This Body is Not Me

 Thich Nhat Hahn:

This body is not me.

This body is not me.

I am not limited by this body.

I am life without boundaries.

I have never been born,

and I have never died.

Look at the ocean and the sky filled with stars,

manifestations from my wondrous true mind.

Since before time, I have been free.

Birth and death are only doors through which we pass,

sacred thresholds on our journey.

Birth and death are a game of hide-and-seek.

So laugh with me,

hold my hand,

let us say good-bye,

say good-bye, to meet again soon.

We meet today.

We will meet again tomorrow.

We will meet at the source every moment.

We meet each other in all forms of life.

Advanced Directives Should Focus on Quality of Life, Not Technology

A letter to the editors of the New York Times: 

 Re “A Better Way to Face Death,” by Dr. Daniela J. Lamas (Opinion guest essay, Jan. 6): Too often, advance directives are construed as immutable guides to how one dies. 

We have found advance directives to be more helpful if we focus on how one wants to live. If we ask about ventilators or dialysis or artificial nutrition, we are typically asking people to express opinions about topics that they do not know well, usually based on preconceived and often inaccurate notions about these medical technologies. 

It is little wonder, then, when actually faced with the technology, patients will change their mind. What was once unacceptable may now be tolerable because life still holds a desired quality. The opposite may occur; treatment that was once strongly desired in the abstract may not deliver the quality of life that was hoped for. A

dvance directives should accomplish two goals: identification of a surrogate — one who can “stand in the shoes” of the patient, and the identification of preferences — what is important in how you live. A focus on evolving ideas rather than document completion will be more likely to bring the patient’s voice to decision-making at crucial times. 

 Margaret M. Mahon Ann Berger Bethesda, Md. 

Dr. Berger is chief of the Pain and Palliative Care team at the National Institutes of Health Clinical Center, and Ms. Mahon is a nurse practitioner with the team. 

 The other letters in response are also worth reading. Excerpts: 

 The anxiety, indignities and angst of advanced age demand acceptance — and a sense of humor. Like most of my peers, I am not afraid of dying but of being kept alive. 

 [My father's] health care proxy came by every day and turned up the morphine, and my dad always turned it down. He said he didn’t have that much pain if he lay still, and he found that he got more relief from holding hands than from morphine.

“If you have an abundance of love to give, you should give it" -- Strangers Make Bucket List Dreams Come True

The Washington Post has a wonderful story about the daughter of a man who is terminally ill, and the strangers who found his story on Facebook and helped to make his last days full of adventure and new friends. He had VIP visits to an MMA fight, a Naval helicopter, and a private violin concert.

Billy Collins: The Afterlife

While you are preparing for sleep, brushing your teeth, or riffling through a magazine in bed, the dead of the day are setting out on their journey. They’re moving off in all imaginable directions, each according to his own private belief, and this is the secret that silent Lazarus would not reveal: that everyone is right, as it turns out. you go to the place you always thought you would go, The place you kept lit in an alcove in your head. Some are being shot into a funnel of flashing colors into a zone of light, white as a January sun. Others are standing naked before a forbidding judge who sits with a golden ladder on one side, a coal chute on the other. Some have already joined the celestial choir and are singing as if they have been doing this forever, while the less inventive find themselves stuck in a big air conditioned room full of food and chorus girls. Some are approaching the apartment of the female God, a woman in her forties with short wiry hair and glasses hanging from her neck by a string. With one eye she regards the dead through a hole in her door. There are those who are squeezing into the bodies of animals–eagles and leopards–and one trying on the skin of a monkey like a tight suit, ready to begin another life in a more simple key, while others float off into some benign vagueness, little units of energy heading for the ultimate elsewhere. There are even a few classicists being led to an underworld by a mythological creature with a beard and hooves. He will bring them to the mouth of the furious cave guarded over by Edith Hamilton and her three-headed dog. The rest just lie on their backs in their coffins wishing they could return so they could learn Italian or see the pyramids, or play some golf in a light rain. They wish they could wake in the morning like you and stand at a window examining the winter trees, every branch traced with the ghost writing of snow. (And some just smile, forever on)

The Advance Directive Said DNR, But....

A crowd of various medical staffers quickly gathered in the small room where an elderly man, Mr. R, had unexpectedly lost his pulse while undergoing a CAT scan. For several minutes, the patient endured multiple rounds of rib-breaking thrusts to his chest to restart his heart. Then, suddenly, a nurse who had been reading through his medical chart screamed, “This man has an advanced directive from six years ago that says he does not want resuscitative measures!” Nearly all the heads in the room turned, many staffers confused as to whether to continue the resuscitation. The advanced directive is a legal document that records a patient’s preferences for medical care in case communicating them is impossible. In most cases, a "do not resuscitate" order alone might stop a medical team from pursuing further intervention. But this man, unlike many patients in the intensive care unit who were clearly close to dying, had walked into the hospital for an elective diagnostic work-up. As of that morning, he was not close to dying, and even within moments of starting CPR, we felt reasonably certain that we could resuscitate him....He walked out of the hospital two days later, knowing that he had almost died. What he did not know was that aside from his heart stopping, he'd come one step closer to death because of a lack of clarity in his code status, which easily could have resulted in us stopping our efforts to revive him.

Bishop Tutu: "An Unpretentious Monk's Homegoing"

From the very wise Amy Cunningham, about the burial of Desmond Tutu:

The church setting was glorious, and the other bishops wore their robes, but surely the great man who helped upend apartheid would exit in a mahogany, walnut or cherry casket with brass rails of some sort. And wait a minute—what’s going on there with the slender foot-end of the Archbishop’s pine coffin resting naked, skirt-less on the church truck? It’s not landing normally. No rails on the sides, just rope. Tiny fist of flowers for a significant public figure like that? Yes. It’s not that the funeral directors I know staring at photos like the one above—longing only for a dignified look—are hoping to up-sell the theologian’s handlers. It’s just that some folks in funeral work instinctively struggle to pair humility with high stature. In truth, I also would have preferred a truck skirt or bier, or modern catafalque in church, but the rolling truck, in the end, had a nimbleness to it, and spoke to transparency. What you see is what you get: an unpretentious monk’s homegoing.