I first learned about how to be with the dying from Suzuki Roshi when he was diagnosed with metastasized gall bladder cancer. His wife and I took care of him around the clock for the last months of his life. I then took care of his body so that his students and the members of the Japanese congregation that he practiced with could sit with his body and say their farewells.
Within a year of Suzuki Roshi’s passing, people started asking me to be with them when they were diagnosed with a terminal illness. In doing this, I have learned a great deal about how to be with dying and death. While everything I describe is legal and could be done by family and friends, people who have no training often seem reluctant to do this without the presence of someone who has more experience.
The first step is to find a chair and place it at the bedside of the person I am with so that I can be near, but not touching, the person in the bed. Touching the body as someone dies often is more for the survivor; it may interfere with the process for the dying person, increasing their suffering. One can be totally present with a dying person without any touching, but just by breathing with him or her. I make sure I am situated so that I can see the person’s breathing at the chest or at the stomach area. I always tell the dying person what I am about to do, even if he or she is in a coma.
I begin by following the person’s breathing. If the breathing is fast and shallow, I may take one breath to his or her two or three breaths. If a dying person is in a lot of pain, I have found that it can be helpful to make the sound of “AH” on the exhalation, allowing the person to join me. This practice can support the dying person, moving him or her toward allowing—rather than resisting—what he or she is experiencing.
If possible, I invite him or her to say good-bye to family and friends, and to give away precious belongings. This seems to help in turning toward the dying process itself.
After the person has passed, I then prepare the body so that I can sit with it for three days. Out of respect for the person who has died, I do not begin the washing process until about an hour has passed after he or she has taken the last breath. I do not want to interfere with that first hour of transition on the part of the dying person. At that point, I close all of the orifices of the body with cotton balls and gauze pads as appropriate. If I am taking care of a man, I place a rubber surgical glove over the penis after placing some cotton balls in its opening. It is important to close all openings, since shortly after the person has ceased breathing there is a relaxation in the body that leads to a release of all of the bodily fluids. Closing the openings helps prevent the smell, which can be an obstacle for people sitting with the body. The next step is to wash the body with tea made with yerba santa.
After washing the body, I put a clean ironed sheet on the bed under the body, a rubber sheet under that, another sheet on top of the body, and a small pillow with a clean ironed pillowcase under the head. I take a piece of gauze and tie it around the head and jaw so that the mouth will be closed as I sit with the body. I put a coin on each eyelid in order to keep the eyelids closed. After about an hour, once rigor mortis has set in, I then remove the gauze from around the head and take away what I have placed on the eyelids.
I do what I can to keep the room cool and to remove all evidence of medicine and sickness. Family and friends coming to say good-bye may bring flowers that can be put into a vase or put on the sheet that covers the body. I use herbs, especially if I have access to native herbs, and rose petals to put on top of the sheet. I suggest waiting three days, until consciousness has fully left the body, before taking the body to be cremated or buried. If keeping it at home is difficult for the family, then it can be taken to a mortuary or crematorium, where a priest can sit with it until the final disposition of the body happens.
I suggest that people who have a close relationship with the person who died make a home altar with the person’s picture and other objects that were important to that person. People might bring a flower, a stone or some gift and take a few minutes in front of the altar to talk to the person who has passed. I encourage those especially close to make a practice of spending a few minutes before this home altar each day for seven, forty-nine or one hundred days or, in some cases, one year.