There’s a chance you’ve already been rocked by this video of brand new father Chris Picco singing the Beatles’ famous “Blackbird” to his son Lennon James Picco from the side of his incubator. For a few days, it was just father and son after mother, Ashley Picco, passed away in her sleep following an emergency C-section. Continue reading
Let me begin by reassuring you that this isn’t going to be a grim post. But it begins in an area people are uncomfortable with. We all must die, yet this is one inevitability that almost nobody feels comfortable talking about. That includes doctors and nurses, as was discovered in a newly published study from King’s College in London. It surveyed the staff that surrounded dying patients in hospices and found that they witness every common end-of-life experience (ELE). These fall into two types, and one of them will seem very strange.
The first type of ELE seeks final meaning. Near the time of death, people often want to be reconciled with family members who have become estranged, and this desire can be so strong that the moment of death is postponed until the estranged person visits. There is often a desire to put one’s affairs in order and to right past wrongs. It is observed that patients who have been semi-conscious will have a moment of sudden lucidity in which they express their dying wishes before lapsing back.
This whole category of ELE is psychologically intimate, and a significant number of doctors and nurses feel uncomfortable being present for it. Two inhibitions stand in the way. Doctors spend most of their energy trying to extend life, so learning about dying isn’t part of their training. Secondly, it is still considered a sign of weakness for a doctor to feel emotional about death, which leads to distancing himself from the actual experience.
The second type of ELE is labeled transpersonal, although the common word for it would be spooky. Dying patients, far more often than is acknowledged, have highly mystical experiences. They get visions of departed ones who have come to take them away. They sense the transmission of light and love from other realities and can visit those realities. The study found that such ELEs could not be accounted for by the medical state or treatment of the person — the ELE occurred in clear consciousness.
Yet probably the most uncomfortable ELE in this category was observed by the staff, including seeing something leave the body at the time of death, finding that a peculiar synchronicity occurred, such as the clock stopping at the moment of death. It’s more common than you would suppose for relatives who were not present when the dying person passed away to have them appear at the moment of death. Needless to say, modern society is skeptical enough that ridicule and quick dismissal of these transpersonal experiences will arise, even though they have been reported continually in every culture since history has been recorded.
The study makes the point that ELEs, which of course do not occur with every dying person, bring comfort and consolation; they seem to be a natural mechanism that surrounds the climactic event of death. Which brings us to the paradox of how we die. In the 1930s, eighty percent of people still died at home; now more than eighty percent die in the impersonal setting of a hospital. Massive expense is involved in trying to cure the last disease each of us will have, the one we eventually die from.
As medical technology shrouds the dying process, as people become more and more discomfited being around it, nature doesn’t seem to care. Mind and spirit experience death the old-fashioned way. Happily, the paradox resolves itself in favor of death being much less scary than we imagine. There is every indication that we are meant to die at peace, and so we do.
Originally published May 2011
By Margaret Westley
My optimism carried me through the extent of my six week hospitalization. Life in a hospital is far from easy, but amazing medical care, family, and friends supported me through multiple surgeries and challenging rehabilitation therapy. However, optimism would only take me so far. And like with any traumatic event in life, a person needs to take time to heal.
More surgeries followed the summer after my accident. One morning I noticed a wound had appeared on my residual limb and it turned out to be an infection that traveled to my bone. More bone would have to be amputated. Though I knew the surgery was necessary, I was tired – tired of surgeries and setbacks preventing me from scheduling an appointment with the person who would fit me for my first prosthetic limb.
A shift occurred. Instead of letting myself feel disappointed, I looked for ways to control the situation and prevent myself from feeling sad. I started with eating as little as possible. Being hospitalized only increased my odds for losing more weight. Eating was the last thing from my mind. The fact my wrists were getting thinner and my stomach more flat were pluses in my eyes. I started to tell everyone I was too tired to eat.
At the grocery store, I started checking labels and counting calories too closely. Low fat, fat free, low carb, carb free were my favorite categories. Though I was a size four/six, the Slim Fast Plan became my new best friend.
Externally, I was upbeat and smiled, but inside I wondered why I had started to be afraid to cross busy streets, and why I trembled during class and why when I looked at a line in one of the textbooks all of the words looked the same. Most people had made positive comments about my weight loss, but I’d already decided I was not yet thin enough. So I joined a gym and survived on coffee, bananas, and diet cereal.
The gym became my refuge where I worked out two or three times a day, and when I felt lightheaded I sat on the toilet in the bathroom until I stopped feeling like I was going to black out. I rarely went to class, but when I did, the bathrooms at school called to me. The quiet in between the stalls was one of the few places I felt safe.
I didn’t yet know eating disorders were a symptom of Post Traumatic Stress Disorder (PTSD). I didn’t even know what PTSD was.
The crash came. My bed was a close second to the gym as my favorite place to be. Everyone thought I’d gotten too thin. I couldn’t balance a full time school schedule, appointments with doctors, lawyers, prosthetists on top of learning how to walk all over again. People began to tell me I was too thin, encircling my emaciated wrists with their fingers to prove I was not eating enough. There were too many questions, and I didn’t have all of the answers.
Withdrawing from school, in my eyes, was the only option. Since I no longer was a student and did not live in the dorms, I sought the guidance of my mentor who had a friend who owned a bar with a boarding house on top of it. The next chapter of my life started in a room the size of a closet. The quiet comforted and frightened me at the same time. I knew it was time to listen to what it was my body needed.
At times, it felt like my world was crumbling, but I knew I would not have made it that far had I not had hope. I found a therapist who specialized in PTSD and eating disorders. She told me I could be sad, mad even, and that I wasn’t crazy. I just needed to take the time to heal.
Yoga became a life saver. I stumbled across the first class I ever took in the East Village. Interestingly enough, I was not nervous. It was as if my body knew being on a yoga mat was where it belonged. At the end of class after the deep relaxation the teacher said, “namaste” and I burst into tears. I knew then yoga and other mindfulness based modalities would be a part of my life forever.
People often want to know about my healing process. Process is a word I prefer instead of overcoming because I don’t want to overcome anything. I want to learn how to be. My amputated leg isn’t going to grow back anytime soon and to be honest, I wouldn’t want it to. I focus not on what I lack, but what still remains.
Life continues to be challenging. My residual limb swells when it’s hot outside and shrinks on a cooler day making it difficult to walk a lot of the time. Phantom limb sensation and spasms are constants. I get tired more easily than before and bed time rarely is past 9:30 pm.
A little over a decade has passed since the accident happened. Sometimes it feels like it was twenty years ago, and there are days where I am shocked it wasn’t just yesterday. I have some regrets, but being hit isn’t one of them. No matter what day it is, I take the time to connect. In the morning, I lie on my back and breathe. Sometimes I cry. A lot of the time I smile. Laughter happens often. There is no shame. Just one incredible journey.
* * *
Margaret Westley is a writer, fundraiser, certified integrative nutritionist, and yoga teacher. Each of these professions were inspired by a near death accident she had when she was eighteen years old and got run over by a bus, which resulted in a broken right ankle and losing her left leg below the knee. Though the recovery was tough, Margaret has always seen the accident has a huge gift! Over the years, she’s been a face-to-face fundraiser, worked in a café, been an office assistant, a healthcare attendant, meditation/yoga teacher, and is currently building a fundraising business and writing a memoir. Everyday, something or someone reminds her about how amazing life is and, for that, she is eternally grateful.
There is one certainty in life – we are all going to die. How and where we die are the only issues.
Will we die quickly or have a lingering death? We don’t know. However, most of us housed people are pretty sure we will die indoors in some health facility or in our own home. In fact, some of us buy insurance so that we are assured of the particular standard of care and facility we prefer in our last days.
However, what about unsheltered homeless people? They live outside and very likely will die outside.
How do I know this? Because over the past several years I have been involved in the end of life care for three homeless friends. I’ve written about Bobby Ojala who passed in late August 2012 and Susan Hunt who died twelve days later in early September. But, Karen Lee Creeden was the first homeless person I helped die indoors.
I first met Karen Lee on July 11, 2010, in Ocean Beach, San Diego, CA. An elderly woman with medium length graying hair pulled back into a rubber band, Karen Lee was sitting on the grass in Saratoga Park. Even from a distance, I could see her distended abdomen.
As I approached her, I wondered how to begin the conversation and decided just to introduce myself, ask her name and inquire how she was doing.
“I’m Karen Lee Creeden,” she said, “and I need size 8 shoes. I just got out of the hospital and I have no shoes.”
“Is that all you need?”
“It would be nice to get some medium-sized warm clothing – it’s cold at night. All I have are the t-shirt and light pants I’m wearing.”
I offered to look for these items, but made no guarantees I could find the needed items in the correct sizes.
Upon leaving Ocean Beach, I called family members and friends who I thought would be sympathetic and would have access to the correct sizes of clothing and shoes. Sure enough, they kindly donated the requested items.
When I delivered these gifts to Karen Lee, she was thrilled. She posed for pictures and had fun modeling her new clothes and tennis shoes. Over and over Karen Lee told me to thank her donors for the much-needed items.
But what to do about her apparent medical condition? I contacted a psychotherapist friend who suggested I ask Karen Lee if she had a social worker and, if so, whether she would give me permission to speak to the worker on her behalf.
Karen Lee did have a social worker and readily gave me her phone number and permission to discuss her case.
The social worker told me what I suspected; Karen Lee was seriously ill and dying. She said she had paid cabs several times to take Karen Lee to hospital after hospital for end of life care, but the hospitals continued to release her.
I offered to go with a friend and take Karen Lee to a hospital and do what I could to get her end of life care.
The results of my efforts are outlined in the following thank you letter I sent to all of the parties who were involved in Karen Lee’s care until her death 24 days later. My letter is a tribute to all of the people and institutions involved in assuring that Karen Lee, an unsheltered homeless person, died free of pain and indoors. It is also evidence of the steps Karen Lee had to go through to die with dignity indoors.
My thanks again to all of those people who provided end of life care to Karen Lee and to all givers of end of life care everywhere.
“August 15, 2010
Dear Concerned Care Givers and Service Providers,
On July 14th, after consulting with her social worker, my friend and I took Karen Lee Creeden to the local hospital where she received excellent emergency care from the doctor and his wonderful staff. Thank you.
After being admitted to the hospital, Karen Lee was expertly cared for by her attending physician, a hospital social worker, nurses, chaplain and staff. Thank you.
I called the president of Alpha Project and he reassured me that ‘no one dies outside’ because of the Alpha Project Hospice Program. His chief operating officer made herself immediately available. Although we did not make use of these kind offers of help, I thank you for your much-appreciated assurances at that time.
After her stay in the hospital, Karen Lee spent several days in the San Diego Rescue Mission Recuperative Care Unit under the concerned supervision of the residential manager. Thank you.
During her brief stay in the Mission, Karen Lee met with a program representative of San Diego Hospice and Institute for Palliative Care who gently assisted Karen Lee in enrolling in this program. Thank you.
At San Diego Hospice and Institute for Palliative Care, doctors, social worker, patient advocates, nurses, chaplain, staff and volunteers compassionately helped Karen Lee. Thank you.
I was going to write individual notes of thanks to each of you, but upon reflection, I thought perhaps one note to all of you might be more appropriate because each of you was an indispensable part of the process of helping Karen Lee transition from this life to the next. And I thank you all for being so supportive of me during this time.
Karen Lee was 55 years old when she died. As you may know, for the last ten years of her challenging life, Karen Lee was homeless. However because of your care, Karen Lee lived the last 24 days of her life free of pain and indoors.
While at San Diego Hospice and Institute for Palliative Care, Karen Lee wrote the following words on the patient white board in her room: “Do you love me as much as I love you?”
Witnessing your many kindnesses and genuine compassion, I can answer her question, Yes, you each loved her as much as she loved you.
May God bless you for your compassionate service for people in need.
Very truly yours,
Christine Schanes, JD, PhD”
Sam Parnia is head of the intensive care unit at Stony Brook University Hospital in New York. He is also a doctor known for specializing in resuscitation – or, more colloquially, bringing people back from the dead. Under his care, a patient who has suffered from cardiac arrest and receives treatment has a 33% chance of being brought back to life (compared with a roughly 15% national average.) His secret? Time, mainly.
Not only should hospital personnel continue resuscitation measures beyond the current 20-minute norm, but they should also, Parnia says, cool the body in order to preserve brain cells and recycle blood drawn from the deceased back through a membrane oxygenator. Such measures, Parnia urges, would give supposedly deceased patients the chance to respond to oxygen and medication, beyond the limit when they would be definitively declared dead.
If the thought of resurrection from death isn’t enough, Parnia takes his theories a step further to question the nature of consciousness. The pervasive scientific notion that the brain produces the mind starts to unravel when you consider the minutes, even hours, of death from which people have returned to life. From Parnia’s own experience, even after a patient’s mental activity has completely shut off, some “psyche” or “soul” remains and can reanimate after resuscitation. It it this phenomenon that leads Parnia to suggest that the mind and memory are non-neuronal in foundation.
While you consider that, take a look at these three amazing stories of people brought back from the dead:
This British soccer player went into cardiac arrest during an FA Cup match. His heart stopped beating for 78 minutes, ten of which responders spent trying to revive him onfield. Despite being officially dead for over an hour, Muamba returned to life and was later discharged with an electronic implant in case of future heart trouble. Medical personnel were unable to establish what caused the 22-year-old’s heart to fail, but let’s hope it doesn’t happen again (at least for many decades to come)!
The 12-year-old was enjoying a day at the beach with his church youth group when waves got out of control and swept him under. It was roughly 25 minutes before the rescue team pulled Dale from the choppy water, but onsite resuscitation efforts were unsuccessful. The boy’s pulse miraculously returned once emergency responders got him to the hospital, and after a several-day coma he finally began showing signs of life.
Kate Ogg gave birth to her premature twins at just 27 weeks – still 13 weeks shy of a full term pregnancy. The baby girl survived the delivery, but her brother, little Jamie, was pronounced dead after 20 minutes of CPR. In her grief, Kate unwrapped her fragile newborn and held him to her chest for two hours, at which point he began breathing and came back to life. According to Kate, “The doctor kept shaking his head saying, ‘I don’t believe it, I don’t believe it.'”
Know of any amazing stories of recovery? Share your thoughts in the comments section!
Would you take your kids to the local emergency room to teach them a lesson in compassion? Arguments could be made on both sides. On the one hand, kids can develop empathy, sensitivity, and selflessness through exposure to real life problems and even tragedies. But it can also be traumatizing to witness the harsh realities of life – for kids and adults. Is there something to be said for prolonging innocence as long as possible?
In this week’s episode of “Perfectly Imperfect Parents” on The Chopra Well, our hosts discuss ways in which parents teach their kids the importance giving back to the community. The ER example comes right from host Dr. Cara Natterson, who uses that tactic in her own parenting. Certain neighborhoods of Los Angeles can feel like a bubble, she and host Mallika Chopra say. You might live in a nice house, own a car, and send your kids to great schools, when just down the street people are living a very different lifestyle. But to most kids, their world is the only one they know. Exposing them to the blood and gore of an emergency room may seem overly traumatic, but in Cara’s words, “To see it is to know it.” With the ultimate goal of raising kind, compassionate humans, the shock of exposure to other realities of life may be worth it.
Empathy seems to develop naturally enough through witnessing other human beings’ suffering, but how do parents convey a sense of ecological responsibility to their children? Do pollution, environmental footprint, and sustainability make sense to us inherently, or these concepts ingrained in us over time, beginning in childhood? For host Dani Klein, water conservation is an issue she’s attempted to tackle with her kids. Her family lives in Southern California, where it is constantly “abnormally dry,” if not downright drought conditions. But as long as the faucets always deliver water and the sprinklers always turn on, it can be difficult for kids to grasp the reality of a water shortage. Dani approaches this by explaining the issue to her sons and implementing a policy of conservation (shorter showers, turning off the faucet when they’re not using it, and so on). These are small steps to start off with, but over time, the child who was sensitive to running water may become a teenager who asks for a fuel-efficient car, and later an adult who goes to work for an environmental advocacy group. See where we’re going with this?
What steps have you taken to teach social responsibility to your kids? Do the small steps count? Let us know in the comments section below!
Subscribe to The Chopra Well and don’t miss next week’s episode of “Perfectly Imperfect Parents”!
By Laurel Lewis
These tips come from my experience of being with hundreds of people as they have died and with the thousands of family members who have witnessed this event. Consider using these tips for dying well… and for living well!
10. Talk about what you do and don’t want.
Tell your family, friends and doctors how you want to be treated and what kind of treatments you want or don’t want! Consider a living will or other advance directives so that your wishes will be known prior to end of life choices. Consider your needs: physical, emotional and spiritual because they all impact your final days.
9. Have a life review. Recall significant and meaningful events .
Share your stories either verbally or written with your loved ones, in a journal or on tape. As you do this forgive yourself and others for everything! Let go of judgments. Judging people and events take up precious energy that could be spent loving instead. Release the judgments and allow yourself to be fully present to what is in your life right now.
8. Express gratitude daily – for something, anything!
This will help move you from the context of small self who is dying to connect with the bigger part of Life that is surrounding us always. Expressing gratitude creates a positive shift in our mental state, which in turn has positive physical benefits.
7. Connect with something more than yourself.
Connect with your family, your friends, nature, art, pets, your God, Spirit, your ideals. Allow yourself to belong to something more than yourself so that when you die, you will be connected to those things in which you invested your time and energy.
Say what you mean and mean what you say. Express yourself courageously holding nothing back. Your vulnerability will be rewarded with intimacy. Allow yourself to feel your feelings – all of them. You are allowed to be just as you are. Give yourself permission to explore this concept and to explore really being YOU! This is the time to do it.
5. Be optimistic and realistic about what is happening.
Expect the best while being prepared for the worst. This can be challenging but from my experience, extremely rewarding. Put your affairs in order. Write your will, choose a mortuary, talk about your funeral, talk about what’s happening in order to bring understanding to your experience and alleviate confusion for your loved ones.
4. Accept what is as it is happening.
No one can really know what you are going through. This is your private journey. All we can do is support and love you. It is true that we are all going to die, but not all of us have the experience of the deathbed. As you find yourself contemplating death and accepting this inevitability look for the places inside that fight against this reality. There is a quote I like that captures this theme, “When we stop opposing reality, action becomes simple, fluid, kind, and fearless.” ~ Byron Katie
As you gracefully yield to your body’s end, you may indeed find peace, joy, and pleasures in the days you have left surrounded by love and loved ones.
3. Say please and thank you.
These words express kindness, respect, and appreciation and will elicit positive responses from everyone who is close to you. The energy behind these words is powerful and respectful. Even if someone has to wipe your butt in your final days you can still maintain a dignified experience simply by the energy of your presence.
2. Look people in the eye.
People generally don’t know how to behave around someone who is nearing the end of life. This is an opportunity to “get real”, to allow yourself to be seen, really seen. Gazing into someone’s eyes without words allows our hearts to connect at a very deep level and can be very satisfying and rewarding.
While you have Life moving through you, allow it to move through you. When you feel tight or anxious: breathe. When you feel sad or tired: breathe. When you feel angry or hurt: breathe. Consciously breathe and open yourself up to the present moment. Allow Life to reveal its preciousness to you for as long as you can and with all of the awareness you have. Live until you die.
If you are interested to know more please contact me through LaurelLLewis.com.
I am happy to share more from my years of hospice work and research and my personal transformation of dealing with the sudden loss of my husband at the age of 27.
Thank you and bless you.
Laurel Lewis, a registered nurse and hospice provider who features on The Chopra Well show, 30 DAYS OF INTENT, shares her tips for dying with dignity. The end of life can be an extremely difficult time, as Laurel has witnessed in her many years as a hospice nurse. Her tips address the healthiest ways to confront death and meet a happy, satisfying end.
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From the confines of a hospital bed, what options do you have to move around? Wires, tubes, sheets, and monitors all conspire to keep the body still and safe, but the inactivity can be agonizing. Many of us take our freedom of motion for granted, and the painful lack only hits home when we are seriously ill or injured and unable to move.
Artist Yuko Kodama found herself in this predicament when she learned she had a rare and aggressive form of cancer in her mouth. The latest episode of The Chopra Well show, Urban Yogis, features Yuko’s story and the role yoga played her recovery. A yogini for over sixteen years, Yuko lay in her hospital bed, desperate to move and stretch her body. In an amazing moment of inspiration, Yuko closed her eyes and began doing her Ashtanga yoga practice in her head. “This is great – I don’t even need a body to do yoga!”
In addition to her other treatments, this imagined yoga practice helped Yuko develop the strength and confidence needed to fight her illness. Back to her paintings, her family, and her regular Ashtanga practice now, Yuko is almost in full remission from the cancer. She credits her yoga practice for why she’s alive today!
Yoga is certainly a physical practice and can be a great way to work on strength and flexibility. But many seasoned yogis and instructors will tell you that breathing and mindfulness are at the heart of the practice. You can deepen your breath, quiet your thoughts, and imagine a vinyasa sequence in your mind’s eye, and the effect might be quite similar to if you were sweating it out on the mat.
So next time you’re sick in bed, cramped in a tiny airplane seat, or feeling antsy on the subway, try Yuko’s method. You may feel stuck and anxious to move, but with a healthy imagination, there is no limit to what you can do.
Read last week’s story about New York teenagers practicing yoga to overcome violence and tragedy.
Subscribe to The Chopra Well and stay tuned for our upcoming interview with Russell Brand on yoga and overcoming addiction.