So I spent last night in the presence of death and two exes: exhilaration and exhaustion. And with a marvelous improvisational violinist, Shira Kammen, whose ephemeral music was fitting for the occasion.
Crossing the velvet bridge
There were others there with me, an auditorium filled with people, to discuss the “usefulness” of poetry as a way of transforming end-of-life experiences.
Think of it as a conflagration of physicians, caregivers, and poets, lighting fires for the dying all in the name of poetry.
It was the last in a series of events led by Jane Hirshfield, Hellman Visiting Artist in Residence at the UCSF Memory and Aging Center and sponsored by the Hellman family.
“Poetry & the End of Life” was intense and moving, with prominent UCSF physicians, Buddhist teachers and founders of the Zen Hospice Project talking about their experiences with death and patients facing death.
Here are a few fleeting images that I have not yet had the time to fully process:
A physician telling of his mother’s death experience and then being brought back to life. She was profoundly disappointed to find herself still alive when she regained consciousness.
A physician describing how medical school has changed in the past 30 years. When he was a student, death was never mentioned. Today, medical students are now required to take courses on death and end-of-life care. And the team at the UCSF Center on Memory and Aging now use poetry as a way to cope with and make sense of the tremendous amount of death and loss they deal with every day, actions that appear to be the result (at least in part) of Jane Hirshfield’s year-long residency at the center.
Other notes from speakers:
The bones of ones ancestors rise to the surface during the dying process.
From Jewish tradition: When we fulfill our obligations to help one another, we are enriched. Helping someone die well enriches our own lives.
Care at end-of-life should transform from a drive to cure to a drive to accompany the dying on their journey.
Dying is not just a medical event. We must strip away all of the ways we have defined ourselves, sit down and have a cup of tea with death. We may find that we are not the separate selves that we have taken ourselves to be.
The stripping away process also reveals that the millions we may have made (or not), the trappings of success that we have strived for (or not achieved), is not what defines ourselves as human beings.
Death Poems, traditionally written near the time of death by the person who is dying, is a practice started by Zen monks. One death poem recited by Frank Ostaseski, a co-founder of the Zen Hospice Project, was written by an old woman who had been homeless and on the streets of San Francisco six months before her death. The poem was phenomenal, but I wasn’t able to transcribe it word for word. The woman asked Frank to commit it to memory so that she could be cremated with the poem. He did, and he recalled it from memory last night. The video of the event will be posted sometime in January. You can find it at www.youtube.com/UCSFMemoryAndAging. (I’m sorry. It is no longer available on Youtube.)
You can read examples of death poems here: Japanese Death Poems
Several of the death poems read during the evening ended on a hopeful note, with the authors not just being resigned to but welcoming the process. Some even went so far as to suggest that death was the beginning of the next stage of life.
One physician spoke of his bout with leukemia and how he found poetry to be profoundly helpful in getting through the experience of being near death. Despite this experience, he told the audience that he has not yet “found the courage to use poetry in his practice with his patients.”
I’m thinking that his thoughtful presentation was just his second step toward adding poetry to his clinical practice. He read and discussed Czeslaw Milosz’s poem, “On Prayer.”
He also discussed the following poems:
Raymond Carver, after learning he had lung cancer: “What the Doctor Said” – saying that Georgetown University is using this poem in their “Interacting with the Medical Humanities” curriculum.
Donald Hall: “Without” written after his wife, Jane Kenyon, died.
John Stone (cardiologist): “Talking to the Family” where we get to see the physician put on his white coat, confront a family and patient with the bad news, weep with the family, then take off the white coat and go home to change a lightbulb in the hall.
Derek Walcott: “Love After Love“
The time will come when, with elation you will greet yourself arriving…
Jane Hirshfield: “The Bell Zygmunt” in the book After
At the end of the evening, Jane Hirshfield shared one last poem:
Catullus on his brother’s death:
By strangers’ coasts and waters, many days at sea, I came here for the rites of your unworlding…
I find the use of the word “unworlding” to be extremely satisfying and descriptive of death’s process.
Perhaps it’s because I identified with one of the speakers who called himself “precociously morbid,” or because I’ve spent some time editing academic work on death and dying, or because I’ve reached the five-year point of my mother’s death and the one-year point of my father’s, it was heartening to commune with folks who are thinking deeply about death and dying and are “using” poetry to lift up so many lives.
I can only hope that I will eventually have the choice to die well, surrounded by poetry and the people who know and love me.
I wish the same for you.
Jilanne Hoffmann 
This is so powerful and moving, Jilanne. I’m especially moved by the Japanese death poems. To be able to be lucid enough to create poetry in one’s dying moments is so beautiful. On my grandmother’s last day of life, family members took turns reading poetry to her.
This post will stay with me for a long time. As I’m sure your memories of your evening will.
Thank you for sharing the circumstances of your grandmother’s death. How wonderful for your grandmother and those who had the opportunity to give her such a loving sendoff! ‘ll be posting the death poem by the woman I wrote about in this post as soon as the video is available, and I can listen to it again. I’m planning to get the book of Japanese death poems for future reading. And yes, last night’s memories will be lasting.
What a fascinating conglomeration of professionals. Interesting to see people of science immersed in this issue (as they should be). I had very little education regarding end-of-life care during my medical training. Glad to see that’s changing. How interesting for you to be a part of this.
It was really a magical evening, as was the evening that focused on neuroscience and poetry. There seems to be a sea change regarding medicine and end-of-life treatment that focuses on more than just physical things. Palliative care now includes the spiritual level. They’ve found that attention to the spirit not only improves the quality of life for someone who is dying, but it also helps them live longer. Who knew that attending to the spirit would have such a profound impact? And I don’t necessarily mean it in a religious sense, but with respect to humanism.
And now that I’m thinking of the phrase “sea change,” I am reminded of Ariel’s song in Shakespeare’s Tempest:
Full fathom five thy father lies;
Of his bones are coral made;
Those are pearls that were his eyes;
Nothing of him that doth fade
But doth suffer a sea change
Into something rich and strange.
Very nice. 🙂
My sister died last year of the same type of cancer that my father died of nearly thirty years ago. The difference in end of life care was truly remarkable. My sister wasn’t offered poetry specifically but was encouraged to participate in art, and to discuss her feelings about her illness and death with those near to her. I’m not going to say the change towards emotional rather than medical care made the experience easy, but it made it bearable, for her and for us. And of course, medical care has changed out of all recognition too.
A lovely post, Jilanne – thank you.
I am very sorry for your recent loss, but I’m glad that your sister’s and your experiences were more positive. One can never doubt the transformational nature of any form of art. I just hope that end-of-life care keeps making such strong progress. It is not enough to live well; one should hope and plan for a good death. And as dreary sounding as it is, advance directives, medical power of attorney, and living wills should all be laid out with an individual’s wishes, and discussed with family members. I am going to post the death poem I spoke of in this post after they put the video on YouTube. i think you will enjoy it. Stay tuned!
Indeed, it makes it much easier when you’ve discussed the person’s wishes and agreed on things like resuscitation etc. I was my sister’s ‘guardian’ and it meant there was none of that doubt/guilt that comes when you wonder whether your decisions are being coloured by your own wishes. And good that the medical profession now ask rather than assuming they know what’s best.
What a beautiful post with so much to ponder and digest. I’m going to have to think about this one for a bit.
Thanks, Laurel. Yes, I’ll be thinking about it for a long time. 😀
Wow, this is wonderful. I never knew about the practice of reading poetry to someone towards the end of his/her life. I was with my grandmother during her final days, but I didn’t feel like I could comfort my grandmother at all. I have a feeling poetry would have been soothing, like a familiar path for her to follow. I’m pleased that such a practice exists.
I, too, missed the opportunity to read poetry to my parents. Poetry or no poetry, being their with them was important, holding a hand. The last thing my mother ate was a fragment of a fresh orange I gave her, a taste that was one of her favorites. Surely just being there in those final hours gave them some sort of comfort.
Being there ~ these words bring peace Jilanne
Yes!
Love your opening reference to “two exes”, Jil, and I may dare to mimic it sometime (if I’m not risking copyright infringement!).
This post was bittersweet as I thought about my father’s passing — we definitely gave him moments of a special journey at the end, and I’m glad for those, but too often the medical side interrupted us, too. It’s important to think of our own ends when we think of dying family members. What would we want for ourselves? Whatever that answer is, it’s a motivation to make sure that our loved ones also get what they deserve. A really helpful and important post, Jil. Thanks for that. An early Xmas gift!
Thanks, Nick! Currently, I don’t know if it’s possible to die without regret within the confines of a hospital, as they have such a difficult time letting go of all the procedures/systems used to monitor and keep people alive. Nursing homes are definitely better, especially if the dying person is being cared for by hospice. But home seems to be the best place by far.
You may “infringe” all you like. 😀
Hope the season is treating you well! We’re nearly frozen solid in SF.
You’re right, I don’t think it’s possible, especially in a hospital with all the processes and paperwork.
Excellent, infringement coming soon!
Same to you and yours my friend!
What a wonderful post Jilanne, thank you
Thanks for reading!
This is a remarkable post, and leads to so many other enriching avenues of thinking about dying. Thank you so much for publishing it. (And also for the “likes” and “follow.”)
Hi Jilanne, I really connected to this post. I feel that I am okay with the deaths of my parents. I was with each as they passed, telling them we loved them and that they could go, that it was okay to go. I read all the links you included. Thank you for that. But I am still processing my young granddaughter’s sudden death in May of 2022. She had just turned 13. I think it will take more than a lifetime to accept but I am getting help.
Oh, Gloria. I am so sorry. I, too, am okay with the death of my parents. They’d lived long and full lives and were ready. In fact, my dad often said he just wished his body would give out, because he was tired. But the death of someone so young is far more difficult, I think, to come to terms with. None of us are guaranteed a certain amount of life. I’m glad you are getting help. And I am sending many, many, many hugs across the miles.
Thank you, Jilanne. I feel those hugs.