“There are no dead people,” Bob Thurman says. “No one is going to become a dead person. There is no death.” He's launching the third Art of Dying conference in New York City, cosponsored by Tibet House, of which he's president, and the New York Open Center. He will talk for four hours, without a lull, a rapids of ideas, imprecations, riffs. The truth is, Thurman says, “there's no way out, no lunch break, no nirvana break, no death break.” After forty years of involvement with Buddhism, Thurman says, he is “unintimidated by death.” It's liberation, transformation. The awareness of death “is the door for us to be alive.”
The conference is a rare meeting of the spiritual and the medical. About eight hundred people have shown up, a majority of them professionals in the field, from doctors to hospice nurses, social workers, therapists, and clergy. They'll flock to workshops on losing a parent or losing a child; coping with sudden loss, with lingering illness, with suicide. They'll try to understand death from the standpoints of other cultures and other spiritual traditions, from the vantage of a burly, lyrical Irish poet (John O'Donohue) and a “music thanatologist,” Therese Schroeder-Sheker, who plays the harp at the bedside of the dying. They'll hear from impassioned doctors in the new field of palliative care, where the emphasis is on the relief of suffering rather than the prolongation of life. Ira Byock and Timothy Quill, for instance, two of the highlighted speakers, are building models of a civilized way to care for the dying. It's stunning to see the power of medicine being used tenderly.
Fred Epstein, an engaging pediatric neurosurgeon who specializes in brain tumors in children, talks about designing his own department at Beth Israel Medical Center. Partway through the process, he called in “experts” to advise him—parents of sick kids. He pointed out the handsome new furniture. “Get rid of it,” said the parents. (Big laugh from the audience: We love to see doctors humbled.) “You need sleep-sofas wide enough,” the parents explained, “so you can hold your child in your lap.” In that detail is the agony of what parents and child go through; in Epstein's project is the compassion that could make it more bearable.
The aim of the end-of-life movement is to give us the death we want rather than the one we fear—that lonely death in a hospital, in pain or unconscious, at the mercy of overworked, indifferent strangers. A key element is educating and sustaining the caregivers. Ram Dass, speaking of environments to die in, started with memories of Benares, with its funeral pyres on the Ganges. But in the West, he concludes, the environment we die in is the mind of our caregivers. “I see sitting with the dying person as a sadhana,” Ram Dass said, “something you undertake to meet God.” Roshi Joan Halifax founded the Project on Being with Dying and offers meditations to support caregivers. There's no question this is tough work. “People talk about wanting 'death with dignity,'” Halifax says. “But death is unbelievably undignified. Don't even lay that on anybody.”
“What happens when the time of dying comes?” Gelek Rinpoche asked in his workshop. The Tibetan Book of the Dead maps eight stages of dissolution following the moment of death; a sadhana he does every day takes him through the stages, visualizing earth element leaving, fire element. . . . “It's sad, indeed, but it's natural,” he says. “The conclusion of birth is death. It's nothing more than going back to primordial mind, primordial source.”
Dr. Leslie Blackhall of the USC School of Medicine tells us she read an article about a woman who felt she owed it to her daughter to die so she wouldn't interfere with her career. “What kind of world is this?” Blackhall asks. “I've got two kids and I'm wiping their butts, and at the end of my life, I'm hoping they're going to do the same for me.” But society is structured so caregiving is impossible, she says.
To Ira Byock, how we care for the most ill will be the central moral challenge of the baby boomers. “It will require a commitment equivalent to last century's wars.” Buddhism is right at the heart of that commitment, a force in lessening the fear of death and raising the value of every moment of every life.
Amy Gross, a member of Tricycle's board of directors, is a writer and editor living in New York City.