Seven Tips from the Edge

For the past 15 years, several hours of each work day for me involves seeing the world from the perspective of someone who is dying. I don't know exactly how it is or what it is in me that chose to do this for a living, but I feel very strongly it's a big part of what I was put on this planet to do with the life I have.

It's not for everyone to do, and I don't think it makes me all that special. I can assure you that when my car makes a funny noise, I'm clueless as to what to do about it and glad that there's a mechanic who is doing what he or she was put on this planet to do, and fix my car. I can't do that. That makes the mechanic way more special to me. I need my car.

I've written elsewhere that recently for an 18 month stretch, I knew a steady stream of 2 or 3 people who died every week. I knew some of these people for days, others for years. That streak got interrupted for a few weeks, but seems to have returned in its brutal predictability.

Being in such close and regular contact with death, of having people gravely ill, dying, frozen in fear or radiating peace, them and their loved ones asking me what this whole gig we call existence is about... Roshi Joan Halifax refers to this space as an "edge state", way out on the horizon where the known and the unknown meet. I believe this horizon is what the existentialists refer to as "absurdity", the quest for relevance and meaning in an otherwise indifferent world that cares little for our individual existence.

Out on this edge of absurdity, I've had these flashes of insight lately as I go about my day that the whole gig is a giant inkblot. We see patterns where there maybe are none, we see images where they may be only empty space, we impose rules where chaos reigns, we see connection when we are really flying alone by the seat of our pants. And it's probably okay to do that.

Our intelligence and capacity for insight gives us choices in what patterns we see, what decisions we make, which rules of the game we choose to abide by. For many of us, religion saves us time and effort, offering us a template of guidance. For many of us, we find our own way.

For all of us, I think the most important facts to keep in mind are these:

1) None of us are fully in control of anything, no matter how much power, wealth, fame or status we accumulate. Pink Floyd sang it best years ago, "all the iron turns to rust, all the proud men turn to dust."
2) The whole inkblot nature of reality does not make violent or mean behavior acceptable. On the contrary, we should treat each other, and all life, lovingly, as we would lost and scared children that showed up at our door. That's really what we all are-- lost animals trying to find our way into the comfort of each other.
3) We waste a lot of energy doing stupid things to keep the crushing absurdity of being alive out of sight. Rather than focus on self-destructive vices like gambling and drugs to indulge our insatiable appetites for fleeting pleasures, we should bear mindful witness to fleeting moments of awe that surround us every day that go un-noticed. We're often too lost in our internal chatter to notice awe, to the point where we often can't dwell in awe.
4) Respect the body. See #3. Our choices should nurture our meat suits, not destroy them. We don't have our body for as long as we would like. It begins to age and fall apart just when you're getting used to it. Don't grease the wheels towards achiness.
5) Find what soothes you that is healthy, and what soothes those around you that is healthy. Create opportunities for soothing regularly. We're all lost children, we want security blankets. There's nothing wrong with that.
6) Structure the ambiguity of our absurd existence with self-disciplined progress towards goals. Exercise, meditation, healthy eating and sleep hygiene form a powerhouse of security and inner resources to ride through waves of suffering and anxiety. I've written about this extensively in my books. You actually have to do these things, though, not just read about them.
7) Live a life that others would want to grieve. This sounds strange to our pleasure driven society, but grief is often a sign that you got close to people, that people got close to you. Grief is healthy, and it's essential. Live a life that people would want to celebrate after you leave. You might not know how to do it now, but if you embrace absurdity with love, you're probably going to find out how.

Lessons From Last Week

No one I know died last week.

That's a relief. A week like that hasn't happened since April 2012. For the past 18 months, I've known two or three people every week who've died of cancer. I had known some of them for months, even years. Some I met just before they died.

All of them have touched me deeply. I can only hope that my presence was beneficial to them and their loved ones.

This is part of what I do for a living. I'm a clinical psychologist. My specialty is in working with people who have cancer and their caregivers. Make no mistake, the vast majority of people who have cancer-- an increasing percentage of the population every year-- do very well, and live on for years without the disease. I get to see many of these people put their lives back together or build on the already strong foundations they have spent a lifetime constructing.

I've been doing this for 15 years. I know I've helped a lot of people at some awful times in their lives. Frequently it's been at the worst time of their lives, and we mutually look forward to the day it becomes a distant memory. All too often, we navigate the mystery space between the known and the unknown, as Roshi Joan Halifax so eloquently puts it, the slippery transition between living and dying.  This means illuminating the bureaucratic and spiritual paths that carry all of us away from this life. 

I would be remiss though in saying I haven't benefited from the experience myself. It's not completely accurate to think of this as a job or a career, although it certainly is that. I think of it more as service.

I can't say I recommend this line of work for everyone. Most people react sanely when they find out what I do. Typically, there's an awkward pause. Then, "wow, isn't that depressing?".

You know what? It's really not. I get to see resilience. I get to see grace. I get to fight for dignity. I get to reduce suffering without the naïve assumption that any of us are exempt from our own mortality. I also get forced into a hyper-acute awareness of how important self-care is for any caregiver, professional or personal. I often get inspiration from reading about warrior cultures past and present, the punishing training regimens that Spartans would embark on, feats of agility and endurance practiced by Mongols and Comanches, or tales of superhuman resolve during more recent combat missions.

In order to serve the ill and dying, I find I do a better job if I'm in perpetual training mode in every way I can. I try to train in the way of our ancient warrior ancestors-- I run in sandals as they did, work out with kettle bells and a mace as they did in the ancient gladiator training camps, meditate twice a day. I eat a lot of plants. Very few jobs raise the stakes so high. Too many of us wait until we realize how high the stakes are to take care of ourselves.

Once in a while, when a week like the one that just passed rolls along, I get to pause and take stock. My work requires training, focus and intention. So does living. So does dying.

Life is constant training for the unknown. Don't wait till the bell rings to announce the next round to get in shape. Don't pack your bags at the airport.

Train now for the unexpected.