rooted conflicts in goals and values that must be addressed from this place of stability and
discernment.
Part 2:
End
: Mark the end of the interaction with your patient; release, let go, breathe out. Explicitly
recognize internally when the encounter is over, so that you can move cleanly to the next patient
or task; this recognition can be marked by attention to your out-breath. While the next step might
be more than you expected would be possible or disappointingly small, notice that, acknowledge
your work. Without acknowledging your own work, it will be difficult to let go of this encounter and
move on. (E/E Axis: Ending)
Conclusion
The BWD training was initiated by the author of this chapter in 1996 in response to requests by a
number of clinicians to be introduced to contemplative and compassionate approaches to end-of-
life care. The training was originally funded by the Nathan Cummings Foundation and the George
Soros Project on Death in America. As the training developed over the years, dedicated and skilled
clinicians in the training became interns in the program, and then some moved into faculty
positions. From there, several have become core faculty in the training and have made important
contributions to the development of the curriculum. All of the current faculty in the BWD training
were former participants in the program, and have established BWD training elements in their
home institutions. A number of the faculty have collaborated on journal papers and are moving
BWD work into the mainstream through teaching, research and writing. As of 2012, more than forty
individuals from the University of Virginia Nursing and Medical Schools have been through the
program. Groups of clinicians have been sent from Rockford Health Services, Duke University,
San Diego Hospice, Johns Hopkins University, Zen Hospice, Maui Hospice and various other
institutions.
The training is entering a new phase with the publication of the G.R.A.C.E intervention and Halifax
A.B.I.D.E. Compassion Model, with research monies being now available to assess the efficacy of
the training and its various interventions. In addition, the core and associate faculty are developing
new curricula to translate the training into all medical and nursing disciplines.
Acknowledgements
Gratitude to Drs. Tony Back, Cynda Rushton, Barbara Dossey, Susan Bauer-Wu, Donna Kwilosz,
Gary Pasternak, Ted Heffernan, Charles Lewis. And to Mary Taylor and Tussi Kluge.
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