by Taido
L was a well-respected retired school teacher in his 70s who was stricken with terminal liver cancer. As the liver function weakens, the body’s capacity to deal with its metabolic by-products declines. The accumulation and deposition of the pigmented by-product called bilirubin imparts a deep yellow hue (jaundice) to the skin, sclera (white part of eyes), urine, even tears. Other waste products can interfere with brain functions and cause drowsiness as well as agitation and confusion. Coma is often the final event in patients who have terminal liver failure.
During a home visit, L was mildly jaundiced and his wife had reported occasional episodes of restlessness, especially at night. He was in his pyjamas, properly tucked in bed, and supported by several fluffy pillows, but he looked troubled. “What’s going on?”, I asked.
“Do you think God has forgotten about me?”, he uttered despondently with his breaking voice. “I have been asking God to help me, but I am not getting any answers”, he continued.
“What are you hoping to hear from him?”, I asked.
“I just wanted him to take me Home… I don’t know why I am still around.”
Prior to his illness, L was someone who was strong in his faith, and had always sought to live by his religion. He now found it more challenging to find peace in his prayers. Disturbed by confusion and restlessness, he had not slept well for the past few nights, and tired as he was, he struggled to rest even in the day.
“Would you like to be able to rest better RIGHT NOW?” I asked, and he nodded.
I explained to him that our sense of ease can often be well localised in some part of our body.
“Where do you usually feel the sense of peace, for example, when you last felt being in deep connection with God?”. I guided him to scan his body for that place.
L eventually placed his palm over his heart.
I guided him to feel into that space to find where peace was “located”. He closed his eyes and fell silent. After a short while, he started to snore. His wife and I glanced at each other, amazed. We took the opportunity to catch up on how she was coping with his care. It was at least 15 minutes later when we realised he had opened his eyes. He was silently gazing and grinning at his wife.
After letting the moment play out for a while, I broke the silence: “What’s going on now?”
L replied: “I am very happy because when I opened my eyes, I see my beautiful wife!”
He was clearly in a different state now – one of contentment and ease.
When we are faced with difficult situations, most of us are quite used to seeking answers from OUT THERE to redress our lack of wellbeing: we get stuff to quell our needs for creature comfort; we get help from others; we try to control what and who is around us; and sometimes, we seek medical attention and medications. All these may be helpful and will have their specific roles in appropriate situations. But if what we seek is inner wellbeing, such as peace and contentment, then the only place where it can happen is IN HERE. Indeed, having too many things to do or get or resolve OUT THERE, we may actually be distracted from seeing what really matters, and what is needed of us IN HERE.
From another angle, it may be argued that it was so easy for L to turn inwards and find his inner peace because he had already been a very spiritual person. But contemplative traditions generally maintain that the capacity to ground ourselves and to introspect is less an innate trait as it is a teachable behaviour – the more we practice, the easier it is for us to use when we need it. As an end-of-life care teacher puts it: this is the work of a lifetime; start now.
Cautionary note: Some may imagine that if only we strive hard enough to get the inner peace (itself an oxymoronic notion!), there is no need for any external interventions. In real life experiences, we often need both – just as we may find it difficult to get inner peace by just focusing on external factors alone, addressing ‘external’ matters are oftentimes essential to create the conditions for us to settle internally. A very common example might be someone who is in severe physical pain from a terminal illness; only when the physical pain is managed (e.g. with pain medications) that the person can be in a better state to do the inner work.
Ending Notes
The modern narrative on the end of life is often crowded and even fore-grounded by a profusion of medical details — of distressing symptoms, unrelenting diseases, futility and hopelessness. But the end of life is never merely a medical event; it is a human experience that reaffirms the inescapable human condition and what it means to really live, if only we choose to turn towards it. “Ending Notes” is a series of anecdotes depicting these human experiences, from which may be aspects that moves, inspires or edifies us about life. While the stories are based on true events, the characters and background have been fictionalised, so that any resemblance to real person(s) is purely coincidental and perhaps reflect how we can as easily identify with the human conditions portrayed.
Taido is a family physician with interest in end-of-life care.
