Dying from cancer in a hospice as a lay person.
Meditation In this meditation upon death and dying,
We will imagine dying from cancer in a Buddhist hospice.
We will begin by establishing body based mindfulness with body sweeping and breath meditation.
Bringing your attention to your sitting posture.
Simply being aware that now you are sitting.
With a straight yet relaxed posture.
At first simply feeling the physical feelings of the buttocks pressing against the mat or the cushion or chair on which you are sitting.
Grounding awareness in this present moment.
Allow a broad natural awareness to embrace your whole body for the next few moments.
For now I suggest taking three slow and deep in and out breaths.
Releasing any tension you may be feeling,
Particularly with the out breath.
Breathing slowly and deeply in all the way into the abdomen.
And then out.
Letting go.
Putting things down.
And once again breathing in and breathing out.
Breathing bringing a fresh awareness,
A sense of being present into each new moment.
And one more deep in and out breath at your own pace.
Now allow the breathing to become relaxed and natural.
Breathing easily,
Ordinarily,
At your own pace.
Just taking small,
Relaxed,
Natural breaths.
Now with mindful awareness try to feel the area around the top of the head.
Simply aware of the various feelings on the surface area of the skin around the area of the top of the head.
Then include the face and the ears and the neck,
Front and back.
Now include the upper shoulder area.
Simply aware,
Knowing the various feelings on the surface of the skin in the shoulder area.
Becoming more aware and at the same time relaxing.
Now include the chest in this awareness.
And then moving down include the stomach area.
Then bring this gentle,
Knowing awareness to include all of your back.
Now include your arms.
Embracing the whole upper area of the body with gentle awareness.
Not judging,
Not discriminating.
Accepting the body as it is with an alert and gentle knowing.
Now include the lower abdomen,
The groin and then the buttocks.
Feel your bottom pressing against the harder surface underneath.
Feel the whole body,
Simply sitting.
Knowing the sitting posture.
Now include the legs and feet in your awareness as well.
Feel the whole body,
Simply sitting,
Knowing the sitting posture.
Now bring your awareness to your breathing.
Being very mindful of each in and out breath.
Simply being aware of the feelings involved with in and out breathing.
Try to be aware of the entire in breath and the entire out breath.
Knowing the sensations of the breath coming in at the nose and through the chest and into the abdomen.
And then as it leaves the abdomen and the chest and out the nose again.
Knowing the entire in breath and the entire out breath.
Each in breath and each out breath.
We are going to introduce a mental noting method now,
So as to assist our mindfulness in staying with the feelings of the in and out breath.
The main meditation object is awareness of the feelings of the breath,
And yet a gentle mental noting method can help us to stay with our meditation object,
Not letting the mind wander off into thinking about this or that.
So we will practice noting butto at first.
Butto means knowing.
And so as you breathe in mentally note but,
And as you breathe out note though.
Aware of each in breath but,
And each out breath though.
But though.
But though.
As this meditation will be a contemplation of death and impermanence,
You can also practice noting with the word maranam,
Which means death or dying.
Breathing in maranam,
Breathing out maranam.
Maranam.
Maranam.
Maranam.
Maranam.
Maranam.
As the remainder of this meditation entails using the visualizing,
Reflecting faculty of the mind,
It may not be possible to be aware of the breath in as much detail as when we take the breath itself as the primary meditation object.
And this is fine.
It is however very helpful to maintain a general awareness of the in and out breathing,
Even while doing visualizations,
So we can alternate between these two words butto and maranam in this way,
Using the noting as an aid to maintaining some awareness of each in breath and each out breath throughout this meditation session.
Simply hear the instructions and promptings and visualize the scenarios as best you can,
Practicing mindfulness of death and impermanence while maintaining awareness of the breath,
Especially in the silent spaces.
Looking past the flowers and the cards on the table beside you.
Out through the window of this quiet room,
You notice that the leaves have all fallen from that tree that used to screen the view,
And whereas before you had enjoyed the vibrant green of summer.
Now you are enjoying the intense clear blue of the autumn sky.
As the months have passed,
You have been grateful for that little glimpse of the world and the sky,
And for the natural light it lets in.
By the time the liver cancer was diagnosed,
Eight or so months ago,
It was already quite large.
Maranam,
Maranam.
Apparently,
It had started in the bowel,
But you didn't notice anything strange at first.
It was when you felt pain and a lump in your side,
And blood appeared in the toilet,
That you hurried to see the doctor.
Maranam,
Maranam.
As the aggressive cancer was quite advanced,
You consented to a series of strong radiation treatments,
Which did slow the rate of growth for a while,
But the tumors did not shrink or disappear.
That was when you decided to forgo any further radiation.
Adjusting to the illness was already quite difficult,
Without the side effects of the treatments to deal with as well.
Maranam,
Maranam.
What a surprise it had been,
And then how quickly your life changed.
Quitting your job,
Selling most of what you owned,
And moving to a small rented apartment.
Then you could focus.
In between herbal treatments,
Massage and acupuncture,
You still had time for a lot of valuable meditation practice.
You are so grateful to that practice now,
And to the good Dharma friends that you made.
You visited your teachers seeking their counsel,
And your teachers visited you to give encouragement.
The treatments didn't help the cancer at all,
But in a way they helped you to slowly begin to accept what was coming.
Maranam,
Maranam.
At a certain point,
It became obvious that no matter how much you hoped,
Or how much you tried,
The cancer was simply not going to subside.
And it seems that this has been this lifetime's biggest lesson on impermanence,
Uncertainty,
And not self.
Maranam,
Maranam.
Clearing the way,
Gathering your resources,
You made some final donations to your favorite monasteries,
Teachers,
And Buddhist organizations.
Family members and friends pitched in too,
Dedicating the merit to you.
And lastly,
You made one large contribution to the hospice where you would die.
Maranam,
Maranam.
Returning your gaze to the inside of the room,
You notice how swollen the middle part of your body is under the white hospice blanket.
But your arms,
Which rest on top,
Are so thin.
Maranam,
Maranam.
There is a tube going into your arm,
And several tubes taking fluids out from your side,
And one under the blanket which you cannot see,
Taking urine out of your bladder.
And there is also another one,
Feeding oxygen into your nose.
How strange it all seems.
Although in some respects,
This is a wretched sight.
You have practiced offering loving acceptance and kindness to this body and to this illness.
It is normal,
Ordinary,
An aspect of nature,
One of the things that can happen to a body.
And with time,
You did simply accept and allow it.
Maranam,
Maranam.
And with an attitude of compassion and kindness,
Both for yourself and for others,
You have practiced being grateful for all of those tubes that intrude and protrude.
Because you realize that all of these things are going to help you to die with some peacefulness,
Dignity and composure.
You don't have to worry about anything.
People are taking care of things.
Maranam,
Maranam.
You have surprised yourself by truly feeling grateful.
Even with the cancer so far advanced,
You have not become bitter or depressed.
For you have recognized all along that there would have been much more pain and discomfort if it were not for the kind care and attention of so many others.
The room is quiet and clean.
And although the pain is horrible,
With the right combination of medicine and a lot of meditation,
It has become bearable.
Your friends,
The doctors and nurses and hospice volunteers,
Give or take a few tears,
Have all been incredibly patient and kind.
And so there is much to be thankful for.
Maranam,
Maranam.
Earlier on,
When you'd first moved to the hospice,
There were half-day outings to the sea with various friends.
Then with those same friends,
There were many lovely walks through the park.
And until recently,
Those kind people had pushed you in a wheelchair to your favorite spot in the garden to sit in the sun.
Lately at your request,
Your friends come and sit meditation in silence in your room.
And this is helpful too.
The clarity,
The stillness and the loving kindness pervading the air remind you to keep practicing too.
Maranam,
Maranam.
As the swelling in the abdominal cavity became more and more pronounced,
Digestion became very difficult.
And so about six weeks ago,
You gave up solid foods altogether.
And three weeks ago,
They took out the tube,
Which had fed liquid food into the stomach through your nose.
Maranam,
Maranam.
The doctors had told you what to expect from then.
As the body metabolizes less and less glucose,
The brain will be starved of food.
And so there will be longer periods of sleep.
And periods of deep unconsciousness will become longer.
You'll finally,
You will not regain consciousness in this body.
Maranam,
Maranam.
Although you were frightened at first,
As your body became weaker and weaker and your mind became more and more tired,
You have been training yourself not to panic.
Keeping the mind centered and alert until the moment you fall unconscious.
And then as soon as you come to,
Once more,
You recollect where you are and brighten the mind with patience,
Love and kindness.
It's okay.
This is sickness and death.
Everyone dies.
It has been encouraging to notice that when you have been awake of late,
Your mind has felt quite light.
There is a growing sense of detachment.
As though the mind understands that there is not much point grasping at this body and life anymore.
Despite the pain and fatigue,
On a deeper level,
You feel at ease,
Serene.
Maranam,
Maranam.
You have just come to,
Once again.
It seems you were gone a long,
Long time.
You notice that your breath is strange,
Deep and labored,
With long spaces in between.
Although you are too weak to open your eyes now,
You can sense that there are many people meditating in the room.
They seem a long way away.
These are your friends saying goodbye.
You realize now that this is goodbye.
In voluntary tears,
Roll down from your eyes.
Goodbye,
You think,
And thank you.
Although nobody said a word,
The tears were noticed,
And your goodbye was felt by all.
The waves of loving kindness flowing back towards you now remind you and help you to gather your mind.
In your heart,
You take refuge one last time.
To the Buddha.
To the timeless truth and the sacred path.
And to the noble community.
You rest in clear knowing.
But-do.
But-do.
You take heart,
Feeling confident that wherever you become conscious next,
You will find this refuge again.
And then,
Everything went black.
Maranung.
Maranung.
In about seven minutes,
We will come to the end of this meditation.
Try to maintain a good,
Clear awareness of your breath for the remainder of this session.
If your mind is peaceful,
Simply maintain your awareness of breathing,
Allowing your mind to stay in its peaceful state until the end of the session.
Hear my voice as if it is in the distance.
If you think that it might be helpful,
You can now refresh the awareness of the body sitting,
Knowing the felt sense of the sitting posture.
Feel the weight of your body pressing against the mat or the chair.
Mindfully aware that you are sitting.
Feeling grounded,
Present,
In the body,
In this moment.
And now mindfully bring awareness to refocus on the breath.
Feeling the entire in-breath and the entire out-breath.
Taking one or two deep breaths can be helpful in re-establishing awareness of the physical feeling of the breath.
You can note the in-and-out breath as before,
With the syllables,
Bhut,
Do.
Bhut,
Do Bhut,
Do We understand that in reflective death meditations,
We are using alsanya,
Or perceptions,
To stimulate a heightened awareness of impermanence and the truth of the inevitability of death.
During the meditation,
We allow the mind to be affected by this exercise,
To be informed on a deep level.
But towards the end of the meditation,
It is good to remember that our visualization meditation was actually just an exercise involving thoughts,
And perceptions,
And feelings.
Arising and ceasing in awareness.
If your mind became peaceful through this exercise,
Wonderful.
And if it did not,
Never mind.
The important thing is that we become a little more aware of impermanence in our lives,
And a little less frightened of the very normal experience of death.
These kinds of meditations can be helpful in both training the mind to let go into peaceful awareness,
And also in preparing us to be able to be mindful when our eventual death does actually occur.
Sometimes it is good to end death meditations with a couple of minutes of metta,
Loving kindness meditation.
Establishing a deep sense of well-being.
Breathing in,
Simply wishing,
May I be well.
Genuinely directing loving kindness towards yourself.
Generating the warmth of positive goodwill in the area of your heart.
Breathing in,
May I be well.
Breathing out,
Wishing,
May I be happy.
Breathing in,
May I be well.
Breathing out,
May I be happy.
Breathing in,
May I be safe.
Breathing out,
May I be free from danger.
Breathing out,
May I be well.
May I be happy.
Breathing in,
May I be well.
Breathing out,
May all beings be well.
Breathing in,
May I be happy.
Breathing out,
May all beings be happy.
The Buddha explained that consciously developing awareness of impermanence creates an enormous amount of good karma,
Or positive potential,
Merit.
Acknowledging that you have been contemplating impermanence and death in accordance with this ancient wisdom tradition,
You can feel joyful and confident.
In a minute or so,
This meditation session will be over.
If you have time,
You can continue with your own meditation.
Otherwise,
You can now consider sharing the merit of this meditation with all beings,
Or with someone in particular.
Bringing to mind the merit that was produced by this session of meditation,
Determine how you wish to dedicate the merit.
I dedicate the merit that arises from this session of meditation to.
.
.
May this person be well,
Be safe,
Be happy.
