180 THE TIBETAN BOOK OF LIVING AND DYING I have often seen also that people who are very sick long to be touched, long to be treated as living people and not diseases. A great deal of consolation can be given to the very ill simply by touching their hands, looking into their eyes, gently massaging them or holding them in your arms, or breathing in the same rhythm gently with them. The body has its own language of love; use it fearlessly, and you will find you bring to the dying comfort and consolation. Often we forget that the dying are losing their whole world: their house, their job, their relationships, their body, and their mind—they're losing everything. All the losses we could possibly experience in life are joined together in one overwhelming loss when we die, so how could anyone dying not be sometimes sad, sometimes panicked, sometimes angry? Elisabeth Kübler-Ross suggests five stages in the process of coming to terms with dying: denial, anger, bargaining, depression, and acceptance. Of course not everyone will go through all these stages, or necessarily in this order; and for some people the road to acceptance may be an extremely long and thorny one; others may not reach acceptance at all. Ours is a culture that does not give people very much true perspective on their thoughts, emotions, and experiences, and many people facing death and its final challenge find themselves feeling cheated by their own ignorance, and terribly frustrated and angry, especially since no one seems to want to comprehend them and their most heartfelt needs. As Cicely Saunders, the great pioneer of the hospice movement in Britain, writes: "I once asked a man who knew he was dying what he needed above all in those who were caring for him. He said, 'For someone to look as if they are trying to understand me.' Indeed, it is impossible to understand fully another person, but I never forgot that he did not ask for success but only that someone should care enough to try." 2 It is essential that we care enough to try, and that we reassure the person that whatever he or she may be feeling, whatever his or her frustration and anger, it is normal. Dying will bring out many repressed emotions: sadness or numbness or guilt, or even jealousy of those who are still well. Help the person not to repress these emotions when they rise. Be with the person as the waves of pain and grief break; with acceptance, time, and patient understanding, the emotions slowly subside and return the dying person to that ground of serenity, calm, and sanity that is most deeply and truly theirs.
HEART ADVICE ON HELPING THE DYING 181 Don't try to be too wise; don't always try to search for something profound to say. You don't have to do or say anything to make things better. Just be there as fully as you can. And if you are feeling a lot of anxiety and fear, and don't know what to do, admit that openly to the dying person and ask his or her help. This honesty will bring you and the dying person closer together, and help in opening up a freer communication. Sometimes the dying know far better than we how they can be helped, and we need to know how to draw on their wisdom and let them give to us what they know. Cicely Saunders has asked us to remind ourselves that, in being with the dying, we are not the only givers. "Sooner or later all who work with dying people know they are receiving more than they are giving as they meet endurance, courage andoften humor. We need to say so .. ." 3 Acknowledging our recognition of their courage can often inspire the dying person. I find too that I have been helped by remembering one thing: that the person in front of me dying is always, somewhere, inherently good. Whatever rage or emotion arises, however momentarily shocking or horrifying these may be, focusing on that inner goodness will give you the control and perspective you need to be as helpful as possible. Just as when you quarrel with a good friend, you don't forget the best parts of that person, do the same with the dying person: Don't judge them by whatever emotions arise. This acceptance of yours will release the dying person to be as uninhibited as he or she needs to be. Treat the dying as if they were what they are sometimes capable of being: open, loving, and generous. On a deeper, spiritual level, I find it extremely helpful always to remember the dying person has the true buddha nature, whether he or she realizes it or not, and the potential for complete enlightenment. As the dying come closer to death, this possibility is in many ways even greater. So they deserve even more care and respect. TELLING THE TRUTH People often ask me: "Should people be told they are dying?" And I always reply: "Yes, as quietly, as kindly, as sensitively, and as skillfully as possible." From my years of visiting ill and dying patients, I agree with Elisabeth Kübler-Ross, who has observed that: "Most, if not all, of the patients know anyway. They sense it by the changed attention, by the new and different approach that people take to them, by the lowering