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In the Presence of Death

Shutterstock / Dariush M

A hospice caregiver ruminates on the many emotions that arise in the presence of death.

Sometimes I wonder how many people have died in this graceful old house. I can only speculate how many hundreds. I’m curious if so much death in one location affects the place somehow.

As I walk through the spacious, elegant rooms of the Zen Hospice Project’s Guest House in San Francisco, California, I sense a deep feeling of goodness, a palpable atmosphere of the decades-long cultivation of reverent, mindful and compassionate end-of-life care. People come to this handsomely appointed Victorian house to live their last days here, and to die here, held in beauty and comfort. This is their chosen jumping off point, their final earthly home, their portal to the absolute unknown.  As they inhabit these sunny rooms, everything drops away from them, until finally something ineffable departs and their lights wink out forever. This serene home graciously embraces all the love, fear, grief, joy and pain that accompany this profound transition. The deep attention, kindness and equanimity practiced here seem embedded in the very walls. It is a sacred place, full of life and love and acceptance, even in the presence of death.

Here at the Guest House we mindfully enter into intimacy with dying in all its mystery and mundanity. As a weekly volunteer caregiver, I observe the processes of dying at close-hand, again and again. Repeatedly looking death in the face normalizes it and brings the natural relationship between life and death into balance. My repeated witnessing does not dull the sacredness of this surrender. Indeed it does the opposite. Death may become more normalized, yet it is never truly knowable and every person’s unique ending is a deep honor to witness. Every day I am at the Guest House I step into the unknown; I work to be present with whatever is happening and to open my heart to all aspects of living and dying. My life is enriched and expanded by deliberately attending to every experience in the spectrum of dying that I witness.  In this intimacy with death, I learn to live more fully.  

When I sit bedside with a resident, I often remember the people in the past who lived and died in that particular bed. I call them to mind deliberately as a way to honor them, to process my feelings about them, and to touch the continuity of living and dying, which is so intensified and transparent here at the Guest House. In this way I also tap into the commonality of our shared human experience. I take comfort that this particular person’s death, as well as my own eventual death, is a part of a universal experience that connects every single person ever born. For me, being in the presence of death dissolves the perception of alienation and separateness that causes so much strife in the world, and in myself sometimes. It relieves me of the burden of specialness; this is a gift. The known and unknown differences between me and the dying people I’ve sat with are real, yet in the presence of death, these differences merge into a more holistic experience of merely being human beings together somewhere on the communal continuum of living and dying.

Sometimes I arrive for my weekly shift at the Guest House to find that a resident has died during the night. Whether I have spent many hours with this person or if they arrived here and died before I had a chance to meet them, I make a point to sit with their body. The dead bodies I have seen at the Guest House have all been incredibly different – some appearing to be sleeping, still so alive-looking, even many hours later. And some seem to look more and more utterly dead with every passing minute. Yet with each body, it is always starkly apparent that the person is completely GONE, only their vacant body is left, like a finely-detailed sculpture shaped by, and completely devoid of life. The enigma of personality, of spirit, of soul, or whatever we try to name the indefinable sublime that makes us ourselves, has unmistakably departed, never to return. This mystery mixes with the emotions of loss, awe, gratitude, love and sorrow as I stare into the inscrutable faces of death.

It is an uncanny experience on many levels to be with a dead body; my lifelong familiarity with the living human body clashes with the profound and unsettling emptiness and stillness of a corpse. So radically unusual is the experience, my mind keeps looking for the rise and fall of breath, my eyes playing tricks on me trying to animate the body. I always touch the bodies lightly, reverently on the hand or forehead, again noting the familiar and foreign qualities; they are cold yet so human, the skin is soft yet the muscles are rigid. Contacting this tangible connection between the familiarity of human life and the mystery of death is grounding to me. Although incomprehensible, I do not find dead bodies threatening; I do not feel fear. Instead I feel it is a unique and rare privilege to be in the presence of death, to face this ultimate reality of life right in front of me. It feels intimate and vulnerable and raw, even as the corpse itself appears neutral. To me, dying is personal but death is impersonal; each person’s process of dying is singular but death will impartially take us all. Again I find ease in this paradoxical insight.

Many, many emotions arise in the presence of death, some more uncomfortable than others, and always I say thank you. I feel gratitude for the lives I have witnessed, for my own life and for sharing in the profound experience of intimacy witnessing someone’s last days or hours of life. Living and dying are emphatically coexistent in the Guest House and I add my own life, love and gratitude. What happens in these elegant rooms unites all of us, even beyond the embrace of this lovely old house.

Learn more about how Zen Hospice Project is helping to change the experience of dying.

Read more from This is Terminal:

Born to be Wild at the End of Life

Dying Surrounded by Laughter and Song

A Hospice Social Worker on Grief and Empathy