by Nina
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| Reflections Rocks and Water by John Singer Sargent |
11.3. The five afflictions (klesas) which disturb the equilibrium of consciousness are: ignorance or lack of wisdom, ego, pride of the ego or the sense of ‘I,’ attachment to pleasure, aversion to pain, fear of death and clinging to life. —Yoga Sutras, translation by Edwin Bryant
It’s in the zeitgeist this week: mortality, and the relationship between truthfulness (satya) and a good death. First of all, I’ve been hearing interviews with Atul Gawande about his book Being Mortal: Medicine and What Matters in the End, which is about how modern medicine can “not only improve life but also the process of its ending.” Gawande is on a mission to get doctors to talk more honestly with patients about end of life concerns, allowing them to make conscious choices about their care, rather than just fighting death with every procedure available, even at the expense of quality of life.
And then there was this article in The New York Times Seeking a “Beautiful Death” that took the patient's point of view, describing how important it is to have honest communication with your doctor about your goals for end of life care and also to insist that your doctor fully inform you about your prognosis and how life-prolonging treatments might actually affect your quality of life.
“The doctor or nurse practitioner should talk with the patient and family about the goals of care and the patient’s wishes and preferences, then put a plan of care in place to insure that those preferences will be honored.”
Of course, I wrote about this a while back in my post Meeting Death at the Front Door, when I concluded that truthfulness (satya) was the only way to achieve a “good” death:
"And it seems that truthfulness—being willing to hear the truth as well as to tell it—will help you face your death and die the way you want to, and to be able to help your loved ones as they die."
But this need for truthfulness has come up again for me because a friend of mine wrote me this week about how her quite elderly parents were experiencing very serious, life-threatening health problems, and were “suffering” and feeling “helpless,” and how she found it hard to accept “this way of aging,” as she had always imagined something more comfortable and peaceful.
I must say I was surprised that my friend was surprised that old age involved difficult physical and emotional challenges. But as sutra II.3 says, we all experience “fear of death and clinging to life.” And, of course, we not only fear our own deaths but those of the people we love. So this aversion must interfere with our ability to see difficult truths. And, unfortunately, denial of the truths of old age and death has been a cultural phenomenon in western society for some time now. (Don’t even get me started about how death is usually portrayed on television and in movies.) But if we’re not willing to face these truths, we can’t be of help to the very ones who need us.
So I just wanted to say I’m glad that truthfulness about the end of life is now becoming part of the our national zeitgeist, with mainstream books, documentaries, and newspaper articles on the topic. And we can all contribute to the discussion by sharing these resources to as well as talking honestly with our friends and relatives about these issues, as difficult as that may be at times.
My friend also said this situation was making her feel “very, very angry.” At first I didn’t understand this at all. Who or what was she angry at? Her parent’s health problems and impending deaths are no one’s fault, right? But then I remembered the five stages of loss and grief: denial, anger, bargaining, depression, and acceptance.
I wrote last week in Truthfulness (Satya) as a First Step that facing the truth of our aging bodies is the first step in our yogic journey toward acceptance, and eventually contentment. In the same way, facing the truth about our aging loved ones—their difficulties and their mortality—is the first step on a similar journey. And if my friend has moved from denial to anger, that means she’s starting to walk the path. It’s a hard journey, of course. But we don’t have to take it alone.
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