Death and Dying . .

NAMAH Body, mind and spirit journal Death and Dying Death and Immortality Dr. Alok Pandey The quest for immortality is as old as man himself. Without knowing death it seems we cannot fully understand life itself. But who can know death? The dead do not tell tales. And the living do not experience death. True we can know something about the process of death of the body. We can perhaps answer what happens to the body when someone dies. But can one know the state of one who has experienced death? For all physical conditions, there is a corresponding state of awareness. There is, for instance, a state of awareness when the body is inert and asleep; a state of awareness when the body walks and runs; a state of awareness when the body is hurt or sick and, a state of awareness when the body is in perfect balance and health. What is the state of awareness when the body is dead? Science is baffled by this question, for, to it death is synonymous with the death of the body. Just as immortality, for the modern scientific mind, is synonymous with the preservation of life in the body. The ancients questioned this presumption. They dared to ask, — does really nothing survive? Is death the ridiculous end of life? Is it the last cruel laugh of Nature on man’s attempt at growth and perfection? Is it the vain end of all we hope and dream, aspire and become? Is it the final abyss where all sink — the sage and sinner, the scientist and the fool? If that be so, the whole significance and meaning of life is subject to question. It would also be absurd to aspire for immortality. For who would care for living indefinitely? The rational conclusions of our mind are however often contradicted by the intuitions and faith of our heart. It is a strange paradox that from birth to death, we aspire and labour for growth. “Despite the knowledge that one day we all die, we always behave as if we are immortal”, why? Genetic programming, — but that explains nothing, only pushes the question back. One shelves off the responsibility to a mysterious, all-determining gene that is struggling for billions of years to survive. And it has succeeded in fooling death. The gene does not die. It only changes form. It passes from one generation to another, defying death. For it replicates itself endlessly like the head of a hydra or the body of an

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Death and Dying amoeba. And man, nothing more than a conglomeration of cells with genes seeks to replicate himself and live endlessly! That is the scientific view. Its offshoot is that the only kind of immortality possible for a person is a collective one, — the prolongation of the race and species. This too, one sees and observes. What one also observes is that the cellular body of the human being changes several times in a life. Yet, a sense of ‘being the same person’ continues to link us to these ‘micro-deaths’. Let us look at the whole thing again. Let us raise a few fundamental questions and answer them in all sincerity. Do genes explain everything — the traits, characteristics, personality, habits, of a human being? We know that human beings show a very wide range of attributes and characteristics not only in degree of expression but also in the quality itself. What is even more interesting is that this wide variation is found not in unrelated persons but in the same family, even in twins and often enough in the same individual. The same person may at one time under one set of conditions display fear and at another display courage. Not only that, even in the same conditions the individual can, by will and learning, so completely change himself as to display a totally opposite behaviour. The myth of the omnipotent gene is shattered. Does it mean that the genetic endowment has been modified? Or perhaps, as is much more likely, the psychological traits are not passed genetically at all. The genes merely lay the broad foundation or perhaps frame the building of the body. But it has little say in the matter of who or what type of person shall dwell in the body. To believe that a few amino acids could determine everything is like believing that a few bricks could, of their own volition arrange themselves and build a beautiful mansion. It is not only possible, but largely probable that the psychological characteristics of an individual are passed down through a process whose nature we do not know. This process would relate with the material and genetic substances on the one side and experience on the other. Thus, it would enrich itself, grow in content and quality and be capable of transmitting itself to all things that are receptive and can hold the corresponding vibration. This non-genetic, horizontal transmission could explain evolution, its growth and enrichment. Genes are then not vehicles of evolution but rather the agents of preservation. They preserve change rather than cause it. If a superior mutant gene was the cause of evolution, one would have expected all genetic diseases to have been naturally eliminated and disappear. That, however, is far from being true. Genes, faithful to their task, seem to carry on regardless of natural selection. The genes themselves, looked at from the point of view of their function are one form of memory imprinted upon the consciousness of the species. This is not the memory, of day to day processes, which is based upon sense associations — of sound, sight, touch and other gross and subtle senses which give a representative ‘image’ to our consciousness leading to a recall. Or else a conscious and voluntary will to reproduce the external scene or image to bring back the usual memory of the event. This memory is based on associations of feelings, associations of ideas, associations of complex psychological states of self and world awareness. The memory of the genes is a subconscious memory which works habitually and automatically. It relates largely to our body’s functioning. Psychological memory (memory of subjective self-awareness) is

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Death and Dying much more complex. It perhaps goes beyond the physical events and experiences of a single life time. It is a fact now well known to modern psychology that memory is a state-dependent phenomenon. Experiences of one state (like alcoholic intoxication) are forgotten in another state (black-outs). However the memory comes back again (on drinking alcohol again) if we are put in the same state. That is how we see the same dream-experiences despite variations in the waking state. It is not that such a loss of memory in passage from one state to another is indispensable. For instance, two different states may abruptly telescope into each other as when someone is suddenly woken up while dreaming. But normally, as these are two distinctly different states, such telescoping leads to a kind of momentary confusion. Hence Nature provides for blank spaces of consciousness through which one travels from one state to another. To integrate these different states is not only possible but an essential work for conscious evolution. The human embryo, for instance, lives in rapid succession the different stages of formevolution — the bird, the reptile etc., — before arriving at the human stage. A secret link of oneness, a universal association always holds everything together despite all outer variations and differentiation. This is done through building bridges to cover the gap between one state of awareness and another. This is a deliberate process that was known and developed by the ancient occult sciences and it was through this that men and women of exceptional caliber and self-awareness went into the domain of death and brought back the real process and significance of it. In India, this knowledge has been largely generalised and widely held through folklore and belief-systems through generations. While at present, to the critical and sceptical modern intellect, these things appear as fanciful imagination, to the eye of experience, these are reproducible truths of experience. It is because of these gaps of unconsciousness that a large number of those who had near death experiences or coma due to any reason are unable to recollect anything in their waking state. Yet, the very same people can, in a state of deliberate hypnotic regression, reveal or relive things forgotten to the outer self. Hypnotic regression is in fact one of the known ways of gaining access to these concealed memories. Death and immortality to be rightly understood, need to be understood through experience. Physical death may be a loosening of the subconscious memory’s associations, — a decentralisation of consciousness. This could explain the ‘genetic accidents’ and ‘errors’ of aging finally culminating in death. If the subconscious association were intact there is no reason why genes should suddenly go crazy after years of faithful and habitual working. After all, certain plants and trees can renew an old and worn-out limb easily. There is no reason why this renewal should not be possible in a human body. ‘Genetic programming’ we might comment, but genes are instruments of a subconscious memory which translates itself as ‘genetic aberrations’ when it fails. Nature however has a utility of the aberration too. The CreativeIntelligence that works with precision and perfection in each element and atom enters deliberately into error and accident. So too genetic deprogramming, the loosening of associations, has a meaning. An association of different elements in Nature (physical, psychological and even social) gives us an infinite field for growth and experience on a finite basis. The need and value of an experience being over, the association must

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Death and Dying dissolve if a fresh experience and new possibility of growth is to be undertaken. The ‘being’ deliberately assumes the bondage; it deliberately dissolves it; and, it deliberately takes it up again. Each time, it takes it up, it is a different and fresh field. It is through these cycles of birth and growth and death and rebirth that the truth of our being grows and becomes ready for manifesting a higher level of force; — Force of Knowledge, Force of Power, Force of the Joy of living, Force of Love, Force of Creative Delight. A time comes when this ascent at one level of form is so complete that the being bursts into a new dimension. There too it begins to seek new possibilities of manifestation. It begins to seek a new form to embody a new level of consciousness, a new force of being. Evolution assumes, in this logic of things, a double sense and purpose. On the one side it is an evolution of forms, as present biology sees it. On the other side, and more importantly, it is an evolution of consciousness and its capacities. It is even likely that the latter precedes the former. An evolution of consciousness serves as a catalyst for a sort of chain reaction on several level till the form it inhabits bursts and surpasses its natural limits and enters into another mode of functioning and being. Modern science is sceptical of this. Firstly, because, it sees in life nothing else but a play of mechanical energy which is amazingly well-ordered in appearance out of a background of apparent indeterminate chaos. All, according to modern scientific understanding, is a mechanical law and process. And whatever seems to escape this fixed law is merely a chance anomaly, a freak of Nature, an exception that only proves the rule. Secondly, science does not admit any being or soul behind Nature. There are phenomena and the laws and processes behind them. At most, it admits a vague, incomprehensible force. This force itself is regarded as mechanical and inconscient, not conscious and self-willed. To the eye of ancient experience, the view of science is based on a limited and partial knowledge. Science has probed only the material domain. Its instruments of science are not geared to pick up the impact of any other forces than material that shape events and acts. Yet even the most complex machine working on material energy is surpassed by the smile of a child. The babble of an infant has a quality that can be felt and experienced but eludes definition in simple terms of mechanics of movement. Conscious experience is not a physical act, it is much more. The same physical act, even identical, can lead to totally different kinds of conscious experience. This difference is due to the difference in cognitive association, a process too complex to be cabined within the narrow range of chemical and electrophysiological neural events. These chemical events are only a basis, they provide a formal material structure but do not determine the experience. Matter serves as a scaffolding to create a bridge between the Spiritual Reality and Nature but it cannot decide what will go across it. So how do these associations form? What determines the process? To know the laws of association and dissolution (birth and death) is to almost knock at the mysterious gates of Death. At the level of waking consciousness, we know it is preferential interest and attention that helps in forming associations. We associate with and remember things which have drawn our attention, either positively (pleasant) or negatively (painful).

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Death and Dying Negative associations are usually thrust into a vast unconscious domain where they lie dormant as a ‘complex’. The pleasant ones are used as a rough basis for a day-to-day appraisal of events and reactions. Keeping in harmony with the unity of things, the fundamental law is the same. At each level, associations form out of a preferential interest and attention. Only the value, need and truth of each level is different and so are the associations. The sensational values of our outer waking consciousness may be quite different from those of our subliminal consciousness. One task life has is to recast the values and associations of our outer consciousness in the true values determined from a greater, deeper, higher level. This means dissolving many of the outer associations which work upon the body as ‘force of habit’ and on the mind as ‘temperament and character’ forming new and fresh associations. So dissolution is a process of evolution. Death is the obverse side of life. In the body itself we find a secret physical consciousness constantly dissolving ‘old’ and useless cells and replacing them by new ones. In this sense, physically we are new born several times in our lives. It is only by habitual subconscious association that we die. This ‘habit of death’, this ‘association of age with decay’ is not an individual phenomenon. That is why no individual by his sole will and effort can conquer physical death. When all the associations are dissolved, we discover the One Immortal Self that shines in us and in all forms. That Self is the imperishable, indestructible element in us. Realising that Self we realise and live in the consciousness of Immortality. It is a state of awareness which remains even after the form dies and perishes. That, in the Indian sense, is Immortality which prepares us for a greater and more comprehensive Immortality. Touched by this dynamic Power, even the very body can become immortal. A new being and a new race can inhabit a new body.

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NAMAH Body, mind and spirit journal Death and Dying Behind the iron curtain — encounters with death Dr. Alok Pandey Editor’s note The encounter with death is fairly common in the life of a physician. While it desensitizes some, in others it leaves a deep impression and raises existential questions. A few such experiences are mentioned since they allow an insight into the phenomenon of death and psychological ways of facing it. We hope to continue some such issues on death. A few case studies Death has many faces. It sometimes comes as a reliever of human miseries, as if to give rest to someone who has walked hard and long on the rugged roads of life. To the thrill seeking adventurer, it comes as a sudden surprise cutting the thread of life to break the monotony of experience and allow a variation of theme. To others it appears as a destroyer who smashes things that were beautiful and grand even as it brings down things that are mean and ugly. It can act as a great leveller who balances everything — the wicked and the saintly, the good and the vile. Its most terrible mask is when it takes away the children. Case I Death of a child Arun was an 11½ years-old child, asthmatic since the age of 1½. He required nebulisers and steroids off and on. The onslaught of asthma had however not daunted his spirits. He came from an extremely modest background but dreamed of big and grand things. Born in an Indian village, he was fascinated by the car that drove the American President and even wanted to be in that seat. He also dreamt of flying aircraft one day and visiting many foreign lands. These dreams were not compatible with his upbringing and his parents tried to stifle his dreams. The family shifted from Jaipur (native place) to Bangalore (on transfer) in May 2000. The child made a strange remark that he would never go back to Jaipur again. This was surprising since the climate suited him well and his asthma had nearly disappeared. On 2nd July 2000, the boy’s mother had a dream where she saw a toy broken. This disturbed her very much. A few days later while offering incense to their deity she noticed the smoke rising towards a photograph of the child placed nearby. This disturbed her again and she felt a deep unease. On 8th July, the boy complained of a mild irritation in the throat which was relieved with hot drinks. The irritation returned on the morning of the 9th. There was no fever or breathlessness but the father thought it prudent to give him a check-up in a nearby hospital. The boy was admitted there since the physician felt he had an

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Death and Dying asthmatic attack. Oxygen, nebuliser, asthalin and steroids were given. The child became breathless suddenly at 7.30 a.m. and he died at 8.30 a.m. despite all efforts. The day prior to his death the boy had remarked, “My mother is an American”. His puzzled mother told him that she was not an American. The boy insisted, “You will be”. Was it a serious statement or a child’s babble? Or was it a secret inner choice to shift scenes? We may never know. But looking back, one wonders. Questions like do we choose to die, come up and demand an answer. Here was a child endowed with an expansive vital who thought and dreamt big, yet was born with a weak body. His father often remarked — “You can’t become a pilot with this problem of asthma”! His background and environment wherein he would have to struggle to realise his dreams too was not compatible. Was death an easy way out? Or was it simply that the body broke down under the pressure of a sudden surge of vital force ( as happens on entry into adolescence)? In any case there was disequilibrium. There were only two choices before the soul. One, to struggle and arrive at a higher equilibrium. The other, to succumb and change form to one more suited to the kind of experience it needed. He chose the latter. This element of choice, which is not apparent on the surface but revealed on deep questioning and casual hints, is often seen. This naturally does not console grieving parents and others who are left behind. One is deeply attached to the form. The soul seems far from us and its intimations too rare for our surface being to hear and understand. What helps those left behind is to get in touch with the soul. And then to invoke peace; a deep, deep peace into the parents. Such a peace, if properly invoked, has the power to dissolve suffering. Parents caught up in the web of pain cannot do it themselves. The physician or someone else has to do it for them. Once they have been heard with empathy, and the power invoked, they are receptive to a deeper understanding. A touch with the soul shows clearly that death is simply a passage the being chooses for its evolutionary journey. Then one knows and feels that the one we loved is not lost but has only changed appearances. The final liberation from the pain of death is possible only for those who can enter into the sense of oneness that exists behind all separate forms. One sees then that what one loves in different forms and names is the ‘One’ who is never lost but ever exists under different guises and smiles at us unvaryingly though different eyes. Case 2 Death — an evolutionary necessity To wait for a near certain and slow death is a predicament worse than death itself. This too falls the lot of some. Rajeev, a fourteen year old boy was brought for counselling by his parents since he felt depressed and contemplated suicide. The reason was a diagnosis of progressive muscular dystrophy, a disease with no known treatment and an invariable slow helpless death. The diagnosis had been made a few years back as he stood on the threshold of adolescence. Normally adolescence means more power, more capacity and a greater joy and thrill of life. But here was a paradox that stared at him satirically. He had started losing his ability to run and walk and then even to stand. He could not stand even with support. Next to go was the power of his hands leading to a

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Death and Dying near inability to write or feed himself. His speech was also affected and though clear in his mind he could not express himself fully. Bound to his wheelchair he gazed at other boys with envy, and then with a growing sense of helplessness against his fate. When he came for treatment the thought uppermost in his mind was, “I can’t do what others can do, so what is the point in living?” A sketchy dialogue followed in this way: Counselor (C) : I understand your state, but is it really true that you can’t do what others can do? Rajeev (R) : Yes. C: For instance? R: Run or walk or play or eat or anything for that matter. C: What about reading? R: Yes ( a glimmer in his eyes as he was indeed reading a lot). C: And listening, to music for instance? R: Yes, I like it. C: And thinking? R: I do a lot of that. C: And praying? R: Yes, I do pray. C: You pray for what? R: To be cured, (after a pause) to be completely cured, soon, from my disease. I do not know what his outer nature meant but the shock of these words (vis-a-vis his outer destiny) opened a door of understanding within me. I felt there a longing for a new body, a covert sanction to death. It seemed as if this life of his was a brief interlude where something was to be learnt from this state of abject outer powerlessness. What was it? C: Supposing I tell you that there is something you can do which most others of your age do not do and perhaps cannot do. R: What is it? (He looked up changing his stooped posture). C: Now see, you can pray and think and read. You can combine these three and make it very powerful. (The very mention of power, even a faint possibility of it made him see hope). C: You see, it is called meditation. He nodded yes. (To my surprise he knew about it and had read something on it. lndeed of late he was reading a lot of religious books). C: Now, can you imagine beautiful things? R: Yes. C: Even things that do not exist but you would like them to exist. Can you imagine them? R: Yes, I can. C: Okay, if someone told you that you had just one more moment to live and you can ask one boon, what would you ask? R: To be cured. C: Yes, but there is only one more moment to live.

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Death and Dying He contemplated this till he got the full import of the question, then spontaneously answered — R: God C: Why don’t you do it then? Try finding God. See your helplessness becomes a strength now. You are not distracted like other boys of your age. Your body is weak but your mind very powerful and concentrated. If there is a choice between body and mind then which is higher? R: Mind. C: And that you have in abundance. So don’t waste it in negative thoughts. You can use your mind in pursuits that others can’t follow. He was visibly happy and cheerful. His parents were relieved. They had never thought of it in this way. I told them that death will come when it has to come. Why die before that by constantly thinking and fearing it? The session ended by giving a list of books for him to read and a set of mental exercises of imagination, will and thought. And of course the need of never giving up. In this case too, there seemed to be an imbalance, a disequilibrium between mind and body where the life-force seemed to be turned towards feeding the mind. Whether this was the primary cause or secondary to his genetic defect, I cannot say. But in either case, death was clearly a mechanism used by Nature for renewing the experience of life with a new and perhaps better form more suited to the evolutionary needs of the soul. The ‘cure’ he looked for was perhaps too radical. Today scientists can change a few organs or a few genes. But Nature, the great artificer, has been changing the entire body so that the soul can have totally new possibilities of progress. Death opens a new door to life even though it closes the door on the present one. Case 3 Facing death with a smile Is our reaction to death a mere convention of the sense? Can we transcend the horror created by the thought of death ? The answer to this came to me from an eight year old while undergoing medical training as an undergraduate. I was attracted by this charming girl. In fact this eight year old fascinated all of us by her enthusiasm. She was bubbling with joy. To meet her was to feel refreshed and rejuvenated. Somehow we never tried to check about her illness. She never looked sick. So we were startled one day when she asked us, “Do you know my disease?” We shook our heads in the negative. She said. “I have blood cancer”. And then a big grin as if it was all a joke. We felt a stab of misery, of the utter helplessness of life, of the unpredictability of bodily existence. But the child’s face reflected only joy. This very unpredictability made the game of life even more thrilling to her; the helplessness of the body awakened an inner strength; the misery of outer existence led as if to a greater happiness and joy! A peep into the dark domain

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Death and Dying As physicians, we are conditioned and trained to see and record gross physical facts and so the subtle escapes our notice. For instance, if we are perceptive enough, we notice that following physical death, there is the withdrawal of a glow that gives life to the form. We are so accustomed to this light that we fail to notice it unless it withdraws after death or is exceptionally brilliant in some rare human beings. At a psychological level, one may observe the ‘given-up syndrome’, or more rightly the absence of ‘a will to live’ some time before the downslide begins. As if something in the being chooses to quit and it is this that translates itself physically as a terminal illness. We are so preoccupied with the process that we do not see the cause. But this leaves many questions unanswered. The simplest is — why do some people succumb while others fight it out? Fred Hoyle rightly observed that there is something more than mere germs and immunity, for people still live despite poor hygiene and malnutrition when they should have been dead. There are perhaps many curtains behind the outer ‘mechanism’ of death and the ‘inner will’ that determines it. The inner reasons for death As seen in these cases, one of the reasons is a disparity between the life-force and the body’s capacity to sustain it. In the first case there was also a gross inner disequilibrium both within the body and with the environment. That could have impelled the ‘choice’ of taking up a new body. I have seen in at least two other cases of young deaths (both in the early forties dying of malignancy) where the disequilibrium between the inner aspiration and the outer milieu was quite marked. It was evident to inner sense that their birth had been mainly to gather a particular form of experience, or more rightly to exhaust certain intrinsic tendencies so that they could start the evolutionary curve on a better and higher note. The need for a particular intense experience appears to be case with Rajeev, as the intensity of outer powerlessness indicates. Of course these things cannot be known unless one knows the person closely and well enough. And even then they may escape one’s attention if one does not probe deep enough. Above all, there may still be many other deeper and inner causes. It is even doubtful if the conventional methods of science, limited as they are to the physical field of observation, can really throw light beyond the dark door. The difficulty is compounded by an a priori denial by most scientists, even though there have been many studies (for example the one by Dr. S. Pasricha quoted in ‘Claims of Reincarnation’ Harman Publishing House, New Delhi, 1990) which validate the existence of ‘something’ that survives physical death. But the mass of the scientific body would refuse to admit this very possibility because a massive paradigmal shift would ensue. And the narrow human mind comfortable in its cocoon of small cabined ideas finds it difficult to open up. After all, it is easier to ‘believe’ in a strict biological determination since it absolves people of all personal responsibility and passes the onus onto our genes. Such genetic fatalism, if one may say so, is quite dangerous. For while spiritual fatalism believes in an underlying intelligent principle that governs our life, a biological causality leaves it all to a play of blind, mechanical forces working randomly in a field of chaos! These are important philosophical sideissues that need to be considered once we accept or deny the existence of a consciousness that survives death of the body.

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Death and Dying Bibliography 1. Dean, D. Techniques and status of modern parapsychology in AAAS Symposium. Science 1970; 170: 1237-1238. 2. Mc Taggart, J.M.E. Human Immortality and Pre-existence. London; Edward Arnold, 1915. 3. Moody, R.A., Jr. Life after Life. New York; Bantam Books, 1975. 4. Pasricha, S., and Stevenson, I. Three cases of the reincarnation type in India. Indian journal of Psychiatry 1986; 19: 36-42. 5. Pasricha, S., and Stevenson, I. Near-death experiences in India: A preliminary report. Journal of Nervous and Mental Diseases 1986; 174: 165- 170. 6. Sri Aurobindo. The Life Divine. Pondicherry; Sri Aurobindo Ashram, 1972, p. 821. 7. Ibid. p. 762-764. Dr. Alok Pandey is a psychiatrist trying to base his life and practice on the vision of Integral Yoga as given by Sri Aurobindo and the Mother.

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NAMAH Body, mind and spirit journal Death and Dying Think it over

Facing death Frank D. Campion It seems to be getting harder and harder for the layperson to make the necessary, crucial medical decisions only he or she can make. Costs have risen, of course. Ethical questions are more complex. And the growth of scientific technology has made many things more difficult to understand. The voice of common sense, of humane reason, does not come through with the strength we might like. Not that I have anything against the strides made in medicine. High-tech medicine stood me in good stead in my first brush with laryngeal cancer 10 years ago, and it seemed to be doing well in managing a recurrence that appeared last fall. But suddenly, this April, as I struggled to recover from radiation therapy, all of my energy, appetite, and strength seemed to go. A CT scan confirmed the worst suspicion: a new tumor was growing in my neck between the airway and the esophagus. My case had taken on a new, possibly terminal dimension. At this point I was in the hospital for tests. The results for some of these were still pending, and my surgeons were due for an out-of-town meeting. The preliminary decision to operate had been made, but the difficult first step - chemotherapy - was at least a week away. "Why not go home", my personal physician suggested. Even after only a week or so in an excellent hospital, my going home was a great change for the better. Our bedroom looks west, through French doors and organdy curtains into a growth of white spruce, elm, and silver maple. It was a warm, sunny day when I came home. A faint breeze stirred the green boughs outside and carried the distant voices of the cardinal and mourning dove. Then, into this agreeable, innocent setting came a terribly out-of-place thought: what a lovely place to die. At first it was neither a totally serious not a totally frivolous thought, but it was one on which I found myself spending more and more time. After discussing my feelings with my physician, he discontinued my mild antianxiety medication temporarily. Both of us wanted my mind clear and uninfluenced. The out-of-place thought started to settle in. I began to examine the risks and rewards of the proposed surgery, a difficult and complex choice for anyone, let alone a layperson. My physicians were patient and considerate, desirous of making things open and clear. I finally decided that I would be in for a long hospital confinement, prolonged suffering, and results that would barely justify the risks, assuming the surgery was successful in the first place. Within our family, the most vocal and articulate supporter of the no-surgery decision was my sonin-law. Both of his parents had died after long illnesses, his father from diabetes-related heart disease, his mother from cancer.

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Death and Dying "A long illness eventually destroys the love between people," he said, "erodes it, just wears it out. That's what happened in our family. I've always felt I never had the chance to say good-bye to either one of my parents. They died in different years, but I think I was the only one in the family to notice they died on the same day of the year." Once I decided (and I should say that my wife Georgene and four children joined in the decision) to let nature take its course, the relief was enormous. First to go was the three-times-a-day torture at the dining table. For 7 ½ months I had been asked 'to eat', yet my appetite was nil; swallowing was painful and thickened saliva made chewing difficult. My wife and I would rack our brains each morning to try to think of something that would 'go down' that evening. For both of us each day began with, "Oh, God, what will we do about dinner tonight?" Perhaps that doesn't sound like much, but try the mental strain for 7 ½ months. About this time I also developed sleep problems. I don't like pills, and I don't usually take them, except under conditions of injury or illness. The sleeping medicines I used were either ineffective or produced nightmares. I was too tired just to put on the light and read, which is what I used to do. I am now sleeping well and am in no pain. My decision was certainly affected by an illness' eventual ability to cause emotional (as well as physical) death. It also set forth an outpouring of love and feeling among all in our family. It established a new level of love between me and my wife, between brother and sister, between half brother and half sister. None of this is to downplay high-tech medicine. We need every bit of it we can get. But, it can get in the way of decisions that emphasize the all-important human factor. Sometimes we let the technology of medicine interfere too much with people who enjoy sunny windows.

(Courtesy : Extract from JAMA, July 28, 1989, p.556.)

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NAMAH Body, mind and spirit journal Death and Dying Think it over

The silence that goes beyond words Dr. Elisabeth Kübler-Ross

Editor’s note: What happens when a person goes into coma? What do we do when a patient alien to us is only a ‘difficulty’ that takes away our time, energy and money? Do we kill him/her through euthanasia or is there another way? Dr. Elisabeth Kübler-Ross, who has been working with the terminally ill for many years, writes that it is here that the patient himself becomes our teacher. Even when he cannot speak or move anymore. This excerpt is an example — There is a time in a patient’s life when the pain ceases to be, when the mind slips off into a dreamless state, when the need for food becomes minimal and the awareness of the environment all but disappears into darkness. This is the time when the relatives walk up and down the hospital hallways, tormented by the waiting, not knowing if they should leave to attend the living or stay to be around for the moment of death. This is the time when it is too late for words, and yet the time when the relatives cry the loudest for help — with or without words. It is too late for medical intervention (and too cruel, though well meant, when they do occur), but it is also too early for a final separation from the dying. It is the hardest time for the next of kin as he either wishes to take off, to get it over with; or he desperately clings to something that he is in the process of losing forever. It is the time for the therapy of silence with the patient and availability for the relatives. The doctor, nurse, social worker, or chaplain can be a great help during these final moments if they can understand the family’s conflicts at this time and help select the one person who feels most comfortable staying with the dying patient. This person then becomes in effect the patient’s therapist. Those who feel too uncomfortable can be assisted by alleviating their guilt and by the reassurance that someone will stay with the dying until his death has occurred. They can then return home knowing that the patient did not die alone, yet not feeling ashamed or guilty for having avoided this moment which for many people is so difficult to face. Those who have the strength and the love to sit with a dying patient in the silence that goes beyond words will know that this moment is neither frightening nor painful, but a peaceful cessation of the functioning of the body. Watching the peaceful death of a human being reminds us of a falling star; one of a million lights in a vast sky that flares up for a brief moment only to disappear into the endless night forever. To be a therapist to a dying patient makes us aware of the uniqueness of each individual in this vast sea of humanity. It makes us aware of our finiteness, our limited lifespan. Few of us live

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Death and Dying beyond our three score and ten years and yet in that brief time most of us create and live a unique biography and weave ourselves into the fabric of human history. “The water in a vessel is sparkling; the water in the sea is dark. The small truth has words that are clear; the great truth has great silence”. — Tagore, from Stray Birds. [Courtesy: Elisabeth Kübler-Ross. On Death and Dying. USA; Touchstone, Simon and Schuster Inc., 1997, pp. 275-276.]

Dr. Elisabeth Kübler-Ross is a psychiatrist who has worked with terminally ill patients in a pathbreaking style. She is today, the world authority on understanding and helping these people.

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NAMAH Body, mind and spirit journal Death and Dying Case study

Sana — the little Zen master Dr. D.E. Mistry Editor‘s note “Time is as short as this. Time is as long as this. Time comes when it comes. 1 Time turns to song in love. “ This is a case of beautiful child who embraced life and death gracefully and left unanswered questions. All doctors who have come across such paticients will have something to empathize. Sana first came to me when she was 5 years-old in September 1999, along with her parents who were from a very economically backward class. She had suffered severe convulsive attacks 2 weeks earlier and was diagnosed as having a supra-sellar cystic mass, causing compression of adjacent structures most likely to be a Craniopharyngioma. Her complaints had actually started when she was one and half years of age after a bout of mild jaundice. Then she began to develop neck pains, that used to come and cease gradually. The parents had tried various treatments, especially herbal remedies and routine allopathic pain-killers, until her first convulsive episode had lead to her hospitalisation and the tentative diagnosis of a cranio-pharyngioma. Unable to afford the sum of Rs.60,000 that would be needed for her hospital and operative treatment, she was given just a month or two to live. What struck me when I first saw this child were her large, expressive eyes. Though just 5 years old, she narrated her symptoms remarkably well and even answered some simple questions that I put to her, about her condition. What came through in my observation about her was her maturity, the preciseness of her narration, a soft, gentle, trusting behaviour and an affinity which immediately linked my deeper self to hers. She took to homoeopathic pills like a duck to water. In addition, whenever I handed her some sweets or toffees she would first give them to her boisterous 3 year old brother and her newly born baby sister. Her concern for all those with whom she came in contact never ceased to amaze me. Whenever she came she would first fold her hands, greet me and ask about my health. Her mother remarked that she was very attached to her maternal grandmother and other family members, keeping a watchful eye on her younger brother and sister. She would be deeply concerned and affected if any one of them were ill. Her compassion and concern extended to her neighbours, even to the 1

Bulbul Singh. Beyond Om. India, Allied Publishers Pvt. Ltd., timeless, p. 64.

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Death and Dying rickshawallah who brought her here and to all others who came in her contact. Once my sister too told me that little Sana had rushed up to meet her on the road once, enquiring about her health. Even my dog Mig did not fail to escape her observation. She talked to my assistant doctors with charm and compassion. Only when her pains became unbearable did she cry out and cling to her mother and grandmother. At such occasions, her friendly side would recede as if clouded over by the intensity of her pain and unknown fears. When I asked her what she was afraid of, she said she was afraid of some darkness that she saw, but could not tell me what it was. Periodically, she lapsed into bouts of semi-consciousness and also incontinence of bowel and bladder which recovered remarkably with homoeopathic remedies I thought fit to give her. When she was well she even attempted to go to a primary school and ate reasonably well. But at times she would sit with a strange wistful expression on her face. What thoughts did this little one have during such moments? She used to tell me, “Dada, why don’t you make me well? I am feeling afraid. My head pains a lot.” I would hold back my feelings and try to reassure her that she would be well. When I asked her whom she remembered at night, she would say, “I remember you a lot and I am looking after you”. Her answer moved me. What connection did I have with this little one whom I had named as ‘The Little Zen Master’? Her parents obstinately refused my suggestion of an operation and I was reluctant to force the issue, realising that it was a major hazard. Months went by with the ups and downs. I took the opportunity of putting her on video and photographed her sitting on my lap. She was quiet and reserved and at times cheerful, chirpy and talkative. By contrast her younger brother, whom I had nicknamed the ‘Goonda’ (rascal), was a veritable cyclone whenever he came to my consulting room at my residence. He would barge in, investigate my table with its books and pens, lift the telephone receiver, go to the kitchen and demand biscuits, sweets and other things from me or my family members. What a contrast these two children were! At times Sana would gently reprimand her brother but would also willingly give her share of sweets to him when he demanded it. At home she had no likes and dislikes for food. Once she told me, “Come to my house and I will cook biriyani for you and we will eat together.” The year 2000 passed in this fashion and the gloomy life prognosis of 2 months given by her allopathic doctors seemed to fade away. Yet in my heart I knew that I was fighting a losing battle. The tumour was pressing on the nerves of her eyes and as shown by periodic scan reports, it was extending gradually towards vital structures. Her mother

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Death and Dying was obstinately against operative procedures and even her relatives expressed their resistance to surgical intervention. During Jan 2001 destiny stepped in, in the form of chiropractitioners from America who had come to demonstrate and heal patients at an ashram nearby. Their leader Dr. Louis was a personal friend and I sent Sana there. Even there, Sana charmed everybody and I believe she had 2 or 3 sittings for spinal adjustments. Once again, miraculously her neck pains and headaches ceased, but I could see that the adjustments had not improved her vision. My medication continued and her condition swung like a ping pong ball. I kept praying for more guidance and hoped that at least the growth of her tumour could be halted. In Sept 2001 she became critical with convulsions and was unconscious, but again recovered within 48 hours with my medication and some intravenous support. I had to decide once and for all about surgery and told the parents that we had to take the risk. If she survived she would be more or less okay, but at this rate she would either go into a comatose state and pass away or lose her visual, hearing and excretory functions. The father and other relatives consented but the mother obstinately refused even then, saying she would prefer her child to die under homoeopathy but not have an operation. A friendly, young, compassionate neurosurgeon consented to operate free with minimum hospital and other charges which still amounted to approximately Rs. 30,000 or so. Friends and relatives were approached for financial help and she was admitted for pre-operative assessment during the first week of November 2001. I used to see her daily with a shaved head and an I.V. drip in her little hand. She seemed to accept the situation easily. Her pains had temporarily ceased and once again her charm and talkative nature fascinated the ward sisters and other patients nearby. I was there throughout the operation, and the surgeon removed 85% of the cystic mass but could not remove the whole cystic wall as it had extended deeply into the pituitary region. She came out of the anesthetic aware of her surroundings. Both allopathic and homoeopathic medicines were given post-operatively and for the first 4 or 5 hours, though I kept my fingers crossed, our hopes increased. She looked as if she would come through the critical 48 hour period of danger. Two hours later she was dead — no reason could be found — it seems as if her little heart just ceased to beat after a bout of strong convulsions. It was a typical case of ‘operation successful, but the patient died’. The relatives were shattered and I was deeply disturbed. The next day I went to the house with my colleague. I saw her lie in a casket prior to burial. I put a sweet on her chest, caressed her head and face, applied sandalwood paste and departed. It seems that 2 days later she appeared in a dream to her grandmother and said that she was in a garden of flowers. She asked her grandmother to tell her father and mother not to cry and also to tell me that she was well and remembered me. Since then there has been no other visitation. She has not appeared to me either so far.

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Death and Dying I have had 2 or 3 such children come into my life in the past for treatment. Such children are wise and mature souls. It seems they come for a purpose. Perhaps to pay off some past karmic debts and teach us lessons of spiritual import. My first such little Zen master child, was spiritually so advanced that even his parents could not understand him. Zen masters teach in various ways — through paradoxes, through abrupt or even harsh behavioural patterns and above all by posing questions which our minds cannot fathom through the intellect. Their lifespan on earth is always brief and having done what their soul had intended, they depart leaving behind wishful memories, unsolved questions and bonds that seem to cross the barriers of time and space. Each such individual that enters our lives is a blessing in disguise, but do we as physicians learn what such a child brings to us? Do we evolve with each such entity? Or do we continue to fall back into our present comfortable role of pills, hi-tech machines and very often harmful interventions? I ask myself if I was right in forcing the issue of surgical intervention and taking the risk that it entailed? Would she have survived more months by some other homoeopathic medicines I was constantly searching for? And was not her mother’s resistance intuitively correct in the final analysis, surpassing my own clinical judgment? Who can tell me the answers to these questions? I leave it to time and my Masters to let me know if they wish. Perhaps Sana herself doesn’t want me to know the answers.

Dr. D.E. Mistry is a well-renowned homoeopathic physician in Sholapur who was also a surgeon in the VMM hospital there.

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NAMAH Body, mind and spirit journal Death and Dying Notes on counselling The terminally ill Dr. Alok Pandey Editor ‘s note: SAIIIHR recently held a conference on the topic of death. One of the most practical difficulties raised during the session by counsellors was: how do we interact with and bring solace to those who are terminally ill without feeling a deep sense of conflict and sorrow inside us? How do we face death day after day without sinking into depression ourselves? Death is a difficult path we all have to tread, yet refuse to look at. This article touches some of these core issues... Death is the question that pursues us from the first moment of life and perhaps even before birth. The struggle for survival begins inside the safe environment of the womb itself. Death is also the last question that life asks, before succumbing. Between birth and death, the question ‘why’ confronts us time and again: in disease and illness, in failure and frustration. Our attitudes and life rhythms are subconsciously decided by its fear, staring from every corner, mocking every effort at victory with a sardonic smile. We are haunted by the shadow of Death lurking like a great denial — the everlasting NO, at the bottom of all living things. The terminally ill only face the issue more crucially. They cannot put the matter off any longer. They cannot run away from it either, into one of those restless activities that men have devised to escape from themselves and the truth. Perhaps they are lucky without realising it! For through it, an answer can be found to many of the questions of life itself. So the counsellor can use this time to help the client look straight and deep inside. So emerges an understanding of this fact of dying that always lurks, but has become of pressing importance for the terminally ill. The physician is in a unique position to assist in this whole new way of looking at death and life itself. Most people when confronted with the prospect of death, go through reactions of denial, anger, bargaining, depression and perhaps finally acceptance. In cultures where death is the end of everything ‘acceptance’ is justifiably difficult. In Eastern societies however, there is a greater acceptance, since it is not seen as a grand finale but only an intermediary stage through which the soul journeys to another life. It is more like a sleep in which we forget the previous days, through dream-experiences, and wake up once again to resume the rounds of life. This reduces the burden of guilt and depression since we have another chance to improve. Still, the anxiety linked to the uncertainty of the unknown remains. Sometimes, depression too, because one is leaving behind a cherished possession. The first thing to reflect on at this stage again is the temporary and transient nature of everything. Death has only brought into sharp focus what we always experience but fail to acknowledge. What is held by the mind, emotions, desires and senses is only ephemeral, however dear or precious it may be to our limited selfcentred vision. Only the soul-awareness survives death since it is immortal.

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Death and Dying

The second thing is to turn the gaze away from our excessive preoccupation with the body and illness toward the immortal soul in us which alone is imperishable. In the Indian tradition, it has been achieved through a contemplative study of the Gita. The same can be achieved through other means as well. Some clients often experience a state of helplessness in the face of death. They wait like a goat tied to a stake. Only, unlike the goat, they are a little more conscious and therefore a little more miserable. If one can understand that death is of the body and not of the inner Self, — that one continues to live through thoughts, feelings, and even genes, that one goes through death towards a still greater life — it would take away a major part of the dread. Finally, having turned to the eternal source, though without losing faith in the possibility of cure, our clients can be led to the point where they can learn to hand over their ‘I’ and death to the Divine. This does not mean totalism. Indeed faith in the Divine grace creates in us the best possibility of cure and at the same time the best possible conditions to leave the body if that is inevitable. This brings us to the psychological state surrounding the moment of departure. Modern medicine does not recognise the importance of this at all, since it sees the death of the body as the end. But our hopes, fears, desires and unwept tears do not end with the death of the body. They continue for a while in a disembodied state seeking resolution, blindly, since their medium for fulfilment, the bodily instrument, is no longer there. They seek other bodies, other forms to inhabit. Arising from the dust of the grave, they continue to haunt the soul in a perpetual nightmare that hampers its onward journey. Like chains, they drag binding the being to the earth, even though released from the body. However, there is a way to sever these bonds before departure. It is by a persistent will that concentrates with faith upon the Eternal. No doubt it is difficult unless the client’s life itself has been consecrated to the Divine. But those at hand can make the difficulty less onerous by remaining in a state of concentrated peace and focussing on the Divine presence. The days following death can further ease the process of release, by concentrating upon the person with peace and love, rather than grief and anger. Compare all this to the atmosphere of gloom and anxiety that is usually so palpable around death. Imagine the state of consciousness of a patient dying with a tube thrust through every opening, struggling with death and his own hopes and fears!! Can’t we make the atmosphere less severe, the departure easier, the staff more sensitive and aware, the physicians more full of peace and trust? Can’t we transmit some peace instead of the usual morphine that only stuns the consciousness and makes it heavy? Yes, provided we have it ourselves. A great failure in our training is the dearth of this human and spiritual side. Our repeated exposure and conditioning to an almost mechanical model of man, means that we have produced an almost perfect robot with the most sophisticated gadgets for the disposal of the body. But this robot knows not the man that inhabits it and is often insensitive to the issue of life and thus to that of death itself.

Dr. Alok Pandey is a psychiatrist trying to base his life and practice on the vision of Integral Yoga as given by Sri Aurobindo and the Mother.

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NAMAH Body, mind and spirit journal Death and Dying Think it over

Death’s Messengers Once in ancient times a giant was travelling along a great highway, when suddenly an unknown man sprang up before him and said, “Halt, not one step farther!” “What!” cried the giant, “a creature that I can crush between my fingers wants to block my way? Who are you to dare to speak so boldly?” “I am Death,” answered the other. “No one resists me and you also must obey my commands.” But the giant refused and began to struggle with Death. It was a long and violent battle, in which at last the giant got the upper hand and he struck Death down with his fist, so that he collapsed like a stone. The giant went his way and Death lay there conquered and so weak that he could not get up again. “What will be done now,” said he, “if I stay lying here in a corner? No one will die in the world and it will get so full of people that they won’t have room to stand beside each other.” In the meantime a young man came along the road. He was strong and healthy, singing a song and glancing around on every side. When he saw the half-fainting one, he went compassionately to him, raised him up, poured a strengthening draught out of his flask for him, and waited till he regained some strength. “Do you know,” said the stranger, whilst he was getting up, “who I am and who it is that you have helped on his legs again?” “No,” answered the youth, “I do not know you.” “ I am Death,” said he. “I spare no one and can make no exception with you — but to show you that I am grateful, I promise to send my messengers before I come to take you away.” “Well,” said the youth, “it is good that I shall know when you are coming and, at any rate, I shall be safe from you for a long time.” Then he went on his way and was lighthearted. He enjoyed himself and lived without thought. But youth and health did not last long. Soon sickness and sorrows came and they tormented him by day and took away his rest by night. “Die, I shall not,” said he to himself, “for Death will send his messengers before that, but I do wish these wretched days of sickness were over.” As soon as he felt himself well again, he began to live merrily. Then one day someone tapped him on his shoulder. He looked round and Death stood behind him and said, “Follow me, your hour of departure from this world has arrived.”

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Death and Dying “What,” replied the man, “will you break your word? Did you not promise me that you would send your messengers to me before coming yourself? I have seen none!” “Silence!” answered Death. “Have I not sent one messenger to you after another? Did not fever come and smite you and shake and cast you down? Has dizziness not bewildered your head? Has not gout twitched you in all your limbs? Did not your ears sing? Did not toothache bite into your cheeks? Was it not dark before your eyes? And besides all this, has not my own brother Sleep reminded you every night of me? Did you not lie by night as if you were already dead?” The man could make no answer; he yielded to his fate, and went away with Death. — Author unknown

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