I write to those of you who have received a terminal prognosis. Having worked with hundreds of dying people, I know I can only imagine the shocks of incredulity, fear, and despair you have endured since you received this news. I know that only someone who has faced the same news can really understand how you feel, how your life has changed. Other people have walked the path you now face, though. Over my years of hospice work, they have allowed me to be their witness and companion. What follows is the essence of what they have taught me.
You have never died before. How do you prepare? You have already been knocked with a wallop out of the ordinary distractions at the surface of life, out of the taken-for-granted next breath. You are already beginning to live with an intensity and urgency you may have never known before.
The end of life is a time when all the spiritual suggestions for living, accumulated throughout the ages, become insistent, illuminated, written in capital letters. As others who are living close to the end of their lives have discovered, these suggestions have always been offered not so much to make us "good" or saintly persons, but because they speak about what works
--what makes living, and especially living with dying, easier somehow, fuller, and, though it may sound impossible as you read these words, more deeply satisfying.
The time of sickness will be the hardest time. As hundreds of hospice patients have described it to me, you will be up with a good test, down with every new discomfort, every new change in your body's functioning. Your relationship with hope will transform. The very meaning of the word will change for you--as will time, and priority, and even your sense of who you are. The first advice I think my hospice teachers would offer you is to simply breathe and learn to detach a tiny bit, watching yourself as you go through these changes and remembering that you are not these symptoms. Practice equanimity
.
Wrap up the loose ends of your life. Practically, wrap up your connection with the world of things. Empty yourself now of all that is not essential. Lighten your load. Physically and spiritually, remember that although medicine has given us much to make living easier, it has made dying a bit harder. Think about what you want for yourself in terms of medicine's ability to artificially prolong life. Ask yourself questions--and make your answers known. What is the minimum quality of life with which you're willing to still live? What do you want for yourself at the hour of your death? What will give you strength? (And, if it will give you strength then, turn to it now.) You should know that you will experience a profound transformation, that will move you through a painful chaos, a perhaps now-unimaginable surrender, and a grace-filled experience of Spirit. Prepare yourself for it. Recognize it when it happens. Practice responsibility
.
Make your peace with the people in your life. If there are those who need to know you love them, tell them. Taste, breathe, and rejoice in appreciation of each other as you may never have before. Practice gratitude
.
If you need to make amends with someone, do it now. For those who have harmed you, as well as for that part of yourself that has done harm, practice forgiveness
.
There is no room for pride or frivolity now. All that we have in the end is our love--for those who have been precious to us, for this beautiful planet, for the gift of life. Let your body be used up in loving. Practice love
.
Live every second that remains to you the way you wish you had lived every second that's already gone by. It will make your living more content. It will make your dying more peaceful. This world is only our temporary address. We were born with no promises except that we would die. That is the price of the precious, fragile opportunity of a life in a human body. But while you still possess the gift of life, practice simply being
.
Find someone to talk with--to express everything you are feeling, without judgment or censoring. You will be better able to handle the way you are feeling, and your truth will be a help and a guide to all who hear it. Practice acceptance
.
The time of sickness can be a brutal physical and psychological assault. Remember that although we do not die easily, we do die transformed. There is extraordinary grace in dying. Find a strong and simple spiritual practice that will serve you in a time of crisis, or deepen your present one, so that there is a spaciousness in you to receive the loving and radiant grace that will fill you. Let the people who love you know about your practice so they can do it with you and for you if you become unable to do it for yourself. Practice prayer or meditation
.
In all likelihood, you will feel weak and sick, and in all likelihood, it will be difficult. Be accepting of yourself in our shared fragility, in our vulnerability, in our utter littleness in the face of a power so much greater than who we think we are. Let your mind empty and your heart break open as you say good-bye. Just as we have no choice but to trust the process of birth, we have no choice but to trust the process of death. The intensity of being that you will discover in yourself as you go through the profound transformations of dying is not without purpose. You will begin to resonate with deeper and more subtle dimensions of being. In your own way and in your own time, you will come to know that you are entering a safe, loving, vaster Existence, radiant with Spirit. Practice surrender
.
May we do these practices in our living and in our dying, and may we all keep each other in our prayers.
