Living Well, Dying Well

Living Well, Dying Well

Two good friends have died in the last two weeks. Long lives, well lived. Companioned in their passage from living well to dying well by family and friends who loved them and who could hold the process with an extraordinary amount of ease and peace. 

In my age group (75 this year) the passage from living well into dying well will become a more frequent occurrence. 

As so often happens, resources about accepting the letting go arrived in my life that same week with exquisite timing. 

The poem Let It Go by Rev. Sapphire Rose is below; dying really can be this peaceful. 

And the focus of this month’s NeuroDharma meeting (24 members; monthly meetings for 15 years; deep interest in neuroscience, contemplative practice, and by unspoken agreement, Western psychology) was an exploration of medically assisted dying by a practicing neurologist who has begun assisting patients who choose to end their own life under California’s End of Life Option Act, including discussing the tension between two ethical tenets of the Hippocratic oath: to do no harm, to relieve suffering. 

The insights from that NeuroDharma meeting led me to read one of the resources listed below in two days, in time to include it in this post. This Is Assisted Dying; A Doctor’s Story of Empowering Patients at the End of Life by Stefanie Green, M.D. is an insightful and warmly humane account of Dr. Green’s shift from 20 years in maternity and newborn care to learning how to “reduce suffering, listen carefully,, affirm choices and empower decision making” in Canada’s new Medical Assistance in Dying protocol, and a thoroughly thoughtful exploration of how patient-centered choices at end of life can open the door to more dignity and ease at end-of-life transitions. 

Back to the NeuroDharma meeting, which focused on what brain studies and Buddhist teachings might have to say about medically assisted dying. There was quite an interesting confluence in what might be happening in the brain/mind at the moment the brain dies (and the body not kept functioning through medical technology). There are a few EEG scans available of patients at the very instant they died. The scans show a spike of activity in the areas of the brain that process auditory, sensory, and visual input, with a corresponding decline in the areas of the brain that make decisions and keep track of a sense of self in time and space and boundaries between “self” and “other.” (And a spike of the high frequency gamma waves as well, indicating an overall integration of brain functioning.)

One of the long-time teachers of Tibetan Buddhism immediately commented that that’s exactly what happens in the deepest experiences of meditation, and of course, Tibetan Buddhist practitioners spend quite a bit of time meditating, contemplating, and preparing for their own deaths, to experience the “clear light of consciousness” at the moment the body ceases functioning that will transition them safely to the next life. 

So it seems to make sense to practice cultivating the qualities of mind we would like to be experiencing at the moment our body/brains dies and want to carry into the next life so that the brain can automatically activate those qualities in that moment of “the clear light of consciousness.” 

The possibility that we might have some choice about how our body/minds experience dying led someone to say they felt “more friendly with death.” Indeed, of all the people who choose medically assisted dying, 25-30% change their mind and die naturally rather than using the medications to time their dying. Somehow the sense of agency and control makes it easier to manage the fear, pain and sense of urgency; their deaths can be more friendly, too. 

As I age and capacities diminish, I have sometimes thought of exploring medically assisted dying. What encouraged me the most about this NeuroDharma evening was the sense of community where it was safe and even very interesting to explore these possibilities, medication and meditation, with interest, curiosity, and compassion. 

Let It Go

– Reverend Sapphire Rose

Without a word or a sound, he let go.

He let go of the fear. He let go of the judgements.  He let go of the confluence of opinions swarming around his head.  He let go of the committee of indecision within him. He let go of all the right reasons, wholly and completely, without hesitation or worry. He just let go.

He didn’t ask anyone for advice. He didn’t read a book on how to let go. He didn’t even search the scriptures. He just let go.

He let go of all the memories that held him back.

He let go of all the anxiety about moving forward. He let go of the planning and all the calculations about how to do it just right. He didn’t promise to let go. He didn’t journal about it. He didn’t enter the projected date in his daytimer. He made no public announcement and put no ad in the paper.

He didn’t even read the horoscope or read the daily news forecast. He just let go.

He didn’t analyze whether he should let go. He didn’t call his friends to discuss the matter. He didn’t do a 5-step spiritual mind treatment. He didn’t call the prayer line. He didn’t utter one word. He just let go. 

Like a leaf falling from a tree. No one was around when it happened. There was no applause or congratulations. No one thanked him or praised him. No one noticed a thing. Without any effort or any struggle, he just let go.  It wasn’t good. It wasn’t bad. It was what it was, and is just that.

And in the space of letting go, he let it all be. A slight breeze blew through him; a smile came over his face. And the sun and the moon shone forever more.


Tricycle magazine review of This Is Assisted Dying by Stefanie Green https://tricycle.org/magazine/this-is-assisted-dying-review/ 

This Is Assisted Dying: A Doctor’s Story of Empowering Patients at the End of Life, Stefanie Green, M.D. 

Medical Aid in Dying: A Guide for Patients and Their Supporters, Lonny Shavelson, M.D.

Film Last Flight Home, the truly heartwarming and inspiring story of Eli Timoner’s journey to a medically assisted death, surrounded, supported, and cherished by family and friends.