Judith Redwing Keyssar is so much more than her impressive credentials. She is someone who is comfortable with death and dying, and assists people through this significant transition. Director of the Palliative and End-of-Life Care at Jewish Family and Children’s Services of the San Francisco Bay Area, Keyssar’s book Last Acts of Kindness: Lessons for the Living from the Bedsides of the Dying (winner of the 2011 Book of the Year Award in the Hospice and Palliative Care category) is an absolute must-read in the school of life.
1. In your opinion, are people scared of dying or “how” they will die? Where does the fear of dying stem from?
Yes, most people are afraid of the unknown. And also afraid of the possible pain involved. Most people tell me that they are not so afraid of death, but of the suffering before death. For some, the fear comes from religious/spiritual beliefs. For others, simply fear of the unknown. In our culture, because we have a cloak of darkness and taboo around death and dying, the fact that people know so little about such an ordinary and commonplace experience creates the setting of fear. When we can look something in the eye openly, it is usually not as scary as our minds tell us.
2. In your book, you talk of the importance of “being present” with the dying than “doing something” because there is nothing to fix. What does “being present” look like?
Being present looks like allowing ourselves to be comfortable with what Angeles Arrien describes as “the sweet territory of silence.” We must be able to be still, be quiet, keep breathing and stay open to whatever arises in the situation. Being present looks like leaving our own agendas and baggage at the door so that when we walk into the room of a dying person, our hearts and spirits are open and willing to be guided to what might need to be said or done or listened to. Open to the lessons and the silence. Open to the pain and the tears.
3. Does the spirit of a dying person feel and hear what a loved one is saying? In other words, can forgiveness issues and unspoken words of love be received in the final moments?
In the world of medicine and hospice and palliative care, it is traditionally believed that hearing is the last sense to leave us. Therefore it is believed that it can be important to express love, kindness, understanding and forgiveness. Even if the person can’t hear you, what harm is there? Hospice nurses typically ask families to step out of the room to have discussions about other things, or if there are arguments or disagreements, so that the dying person is not agitated by the energy in the room. I believe, as I say in my book, that in the end love truly is all that matters. When my father, who had been a doctor with a very busy life, was dying, he said, “All that matters is how much I loved my family. Nothing else.” That was very different from how I had experienced his priorities in his working days. But it felt very important for him to say that to me.
4. Death and dying seem like very lonely experiences in the West. How can we all support each other through this significant transition, one we must all face?
Show up! Rather than shrink from an invitation to the bedside of a dear friend, show up. When your loved one is ill, be by their side. Make sure that the person is not alone, unless they ask to be alone. Make sure that their loved ones are cared for as well and that help is hired (if possible) to do the actual physical care of the dying person so that the loved ones can just be there to have the experience. Working on our own fears and feelings about death and dying is critical to changing how our culture deals with this inevitable journey. Face your own fears. Write them down. Talk about them. Write your own advance directive and talk to people about your own end-of-life wishes. Read my book! The more familiar we can be with dying, the less afraid and the less frequently people need to have a “lonely” experience. Celebrate death as a part of life, the same way we celebrate the transition of birth. All part of the same circle!
5. Tell us about the importance of rites and rituals in the grieving process.
I believe that cultural and religious traditions around death and grieving serve the purpose of allowing people the time and space to feel. To feel the depth of emotion that is stirred by loss. To feel the sadness and pain. Dr. Rachel Naomi Remen tells us in her book “Kitchen Table Wisdom” that “ritual is a way of consecrating the ordinary.” Death is ordinary, and it is important to also acknowledge the sacredness of death, the spirit moving on from the body. Many traditions have periods of days or months or even a year in which mourners are not “ordinary” people. They are given space to acknowledge their feelings so that thay can let go of the past. It does not mean letting go of love, but letting go of our attachment to what was. In America, we are not good at relating to the concept of “impermanence” but the more we practise and create rituals to help us, I believe, the better off we will be as a culture.
Part 2 of this interview to follow soon…