Thursday, March 23, 2017

Being Mortal (March 19, 2017)



Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

Dylan Thomas wrote, as he anticipated the death of his father. These words capture something of our cultural attitude ; we live in a death denying culture. We believe and behave as if life must be preserved at literally all cost. We spend a surprising amount of our health care budget as a nation trying to prolong the end of life. “According to one study, 30% of all Medicare expenditures are attributed to the 5% of beneficiaries that die each year, with 1/3 of that cost occurring in the last month of life.“ That makes sense to me- what wouldn’t I give to help a loved one in their critical hours. Unfortunately it turns out all that intervention may not really be making our dying easier “…In the Archives of Internal Medicine, a study asked if a better quality of death takes place when per capital cost rise. The study found that the less money spent in this time period, the better the death experience is for the patient.”[i]

If all those extra interventions at the end of life aren’t making the patient happier, making their death easier, we must be doing those interventions for another reason. I think on some level we believe that it is our duty to fight, as long and hard as we can. As if the value of a life is measured in the number of hours our heart beats. As if longevity were a form of virtue. But, as my teacher Don Bisson assured us, death is not a failure. The very fact that we are alive means that someday each of us will die. Let’s take a moment and just sit with that truth. How does it make you feel? Sad? Angry? Scared? numb? Perhaps in our culture there is a subtle taboo against even thinking or talking about our own very real mortality- as if by thinking about it we make it so.

When I was 5 years old I remember lying in bed as my mom, having been awoken by her terrified daughter in the middle of the night, patiently explained that we did not live near a volcano, and no one in Pennsylvania was going to die in a volcano before morning. Her patient explanation did nothing to sooth me though, because once you realize, deep in your bones, that your time is finite, it awakens our most basic human fear. When I was growing up I had, as one family therapist called it, a precocious sense of my own mortality. When I was about the age my son Nick is now, I remember writing a will and telling my family that I wanted every intervention, every modern marvel of medicine used to keep me alive as long as possible.

Part of the reason I ended up going to seminary was because this dread of death was keeping me from truly enjoying life- death seemed too high a cost to pay for living. Fortunately, my very first semester in seminary I took a class in Buddhism which teaches us that much of the suffering we experience comes from the energy we spend pushing way, denying, and otherwise trying not to look at our own impermanence and the impermanence of everything under the sun. I began during that class a practice I continue to this day; whenever I think about death now, instead of trying to run from the idea in my own mind, I just slow down, breathe, and with compassion for myself notice those difficult ideas and feelings. From that compassionate place I began to wonder- does death have a value of its own? Consider that every death is as unique as every birth, as every person. Dying is the end of every life story, so what if we allowed ourselves to give attention, thought, even grief to shaping the end of our story. Are we empowered to shape our death as we shaper the rest of our life? Could we ever feel clear enough to say "enough" or "this is my time"? Could we give our own death at least as much thought as we would give moving to a new town, or starting a new job? Because I believe in doing so we might not only make our own death easier for ourselves and easier for our loved ones, but we might improve the quality of our living as well.

Psychologist Erich Fromm writes, “To die is poignantly bitter, but the idea of having to die without having lived is unbearable.” It’s easy to let the ordinary patterns of life carry us inexorably through the years as we wait for our life to begin. When we remember the reality of our own death, it can be the shock that wakes us up. Perhaps it has happened to you that a scary diagnosis, or the death of a loved one, or even a scary moment in traffic as you white knuckled your way out of a near crash has woken something in you that remembers what a precious gift life is, that its brevity makes it only that much more urgent that we live fully and well. This past Friday the Adult RE class explored the writings of UU minister William Schultz who said:

“I think the great Danish existentialist Soren Kierkegaard had it exactly right when he suggested that “fear and trembling” are requisite to being a religious person and that only when we overcome our denial of death are we likely to truly “remember existence.” [Finding Time and Other Delicacies William Schultz p. 120]


So let’s take some time this morning to sit with death; to look deep in ourselves and see what comes up for us as we do. First, let’s take just a moment here together in this safe and loving space, to imagine ourselves at the end of our own lives. [You’ll find an insert in your order of service that includes a place where, if you choose, you might take some notes for yourself if you choose. ]

As you imagine the end of your own life, what images or feelings come to mind?.....Most of us can’t choose the moment or circumstances of our death, but there are often choices we can make. Imagine what death you would choose for yourself? [pause for reflection]

I asked my son’s permission to share my memory of a time when Nick was about the same age I was as I worried about those volcanoes. He asked me, inconsolable, what would happen to him if we died. I talked to him about feelings and about theology, but ultimately it was when I explained that we had a plan, called a will, all written up that his worries seemed to calm a bit. I told him that his Godmother Suzanne had the plan and would make sure it got carried out, and that my sister and her family had agreed to take Nick into their home and raise him like a son, like a brother to his cousins. And I explained about life insurance, so he wouldn’t have to worry about money. He seemed much comforted. By bravely considering the practical aspects of our own end of life, we have a chance to make a challenging time a little smoother for our loved ones, and to ease our own worry as practical planning often does. Let’s take a moment now to think about what things we’d like to do to make our own death easier for those we care about. [pause to reflect]

As a beloved community we also think about how we can support the dying process for everyone. For example, in January the Medical Aid in Dying Act for 2017 (S.3151/A.2383), was reintroduced in New York State. This is “a bill to give New Yorkers the option to make end-of-life healthcare decisions that are right for them in the final stages of a terminal illness”.[ii] If there are options you would want in facing your own death, you might consider calling or writing your state representatives to let them know. 

And now imagine holding everyone in this room in a spirit of compassion. In this compassionate space, look back over your life knowing it is finite, and notice if there is anything that you feel called to do in your remaining time? To hold your loved ones more closely? To have more fun? To mentor someone younger? To seek forgiveness or reconciliation? Is there anything you might do that would give your life greater wholeness and meaning? [pause for reflection]

I believe with Mary Oliver that:

To live in this world
you must be able
to do three things:
to love what is mortal;
to hold it
against your bones knowing
your own life depends on it;

There is a real danger that an awareness of our own mortality could cause us to closer our hearts to all that is mortal, knowing that we will lose it. But Oliver counsels us to courage. Loving the impermanent things of life, loving them deeply is what life is made of. We hold the things we love “against our bones” knowing that our life does in fact depend on it. This is the only thing that can protect us from dying without having lived.

Part of the reason I no longer live in my teen-aged panic of death, is because I finally feel I have lived. I have had adventures and made mistakes. I have loved people dearly, and been helpful where I could. And so I went back to my family and said I no longer feel like I want and need every intervention science has to offer. That if I have a chance to die quickly, peacefully, near people I love, I ask them to let me go. That’s other part of Oliver’s advice - “when the time comes to let it go.” The Buddha taught that much of suffering comes from our attachment to things just as they are, things as we want and expect them to be. At some point we must turn our energy from holding what we love to our bones, to letting it go. And if we are lucky, that letting go may have some grace and peace to it. If we prefer to rage rage against the dying of the light, that is our choice too. But let us bring as much consciousness, as much compassion as we can muster to our moments of loss and transition, because they are an important part of life.

As difficult as it is to even consider our own mortality, I believe it is one of the most important parts of the spiritual journey. And one of the most important parts about being in beloved community is sharing these questions and concerns with one another. Consider who you want to talk with about these issues, whom you want to be there with you at the end, who should know what you want and what you value. We, your beloved community, want to support you and be present for you in the whole of our lives together, including all the complexity and intensity of our dying.

A couple of years ago we had a class here called “Ending Well” where we had an opportunity to talk together about these difficult questions. I will make the same deal with you that I made with the class – if you think of something you want to do to prepare for your end of life, we want to help. If you create a document about your choices and need witnesses, bring it to church and we will witness it. If you need someone to talk to, look around the room and consider who you would feel comfortable talking to. This is definitely you are welcome to call your minister, but there may be others here with whom it would be easier to speak, or who have more experience. On the back of your note sheet, there are some useful links that can help with practical plans if you are feeling called in that direction. One is called “the conversation project” whose only aim is to help us have these important conversations with our friends and families. I have also included links where you can find forms for advance directives for Pennsylvania and NY state. If you create a goal and then accomplish it – if you have a conversation with your partner, or create an advance directive, or update your will -- I personally promise to bake you a dozen cookies. Just let me know.

Death is not a failure. Not our own death, nor the deaths of our loved ones. Death is an important part of life, the last chapter of each story. When we deny death, we miss the chance to make choices and decisions that will affect us and our loved ones. We miss the chance to grieve and to rage and to find peace. We miss the wake up call that death brings, reminding us how precious is this very moment -- how precious is the life of every being. Let this be a community where together we bravely shine the light of consciousness on our own mortality, and ask together “knowing that each must dye, how then shall we live?”




Resources for thinking more about these questions:

The Conversation Project is dedicated to helping people talk about their wishes for end-of-life care. http://theconversationproject.org/

Information about and forms for Advance directives can be found:
New York State:
https://ag.ny.gov/sites/default/files/pdfs/publications/Planning_Your_Health_Care_in_Advance.pdf
http://www.aarp.org/content/dam/aarp/relationships/caregiving/2011_01/ad/NewYork.pdf

Pennsylvania:
http://www.aarp.org/content/dam/aarp/relationships/caregiving/2011_01/ad/Pennsylvania.pdf
http://www.pabar.org/clips/AdvanceHealthCareDirective.pdf

Alternately, some prefer to use the “5 wishes” format found here:
https://www.agingwithdignity.org/

Frontline: Facing Death- This site contains a documentary about end of life care, and educational resource guides
http://www.pbs.org/wgbh/pages/frontline/facing-death/

Compassionate Choices has resources both for making decisions about your own choices, and also to support legislation that provides the right to make those choices to all:
https://www.compassionandchoices.org/

Resources for healing grief:
http://www.journeyofhearts.org/
http://www.griefnet.org/about/navigator.html