7
Death is a part of the whole cycle of life, and it is probably the biggest contributor to the field of fear in health care—and possibly in our culture as a whole. We fight against it, physicians fight against it, we spend enormous energy and health care dollars fighting against it, and yet it comes to us all. Though it is imperative for each person to work with this fear, I do not have any specific suggestions for doing so; even religious and spiritual leaders seem unable to alleviate this deepest fear, which expresses itself uniquely in each individual.
For me, the release from the fear of death came as an unexpected grace—one day the fear was there, the next day it was gone. In the middle of an anxiety attack prompted by fears of death, I picked up a book1 that had been sitting by my bedside for six months. Even before opening it, I felt waves and waves of peace wash over me. Perhaps it was all the years of personal work finally coming together; perhaps it was the beauty of the author of the book, who transcended his own death to grant me peace. Many people don’t realize this peace until death is actually near. But perhaps the answer is simply to face it like any other fear—acknowledge it, work with it, release it, and find something to replace it.2
An idea of health that does not generously and gracefully accommodate the fact of death is obviously incomplete.
—WENDELL BERRY, LIFE IS A MIRACLE: AN ESSAY AGAINST MODERN SUPERSTITION
Bernadette’s Story: Facing Death in Childbirth
This is one woman’s story about her experience with various fears, including the fear of death, during the process of giving birth to her two children. Her story is not everybody’s; it is hers. But it is a good example of how to deal with this fear.
Bernadette had two very different pregnancies and births. The first was easy, and Bernadette knew the baby was safe the whole time. The fears she carried had more to do with her own performance anxiety—would she be able to do what was necessary in the birthing process?—and the kind of welcome her daughter would receive when she appeared.
“I was concerned—would there be fear present at her birth?” remembers Bernadette. She saw herself as her daughter’s spiritual guardian, responsible for protecting her psychic space at birth. This was what ultimately made her choose a home birth, so that she could control the environment into which her daughter was born. What Bernadette wanted more than anything was for her child to be born into a field of love, something she thought was missing in her prenatal encounters at her clinic.
Bernadette’s second pregnancy was much different. She decided early on to have another home birth because of the beauty and richness of her first experience. But she experienced inner fears almost immediately during her second pregnancy. She characterizes them as “the traditional fears that mothers-to-be have—that something’s going to be wrong with their baby, that something’s going to go wrong, that something’s already gone wrong, or that something’s just not quite right, but you can’t put your finger on it.”
Though her first response to the fear was to “check out and try to ignore it,” Bernadette began working consciously with her fears. She found physical support in various kinds of bodywork and discovered that she could “breathe into” some of the unconscious lingering fears from her first labor and let them move through and out of her body. She also recognized the need to admit her fears to her husband and ask him for help. “Then it really shifted, and the second trimester was very different.”
In her second trimester, Bernadette’s fears had to do with misinformation—inaccuracies that were recorded in her chart and could have jeopardized her plans for a home birth. Though the midwives eventually caught all the mistakes, Bernadette had to live with the fear for several days each time.
In the third trimester, the fears were about the baby’s heart tones, which began to dip. Heart tones are the sounds made by heart valves opening and closing during each heart-beat; this is the “lubb-dupp” that you hear when you put your ear against someone else’s chest. Bernadette resolutely held on to the plan for a home birth, knowing that some people would consider her crazy for doing so. In fact, she says, “We got kicked out [of our clinic] in the ninth month of prenatal care. They told us we couldn’t see midwives [for our check-ups] if we were doing a home birth; we had to see a doctor. So there I am, naked on the examination table, and she comes in and tells me, ‘I’m sorry, we can’t care for you.’”
Bernadette chalked this up to the clinic’s fear of liability problems. Her husband panicked at the news but she remained calm, telling him, “We have to focus on the baby; we have no extra energy to get caught up in that fear. Stay on track.” She was convinced that she could have this baby at home, so she found another clinic that would support her decision. “Had we gone into fear and let that run the decisions throughout the whole pregnancy, then we would have done a hospital birth, and the birth would have been very different; it probably would have been a C-section.”
Bernadette points out that either choice would have yielded a safe, albeit very different, delivery. But she believes that “if there’s fear and there might be a problem, then you should go where those fears are going to be calmed.” For her, calm came from processing the fear and listening deeply to the baby in her womb. “If I hadn’t done that, we would have gone and gotten more tests and done a lot more medical intervention, and rather than helping, in . . . our case, it would have fueled the fear more and it would have altered the course of all our decisions to follow. We would have been listening to the information outside of ourselves rather than what we needed to keep listening to, which was the baby, who was talking to us and the midwives. That’s hard to do. When you’re in such a vulnerable place you just want to go to an expert and say, ‘Tell me what to do.’”
Shortly before her due date, Bernadette had a friend come over to listen to her as she named all of the fears she had been through during the pregnancy. “I just wanted to say out loud—to someone who could witness it—what the fears were, because I hadn’t really done that. I hadn’t wanted to talk about them too much because I didn’t want to give them more power, so a lot of them I dealt with on my own during the pregnancy. As I’d be lying in bed at night . . . I would do my own thing where I would visualize the fear getting smaller, and my power getting greater; maybe surround [the fear] in light, or send it away.”
Bernadette feels strongly that all of this work allowed her to deal with what eventually came: a turning point during her labor when she needed to decide whether to remain at home or be transported to the hospital. “I think if I hadn’t faced the fears all along, worked with them and gotten help and support, transformed them, and used them as a catalyst they would have all come up in that split second. It could have clouded everything then. But I knew exactly what I needed to do, [to go to the hospital in the middle of labor], and exactly what help I needed to ask for inside myself and outside myself. I have never been so clear in my life. [In the hospital] I was saying [to the doctors and nurses and midwives], ‘I need you to do this, and you to do this.’ I would go into the letting go, and I would come out and . . . it was like being in charge and out of control at the same time. When it’s a life-or-death choice you really want to be able to call on that ability.”
Bernadette is really in touch with her own inner wisdom, and she uses it along with external information to create her own birthing experiences. She regularly works with and breathes through any fears that arise in order to keep coming back to herself. This power is available to us all, especially with the love and support or simple witnessing of others.
After listening deeply, Bernadette followed her instinct with such certainty that her requests or commands were followed, even in the emergency room of a hospital where the voice of the physician is usually sacrosanct. While not all of us will be able to achieve the level of confidence and decisiveness of Bernadette, particularly in the face of a scary situation, we can look to her as an example. And we can use her as an ally in our visualizations, as we imagine those who have gone before us.
AN EXERCISE FOR WOMEN
Women in Western cultures have been taught to fear their bodies and their childbearing capabilities. These abilities and everything associated with them have been turned into medical conditions rather than natural functions. Menstrual periods have been called “the curse,” and we are taught to expect pain and discomfort from them. We are derided and paid less at our jobs because we may be unable to function at peak capacity when we are having our periods or during pregnancy and for some time thereafter. We are then taught to fear the end of our childbearing years because we will look old and withered, and because we will no longer have any “purpose” in life. (See the sidebar Fear and the Media on page 20.)
In addition to these cultivated fears, pregnancy and childbirth bring us face to face with our most primal fear—the fear of death, which I believe ultimately underscores most of the other fears in our health care system. Though many of us like to think of pregnancy and childbirth as completely natural and safe, the truth is that creating life is a complicated, mysterious process that does not always have the anticipated or desired outcome; either the mother or the child or both can die in the process.
My thesis was that the fear of death is so predominant in the origins of modern medicine that it becomes a barrier to moving into any new models.
—LOIS, A FORMER HOSPITAL ADMINISTRATOR
It is best to begin young in cultivating an attitude of gratitude for this awesome, terrifying, and miraculous gift of creativity and power that our bodies possess—as well as for the new freedom and creativity we enter into when the physical birthing potential leaves us. Showing our daughters this attitude is imperative, and cultivating it in ourselves as adults is tremendously beneficial. I had just achieved a feeling of joy and gratitude at the point when my menses began to leave me; I wish I could have done that sooner.
If I’m afraid of death, then I will become extremely cautious and worried in life, since something might happen to me. So the more I fear death the more I fear life, and the less I live.
—TREYA WILBER, GRACE AND GRIT
Exercise 7.1: Making Friends with Our Menstrual Cycles
Take the opportunity of each menses (or, for those of you who either have stopped bleeding or haven’t yet started, each full moon) to reflect on at least one reason why you are grateful to have a body that is or has been capable of giving birth—with all the awesome power, responsibility, joy, creativity, pain, and fear this ability brings with it, including the fear of death.
AN EXERCISE FOR MEN
I am not aware of a life experience for men that is similar to the woman’s menstrual cycle, except perhaps the process of aging. One of the great clichés of our culture is the older man who seeks out the company of a much younger woman, presumably to deny the fact of aging and the underlying fear of death.
I haven’t resolved my own fear of death, but what I have learned from Jim [Brigham] is how to sit with someone, just sit with them while death walks in the room. I wonder what it will be like to be a doctor who doesn’t see death as the enemy.
—MAREN R. MONSEN, M.D., FROM THE DOCUMENTARY THE VANISHING LINE
Exercise 7.2: Making Friends with Your Life Cycles
Take the opportunity once a month, perhaps at the new moon, to reflect on at least one reason why you are grateful to be the age you are right now, with the body that you have right now—a body that may show the wear and tear in its wrinkles and sore muscles but also reflects the life wisdom you have achieved. Be sure to acknowledge your sadness and fears, especially that of dying, as well as your triumphs and joys.
FOR HEALTH CARE PRACTITIONERS ONLY: MAKING FRIENDS WITH THE CYCLE OF LIFE IN YOUR PATIENTS
Making friends with the cycle of life obviously includes accepting death. But I think Jim Brigham, a social worker who worked with patients facing death, is correct when he says that the difficulty he had in talking with dying patients was in large part due to his own unresolved fears of death. The answer for you, as for everyone, is to do your own work with your fear.
Though I feel as though I have made my own peace with death, occasionally I still find myself in a place of, if not fear, apprehension mixed with curiosity. It is a great mystery, after all. And, as with so many aspects of the journey, my relationship with this momentous one changes as I change, sometimes from moment to moment.
My medical training focused on procedures, not on how to talk with patients about their death. An uncomfortable thought was creeping into my mind: was the problem just my training, or was it my own terror of looking death in the face?
—JIM BRIGHAM, FROM THE DOCUMENTARYTHE VANISHING LINE
I recently told a friend that I sometimes feel like an impostor: here I am, publishing a book on healing without fear and leading workshops on the same topic, when I often lapse into fear as my first response. But that is what acute fear is for—alerting me to possible danger and then, hopefully, subsiding. I find that it does subside ever more quickly, as I take my own and others’ advice to pause, breathe, reflect, and try something new. May it work as well for you, that we might all release the mantle of chronic fear that currently seems to cloak our health care system.
Namaste.