“Mom is dying, what do I do?”

We will all face this process one day, and it is assured that we will probably be witness to it as well. It’s part of who we are. When it’s your own family member, the process can be very difficult, and a strong support system may be the best we can do to get through it, we are too close to the situation to be of any help, we need help ourselves. Some people do well by discussing it; others go to that door with little or no discussion at all. There are no hard and fast rules; everyone goes through this final act in their own way. But allow me to say one thing to you before going on. You are not being selfish by feeling anger at this process, nor am I going to tell you that it will get better with time. You are going to miss them physically, and if you are reading this, you’re probably at the stage of just wanting this not to happen, or if it has already, you just want them back. You just want them back. That’s OK, and perfectly normal. You are not being selfish. It’s called love and right now it hurts.

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But if you’re paying attention, there are signs that the process might be progressing in a more imperceptible manner that family members and even the medical professional might not be aware of.

Every effort, of course, should be made to maintain adequate and appropriate pain control, fortunately this has progressed to the level of fine art since my father passed away. No person should have to experience the kind of pain that robs us of our ability to die with respect.

But even when this can’t be achieved, any discussion the person is willing to participate in can help reduce their fears. Sometimes this cannot be accomplished by another family member; here is where the professional caregiver can work wonders. This process is made the more powerful by helping others through it; I would imagine that it helps each of us when we also face this process.

One of the most effective things you can do is ask the person how they think they are doing. Medical professionals are people too, and face the same fears the rest of us do, too often they are willing to tell the patient how they think the patient is doing to try and make it OK, which can overwhelm the patient into not saying anything. Patients know far more than we give them credit for and they have a need to be acknowledged and heard.

Never forget that the patient can hear you when you speak even when they are unconscious. I have witnessed more times than I can count, when the caregivers assume or at least forget that consciousness and awareness of their surroundings are not necessarily measured by the patient’s lack of response. I assume at all times that the patient can hear me, and even in extreme cases of brain damage, they are aware at some other level what is going on around them.

I am not going to get into other energetic processes observed in Buddhist texts, the majority of these are minute processes that only individuals practiced in identifying these techniques can actually see and feel, and don’t have much bearing on the average situation in the Western perspective. But they are certainly worth reading if you are interested, the references are in the back of my book. To a practitioner of energy work in the West, some of the processes are recognizable and can be observed.

But some of these energetic processes do seem to be associated with physiological and psychological changes that can be used as benchmarks for impending transition. What I found remarkable, that like the birth process, almost all of these stages with the exception of the last one, the actual exit of the person’s energy from their body, can be stopped and even reversed, and frequently are stopped unconsciously by the patient. As I have said, our intention drives us, and most often fear of dying, waiting for someone to come say goodbye, or even permission to leave are usually the reasons why these processes are temporarily reversed.

The most common sign that death is pending is when the temperature of the extremities drops to the point of feeling ice-cold to the touch. This is one of the preliminary signs and very easily can be turned back. But this always marks the beginning of the process. This correlates with the exiting of the “winds” in Buddhist literature, in a way, another word for physiological energy. It makes sense that as the body’s energy diminishes, so does the body temperature.

Just prior to transition, the heart and respiratory rate in all cases I have observed becomes irregular and spasmodic. At the very end, the respiratory rate drops down to two to four breaths per minute and the heart rate down to the 20s and 30s. This is a stronger, more immediate sign than losing body temperature, although I have seen patients pull back from this stage as well. Loss of body temperature can occur weeks ahead of transition, or just prior to it. The slowing of the heart rate and respiration usually means that transition is closer, just usually days away, perhaps a week at most, and again, sometimes just prior to passing.

A different process that many people find uncomfortable is the patient sometimes seeing or talking to people who have already passed over.   Persuasive argument could be made for both sides of the issue, that brain function is deteriorating, the patient is losing contact with reality and is hallucinating, or that this is the beginning of the next reality. My feeling is to let them be, unless it seems to be agitating them too much. The patient can very easily control this phenomenon, by telling them to go away, we have more control over our surroundings that we realize. Sometimes that is all that is necessary, just telling the patient to tell them to go away. A good rule of thumb to remember is that if they are peaceful visitations, most likely they are real, or they are real to the patient and are serving a psychological need that the living cannot serve at this time. If they are disturbing, then perhaps thought should be given to administering an anti-anxiety medication.

This touches on another issue, the use of psychotropic medications with the dying. They can be invaluable tools to assist in the comfort of the transitioning patient. But the fact that the relatives are uncomfortable that Dad wants to talk about dying is not sufficient reason to medicate!   Anti-depressants can be useful particularly when the patient is depressed and having trouble sleeping and eating and can make them much more comfortable. “Sundowner syndrome,” anxiety attacks that occur at the end of the day can be greatly relieved by the use of anti-anxiety medications. None of this should be taken as a mandate, every patient is different and I am not a licensed professional, it needs to be assessed on a case-by-case basis. But sometimes the discerning and appropriate use of these medications can do wonders and the family is not always in the best emotional shape to remember about these very useful tools.

The last process is the hardest to pin down as to when it exactly occurs. It can vary, and family members are frequently very puzzled and hurt by it. It is an amorphous stage, although an energy healer can generally identify it very quickly, because the patient’s energy field begins to “loosen” around the patient’s body. It starts looking like an old pair of socks that one has worn too long, usually grey-white in color and varying in shape, but overall getting much larger and grainy in appearance. This is when the patient begins to detach emotionally from this plane and all who live in it. Sometimes it is misidentified as the patient being overmedicated and repeated attempts are made to “bring the patient back to reality.” Family members would frequently come to me in tears, hurt and offended, not understanding that this is part of the process. To go “there,” the patient must let go of “here.” It is not that they love you any less or don’t want to talk to you, but they have more pressing matters to focus on right now. I have seen women in labor get this inward stare as well. At this point it’s no longer about you.

It may not be about you, but always remember to include yourself in the equation when talking about how to deal with this issue and your transitioning loved one. Caring for the emotional needs of the transitioning patient can be emotionally harrowing, and adding caring for the patient at home only adds more on the burden. You cannot do this by yourself. Sometimes we need someone to tell us in this in bold print! Over time you will be the one who suffers the most, and sometimes the unresolved issues between the patient and us can literally drive us crazy, they still know how to press our buttons! One needs to have help and to take breaks, to keep one’s energy up over the long term.   There are many agencies out there and hospice care that can assist the family in this process.

Remember to grieve, you are not being selfish. You miss them, it’s a normal process. It also takes a lot of time, far more time to accept than our culture gives us time to for. I remember watching “Sleepless in Seattle,” where the character played by Tom Hanks was admonished by the telephone “therapist” after his wife had only been dead for a year, implying that he was “stuck” in his grief. It takes an average of two years to assimilate and accept a partner’s passing, and that is when the person left behind is processing their grief at an average rate! For many people it takes much longer! But again, our culture is uncomfortable with anything less than instant gratification and no pain. Life has pain. People who have gone through successfully have frequently told me that it’s not a thing you “understand,” it’s just recognized and assimilated into your lifeworld. It is what it is. Would the highs in your life be valued as much without the possibility of losing them? I doubt it.

One needs death to be able to harvest the fruit.

Without death, life would be meaningless,

Since the long-lasting arises again and denies its own meaning

To be, and to enjoy your own meaning,

You need death,

And limitation enables you to enjoy your own meaning.

Carl Jung, The Red Book

Copyright, excerpt from “The Anatomy of Death: Notes from a Healer’s Casebook”

Feel free to use it, but please give me author’s credit.

Good night, sweet Prince

We lost several stars this week, the firmament has been shaken for a moment.  The trickster rockstar, David Bowie, had an idea of his import; go watch Blackstar if you haven’t already.  His last video is a declaration of impending death, cognizant of the impact he has had over the decades, yet also clearly embedded in the briefness and anonymity of this life.  His was a persona that provided a newly christened bending of gender roles for a million kids who had no other place to understand their newly-felt identities.  I carried no such burden, to me, his music was amusing and well-executed, but I listened to it for no other reason than to shock my father.  I was too young to understand Bowie’s intelligence, message, or ground-breaking iconography.

Another passing occurred a mere three days ago, it seems forever now, I’ve given it so much thought.  Alan Rickman, Shakespearean actor, purveyor of the arch-villain with the dark-colored voice, passed quickly from pancreatic cancer on January 14th.

He is perhaps best-known for his portrayal over eight films of Severus Snape, the nemesis of Harry Potter, or so we thought, until the very last film.  Snape was the ultimate cypher of loyalty and unrequited love.  Few of us can imagine holding such an ideal in our minds and hearts for as long as Snape toiled for his long-lost love, Lily Potter, and then for her son, whom he detested.

9349261Make no mistake, despite his sacrifice, Snape was a bully, he had no qualms about emotionally torturing Harry for years on end.  He danced with the soul-defiled devil, Voldemort, and you were never completely sure where his allegiance lay.  He reviled his human heritage, identifying only with his mother’s magical blood, hence the name he called himself secretly, the Half-Blood Prince.  He remains one of the most complicated characters of recent literature, only revealing his true colors upon his imminent death.  On first glance, emotionally, he little resembles the man who depicted him.

Of course, a legion of young fans of the series burst out with an outpouring of grief on hearing of Rickman’s passing, as the last of the franchise, Harry Potter and the Deathly Hallows Part 2, was only released in 2011.  What also followed was a series of heartbroken eulogies from his fellow actors and colleagues, many writing essays of considerable length.  His goodness of heart, his friendship, his mentorship of young actors were all expounded upon.  You could easily read the pain and sorrow they held for the passing of their friend.  Oliver Wood, Daniel Radcliffe, Emma Watson, Emma Thompson, JK Rowling, many others, all spoke of his giving heart and his bottomless, lifelong loyalty to others.  Wood in particular, described the countless times Rickman promoted him, helpfully critiqued his work, selflessly cared for him.

I wonder if there weren’t more similarities between Snape and his wizard in this world, Alan Rickman, than is clear at first glance.  Both were defenders of those weaker than himself, the children, one with a scowl and in secret, the other with a smile and a giving heart.

Now cracks a noble heart.  Good night, sweet prince;

And flights of angels sing thee to thy rest.

Hamlet, William Shakespeare

Seeing Beyond the Veil

My uncle, a week before he passed at 100 years of age, saw his father coming to to take him home.  His caregiver, Ed, told me in heavily accented English of the dream that woke my uncle, and Ed also with his yelling, in the middle of the night.  He was pointing at the ceiling, and babbling about his father, whom clearly he could see, but no one else.

From my own experience, I was not surprised at this; when someone is really getting ready to pass over, that is one of the hallmarks, they see their loved ones in spirit coming for them.  I can feel them, and see them as well.  When the room is full, then I know it’s time.

Neither of these phenomena, the appearance of their loved ones in Spirit, nor my ability to sense them, are unique.  The first of these has been documented, and quite a bit.  You can find it in the medical/nursing literature–several papers I referred to in my dissertation (Betty, LS, 2006; Brayne S et al, 2006) cataloged rough percentages–30-70%–of people dying in hospice who experienced this.  More significantly, CNN made note of it as well in the documentary, Do the dead greet the dying?  It doesn’t appear to be talked about much.

Many insist that it is the paroxysms of the dying or drugged mind that creates such visions.  Perhaps–but many occur weeks before death when the person is in relative comfort and quite lucid.  But if they are real–and I confess to believing as much, then what a comfort that could be upon our last journey?

P1050658How I know is part of what I do, and that is not uncommon either.  All mediums have some means of perceiving the dead.  It took a while to open the channel, and then get familiar with such contact–but it’s much like being a doctor or engineer, it’s part of my job–a part of my professional toolkit.  I am not an isolated case, there are many others that do this.  One I can think is Rosemary Altea, who wrote The Eagle and the Rose.  There are other beliefs and sites that talk about it, NWSpiritism is just one of them.

Elizabeth Kubler-Ross, upon her deathbed, asked a student about what they thought about the dead visiting the dying.  His student replied that it was only the dying brain producing comforting hallucinations.  She looked at him and sighed, “It will come with maturity.”

Perhaps at some point we also, with maturity, will see beyond the veil.

The Anatomy of Death: Notes from a Healer’s Casebook

The Anatomy of Death: Notes from a Healer’s Casebook

So then, finally, my book has been published on Amazon!  It has easily taken a decade to do this, and the moment is here.Blog_cover  I am thrilled that this has finally come to fulfillment.  The origins of this book began over 30 years ago, at the death of my father.  He chose to die at home, and his ending was horrible.  Here, in the most technologically advanced society that has ever been, that someone had to die like this was beyond me.  I made a promise to him then, that I would find out everything I could about this process, for the betterment of all of us.

So began this search; it led me to graduate school, to work with the dying, to research, and to collate my notes into my dissertation, and then this book.  We are so afraid of this process–we no longer have the ministrations and trappings of religion to guide us.  In some ways this was a good thing, because we are now required to look for those guidelines within ourselves.  But sometimes it’s a bad thing–or at least it causes more anxiety–to not have looked for guidelines as to what happens after death. Because when we then arrive at its door, without preparation, the fear overwhelms us.  There is no need for that.

Can I say with certainty what happens after death?  No.  But do other cultures and belief systems have much to say on the matter?  Yes, they do.  Have I had personal experience in altered states of consciousness with the dying that may help us?  I think so, I hope so, I pray so.  Many still die in abject pain and fear, and their caregivers have no way to help them.  Here, I hope to present one way.  To think about what you believe, and put it into practice.

What we choose to believe is indeed our choice.  We can choose to believe that’s there’s nothing after this, and our energy dissipates to nothing, or we can choose to believe that we go on from here.  Not a single person living can say one belief is better than another.  But I can tell you this, when one does believe that we go on from here, it becomes much easier to accept passing, and to come to terms with the end of life.  Science does not, and cannot answer these questions.  Perhaps it will someday, but not now.  So in the meantime, why not choose what way seems best to you, and allows you to live this moment to its best, and to face what all of us must ultimately accept in humility.

“Dust though art, and to dust, thou shalt return.”

I will add one thing to that; to shed the dusty shell allows one to mount wings and fly.

The Man with No Face

The Anatomy of Death: Notes from a Healer’s Casebook

So I like to read all sorts of paranormal type discussion groups and forums.  Sometimes it’s difficult to weed out whether it’s a flight of fancy or if it really happened.  You can get into some interesting discussions, without someone interjecting that it was merely a hypnogogic experience or some trick of the mind.  Often there is an explanation that is more mundane, but sometimes that does nothing more than truncate the discussion about what it possibly may have been, outside of accepted mainstream convention.  That’s when it gets fun.

Several of these discussion sites are on Reddit, such as Glitch_In_The_Matrix or The Truth is Here, always interesting, because the mods purportedly only allow true stories to be posted in them.  Of course, there’s no way of confirming this, sometimes you just have to take the poster’s word for it, always risky on the Internet.

So recently there was a post from a young woman who had seen a man with no face walking down the road, in the middle of the lane.  This was unnerving, to say the least, everything looked normal, arms, torso, even a head, just no face or lower legs.  Almost at the same time, she saw an ambulance roar by on the way to a call and stop where she saw the man.  She ran screaming to her friends, by the time they got to back to the window, the man was gone.  What what tipped me off was the ambulance–death was nearby.IMG_0621

I found it interesting that he had manifested with no face. Our intention drives us, even in death.  Many spirits I have found wandering around, still left on this plane, were fairly shocked to realize that they had died, and didn’t have to stay here.  I suspect that something like this happened to our faceless man, it was moments after death, and he was momentarily lost. That’s my interpretation, anyway.

I have attached another story, this one about lost spirits on this plane, and how that might happen.  As you can imagine, hospitals, particularly old hospitals, are absolutely full of these things. I don’t hold much with the ghost hunting TV shows, as too much can be faked, but there does seem to be something that can remain, if jolted out too quickly.

The juncture between the observed, the unknown and the rational, evidence-driven perspective seems wide sometimes. The attached story belies that–sometimes they can intersect, even to the scientific mind, as long as you’re willing to observe.

Death–The Next Great Adventure

The Anatomy of Death: Notes from a Healer’s Casebook

So I have written a book about my experiences with the dying as a psychic-shamanic practitioner. I call it shamanic practitioner, as although I am part Native American, I cannot say that I learned of my calling and how to do it from a Native American Shaman, so I am not a shaman. I would call my mentor one, but she would not. She calls herself a student, as I do of myself.

What is this book about?  Who is Sarah? As Dumbledore might say, “To the well-ordered mind, death is but the next great adventure.” In conducting NIH-funded research in Reiki for chronic pain and in my own private practice as an energy healer, I found that some people who came for Reiki immediately got better, some did slowly over time, and some did not.  Others met with that final door we call death progressing through a distinct set of steps common to all of them, but in a relaxed and joyous way.  How and why was this?  In the course of their dying process, what had we done that was different?5031814-lg

The Buddhists have studied these processes over time and possess a finely tuned understanding of the function and meaning of death within their culture. For them, death is merely a punctuation mark, a single brushstroke in a much larger picture that goes on forever.   It’s all well and good that the Eastern perspective has come to such resolution about this process, but in a culture that worships youth and believes science has the answer to everything, how can death be looked at as anything other than a defeat?

I am primarily a storyteller; after a lifetime in the hard sciences, I now believe it is our stories that hold the ultimate power to transform. Though I have been given permission both by the patients and their families to tell these stories, their names and even some of the extraneous facts have been changed to protect their privacy. So attached to this post is Sarah’s story, which is about her journey through that final door.

The book will be published shortly on Amazon, The Anatomy of Death: Notes from a Healer’s Casebook. Feel free to print it, hand it around in its entirety.  Take it as allegory, if you like, or as an interesting, What If?

Photo: beckycockrumphoto.com

Laugh at Last, Robin

While clinical depression was a topic that I never intended to talk about here, it’s already come up once, and with the passing of Robin Williams yesterday by his own hand, I feel compelled to speak again. Those of us that have been there are members of a secret cadre that speak of it almost never in public, it can impact your relationships, your employment, your health insurance, everything, with devastating effect. A few of us have recovered, and it can still be a day-to-day thing, you’re always watchful for changes in eating or sleeping habits, and if you had a good therapist, their phone number is still in your contact list.

Robin Williams was one of my favorites, as he was for so many. He could render you speechless with laughter, yet to me, he ultimately appeared as terribly fragile. The incandescent ones–their midnights can be deep indeed. And where there is despair, there is no god and no tomorrow. Those who have not been beaten down by its mighty fist cannot imagine what this is like.

There are still many mysteries involved with this illness, why it happens, how to treat it, if it can be treated effectively over the long term at all. Since I know little of the circumstances, I can’t say anything as to the cause of his illness, although I do know from personal experience that alcohol exacerbates its effects.

Robin-WilliamsCertainly it’s a matter of a neurotransmitter imbalance, but recent research is suggesting that it may be a bit more complicated than that. If it were that simple, then just prescribing the correct antidepressant (that’s a battle in itself) would correct the issue.  But the most recent research is indicating that the causes are multifactorial, with everything from family dynamics to baseline interactional skills playing into the mix.

“A nut is a suicide whose rope broke.” Most of us who have been caught in this trap have either strongly considered ending it, or have tried to kill ourselves.  Some of us, the lucky ones, got stopped by someone near to us, a professional or a friend or family member, or even by fate. The really unlucky ones tried and half-way succeeded, those are the truly horrifying cases.  They are trapped in a twilight that lasts for decades until their deaths from medical complications.  The brain-injured, the anoxic-damaged and the crippled. Robin Williams finally turned away at last, looking to escape the unrelenting hammer, and there was no one present to stop him. A friend of mine who works in mental health told me this once long ago, “We have few tools, most of the time it’s just a waiting game of keeping them safe from themselves, and hoping they find some ray of light to grab onto, despite all of our drugs and locked-door institutions.”

When I worked as an EMT long ago, attending a suicide was always a dismal affair.  Even if it wasn’t a mess from a gunshot wound, say like a drug overdose or a carbon monoxide poisoning, a heavy pall of despair always accompanied the scene.  Someone had turned away and walked through that door, seeing no hope.  Many of us are just feet away from that door.

Despite my aspirations of spiritual evolution and cultural maturation for all of us, I’m not so foolish to think we’re all going to get there by a straight-line, ascending horizon of understanding, as Gadamer might say. It’s still a perilous trip, all sweetness and light all the time is a myth, and only true in advertising.

I hope that the “stink” of mental illness can be lessened by better awareness, but it’s going to be a long, slow climb.  Getting thrown under the bus here, particularly when you look basically unscathed, is a hard hole to climb out of.  Some never make it.

I like to think that Christopher Reeves was waiting for him when he crossed the threshold, and that God is now enjoying an impromptu improv show.

Godspeed, Robin, Laugh at Last.