Thursday, March 6, 2014

Death And Dignity



A few days ago Sherwin B. Nuland died. Some of you may know him as the author of the Pulitzer Prize-winning and bestselling book How We Die, published in 1994. Nuland sought to dispel the popular myth that most deaths take place the way they do in the movies – a few poignant, funny or enigmatic last words, then the eyes closing and then a peaceful and swift slipping away. As a doctor Nuland knew that only a few have the good fortune to end like that, and he did not flinch to describe in detail what it is often really like. It is for the most part pretty much how the Buddha described it – dukkha, sometimes extreme dukkha. Nuland added to this that modern medicine sometimes actually adds to the dukkha  by prolonging it. Only recently I read an article in the local newspaper about the death by cancer of a Singaporean personality. The writer commented approvingly that “she fought it to the last”. This unhelpful attitude, so widely promoted nowadays,  is also  a cause of a great deal of pain and suffering in the months or weeks leading to up to death. The old idea of having the wisdom of knowing when your time has come, accepting it, and letting the process take its course, doesn’t accord with the  popular insistence of putting a positive spin on everything. Nuland wrote: “If the classical image of dying with dignity must be modified or even discarded, what is to be salvaged of our hope for the final memories we leave to those who love us? The dignity we seek in dying must be found in the dignity with which we have lived our lives.” Nuland was 83 and he died of can prostate cancer. I hope it was for him a peaceful and easy end.       

4 comments:

  1. I'm tempted to say that death, like many other human experiences, is probably overrated. I give it 3 stars out of five. Of course all jokes aside, death is the great leveller of status, wealth and reputation. Probably the greatest apprehension we all have in regard to death is the possibility of mortal pain and suffering leading up to the break up of the body and the crossing of that great event horizon to the unknown. The notion that westerners don't cope with death as well as people of the east is just that, an unhelpful cliché and generalization. For instance the Tibetan tradition of chanting over the deceased for 40? days, always seems to me to be more about the process of mourning rather than "wire guiding" the deceased through the bardo to a "soft landing" in a fortunate rebirth. Such a tradition can only be supported in a low bacteria, near freezing environment. The loss of those close to us has the tendency to open up an uncloseable hole in our otherwise "safe" and familiar refuge of living with all it's hopes and dreams. Of course, that's why we call ourselves Buddhists, because the Buddha has been truthful and to the point about how best to conduct our lives. When the prospect of, or actual moment of death takes hold, we will have the least cause for regret and apprehension. Like many other things in life, we can at least train ourselves and prepare for what we call death. Happy trails everybody!

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  2. I've thought for a long while that a case could be made that there is no such thing as death. If death existed then gradually, over time, the "stuff" of life would be slowly extinguished as each little bit of it dies and is removed from the possibility of life. Slowly, or perhaps rapidly, death would overwhelm life by claiming for itself the potential for life in every bit of living tissue that dies. But we don't see that happening. What happens is that the "stuff" of life (the elements) gets picked up and reused over and over as if it had never died. The abundance of life today, after billions of years of death claiming untold numbers of lives seemingly disproves that there will every be a shortage of it at all.

    Of course it's extremely flinty, to say the least, of postulating such comments around people who are sick or dying. I should investigate such things and establish a practice while I'm healthy, so that the rewards can be enjoyed in a healthy state. What distresses me so about death is what dies: the particular, the Ego, the I. Perhaps it's best to kill those things now and get it over with.

    I've also often wondered about the term "the Deathless" i.e. becoming invisible to death. But if I become invisible to death what do I become visible to? A circle of Buddhas, perhaps…happy, welcoming beings wondering what took me so long. Buddhism is hard work, but worth every effort.

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  3. The problem with certain slow deaths (cancer) is mainly the pain. There is no way even through Buddhism to get rid of this kind of dukkha, as extreme pain can only be managed by medication and just alleviated, but not extinguished, by the mind. That could be one reason why it might be more pragmatic to deal with pain management in life than with an extension of patience and serenity. The other point made here, the ability to let go and know of the right time to die, could very well be perfected by suicide in the face of hopeless decay. This is an almost perfect way, if done right, to know the right time.

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  4. "Kaya passaddhi" is the state of the mind which does not feel pain from the body. (The mind that clings, let go of the body it is clinging to), having developed "sekha bala"

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