Wednesday, October 22, 2003

I was in the bathroom, from where I can't hear the phone ring, but I sort of heard part of what Janna was saying, which sounded like: "I have good news, come anytime." It turned out it was a good movie, and it was Fargo. Whadda you mean, come any time? The correct way to invite me would have been "It's just started, come as soon as possible". At least, while the movie is still playing.

Janna is very funny sometimes in her loose use of the English language. She bought a car once, and started a phone call for car insurance.

"What kind of a car do you have?" asked the agent.

"A white one!" Janna answered quickly.


This year, I installed her DSL for her, because she cannot follow any kind of instructions, and at one point I asked her to call customer service at Verizon, I forget exactly what for, it had something to do with the fact that she had two phone lines, and that by installing DSL she was going to cut back to just one phone line. She loves Verizon, they have customer service in every language, including Russian, so she feels right at home and confident calling them.

"Are you installing DSL yourself?" they asked.

"Oh, no!" she answered, "My friend Pat is here."

Watching a movie, or anything else for that matter, with Janna is a challenge both to your attention span and your imagination, because she hardly ever stops talking. If it's a movie, she is telling you the story line of another movie she has seen a particular actor in. If it's part of a series, she is telling you what happened in last week's episode. The result is she suddenly stops talking and says: "I don't understand what is happening."

So you have to fill her in and tell her what she just saw, because she was watching too, same as you, but it didn't register, and in the process, you lose the thread of the action that is taking place right then and afterwards, you have to play catch up. It's the price you pay for being in a relationship with her, so just relax and go with the flow.

The very best thing to watch with her is Alias, because it moves so fast.

"I don't understand," pleads Janna, "Who is this man?"

"He's CIA," I tell her.

"How do you know?" she asks.

"Educated guess," I answer.

Whenever it happens I was right, she turns to me with a triumphant: "You were right! How do you know these things?"

I don't. I am just hanging loose instead of getting tied in knots, because I really don't enjoy interrupted viewing. I make a game of spotting the double agents ahead of the plot, I can usually foretell the characters who will come back from the dead, and so on. It adds another dimension to the plot.

Janna sometimes puts in her two cents: "I know this sort of thing really happens because [insert any kind of story about KGB].

Yup, KGB, CIA, MI5 and MI6, Mossad, we are all expecting dirty tricks from so-called intelligence, a misnomer if ever there was one.

KGB lost some credibility for me in the terror department one day, and was reduced to a bunch of human beings just like the rest of us, when Janna told me KGB agents always carried a silver spoon in their suit pockets, when they went out to dinner in the West.

"Whatever for?" I asked, a little startled, I admit.

"Because they can stir their drinks with it, in case they are poisoned; silver neutralizes the poison..."

Aaaaaah! Success is often due to such attention to detail.

Janna once gave me a silver spoon which she found in a box she bought at auction, so I am now equipped, in the pocket department, for a brilliant new career. Actually, please don't anybody contact me with any offers, because I don't know where my spoon is at the moment.

After Fargo, we watched the news and that terrible story in Florida, about the woman in a persistent vegetative state and the intervention of Governor Jeb Bush, challenging the decision of the court to authorize the removal of feeding and hydration tubes. The ins and outs of this case are complex. There is the point of view of the parents and their reluctance to see their daughter die, there is the husband's point of view, medical diagnoses and prognoses, medical ethics, constitutional law and the correctness of having the court approved decision of a guardian overturned by the Governor of the State, without so much as a procedure being engaged to remove and replace the guardian legally, the ethical decision of the doctors to implement the Governor's decision, not to mention the nagging question, when do parents, or do parents ever, lose their parental rights, their "ownership" of their grown-up children, to make choices for these incapacitated but independent children, choices contrary to the avowed wishes of those children when they were really able to decide for themselves and to speak up in their own words.

So, I won't go into the Schiavo case at all. I will just express my own feelings about dying, my own understanding on that most serious matter.

First off, every living being born to life eventually dies. I happen to hold the Buddhist belief that life is eternal. It is a continuum, with a phase of living, and a phase of dying, just as in a 24-hour period of daily life there is a waking phase and a sleeping phase.

Humor me, please, and explore what follows from this premise.

What follows is this: In the same way that a good night's sleep ensures a good start to the next day, a good death determines in part the quality of your next life.

It is absolutely essential, therefore, to have a good, peaceful, natural death.

Apart from accidents, disasters, wars, crimes, suicides, etc., deaths are due more to a process than a single violent event. Even someone with cancer, for an example, dies not from cancer per se but from the shutting down of all biological processes: kidneys fail, livers malfunction, circulation becomes sluggish, the lymphatic clean-up team packs in its garbage removal, the brain misplaces its marbles, the heart forgets its rhythm, finally, the whole system loses its integrity and the balance of life snaps, the dissolution of the elements composing a living entity begins, a living organism reverts to insentient elements, and the body begins to decompose.

Obviously, there is a defining moment when life is gone, sentient becomes insentient, but even doctors find it hard to pinpoint this event, which is why they have such separate definitions as "brain death", as opposed, for instance, to considering the stoppage of the heartbeat to equate death.

For my part, I have wondered as a practicing Buddhist how hard I should struggle to maintain my life when it entailed pain, and paindful treatment and operations, with little hope of a cure or sometimes even any assurance of quality of life.

I went to my chief priest to ask him what an ideal attitude might be, for someone wishing to be guided by the tenets of her faith and practice. His answer was quite simple: it was entirely up to me to decide how I wanted to proceed, there was no right or wrong way. He said that in his own case, after a certain number of operations to prolong his life, he would probably reach a point where he would say: enough, no more. He said there is such a notion as a natural death.

It was a great relief to me to be told it was up to me to decide how to go off into the dark...

A year or two later, one of our assistant priests was giving a group of us a presentation on the significance of practicing every day, without fail, which was in order to pass through the moment of death, that defining moment, with the consciousness that it was the last moment of one's life, "without dishevel", as he quaintly put it.

"Dishevel" was defined as that state of chaos, unrest and associated pain resulting from any one of a number of incorrect attitudes towards death, such as: attachments, such as attachments to one's loved ones, one's position in life, one's money, etc; becoming overwhelmed by the physical or emotional pain and anxiety attendant on the physical death process, the disintegration of the body; or refusal to face the reality of death.

The moral of his story was basically this: There were two kinds of preparation for death, one over a period of years, and the other at the very moment of death.

The first one involved establishing a correct, consistent practice over the years, which would enable you to be conscious of the fact, when the time came, that this was your final moment, so that you could continue to chant without "dishevel" until that very last moment, thus guaranteeing a peaceful end and a quiet new beginning.

On another occasion, another one of our young priests had made a presentation about dying from the point of view of the ideal attitude to be held by people surrounding a death bed.

In this case, a few points should be observed:

* The dying person was to be kept in a quiet, peaceful environment, not too hot, not too cold, with a certain amount of privacy.

* Loud people were to be kept out of the room, as well as people who smelled bad, either from liquor, tobacco or garlic, for example.

* People disliked by the dying person should be denied all access, even if they claimed some form of close ties.

* When the end approached, no food or water should be administered.

* Persons attending were encouraged to chant, in a quiet, harmonious manner, and if the dying patient was able to join in, the rhythm should be adjusted to match his tempo and his breathing pattern.

My personal experience after surgery had been that thirst was the single worst of all pains, the one without relief from painkillers, so I went to the young priest afterwards and questioned the "no water" point.

What he explained is as follows: When the body's functions are shutting down, this is a natural process. Attempting to retard or reverse it creates conflict, bringing pain to a process which otherwise should be painless. He said that when the process of dying is fully engaged, hunger and thirst actually abate, just as breathing slows down, and he said that the very fact of withholding water in the final stage actually assures a more peaceful, painless death.

This explained to me the stories I had heard of sages who had stopped all eating or drinking during the last week of their life: they knew, and they were wise enough to apply the knowledge.

I was interested to find this withholding of water mentioned in a Japanese book on dying. I forget the title, it's probably on one of my shelves.

It also confirmed what I had read about extreme burn victims. The decision in certain cases is left up to the burn victim, the choice between no treatment, and a swift, peaceful, painless death, or the chance of survival and rehabilitation, which would necessarily bring with it all the terrible suffering of the treatment, the painful debridement, etc., with no guarantee of success.

I think the greatest show of love any human being can have for another is to respect their wishes on the way in which they will face what is actually their own death, when it finally presents itself, especially when those wishes are not the same as the ones you personally hold.

Written? Unwritten?

It must be a matter of conscience, and honesty, and ethics, when they were not written down. Courage too. Surely, if you have shared intimacy with someone you love, and you know what they wanted, or did not want, it behooves you to honor their wishes, as closely as you understood them.

It is perhaps easier, though not necessarily so when they differ very much from those that fit your own beliefs, to honor someone's directives when they were written down in a living will.

This is a matter of such importance that I think it would be a good idea for anyone who cares one way or the other what happens to them to set down their wishes in writing, even early in life when they are perfectly healthy and not expecting an untimely demise. Let's face it, it is not only the old who die, and it is not only the old who experience traumatic events which leave them incapable of expressing their wishes directly.

When all is said and done, what I want for my life is to live it as a full human being as long as possible, with as much quality of life as possible, and then I want to experience quality of death. No heroic measures, no resuscitation, no feeding tubes or hydration tubes, no final experiments.

I would hope to be chanting Nam-myoho-renge-kyo with my last breath, and if that is not possible, at least I would want to be able to express it in my heart.
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