeling—rather than a monster—more like some great mother coming to tuck her children into bed.

I watched as she enfolded everything in a calming embrace and when the shadow finally reached my toes I sat stock-still, observing the light that bathed me fade as the sun sank behind the mountains. Suddenly, I felt excited and couldn’t wait to change into my long underwear, brush my teeth, and climb into my good-to-15 degrees-below-zero sleeping-bag.

I zipped around and still had enough time, after climbing into my bag, to watch as the last rays of light disappeared from the higher ring of mountain peaks that surrounded me. Everything terrestrial was now encased in the beginning shadows of twilight but it would take a couple more hours for everything to move into full darkness. I lay there, looking up at the fading blue of the sky and realized that the shadow was still reaching skyward, enfolding even the air, molecule by molecule, and as I watched the darkness deepen in tiny degrees I began to tingle at the thought of seeing the stars.

Back in the Sierra Nevadas during the long nights of my survival training course, while lying there looking up at the brilliant, twinkling worlds spread out above me, I’d slipped into a state of quiet, serene delight. Feeling like no matter what happened everything would still be all right, that I was safe and cradled in ways that defy explanation. As the memories of those nights came flooding back I grew excited–couldn’t wait to feel that sense of well being again–but since I knew it would be a while yet, in the meantime I turned to gaze at the deepening shadows on the ground around me.

My enthusiasm swiftly unraveled as I watched the things of this world, the trees and mountain peaks, flitting birds, the carpet of dusty pine needles and stones, the three plastic water jugs and backpack I brought with me, disappearing into the gathering darkness. The horrified, creeping fear returned as I felt myself being cut off and isolated, stripped of everything familiar, and I began to wonder again if something would come out of that dark unknown to get me during the night–a cougar, a drunken hunter, a wave of bone-chilling cold, a demon. I frantically reminded myself of the stars that were coming as I turned my eyes back up to the deepening darkness of the sky.

And it was in that moment, as I lay trembling and unexpectedly longing for the darkness of full night to arrive, that I had my revelation. In a flash I recognized a truth that seems so obvious now but that I’d somehow completely missed.

Both the light and the darkness conceal and reveal. The light reveals the ordinary world around us. It gives us one another and makes everything seem smaller and more manageable, wrapping us in a bright and sunny cocoon because as mortals we’re tiny and fragile and need a sense of protection. But it conceals, too. It creates the illusion of a blue sky, a ceiling, a world that has limits and is safe and known and predictable.

It isn’t until night arrives that this seductive illusion of containment dispels. The darkness comes swallowing everything in its shadow, tugging us away from the usual daylight edges we cling to with white-knuckled fingers until there, in our moment of greatest fear and isolation, it tenderly unveils the larger truth…that we’re cradled, floating in infinity.

The insight was blinding. Even though it didn’t alter the basic realities of the situation–I was still all by myself out in the middle of nowhere exposed and trapped–it transformed the darkness from a terrifying, alien thing I had to outsmart and survive into a bringer of gifts and grace. I felt as though I’d reluctantly entered the enemy’s camp only to discover it wasn’t an enemy at all. It was an ancient, lovely world of starlit depths that had been longing for me, calling me home for years.

A decade of depression slipped away as I fell into an exhausted sleep and, when I woke back up again a few hours later, a twinkling universe stretched out above me. The soft radiance bathed me as I lay there and quietly wept under the steady, pulsing of starlight.

(Next week, the conclusion.)

copyright Dia Osborn 2010

When Not Quitting Is The Miracle

Posted by Dia in Living and Dying, Triathlon and tagged with agoraphobia, change, disabilities, Living and Dying, Miracles February 24, 2011

Thought I’d post a quick update on my mini-triathlon quest. There’s good news. Progress is now detectable. The trainer who adopted me at the YMCA is terrific, enthusiastic, and more importantly has learned to scale back her ambitions where I’m concerned. Her early training schedule with six days of alternating weights, running, bicycling, swimming, and stretching with a seventh of optional hiking has been revamped to three days of weights and running.

And I’m consistently hitting two of them! To the outside observer that may not sound like much…and the trained athlete of bygone days in my head would emphatically agree…but to the shell shocked depressive inside who’s spent the last six years floundering between seclusion and creeping paralysis, two days of successful sports training is definitely cause for celebration!

Honestly, I’m a little breathless at my biggest achievement to date…I haven’t quit. It hasn’t been easy. This whole thing has felt a lot like sailing along a treacherous coastline littered with underwater rocks. Each time I start to pick up speed, working out two or three times in a row on schedule, I think Aha! NOW I’ve got it. Now I can unfurl the sails and really fly! Then I hear that damn thud and scraping on my internal hull and suddenly, for the rest of the day, I can’t even leave the house.

Which means I have to keep starting all over again and it’s frustrating. Early on these frequent stumbles really scared me because I thought if they kept up, they’d eventually make me stop. But two months into the whole thing now and my confidence is starting to build. I wonder if this is what it’s like for an athlete who suffers a big injury and has to learn how to perform all over again with a new and different body. Only in my case, the injury was to my mind. Everything I used to take for granted…simple emotional discipline, mental focus, and freedom from chronic fear and occasional panic…is kaput, so I’m having to learn a whole different set of mental skills and strengths to compensate for it.

It feels good though, even if it’s producing some additional anxiety. The hardest thing by far is making myself go to the gym. You may not know this but gyms are very social places. Lots of active, purposeful, energetic people all striding and pumping and pulling on complicated, noisy, bewildering equipment. It’s like a ten freeway interchange with heavy traffic flows and well-orchestrated on and off ramps. Everyone else seems to know exactly what they’re doing and then here I am, an outed hermit dressed in frumpy, old activewear, newly sucked out of my hole and doing my best not to trip and fall off the treadmill (yes…I’ve done it once so far) or hold up the line of nice but impatient people waiting to work on the weight machine I’m currently tangled in.

So much for dignity. But in spite of everything I’m actually starting to feel individual muscles once in a while instead of the more generalized trembling and collapse I started out with, and the length of time I can run without walking is definitely growing. I even tried my hand at running on the track yesterday, instead of the treadmill, and I’m happy to report that I didn’t trip, run into anybody, or attract undue attention with all the extraordinary bouncing going on around my chest, hips, and behind. (The complex physics involved with fat on a jogging person is really something to experience firsthand, let me tell you.) I’m still trying to get a handle on the whole fashion element involved and have yet to figure out how all these women are wearing what amounts to tights with no…I repeat no…visible signs of underwear. Surreptitious observation in the locker room has only revealed one thong so far, so something else must be going on. The anthropologist in me is intrigued.

I’ll keep you posted.

In the meantime, if you’ve got an extra ten minutes, here’s an ESPN awards video telling the stories of two, physically-disabled athletes who have been changing the world. Jim MacLaren, who endured two catastrophic accidents that successively stripped him of his athletic gifts, but who went on to make his miracles anyway, died in August last year. But his inspiring legacy continues to grow through extraordinary disabled athletes like Emmanuel Ofosu Yeboa of Ghana. Seriously, if you want something that both puts life in perspective and inspires you to keep hoping, watch this.

Because sometimes just not quitting is the most amazing miracle of all.

copyright Dia Osborn 2011

A View From The Edge, Part I

Posted by Dia in Living and Dying and tagged with Depression, facing fear, medical paradigm, Oddities, the natural world February 18, 2011

It’s tax season and I’m buried. No time for writing much of anything but expletives on the bathroom wall, so the next few posts will be an excerpt from the book. I’d love to know what you think!

Chapter 5: A View From The Edge

Journal entry:

…I lay there on the hard ground in the cold and dark, peering up into a universe unimaginably deep, and watched as the stars shifted and flowed across the heavens. I was comforted—remembering I’m a part of something far bigger than just this ordinary, deeply beloved world. And it’s like that for me, again, in the dying world. Where I get the opportunity to peek out beyond this small life, if even just for a moment, at something that’s both so vast and yet impossibly, delightfully hidden most of the time–disguised by our bodies and abilities, memories and choices.

By everything we keep mistaking as ourselves.

With the advent of palliative and hospice care we’ve seen the first glimmers of change but, by and large, the modern, western medical paradigm still looks at dying as a failure and a waste. The metaphor I hear employed most frequently outside of hospice, by medical professionals, media, friends and neighbors, is that death is the enemy and all of us must wage a war against it. Either individually within our own, dear body or as a group using the big guns of scientific advancement and policy change. The metaphor of war is a powerful one, invaluable for generating the will necessary to marshal our resources for a single minded, all out attempt to get better–to survive and thrive as an individual or a society.

But what many don’t realize is that the cost of a martial metaphor is a high one. In a war whose sole aim is to preserve life, those who perish anyway die as casualties and losers.

It was always difficult to watch—the myriad ways this sense of failure manifested in the people I helped care for. Some felt bewildered and abandoned by a system that only seemed interested if there was still a possibility of cure. Others, that dying was their own fault and a punishment of some kind—because they didn’t get a second opinion, have more insurance, take better care of themselves, screen often enough or for the right disease. Some felt unlucky because they didn’t respond to the drugs or treatment the way they were supposed to. Others felt guilty because they’d just grown too exhausted and frail to fight anymore.

It seemed more than a little strange to me. Dying is already such hard work. Why in the world would we adopt a way of looking at it that actually increases the suffering involved? Perhaps it’s the natural outcome of our separating dying from life, of deeming the first as a terrible and monstrous thing and the second as our only sanctuary from it. Whatever the cause, an unintended outcome of focusing wholly on the protection and preservation of life—of regarding our natural transition into death as a sinister and horrible collapse—is that we’re unwittingly multiplying everything about dying we fear most.

It’s ironic. While the duration and quality of life have unquestionably improved over the last century, the quality of dying has been in a corresponding decline. All our efforts to delay and defeat death have unintentionally prolonged the process so that it now takes longer than ever. It involves new and novel layers of suffering caused by an ever-multiplying array of interventions, requires increasingly complex—sometimes unbearable–choices, and costs so much more that it frequently not only strips surviving loved ones of any remaining resources but leaves them crushed under a staggering burden of debt.

Over the years I noticed that frequently, especially in the case of a last minute referral, by the time a dying person and their loved ones washed downriver to us, we were among the first people they’d encountered who weren’t afraid of the mists gathering around them. Every good hospice team has a host of important jobs to do but one of the first is the simple act of trying to normalize what’s taking place, to convey in both words and demeanor that in fact, everything is still okay. We see and welcome whoever it is wholeheartedly because they are, regardless of what’s happening, still alive and vibrant and real. If there’s enough time, if they’ve been referred for end-of-life care early enough, that wild, spinning-out-of-control feeling people so often experience in the deteriorating pursuit of a cure has a chance to stabilize, allowing them to find firmer ground so they can return to the rest of their lives. It can make all the difference between someone fully embracing whatever time they have left or just gritting their teeth while sliding over the cliff.

I began to wonder if the transition from living to dying need be quite this traumatic. Could there be some way to weave the acceptance of dying still largely unique to hospice and end-of-life care into the branches of medicine which focus primarily on cure? I started casting about in my mind for a bigger metaphor than that of war I could employ, one that would contain both my longing and reverence for life as well as a deeper wisdom and regard for death.

Something that would not only arouse and inspire me to live but also reassure and cradle me when I die.

* * *

In the fall of 2001, after years of navigating the ups and downs of a deep depression, I decided to try a new and novel treatment option. I was nearly paralyzed again—all the diverse and multiplying anxieties that had flourished in me over time eventually consolidating into a single, more efficient terror of just leaving the house—and one day it occurred to me that I was at a threshold. I was either going to have to take some drastic, even reckless action to counter the trend or else surrender to life as a shut-in.

So the day my husband suggested that we hike into the mountains separately for a spiritual retreat, to spend three days and three nights alone with God at 9,000 feet in autumn during bow-hunting season without flashlight, fire, or food, something desperate leaped up inside me shrieking YEEEES! Cal had been doing this kind of thing for years, had invited me to join him every time he’d gone in the past, but somehow it never held much allure for me. So it took him off guard at first when I agreed–he thought I was just messing with him. But once he realized I was serious he became so excited that later, when I came to my senses, I didn’t have the heart to back out.

To be honest though, deep down I didn’t want to back out. I’d reached the point where the constant, chronic fear I was living with finally seemed worse than anything that could conceivably happen. It no longer sounded as bad to me; freezing to death, being impaled on a stray arrow, mauled by a drought-starved bear, trampled by a rutting, bull elk, falling off a cliff, going into hypoglycemic shock from lack of food, burning alive in a forest fire, being struck by lightning, buried in a snowstorm, or captured and toyed with in unspeakable ways by some caricature of a deep-woods crazy. Nothing I imagined anymore could possibly be worse than spending the rest of my life locked in the bedroom cowering under a blanket. It had become unbearable, losing access to everything I loved drip by drip, the slow suffocation of walls closing in. The time had come to summon all my fears to sit down in a circle with me–time to either break the back of the depression or die trying–and frankly, I didn’t care anymore which one.

It can be both a devastating and invigorating place to reach, the feeling there’s no longer anything left to lose.

Next week: Chapter 5 Part II

The Stars We Steer By

Posted by Dia in Living and Dying and tagged with Beliefs, change, Living and Dying, medical paradigm, Surprise, Talking about dying February 11, 2011

LH 95 star forming region of the Large Magellanic Cloud

The results are in from the thirty-seven people who voted in the poll, (hardly representative but enough for a tiny feel), and I’m both surprised and heartened.

But before I launch into that discussion, I wanted to thank everyone who voted, as well as everyone who tried to vote but couldn’t because of technical difficulties. There were a lot of you latter, I know. This post got about five times the number of hits as translated into votes so clearly, the glitch some of you reported was a big one. Bummer. I really wanted to know what you thought. I’ve recently been assailed by doubts about the value of what I’m trying to do with this blog and the eventual book, and I was trying to establish whether there was really a need for it or not.

Note to self: Learn more, much more, about conducting a casual poll.

And now to the results. Taking into consideration that the sampling was minuscule and the line of questioning was leading at best, I was still surprised to find that my suspicions were baseless. In spite of all the progress medical science has made over the last century, everyone who responded still sees death as the natural conclusion to our biological destiny. While there were those who thought our age span might be extended beyond 120 years, a few who thought we’d find a cure for aging, and some who thought disease would eventually be eradicated, nobody checked the Live Forever box. The proponents of Immortalism will undoubtedly be bummed, but it makes the job I’ve undertaken seem more feasible.

For those who didn’t know yet, I have an agenda here.

We all have our particular stars to shoot for and I’m no different. Mine involves trying to ease some of the unnecessary levels of fear I’ve seen around dying. I’m not gunning for ALL the fear mind you, because some of it is appropriate and perfectly healthy. It’s like a couple of people mentioned in their comments; the instinct to survive is in our DNA and, without the fight or flight response, we wouldn’t last long as a species.

No. What I’d like to target is the unnecessary fear. The excess. The bogey man part. The kind of terror that results from things like lack of education and unrealistic expectations, from misinterpreting symptoms to grossly underestimating our own strength. I want to tackle the kind of creeping, obsessive fear that arises from focusing on external, technological solutions which we often can’t control, to the exclusion of internal strengths that we can.

That last one was what I was trying to gauge with the poll. As a society, we’re dedicating our resources and faith to medical science at a rate that’s escalating geometrically, and I wanted to find out just how much faith. Because if most people are starting to believe deep down that dying is ultimately unnecessary then, honestly, there wouldn’t be much left for me to do here. The hope of living forever raises an entirely different set of fears about dying that I wouldn’t have a clue how to address.

If that was the case I’d be free to begin a whole new star-hunt.

However, thirty-seven out of thirty-seven people still believe that dying is biologically inevitable and, while it’s not universally representative, it’ll have to do. I’ll just assume that trying to ease some of the fear around dying is still a relevant and worthwhile goal to pursue after all.

Note to self: Possible things to talk about in future posts.

1) Cultivating internal resources like courage, endurance, gratitude, trust, humility, strength, inner dignity, etc., provides the most powerful fall-back position for when technological solutions fail. (Other options: Despair. Rage. Blame. Generally falling into the abyss.)

2) Cultivating the above also dramatically improves the quality of life before dying.

3) Instead of devoting all our attention to fighting over who’s going to pay for the viral growth of outside, institutional services, we can also look into designing and building closer, committed homes and communities where it’ll be easier to help care for one another.

4) Before we pour our hearts, souls, and tax dollars into more of the bitter, divisive legislative battles raging, we could first try to weave a constructive, workable meaning for suffering to help us navigate with a little more grace. (Of course this would require courage, trust, humility, etc., which brings us right back to the practical uses of number one.)

I know there’s a way to die that isn’t as scary as most people think it is. I’ve seen it. I witnessed a variety of ways to navigate the process that not only make it less devastating for the person who’s dying, but actually helps buoy and heal those who have to pick up the pieces afterwards and carry on. I just need to figure out if there’s a practical way to communicate what I learned to anybody else.

That’s my star.

Poll: Do You Think Medical Science Can Someday “Cure” Death?

Posted by Dia in Living and Dying and tagged with Beliefs, Life, medical paradigm, Pharmaceuticals, questions, Talking about dying February 8, 2011

Update: There was some confusion about where to find the poll. Bad post design. Sorry. I’ve now moved it up to the top. Please click on all the answers that seem true to you.

This week, my friends, I’d really like to get your input on something.

The other night, as I was watching the usual parade of age-related drug and medical commercials during the evening news, (the target demographic for network news is pretty unmistakable these days,) I thought I heard a subliminal message running throughout. If I’m hearing correctly, it’s an oblique, unspoken promise to the general population that goes something like this:

If we (i.e. medical scientific research) can find a cure for aging and disease, then nobody will have to die anymore.

Is it just me, or is there an unconscious (conscious?) expectation being fostered in our public awareness that someday death will be “cured”?

Do you think death is curable?

In order to take a broader pulse, I’ve developed this brief, informal poll. (Here’s hoping it works. I’ve never done a poll before.)

If you wouldn’t mind, I’d really appreciate your taking a moment to answer. In fact, if you wanted to invite anybody else to take this poll, too, well that would be just dandy. There are various ways to share the link below, or you can always cut and paste the URL yourself.

The more the merrier.

And if you’re as curious as I am to find out if there’s a real paradigm shift taking place (i.e. we’re starting to believe en masse that we don’t have to die) there should be a tab at the bottom of the poll you can click on to see the results so far.

I know the possibilities I’ve provided are pretty limited, so if you have an insight that doesn’t fit in to any of the choices provided, feel free to expand in the comment section. I’d really like to hear what you think. This is driving me nuts.

Thanks.

A Dream of Her Dead Beloved

Posted by Dia in Living and Dying and tagged with Decline, Oddities, Relationships, wonder February 4, 2011

image by Salvatore Vuono

I arrived at a patient’s house one morning to be greeted by the news that Adelle, 104 years-old, had seen her husband last night in a dream. It was a vivid, full screen, Technicolor kind of dream that she couldn’t stop talking about once she woke up. Father of her children, love of her life and dead for over 40 years, she told me how healthy he looked in a tone of mixed surprise and delight, her face luminous with a happiness I hadn’t seen there in the year I’d helped to care for her.

Usually, she didn’t remember her dreams—in fact she was remembering less and less of just about everything. Nearly blind and almost deaf, her retreat into the chambers of stillness and shadows had been recently accelerating. We’d all noticed. The complex web of threads that had once moored her here to the people and places she loved was unraveling, while her physical senses, whose job it had been to reach outward and connect her to the things of this world, were now reversing and cutting her off. Spinning closer and closer around her like some kind of growing cocoon.

A shower fog thick with shimmering and whispers slowly curled around us there in the bathroom as I toweled her dry.

It was like nothin’ I ever seen before she confided softly and I felt a little breathless myself at the strange radiance lighting her face. Her words helped lift a growing load from my heart. She’d been turning inward, slipping away from us to struggle alone across the borderlands for so long that I was relieved she was finally coming within reach of the other side.

Adelle lived a long, clean, healthy life and her heart, while ancient, was still strong and vital. For over a hundred years that had been a good thing. But now, as the rest of her body was slowly grinding to a halt, her persistent, tenacious heart had unexpectedly become a liability. It was yet another of those odd reversals that take place in the dying world—how good health can turn out, at the end, to be something unlucky. I saw it a few times in those with unusually strong physiologies. There was a man with the strength of an ox whose cancer advanced to a degree of horror before his heart finally (finally!) gave out. And another woman centenarian whose muscular control and mind had long since failed but whose heart (Oh, fabulously strong, pulsing, galloping heart!) continued it’s pounding on and on.

It puzzled me, how one organ could be so oblivious to the fact that its fellow body parts were dropping around it like flies.

Or, even more bewildering, why we would step in and medically intervene with a heart or any other body part that was paying attention and trying to shut down. Propping them up with the brilliant science and medicine we’ve developed over the decades and thereby unintentionally furthering a degree of suffering that was never naturally intended, aggressively slamming shut every other door that offers a kinder and more timely exit.

I’ve been viscerally struck by the dear and true friend that various acute diseases turn out to be as we decline and fall apart. Even with as miserable as things like diarrhea, flu and bacterial infections are in the short term, they can save us from an equally miserable and far, far longer dying process.

Adelle was blessed with an extraordinary heart. She was the last of her generation by a long shot, and now longed to catch up with those who had gone ahead…more than ready to leave but forced to linger on and on. I don’t understand, in the grand scheme of things, why her journey entailed the extended suffering that it did and it’s not my job to judge it in any way. (Thank god.)

But I’d grown to love her and in my heart I couldn’t help but feel she’d endured enough…enough joy and grief, love and loss, strength and pain, enough long, long life. She was ready to go and as far as I was concerned she deserved to. She’d earned it.

I was glad her beloved had come.

Van Gogh