When the doctor sent my mother home to die, I went with her even though I didn’t know what I was supposed to do. In those days, hospice offered little support beyond a weekly nurse visit. I moved in, kept my mother clean, took care of her cat, made smoothies for her as long as she was able to swallow, and stood back when my aunt and sister came and went. I often told her I loved her.
But I made one mistake. When the nurse told me my mother would die that day and then left us alone, I laid down next to her and said that she didn’t have to be afraid, because God was waiting for her in heaven. We weren’t religious, and it rang false even then. I said it because I didn’t know what else to say.
A decade later, I left my conventional life and moved into a Zen monastery where I ordained as a priest. And a decade after that, back out in the world, I found work as a hospice chaplain. No one can teach you how to be a chaplain, so in learning what to say to dying people, and finding the courage to open my mouth and let words come out, I found my own experience to be my best teacher. I moved from wanting a person or a book to tell me exactly what to do and say, to contemplating for myself: What is this person really asking? What would I want, if I were them? What is helpful?
For some decades, death was hidden in hospitals behind closed curtains, turned over to the experts as if it were a failure, so my hospice patients were often surprised to learn that this time they weren’t going to get better. I believe that understanding what’s happening makes it easier to accept, and that acceptance is the key to grace, so I tried to talk openly with them. I used qualifiers, such as “just in case” or “if the doctors can’t find any more treatments,” to cushion the news that death was approaching.
It’s harder to listen than to talk, and my meditation practice helped me pay attention, to discern whether the information I was delivering was useful or hurtful, whether I should continue or whether I should back off and rest in platitudes. It was up to my patients. My only job was to not turn away.
I’d been a chaplain for about a year the first time I talked directly with someone about his death. By that time, I’d seen enough to have an idea of how his death was likely to go and had visited him enough times that there was trust between us. One afternoon when we were alone in his darkened hospital room, I asked whether he wanted to talk about his dying. He was eager to hear what I had to say. He was very old and worn out and had been bedridden for months, so I felt safe in telling him that watching death is like watching the lights go out gradually in a large house, one at a time, until the building is dark. I told him that his death would probably be like that, a fading away, and that he probably wouldn’t feel pain or even distress. He was grateful and, as it turned out, his wife and daughter told me that his death was indeed gentle, and my talking about it with him was the kindest thing I could have done.
Many people struggle to hold on to life. When death approaches, they grow restless and agitated. They fight. Sometimes what people need to know is that their job of waking up one more day, no matter what their circumstances are, is over. They can relax.
I found something useful to say when I told a dying woman, “You know, this is only going one way. The doctors say they’ve done all they can do, and you’re probably not going to get well this time. You have before, but not now.” Another thing I said, because that’s what I would want to hear, was “You are safe.”
What I’d tell a lot of people is that curiosity about death can replace fear. I’d say, “This is just death. You’re okay. I mean, I know that’s easy for me to say. You’re the one who’s doing it, not me, but this is the very natural thing that we all know is coming. It’s just coming soon for you.
“We’re afraid of death because we think we’re separate, and we have to keep our walls up. There’s something else going on, though, and I think you already know about it—you’re a part of the universe and will never be separate from that no matter what happens to your body. It’ll help if you can remember that you’re connected.
“And there’s something else I’ve heard about working with the fear of death. I heard this in a talk from a great American Zen master. He said his wife was dying and that she was facing it with an attitude of curiosity, asking over and over, ‘What is this?’ If you’re engaging with curiosity, there’s no room for fear.”
There were times when words weren’t possible. My patient Catherine had outlived her friends and her money, so she was living in a sad facility. She was cheerful and well-liked, and such staff as there were, were glad she had a regular visitor at last. The only time I heard her complain was when she said she’d been left in a dirty diaper for hours over the weekend. When we first met, she was nearly deaf, so I would slowly shout answers to her questions. As her hearing became worse, even that was impossible, so I’d ask her to tell me stories about her childhood and settle back and listen. We became friends. By the time death was near, when it was clear she was down to her final hours, the only way I could offer comfort was to sit by her bed and put my hand on her arm to let her know she wasn’t alone. I believe she knew I was there, and I believe it was enough.
Ira Byock, an expert on death and dying who has written many books, says we should tell dying people four things: “Please forgive me,” “I forgive you,” “Thank you,” and “I love you.”
Although those words don’t come naturally to many of us, they need to be said, either with words or actions. When patients’ families asked me what they should do, when it was clear that their loved one was going through the final hours of life, what I could tell them with confidence is that their job was to love. I’d join them in prayer if they were Christian. If they asked me to beg God for healing, I’d suggest acceptance instead. Many of my patients were not practicing Christians, yet they also wanted some spiritual reassurance. They often asked me where I thought we’d go after death, and I always said I didn’t know. “Sit with your mother and love her,” I’d say. “Let her know she’s not alone, and that her work here is finished. That’s what she needs now.”
One day when I was visiting in a large facility, I entered a long corridor and heard someone repeating, “Hello? Hello? Hello?” I saw an old lady standing in an open door, leaning on her walker and calling out. I went to her and introduced myself and soon realized that she was blind and her talking watch had been mis-set and was telling her it was time for dinner when it was only mid-afternoon. We went into her room and chatted for a bit. I was able to use my phone to find instructions for setting the watch, and I took care of that. But for me, the time and the dinner weren’t the point. The loneliness was, the calling out for help into the silence.
She was giving voice to what we all feel, what we all need: “Hello? Am I alone? Does anybody see me?” In death and in life, the one best thing there is for us to say to each other, however long we might have between this day and our death, is “I see you. You’re not alone.”
If I had my mother’s death to do over, knowing what I know now, I’d do just what I did then, except for that one thing I said at the time of her dying that I can’t take back. We had already offered and received forgiveness and gratitude. So, I’d only say I love you, again and again, letting those be the final words she would hear as she left this life.
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