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If we're not willing to explore our own suffering, then we will only be guessing as we try to understand our patients. It is the exploration of our own suffering that allows us to serve others. This is what allows us to touch another person's pain with compassion instead of fear and pity. And we have to be willing to listen, not only to the patient but to ourselves.
We must pay careful attention to what's immediately in front of us. A year or so ago a very tough, eighty-year-old Russian Jewish lady was in the process of dying. As I walked into her room I saw that she was gasping for air. The attendant sitting by her bed said to her, "You don't have to be frightened, I'm right here with you." The woman replied, "Believe me, if this was happening to you, you would be frightened." I just watched. Then the attendant said, "You look a little cold, would you like a blanket?" The woman replied, "Of course I'm cold! I'm almost dead." If I was going to be able to help her, I knew that I would really have to listen. I really had to pay attention to what she was telling us.
She was struggling with her breath, but she wanted to be dealt with honestly-she didn't want any bullshit. I said, "Adèle, would you like to suffer a little less? Would you like to struggle a little less?"
"Right there, right in between the in-breath and the out-breath there's a little place in which I've seen you resting. Can you Put your attention there for just a moment?"
Now remember, this was one rough, tough Russian Jew with absolutely no interest in Buddhism or meditation. But she did want to struggle less. So for a few moments she tried this and, as she did so, I saw the fear in her face begin to wash away. She took a few more breaths, and then died quite calmly.
If we are going to be of service we have to pay attention to what's immediately in front of us, act with minimal intervention, and bring to the experience the same attention and equanimity that we cultivate on our meditation cushion. The degree we are willing and able to live in this ever-fresh moment is the measure of our ability to be of real service. When the heart is open and the mind is still, when our attention is fully in this moment, then the world becomes undivided for us and we know what to do. Each of us here can do that, we .don't need twenty years of Buddhist practice. Each of us has the capacity to embrace another person's suffering as our own. We have been doing it for hundreds of years-we've just forgotten how, and so we have to remind each other.
When our hospice first opened, one of our volunteers, Tom, was helping a patient with AIDS to move from the bed to the commode. As they began to move the patient fell, causing chaos: his pants fell down around his ankles and the commode tipped over-it was like a small Hiroshima. This is what care-giving is really like. Anyway, Tom fumbled through it all and got the patient back into bed. Then he called me. "Frank, I want you to review with me the techniques we learned in the training about positioning people in bed." I said, "OK, let's just do this: the next time you go to move J.D., before you start just check your belly. See if your belly is soft. If your belly is not soft, don't do anything."
'Don't give me that Buddhist stuff. I want to know what do I do with his knees?" "Just check your belly and call me back later."
It was a bit like saying, 'Take two aspirins and call me in the morning', but he did call back a bit later.
"Frank, it was the most amazing thing. I went to move J.D. and my belly was hard as a rock, so I stopped. I took a few breaths, my belly softened and the next thing I knew, J.D. was in my arms like a lover or a small child. It was no trouble at all."
We all know how to do this.
Buddhist practice includes this notion that we have all been born many times before and that we have all been each other's mothers and fathers and children. Therefore, we should treat each person we encounter as if they are our beloved. As we inquire into the heart of service, we see a pattern: common to all habits that hinder us in our work is a sense of separateness; and common to all those moments and actions that truly seem to serve is the experience of unity. Einstein wrote about this, and Sogyal Rinpoche quotes it on page 98 of The Tibetan Book of Living and Dying:
"A human being is part of a whole, called by us the 'Universe' a part limited in time and space. He experiences himself, his thoughts and feelings, as something separated from the rest - a kind of optical delusion of his consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest us. Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty."
When the heart is undivided, everything we encounter becomes our practice. Service becomes a sacred exchange, like breathing in and breathing out. We receive a physical and spiritual sustenance in the world, and this is like breathing in. Then, because each of us has certain gifts to offer, part of -our happiness in this world is to give something back, and this is like breathing out. One friend calls this 'simple human kindness'. Our work, I think, is to get out of the way of our own innate wisdom and compassion-that simple human kindness-and allow our inborn ability to see what another needs, to serve the dying and the living.
Quotation by Rachel Remen from Noetic Sciences.
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