And who by fire, who by water,
who in the sunshine, who in
the night time,
who by high ordeal, who by
who in your merry merry
month of may,
who by very slow decay,
and who shall I say is calling?
–Leonard Cohen, “Who by Fire”
Do you want to die in the ER? In an accident? In fire or water? How about in a nursing facility or a memory care unit? Probably not. If you’re willing to think about it, you’d probably rather die at home, with a compassionate presence nearby. You’d like to be free of unbearable pain. You want to have had a voice, and you want your wishes to be respected.
If you meditate, you may hope to be practicing when you die. Imagine being seated in posture, with candles and subtle incense burning, sporting a serene, Khmer Buddha–like smile as your final breath is drawn, conscious to the last.
The odds are against you, of course. While approximately three-quarters of Americans state that they’d like to transition at home (dying peacefully in one’s sleep is a perennial favorite), only about one-quarter actually do. Many people die a “default” death: in an institution, with decisions made by staff according to protocol and legal guidelines. Most don’t have a living will, and many haven’t spoken with loved ones about end-of-life priorities.
Fortunately, recent statistics show that the paradigm is changing: The topic of death and dying is coming out into the open, palliative and hospice care are gaining recognition, and more and more of us are signing advance directives. We’re attending workshops, having meaningful conversations, and making timely decisions about our effects and remains. We’re preparing, as best we can, for “a good death.”
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