Reiki Contra Ross

There is sometimes in hospice a spiritual tendency to refer to the moment of cessation of physical function as "transition" rather than as "death." With all respect to one of the great contributors to compassionate care in the Western World, I have thought of this dilemma as "Reiki vs Ross." What exactly is this about?

Some time ago I was talking about an upcoming presentation on "End of Life Care" with a main stream Protestant Bishop, and he said to me, (in a friendly yet "older brotherly" way "young man, you doctors have no expertise to speak about End of Life, you have only learned about mortal life."

And in fact, Islam, Christianity, Buddhism, and Judaism all share similar beliefs in Heaven. When I ask patients and families what they believe happens when their heart stops (in an open ended way "permitting" them to tell me what they really think) - over 90% of patients say they believe in Heaven - one way or another. Many say, "I'm not religious, but I believe in God." Some have said to me, "thank God we finally found a Christian doctor" (though I am Jewish - my tendency is to be there for my patients, when I am in the room of a patient nearing "transition" I like to think of myself for that moment as whatever THEY are in support of THEM in that moment).

Yet in a recent article in the highly respected Journal of Pain and Symptom Management (Jan 2010 Vol 39 #1) an article scientifically assesses by Questionnaire "the Quality of Dying and Death."

Pragmatically, once we say that the patient must "deal with death and dying" we have, from a Spiritual perspective already condemned the patient and family to a cycle of suffering. We have denied the beliefs of the major faiths, and asserted a hypothesis of science that has no conceivable scientific capacity to test. Yet - I ask myself, if all the major faiths on our planet assert a continuation of spirit after death, and over 90% of the thousands of patients I have spoken with have had such a belief, is this "random" (in a scientific sense). If I tossed a coin and it came up "heads" over 90% of the time could I say, "that doesn't matter."

What if - patients ought to be encouraged to speak of "transition" rather than "death?"

When I have visited Jerusalem and when I have visited Kurama Mountain (a place that a Japanese Hotel clerk who was not involved in Reiki described to me as "the Jerusalem of Japan") - I sensed in both places 3 different "levels" of thought.

At one level there is a perception that God exists - far away - beyond one's own capacity to understand, but exists. It is an incredible feeling that we are not "alone," that we are "connected," and that the world has order and hope, and a reason for compassion.

At another level one senses that one can follow a path, that if only one adheres to a proper path one can be at one with the Creator - and the problem here is that we as human beings, often have difficulty respecting one another's path. We see "far in the distance" what some call "Heaven," what Buddhists call the "Pure Land," but it is far away from us.

At another level we understand what is said in Deuteronomy 30:11 "it is not hidden from you and it is not distant. It is not in heaven or over the seas, but in your own heart." Thict Nhat Hanh, a Buddhist scholar reminds us that the Pure Land is within our own heart, "Buddha did not choose any other place to become enlightened than in our own world."

The language of transition then becomes a language permitting patients and families to make these moments precious, and to allow in these moments the faith hidden within their own heart to emerge. Reiki assists in doing that - whatever the faith - by simply opening a door and being present. We are here and in a compassionate way we care enough about you to simply "listen." We do not see you as "dying" or leaving the "living," we see you in a more important fashion, a human being near a journey of "transition." We sit with you, not in judgement of you. We do not place you neatly into categories of "grieving" - but as a flower that is opening. We are - quite simply - here.

The patient in this moment is not condemned to the path of suffering that follows from the confrontation with impending "death," or the process of "dying." The patient - if they choose, has the opportunity to share with us the journey they perceive happening within themselves, what we call a transition to "the bonds of eternal life" or "life everlasting" and what the Buddhists call the opening of the Lotus.

Are we up to the challenge of simply being present and compassionate at a time of "transition," or does our training and "white coats" - (all of which have failed the patient to bring the to this moment) - need still to assert our "control" and scientific evaluations of the quality of dying?

For some of us, our goal is to assist the patient in living as well as possible - for the precious time that exists. Allowing with humility that faith may have value where science has limits, we may help our patients (and ourselves), to turn toward an infinite light, rather than demand that we face a limitless void.