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The Terminally Ill

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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. 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 and at times, 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 self-centred vision. Only the soul-awareness survives death since it is immortal.

The second thing is to turn the gaze away from our excessive preoccupation with the body and illness and 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, patients can be led to the point where they can learn to hand over their ‘I’ and death to the Divine. This does not mean fatalism. 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.