Writing Into The Dark, Muddy Holes

Ach.  I’m wrestling with a painful, scary part of my book right now and it’s hard slogging.  It involves writing the story of some early violence in my life and feels a lot like Brer Rabbit wrestling with the Tar Baby.  Sticky stuff.

So far every time I reach for the memories I feel like one of those old-time Mississippi fisherman going after catfish in the river bank.  Back in the day they used to swim down through the murky water to the holes in the mud where the catfish hide, then they’d stick a fist in.  If there was a catfish in there, and if it wanted to eat (but catfish allus wanna eat) it’d swallow that fist whole and not let go again till the fisherman pulled it out of its hole and all the way back up to the surface, just a-dangling off the end of his arm like a long, slimy hand.

Dinner served.

But sometimes…sometimes…a man would hook one of the old giants and then there’d be hell to pay.  Too big to pull out of its hole with a mouth too strong to break free of, the tables would be turned.  Oh, that unfortunate fisherman would struggle for a while to be sure, but in the end his thrashing would slow and stop and his body’d just float there in the current, bumping up against the bank from time to time all white and wide-eyed, like it was so surprised it was now the property of Ole’ Man River his self.

These memories of violence are like one of those old catfish giants and I have to be real careful swimming that deep.  I know which holes are theirs, down at the very bottom and darker than all the rest, but I also know that if I do this right, if I’m brave and smart and catch ’em to where they have to give me a gift to make me let ’em go, then they’ll make me not be afraid anymore.  That’s all I want.

So how do I perform this mythical feat?  How do I catch ’em?  That’s where the vast power of language comes into play.  The events themselves, those sudden and brief eruptions of rage and violation that happened so very many years ago now, are long dead.  But they set their stories loose in my life, dark tales feeding and growing down in their holes.

I need to reshape and retell these stories.  Need to put them into harness and make them work for me instead of against me.

Namazu and Kashima from Japanese mythology

It was the dying who tried to teach me how to do that and if I can just get through this first part of the book and finally reach their stories…their luminous, beautiful stories…I know it’ll get easier.

copyright Dia Osborn 2011

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Preventive Cancer Screenings: “Serpentine Shel! Serpentine!”

I talked about the terrible experience we had last year as the result of a false positive PSA test for the hubster in the post False Positives Are The Tenth Circle of Hell.  Since then, I’ve been following closely as the U.S. Preventive Services Task Force tackled the question of whether PSA tests do more help or harm and am am not surprised that, today, they announced the answer is harm.

There’s an opinion piece in CNN.Opinion today, by Otis W. Brawley, chief medical and scientific officer of the American Cancer Society and professor at Emory University, where he eviscerates the practice of mass screenings for PSA that has become the gold standard.  Particularly chilling is his memory of a discussion he had with the marketing executive of a major American hospital fifteen years ago who was explaining his lucrative “prostate cancer business plan.”

As he explained it, for every 1,000 men over age 50 who were screened at the mall, 145 would have an abnormal screen, and 135 would go to his hospital for evaluation. Fees collected from them would easily cover the cost of the free screening event. About 45 in that group would have cancer; the rest would be false positives.

The marketer had figured out how many men would be treated with surgery, radiation, and hormones. He had estimates of all the money the center would make from treating all 45 cancer cases. He knew how many men would be treated for urinary incontinence, and what his net profit for treating that would be. Amazingly, he even knew how many of the men would want penile prostheses surgically implanted to treat their impotence.

I asked him one question: “How many lives will you save if you screen a thousand men?” He looked at me as if I were a fool, and said, “Don’t you know? No one knows if this stuff saves lives. I can’t give you a number on that.”

I’m keenly aware and deeply grateful that the adverse effects of this test on our lives were relatively small.  An invasive and potentially dangerous biopsy is as far as it went.  There are a lot of men out there (about a million) who fared worse.  I’m also aware that with a family history of the disease, the hubster is at higher risk than the average man and a false positive on the last test doesn’t mean he’s now bullet proof.  Future PSA tests are by no means off the table but they’ll be approached with more caution and far better reasons in the future.

What makes me so angry is that the considerable risks involved were either not explained to us fully or glibly dismissed before the hubster obediently began the regimen of annual PSA testing.  Pretty much all we heard for two decades, in the media and in doctor’s offices, was the mantra-like assurance that it saves lives, this in spite of the fact that there was no direct clinical evidence to support that claim.  It blows my mind that the first clinical trial suggesting that PSA mass screening does save lives wasn’t published until 2010, and even then the trial had internal inconsistencies that make it suspect.  From Otis Brawley again:

 It showed screening saves lives in the Netherlands and Sweden, but not in five other European countries. Even the positive parts of that study did not show a considerable increase in lives saved.

It makes me wonder what really drove the push for mass screenings over the last twenty years?  The above mentioned hospital marketing executive springs to mind.

The good news is that everything we went through with the hubster’s PSA false positive broke trail for my own more considered, skeptical, research-laden approach to the mammogram alarm I received shortly thereafter.  Before the PSA fiasco I, too, would have obediently returned to the hospital for further scans and a probable biopsy (considering the incredibly vague nature of what was flagged on my original scan.)

But because we were already once burned, I dug in and started looking for more information.  I discovered that with all factors considered I’m actually in the lowest risk category for breast cancer, that an “architectural distortion density” is basically a last shotgun-scatter call for a radiologist practicing defensive medicine, that the rates of mammogram false positives range anywhere from fifty to eighty percent depending on who’s talking, and that no less than five different factors put me in the highest risk category for a false positive diagnosis.

I also learned that once a woman has one false positive, her mammograms are at much higher risk for being flagged again, and that women with false positives receive more diagnostic scans and resulting radiation exposure than women who actually have breast cancer.  Add to all that the fact that the rates of antibiotic resistance infections received in clinical settings are increasing at a clipping pace, and I decided that a biopsy should probably be avoided if at all possible.

Weighing everything I learned, I eventually realized that if I adopted a watchful waiting approach, the odds were in my favor for a good result.  I was right.  After waiting for eight months I finally went back for a follow-up mammogram that could be reasonably compared to the first one, and the new scan was deemed clean.  Nothing had changed indicating nothing was growing.  I was satisfied.

Granted, as a depressive, I still lost most of last year to the threat of slipping into another episode from all the stress and anxiety, but at least I managed to avoid most of the physically invasive fall-out.  And for last year at least, that was enough.  However, in the future I’ve decided not to pursue annual screenings unless I find a lump.  For me, the risks outweigh the benefits.

And that’s the main takeaway I’d like to offer with this post.  Each person is completely unique and there is no medical screening, procedure, or treatment out there that is a one-size-fits-all solution.  On the one hand, be skeptical.  Ask questions.  Do research.  Learn from past mistakes.  Make educated choices and, if your doctor doesn’t provide you with all the information, then go out and get it on your own.  Whether you’re confident in the continuing value of PSA tests and mammograms or not, make your own decisions based on what you feel is right for you.

But on the other hand, respect and support the directions that others are exploring, too, even if they’re different directions than you would take.  I felt mostly alone last year, trying to figure out what to do, because almost everyone I tried to talk to went straight to an expectation of the worst possible outcome.  I could see it in the back of their eyes, that dark flash of terror like they were looking at a woman who was about to be dead because she wasn’t doing what she was supposed to.

I’m not anti-preventive screening.  Far from it.  A pap smear in my twenties probably saved my life and, even with all the other chaos going on last year, the hubster and I both still got our colonoscopies.  But honestly, most of my preventive energy and attention goes into how I live because after working around the dying I finally got it, how little power we’re ever going to have where death is concerned.  I don’t want to waste the precious little time I have tilting at windmills.

I’d rather just live openly with death as my inevitable companion.  I’d prefer to amble around, and graze, and play, and explore the meadow of my life, relaxed and peaceful…and then die…rather than trying to zig zag back and forth across it (Serpentine Shel!! Serpentine!), bent over through the grass trying to hide from it all the time…and then die.

Because that’s exactly what I felt like last year; Alan Arkin trying to dodge bullets in the original The In-Laws.  And pooh on that.  I remember again the wisest thing my father…a grizzled, old warrior with a couple of gruesome wars under his belt and a vast experience of death…ever said to me:

Dia, if it’s your time to die then it’s your time to die, and nothing’s gonna save you.  But if it’s not your time to die, then it’s just not, and there’s nothing out there…nothing…that can kill you.

As a parting gift, here’s one of the funniest movie scenes of all time: the serpentine scene from The In-Laws.  Watch it and weep.

copyright Dia Osborn 2012

Part VIII: Advance Directives: Dying Inside Our Big, Hairy Healthcare System

(Continued from Part VII: Advance Directives: Ours.)

Giants and Freia by Arthur Rackham

Turns out there’s a huge, third party squatting in the room with us, as we wade through our advance directives.  It’s our healthcare system.  We didn’t realize until now what a disproportionate influence it wields on our choices about dying and I’m struggling with some real sadness about it.

We discovered that the choices we’re making today are different than the ones we’d be making if we were either very wealthy or had access to universal health care.  

The unsettling truth is that we’re both opting to die a little earlier for reasons of cost and care burdens.  In our current healthcare system, dying could cost so much for medical intervention and help with day-to-day care, that it could easily leave whichever of us was left destitute and/or with broken health.  It’s happening every day to people just like us…middle class with decent insurance (I saw a couple of tragic examples when I worked with hospice)…and the hubster and I simply refuse to do that to one another.

I had a very hard moment the other night when I suddenly realized I wouldn’t mind so much, lying in bed for months or maybe even years, slowly declining while looking out the window at my beautiful garden, as long as I could still write and visit, study and learn, meditate and muse.  It surprised me.  I’d always thought if I couldn’t hike, escape to the mountains, garden and swim anymore, that I’d be done.  I had no idea that I could still be happy without those things…if only the burden of care was spread across the shoulders of enough people to protect them all and care for me well.  If only we were wealthy and could afford to hire them.  If only our healthcare system was universal…and actually helped with home care to begin with (which it doesn’t.)

For the first time I realized I’m not so much afraid of being disabled as I am of destroying the people I love with the burdens of my care, or of being cared for negligently in an institution somewhere (I saw too many tragic examples of this), and I experienced an unexpected and poignant wave of love and deep longing for my life.

On the one hand, I’m irrationally wishing we were born in Canada, or England, or Cuba instead…some country with universal healthcare that cares about all its people equally.

On the other hand, I say irrationally because I know that if I turned Fate loose for a do-over like that, we might just as easily have been born in Bangladesh or Somalia.  Some other country where dying can happen even faster.

I suppose there’s no useful purpose to be had in bemoaning destiny.  The hubster and I were born in this country, we’ve lived here all our lives, and this is where we’ll die.  And to tell you the truth, we don’t really want to die in another country with better healthcare anyway, even if dying here could come earlier and suck more.  We’ve loved our lives here.  This is our home and no country is perfect…a corrupted healthcare system just happens to be our particular Achilles heel.

So yes, all things considered, it’ll be okay if we wind up dying a little earlier here than we would if we were living in an ideal world.  I guess comparing our situation to perfection isn’t the best idea.

(Next the conclusion: Part IX: Out of Town And Back Again (With Advance Directives In Tow)

copyright Dia Osborn 2011

Unthinkable? No, Dying Is Perfectly Thinkable.

living will

The Los Angeles Times posted an excellent article by Steve Lopez last month discussing the urgent need we all have to not only discuss our wishes with those who are likely to make them, but codify those wishes in written and legal form.  For anyone who’s been thinking about doing so but is unsure how to proceed, please take a look.  It has links to some great resources that might help.

There’s only one thing about the article I took issue with; the title.  Having To Think About The Unthinkable.  Because it reinforces the wrong but tenacious belief in our oh-so-death-averse culture that dying is an unthinkable (not to mention unspeakable) topic.

That’s just not true.  Dying is totally thinkable.  In fact, collectively, we do it all the time.  I do it.  So does everyone who works with hospice and palliative care.  So does everyone who’s currently dying, and all the people that love them.  So do elders who are fast approaching, people who get questionable results on scans, and those who experience a close call in a plane, on a highway, or in a hospital.  Anyone who follows the news is exposed to reports about dying every day, and a movie about dying called Final Destination was seen by so many people, so many times, that it spawned three sequels and made its makers hundreds of millions of dollars.

In fact, our tendency to secretly think about dying a lot is at the heart of our entire preventive health care system. No one in their right mind would consent to (much less insist on) the discomfort, indignity, potential danger, and expense of so may foreign objects poking our veins, irradiating our tissue, and probing our various holes without the thought of dying as a strong motivation.  So, no.  The idea that dying is unthinkable is a total myth.  Not only is it perfectly thinkable, there’s a respectable portion of the population secretly doing it at any given moment.

What I’d like to do is encourage everyone to think about it more openly.  Because keeping all those thoughts and fears chained naked to the floor down in your seriously clenched gut only serves to make the prospect of dying more frightening, not less.  Trust me on this one.  Dragging the monster out from under the bed where you can negotiate with it and set up some ground rules is a very, very good thing to do. 

Okay, yeah.  I’m gonna die.  You win there.  But this is how I want to do it; no tubes, no persistent vegetative states, no bankrupting the family and leaving them destitute.  However and whenever you decide do this buddy, I want to minimize my own suffering as well as the suffering of my loved ones.  This is important to me.

I think a lot of people don’t realize that death is absolutely fine with that.  Contrary to how it’s portrayed in Final Destination, death is a neutral force, not a malevolent one.  It doesn’t want us to suffer and it doesn’t care if we take steps to prevent that from happening.  It leaves full control for how we navigate the process to us.  It’s like kayaking.  We can either take time to study the river beforehand and craft an intelligent plan for those class 5 rapids with a forty-foot waterfall at the end, or we can fall into the boat backwards and wing it.

Which ride would you rather be on?

Death is like the river.  It doesn’t care about the quality of our ride, it’s only job is to sweep us downstream.  The rest is up to us.  And if we decide we’d rather do it with foresight, skill, and courage?  Then our relationship with the dying process is transformed from a catastrophe into a partnership and the gifts of that–the power, dignity, strength, love, sacrifice, generosity, and surrender it generates–remain long after we’re gone to help those we love recover and return to a full life.

Thinking and talking about dying, long before it happens, is well worth it.

Here’s a link from the article that has an excellent guide on how to have a conversation about end-of-life-care wishes with your loved ones. (You can use it as a starting point to have a conversation about it with yourself, too.)  And to download a copy of your state’s Advanced Directive, here’s a link to a website called Caring Connections which has a wealth of other information as well.

And because I mentioned kayaking, here’s the trailer for The Halo EffectIt includes some unreal footage of kayaking elite and waterfalls.  The opening narration tries to explain why these guys do what they do and is worth a listen, but if you just want kayaking footage, it starts at 1:00 into the trailer.  It’ll knock your socks off.

copyright Dia Osborn 2012

TRUE OR FALSE? “Talking about dying will kill you.”

FALSE.  Talking about dying is non-toxic and perfectly safe for all ages.

I hit this wall a lot though, because deep down the majority of people believe it’s true.

In polite company, when it comes up that I’m writing a blog about…well…the “topic” (maybe if I don’t say the word, you won’t run)…I usually get a blank stare, long pause, and visible squirming, followed by an abrupt change of subject. Some people even turn around and walk away without saying a word.  (Which I admit makes this topic a valuable extraction tool in a pinch.  For anyone seeking to escape a chatty person, its eerie power of repulsion does have uses.)

In any case, there’s rarely an opportunity for a follow-through discussion.  The conversation is dead before taking its first breath and, so far, this hurdle has stumped me.  That’s why I spend so much time poking around the carcass in my mind afterwards, trying to find another angle which might induce more people to join me.

For instance this morning I was chewing on the common question; I’m not dying yet.  No one I know is dying yet.  So why should I think about it now?

This, of course, is the unstated question behind most blank stares and…I’m not gonna lie to you here…it’s a good one, possibly the most important question of all.  In spite of my flippancy, I fully understand why people don’t want to have this discussion: Talking about dying is a courageous act.  In order to do it, you have to stop running, turn around, and face the very monster that IS someday going to kill you and all your loved ones.  Let’s face it, as conversations go, it just doesn’t get much braver than that.

So when I broach the topic to someone who’s half-dressed at the next locker, or trapped next to me for three hours on a plane, or suddenly choking on their turkey over Thanksgiving dinner, I understand their reluctance.  I do.  I realize I’m asking them to start thinking right now about a real-life horror flick that at best they can delay, but will never escape.

Which brings me back to the question, Why should they?  The reasons had better be compelling.

Well they are.  And actually there’s just one:

It’s so they don’t have to spend their whole lives dragging the deadweight of this secret dread behind them.  Once a person learns how to talk comfortably and freely about dying, they can finally stop looking over their shoulder and relax a little. Living every hour, every day, year after year, with a yawning, existential, chronic fear…even if it’s kept pinned down in the subconscious most of the time…is draining and toxic.  Denial can help for a little while, sure, but ultimately it has huge downside.  Huge.  Trust me on this one.  As a long-time phobic I know.

Courage is a far better option and, while it’s harder to muster initially, it makes up for it by having no downside.  None.  In fact, courage not only eases the fear around talking about dying, it actually makes the event itself a whole lot easier to deal with when it finally arrives.

So when I grin at a 31-year old cashier and say Hey!  What do you think about this whole dying thing anyway?  It’s not because I’m the Grim Reaper’s administrative assistant trying to schedule an appointment for her.  It’s only because I’d like to ease some of her fear about the whole thing.  I’m willing to stay and hold her hand.

Facing into any fear shrinks it, and facing into this fear–as early in life as possible–can improve every day that follows in a way that most people don’t even know is possible yet.  I mean, how could they know when nobody ever talks about it?!

Sheesh.

So, what would make you more likely to stick around and have this chat?  If I said:

1)  I write a blog about dying.

2)  I write a blog about talking about dying.

3)  I write a blog that can help ease your fear about dying.  (Actually, is that even true?  You’ve read this.  Are you less afraid of dying now?  More afraid?  Unchanged?  Are you at least more willing to talk about it?  Are you even there?  Hello?  Hello?)

If anyone else has ideas about how to broach the topic of dying in a way that doesn’t repel everything within a hundred yards, I’m totally up for suggestions.  (And please don’t feel you have to be serious.)  Comments are even more welcome than usual on this one.

Thanks.

copyright Dia Osborn 2011

P.S.  The terrifically fun photo above is from Ambro’s Portfolio.

Maybe I’m Just Dreaming Here…

In ordinary, everyday life, things look ordinary and everyday.  They just do.  Days tend to go the way we expect them to which makes life comfortable, predictable and…let’s face it…easy to take for granted.  Abundance is one of the things that breeds this kind of carelessness.  When it looks like we still have an unlimited supply of tomorrows it can make what we do with today seem unimportant.  Less urgent.

Which isn’t true of course.  Every last thing we ever do from taking a breath, to grumbling about chores, to graduating from college, to losing a job, to giving birth, to getting old, to dying, is an irreplaceable, priceless gift of life on a long chain of irreplaceable, priceless gifts.

But the illusion that any given moment doesn’t matter can be powerful and, when I think about it, perhaps not altogether unnecessary.  After all, it could be hard to get stuff done if we were face down on the floor all the time, incapacitated with the kind of wonder, longing, and gratitude for life that often comes to a person when they learn it’s their time to die.  I mean Big Awe can be fabulous, for sure, but it’s not terribly practical when you’re tackling a to-do list.

And yet, I do so love that feeling of dawning wonder.  Those moments when I look at my life and realize (for a mind-blowing, gut-wrenching moment) just how fragile, miraculous, and brief all this is.  Oh sure.  Those moments tend to wreak havoc with my daily routine because after a glimpse like that I want to slow down and savor everything.  Even things like taking the trash out and wiping under the rim of the toilet bowl take longer because crappy though they are, they’re suddenly glowing, like everything is glowing, and it’s really distracting.

But this spike in inefficiency is worth it to me because, for however long those moments last, I’m not afraid anymore.  Of anything.

Look.  I realize that dying is generally held to be a morbid subject and I know it’s odd for me to want to talk about it as much as I do.  But I can’t shake the hope that if I could just capture a couple of those brief and luminous moments in words, that maybe somehow it might help ease some of the deep, unconscious fear somebody else has, too.  That maybe if some of the general, widespread terror could be alleviated, our lives and relationships with one another might be transformed today, long before we ever have to face dying ourselves and embark on our own journeys.

Of course this is probably just a pipe dream.  Most likely, everything is perfect just the way it is and I should just be quiet and garden instead.  Dying is probably a reality too big to cope with in everyday life, too vast and searing to look at until we’re right on the brink of falling in.  Maybe we’re supposed to just forget, fall asleep and live in the dream of small, safe things until the yawning maw opens wide to swallow us at the end.

But then again…maybe not.  What if there’s no law ordaining that we have to wait until we’re actually dying to glimpse the strange, revealing light it offers?  What if the rules are more flexible than that?  What if it’s perfectly okay, even good, to look around us sometimes with transformed eyes while we’re still healthy, happy and whole, so we can see once again, however briefly, just how huge, beautiful, terrifying, priceless, miraculous and brief this life really is?

What if, however impractical or inefficient they might be, moments of heartbreaking wonder were actually good for us?

copyright Dia Osborn 2011

When extraordinary forces act upon mere humans beings (even if we don’t want them to.)


NASA photo: Solar particles interacting with Earth’s magnetosphere.

Nine times out of ten when a person found out that I worked with hospice they’d stare at me wide-eyed and say I could never do that. But I was never fooled by this.  Of course they could.  Anybody can.  Bathing, dressing, and toileting are not rocket science.  They don’t require rare tools or four hands.

I always knew what people really meant was I never WANT to do that…a sentiment which, while perfectly normal and near-universally shared, is irrelevant.

Life is full of things we don’t want to do but at some point wind up doing anyway.  And sometimes, much to our surprise, when the time comes we wind up doing them gladly.  It’s important to remember that, no matter how skillfully we hide, sooner or later we’re probably going to be dragged back out of our hole and plumped down beside the death bed of someone we love anyway.  And once we’re there, yes, of course we’ll be as rumpled, wild-haired, and sleep-deprived as everyone else who ever sat by a death bed before us.

But here’s the thing.  With as hard and devastating as it’s likely to be, we’ll also probably experience that same unexpected, fierce moment when we completely forget about how we never wanted to be there, because all we now feel is a throbbing, shattering gratitude that we are. That we get to hang on for dear life to their hand one last time and whisper how deeply, how much, we will always, always love them.

Y’know, there’s nothing wrong with the profound and irreparable wounding that comes to us through our great love for one another.  Far from it.  This wounding is essential and deeply human.  We’re supposed to be dragged under and scarred sometimes.  It’s a big part of what helps save us from the aching emptiness of a shallow life.  I’m not trying to mislead anyone here—all beauty aside, dying and its accompanying losses tend to be brutal for everyone involved.

But I’m telling you, somehow every single person I worked with went right ahead and navigated the journey anyway…and I can’t begin to tell you how much that one, simple fact floored me.  At first I couldn’t quite believe it.  Then later, as I watched each one of those ordinary, average, regular, everyday people negotiate an event with a destructive power equal to any earthquake or solar flare, I experienced a growing sense of both wonder and indignation.

Wonder at how infinitely much stronger we are than I’d previously understood.  And indignation that somehow, somewhere along the line, I’d been lead to believe we weren’t.

copyright Dia Osborn 2011

The Worst Kind of Natural Disaster

With Japan’s ongoing crisis very much on my mind right now, I’ve been thinking a lot about natural disasters in general.  Most regions are vulnerable to some kind of disaster and, usually depending on how recent the last one was, the people who live in them wind up developing both a deep-seated fear about theirs and an emergency plan to help them survive it when it comes.

When I lived in Iowa I always had an ear cocked for the wailing of tornado sirens at the onset of a violent storm.  In Southern California I dutifully bolted bookcases and water heaters to the wall in case of a possible earthquake.  In Hawaii as a youngster I learned all the warning signs and action steps for surviving a tsunami, and living in Idaho today the hubster and I have supplies and an evacuation plan set up in case a catastrophic fire ever sweeps through our neighborhood (as one nearly did last summer.)

This basic disaster reality is everywhere.  The Gulf coast has hurricanes, the communities along the Mississippi river are prone to floods, Boonville, New York gets buried under record snowfall every year…

a bad year

and North Dakota see wind chills in winter that can equal the flanks of Mt. Everest.

But in Quinault, Washington, where we just spent a week at the southern end of Olympic National Park, I witnessed the residents living with a niche type of natural disaster that’s particularly unique.  These people live with the ever present danger of falling trees.

No.  Wait.  Let me rephrase.  Falling big trees.  Huge.

The tiny community is nestled in the Valley of the Giants, so named for the towering Douglas firs, western hemlocks, western red cedars and sitka spruces that fill the valley.  These behemoths are spawned by the twelve to fifteen feet of precipitation the area gets each year.  (That’s right.  I said feet.)  In fact, the Quinault Valley is home to six of the largest living trees of their species on record.  Short of the sequoias and redwoods farther south, trees just don’t get a lot bigger than this.

Me in the middle, standing on the root of a Sitka spruce that’s over 1,000 years old.

In other, dryer places trees are considered large if they reach a hundred feet.  But around Quinault, a hundred feet is just the point where branches start on the older Douglas Firs.

What it felt like in there.

It was like time traveling, walking around under a fern-laced, moss-draped canopy like that.  The light is filtered, soft, green, and primeval.  If you ever doubted that water is indeed life I highly recommend a visit to this place because wandering around the area was like watching the life cycle in hyper-drive—bursting, spurting, reckless growth delicately balanced with every conceivable form of sagging, creeping, bulbous decay.  It was heady stuff, and fascinating.  A wee bit unnerving at times but utterly breathtaking, too.

It changes one, being underneath it for a while.  I’m not quite sure how, it just does.

Anyway, apart from their staggering beauty these giant trees have a lesser known, scarier quality.  Because most of the ground water in the rain forest is contained in the top three feet of the land, that’s as deep as their root systems grow.  Horizontally, they spread out over mind boggling distances, but vertically, they don’t bother because there isn’t anything they need down there.

But wait, you might think.  What about stability?  Don’t they need deeper roots to keep them from falling over? Well, that seems logical enough if you’re thinking like a human.  Our species lives by the belief that surviving to the oldest possible age is a valuable goal.  But the rainforest trees of the Quinault Valley have a completely different agenda which includes eventually toppling over while they’re still alive and relatively resource rich.  Because if they don’t, new, baby trees won’t be able to grow down on the forest floor.

You see, the reason most of the ground water is held at the top is because there’s a three-foot thick layer of moss and fungus lying between the air and the earth.  This layer serves as a sponge and can hold a tremendous amount of water (which, trust me, is necessary in a place that gets twelve plus feet of it a year.) But there isn’t as much in the way of dirt and nutrients available in this layer so seeds falling to the ground have little chance of putting on significant growth without some kind of additional support.

This is where the falling trees come in.  Not only do they provide an elevated surface, but as they settle and begin to decompose all the nutrients and other resources stored in their wood become available, so seeds falling on their trunks and branches have everything they need to get a good start in life.  These fallen trees are called nurse logs because they literally become giant nurseries for the future generations of forest life.

A fairly new mom.

Below is a picture of what the middle stage of a tree’s growth looks like.  This is an initially successful Douglas fir with roots working down the sides (of a nurse stump in this case) to establish themselves permanently in the forest floor.  I’m not sure why all the moss and other growth was stripped off here…kind of disturbing actually…but it reveals the process.   Sorry the photo’s a little fuzzy but this was taken with a camera phone.

And finally, here’s a photo of the bottom of an older tree after the original nurse log has completely disintegrated.  It was fascinating to see how all the big trees had multiple “legs” at the bottom like this.  This is what those skinny, snaking little roots grow to look like years later.

I admit, the generosity built into this kind of life cycle takes my breath away.  I love the idea of elders giving back everything they’ve managed to collect and contain over the years to nourish the younger life just getting started.  It makes more sense to me than the way it’s so often done in the human world, where increasingly our resources are directed toward the aging and children are left to bear the brunt of the resulting scarcity.

So, getting back to the original narrative of a falling-trees-natural-disaster, what is it that eventually knocks these gigantic puppies over?  Well, there are hurricanes that come in off the Pacific ocean periodically and the winds they generate knock down trees.  Small hurricanes take out smaller trees.  Medium hurricanes take out medium ones.  Big hurricanes knock over some of the big ones.  And then every hundred years or so you get a monster hurricane, and that’s when the giants can start coming down.

The last monster hurricane hit in December of 2007 and it just so happened that the hubster and I showed up in Quinault a scant three months later for our first-ever visit to the rain forest.  Driving into the area we had no idea what had just happened.  Strangely, there was almost no mention of the local impact of the gale in regional news coverage at the time, which seemed really strange considering the extent of the devastation both to the forests and the human communities along this stretch of coast.  (I imagine that, because it’s a rural area, there weren’t enough people impacted to be considered newsworthy.)

We couldn’t figure it out at first.  Driving up the coast from Oregon on our way to Quinault we noticed that a significant number of houses and buildings in every coastal town we drove through had extensive roof damage.  Blue tarps covering big holes were everywhere.  Then, as we turned inland, we drove past entire hillsides that looked like some kind of huge buzz saw had gone through.  In these places, literally all the trees were snapped off midway, like matchsticks, every single one, but we just figured the timber industry had come through and done a really shitty job of clear cutting.  (Sorry guys.) It wasn’t until we checked in at the Lake Quinault Lodge and started chatting up the locals that we learned about the real nightmare.

Evidently they’d had no warning in Quinault.  The local Forest Service had mistakenly forecast 50 mph winds for their area so everyone assumed they were looking at an ordinary storm.  They made no additional efforts to prepare for what was actually coming.  When the strongest winds hit, (sustained 100+ winds for about twenty minutes or so) some said it sounded like a fleet of jet airliners were all coming in to land simultaneously.  Others just described the sound as deafening. They all remembered that you could hear the trees crashing down through the forest like explosions, and that there wasn’t a house in the area that escaped unscathed.

Before the winds had gotten really bad, when the locals still believed they were dealing with an ordinary storm, there was a small crew of men who set off in a truck with chainsaws to clear the two mile stretch of road out to the main highway.  Six trees had fallen across the road early in the storm and the locals hopped in the truck thinking it was road-clearing business as usual.  But once they finally cleared the road all the way to the highway, they turned around to discover eight more big trees had fallen behind them that they had to clear to get home again.  They made it back safely, but with more trees falling behind them the whole way.

On that trip we talked a lot with the brand new owners of the little local mercantile (built back in the 1920’s) across the street who told us their story.  They said that once they realized how dangerous the storm had become, they decided to evacuate  over to the Lodge for more protection.  The wife had run upstairs to their apartment over the store to grab a few things when the 200 foot Sitka Spruce on the hillside behind them gave way, crashing down right on top of her.  The only thing that saved her life was the old, stone chimney running up the back of the building.  The tree hit it dead center, miraculously stopping it from completely crushing the store, but a large branch broke through the roof striking her in the head and knocking her out temporarily.  When she came to she discovered she was trapped and had to wait for her panicked husband and a few other men to cut her out.

During that first visit we stayed for two weeks and the hubster and I had ample time to wander around and soak in the aftermath.  A lot of the trails were either partially or completely closed.  Indeed, sometimes the forest had just collapsed on top of them.

There was one section in particular where a microburst had ripped about a mile long path of devastation through the trees.  Here’s what one section looked like in 2007.  A few months earlier this was dense, lush rain forest.

And here’s what another part of the area looked like last week:

A lot of the debris that originally buried the creek was washed away by successive spring run-offs in this spot, but there were other areas where we still couldn’t see the creek for all the fallen trees.  We could hear it though, and then watch where it reemerged later downstream.

And here’s a picture from 2008 of what it looks like when one of the big trees gets snapped off near the base.

Fast forward to 2011 and it was fascinating to return and see all the ways the forest has been healing itself from the carnage.  We took the same trails we’d taken before and there is now a layer of moss, algae, fungi and ferns softening all the ragged, shattered edges that were so fresh on our last visit.  There are new trees sprouting out of the many fallen trunks, and all the giant root systems that were ripped out of the ground and left exposed (some of them fifteen feet tall) are slowly transforming into beautiful, vertical walls of moss, trapped stones, and epiphytes.

I’m happy to say there’s also some healing taking place among the human population, but it’s gradual.  The wife trapped by the falling Sitka Spruce was the only person to sustain any physical injuries during the hurricane, but the deep mental and emotional scarring that took place was distributed more evenly.  Everybody who went through it has PTSD.   Everyone.  You can see it in their eyes whenever they hear a strong gust of wind, the uneasy way they turn to look out a window or peer up into the swaying tree tops.  The man who was supposed to lead a group of us on a guided tour around the lake canceled it an hour beforehand because the forecast was calling for possible high winds and nobody there likes to take chances anymore.  Honestly, by the end of this trip I was starting to feel a little nervous myself as a big storm rolled in off the ocean the day before we left.  I caught myself glancing up into the canopy to gauge the strength of the wind as my pace picked up on the way to the car.

I think we’re designed to learn from one another like that.  I think it’s hard-wired into our brains to listen and observe the people we meet when we travel, especially in new, unfamiliar zones that lie outside our ordinary range of experience.  A couple days after the Japanese tsunami struck I heard a professor being interviewed on the news about everyone’s horrified fascination with all the images being broadcast.  He said we do it, at least in part, because there’s an enormous amount of information encoded in those kinds of images.  Biologically we’re all deeply wired to survive and that’s why, unconsciously, we’re always scanning the horizon for possible threats and any information we can glean about how to survive them.

There have been a few times since we returned home, as I’ve watched the tsunami coverage, that my mind has gone back to the two days we spent strolling along the beaches of the Washington coastline.  We’d discovered rare pathways down the cliffs and then walked along the shoreline for hours, enjoying the sand and rocks, playing in the swell of water as it rushed up to our feet and then retreated again.  Even though there are signs along every coastal highway indicating tsunami evacuation routes, we never once seriously considered that such a monster wave might come while we were there ourselves.  That it might catch us unaware, rolling up while we were lost in our long, relaxing reverie of salt spray and sea gull cries, sweeping us right off the narrow, exposed stretch of beach we were exploring between water and cliff.

I’ve considered it since though, as I’ve watched the footage from Japan, and that professor is right.  I’ve gleaned enough information from the images to realize that if a 9.0 earthquake had happened off the coast of Washington instead, a few days earlier while we were there, the resulting tsunami would have swept us away.  The hubster and I would have vanished and no one would ever have known for sure what happened to us.

Looking into the face of that kind of stark reality is sobering.  I’ve had the wild, frightened thought a couple of times that, on our next trip, I won’t return to the beaches at all.  Just in case.  It’s in those moments that I have to make myself remember.  Make myself step back and say, Wait a second, Dia.  How much are you willing to sacrifice  here to be safe? Am I really going to give up the ocean, or hiking through rain forests, just to be safe from tsunamis and falling trees?  And if I’m willing to give those up, where else won’t I go?  Anywhere where there might be an earthquake?  A hurricane?  A typhoon?  Anywhere where I might fall or freeze or burn or be eaten by wild animals?  Anywhere where I could possibly be mugged or raped or otherwise terrorized?  Just how small am I willing to allow my world to get before the ensuing suffocation makes my life not worth living anymore?

Again.

And that, my friends, is the real kicker.  I’ve already been to that place.  I’ve already lived in the weird, terrifying world of phobia and creeping paralysis and, between you and me, I think falling into that abyss is the worst kind of natural disaster that can happen to somebody.  The fact that it’s internal doesn’t make it any less real or devastating, and the fact that nobody else can see the destruction doesn’t make the struggle to recover from it easier or less necessary.

The Great Gale of 2007 is long over but even so, during each subsequent storm, those who survived it are experiencing another sliver of it again.  For them, that storm is still real and, inside them, aftershocks are still happening.  Its ghost is alive and well.  The great tsunami that just devastated northern Japan is now over, too, but the ghost wave it left in its wake will be alive and haunting that land for a long time to come.   That’s just the way an internal disaster works.  They’re longer and slower and more ephemeral.  They can also be trickier to rebuild from, than the ones that happen on the outside.

But it can be done.  For me, over time as the fears have receded and I’ve started to recover, I’ve discovered a lot of nurse log-type activity going on inside.  The years of depression and agoraphobia were unquestionably destructive, and a lot of my old life was toppled over and swept away during the worst of that illness.  But even so, these days there’s some fascinating new growth coming up out of the hopeless, twisted, tangle of what my world used to be.  I’m considering things, experiencing little sprouts of hope and ingenuity that, during the worst, I believed would never be possible again.  Maybe these little sprouts will someday grow up to be big trees of their own or maybe they won’t.  I know that another wave of depression could always come along and sweep me out to sea again because that’s the risk of the region I live in now, but deep down inside me I’m not sure that would really matter anyway.  I’m beginning to suspect what’s most important is the fact that I’ve been able to endure, survive, and live at all.  For however long it lasts.

Because isn’t that just the thing about life?  Whatever winds up happening with me, with any of us individually for that matter, Life itself will never stop because it has an endless capacity to reroute.   Sure, accepting the details of that rerouting sometimes involves my having to step back and expand my view a lot, having to accept that life is something far bigger than just my life.  Life is actually our life, something we all get to participate in for a little while together, and something we all still continue contributing to after we’re gone.

It’s like how the pattern of old growth tree roots reveal the place where the nurse log that gave them life once lay.  In a thousand, million different ways, large and small, we all wind up as nurse logs for this world and for each other; each of us profoundly effecting and altering what’s around us during the brief but blazing time we’re here.  I think the magnitude of our impact is far, far greater than we’ll probably ever understand, and that our gifts to this world will never be wiped away because they’re far too necessary to ever waste like that.  On the contrary they’re transformed; reabsorbed and used to nourish all the generations of life that follow, life that wouldn’t have been possible if we hadn’t existed here for a little while ourselves.

My prayers go out for everyone who died–everyone who is still dying–in Japan, and I send my wishes for deepening strength, resilience, and healing for all those who ultimately survive them.

copyright 2010 Dia Osborn

Part III: Both The Light And The Darkness Conceal and Reveal

(In Part I and Part II of Chapter 5, I described my quirky attempt to break free of agoraphobia by hiking back into the mountains for three days and three nights alone with my fears.  When I left you last week I’d just come through my greatest terror; that of the sun setting, leaving me alone in the wilderness at night.  Part III is the conclusion.)

The perspective I gained that evening, that darkness delivers a profound gift has, over time, effected a slow yet massive transformation.  Initially, during those three days up in the mountains I clung to the realization primarily as a way to help ease my fear of being alone at night in the wild.  But over the coming years it unfolded in ways I never could have imagined, slowly permeating and changing my understanding of another, more human dimension of darkness; the kind that arises inside us from living with things like pain,  suffering, and death.

It was during this mountain retreat, six years after my grandmother’s death, that I decided to begin my work with hospice and later, by the bedsides of the dying, I wound up experiencing the same sense of revelation and coming home that I’d felt under the evening sky.  All the vulnerable, generous people I worked with were like the stars all over again—shining beings gradually re-emerging as the bodies that had veiled them faded and thinned.  During the hours I spent with them and their loved ones—bathing and turning and wiping and rinsing and listening and laughing and crying—I felt like I’d finagled a seat in their caravan as they journeyed out all together to the farthest edges of life, a beautiful, twilight place that reveals something else, something breathtaking that lies out just beyond.  And as I watched this transformation take place over and over again it slowly dawned on me that the process of dying is not so much about shrinking and expiring as it is about finally growing too big to contain anymore.

A gentleman who’d lost his wife of sixty-plus years once told me that he woke up a couple of times, in the nights immediately following her death, to glimpse her for a moment standing next to his bed looking down at him.  That sometimes, in quiet moments he’d still hear her voice clearly speaking his name.  A woman devastated by the recent loss of her husband told me it was eerie how she kept seeing an eagle overhead–a bird he’d always felt an affinity for–every time she felt like she couldn’t go on.  And still another man confided in a low voice that he’d seen his dead brother the day before, waiting by the graveside as the wife who’d only survived him by eight months was laid to rest.  Over and over I’ve heard similar stories from those who’ve bid a loved one good-bye, and while the events they relate take different forms there’s a common theme between them—a sense that the bond of love itself is not severed even though the loved one has physically disappeared.

Lying there in the mountains I was aware that many of the stars I looked at were actually gone, exploded millions and billions of years ago in supernovas.  What I was gazing at, breathless and awed, was their remaining light, the part that continues to travel through the vast reach of space and time long after the stars themselves die.  I wonder if these stories people told me of sensing the continued presence of a deceased loved one are like that somehow, indicating that sometimes, for those who are aching with injury and loss, there’s another tender, reassuring glimpse available to remind us we don’t have to worry.  We don’t entirely disappear.  No matter how dire things look in the short-term all the light…the love…that we generate over a lifetime continues on.

Here’s an example of something I experienced that falls into the pilot and lightning, lovely-but-not-a-clue category.  Over the years I noticed a phenomenon taking place in the midsections of patients engaged in the late stages of dying.  There was a faint radiance emanating from their solar plexus which increased in intensity as the wasting process accelerated.  I speculated on physical causes, wondering whether there might be a link between the physiological deterioration taking place and an emerging light source.  In physics, unstable atoms emit photons of light when one of their electrons jump from one level to the next and I wondered if perhaps a dying person’s atoms become increasingly unstable as their body shuts down, emitting a cascading increase of light.  I also considered a possible late stage, chemically-induced bioluminescence, like fireflies or the microscopic, sea organisms that light up the wakes of boats.

But most of the time I was just bemused by it.  Those glimpses had the same effect on me as struggling over the last, hot sand dune to gaze across the sparkling expanse of the sea.  The beauty soothed something hunched and shaken inside me.  The radiance in those exhausted, collapsing bodies was so unexpected and lovely that it felt as though the ordinary world was slipping out from beneath my feet and, whatever was happening, whatever was causing it, seeing that light triggered moments that made my heart both break and soar.

But as tantalizing as glimpses of that kind of phenomena were, I have to admit the view that really knocked my socks off was the one looking back towards here; this small, ordinary looking, blue, sky-encased life we live in most of the time.  It’s not that I started seeing unusual things here, too.  It was that, from out there at the edge, everything ordinary taking place back here looked like a miracle.  Changing a shirt, taking a bite out of a sandwich, saying hello, saying good-bye.  Complaining and tears.  Smiles and breath.  People longing and loving, pooping and peeing—nothing looked mundane or small anymore.  Nothing.

I remember all those moments when I turned from a dying person’s bedside and headed back to my life—when I left their homes, climbed into the car, and just sat there staring, gripping the steering wheel with white knuckles like I was about to fall off a cliff.  I’d tremble for a while, looking down the street at the trees, cars, and houses, my heart ripped wide open and bleeding down somewhere near the gas pedal because everything suddenly looked huge and luminous.  And I’d reel from the fact that just a few hours earlier I’d been totally oblivious, taking it all for granted.

Stupid, stupid me.

Knowing that in a few hours time the awareness would fade and I’d be taking it for granted all over again.

Secretly, I like to imagine there’s something mysterious and radiant hidden inside of me, too—a hitherto unsuspected light in my midsection being slowly strengthened and seasoned by all the suffering and love, loss and joy, despair and redemption I’ve managed to endure and survive.  And that when my time comes it won’t be disease or neglect, violence, incompetence, or age, but instead this very light inside that kills me by swelling to an immensity, a brilliance, that finally grows too big for further restraint.

These days I spend a lot less time thinking about how not to die and more of it trying to truly live, to touch and savor everything I can while I’ve still got the chance; the pleasant and crappy, fun and hard, dark and luminous, all of it.  It doesn’t feel so much anymore like my dying will come as the result of a final, catastrophic failure; of my body or my choices or the medical system that cares for me.  Rather it seems like it will simply be the arrival of my own promised twilight, finally coming full circle in a vast and primordial cycle encoded in my body from the start.

copyright Dia Osborn 2010

A View From The Edge (Part II)

“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

A View From The Edge, Part I

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

copyright 2010 Dia Osborn