On providing a live-in service for those who are dying; being with ‘not-knowing’ and support for those who want to die with awareness.
I first met my client when she was in hospital. It was ‘connection (if not love!) at first sight’ – I think for both of us. That meeting was short, but long enough for her to ask if I would be willing to work intensively for her – to actually stay in her house, with her and her daughter – during the two months’ period in which I was available. She had just received her diagnosis of ovarian cancer, with her prognosis being ‘anywhere between 2 months to 2 years.’ From the outset, she accepted that any treatments she underwent would only give her a little more time; that death was a given. As a meditator, she wanted to use whatever time she had to prepare for a conscious death.
For my part, I was delighted to find in her a client who had the desire to consciously prepare for her death, and I felt honoured that she wanted me to help her, and clearly trusted me enough to invite me to live in with her. Perhaps I’m more aware now, than I was then, of how incredibly gutsy she was. She would explain to someone else, after our time together, that living with me had been a constant reminder that death was around the corner; that my presence had kept pulling her back to reality, ‘and the reality was death.’
That sounds pretty grim: to have a house guest, someone whom you inevitably keep bumping into, who reminds you of your own death! In fact, we became friends quickly. This is an aspect of working with the dying that is immensely attractive to me – the fact that when the client has accepted the inevitably of their dying, life takes on a wonderful immediacy. There is no longer the time or a place for social niceties, for fake emotions – fake anything. Feelings are raw – from huge anger and soul-quaking fear, to tremendous gratitude and deep love – and the censor is swept aside in the wake of the need to express them.
This particular client was a straightforward kind of a person, and didn’t hesitate to communicate her changing feelings: her pleasure in the small things that she found in everyday living; her fear of dying; her resoluteness to keep meditating and to confront her issues through our daily sessions; her rage against life; her sense of impotence and frustration; her appreciation of the absurd, and her wonderful sense of humour.
In my experience, dying people appreciate one’s being honest. I recall a dying friend to whom I wrote, at one stage, that ‘I feel out of my depth; I just don’t know what to say’. I felt so inadequate; I, the one whose chosen work was exactly in this aspect of life, was at a loss! I, who so wanted to love her and support her. Yet, what to do? That was the reality. In spite of my love for her; in spite of my learning, my experiences, my skills, I felt I had nothing to offer except my feeling of inadequacy.
By this stage she was very ill, wanting no visitors and attended to only by her partner. By way of response she wrote, simply, “Darling, we’re all out of our depth!” I understood then that to acknowledge and articulate such a feeling is not a sign of not being supportive. In fact, I felt a new kind of connection with her: the shared intimacy of not-knowing; a shared admission of travelling together into unknown, and perhaps unknowable territory.
But to return to my client…We laughed a lot; we ate healthily and heartily; we hung out, talking about our respective lives, mutual interests and friends; we meditated together and alone; we put on our favourite music and danced. Each day we slipped easily and naturally into the roles of client and therapist; we had time together in the house or taking walks in the neighbouring fields; and took time apart too. I met her teenage daughter, who was living with her (and had a session with her, too); and her estranged husband, who visited from elsewhere.
Our time together also included preparing for her chemotherapy, and my accompanying her to the hospital. I was available to be with her in her visits to her doctor; and to liaise with others involved in her care. She also used the opportunity to confront her feelings about her life being truncated, her not being able to enjoy the sweet little cottage which she had bought so recently, her fears around dying, and so on; and she focused, too, on the actual time of her body’s dying. She said, “I don’t know what death is, but I want to meet it in meditation”. That was her goal, the point of all her psychological and spiritual work up until her death. I have created a meditation to prepare for the death and a second one that is a rehearsal for death and a support as one is actually dying [In Transition CD]*. These we practised, then later talked about, so that she could feel reassured and relaxed about the nature of the journey she would be taking, sooner or later.
I would have loved to be able to stay with her in her last days and hours, and for her death. As it happened, I had commitments elsewhere. A few days after I left her I phoned her to say goodbye: I was about to fly to India. “Have a great, trip, beloved!” I said. Her voice was very weak, but she did manage to reply, “And Maneesha, you also have a great trip!” and we laughed.
Her daughter and her former husband were sitting either side of her when, four weeks later, she left her body. From their account, she was sitting up in bed, meditating. One moment they saw her chest rising and falling as she meditated; the next moment – her eyes now open, she was looking straight ahead, and her breathing had ceased – she had ‘died.’ The transition could hardly have been smoother. When I heard about it sometime later I was so happy for her and proud of her: she had worked for a conscious death and, apparently, that is exactly what she had….
I’ve written elsewhere of the great parallel I have experienced between midwifing a birth and midwifing a death.
Just as more and more women are opting for a home birth, with a midwife of their choice invited into their homes, why should we not create a similar scenario for dying?
Part of the service I offer is exactly that – to be present in the home of a client while she or he is dying. And before that, perhaps long before that time, to be available too. It may be that my client has had a relapse; she may want special support for the days following her chemotherapy sessions. She may be in a state of crisis and feel a need for intensive support: I am available to live in for the days of crisis; being, as is appropriate, an active support, and/or a constant presence that can just ‘be-with’ my client. My work also encompasses the family and friends; they may need support in the form of individual sessions or as someone who can just be with them.
I should like to provide the very best support, support that is designed around the individual needs of my clients. I know this time can be transformative, both for my client, and for those of us around her. My greatest joy is in being with those who want to face this last phase of life consciously, those whose trust in life (though it may waver from time to time) is paramount, and for whom personal growth never stops….
*In Transition CD has been superseded by Osho Bardo.
A short video clip of Maneesha working with her client