Building Immunity: Dying isn’t avoidable, but the horror of it is.

So what drove me to work with hospice in the first place?

Dying encompasses a significant chunk of our total life experience yet, because our society has such an ingrained revulsion and fear of it, we tend to quarantine, hide, then ignore the people who are actually doing it.  And because I grew up in our society, I dutifully learned to wrinkle my nose, too, to try and avoid things like illness, decay, ugliness, aging, abuse, and death.  Poop and throw up.  Sadness and sagging.  Helplessness, wrinkling and loss.

Everything was going along just fine until one day I started to notice that, with aging, more and more of the people and places I loved were passing under the shadow of these things.  This, of course, made avoiding the necessary things more difficult and I started to chafe.  But it wasn’t until it reached the point where avoiding the scary stuff became synonymous with avoiding the people I loved who were experiencing them, that something inside me finally mutinied.

The system clearly wasn’t working the way I’d been told it should.  So, after some thought, I dug my spear out of the closet, painted and crossed myself, then marched off into the heart of darkness to investigate that big, hidden chunk of life for myself.  Go explore it.  Learn my way around.  Find out if it was really as bad as everyone said it was, and discover if I had the stomach for it or not.  I quickly found a hospice where I could volunteer, then approached my first bedside and sat down with a catheter bag knocking against my knee, the fumes of urine wafting steadily up into my nostrils, for the next two hours.

And in direct contradiction to all I’d been led to believe, I survived.

So I continued.  I stepped in and volunteered some more.  Decided to go a little farther and return to school to get certified as a nurse’s assistant.  I gave my first naked, elderly gentleman his bath, wiped fecal matter from the wrinkled genitals of a younger woman whose multiple sclerosis had left her paralyzed, and slipped my arm and strength behind the shoulders of a grandmother who could barely raise her head from the pillow while she heaved up blood into a trashcan.

And, lo and behold, I still survived.

So I relaxed a little and started falling in love with people.  I listened to their stories, sometimes over and over again, and fell deeper into love.  I studied those struggling in the depths of decline and loss; witnessed those who once walked stopped walking, those who once spoke stop speaking, those being left behind look around blindly, their hands reaching out, bewildered and lost, for something they’d never find.

And I started to do more than just survive.  I started to change.

I began to see through the blood and wasting and smells, the crushing overwhelm, occasionally catching glimpses of something shining behind the clammy skin and unfocused eyes.  I occasionally heard something in the way people spoke, something gentle just beneath their words that was so vast it wrenched my heart and stole my breath.  And sometimes—sometimes—I’d feel that thing there in the room, flowing all around us like a current of air or water, an underlying, pulsing love that was so searing and tender it left me sobbing over the steering wheel afterwards, shaken to the core.

Something transforming me, bit by bit by bit.

The concept of immunity fits well with the changes I’ve experienced.  You see, it’s not that the dying process isn’t as hard as I feared.  It most certainly is and, what’s worse, I now have all the details.  No.  I didn’t become magically oblivious to the horrors involved.  What seemed to transform was my ability to witness and contain the dying of others without being devastated by it.  It was a gradual process of course, requiring a gradual exposure, but over time, as I discovered how much stronger people are than I’d previously suspected I felt myself growing freer from my fear for them, and as my fear dissipated it allowed me to see their strength more clearly.  It became a self-perpetuating feedback loop of expanding perception and depth inside me.

This developing immunity involved something inside me growing larger with each passing day.  I’ll say it one more time because I feel it’s so important to understand—it’s not that the suffering I witnessed diminished in any way.  The hardships endured by the people I was serving remained just as real and grueling as ever, and my heart never ceased breaking for them because that’s what a heart is designed to do when confronted with the profound human suffering of others.

But as my immunity to the horror grew, my heart began to break in a different way.  Not in the destructive way that leaves smoking ruins and rubble in its wake, but more like the way an egg cracks open to release a new and different form of life into the world.  That’s what it felt like time and time again; as I watched a frantic daughter stumble into the room at the last minute to collapse by her mother’s bedside, sobbing with relief because she’d reached her just before she died, or a husband, desperately struggling out of a morphine fog for a few moments to take his wife’s hand and tell her how sorry he was for not recognizing her.  That inside, where he still existed, he would always, always love her.  Each time I felt the enormity of their love and loss inside me like a physical blow, felt a sharp pain inside my chest as something smaller and restricted cracked violently open allowing something fragile and dripping, unfolding and new, to spill out and fill me.

It was as though I was dying a little too–each time—and then being reborn again as something clearer, larger, and calmer emerged from the shards.

In a very real sense I felt like I was being vaccinated with the pain and dying of these people, so that my own capacity to bear such things, to understand and contain them, could grow.  I’d always thought of immunity as a physiological response but the capacity seems to exist on the mental, emotional and spiritual levels as well.  It became increasingly clear to me that, while the benign and loving experiences of my life are what nourish and prepare me, it’s the injuries and hardships along the way that force me to harness and deploy that strength.

I’d like to leave you with a quote that best describes this process of immunization for me, as well as its resulting gift of strength.   It’s from Victor Frankl, a Viennese psychiatrist who survived imprisonment at Auschwitz and afterwards authored the book Man’s Search for Meaning, and he captures the insight far more succinctly:

That which is to give light must endure burning.


copyright Dia Osborn 2011