In this conversation, we explored death and dying with Frank Ostaseski. Death does not have to be a bummer. I believe you will really enjoy diving into the deep end of the pool with Roger, Frank and myself. Welcome to Deep Self, Society, Spirit, Life enhancing paradigm rattling conversations with cutting edge thinkers, contemplatives and activists. With Dr. Roger Walsh and John Dupuy.

I'm Roger Walsh and our co host is John Dupuis. And our conversation today is about the transformation that our culture has been undergoing in a much needed way over the last few decades in its attitude and treatment of the dying. For so long, our culture hid death and dying from our presence, shoved the dying away in secluded places and basically tried to admit it wasn't happening. That's been changing in fortunate ways. And one of the people leading that change is Frank Ostasesky. Frank is with us today and he is the founder of the San Francisco Zen Hospice. He also initiated the Metta training program. Meta, the Buddhist term for loving kindness, is a training program for end of life care counselors. He's also author of the incredibly credible book the Five Discovering what Death Can Teach Us About Living Fully, a book I'll have more to say about because I'm absolutely blown away by it. But Frank, welcome. It's a delight to have you with us and thank you so much. And perhaps we can begin by going back and asking, what was it that drew you into your work with the dying? Because this was very unusual when you started.

Well, first of all, nice to be with Raja and with John as well. Well, who knows what gets us to one particular place, right? So many causes and conditions contribute to where we are in a given moment. You know, my own parents died when I was quite young, so that was a big influence. I worked with refugees in Chiapas in Southern Mexico, where I saw a lot of horrible dying. Another great big influence, the AIDS epidemic in San Francisco, you know, where I had lots of friends dying and horrible deaths, actually awful deaths. Many times. Kubler Ross was an important mentor. So all of these things, I think contributed to my work. But mostly I thought there was a natural match, Roger, between people cultivating what we might call the listening mind and through meditation and people who really needed to be heard at least once in their lives. Folks who were dying and what might it be like if they were dying, surrounded by love and calmness rather than fear.

A beautiful question and a question, it seems like that has guided your life.

Well, it's an influence, of course. You know, I like to stay humble around These kinds of things. We'll see what it's like for me when my time comes. Yeah.

Yeah. Well, that is, of course, is the test for us all. And John, you've actually faced that.

Yeah, A few years ago, I don't know, my. Five or six years ago, something like that, I was in Grand Junction, Colorado, on the road with my dog, and I went to the gym that I work out when I go there. And coming out of the gym, I had this massive heart attack. And I'd never had a heart attack, but this was not subtle. It was like I was in great pain. So the first thing I thought about, I've got to get back and make sure my dog is taken care of. So, like an idiot, I didn't dial 91 1. I drove in a pot and this old person going really slow for 3.8 miles to get back to the. My hotel room. And I got there and I had met the manager before, and she loved dogs. And so, okay. Then I called once I got back with my dog to that, and yeah, it was. I was pretty sure I was going to die. Certainly felt like it. And I was just like, well, okay, God, this is it. Here I am. And there wasn't that much fear. You know, I was trying to say any. You know, just forgive me and help me to forgive and, you know, all these things. But basically, God, and that sort of thing was on my mind. And then they put a stint in my heart, and it just like, opened up. I could breathe again. I said, wow. I said, you guys just saved my life. Thank you so much. And then I had for about an hour and a half after that great sense of clarity psychologically and spiritual. And I was at great peace. And I said, maybe I'm getting ready to die. I hear that happens sometimes before people die. And no. So I called some people to make and said, you know, I'm sorry, you know, forgive me for not being in touch. My brother, for one. And then. Then after that, it felt like a mule had kicked me in the chest. And I was like, okay, this is what it's like. And it became very difficult. But I had very little fear, except for my dog, her being abandoned. And when I was in the operating room, it was Grand Junction, Colorado, and had a great Catholic hospital cardiac center there. So it was. Any place on my trip, I would have died, no question. But I was right there at the right place in the right time. So there was acceptance and peace and just trying to forgive and ask for forgiveness of people I had offended or had offended me and clear up with that. So it's always been very, very on my shoulder, very close to me ever since then, because once you have that experience, you know, it's before and after. And so it's very happy to be here with you because I've been listening to your presence a lot on YouTube and feel I have a lot, I have gained a lot, and I have a lot to. To learn with you. So anyway, thank you for asking, Frank.

So, John, may I ask another question? I saw a kind of tenderness that came over your face when you talked about forgiveness for a moment, forgiving your brother and forgiving. So I'm curious about how this experience has stayed with you now. I mean, there was. You spoke about the initial impact that it had, but how is it with you now? Because it's been some time.

Yeah, well, sometimes it changes. Sometimes I'm sitting in a place where it seems very okay, and other times I'm just a human being that's going to die. And it's scary because I don't know exactly what's going to happen. So I seem to alternate between those two. And right now I'm at this moment with you, with everyone here. I'm feeling at peace with it for whatever because of the transmission or the field that's created or who knows why? But I've been through fear of mortality and at peace with it. And I had an experience one time. I'll just give this. I was in a deep, meditative, prayerful state. And sometimes it feels like I'm just in a place where I can ask any question. You know, the oracles are open. And I said, okay, God, it's a big one. What about death? And the answer that came, that's really sustained me was I will be there. Not me, but God will be there. And I said, well, that's enough. That's all I need to know. That's more than enough for an answer. So you can make of that what you will. But I always go back to that. And there was not a lot of fear when I thought I was dying. It was like, okay, here I am, and God help me, I should have done better. But help me to clear it up in the next few minutes while I'm in this body to anything that's behind.

Well, thank you, John. I mean, as you know, I had a series of heart attacks and strokes as well. And we won't go into an organ recital. But while after my. After those experiences, I read the works of people who'd also had heart Attacks, just so I could understand. Abe Maslow, you know, had a very big one, and. And he said the encounter with death makes love, passionate love, more possible. Yeah. And I love that that was his takeaway, if you will. That was what kind of stayed with him after these, what were frightening experiences. Of course, yeah.

I'm struck that both of you have been through these, really looking death in the face, you, Frank, on several occasions. And both of you are deep contemplative practitioners. And I wonder how has that shaped or molded the way you are able to be with death, your own, and with the many, many people you've sat with, Frank?

Well, I've had a few trial runs, as we were speaking about a moment ago. I mean, this happened to me just a few months ago, Roger, as you know, and I was having a kind of pain, and I sat. I got up out of bed, not quite knowing what's happening, and I sat on this little chair in my home. And honestly, Roger, my mind was like a barking junkyard dog. It was just all over the place, you know, and all of my meditative tricks and of the trade, so to speak, weren't very useful. And then I just began to remember the people I love, and that was a kind of stabilizing influence on me. And then I could draw my attention back to the contemplative practices that you and I are familiar with. And there my mind became a little bit more stable and I could take action that was appropriate at that point. Call 91 1. But the truth is, I was in complete denial about the experience, and I don't think that's uncommon. John just referenced that as well. I don't think that's uncommon because I think our sense of self, our egoic self, can't really conceptualize it's dying. I mean, we can conceptualize it. We can think about it. It's not enough to help us meet this experience. It just can't do it. And so we have to discover something in ourself that includes ourself, but is larger than ourself. We could say, yeah, only that can help us meet this experience.

Was there a lot of fear for you when you were going through this experience?

At times there was. At other times, no. You know, in another experience, I had a rather severe stroke. And what I noticed, John, was that while it felt like someone was taking a jackhammer to my head, I got up and I couldn't find my way to the bathroom in my house, which is only 10ft away. And I wandered in that 10ft and then I began to notice that my ability to tell night from day was going offline. My ability to find direction certainly was going offline. But awareness was present. Awareness was there. And even though the functionality of my brain was not what it ought to be, awareness was conscious of that. And so in moments, there was fear, of course, but there was also awareness. I don't like to prop myself up as anything special. I just think that's the nature of awareness. It's trustworthy. Yeah, trustworthy.

And your contemplative practice, it seems, has been central to the way you've been able to approach the dying. It just feels, as I read into your book or into your being, it just feels like there's something about all those years of contemplative practice which has enabled you to be present in a way most people aren't.

Well, perhaps, although I want to add here, Roger. That I've been with, oh, a thousand or two thousand people going through their dying process. Many of them were people who had no inner life practice, who had no contemplative practice to speak of. And yet the experience of dying introduced them to something, had them seeing themselves as something larger than the small, separate self they'd taken themselves to be. So I would suggest here that dying has about it certain conditions which are conducive, helpful to our waking up or discovering ourselves to be more than our small, separate selves. Yeah. And so that's why I want to say that dying is not predominantly a medical event, and we ought to stop treating it as if it were. You know, we should bring the best of medicine to the care of the dying. But dying can't be managed by medicine alone. It's too large for that model. It's too profound for any single model. Yeah. Can't show up. It can't help us to see all that death has to teach us. So I would want to stop compartmentalizing death, cutting it off from life. Suppose we imagine death as this unprecedented opportunity for transformation. That helped. What would happen if we turned toward death and said, please tell us, what do you have to teach us? That interests me?

Yeah. And of course, that's what you've discovered there and just communicated to us is very congruent with the teachings of not one, but several of the world's great spiritual traditions. That death, from their perspective, is one of the most important events in life and has that profound spiritual potential that you pointed to.

Yeah.

What other kind of transformations you've seen people go through?

Oh, boy, that's a big question, Roger. What I think I've seen oftentimes is in the final months of life, the final weeks of life, days, minutes of life, this sense of discovery that we've been, you know, chatting about here, where people, not unlike what John was just talking about earlier, see what's really important, you know, find what really matters, you know, and we might say too late. And I would agree we shouldn't need this until we find ourselves on our own deathbeds. But the point is, if that opportunity, if that understanding can emerge in the time of dying, well, then isn't it available to us now? And why wait until the time of our dying to discover it? Yeah. So, yeah, I don't want to rattle on too much here, but I think that, you know, Kubler Ross was one of my mentors early on, you know, and she of course developed her famous five stages of grief which people apply to the dying. She never meant them to be literal, I don't think. But the final, you remember, was acceptance. And it's been my experience in our contemporary medical care, including very good hospice care, that oftentimes we are pushing people toward acceptance and thinking or imagining that it's some final stage. I think acceptance is just the beginning. I think when we accept, usually it just means we're accepting that we're mortal. You know, we come to terms with this undeniable experience. But that's just the beginning. What I've seen frequently after this stage of acceptance are appreciably deeper states. When the ego structure comes into contact with acceptance, it freaks out. You know, it's not a pleasant experience. It's not all warm and fuzzy. It's often chaotic. There's this sense of, you know, being pulled apart or everything. All the ways we've defined ourselves as being stripped away in this process. And it's frightening for most people.

I'll just add to that, just talking to you here is bringing me back experience. But I don't remember that. Finally they got me to the emergency room, you know, went to the ambulance, you know, all this stuff is going on. And there was no fear until later on. And I realized what happened, you know, and I've become very much aware of death, that sometimes my ego gets really scared of it. But in the moment when it was happening, I was very much on what matters. My dog, the people that I love, and God.

Well, John, you know, acceptance is important. Acceptance of impermanence in our day to day life helps us to learn how to die. I think it also helps reveals the flip side of loss, which is that letting go is also an act of generosity. I mean, when we let go of old grudges, we give ourself to peace. That often happens to people in and around the time of their dying. When we let go of fixed views of who we are, we give ourselves to not knowing. When we let go of all our self sufficiency, we give ourselves into the care of others. So letting go has a important and beautiful role in this process of dying. But I think that there's a deeper dimension to this and I think it arises out of the chaos that I was describing, the fear that you were speaking to just a moment ago. And that's the role of surrender. And I don't think it's the same thing as letting go. I think that letting go has this quality of being released, you know, from some previous, I don't know, idea of restraint, we could say, but it has this way of distancing ourselves from something. We set something down, right? Surrender is different. Surrender has this quality of coming closer to something, closer to something perhaps that we already have a taste of or have some familiarity with. And surrender, to me at least, when being around people who are dying, it has a different quality. It has a quality of expansion, actually. So the freedom that comes with that isn't exactly by setting something down, but rather becoming larger so that it can include whatever is occurring, including the fear that you're just describing. So I think that out of this chaos can often come this possibility of surrender again, infinitely deeper than letting go. And in that surrender then becomes. That becomes a kind of gateway to the possibility for transformation, to see things in a new way, where it's not just, you know, some activity that's being tacked onto the same old you, you are changing, you are being reconstituted in this experience of surrender. And I'll say one more thing about this. We might think of surrender as, you know, the result of religious practice or faith or inner life work, all of which is true. Those are remarkable contributors to the possibility of surrender. But I also think that exhaustion is one of the greatest contributors to the experience of surrender. I mean, if we think about those of us who have been on meditation retreats and the like, oftentimes what happens is that we're just too bloody tired to continue. We're tired of fighting with the pain in our body. We're tired of, you know, struggling with the chaos in our minds and we finally just give up. We cease to battle against the situation. And that's the doorway of surrender. And then the veils lift and all kinds of things are possible. And I think in the case of dying, that's exactly what happens. So we get too exhausted, the body can't fight anymore, a sense of self just is too damn tired to keep it all going, and it starts to get exhausted. And out of that experience oftentimes emerges the experience of surrender.

Beautiful. Thank you, Frank. And it does feel like you're pointing to something both more than and possibly beyond simple acceptance. And the word surrender is the term that's most commonly used and valuable, but also feels like for many people, has negative connotations. And you're pointing to something beyond those negative connotations. You're pointing to something which I'm looking for further terms, perhaps an opening to, but something that comes out of. Out of no longer being able to maintain the ego structure and the beliefs and positions and attachments, et cetera, that we've cobbled together for perhaps a lifetime. And the discovery that holding. That our ego act together really is.

A lot of work. Yes, it sure is. And in the dying process, you have this again. I. I want to suggest, and I'm not romantic about dying at all. I think it's the hardest work we'll ever do. So I don't have some, you know, new age notions about dying, but the process of dying strips us of our identities, or we gracefully give them up, but they all go at some juncture, and then who are we? Then? What's. What's there? What's left? And I think that's a really interesting point or moment in the dying process. Yeah. Roger. I was rafting down the. Through the Grand Canyon once, and in these big, big, big wonderful rapids that are there. And I got thrown out of the raft and into a kind of whirlpool that started to take me down. And I did all the wrong things. You know, I. I tried to swim to the edge of the whirlpool as if it were the edge of a pool and I could climb out. They threw me ropes and I couldn't get to them. I did all the wrong things. And finally the whirlpool took me down, and it took me down, and it was not a beautiful moment of dying. It was chaotic and the water was muddy, and I couldn't find myself. It was like being in some giant washing machine. And I fought and fought and fought until finally I was too exhausted to keep fighting. And then something released, and it wasn't beautiful. It dragged me down to the bottom of the river and pulled me along the bottom of the. Along the Mud and rocks. But there was some moment of releasing that happened in that. I can't say that it was graceful. And eventually it dragged me down the river and brought me into an eddy and spit me out into the shoreline. And I felt like I emerged with a different set of eyes. Now, I'm not a big believer in near death experiences. I don't think that's what happened to me. I think I almost drowned. That's as clear as I could be about it. Yeah. But it helped me to understand later when I would be with dying people and Barbara would say, I'm just putting my head in the lap of Jesus or, you know, not my job anymore. Or they would say things like this to me and I would begin to understand something of what they were talking about. Some deep relaxation, I could say. And I think that this is another way of us understanding surrender. It's not just as a giving up or that we're losing the battle, but rather that we're not fighting. And so we have the opportunity to see more of who we are, see more of the experience, because our vision isn't just focused on keeping it all going.

I have a question for you, Frank. Do you often feel when you're talking or you're teaching to us, like now, that sometimes you're talking to your own soul? In other words, you're giving yourself the medicine that you need. I had an experience yesterday. I was doing a guided meditation two days ago, which I do every week, and I just started talking about, you know, the great mystery of existence. What math can't take us there. We don't know death came into it. I think it was probably I was influenced by the preparation for this conversation with you. And we talked about. I can't remember all I said, but when I finished, I had this great sense of peace about existence, about non existence, about death, the great mysteries that confront us. And I was like, man, I was talking, you know, my soul was preaching to my soul or something. It was coming through and it really helped. So do you experience that when you're in the zone and when the presence that you have, this sense of peace and wisdom that you transmit is also coming back at you and helping you in your own struggle with the great mystery of our imminent death?

Well, I'm getting it from you right now, John, really hearing your presence and how all this, this conversation is impacting you? I mean, teachers always teach what they need to learn, oftentimes. And I remember when I first started teaching, a dear friend of mine gave me a mantra he said, this is a very important mantra that you should learn as a teacher. And I waited, you know, for the great wisdom to appear. And the mantra was, I might be wrong, you know. And so I hold that closely, that particular mantra. A while back, after a series of strokes, I was sitting in front of my computer one day, and I looked at the computer, and everything got very pixelated. And it wasn't just on the screen of the computer. I turned toward the wall, and the wall was pixelated as well. And I thought, what is this? You know, maybe this is some great awakening experience that I'm having. Yeah. And then I realized, oh, no, something else is happening. So I called my wife at the time, and I said, I think I might be having another stroke. And so she said, okay. And she called 911 and I'll be right there. And I continued to just stay looking at this pixelation. And she got home, and I live on a houseboat, you know, And I have to walk down a long dock to get to the parking lot. And my wife said that emergency techs are coming. And I said, I want to walk down the dock. And she said, you foolish old man. No, just stay still. You know, they'll come with a gurney. I said, no, I want to feel my feet. So we started walking down the dock. And I was quite unstable. I mean, physically, I had to hold on to her and the railings. But internally, there was this great sense of ease and a great sense of love. And I wasn't doing anything, John. I wasn't trying to do Mecca practice or loving kindness practice or any of these things. It just was there. And about halfway down the dock, I said, just a minute. And she said, no, we have to go. And I said, just a minute. I looked over the railing into the water. And as I did, everything disappeared. Everything. There was an absolute absence, different than emptiness I'd experienced before. There was no qualities to this absence. It was before qualities. I don't know how to say it. It didn't feel kind. It didn't feel wise. It didn't feel any of these things. It just was absent of everything. And I remained in that for a while until she grabbed me and said, we have to go to the ambulance. And we went down a little bit further, and I had a grand mal seizure into the arms of the emergency tech. They gave me some medication, took me to the hospital. This was during COVID so she couldn't come in. And while I was in the hospital, they gave me some more medication. And one of its side Effects I learned later is paranoia. Roger, you know about these things. I'd never been paranoid in my life. I've been with paranoid people. But it induced this paranoia and it stayed for a long time, maybe two days. I was so paranoid, I couldn't tell the healthcare clinicians that I was paranoid. And in this state again, I couldn't stabilize really. So I just started to repeat this phrase, right now it's like this, right now it's like this. And that was helpful. Ultimately, the paranoia wear off. Maybe I adjusted to the medication, I can't say. And sometime later I spoke to one of my teachers about it and I said, you know, suppose this was the moment of my dying. And he said, well, it doesn't, you know, I told him the story I just told you. He doesn't surprise him. You had all this love or you've been cultivating it all these years, of course you had. And I said, yeah, but what about the paranoia? Suppose that was the moment of my dying. He said, oh, it'd be okay. I said, okay? What do you mean it'll be okay? He said, oh, when you died, your brain would stop and the paranoia would go away and awareness would return. And it was a little too simplistic for me at the time, but I thought it's a pretty wise teaching, actually. It's a very wise teaching. So I have confidence in this. I have a deep confidence in this, in my own experience. And when I'm sitting beside someone who's dying and I think when we can reside in this and there's less and there's more fearlessness, and I don't mean there's no fear. And I think this is a great aid to people in their dying process and I would hope to encourage this in the lives of others.

Yeah, I wanted to say the kind of the opposite of that surrender is the contraction that we feel around fear. You know, you start thinking about our non existence or dying. I can actually feel kind of my heart closing up. It's definite contraction. And what you're talking about is this surrender and opening what feels like grace for me. Like I said, I'm pretty God centric, I talk in those terms, but it feels like something beyond my own dedication to practice and everything. There's something that kicks in that's I can't take credit for, but that I'm.

Grateful for imagining that, John, that God is holding your hand, so to speak, and your heart is hurting, right? It's literally physically hurting and it's contracted. There's this sense of, oh my, what's going to happen next. Right. But imagine if something or someone was holding your hand in that moment and that something or someone wasn't so afraid. What do you think the influence on you might be? So, you know, this is why I'm, of course, I'm interested in how we care for people at the end of life. This is very important to me. But I'm much more interested in what do we learn from being with dying that can help us to live more meaningful and rich and full lives, purposeful lives. That's what really interests me these days. I'm a little allergic to the idea of a good death, to be honest. In our culture, we tend to promote this idea. And it's not that we shouldn't try and help people to have ease of pain or ease of from certain symptoms, but I'm a little worried that we add on or subject people who are dying to our standard about how it should go, what it should look like. I mean, I think dying is pretty damn hard. It's hard enough without us adding onto it some spiritual standard about how they should go through. So I don't have a way in which I think people should die. I've been with people in all kinds of situations and all kinds of circumstances, and we die the way we die. I don't think it's true that we die the way we live. I don't think that's. I think that's another cliche. I think we just die according to the causes and conditions that are present in that moment. And yes, of course, it can be helpful to have a kind, loving, fearless person next to you, but don't want to add a bunch of how people should do it. I just don't want to do that. I think however they do it is fine.

And that feels like one of the central themes of your work and the way you approach death and the dying. Frank, from reading your book and the five invitations is there's a radical acceptance on your part and radical openness. And I guess that's close to two of the central principles you enunciate in the five invitations. You call them invitations. One could call them principles or suggestions for ways of approaching death and life. One of them is cultivate don't know mind. The other is welcome everything and push away nothing. And feels like that's. Those are very central to this attitude you're suggesting or the don't know mind about dying. You know, it's like, great, so we brought dying out of the closet. But now, but There's a trap at every stage of both individual and cultural development. Now it's like, oh, now we know more about dying and this is a possibility. So we should all have this experience, right.

And honestly Roger, it's rampant in spiritual communities and in our transpersonal psychology movements, you know, it's rampant about how we should do it. I was sitting retreat with someone you know very well and this person was speaking about the last moment is the most important moment in the dying process is a, you know, common Buddhist teaching, right. And I went up to this person afterwards and I said, can I ask you please to consider something? And this person said yes, of course. And I, I, I said would you please stop telling people that? And, and he said but you know, it's, it's in the text and it isn't, isn't it most important? I said it's very conducive to making people feel guilty that they didn't do it. Right. That their mother was on morphine and which should we have given her the morphine or not to manage her pain and did we cause her to be less conscious, et cetera. And again, these are idealistic ideas that keep us from being with what's actually happening as it's happening.

Yeah. And it feels like that is also so central to what I take away from your book and your teachings is that the being with in an open hearted way, as you say, don't know mine. And that feels like a priceless gift to give someone, free them from our expectations. Ram Dass once told a story years ago which really stuck with me. He said, imagine you're a person, you're dying. And I think he said just imagine you're, you're a young mother who's dying, you're leaving a couple of kids and imagine everyone coming into your room carrying those, you know, their expectations about how tragic this is. And so, and I thought that really stuck with me as a story.

I was with a young woman, late 20s I think she was, and she had been in a very somnolent state for days and not eating, not drinking, not speaking, etc. He wasn't in a coma, but not reachable for us. And her mother came to visit and her mother was, and her had a very difficult time. They were, mother had been abusive to her in different ways and they were estranged. And the mother came and sat beside the bed and said please forgive me, forgive me for all the things I've done. I love you, I'm so sorry and apologize. I think sincerely and in this moment, this young woman sat up like a rocket, came out of this side mount stage, looked at her mother and said, I hate you. I've always hated you. And then she died. Now, is that a terrible death or is it a truthful death? I don't know. But I know that it was important for this young woman to be able to say that, and it was important for the mother to hear it. And when I worked with that mother over the next several months, it was very important for the mother to work with what her daughter's last words were to her. And the healing that came out of that was important for the mother. Now the challenge for us is, can we just sit still in a room like that? Can we not leap in to save the day? I didn't say a word in that experience. There were no words that could touch that. All we can do in such moments is to stay present, to not run away, not leave the room. And so, again, I don't have too many ideas about how it's supposed to go, but I have a lot of trust in the dying process, an awful lot of trust in it and what it can show us. What we were talking about earlier, about the chaos and surrender, transformation that's possible in this process that we are, we've become so frightened of.

One of the things I took away from your book. And maybe I want to just take a moment here, Frank, and just talk about the book, your book. The Five Invitations. Discovering what Death Can Teach Us About Living Fully. You know, I've heard about this book, and I think my late wife, Frances, had it. She was one of your faculty members in your end of life care counseling training program. But I'd never actually read it. And three days ago I started reading and I figured, oh, dear, I probably won't get through it. And this book touched me as much as any book I've read in a long, long time. So much so that I stopped my. I dropped everything I could. I stopped writing. I just wanted to get through as much of this book as possible, both in preparation for our dialogue today, but more for my own. I was so touched by it. So I'm just. I find this enormously touching, wise, impactful, beautiful work, a distillation of what you've learned. I was very touched by it. I really can't recommend it highly enough. So thank you for. Thank you for that.

Was there a major takeaway from the experience of reading the book? Because we talked while you were reading it and we were talking about it. Just what you're saying now, how powerful it was. Is there one thing that you take away from this?

I think there were so many. It's one of those. Felt like this is the distillation of wisdom, of a lifetime of learning from the. From opening to some of the most powerful experiences that human beings can have, and that the wisdom that dying and being with the dying can convey and its transformational impact, potential transformational impact. And the idea that so much of what we have assumed in our culture about death and dying is wrong, and so much what, as you said, Frank, the tragedy of the way in which death has been medicalized and reduced to a medical event rather than a profound human and interpersonal process and passage. So all of those. And maybe I'll frame this as a question. I was also painfully reminded of how inadequate medical training can be for dealing with the dying and how unbelievably inadequate it was in my own time. And I've had a very fortunate life, blessed in so many ways. I don't have a lot of regrets, but one of them is I'm getting teary. I deeply regret the way I, you know, I was inadequate to people who died. I was caring for them.

Yeah. I. Well, first of all, thank you for all your kind comments, but this moment that you're experiencing now, Roger, I can't speak to what it is for you, but I know when I touch this kind of remorse in myself, it's really important. It reminds me. I like it, actually. It's the most. It's so human, and it helps me to see that. I want to know that pain because I don't want to repeat that experience.

Yeah. I would like for other physicians and health professionals not to have to both inflict what I did on the dying, not in a callous way, but out of. Out of ignorance and fear. And I would like. Yes. And I would like to learn from this myself.

Yeah. Oh. You know, during the early days of the pandemic, I was working with a lot of emergency room teams in New York and Houston, places where Covid was, you know, out of control. And in those early days, of course, people were dying quickly, and clinicians were in dual roles where they were not only providing their professional expertise, but they were being the family members, because, as you remember, families couldn't come to visit them. And they were a wreck. They were a wreck because they had had to open their hearts to fill the role of the family member. And they didn't have the same defenses that they were accustomed to from their professional roles. And so that fourth wall it was broken, you know, for them. I sat with them and I said, you know, you guys, you're not normal. And they left, and they said, it's not normal to be with people who are dying on a daily basis. And so the normal coping mechanisms that you have are not sufficient to meet the conditions that you find yourself in. You can't go home and just watch Netflix and have a glass of wine. It won't be sufficient to meet that kind of moral suffering they were experiencing. And so I think I have great empathy for physicians, people with medical training like yourself, who were really taught a particular way of being which had themselves closing their hearts and cutting themselves off from their humanity, honestly, their humanity, and cutting themselves off from the innate wisdom in their good hearts. And so much of the work was to help people remember, to trust their wise hearts in the course of the work that they found themselves doing. So. Oh, it's so hard, isn't it, Roger? It's so hard.

One of my jobs when I was in graduate school was going around to physicians and having them fill out death certificates so families could take care. But it was called anyway, it was a really good company. They didn't charge much for their service, and there was a lot of integrity there. Neptune society. You know, people felt I was doing a good thing. But I noticed that the physicians often had hard times. They felt like they were failures, you know, somehow that death was a failure. And it was like, no. I would just try to comfort the doctors so they could do their paperwork and help this family move along with the process.

Now, you know, there was a dear friend of mine, common friend that Roger and I share, Rachel Naomi Remond. She was the author of wonderful books, Kitchen Table Wisdom, My Grandfather's Blessing. She worked a lot with clinicians. And one day she came to me, she said, do you know so? And so she's a doctor? And I said, yes. You would think she was in one of my workshops. She said, what did you say to her? I said, I don't understand. What do you mean? And she said, now she goes and pronounces people dead at a major big city hospital, and you should understand something about how she does it. And I remember this one woman coming to me in a workshop and said, would you give me some Buddhist rituals that I could do around the time when I'm pronouncing people dead? And I said, no. And she said, well, why? And I said, because you have to find what your own ritual is. You're not Buddhist. And if you just take on One of those things, it'll just be something else you do rather mechanically. So this young woman, whose, of course, father and grandfather had been physicians, a common experience, went out and got her grandfather's medical bag that he used to go house to house with. Yeah. And she got her father's stethoscope that he had left her. And she went and got this rose oil that her grandma used to make, and she kept them all in this bag and in her locker at the hospital. When it was her job in this big city hospital to go and pronounce someone dead, she would go and get the bag and she'd take out her grandfather's, you know, leather valise and pull out of it her father's stethoscope and some of the little rose water that Grandma used to make. And she would apply this rose water and say to the person, I want to let you know that you've died now. It's okay. I will be here with you. And she took out her father's stethoscope, listened for a heartbeat, et cetera. And this is how she began to pronounce people dead. She found her own ritual with it. And so I think within medicine, there are people who are doing these kinds of things all the time. It's just that we're not necessarily seeing that. There was a fellow, he was a nurse's aide, basically, and his job was to go into a surgical room, oftentimes, or even a room in the er, and clean up after the mess when someone had died. And oftentimes, what would happen is the person would still be there. He would go into this room, and the room was chaotic, and there were bloody rags on the floor and all these kinds of things. But the first thing he would do is he'd go over to the person who died, and he'd lean over and he'd say to them, I want you to know that you've died, and I'm here, and I will clean up this mess in the room and the chaos that's here and wash away all dust and confusion. That was his line. Wash away all dust. And of course, the other nurses would peek their heads in the door and say, hurry up. We need the room. We need the room. But the supervisor on this unit understood what this young man was doing. And so she would lead, she'd come and she said, take your time. It's okay. Take your time. Yeah. And I think things like this are happening in medical centers all over the world. And I want to raise a glass, so to speak, to the people who are doing these kinds of things in the midst of what are often very toxic, very difficult environments. I'm very grateful to the people who are working as healthcare clinicians these days and that they can. Some of them are secretly doing these kinds of things that I'm really grateful for. One last thing about this, I was giving a talk, grand rounds at some big hospital in the Midwest. I forget where it was. And I. So we were walking as the head of nursing was taking me to the theater where I was going to do this talk. I heard Brahms lullaby come over the back of the speaker system. And I said, oh, what's that? And she said, oh, every time a baby's born in her hospital, we play Brahms lullaby. And I said, you mean just here in the hallway? She said, no, no, it goes into every room. I said, you mean the operating theater goes in there? Yes. It goes into the morgue? Yes. It goes into all the offices of the administrator?

Yes.

I thought, what a beautiful ritual that this happens. One day we will have such rituals for when people die as well.

Stay tuned for part two of our conversation where we continue to explore death and to help us move into the experience with more wisdom and peace. Thank you very much for being a part of. Of this conversation. We hope that you were moved as we are moved, being part of it ourselves. We'd also like to say that this is being funded by Roger and myself. It comes out of our pockets. So if you would like to help us to mainly to get this podcast out to more people because the bigger audience have, which is steadily growing. But the more people we can reach and the more marketing we can do, the more positive effect we can have on the world. So we've done a couple of ways, but we'd like you to buy us a cup of coffee. Very simple. And I do that with podcasts that I support and I find it's very satisfying. So thank you for your help, thank you for your presence and thank you for all you are and all you do. We love you.

Sam.