Being with Dying
“I'm up late admitting patients to the inpatient hospice unit. Just when I think I'm too old for these
late nights without sleep, a person in all their rawness, vulnerability and pain lays before me and as
my hands explore the deep wounds in her chest and my ears open to her words, my heart cracks
open once again.... and this night a sweet 36 year old woman with her wildly catastrophic breast
cancer speaks of her acceptance and her hope for her children, and she speaks with such
authenticity and authority. And her acceptance comes to me as the deepest humility a person can
experience and then again, once again, I remember why I stay up these late nights and put myself
in the company of the dying.”
(Gary Pasternak, MD, Associate Faculty: Being with Dying)
Gary Pasternak read by Joan Halifax
“Being with Dying”
1:23 min
These are the words of a palliative care physician who was trained in Upaya’s professional training
program in compassionate end-of-life care. Dr. Pasternak joined our faculty, and is now the
director of a hospice in northern California. Dr. Pasternak’s words reflect the inner qualities that
make for a great physician. He exemplifies what we endeavor to cultivate in clinicians, this heart of
compassion and deep humility, courage, and respect. As Dr. Pasternak was an early trainee in our
BWD clinician training program, he taught us much about what will serve doctors and nurses who
are daily faced with patient, family, and institutional challenges. He, like so many others in our
program, also communicated what our core faculty knew, that this work with dying people touches
the deepest values that we have as human beings and can lead us back to ourselves in the right
circumstances.
I had long known this, because this world of caregiving had opened for me in the process of my
grandmother’s tragic illness and death. I also knew this from my anthropological work in Africa and
the Americas. As an anthropologist and student of religion, I had looked deeply into the world’s
religions exploring teachings related to compassion, dying and death that could serve those who
were facing death in the contemporary world and those caring for the dying. As well, I was
fortunate to have received teachings and engaged in practices from the
Theravada, Mahayana
and
Vajrayana
schools of Buddhism. I learned that all three schools of Buddhism could contribute
greatly to the understanding of how to train clinicians and caregivers in compassionate care of the
aged, the dying, and those suffering from catastrophic illness. I also learned that other cultures
often care for their dying in ways that were more compassionate and realistic than ours.
I began my direct work of compassionate care of the dying in 1970 as a medical anthropologist at
the University of Miami School of Medicine’s Dade County Hospital in Miami, Florida. While
working in this big county hospital, I saw that the most marginalized group of people in the hospital
system were those who were dying. As someone involved with curriculum development at the
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