Death and Letting Go

On Rosh HaShanah it is written, and on Yom Kippur it is determined, “Who shall live and who shall die.”

In America we associate dying with sickness and disease, something which takes place in hospitals, out of sight. In ancient culture, and, in fact, up until the modern era, death was much more integrated into daily life. The Hebrew Bible is very straightforward about death. Joseph says, “Behold, I am now about to die.” When King David is on his deathbed he says, “Behold, I am now about to go in the way of all the earth.” Simple, painful, undeniable. Dr. Paul Kalanithi, a 36 year old neurosurgeon who died in March, 2015, wrote a powerful journal of his final months which was a bestseller this year- When Breath Becomes Air. “Death,” he writes simply, “always wins.”[1]

We need to look back only a generation or two in our own society, to a time when people were more connected to the land, where the birth and death of animals introduced children to the reality of the cycle of life, and where most people died in their own homes, surrounded by loved ones. Speaking of generations, there may be those listening to these words who are young and wonder why they should care about issues of death and dying. To you I say- perhaps you have parents or grandparents who are grappling with precisely these issues? How can you support them as they confront challenging choices in their lives? And, more starkly, today is the day when we come face to face with our own mortality. None of us know when our thinking about our own lives and deaths will move from the realm of intellectual consideration to the realm of gut wrenching reality.

We cling to life; we are hard-wired to live. Maurice Lamm tells the story of Yosef, desperately poor and trapped in a body that brought tremendous pain each time he bent down to pick up a twig or scrap of wood. Daily he cried out to God that he was ready to die, that the pain was unendurable. One day, as he placed a larger than usual piece of wood into his sack, the sack ripped and all that he had gathered was scattered on the ground. “I told you I’ve had enough of this wretched life. Take me away from this pointless life. Let me die!” The Angel of Death appeared to him- “You called for me?” “Yes,” Yosef replied, “I was wondering whether you could help me pick up all of these sticks?”[2]

The psalms speak of “three score years and ten, or, if by reason of strength, four score.”   Seventy or eighty years, to our ancestors, was a long life. Today when we wish each other, “Ad meah v’esrim, you should live to 120”, it has become a realistic expectation. Now that we are living longer, we question how are we living, how can we live better, and what happens at the end of days when our suffering outweighs our joy in life? As human beings, we crave meaning in our lives. How do we discern when there is enough meaning to go on, and when we are ready to surrender?

It is a terrible and heroic thing to “preside over the disintegration of one’s own body,” as Mary Chase Morrison wrote in her late eighties. “. . . looking on as sight and hearing, strength, speed and short-term memory deteriorate.” [3] Then there’s the loss of status as we give up the satisfaction of work that has defined us for a lifetime, the disruption of moving from our own home, the terrible diminishment of our mental capacities. And the agonizing loss as we watch our generation die away. An aging elder described it thus, “It is as if we are soldiers running across a battlefield- people are falling on either side of us. When will it be our turn? That’s our life from now on. How do we get used to it?”[4] More states are enacting legislation to allow aid in dying.

There are great spiritual opportunities as we age, time to gather in the harvest of patience and wisdom, gratitude and equanimity, forgiveness and joy. Israeli feminist Alice Shalvi wrote that, “What I have lost in longevity, I have redeemed by profundity. Compelled by failing physical strength, I sit more, recline more, rest more frequently. But in those moments of physical nonaction and bodily passivity, the spirit can soar if I unleash it from everyday concerns.”[5]

Contemplating our own death is fraught with fear. Dr. Kalanithi describes his terminal diagnosis as not “life-altering” but “life shattering.”[6] He says that before his diagnosis, he knew that he would someday die. After the diagnosis, “I knew that someday I would die. . . but now I knew it acutely.”[7]

The precious, precious value of each human life, a deeply held Jewish belief, is weighed against the quality of that life. The time has come to embrace maximal treatment for pain, even at the expense of minimally decreasing life span. There is a fine line between medicating to control pain and hastening death. Some choose to forego further nutrition and hydration, with or without sedation, as a means of letting go. There is no magic formula which will tell us the right thing to do in any given situation.

We fear suffering and we fear causing our loved ones to suffer. We fear loneliness and loss of independence; we fear a lack of meaning. It is vital that we initiate serious, open conversation with our loved ones about our own vision for the end of life while we are still healthy and dispassionate enough to do so. By a show of hands, how many of you think that it is important to talk about what we do and do not want at the end of our life’s journey? Okay, now, how many of you have had that conversation? We at Temple Chai invite you to join us for our Conversation Project Shabbat on Nov. 18th, and continuing with next year’s discussion of the book Wise Aging. You can find information about these programs in your Yom Kippur bulletin.

Our tradition allows us to refuse further treatment and place ourselves in God’s hands. God’s hands in our community are thankfully represented by hospice, an organization which has devoted itself to expertly caring for the dying and their loved ones, at home or in hospice facilities. Hospice dedicates itself to the physical, emotional, and psychological aspects of dying with great gentleness, allowing the dying to focus on the spiritual work which many of us would hope for as part of our vision of “a good death.”

Sometimes death comes in an instant-there is no time to prepare and no time to say goodbye. Some of us might pray for just such a death, that we might be spared the pain of letting go. Do you remember the Kenny Roger’s song, The Gambler– “the best you can hope for is to die in your sleep?”

Yet the end of life is a time when we can achieve a sense of resolution and peace through many holy actions- asking for and receiving forgiveness, letting go of negative patterns, making charitable bequests, and even donating organs. All of these are ways that we may redeem ourselves at the end of our days. The example of how we die is as much a part of our legacy as how we live. Rabbi Cowan and Linda Thal define dignity in death as “. . . more than avoiding being hooked up to tubes and machinery. It is taking responsibility for setting our affairs in order, preparing the next generation, saying good-bye, receiving farewells, offering forgiveness, bestowing blessing, and modeling how to die without fear.”[8]

The soul at the end of life is compared to a flickering flame. Traditional Jewish practice did not allow intervention to hasten the end. The rabbis did permit removing any impediments to dying. We are under no obligation to prolong life, and must respect the wishes of our loved ones who choose not to seek further treatment when their time is at hand.

A good death is one where the dying person is not isolated, where there is a hand to hold through the darkest times. A good death is one in which the needs of the individual are paramount. Rabbi Dayle Friedman suggests the following questions, “Will a proposed treatment advance the person’s comfort or well-being? How well are we really caring for her? Does he have a pillow with a soft cover? Does she have her perfume? Is there music he likes? Is whatever food she can eat really delicious?”[9] Jewish tradition teaches us that it is a mitzvah, a sacred obligation, to stand by a person at the moment of death. In fact, if a person is near death, it is forbidden to leave them alone. We are so grateful to the members of our Temple Chai community who have trained to be part of the Chevrah Kaddishah, the holy society lovingly preparing our bodies for burial.

We are all of us dying even in the midst of life. Almost two thousand years ago Seneca taught that, “Throughout the whole of life one must continue to learn how to live and, what will amaze you even more, dear friends, throughout life one must continue to learn how to die.” Acknowledging this reality need not be depressing, it can lead us to the deepest appreciation of each moment with which we are blessed. It can lead us to say what needs to be said, to do what needs to be done, now- with no expectation of an unlimited future which may never come. The consciousness of our own death distinguishes us from all other creatures, but it is also what empowers us to live lives whose meaning will endure beyond the cessation of our physical being. When we remember that we are dying, we achieve a clear sense of purpose, we no longer waste time, we exert ourselves to extract the maximum potential available in each moment. Suddenly priorities become clear and flexibility seems possible.

Meaning derives from appreciating every day, every moment, with which we are blessed, as expressed so simply and beautifully in this poem by Jane Kenyon- Otherwise.

I got out of bed

on two strong legs.

It might have been

otherwise.

I ate

cereal, sweet

milk, ripe, flawless

peach.

It might

have been otherwise.

I took the dog uphill

to the birch wood.

All morning I did

the work I love.

At noon I lay down

with my mate. It might

have been otherwise.

We ate dinner together

at a table with silver

candlesticks. It might

have been otherwise.

I slept in a bed

in a room with paintings

on the walls, and

planned another day

just like this day.

But one day, I know,

it will be otherwise.

Let’s not shed tears over our inevitable demise. Yesterday is history and tomorrow is only a promise. All we really have is the present moment and what we bring to it. Our love and our memories endure beyond the grave, it is to these that we must renew our devotion if we would give our lives meaning and purpose beyond our limited days.

“To live in this world,” wrote Mary Oliver, “you must be able to do three things: to love what is mortal; to hold it against your bones knowing your own life depends on it; and when the time comes, to let it go, to let it go.”

There is, as we read in Ecclesiastes (3:2), “A time to be born and a time to die.” May we all be blessed in our lives with the ability to love and to the ability, when the time comes, to let go.

[1] Kalanithi, Paul, When Breath Becomes Air, NY: Random House, 2016, p. 114

[2] Cowan, Rabbi Rachel and Thal, Linda, Wise Aging, NJ: Behrman House, 2015, p. 252

[3] quoted in ibid., p. 65

[4] ibid., p. 220

[5] quoted in Berrin, Susan, A Heart of Wisdom, VT: Jewish Lights Publishing, 1997, p. 181

[6] Kalanithi, op. cit., p. 120

[7] ibid., p. 132

[8] Cowan and Thal, op. cit., p. 262

[9] Friedman, Rabbi Dayle A., Jewish Wisdom for Growing Older, VT: Jewish Lights Publishing, 2015, p. 88