“Death, your servant is at my door;
He has crossed the unknown sea
And brought your call to my home.
The night is dark and my heart is fearful,
Yet I will take up the lamp, open my gate,
And bow to him my welcome.”
Rabindranath Tagore
“I always knew that everyone dies,” the writer William Saroyan remarked during the final hours of his life, “but I really thought there would be an exception in my case.” There is a humorous intention here, of course, but I suspect Saroyan’s wit reveals feelings regarding death that many of us share. During our daily lives, most of us naturally begin to think that our concerns are more important than those of other people. If my car gets a flat tire and I’m late for an appointment, the inconvenience seems of much greater significance than an earthquake in Fiji, though I may keep this hierarchy of values to myself. I too secretly believe that I’m “exceptional” in the sense that Saroyan meant, and if I sometimes lie in bed at night and find my thoughts scanning forward to the moment when my life will end, any unease about this lasts for only a second or two. I carry the belief that I’ll live to a ripe old age and then effortlessly transition into my next phase. I can’t remember ever not existing and I can’t really imagine not existing at some point in the future. Can you?
Yet somehow, at the same time, I know that “David Simon” will not exist for more than another sixty years. I am just a parenthesis in eternity. We all have this dual nature: We are immortal, invulnerable gods and, paradoxically, tiny insects waiting to be crushed by the heavy foot of eternity. Somewhere between those extreme visions is a mature awareness informing us that someday our lives will end, and that the world will really go on very much as before. (But in my case it will first completely shut down for ten days.)
This paradox of simultaneously being an immortal spirit and a skin-encapsulated ego is the ultimate challenge of life and the basis of all anxiety and fear. Freud said that neurosis is the inability to tolerate ambivalence, so until we have reached a state of absolute enlightenment, all of us are, at least, a little neurotic as we seek to reconcile these apparent polarities.
During a prolonged meditation course I remember having the experience of transcending timebound, localized awareness and thinking, I now know that I am a spiritual being in complete union with all other beings. I am neither above nor below anyone because we are all expressions of universal intelligence—we are all manifestations of God. I have finally gone beyond my ego. And then, a little voice arose in my otherwise serene awareness: You know, there are not a lot of people around who really know this. I started laughing at myself, realizing that even as I was surrendering to my egoless state, my ego was doing its job of judging and comparing me to others. This is the nature of individuality while we are striving to establish our universality.
What do we really know about death? We think of it, we may even speak of it sometimes, but we can really only talk around the subject of death rather than about it. Hamlet calls death “the undiscovered country”—and how can we describe a landscape that lies off the edges of our maps and beyond the reaches of our telescopes?
For most of us, only one fact is certain about death, and for the greater part of our lives this fact has considerably more reality than the knowledge that someday we will indeed die. Fear is that one certain fact: We know that we’re afraid of death. But, again, what do we really fear from something we understand so little about? Since we don’t know the source of our fear except in the most vaguely conceptual way, how can we hope to deal with it or get beyond it or somehow bring that fear to an end?
In this area, a physician can really claim no more expertise than anyone else. Although I’ve witnessed hundreds of people die, I do not believe any of us can fully grasp the significance of death until we are imminently facing it. I am proceeding with a high degree of humility in addressing the subject of our mortality and the fear that attends it. I will suggest, however, that our fears about death can be separated into two categories. It’s certainly true that nobody knows what’s going to happen, and this sense of the baleful unknown would seem to be a primary expression of our fear of mortality. But, as I suggested above, how can we be afraid of something of which we know nothing? Freud approached this question in discussing children’s fear of the dark, and concluded that children are really afraid of what they think might be in the dark, rather than of the darkness itself. But whatever we may believe that eternal darkness holds, each of us is going to face it alone—and I believe that this utterly solitary quality of the death experience is one of the most important sources of our fear.
As my friend and Ayurvedic teacher, Sunil Joshi, once eloquently expressed to me, life can be seen as a sort of arc. It begins with our existence as pure spirit, in which we have formed no attachment to any of the diverse beings and objects that fill the physical world. Conception, birth, and later development can be seen as a process of engagement with these worldly “furnishings.” This is the phenomenon of ego development, and we can watch it take place in children. At first, but only for a little while, the whole notion of possession or the relative value of objects is outside a child’s consciousness. A diamond means no more than a rhinestone to an infant, and a cardboard box can be as much fun as a Mercedes-Benz. Rather quickly, though, the ego begins to assert itself, so that a three-year-old can be as possessive and willful about what’s “mine” and “yours” as any adult can. There are still intermittent periods of egoless play for a toddler, but consciousness is really developing in the direction of engagement with the world and with assimilating the value system of the family and of society. Gradually a young person’s focus sharpens, and he or she learns that some things are more valuable than others … that some objects are beautiful and some are not … and that some people are lovable but many aren’t. When the English poet William Wordsworth wrote, “Though nothing can bring back the hour/Of splendor in the grass, of glory in the flower,” he was referring explicitly to the loss of our childhood capacity to find supreme beauty and joy even in the most commonplace things.
This process of ego engagement, of bonding and sometimes binding ourselves to the people and things in the world around us, must eventually confront the fact that it cannot continue forever. Especially when we contemplate our mortality, we must recognize that our ties to the material world are going to be severed someday, and that this is going to take place whether we resist it or not. Ayurveda, like every other spiritual tradition, counsels us to create a state of awareness in which we realize we are in this world, but not of this world. This cultured detachment allows us to participate in the adventure of living while always being alert to the transitory nature of everything we experience in the world. Meditation is the most important Ayurvedic technique for accomplishing this, but even if we’re not acquainted with any spiritual tradition, the natural arc of life will lead us back toward the egoless consciousness that was ours in childhood. Many people in later life are able to regain something like the state of pure awareness that exists in the first few years of life. In view of this, I suspect that perhaps Wordsworth was wrong: We can regain our sense of splendor in the grass—in fact, we need never lose it at all. To the extent that we are able to maintain the unity consciousness that was once ours, the fear of separation, of isolation, that is so basic to the fear of death will melt away.
Although as young children the two brothers were inseparable, Jack and Michael became increasingly competitive as they matured. Each perceived the other as the favored child and neither ever received enough attention. Their resentment intensified as they entered college, and upon graduating and entering the business world, their competition escalated to real hostility. After years of bitter arguments, they cut off all communication and publicly derided each other’s faults whenever the opportunity arose.
At the age of fifty-five, Jack developed unrelenting abdominal pain. After resisting medical care for months, he finally saw his physician, who immediately sensed the seriousness of his illness. After a series of tests, Jack was told that he was dying of untreatable pancreatic cancer. This news was the catalyst for a dramatic transformation resulting in Jack’s strong desire to vent his feelings about being wounded as a child to his brother.
After almost ten years of not speaking, Jack entreated Michael to visit him. When they met, Jack’s heart poured out the pain that he had been carrying, and with each remorseful tear, his anger transmuted to love. By the end of their emotional exchange, the brothers were confessing how much they had always loved each other, even though throughout their lives they had only expressed their disdain. In the melting of their egos, the unifying essence of spirit was allowed to shine.
The ego lives in fear. It fears loss of power, loss of approval, loss of money, and of course, it fears death, which is perceived as the loss of everything. Spirit, which exists beyond the needs of the ego, has no fear of death because it never dies. To the extent that we are aware of our unity with spirit, we can transcend the fear of death and experience our mortality with acceptance, and even with love.
A second component of our fear of death derives, I think, from a sense of impending powerlessness. At the last moment, after all, what if there are still a lot of things we want to do? It won’t just be all the new films we’ll be missing—we’ll be helpless to recapture the days and nights we wasted in worry, or the hurt we inflicted on others, or the love we failed to return. We all have sins of commission and sins of omission. In short, we may be faced with our regrets.
This prospect may indeed be worthy of fear, but only if we fail to see it first as a spur to action. Carpe diem—“Seize the day!”—has been a theme of poetry since ancient times, and in Ayurvedic teaching it is referred to as present-moment awareness. Just as a blazing fire can burn a log to a fine ash, by really experiencing every day to the fullest we can eliminate regrets and residual guilt-ridden emotions from our consciousness. If we can fully process the events and relationships of our lives—really digest them—we can leave the table without hunger when the feast is finished.
The truth of this, I’m sorry to say, was made clear to me when my older sister died of cancer when I was still a teenager—
I had never been close with Jill, who had no apparent need for an annoying little brother. We kept our distance and I rarely paid her much attention throughout my teenage years. Then, while home from college on winter break, I learned that she was having trouble swallowing and was going to see a specialist. Things proceeded at a reckless pace from that point on. A biopsy showed that my twenty-one-year-old sister had a rare form of throat cancer and needed urgent hospitalization to have her voice box removed. A tracheostomy tube was placed in her, but the major surgery had to be delayed because she had contracted an upper-respiratory infection. I remember seeing the terror in her eyes when I visited her in the hospital and the tears that flowed when my parents told her I had donated blood for her. Although there seemed so much she wanted to say, she was unable to communicate verbally.
While preparing to go to the hospital the next day with my parents, I received a phone call from her surgeon saying that something tragic had happened. Because the tumor had so damaged her throat tissues, the breathing tube had eroded into her carotid artery. Despite emergency efforts to save her, she was gone.
If she had lived longer, perhaps many of the emotions that remained unresolved between us at the time of her death would have played themselves out. Perhaps she and I would have been able to express things to each other that are only dimly sensed by young people. I don’t expect ever to fully recover from this experience and I know that my parents do not go a day without thinking what more they could have done for her. Almost all of us live with, “If only I had …” or “I should have …” or, “I could have …” and these are the big lesson opportunities that life offers. We are reminded that being human is an ephemeral, remarkable gift that must be cherished every moment we’re alive.
Many years after my sister’s passing, while caring for a patient as a neurology resident, I had the opportunity to try the lesson again. Although this gentleman was a dairy farmer, and I had rarely been near a cow, I was drawn to a spiritual quality I sensed in him. Although we talked very little during my busy days on the neurology ward, I felt a quiet connection with him. His condition was very serious, and I knew he was going to die. He knew it also.
One Sunday, although I was not on call, I had this strong urge to return to the hospital and spend some time with this patient. It was an unusual encounter for us. Normally he saw me in my white doctor’s coat during a typically busy day, but now there was far less activity and I was in jeans and a casual shirt. Perhaps it was the removal of my professional barriers that allowed him to talk freely with me, and though he had a moderate speech impairment from the tumor in his brain, we spoke for quite a while. He talked about how much he had loved farming and getting up early in the mornings to milk the cows. It wasn’t an especially profound conversation, but it seemed meaningful and we both shed some tears. He had no regrets about his life; he had done what he’d loved for as long as he could, and if he had been offered anything in the world he would simply have chosen to do the same thing. He was alone in the hospital, but this didn’t seem to trouble him particularly. He knew that his wife was at home taking care of their farm. Finally we said good-bye, and I left. He died about three hours later, and although I felt sadness, I had no regrets. He was alive when he died, as a saying goes, and his life was really over just when it ended.
This simple man reminds me that we are waves on an ocean. While we are alive, we mostly see ourselves as separate, comparing our qualities and what we have achieved to those around us. And yet, each wave is ultimately the unbounded ocean temporarily disguising itself as separate, but never losing connection to its source—which is the same source of all the other waves. Knowing that at some point our individuality will merge again with universality is a tremendous gift. The urgency it bestows upon our daily life is an opportunity to embrace the moment, living it as if it could be our last.
As I board airplanes these days, I have the thought that every person who died in an airplane crash did not believe that his or her life was about to end. Although we all know there is the possibility of our dying on any given day, we are fairly certain that it is not today. Throughout his stories, the sorcerer Don Juan reminds Carlos Castaneda that death is always stalking us, and this is the driving force to live a life of meaning, ever alert to the miraculous opportunities available at every moment.
Timebound and timeless, individual and universal, local and nonlocal—these are the contradictions that Ayurveda suggests can only be resolved by going beyond the realm of duality with its names and forms and becoming intimate with the silent field of spirit. When our understanding of spirit merges with our direct experience, we have wisdom—the wisdom of life—the wisdom of healing.
In my dream I am walking along the shoreline on a pristine beach. The white sand is sparkling as a brilliant sun beams its light onto the turquoise water lapping against the shore. I become entranced by the scene that is unfolding in front of me as I discover human beings silently emerging out of and returning back into the sand. I realize I am witnessing the primordial dust from which we are made and to which we all return. I recognize the endless cycle of birth, life, and death flowing in a continuous stream and I see a celestial hand compassionately performing this divine work. In the same gesture that a newborn’s umbilical cord is pinched off to begin a new life, the airway of a dying man is gently closed off at the end. The wheel of life eternally turns.