gold dots of sand running through hands illustration for story about the fear of death
Blue Hands I–X, 2005, perforated digital c-print on aluminum lightbox. © Daniele Buetti

After my mother-in-law’s recent funeral, my husband Bob and his two sisters, Bonnie and Val, took her ashes to the bank of her favorite creek and sprinkled them in. They hiked back with ash-dusted hands.

“I hate to wash,” said Val, rubbing her mother’s powdered body into her palm. “It’s Mom, you know?” I could see the dusty gray ash on her knuckles.

“Were there any big pieces?” I asked. “A few chunks,” she answered, as she turned toward the sink.

Val teaches veterinary medicine. Her sister is a nurse like me, and none of us is squeamish. We do things at work that most people find hard to imagine, and all of us wash our hands with great frequency. I work with cancer patients. Not infrequently, people ask, “How can you stand your job?” They mean different things by this question. Some mean the pain, the deaths, but many simply mean the bodies, the bodies themselves—sick and weak bodies, and all the fluids bodies produce and we try so hard to hide. Part of my job is to help people deal with matters we are all trained to think of as intensely private. I know that bodies leak and smell; I know that bodies fall apart and turn to ash in our hands.

Related: Travel Guide to the End of Life

As Buddhists, we work to accept the impermanence and inevitable decay of the physical body. But it’s not enough to accept it as a fact; we can believe in this and still not want it in plain sight. Nagarjuna said, “Change makes all things possible.” It is only because of change that suffering can end—and it is because of change that our bodies fall apart, like all compounded things. We cannot have one without the other, but we try.

It’s one of the blessings of my work, this intimacy with the authentic, unmasked body, with the body as an object in a world of vibrant, shifting forms. But it isn’t enough. I can talk bluntly about funk and decay all I want, but unless I can squarely face my own body as it is, I’m missing the point. We fear bodily fluids as vectors of disease, but this is actually a modern concern. Our real fear is a deeper and more primeval one—a fear of taint, of corruption. Bodily fluids are vectors of change, harbingers of all that we can’t truly control.

The natural function of our fluids is to invade the world. The word effluvium is from Latin; it means “flowing out.” Our fluids leave us and spread themselves into public space through odor and sight and touch. Every day, my body produces effluence that needs to be managed in some way. Can I manage it without flinching? Feces, vomit, sweat, sputum, blood, semen, urine, saliva, and tears—none of us can escape these things. In fact, if there is anything that can teach us we are more alike than different, it is the sickbed and the toilet. For Buddhists in particular, they are places of great spiritual practice.

People in most cultures are trained from an early age to be somewhat private with their bodily functions and averse to those of others. There is a lot of wisdom in this, instinctive feelings about privacy and sanitation. This kind of aversion, more of a polite avoidance, has an important place in community. But aversion is also a Buddhist technical term, pointing us to a deep koan. It includes a continuum of reaction from mild distaste to deep disgust. It is resistance, obstruction, and desire at once. Aversion is a form of clinging—in this case, clinging to what is not, a desire for change from the way things are. One form of aversion we all know is that of holding onto our ignorance, refusing to accept the whole of reality—picking and choosing what we prefer, and turning away from the rest.

The physical control we maintain over our bodies is an aspect of internal control. It is an expression of all our ideas about what constitutes self and what is truly other. Small children may be proud of their bowel movements, of this interesting thing they have produced. Their natural and innocent inclination is to share what their bodies make—until they are told, by tone of voice and facial expression and command, not to do so. Part of what we are training children to do is keep the body to itself, to hold onto the fiction that the body can be controlled—that it is not the poorly bound sack of fluid that we secretly feel it to be. Westerners are often toilet-trained to a level of fastidiousness so intense it becomes a kind of loathing.

Those who are free or open about toilet functions may be seen as coarse or deliberately offensive. To be simply relaxed about one’s toileting—to be, that is, unashamed—is seen as a kind of licentiousness. It is traditionally a mark of people outside the pale of a society, that they are freer with their bodies and the bodies of others than people in the mainstream. Little social respect is given to those who care for the bodies of others. In the caste system of India, only the untouchables handled corpses. The fact that the Buddha’s disciples made robes from the clothes of the dead and sat with corpses were some of the Buddha’s most radical acts.

I have reared three children and now have three small grandchildren by my eldest son. Their mother has strong feelings about privacy around toileting, and even at the age of three my granddaughter is quite reserved in the bathroom. But at the same time, she is as fond of her own smell as most people are. Smell—effluence—is one of the ways we bond with people we love. The territory of the body is the territory of relationship. We like the perfume of the nest, the smells and flavors we associate with home, with our tribal identity. These may be as different as shared food or a parent’s cologne, but they are always the flavors of bodies themselves.

In a sense, all of Buddhist practice takes place here, in this most intimate realm: here, in the family, shoulder to shoulder with fellow workers, beside each other on the cushion. Even alone in a cave, there is no way out of the sense object we call the body. We meet each other face to face, and so have all our teachers and ancestors met each other. In this way have all the Buddhas taught. Hand to sweating hand.

 Blue Hands I–X, 2005, perforated digital c-print on aluminum lightbox. © DANIELE BUETTI for story about the fear of death
Blue Hands I–X, 2005, perforated digital c-print on aluminum lightbox. © Daniele Buetti

The medieval Japanese Zen master Eihei Dogen described at length the proper way to brush one’s teeth. He tells a story from the Kengu-Kyo, “The Sutra of the Wise and the Stupid,” about the Buddha brushing his teeth with a willow twig. When he threw the twig to the ground afterward, it grew into a great tree under which he preached the dharma. For Shakyamuni, to clean his teeth with complete attention and wholeheartedness was itself the foundation of the Bodhi seat. By brushing his teeth, he made a place from which he could speak the dharma. Dogen notes the cause and effect at work here, but more than that, he is pointing us at the irrevocable nature of the body as the vessel for the Truth.

Buddhist practice requires us, as it were, to encounter the body with the body itself. That sometimes means looking deliberately at what we don’t want to see. It means smelling what leaks out of ourselves and each other, and noticing what thoughts arise with the smells. It means noting our reactions, both physical and otherwise. It means noticing our aversions and turning toward them with curiosity and attention. Dogen was fond of referring to people as “skin bags.” He never tired of reminding us what fragile vessels we are. His own teacher, Rujing, had, at his own request, been Head of Toilets. Dogen developed a great respect for the varied meanings of hygiene and its power in practice. Dogen’s particular wisdom shines most brightly at the precise intersection of the vast view and the blunt act, and in his years of teaching, he sometimes focused intently on taking care of the body. In the fascicle Senjo, devoted to the topic of washing, he wrote, “At just the moment when we dignify body-and-mind with training, eternal original practice is completely and roundly realized. Thus the body-and-mind of training manifests itself in the original state.” The very next sentence refers to cutting one’s fingernails.

Dogen wrote detailed instructions on how to clean oneself after a bowel movement, how to cut one’s nails, shave one’s head, use a towel, brush one’s teeth, and wash one’s face. A certain amount of his instruction is simply the necessary teaching of the untutored, and the kind of attitude required for people to live in close quarters in harmony. Some of the advice is painfully relevant today: For one who is in the toilet, he writes, “Do not chat or joke with the person on the other side of the wall, and do not sing songs or recite verses in a loud voice. Do not make a mess by weeping and dribbling, and do not be angry or hasty. Do not write characters on the walls, and do not draw lines in the earth with the shit-stick.”

Shakyamuni’s life and teaching was based squarely in the management of the body in daily life, and so Dogen’s work is based on a great foundation of teaching about the body. He cites a number of Vinaya texts, several sutras, and Chinese texts on monastic behavior. He grounds the details not only in his current place and time but in history, in the ancestors themselves as the body of the Way. “The buddhas have toilets,” he wrote, “and this we should remember.”

Dogen’s instructions can be minute, covering every aspect of movement into and out of the zendo, into and out of robes, the precise way to fold a towel over one’s arm while walking. He is teaching a level of mindfulness that can be seen as infinite—infinite in its nuance, and infinitely deep in its meaning. By forcing us to consider the most commonplace details, he forces us to consider how details become the vessel of enlightenment. His tone is matter-of-fact when he is describing how to brush one’s teeth, and just as matter-of-fact when he is describing how brushing the teeth is awakening itself. For Dogen the acts themselves are layered with dharma—marbled with dharma, for the deeper mind cannot be separated from using the toilet and folding a towel.

Dogen criticizes those who don’t care about hygiene or reject the possibility of using care of the body as a vehicle in practice. But he also criticizes those who seek after purity, who want to skirt past the messy nature of the human. An earlier ancestor, the famous Chinese woman known as Kongshi Daoren, wrote in a poem on a bathhouse wall: “If nothing truly exists, what are you bathing? Where could even the slightest bit of dust come from?. . . Even if you see no difference between the water and the dirt, it all must be washed completely away when you enter here.”

I can talk bluntly about funk and decay all I want, but unless I can squarely face my own body as it is, I’m missing the point.

Dogen reminds us that we are neither pure nor impure. Awakening is the state of seeing past the false opposites of emptiness and form, purity and profanity. So brushing teeth and having a bowel movement are not acts that can lead us to purity—they are themselves purity. They are complete in themselves. And even so, it isn’t enough just to wash—we have to discover what it is to be this naturally pure form. “Without washing the inside of emptiness, how can we realize cleanness within and without?” Such apparent paradox is part of the endless repeated pairing of Buddhism: wisdom and activity, each incomplete alone. Such couplings are the skin and bones of the Buddha’s body, and they are found in our skin and bones. They are the inside of our emptiness. Aversion is one of a pair; to be averse to one thing implies being drawn to its opposite. But if we are averse to the body, toward what are we drawn? What else is there for us here? “Remember,” Dogen writes, “purity and impurity is blood dripping from a human being. At one time it is warm, at another time it is disgusting.” The opening of the wound may be hard, but the flowing of the blood is very easy. Dogen cautions us not to be drawn into a life solely of the mind or spirit, away from the reality of the body, but to be working always at a true and total presence in the self, here and now—the self, in his words, that is always “flashing into existence.”

If we see the body and its fluids as tainted, we ourselves become tainted—not by the fluids, but by the fear. To be truly untainted is to be free of fear—that is, free of self-concern and self-regard. Impurity lies in fleeing reality on any level, physical, metaphysical, or in between. Both the acts and their meanings—the commonplace acts and the multiplied meanings—must be taken together. This way we are able to step outside both, and embrace both. The opposites of pure and impure disappear. Completely present, we emerge into true purity. One of the blessings of long relationships is seeing the changes in the body of another, and embracing them. We watch our friends and family grow gray and wrinkled and stooped, and this is a gift, a strange kind of nakedness. We watch our own faces change and blur in the mirror, and we are watching endless, endless change. We are watching eternity.

At the end of our lives, we will find ourselves in the hands of others. I go to work. I cause pain, I relieve pain. I clean up vomit and feces and blood. I dig in, and sometimes I get disgusted, from somewhere down near the brain stem and the gut. I keep a straight face. I see how afraid people are of being judged in just that way, how devastating it is for them to confront the way their bodies crumble. They are so afraid that I will turn away, that they are no longer worthy because they are crumbling. But we are all crumbling, all the time.

Now and then, I think about Dogen dying, soiling his bed, being nursed by Egi, one of his female students. I imagine nursing my own teacher someday. I think of the Buddha dying from food poisoning, puking in his death bed. I think of myself washing him, his undefended, old body: his skin as fragile as fine paper, tearing at a rough touch, so thin I can see the pulse of blood along the veins of his hand. I imagine his wasted, bony body, the tendons on his neck standing out plain and clear as he gently takes his last breaths.

I think of Dogen and Shakyamuni, and all the rest, after this last breath—after their bowels relaxed and ran, and their bladders emptied and their eyes clouded over. I think of the flies arriving, and laying their eggs, and what happened after that.

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