Icicles by sun and moon.

Took these shots up at the cabin this winter. Wish I’d had something more than a cellphone camera to take the night pic, this just doesn’t do it justice. The moonlight reflecting off the ice was…I don’t know. Sublime? Stirring anyway. In a very good way. I was spellbound by the fragile, unearthly beauty of it.

For what it’s worth…

icicles by dayicycles by night

In the comment section after my last post, a couple readers asked if I could explain what the “powerful reason to live” was that I came by during my last bout with suicidal ideation way back when. I did my best to explain it with words but there was just no way to describe it that was ever gonna work.

These pictures explain it better I think, especially the night one. The wonder I felt when I woke up and saw the beauty of moonlight reflecting off the ice was similar in some way to that unearthly light I experienced in the depths of my despair.

I think it was St. John of the Cross who said something like “…when I thought the dawn was forever lost I found Your love in the light of the stars.” I’ve also heard that in some ancient spiritual traditions it was believed that the insane were actually touched by something divine and therefore sacred. I relate to that. During that hour when the obsession to die had taken over, my thinking was clearly irrational and insane. And yet it was in that madness, experiencing things that my rational mind would never allow, that I was finally touched by something transcendent and radiant that helped me finally find an enduring reason to live.

On a side note, I really wish this ongoing conflict between science/medicine and religion/spirituality would stop and we could instead start openly exploring the places where they intersect, what they could heal together. Each field has such profound and life-nourishing tools at their disposal and I know, in my case, if it hadn’t been for the help I received from both it’s unlikely I’d still be alive.

Just imagine if their resources were pooled, what the synergy of that interaction might reveal. The thought takes my breath away.

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Claustrophobic but Joyous and Free

I just watched an exuberant, freeing kind of Youtube video and thought I’d share it here for anyone feeling, perhaps, a little suffocated today…(by anything really, it doesn’t have to be lack of air. For instance I’ve felt suffocated by things as various as failure, fat, saunas, speaking up in front of strangers, and a hyper-inflated sense of responsibility. Really, so many things can suck up available oxygen.)

Fear is usually involved, at least for me.

Well, here’s an example of people facing into some big fear and people helping them do it. The Marine Discovery Dive is an event out of Malaysia that takes a group of physically disabled people scuba diving every year in order to free them from the usual limits placed on not only their bodies, but their minds and spirits as well (which, let’s face it, is where the most severe disabling usually takes place.) There’s a lot, a LOT, of joy in this. Watch and breathe:

It reminds me of a hospice patient I once worked with who was dying from a disease similar to ALS (I can’t remember the name now) which was relentlessly shutting down his autonomic nervous system. As he felt it progressing, and knowing full well where it was headed…he was a highly intelligent man…he sometimes felt like he was being slowly buried alive inside his own body. Not a pleasant sensation by all accounts.

Well, we had a counselor working for the hospice at the time who’d been learning about different kinds of “energy” work for lack of a better term. In any case, she tried it out on this patient and lo and behold, it actually helped alleviate the growing sense of claustrophobia he was struggling with so, needless to say, he became very attached to the treatment.

Fast forward a couple months and said counselor, preparing to leave for two weeks of vacation, asked me if I’d take over while she was gone. I was reluctant because, frankly, what was involved felt a little strange and embarrassing to me. However, when the patient started adding his own earnest entreaties…well, who can say no in the face of that kind of raw need?

Which is how I found myself one afternoon standing over the body of said patient where he was reclining in…well…a recliner, eyes closed. I was waving my arms back and forth over him in the prescribed manner feeling very much like a five year old solemnly pretending to be an ocean tide. Awkward? Yes. Lame? Felt like it to me.

And yet, and yet. He responded to it in spite of my resistance. He gradually, visibly relaxed, the fear lines in his face smoothing, the tension in his body loosening to eventually disappear. There was a look of profound peace that settled over him and even I, Little Miss Judge-It-All, could eventually feel a kind of tactile, tangible silence in the room.

It wound up being a pretty profound experience for me (not that I remotely mattered at the time but, still, it was nice to think about afterwards.) The whole thing wound up wreaking havoc on a set of mental limits I was tenderly suckling without even realizing it, while simultaneously opening me up to the possibility of more possibilities. (Why in the world that seemed so threatening is a mystery, but there you have it.)

What I took away from that experience, and what I take away again from watching the blossoming transformation in the faces of the disabled divers in the video, is that much of the potential for real freedom and joy…the genuine article…lies inside our own minds. My patient’s physical disease didn’t go away but the way he was experiencing it completely changed for a little while. And neither did the disability of any of these divers go away and yet, they all seemed to feel liberated…transformed…in spite of the limits. Maybe it wasn’t a permanent transformation but it was certainly a start, and God only knows what a start can lead to. I’ve seen entire sidewalks…parking lots even…eventually overgrown from a single, tiny weed starting in a single, tiny crack.

So I know…I can feel it…that even though the people in this video are exploring frontiers (disability, like dying, is very much a frontier to me) that I haven’t visited yet myself, it doesn’t mean the things they’re learning aren’t supremely important for me to learn too.

Which is why I write it down here under the guise of sharing it with you. Really, I suspect I’m just archiving it where I can find it again, but if you get something out of it, too? All the better. Have at it, my friends. I think there’s more than enough to go around.

When snow comes peeking in the window.

Snow window

We had a major winter storm blowing for most of this last trip up to the family cabin. I’m guessing there was only a couple feet of new snowfall but fierce winds blew it into big drifts and that’s what caused all the fun. We do so LOVE weather, the hubster and I! This is a view through a back window. The door, just a couple feet over, is completely blocked and will just have to wait till spring thaw to open again.

Winter is our favorite time of year to vacation up here, which some people understand completely and some people never will. I think it’s similar to dog people and cat people. The guy who’s getting ready to replace our fence down in Boise was excited and congratulatory when he found out we were up here during the storm, while a friend from L.A. just shakes her head and says, every single time we come up, I wouldn’t do it. I’d freeze to death. And yet she skis (in winter, on snow!) so I’m confused. What’s the difference? Is winter not just as cold when you’re hurtling down a mountainside at 30 miles an hour? In fact, isn’t it even colder with the wind chill?

People. Personally, I don’t think we’re anywhere near as rational as we like to think. More like big bundles of unconscious bias in fact, overlaid with a very thin veneer of reason which is of course the part we preen ourselves on and strut about holding up to one another because it makes us feel so special.

 I do it myself. Which is totally ridiculous, I know, but it can’t be helped. Oh well. We humans are just so incredibly absurd and vulnerable, y’know? And there’s so much to love in that.

The Camera Phone and the Dilettante Photographer: Part 2

In Part 1 I think I mentioned that I’m a little fixated on skyscapes. (I’d probably be fixated on starscapes, too, but night photography requires a level of skill that is clearly, judging from the deplorable quality of my photos, lacking.)

Most of the great skyscape photo opportunities I get are from the front deck of the hubster’s family’s cabin in Stanley, Idaho. It’s a breathtaking view and, as far as results are concerned, highly ego inflating. You can’t take a bad picture from the place, you just can’t. I challenge anyone to try. It’s a favorite playground for the Northwest weather gods who are forever romping around, rolling in from one end of the valley or the other, or spilling over and between the mountain peaks, or rising up from the early dawn river as fog, or shooting down between a crack in dark clouds as ethereal, roving spotlights. It’s amazing and kind of spellbinding. The first time I ever visited the cabin I just sat at the front window staring outside for three days. (It was also the first time I ever met the hubster’s family who, fortunately, forgave me. They’re pretty proud of the place.)Carpe Musings

Shaw mesa winter storm lighting

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Shaw mesa dramatic storm front copyTired yet? But I have so many more. Sigh.

These last two were taken by the hubster. The first is morning fog filling up the deep valley between the mesa we perch on and the mountain range on the other side:View this morning B copyAnd the last is…well, we have no idea what this is. It’s a phenomenon we’ve only ever seen up at the cabin this once. It was a column of light that shot up unexpectedly from the setting sun. It was HUGE. The photo doesn’t capture that part. And most odd, lasting about two minutes from the time we first saw it.Morning light column over Sawtooths copySorry for the enormous size of the photograph. WordPress changed the download media feature while I was gone and I haven’t figured out how to resize yet. As mentioned…dilettante. 

The only other time I’ve seen this column of light was on the morning Obama came to Boise to speak while campaigning for his first election. It shot up into the sky from behind the Boise mountains directly over the Taco Bell Arena where he was scheduled in an hour’s time and, between you and me, I think it was an expression of total Idaho flabbergast. A Democratic presidential candidate campaigning here? It was as astounding as if a migrating flamingo had been blown off course and landed in one of the ponds over in Katherine Albertson Park. Even the sky was surprised at such a turn of events and it shot up a great big exclamation point of light before it remembered itself and regained its poise.

I would love to know what causes it though. Any ideas?

copyright 2016 Dia Osborn

The Luminous Nature of Life

Here’s another great quote, only from Carl Jung.  

“Life is a luminous pause between two great mysteries, which themselves are one.”

I ran across it this morning and it knocked my socks off because it so exactly describes the experience I kept having while working with the dying. It appeared so obvious in that setting, the luminousness.

I mean it was fascinating enough watching all the tricks and ploys life uses to extricate itself from the bodies that have housed it for years and years, but what I wasn’t expecting was the faint radiance I kept seeing in people’s solar plexus towards the very end. It looked for all the world like the glow of a rising sun starting to burn off a dense morning fog.

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(By Brocken Inaglory – Own work, CC BY-SA 3.0, $3)

I came to think of that radiance as life itself and it always changed me for a little while after I saw it, relieving me of some deep and nagging fear that I’m not usually aware I even feel. It was nice. This morning reminded me of it again, only this time as sandwiched between two great mysteries. How great is that?

Well done, Carl. Thanks.

 

 

Selfie in Hells Canyon

The hubster and I spent most of last week in Hells Canyon tent camping for the first time in decades. (It went well. Fantastic in fact, so we’ve decided to plan another trip.) While hiking on one of the trails through the gorge below the dam we got a wild hair and took a selfie…mainly because it’s the only possible way we were ever going to get a shot of both of us in the same frame. It was fun and, surprisingly, turned out halfway decent considering we’d been camping for four days with accompanying grime build-up.

Here it is.

Cal & Dia on Snake River Canyon

Truly though, the surrounding scenery looked better. For example:

The canyon

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The snowcapped Wallowa Mountain range

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A wild rugosa in bloom

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Cascara sagrada leaves (from the tree whose bark gives us the active ingredient in ExLax. Gaze and be grateful.)

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Our campsite (just prior to departure so sans tent, etc.) with Sherpa Pepe and the Kayak Twins

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And an alpine rock garden on top of one of the many peaks

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Did I mention it was wildflower season? It was wildflower season.

We also saw a couple of mountain goats, nesting bald eagles, and a brown bear but alas, being no wildlife photographer, I was unprepared and missed the opportunities. Oh, there were also bats. And a head full of ticks…no, two head fulls…but we were way too frantic trying to rip them out again to even think about taking pictures. No rattlesnake sightings though, even though the canyon is full of them, and thank God for that.

copyright Dia Osborn 2014

A Little Post-Olympic Joy From Russia

This fabulous flash mob video from Moscow is a great reminder for me that Putin and the Oligarchy don’t define the true Russian people anymore than Washington and its incredibly malfunctioning Congress define us. I’m pretty sure that on the whole we the people, of any nation, just want to be free and happy…preferably together.

Here’s how some Russian people did just that recently. (Maybe it would help if all our government leaders got together like this? I bet THAT video would go viral.)

Of Storms and Stars, Whales and Grief

“People gonna be okay, storms never come to stay, they just show us how bad we need each other…how bad we need each other.”

— Mark Scibilia

I’ve been at something of a loss for words over the last few months with the successive hits that mine and the hubster’s families have been taking. Two suicide attempts by young members (one successful and one thus far not) as well as the dignified and loving departure of a beloved elder seem to have taken their toll on even my desire to talk about dying.

Who would have thought?

But this morning I came across an old Yuletide letter I wrote back in 2002 and the tender perspective expressed in it helped me remember the rich beauty and wonder I once found in the rooms of the dying, sprinkled in among all the horrors. Reading it again reminded me that what I saw back then is still true today…the dying world really does contain profound and graceful gifts…even if I can’t currently see any of them in the aftermath of recent events.

suppose this is where some faith helps. I needed reminding that the stars still hang up there in the depths of the night sky and that they’re just as luminous and lovely as ever. Certainly once this storm has spent all its fury and the clouds have finally cleared I’ll be able to find them again.

In the meantime, I can always read my old stories. 

I thought I’d go ahead and paste in the old Yuletide letter here, just in case anyone else is slogging through heavy weather and hoping for a break. Maybe it can help.

**************************************************************************

Dear everyone that we hold with deepest affection:

 Cal and I (and all unbeknownst to them—the kids) send our warmest greetings in this season of silence, celebration and relentless Christmas catalog barrage.  Here in Idaho’s banana belt we’re experiencing an inversion—a meteorological event where the warmer air at higher elevations traps the colder and dirtier air at lower elevations and those of us down under reap the harvest of all our months of collected carbon emissions in the form of smog.  A ban on wood burning is currently in effect in the valley so the cord of wood we just split stands leaning precariously by the garage while the fireplace waits cold and patient.  Cal’s primal and eager impulse to poke around in a nest of flaming materials is temporarily thwarted so for his sake I hope a low-pressure system returns to the area soon.

 This year seems to have flown by faster than any year before (a trend we’ve been noticing of late) and I suspect that it speaks to the fact of our aging.  When I think about it, it seems logical enough.  Between the two of us Cal and I now have almost 94 years of collected living to our names with all the learning and memories, laughter and heartbreak, wisdom and foolishness that that much life of necessity contains.  Think about it for a second.  When held up and compared to such an accumulation of time how long can a single year really take to pass after all?  Sometimes I think of an old-growth redwood or an ancient mountain peak or a star and I wonder what a year seems like to them.  I imagine it would be like a breath or a blink.

 A solitary heartbeat lost in aeons of warm and pulsing rhythms.

 Two great things happened this year for us.  One was a cruise to Alaska—a generous gift from Cal’s dad up one of the most magnificent coastlines I could ever imagine—and the other was the work I began with hospice.  Somehow the two are closely entwined although I’m not entirely sure how. 

The cruise was something of an enigma for me.  It was our first time and in preparing for the trip I found myself conflicted around issues of the seemingly decadent opulence of American spending and a very real anticipation of fully immersing ourselves in it. 

The food was everything I’d ever heard it would be.  We ate lobster and shrimp and French dishes and baked confections in lush dining rooms with scores of people waiting on us hand and foot.  All we had to do was ask (frequently we didn’t have to ask at all) and nothing was denied us.  There was even one climactic moment when we were sitting with our aperitifs at a linen-covered table, gazing out a huge window at the dark and choppy waters we sailed through when suddenly, Cal said, “There’s a whale!”  And when I turned to where he pointed a giant humpback suddenly breached about twenty-five feet off the side of the ship, surging up into the air with a mass and drive that staggered the imagination.  As it rose it gracefully spiraled 180 degrees, arching its body back and outwards as it twirled in a movement that looked like some kind of liquid ecstasy, before plunging back into a whitened maelstrom of water to disappear again beneath the surface.

 I felt overwhelmed by the wealth of it all—both the riches of human civilization and the priceless treasures of the wild.  Cal and I tended to forego the lure of bingo and Broadway shows, naturally gravitating toward the decks and railings of the ship where we spent our time watching the mountains and islands and vast tracks of forest gliding by.  During one shore-leave we hiked on a mountain in Juneau, climbing up beyond the hordes of camera-snapping, cruise-line tourists (no doubt attempting to elevate our own camera-snapping activities to a higher moral plane) and on into the mist and muffled silence at the top where I sang to occasional marmots and ptarmigans who tipped their heads in curiosity. 

Throughout the seven days we saw harbor seals whelping, bald eagles flocking, glaciers calving, and ice so old and compressed that it had turned a luminous color of blue.  At the peak of the cruise we sailed up a fjord (I felt such a smug sense of satisfaction to finally experience the thing that carries such an exotic name) and on that morning I stood alone out on the deck for hours, shivering in the drizzling rain and cold breezes, held spellbound by the sheer, green cliffs rising up from icy waters—their towering heads hidden by clouds, their sides split time and again with plunging waterfalls fed by spring-melting snows—and in the cold, wet, wildness of it all a silence of great age, of vastness, weighed upon me, somehow aging me, too.  Lending me a temporary grace that I suspect only comes enduringly with advancing years.

 And I recognize the same vast silence I felt that morning each time I sit by the bedside of someone dying.  It’s such a paradox to me, the moments that exist—tucked in among the bathing and dressing and care of wounds, among the laughter, overwhelm and expressions of tremendous sorrow and tenderness, among the changing of oxygen tanks and long hours of just listening and listening and listening—when I feel that same great weight of grace I felt in the fjord pressing down upon me again.  Whispering to me of an indescribable beauty of great depths and muffled echoes and mist.  And in spite of the moments of horror and heartbreak, I feel strangely uplifted. 

I’ve come to wonder if much of the difficulty in dying lies in the necessity of having to give back all the many and deeply treasured gifts we’ve been loaned for the process of living.  There’s so much to love in a lifetime be it brief or long, so much to wonder at and remember and touch with trembling fingers one last time. There are all those whom we love and our many achievements, the mountains and moonlight and extraordinary beauty of the world, the gifts of walking and laughter and being able to feed ourselves and go to the bathroom alone, and in our last moments the necessity of returning even the gifts of sight and touch and breath.

But in the end, while the gifts themselves must be returned, somehow the deep love and gratitude that they forge within us remains, growing ever more quiet and measureless upon being freed.

 I remember again the brief instant of that breaching whale.  The suddenness of it and surprise, the delight and the awe, the twisting, the power, and the arc of it’s body that seemed to express not so much purpose or deep import as a simple moment of sheer and unbridled joy.  A moment of irrepressible delight, driving it to rise high and higher for an instant of unforgettable and breathtaking splendor.  And so I’m coming to think of life.  Something so brief and unpredictable and extraordinary surging up from invisible worlds, rising within us with such drive and vitality and joy—learning through us, loving through us, touching and being touched for what amounts to only a fleeting heartbeat in the vast rhythms of creation—before ultimately returning once again to the deep and gentle mystery of the waters that are its source.

With our newly graying hair and sagging bodies we wish for you all, this year and always, that each moment of the great wounding and joy of Life will be just such an arc of unforgettable beauty.

With all our love,

Cal and Dia

Returning to the world.

Forgive me. It’s been almost three weeks since my last post which is a record. I’ve kind of let myself go on a lot of levels since Cam died, including eating somewhere in the neighborhood of fifteen to twenty pounds of chocolate and sugar in various combinations…which I admit I thoroughly enjoyed but in a probably perverse way.  Still, sometimes you need to stop doing everything and just float for a while.  Let the wind blow you around.  Drift. Rest. Think. Remember. Digest.

There’s much to digest here.

But this morning I feel myself returning to the world again, both figuratively and physically.  The hubster and I spent nine days out of the last twelve running away to the wilderness every chance we got and there’s nothing quite like getting out on the water surrounded by snow capped peaks, and paddling for miles and miles and miles to help rebuild a crumbling perspective.

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I think everyone develops their own way of finding a path back to that feeling of home at their center when they’ve become lost…prayer, meditation, service, gardening, cleaning house, work, family, friends, community, etc.

For the me the way back has always involved the silence and deep mystery of the natural world. It’s where I instinctively turned as a child for congregation and confessional and where I’ve returned ever since, especially when a wound needs tending.  The stars and storms, mountains and forests, wind and waters have a way of taking the torn, raggedy edges from any injury and pulling them gently back together again, giving them a chance to meet and knit and eventually scar over.

The hubster loves the wilderness, too, only for slightly different reasons.  He feels the silence, too, and needs it as much as I do, but his nature is more wild than mine, or at least wild in a different way.  Where I crave the wonder and mystery of vast and ancient forces, he’s after all the grand adventures that wilderness provides, and over time he’s taught me a little of that particular joy he finds in throwing himself, over and over, against inclement everything…weather, conditions, terrain, the absence of any kind of safety precautions.

Looking back I have to both laugh and shake my head at some of the stupid, stupid, STUPID things we’ve done over the years. The hubster is naturally fearless and impatient of anything that stinks of planning…which I, on the other hand, tend to be a little obsessive about. (My basic nature exacerbated by the depression.)  But he was always so irresistibly charming and relentlessly persuasive that I followed him anyway, over and over again, into situations that were way over my head.  Often over his head, too, but then he loves that.

But since we were lucky and actually survived it all, I now have a treasure cache inside me of memories when I followed him blindly through the labyrinth of all my clamoring terrors to emerge in breathtaking places of grace that were magical and impossible, as if I’d flown there.

My God. I shudder to think what the darkest years of the depression would have done to me without him there to drag me along behind on his adventures, bumping and pointing out every last, little, innocuous threat along the way. I’m pretty sure I would have ended up as a shut-in. It’s really too bad that the man can’t be bottled.

I owe him much, this beloved husband of mine.

Happy anniversary sweetheart and thanks for our continuing grand adventure together. I do so love you.

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“Is it true? Is it kind? Is it necessary?”

I heard these questions posed today in the context of a discussion about how to “think before you speak.”  (Not my greatest strength.)  I was so struck by them that I’ve decided to adopt them as a mantra to try and repeat…every time…before opening my mouth to insert my foot again.

With the highest hopes,

Curious Dia of the Cannot-Keep-Their-Mouths-Shut Clan.

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St. Anne

A very hard week.

Cameron black and white

Hey everybody. I was working on a different post for this week but it was sidelined when our family got hit with a devastating event.  The hubster’s nephew, an extraordinary, loving, and gifted young man, took his own life Sunday night and everything since then has been aftermath.  His parent’s did everything conceivable to get him help and prevent this from happening but in the end his illness overpowered all the rest.  My mind is whirling with all the things that could and should be said about what’s happened…the desperate need for people to be more aware of how profound a danger this is to our children, the desperate need for everyone to be more willing to talk about suicide instead of hiding from it, the desperate need for better funding for our hotlines and mental health infrastructure and suicide education for the school staff who often serve as first line of defense, and the desperate need to break down the current stigmas associated with mental illness…but for today I’m still too heartbroken.

Here’s a link to Cam’s obituary that just came out today. If you’d like you can take a moment to read it and, in your heart, celebrate the beautiful life of someone who did tremendous good and helped a lot of other kids during the short time he was here, and perhaps say a prayer for him and all those who loved him, it would be more deeply appreciated than you know.  His parents felt very strongly that his cause of death should not be hidden or spun in this notice of his death as they know…better than most now…just how critical it is for all of us to start talking about this more openly.  This from the obit:

“But through all the laughter, Cam suffered from depression. He tried to disguise his pain and put to use the deep empathy, love, and compassion generated from his own life’s survival experiences to help as many other people as he could. In the end, he took his own life but he would have wanted everyone to know it was not the outcome he longed for.” 

I can’t begin to tell you how unbelievably brave his parents have been or how, even in the midst of their own devastation, their concern for the many, many other kids reeling from this loss has been uppermost in their minds.  There was a prayer vigil the other night that Cam’s dad helped organize where four or five hundred kids and parents showed up to grieve and sing and tell stories and also talk openly about suicide and the things we can do to watch and help one another to prevent this from happening again.  Everyone in that hall wanted to know.  Everyone there wanted to hear it discussed openly.  The kids especially needed the evening to help them understand and try to come to grips with what’s happened, and the way they came together and were holding and supporting and loving one another through their grief was one of the most extraordinary and moving things I’ve ever witnessed.  They’re so much stronger and courageous and wise, our children, than we tend to believe.  We grown-ups owe it to them to face into our own terrors and finally stop hiding from this.

But enough.  Today I just wanted to say I love you all, even if I don’t know you, and I can’t tell you how glad and grateful I am that you’re out there right now and still alive.  Because that one simple thing gives me more hope than you can possibly imagine. Really love one another today and reach out to someone nearby just because you still can, and do something kind or make someone smile because thats how Cam used to live every single day and why, even with all the turbulence right now, the most lasting legacy of his life will ultimately be one of laughter, love, compassion, and song.

Important links for those considering suicide or those who know someone having suicidal thoughts:

NAMI (National Alliance On Mental Illness)

List of National Suicide Hotlines (Scroll down a few inches to list)

 

Odd Thing About Dying #2: We’d like some destiny with our death please.

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Atropos of the Morai (One of the Sisters of Fate)

In the previous post Odd Thing About Dying #1: They’ve blocked most of the exits I talked about how challenging it is to die these days because the modern medical system has evolved to prevent it wherever possible, even when a person reaches the end of their natural life and is more than ready to go.  And so far hospice (along with the growing palliative care specialty which often goes hand in hand) provides the only officially sanctioned exit where people are allowed to leave the system without a fight.

Now, that being the case you’d think that everyone who didn’t want extraordinary measures taken to extend their lives would be fighting to get enrolled in hospice as early as possible, yes?

Well, no.  Far from it.  Hospice care is one of the most misunderstood and underutilized services out there while, where palliative care is concerned, the majority of people haven’t even heard of it yet. There are a number of reasons for this (including the fact that most people don’t WANT to understand them because it involves talking about dying) but there’s one reason in particular I’d like to discuss here and it essentially boils down to this:

Most people feel to some degree that, if they enroll in hospice, then they’re choosing to die.

This isn’t true for a couple of reasons:

1) When a person enrolls early enough, hospice is about deciding to LIVE WELL UNTIL one dies.  It’s about life, not death.

2) Dying isn’t really a choice to begin with, it’s a destiny. Choice implies we could decide not to die if we didn’t feel like it which of course we can’t.

People aren’t entirely wrong however. Due to some brilliant medical and public health advances we don’t usually “just die” anymore, we have to choose when; when to stop seeking treatment, when to forego that surgery, when to surrender to that infection, when to decline that CPR, or when to remove that ventilator.  Either we or our loved ones have to huddle with our doctors, weigh all the options, and then consciously decide whether to fight for the possibility of extra time or to let it go.

Of course at first we hailed these advances as unqualified blessings but over time it’s turned out that all the new choices can create something of a burden, and sometimes a curse.

You see, there really isn’t a clear point anymore where a doctor has to tell a patient, “I’m sorry but there’s nothing more we can do.” There’s always something more they can do, which means that until a person get decisive and say, “No, that’s it, I’m through. Please stop now,” chances are the doctors will keep suggesting something else.

Just so you know, this is a sea change in the way we humans face death.  It’s historic.  As far as I know, never before in human history has there been a point where the majority of people had to consciously choose when to die, or have a loved one choose for them. This development is an unintended consequence of all our new medical possibilities and, along with the miraculous blessings it bestows, it also requires that we now stand up and assume a level of responsibility for our own death that was unimaginable just a few decades ago.

Only we don’t really want that kind of responsibility.  Turns out one of the things we actually liked about the old way of dying was that we didn’t have a choice.  Destiny used to shoulder that burden for us, which we thought we hated at the time but are now starting to realize was maybe not as bad as we thought.

For a while everyone thought that of course our doctors would take over from destiny and let us know when “our time” had come.  But it turns out they don’t want that responsibility either and, honestly, who can blame them? The burden of telling someone they’re going to die is extraordinary, even when a person wants to know.  And if they don’t?  Well, that can be a lawsuit.

So doctors try and sidestep any kind of straightforward prognosis and hand us the research and statistics instead, from which we then have to try and divine the tea leaves for ourselves.  In addition, the majority of doctors still tend to encourage us to pursue aggressive treatment, often far past the point where they would themselves, with the stated goal of preserving hope but really for the purposes of distraction.  While they often have a good idea when a treatment will be futile, they also know that even a futile treatment can offer us temporary shelter from our terror of dying, which on the one hand is genuinely kind and deeply human, but on the other is a lot like that old bear attack joke:

Question: What are you supposed to do when you’re being attacked by a bear?

Answer: Run like hell.  It can’t save you but it’ll give you something to do for the last thirty seconds of your life.

Only dying is now taking a lot, lot longer than thirty seconds and people are starting to feel like there are better things to do with that time.  But our instincts work against us.  Seeking further treatment still feels like the most right and natural thing to do, and besides everyone else is seeking further treatment, and on top of that there’s major disagreement about when it’s wisest to stop because it’s completely different in every case.

So to recap, while destiny is still in charge as far as death itself is concerned…we all still die…our medical advances have allowed us to seize more control around the timing issue.  Only that means somebody now has to decide when to treat and when to stop, and while we’d mostly prefer that our doctors made the decision since they know so much more than we do, they’re proving reluctant.  Which leaves us to make the choice ourselves, only 1) we don’t know enough to make an informed decision, and 2) we’re unwilling to educate ourselves because that would mean actually talking about dying and we don’t want to do that either.

The whole situation reminds me of a teenager who wanted nothing more than to move out of the house and call all the shots, only to discover the new freedom requires getting a job to pay the bills.  Well, it looks like our new miracles also demand that we assume more responsibility. We’ve created a bewildering array of new choices around the question of when we actually have to die and our new job is to figure out what, among all those choices, constitutes a wise one.

Next up, I’d like to explore some of the reasons why the current choices we’re making aren’t working out so well.  I’m curious to see if breaking them down and examining them more closely might suggest better options.  And, as always, If anyone else has some thoughts on this subject I’d be eager and curious to hear them.

copyright Dia Osborn 2013

Related articles:

A Better Way To Die

There’s a whole lotta love coming out of Oklahoma

20130812_131340_resizedBook Review: Transitions: A Nurse’s Education About Life and Death by Becki Hawkins.

Some of you may remember an old post I wrote called Someone Else Wrote My Book: What Now? where I expressed some angst at the discovery that a hospice nurse/chaplain from Oklahoma had just published the book I was trying to write.   Well, after a year of dark muttering in my cups I finally read Transitions: A Nurse’s Education About Life and Death by Becki Hawkins and loved it.  Loved.

Her book brought it all back to me again in the best way, what it used to feel like when I worked with hospice and how the people I served strengthened, nourished, and changed me.  Transitions provides an authentic portrayal of the endless number of ways that people face catastrophic illness and death, not in a clinical or grisly way, but in terms of the beautiful and vulnerable humanity that inevitably surfaces.

More poignant still, Becki reveals the transformative power generated by something as simple as accepting the overwhelm and grief of another human being.  There are some terrific reviews over on Amazon that do a better job than I could at describing her gentle, loving handling of the subject matter (especially the one titled Nurse Conquers Attack Geese, Copperheads, Sceptics which I wanted to copy and paste in full here but didn’t for fear of getting caught) so I won’t try and cover that ground again.  I’ll just mention a few of the particular reasons why I loved the book so much myself.

Number one, Becki’s career spanned decades and her stories are written through the eyes of someone who’s seen people die from a lot of different things, something that’s actually pretty rare.  I got to take the journey again with her as she evolved and changed through the work and it took me right back to the mystery, magic, and intense vulnerability one experiences while roaming the dying rooms.  The way that each person winds up teaching what an extraordinary, mind blowing feat it is to live an entire life from beginning to the very end.

There is no such thing as a boring life, just boring ways to talk about it (something one encounters both in and out of hospice.)  But with some practice, good listening skills can overcome that problem and Becki’s clearly a master listener.  She draws out the thoughts of those she worked with in a way that allowed a quality of luminous, trembling soul to shine through and the book is full of the kind of dignity and strength that results from that level of respect.

Which brings me to the second reason I loved the book.  Becki not only captures the full range of experiences of what it’s like to work with the ill and dying, she captures it in the abundant charm of the Oklahoma vernacular.  She has quite an ear for the spoken word and delivers her stories in an enjoyable blend of modern medical language and the older, traditional language of her people. For me, the book was as much a loving portrayal of the culture and people of rural Oklahoma as it was of their health status, and when reading her stories I felt like I was peering in through a window to catch glimpses of an old wisdom tradition passed down through the generations.

A quick head’s up for those who are not of a religious bent, a lot of this wisdom tradition is couched in the religious terms of the region and from a couple of reviews I read this was a stumbling block for some people.  It was actually part of the reason it took me so long to read the book myself but as I got to know Becki personally over the last year I discovered that she’s one of those people who can love her own faith while also respecting and supporting the beliefs of others and that knowledge helped me relax and let down my shields.  I’m really glad I did, as I would have missed something beautiful, heartfelt, and universally true otherwise.  No matter how we express it individually, we all die with the same aching mixture of heightened longing and love.

And the final reason I loved it that I’ll mention here is because in the last section of the book Becki reveals how her professional work with the ill and dying eventually helped her navigate the illness and dying of her own loved ones, and I found her experiences to be a confirmation of my own.  While the illness and death of a loved one is just as overwhelming for those of us who’ve worked with the dying…the loss as great and the grief as piercing…still our familiarity with and intimate understanding of the dying process helps enormously when the time comes.  I can’t say this enough.  A knowledge and understanding of dying is an anchoring influence for everyone involved.

Of course everyone can’t go out and become a nurse and work for decades in the field to gain that kind of familiarity and understanding, but everyone can read books like this and begin to arm themselves with the knowledge of those who have.

I know I keep saying this over and over again but it’s only because it’s so important: We all need to be better educated about this last and greatest journey of dying, and we need to start doing it now.  The number of aging people approaching their final threshold is growing daily and in the next few decades dying will become a central, collective social event.  But that doesn’t mean it has to be a sad, tragic, and horrible era.  At all.  With the tools and perspective that hospice and palliative care provide it’s entirely possible for us to collectively craft a thoughtful, courageous, and wiser way to approach the end of our lives, one that’s dignified, loving, generous, and ultimately life-nourishing for us all.

Transitions: A Nurse’s Education About Life and Death is another book among a (thankfully) growing number that provides a window into such an approach.  I highly recommend it.

Other references:

Here’s a Youtube video of an engaging talk Becki Hawkins gave in Sedona, Arizona about some of the spiritual experiences she saw in her work.

And here’s a link to Becki’s blog Transitions.

What Color is Dying? (Hint: It’s a Trick Question)

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During a chat over coffee this morning a colleague asked me the above-mentioned question and…I admit it…the first color that came to mind was black.

He smiled and said that was the first color that came to his mind, too, and during the following discussion we agreed that black would probably be the first color springing to mind for the majority of Americans and possibly other western cultures, too.  (It would probably be white for many of those from eastern cultures.)

So why is this a trick question?  Because black (and white in some cultures) is the color associated with death.  But dying people aren’t dead yet.  They’re still very much alive.  This question reveals how we tend to subconsciously view the dying as close-enough-to-dead-to-count, an unfortunate tendency that does a lot of harm to everybody.

This prejudice is deeply ingrained as evidenced by the fact that even my colleague and I (who have worked extensively with the dying in hospice) still defaulted to black as our first association.  Like any solid prejudice I believe it’ll take work to examine, uproot, and then change it, but it’s worth the effort because if we don’t, we’ll all wind up as one of “those people” while we’re dying and suffer the stigma and exile that currently goes along with it.

Once my colleague and I recognized and talked about our conditioned response, we then asked the question again and came up with completely different responses.  He said that, for him, dying is actually quite purple, a color that he loves and relates to on a deep level.  I on the other hand kept seeing a prism in my mind, shattering a sunbeam into a thousand different colors.

And here’s what I found most interesting about the difference.  When I saw dying as black I felt like I’d just pulled a plastic bag over my head.  But when I let that go and suddenly saw it as a prism full of rainbows instead, that feeling of suffocation turned into curiosity and wonder and a delightful sense of mystery which honestly was the experience I tended to actually have when I worked with hospice.  It was really, really magical hanging out with dying people, not black at all.

BTW, the opening/closing question marks at the top of the post came from a Wikipedia discussion of question marks (“also known as an interrogation pointinterrogation markquestion pointquery, or eroteme”), which was kind of interesting in its own right and totally distracted me.  (Not hard to do though.)  Here’s the link.

copyright Dia Osborn 2013

How to talk with someone who’s dying.

There’s an extraordinary video blog I’ve been following for a while which chronicles the cancer adventures of a man named David and it’s been heartening to me, watching someone talk so freely and openly about what it’s like to face the realities of catastrophic illness and the possibility of impending death.  David is very engaging.

I was a little late to his most recent post (posted back in June) but it appears that after a glorious period of remission his cancer is back, with a vengeance, and the prospect of impending death has now turned into the certainty of it.  This video addresses the various thoughts coming up for him around the sudden turn of events.

I HIGHLY RECOMMEND WATCHING THIS for anyone who’s ever wondered what in the world they’re supposed to say to someone who’s dying.

It’s about ten minutes long and worth every second.  David covers what it feels like to have people tell him that he still looks great, or talk about/plan future events that he’s not likely to share in, or in other ways try to skirt or deny his new dawning reality and place him in a position of having to pretend like everything’s still okay.

Then…and this is the extraordinary part for me…he talks about what it’s really like living in the constant awareness that everything he’s now experiencing is probably for the last time.  How in some moments he experiences great fear of the passage to come and how at other times the world around him is highlighted with an exquisite, poignant beauty that’s both heartbreaking and luminous.

These are the kinds of things that all dying people think about but usually find it difficult to share.  David is brave and articulate enough to step up to the plate and actually tell you about it.  I warmly invite you to take advantage of this rare opportunity and learn from him.  It’ll hopefully help make your next encounter with someone who’s dying more nourishing and comfortable for you both.

UPDATE: The hubster pointed out that, in spite of the promise in this post’s title, neither David nor I gave any explicit instructions about how to talk to someone who’s dying.  (It wasn’t David’s intention in the first place and I…well, I just dropped the ball.)  To remedy the lapse:

In a nutshell, don’t run, don’t deny, don’t deflect.  Instead, listen carefully to what they’re trying to tell you, let it in, then follow their lead….as best you can of course.  There’s always a learning curve so be patient with yourself.

That approach usually opens up whole new worlds.  –Editor