discernment, two features that are related to compassion.
I was not there the moment Matthew died. When I arrived to help, twenty minutes after he had
passed, I found a calm and very moving scene of loving care taking place. His partner was gently
swabbing his mouth clean of mucus; his twin sister was holding his hand and thanking her brother
for all she had learned from him. His closest friend and the hospice nurse, their arms around each
other, softly prayed for him. No one was rushing around, lost in busyness and trying to avoid what
had just happened. We were, in a very quiet and connected way, being with dying, and being with
dying from a base of compassion.
To support CMC care, clinicians and caregivers need to: value well-being, insight, compassion,
and self-respect; recognize challenges and stress; commit to physical, emotional, mental, spiritual,
relational balance; and engage in strategies supporting “best practices” with CMC care toward the
dying, community, colleagues, self, as a base. There are so many stories of why a CMC in the
end-of-life care field is important. To complete this chapter, I offer one more.
Story: A final story to illustrate the how compassion forms a base for care of the dying: When Mary,
who had lymphoma, came to see me, I was moved by her appearance. Because of chemotherapy,
she had no hair, no eyebrows, no eyelashes. Flaring from her neck were huge tumors. Although
her friends had told me Mary was in denial, I found her denial curiously radiant. In our first
interview, she leaned toward me and said, “I am not going to die.” At that instant, I felt she spoke
the truth.
When we cut through the illusion of ourselves as solid and separate entities, we may well come to
the conclusion that nobody dies. One day, Mary’s network of friends, about twenty-five women in
all, came together. We sat in council and I asked the simple question: “What are you feeling?”
They responded with suffering and frustration. I could not blame this circle of good-hearted
women. Something was definitely not working for them. For one thing it bothered them all that
Mary was “in denial.” On another level, they had not quite got themselves organized, they felt
demoralized, and their care of their friend was erratic. They seemed to be in a world apart from
her, and at the same time they loved her and wanted to do their best for her as she was dying.
We listened deeply to each other and explored the question of denial and how Mary’s refusal to
accept the imminence of her death could on some level be a reflection of her insight into
deathlessness. I shared with them that this was a possibility that might free them to accept Mary’s
attitude of denial. Mary’s friends could not ignore their shared fears and frustrations, once they
were spoken aloud. When they heard one another, they shifted to a position of compassion for
themselves, as well as a greater understanding of their friend’s perspective on dying. We then set
out to do the most practical thing, which was to make a schedule.
Over the ensuing weeks, it seemed as though everything went much more smoothly. People
showed up at Mary’s on time and worked with accepting her just as she was. I also was part of the
schedule, and had the joy of sitting with her several times a week. She and I listened to music, sat
in silence, and occasionally talked about simple spiritual issues.
Mary stayed in “denial” up until the moment of her death, when she died peacefully. Her last words
were “I am not dying.”
It’s easy to consider denial as some kind of pathology. However, in being with dying, we simply do
not know when it might be serving a positive or healing function. “The difficulty,” said philosopher
Ludwig Wittgenstein, “is to realize the groundlessness of our believing.” This is truly not knowing.
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