Off the Cushion: The Eternal Care Unit

Chester Arnold, A Hawk’s Attention, 2015. Catharine Clark Gallery.

To what shall I compare
this life of ours?
Even before I can say
it is like a lightning flash
or a dewdrop
it is no more.
Sengai (1750–1837)

By Pamela Gayle White 
(Reblogged from

When I was in retreat, death and impermanence—death’s harmonic base—provided the background tone of every practice, from preliminary contemplations to yogas focusing on the dissolution of the elements and aggregates that occurs when we die. For months, maybe years, my beloved retreat master, Gendun Rinpoche, answered virtually all my questions (even the most abstruse) with a laugh and the suggestion that I delve deeper into impermanence.

I’m still burrowing. Here at the hospital, we witness the dark side of impermanence every day. The hemorrhage that floods the brain on the eve of a long-anticipated cruise, the tumble from the ladder, the drive-by shooting. The stillborn twins, the metastatic rampage, the overdose. As chaplains, every day we tend to the dying, their families, and their caregivers—and still it is difficult to fathom that we too are really, truly going to die.

Even in Buddhist circles, traced on the ever-shifting ground of birth, aging, sickness, and death, many of us have neglected to sign advance care directives or even designate someone who can make decisions for us when we are no longer able. My own form needs updating; it awaits somewhere on my to-do list. There’s always tomorrow. Until there isn’t.

At work one evening a nurse asked me to see an elderly woman whose husband’s health had taken a sudden turn for the worse. In intensive care, Claude was sedated as machines ensured continuity of his essential bodily functions. Willie, his careworn wife, broke down and sobbed in my arms; they had been married for six decades, and she wasn’t prepared for widowhood. We prayed.

The following afternoon I approached Claude’s room with a sharp pinch of dread; clearly he would not recover, not even enough to go home to die. But the atmosphere was unexpectedly welcoming, with music playing softly in the background and Virginia’s Blue Ridge Mountains in the distance. Claude had transitioned to “comfort care”; he was awake and alert. Gone were most of the tubes, beeps, and bustlings. The priest had been through. Family members were en route.

“I’ve been blessed by the love of a good woman, and I have no doubt where I’m headed,” Claude told me. His serenity and faith enhanced the room’s warm glow. Willie’s grief had become deeper, yet more accepting. Later on, as his family surrounded him in love and song, Claude did go gentle into that good night.

We’ve been programmed for life since beginningless time; programmed to use our perceptions as the building blocks that make existence seem solid.

It was as “good” a death as can be imagined. What made it particularly poignant is that Claude knew he was about to die. Most of the dying people here are too sick to truly take stock of their situation; few are as lucid as Claude was. Some go in gratitude for how their life has blossomed and for the seeds they have left behind; others depart in agony or anger, praying for a miracle of healing to the last breath; yet others, seemingly unaware, simply slip away.

What would it be like to know that death looms? Last autumn, at the Buddhist Contemplative Care Symposium in upstate New York, I attended a workshop during which we were invited to close our eyes and imagine our funeral. The workshop leader asked who was having the hardest time dealing with our own death. I was surfing that one pretty comfortably until I pictured a memorial of sorts and there was Moune, my sweet shaggy dog, whining softly and looking around for me. That’s when my anguish cracked open. My Moune without me.

There was a discussion after the exercise. A young woman said that even though she’d spent a good deal of time contemplating and practicing with the subject, she still couldn’t imagine being dead. Her comment was left dangling, but it had weight. Death is uncharted territory for this unlikely, transitory medley we think of as “me.” We’ve been programmed for life since beginningless time; programmed to use our perceptions as the building blocks that make existence seem solid. How could we imagine not perceiving? How could the world possibly continue to spin without us?

Since it doesn’t make sense, it may seem easier to just pretend it’s not there. The Voldemortish “That-Which-Must-Not-Be-Named” aura doesn’t help. Euphemisms abound: pass away, croak, meet one’s maker, bite the dust, shuffle off this mortal coil. . . . A nurse on one of my floors calls it “heading for the ECU: the Eternal Care Unit.”

But it is, inescapably, death. It can be a great relief to embrace the inevitable, to give voice to it, to hold it, and, finally, to leave the mystery unsolved. In The Cancer Journals, the poet Audre Lorde wrote, “What is there possibly left for us to be afraid of, after we have dealt face to face with death and not embraced it? Once I accept the existence of dying as a life process, who can ever have power over me again?”

Naturally, I wonder what it will take for me to be able to die, like Claude, unafraid and in peace. I’m praying that I will be ready, inspired, and awake. That I will not be hampered by too many burdens of regret or unfinished business or important things left unsaid. That curiosity, connection, and gratitude will get me through. Though he died almost two decades ago, I can imagine asking Gendun Rinpoche for advice on how best to prepare for death. And I hear him urging me to reflect on impermanence, now, and laughing.

Pamela Gayle White is a dharma teacher and translator in the Bodhi Path network and a Tricycle contributing editor. She is a chaplain resident at the University of Virginia Medical Center, “on sabbatical” from her regular activities.

Chester Arnold, A Hawk’s Attention, 2015. Oil on linen, 46 x 54 inches. Image courtesy of Catharine Clark Gallery.

PNA Swoosh


The House II

By Marilyn Zuckerman

Zuckerman home deck (courtesy Louise S. Wright Design)

(Photo courtesy Louise S. Wright)

Deck Afternoon

Hello Louise,
I’ve been sitting
on your beautiful deck
imagining I am
on the deck of a steamer
although I am listening as well
to the pileated woodpecker
ratatatting away
a few blocks below me
(unless it was a neighbor
driving nails)
but, no it had that intermittent
woodpecker tattoo.
So thank you.

Pileated woodpecker

The deck for me is the star of the show for one who can no longer travel. It is my ship reaching out to the Sound and to the mountains and to go on sea voyages. So I’m almost surprised not to feel the swell, not to get seasick.

When one is of ripe old age, it is easy to imagine many things as one watches the sea and the earth with its billions of years – earthquakes, mudslides, floods and death that old trickster lurking.

My Ship

Sitting alone
on the deck in the dark
in a steamer chair
counting airplanes and Christmas lights
instead of stars
watching the storm break
breathing fresh air
staring at the Sound
for this is what I came for

I said I wanted a deck to see the world from, a balcony of cables so slender you could forget they were there. I said I wanted something spacious, I wanted sun and shade and now here’s the railing burnished red, there the fragile cords fine as threads. Now someone as restless as me is calmed by the scene before me – the sea, the trees tumbling to the ground, the wild wind singing.

Crows: An Anthropomorphic Poem

Crow on a Branch by Kawanabe Kyosai (1831–1889)

What do two crows say to each other
sitting on a wire above the deck
staring as I am at the sunlit waters of Puget Sound
They are:
sometimes posing in haughty indignation
beaks at dueling position
a high wire act
as one sidles over in sad supplication

She: seductively
maybe we can stop tormenting eagles
and settle down
spend more time together
He: sleepily
we’ll see
though he has clearly
begun to feel
the lure of a quiet life

when one flies off
the other follows in hot pursuit

·    ·    ·

Dedicated to Louise Wright who designed not only the deck, but so much of the house.

These poems form the second installment in an ongoing sequence about the construction of my home—read the first here.

PNA Swoosh

How Americans’ refusal to talk about death hurts the elderly

the conversation about death is really about autonomy (via Vox)

By Sarah Kliff
Vox—January 11, 2015

In my family, we don’t really talk about death. But, every now and then, we joke about it.

For some reason, there is a running joke among my immediate family about how my parents will die. Specifically, my brother and I will come home for Thanksgiving one year and find them decomposing on the couch.

…these conversations could be the starting point for a health-care system that cares just as well for patients who will heal as those who will not

Yes, this is a bizarre thing to crack jokes about. But it’s also, in its own, ghoulish way, a bit of a fantasy — an affront to the way that Americans tend to die in the 21st century, with ticking machines and tubes and round-the-clock care. In this joke, my parents’ death is a simple, quiet, and uncomplicated death at home.

I joke about death because I am as terrified of having serious end-of-life conversations as the next person. Usually I don’t have to think much about dying: my job as a health-care reporter means writing about the massive part of our country devoted to saving lives — how the hospitals, doctors, and drugs that consume 18 percent of our economy all work together, every day, to patch up millions of bodies.

But recently, the most interesting stories in health care have been about death: the situations where all the hospitals, doctors, and drugs in the world cannot halt the inevitable.

Read the full article here