[Woman vocalizing] [Playing jazz music] Carlos Santana: Well, the Beatles--"All You Need Is Love," "Imagine"--John Lennon, "What's Going On"--Marvin Gaye, you know, they're all saying the same word-- invite one and all to rekindle your aspiration.

Otherwise, you're going to have a really almost, like, a wasted incarnation.

I want to quote, uh, Satchel Paige, who dismissed things by saying, "How would you be if you didn't know how old you was?"

That means that even age, gravity, time, it's all an illusion.

Phil Cousineau, voice-over: On the edge of this ancient hillside city lies the Assisi town cemetery, where generations of Italians have come to make peace with Sister Death.

Here in Italy, as throughout the world, living and dying are deeply connected.

It seems that our most basic understanding of life is largely determined by our understanding of death.

All of this makes me wonder, how can each of us in our everyday lives better prepare for the inevitability of death?

Can death actually be a transformative experience, and if we can talk about the art of living, can we talk about the art of dying?

To explore these and other questions, we are delighted to bring together two teachers who have worked intimately for many years with the dying.

Therese Schroeder-Sheker is a lay Benedictine.

She is the founder of the Chalice of Repose Project and a palliative medical modality known as music-thanatology.

Frank Ostaseski, practicing Buddhist, is the co-founder of the Zen Hospice Project and currently serves as the director of the Metta Institute.

Welcome to "Global Spirit: The Art of Living and Dying."

Welcome to "Global Spirit," Therese Schroeder-Sheker.

Welcome, Frank Ostaseski.

I deeply appreciate this chance to speak with the two of you about such an important topic, and where I'd like to begin is, in your own work, what have you found that people have tended to focus on in those last days and hours?

Well, I think, uh, of course, people focus on different things.

Initially, there's the whole question of survival and, um, "How will I meet this illness?"

um, the issues of pain and emotional suffering.

Then, I think, there are two big questions, and they are, "Am I loved?"

and, "Did I love well?"

I think those are the two big questions people face at the end of their lives.

Yeah.

Therese?

Yeah.

I'd agree.

I'd agree, uh, and sometimes the question, "Is there anything left that remains-- that needs to be said?"

Um, sometimes the intimacy can be so great when the vulnerability has increased that if, uh, in other times, it would take weeks and weeks and weeks of conversation, but sometimes when something is right, cooked down to the essentials, sometimes all we need is one or two sentences and--and direct contact between us, so-- This seems so natural, and yet, for most people, there's a lot of fear at this moment, but what are people afraid of-- loss, pain, the unknown?

What do you think, Frank?

You know, um, first of all, we are afraid that it's gonna hurt.

Now, we can do something about that.

We can--we can address people's pain, and we need to address their pain.

Um, then they're afraid that there won't be a future with them, that they'll be emotionally abandoned because, uh, there's no future, uh, that they can share with another person, but then there's something much more fundamental, I think, and it is that the process of illness is a stripping-away process.

All the ways, I've defined myself-- I'm a father; I'm a talk show host; I'm a Buddhist teacher-- all of those identities fall away, and then who am I?

And this question, I think, is what troubles a good many people--who am I when I'm not all the things I've defined myself as?

That--that's-- I--I would agree 100%.

Uh, sometimes you see something similar after somebody has retired, and when you're no longer the department chair of Oncology or whatever it is, who am I now, uh, as all these layers of identity either fall away or are taken away, and I think the walking into the unknown is huge.

I--I've had many people-- I've heard many people say that they were not so afraid to die, but they were afraid of the idea of unmitigated pain if they didn't have enough pain meds and, um, certainly of being forgotten.

Yeah.

Hmm.

Well, this is a propitious moment, then, to listen to you and respond to your work by looking at a video segment which gives us some perspective from your 900-year-old tradition.

Schroeder-Sheker: The historical spiritual inspiration for the work of contemplative musicianship and music-thanatology finds one of its primary resources in Benedictine Cluniac life, particularly in manuscripts of the 11th century, and we read those documents and say, "What can we learn from these today?"

In their infirmary documents and in their values system, you know, they don't say even the day of death, so they don't use the Latin "morir."

They use a different word and the word "Transitus," a movement, passage, and it implies motion and evokes this whole notion that in the human biography is an entire series of rites of passages.

In the Christian tradition, we--we have the notion that our biological death is not an end.

It is not a finality, but, in fact, a movement, Transitus, a movement, passage, a voyage, journey, and if we give any validity to nature and to what happens in the world, we see things blooming and coming into first little, precious, tender sprouts and--and--and little, green, delicate things and blooming into fruits and flowers and vegetables and then coming of age and slowly kind of dying and decomposing, and it's all part of one cycle... but I love the fact that the Benedictines and the Cluniac culture accepted death into the human life cycle.

They didn't try and separate it from daily life or perception.

They looked to what it can give us and teach us.

"Where have I been really loving?

"Where have I missed the boat in loving?

"Are there any acts or conditions or postures "of forgiveness that could bear fruit right now?

"How does that blossom out into the world, into the universe?"

Deeply moving segment, Therese, and I'd like to explore this aspect of the end-of-the-life question and the relationship of love.

That's, uh, pretty poignant when you say that so many people ask themselves, "Have I loved enough?

"Have I been loved enough?"

What's the role of love in this work?

Biggest question in the universe.

Um, without love, I don't think that the caregivers can go on being present.

Um, I can definitely say I've played for many, many, many inner-city people who had no family, who had no friends, who had no support system, and somebody might say, "Oh, well, they haven't been loved."

On the other hand, I've seen the way doctors and nurses cared for them as if they were their own flesh and blood and lavished them in love, and, um, love is probably one of the most profound currents and energies in the world, and the dying always know if we're being truthful with them, if we are approaching them with love, and that can create room for new love to blossom, even if it hadn't been possible in the past few years of their lives, um, so I think there's always room for something new, and that's what I mean by dying and becoming are always blossoming together, even in these most crucial moments, even when you're hemorrhaging, uh, dealing with the tumors and all the rest of it.

I--I think that the work of love is the most fundamental piece of, um, being with anybody, period, whether we're talking about working in the hospital or hospice or just living our lives.

Well, also, you know, we often think about-- when we think of love, we think of romantic love, or we think of familial love, but, well, it's useful, I think, to think about the qualities of love, the--the nurturance of love, but above all, for me, it's the receptivity of love.

I mean, in my experience, when--when love enters, it doesn't chose sides.

It just embraces whatever it comes into contact with, even if, at first, that thing or that person seems completely unlovable, and so it functions as a kind of healing salve, we could say, a certain kind of holding in which, then people can relax.

They can rest.

They can trust.

Yeah.

The way you did that reminded me of something I've heard you say previously where in these moments, breath is the only thing in the room.

Ostaseski: You know, um, when you think about even the story of Genesis, God making the world, you know, God, uh, says, "Let there be mountains," and there are mountains, and, "Let there be oceans," and there are oceans, but then when He comes to making man or humans, He does something quite different.

He breathes into man.

He breathes into the human being, and so breath can take us to places beyond where words can take us.

Breath is the transcendent, that which can bring us to God, to the ground of being, to the soul of our nature.

Yeah.

Yeah.

That's remarkable.

I worked on a book about soul many years ago from Socrates to Ray Charles and found out that in cultures throughout time or all around the globe, the word for soul, spirit, and breath are identical.

It seems to be our name for that mystery.

A breath, where does it come from, and then where does it go when we die?

Well, when--when someone is dying, uh, as Therese mentioned earlier, you know, all of the identities are being stripped away or unbinding in a way, and what remains is breath, the simplicity of breath.

Is this your experience, as well?

Uh, absolutely, absolutely.

It's no longer important that I went to Harvard and graduated magna cum laude and earned this much money.

These are falling away, and, um, we enter this new place, and so rather than all the layers of identities which used to separate us from one another, what is left is heartbeat and breath, and certainly, with music and music-thanatology, that's what we're left dealing with so that they can rest into-- rest into their own process, their own process, the depths of their own process.

I mean, it's curious to me that we've severed death from life.

We haven't done that with birth.

We recognize birth as an essential part of life, but we've severed the dying process.

Uh, out of dying is always becoming.

Always out of dying is becoming.

A tree falls in the woods.

It decomposes and becomes something else, doesn't it?

Yeah.

Now, this is mysterious as to how this happens, and none of us can say for sure exactly how this goes--goes about or what happens specifically after we die-- who can say?-- but it's not a full stop.

This we can be sure of.

Hmm.

Process.

Schroeder-Sheker: Yeah.

It's a process, and one of the things I think that, uh, it--it invites, a whole new quality of, um, modesty and humility because you suddenly realize, even if we're really present to each other in this moment, I don't have Frank's whole story.

Frank doesn't have Therese's whole story.

What we have is this moment, this snapshot, and takes some stepping back to get a much larger sense of an arc.

Should we qualify this notion that we have separated life and death, a kind of binary system?

I think we have done that in America, but there are other cultures in which life and death are almost indistinguishable.

It's a good point.

Thanks for bringing it up.

I do think that in America, where we are more oriented toward the externals of life, the material-- our material possessions, our achievements-- we tend to put-- we tend to see death as failure.

we tend to see death as defeat, um , as opposed to--to being an integral, um, part of our existence, you know part of our life.

Yeah.

Frank, this is a good moment to look at some video of your work, and then afterwards, we'll come back and discuss it.

Oh, great.

Ostaseski, voice-over: Much of what I do in accompanying the dying is bearing witness, and in this context, bearing witness means giving our full and complete attention, whatever's arising in the situation or to whatever's emerging in the person that's dying.

This kind of attention is a compassionate act... and this compassion is felt as a kind of attunement between myself and the other person.

When this attunement is present, the heart of the other person recognizes it and feels it, and so it opens... and they go toward things that would otherwise seem very dangerous to them not because everything is safe, but because they feel understood and accompanied.

They are willing to move toward their suffering, and it's in the moving toward our suffering that our healing is always found, and so to be with people at this time is actually a great gift, a great gift for us as the caregiver, and I often bow to them as my teacher because I know that they can show me something about how to live this life more fully.

We often think about death as something that happens at the end of our life or at the end of a long road, but it's with us all the time, always here.

It's sitting on our shoulder, keeping us company.

I love the passage here, Frank, where you say that the dying process itself can teach us how to live more fully.

That's wonderful, that's poetic, but how does it do that?

The process of dying is a clarifying process.

It shows us what's most important, yeah?

I've had very few people that I've been with at the end of their life who told me that they wished they'd had a second Mercedes or that they'd worked more in their life, you know, so it's a clarifying process, I think, and--and, um, I'm not so sure that we can actually prepare for our dying as such, but I know that we can use dying to show us how to live our lives, yeah, and the tragedy for me is not that people die.

The tragedy is that we wait until the time of our dying to do the work of a lifetime.

I mean, it's an absurd gamble to imagine at the time of our death, we will have the strength of body, the emotional stability, the mental clarity to do the work of a lifetime, so our--uh, uh, we're encouraged to practice now, to study now, to die now.

Right.

It's reminiscent of the memento mori, the skull on the desk of the writer, the scholar, the painter, the mystic, not in a morbid sense, but just, "I better remind myself on a daily basis I'm not here forever."

Yeah.

Therese, what comes up for you about this?

Uh, this thankfulness for the life I really do have is, um--is also an amazing teacher.

I don't know anybody for whom our life, or your life--your life-- Our lives don't ever turn out the way we had imagined them to be, so we're all the time being asked to enter the unknown.

It's just that the process towards the end warms and clarifies it, so my sense is that culture describes it as though we die once at the end of a biography, but I--I think we're letting go of old ways of being many times throughout the journey and letting go of old identities, and that's a big preparation for, uh, tra--transition.

Suddenly, you're realizing that you don't have all the time in the world to--oh, to hold your child, to say, "I love you," whatever it is-- students, family, whatever, whatever it is-- and that every moment really does count.

It's--it's incredibly powerful.

It magnifies everything, um, and it--it--it also keeps on coming back to the whole idea of gratitude, and also in your photographs, I saw something really important.

I saw your caregivers are really present so there's a strength.

They're really present, and, uh, I think the--the people for whom they were caring, then, could trust, could lean into them, and so one of the things that I saw in those images is a--is the dual presence of both strength and tenderness.

Bo--both strength and tenderness in equal proportion just, ooh, uh, makes it very alive.

For me, just the way that you're moving your hands, the mudras, your hand gestures suggest the importance of touch in all of this, and how can we be tender with ourselves or with the dying or with the families unless we're actually touching, and, I mean, is-- isn't it true that in these situations, people are afraid sometimes to touch?

Ostaseski: Of course they're afraid, and-- and people whose, um, bodies are changing have all kinds of issues about their own self, uh, um, their self-esteem and their self-image.

Look.

Touch is the oldest form of healing.

We all need to be touched.

People are touched in hospitals all the time.

They're--have PICC lines put in them, and they have all manner of procedures done to them, but rarely is that touch experienced as a healing presence.

I think what Therese is speaking about is the naturalness of our human presence, yeah?

You know, my grandma used to give the best head rubs, you know?

She never took a massage course.

She never trained for this, but when I was in her presence, I felt like I was the only one in the world.

I felt like I was the only one that really mattered, and I would just lean back into those confident hands and relax, and I think, um, we all need that as human beings, you know, so touch is essential, and I think, yes, we are afraid to touch people who are sick, and this is a fear that we need to meet and confront and not be swept away by.

Schroeder-Sheker: Yeah.

It's like the whole world is your altar.

Heh.

Um, working with anybody intimately and, uh, genuinely establishes some kind of rapport that is unlike any other rapport we have, and, um, I--I have this sense that, um, there's not only the literal touch of how we might, uh, pay attention to pulses and vital signs and all that, but also even the way we use our voices is a kind of touching.

Uh, if I come in loudly and, uh, you know, bang on the pillow and, "How are you doing today?"

and--it--it--that's a kind of abrasive quality that--that is very much akin to touch, but if the way we're speaking with one another eye to eye, gesture to gesture, that's an extension of touch, you know?

When--when I'm training health care professionals, one of the things I ask them to look at is, what's the moment when you first begin to touch the patient?

And it usually happens a long time before we ever physically touch them.

We touch with our eyes when we scan the room.

We touch, as you're suggesting, with our voice.

It can be modulated and calm or, uh, driven by agenda.

I think we touch with our ears.

We touch by the way we listen to people, the sound of their breath, um, uh, the stories that they want to tell.

Schroeder-Sheker: Sometimes somebody who's dying hasn't been touched in maybe 20 or 30 years, and you can't compensate for lack-- that--a great body of time in which somebody hasn't been touched for a long time in the last few moments, but I wanted to say, there's a strong relationship in our work with the way we might touch and activate the harp strings really conveys something equal.

They know that that's how we would be touching them, and they--they know exactly what kind of strength and tenderness required to make those strings sound beautifully.

Uh, we say that in ordinary language, right?

"That music touched me."

Maybe music is a kind of promise of touch.

"If someone weren't afraid of me, maybe I would be touched this way."

Mm-hmm.

Mm-hmm.

I'd like to address one more thing that came up in that wonderful film clip of yours, Frank, where you say, "Moving towards our suffering is where healing is found."

Moving towards our suffering, what does that mean?

You know, we have a strong habit in our culture to turn away from what's difficult, to turn away from the stress and suffering of our lives, but in actuality, um, the healing, the--uh, the learning occurs by turning toward the experience.

Originally, the word "compassion" meant to suffer with, Yeah.

so I wonder, in a culture where we are such die-hard individualists, is it harder for us to actually bear witness, take a moment out of our own lives to bear witness to somebody else's?

I--I think our-- our human presence is the most undervalued, um, offering that we can make.

Um, our presence, our ability to be mindful, our ability to be compassionately available to someone, you know, is the tool that we can use in almost every situation, yet rarely is it valued as being important.

Our attention, our ability to pay attention to one another, is probably the most gracious gift we can offer each other.

Um, I can't think of anything that we're really asking for more than that to one anoth-- of--of one another.

And that's about listening and responding, isn't it, Yeah.

listening and responding, listening and responding instead of being, uh-- Maybe an opposite would be where I'm so distracted, so utterly full and preoccupied, I don't have room to receive you.

So how does that play out when you're playing?

It sounds beautiful, listening, responding.

I'm wondering how that works as you play your harp.

Schroeder-Sheker: I have to practice periods of silence, li--literal silence in my life, and I have to fast from sound sometimes in order to play music in a new and living, streaming way.

I actually have to consciously choose to have times of emptiness in order for me to even hear what's possible to respond to you in a completely new and unique way so that I respond to you, uh, Frank, utterly differently than the way in which I would respond to you because you're so different in constitution and temperament and condition and story and narrative and all that.

Ostaseski: You know, I--I don't have any idea how people should die.

I used to have lots of ideas about it, but I don't anymore, you know, particularly since my own heart attack, so I have less and less, um, understanding about how this dying is supposed to happen.

Um, what I try to do-- and I'm sure you do in your work, as well--is listen.

I listen very profoundly.

I listen for their truth, even if it's one that I don't agree with, so for me, some much of the work is learning to stay in the room when the going gets rough, you know, uh, staying present in the territory of unanswerable questions, actually.

Uh, for me, this is the work of being a companion to someone near the end of life.

Look.

When I'm dying, I want mastery.

I want a physician, a nurse who knows what they're doing.

I want my pain to be controlled.

I want my symptoms to be well-managed, but that won't be enough.

I want somebody in there who's comfortable in the territory of meaning with me, who could help me see what the purpose and value of this life has been, but even that at some juncture falls away.

Meaning falls away, and there, we enter into an entirely new territory, and that's the territory of mystery... Schroeder-Sheker: Yes.

Thank you.

territory of unanswerable question...

Thank you.

Thank you.

um, and this is, um-- there's endless discovery here, yeah, and this door is open for everyone, ordinary people and mystics alike.

Schroeder-Sheker: I just think that when we're really being born or we're really becoming or we're really dying, it's not neat and tidy like, "This is good.

"That's bad.

This is joyous.

This is sad.

This is anger.

This is, uh, peace."

I don't think it's that tidy.

I think everything about our life processes, no matter where it-- they may fall in the spectrum and the journey of life, I think that there always a mix, and that's why we were trying to say before, dying and becoming, the garden, blossoming, decaying, all those things are found together.

Look.

Dying is the most human experience we will ever go through, and it includes it all.

It's a messy process, and it will include anger and sadness and numbness and depression and incredible fear, but there's a way in which we can relate to these things as if they were storms moving through the room, yeah?

They aren't the only thing that's happening.

They are storms moving through a particular period of time, but what else is here?

So sometimes we have to ask that question-- what else is here in addition to this anger, the storm that's passing through right now, yeah?

Is this something you ask yourself?

I think when I'm-- when I'm with someone who's dying, I'm always looking at my own grief.

I'm looking at my own relationship to loss.

I'm looking at my own sense of anger, my own fear.

I have to be.

That's what allows me to build an empathetic bridge to the other person's experience.

Um, I was with a guy once who, uh, was screaming at the top of his lungs.

"I can't breathe in this place!"

he would scream, and everybody was frightened of this fellow, and they said, "You got to go talk to him."

I said, "I'm scared of him.

I don't know if I could talk to him," but I sat down-- went into the room, and I sat down, and this is my favorite intervention, just simply to sit down.

When I sit down, I'm less likely to run away.

Sitting there in the room with him, he's screaming at the top of his lungs that he can't breathe, and I realize I'm not breathing very well, either, so I contact my breath.

As I feel my breath in my belly, I'm a little calmer.

Then I realize my feet are cold.

I can't feel them.

They're not on the ground, so I put both my feet on the ground.

I reach under the covers, and I begin to hold his feet, and now we have another kind of connection.

He's still screaming.

I said, "Take a breath in."

He took a breath in, and I noticed that as he took a breath in, he wasn't screaming so much, yeah?

As he began to calm down a little bit, I said to him, "You know, so many of us around here, we really love you, you know?"

and he said, "Yeah?

Who?"

and I--I--I reached for the archetypical.

I said, "Your mother," because that's the love we always want, yeah, and he said, "Oh, I hope so," and we were now in a whole 'nother conversation, you see?

If we had been--if we'd been frightened of his fear, if we'd only flid--fled from the room and we weren't willing to meet him, we weren't willing to meet our own fear, that conversation never would've come about, yeah, so all of it is part of the mix.

As--as Zorba said, the whole catastrophe's there, yeah?

Is the fear different for atheists and agnostics than it might be for someone with more traditional religious beliefs, or is everybody the same with one foot on the edge of the cliff?

Ah.

Um, I think people's relationship to faith, um, can alter dramatically their relationship to fear, although worked with a fellow who was the president of the California Atheist Association.

When I said to him, "What do you think's gonna happen after you die?"

he said, "Nothing."

I said, "What do you mean, nothing, like a dial tone?"

and he said, "No.

Nothing," and I said, "Well, will you have a nose?"

He said, "No.

I won't have a nose.

"I'll just be there.

"I'll just be molecules mixing "with all the other molecules in the universe."

I thought he was gonna be just fine, you know, yet everybody has a sense of what happens after we die, everybody.

We all have a story about it.

It's not my job to impose my story.

It's my job to discover theirs.

Schroeder-Sheker: Yeah.

Yeah.

Yeah.

Absolutely.

A--as a Buddhist, do you have a different response to this?

My, um, beliefs, my faith are supports for me, but they're not something I necessarily want to impose on someone else.

What I do know is that everything changes.

This I can witness in my life.

I don't have to have a--a belief in this.

I can bear witness to this experience.

When I know that everything changes, um, I tend to regard dying as another change in the--in the--in the experience of life, and so it isn't as frightening as it might have been before I began to really embrace and own it.

Cousineau: Let's immerse ourselves a little deeper into these thoughts by showing now a video segment of your practice at your zendo.

Ostaseski, voice-over: The process of dying and the process of meditation have lots of similarities.

There is a withdrawing from the world, a turning inward, a gradual practice of silence, a stance of humility.

In meditation practice, we go beyond the sense of self to recognize something more fundamental in our nature, and the same is true in the dying process.

As we are stripped away of our identities as the things that have previously defined us, we open to a deeper dimension of who we actually are.

In Buddhist meditation, we study life-- that's our practice-- and this brings us beyond the realm of concepts and beliefs into contact with the immediate and direct truths of our life, the truth of our interconnection, our interdependence with one another, and the truth of impermanence.

When we begin to really rest into the truth of impermanence, we have a sort of ease with constant change, and so death doesn't come as a surprise to us.

Rather, it's the natural outcome of a life fully lived.

Nature, in some ways, is our greatest teacher.

It's always showing us about living and dying.

It's helping us to appreciate just how fragile this life really is, how precarious it actually is.

[Birds chirping] Everything is coming and going.

Things are being born, and things die.

When we come to appreciate just how precarious this life is, we also come into contact with how precious it is.

Then we don't want to waste a moment, and we want to step into our life with both feet.

We want to tell the people that we love that we love them.

We want to live our life fully and completely.

This is a process of continuous discovery that requires flexibility and risk-taking.

It asks of us to forgive constantly and to be willing to not know how it's gonna turn out.

Forgiveness seems to come up with everybody in the room-- the patient, the families, the staff--so how do you deal with it?

Ostaseski: You know, I-- um, I would never tell someone that they should forgive, but I would say that in about 90% of the cases that I work with, people at the end of their life, forgiveness has been an essential part of their healing.

Um, forgiveness is about touching with mercy that which we have held in, uh, judgment.

Um, it is about releasing that which we have clung too tightly to.

The image I often use is squeezing a hot coal in our hand, a resentment that we've been holding maybe for years and years and years, and forgiveness is the experience of simply opening our hand and allowing the coal to drop.

Schroeder-Sheker: I think a lot of times, it's actually some of the easiest work to-- for one person to forgive another situation or an event, and it's the hardest to forgive ourselves of our own things that "we used to call" failures.

I think that, for many-- uh, many, many very independent people, that may be a difficult piece, to forgive ourselves.

For me, forgiveness isn't about forgetting.

It isn't about condoning bad action.

It is about healing our own hearts.

Schroeder-Sheker: Mm-hmm.

It is about not holding on to what would close our hearts, yeah?

When we're dying, we want to be free.

Forgiveness is a step toward that freedom.

Schroeder-Sheker: Mm-hmm.

We live in a competitive world today, and sometimes people think that being bigger, better, faster, and more is some sort of success, but the subtext there might be that if you're any good, you should be aiming for perfection.

I've never seen perfection bear fruit, uh, not really.

It seems like it could get in the way and be sterile.

Is there anything that you can say or we can say, that a family can say entering the room to help someone take that pressure off themselves?

There's two things that are really important-- 3 things.

One is to say, "Thank you"... Schroeder-Sheker: Yeah.

just to say, "Thank you.

"Thank you for the life that you've given us.

"Thank you for the lessons that you've taught me."

I think this is unbelievable, and the second is to say, "I forgive you.

Yeah.

"I forgive you for whatever you might "have done, consciously or unconsciously, "that caused me harm.

I forgive you," and then finally, to really lean in and say what's true-- "I love you.

I love you," yeah, so these 3 things, I can't imagine that there are more powerful gifts that we could offer people near the end of their life.

"Thank you.

I forgive you.

I love you."

Schroeder-Sheker: Mm-hmm.

Mm-hmm.

Uh, gift and-- and giving seem so closely identified.

When we forgive, we're giving somebody a gift, and we're also giving ourselves a gift at that moment.

Mm-hmm.

You used the word "gift," both of you.

You seem to use the word "gift" a lot in your work.

Can you talk about that?

I--I work in hospital systems, and, um, I'm also a teacher, and so we have to mentor the student interns.

They were present.

The man was dying.

The doctor, primary care physician, came and showed up, sat on-- fir--well, first stood far away against the wall, then slowly approached the bed, then gingerly sat on the side of the bed, and the patient opened his eyes and looked beautifully and directly in the doctor's eyes and took him into complete disarmament, and he stretched out his little, bony hand and said, "I forgive you," out of the blue, and, of course, he meant for everything that he went through with the cancer regimes.

"I forgive you the radiation, the chemo, the stem cell.

It was all really difficult.

I forgive you."

Doctor was so disarmed, he took big in breaths, and all of the students were present and witnessed this.

It was such a teaching, and the doctor gulped and said, "Uh, uh, uh, uh...

I love you."

He--he'd practiced medicine for 30 years and never said that to a patient before.

That's something that all the students and teachers remember, but it completely took the doctor by surprise, and--and it was the most innocent and truthful thing for the-- for the dying mane to say, and he meant every word, one sentence.

This is a perfect chance to go back and see some of your work where you weave together your beautiful talents for music, compassion, but also silence, when to know to be silent.

[Bells ringing] Schroeder-Sheker, voice-over: What really inspires me as a modern woman is the notion of an interiorized monasticism rather than becoming a member of another order... so I've been working out in the world, but I love the idea of an interiorized monasticism.

[Harp playing] I would describe my own relationship to musical artistry and to the care of the dying through the lens of what I've come to call contemplative musicianship.

Everything about harp is the picture of strings being completely stretched and pulled in opposite directions to maintain the tension of opposites.

That's a contemplative orientation.

The body of the harp is completely empty.

You can't even create beauty of tone without this inner emptiness.

This has filled me with great inspiration.

Our practice is called music-thanatology, and so everyone with whom we work is either processing the approach of their own death or actively dying.

We play music in such a way that we phrase with their inhalation and their exhalation, so I have to make room inside of myself to hear you, to receive you, to meet you as you are instead of through some interpretive lenses.

If we can help people facilitate their own depth, than we can help them facilitate a conscious death or dying, letting go, unbinding at their own time, at their time, not your time, not my time, not hospital time... in amidst dialysis and pumping machines and ventilators and life-support systems, at their time.

If I go into a room with a preconceived notion of what somebody needs, I'm of no service at all.

I'm not even present, so I--I have to go-- practice inner emptiness first and-- and then come and listen and breathe with them.

Is--is this analogous to what you said before, that if you try to play music on your harp that you've played before, it's dead music, as opposed to music that's alive and in the moment?

If--if I'm trying to play exactly the way I played it last Friday night when I played it really well, I'm trying to imitate a shadow of something that's already gone by, and that's where I become dead, uh, or--or the music that I'm playing is less than alive.

If I'm absolutely risking entering the unknown and playing in a whole new way, uh, then living, streaming music can happen, and that's very, very different.

It's completely different.

We don't have recipe lists that you play this when somebody has cancer and that when they have end-stage COPD and that-- That sounds ridiculous, but actually, people who don't know think that maybe that's what we're doing.

I--I see a paradox here, as well, that, where on one hand, it seems to be very wise to say, "Let go.

Feel the room.

Read the room," on the other hand, many of us simply feel a sense of urgency.

My own mother has been very sick over the last year, and I have felt that when I go to visit her.

We have to talk about things that need to be talked about, my brother and sister, friends and family.

I want to go in and be absolutely in the moment.

On the other hand, there's a kind of responsibility to the way our lives have converged at that moment.

How do you balance the notion of surrender and urgency?

Ostaseski: So can't you go and be with your mother and ask her a question that needs asking but also be open to a different kind of response than you might have been imagining?

That's how we be present.

We--we're present simply by being open to whatever comes to us, doesn't mean we have to like or agree what comes to us.

It just mean we have to be willing to meet it.

Cousineau: Now, I know you've had your own brush with death in these last few years.

How did that episode affect the way you now deal with those in the dying process?

You know, it's a different view from the other side of the sheets, I say.

My own brush with death, I had a serious heart attack.

Um, uh, the result of that was that it left me feeling very vulnerable, extremely vulnerable, and at first, that vulnerability was experienced as something like helplessness and weakness, as dependency on others, but gradually as I stayed with it, I saw something that my patients taught me.

They taught me how to be porous, how to become more transparent.

That's what happens in the dying process.

Um, as illness strips away our identities, we become something of a more transparent thing.

Schroeder-Sheker: I--I was so impressed with the power of vulnerability, and--and in the Christian tradition, we've got that Pauline sentence-- "When I am weak, then I am strong," and one of the amazing pieces that comes with that vulnerability is coming to the place where you ask for help... ask for what you need.

Uh, maybe if you've been uh, the leader of s-- if you've borne a lot of responsibility, if you're the mother or the father, everybody's used to you being in charge, but being completely, totally vulnerable and saying something as simple as, "Will you wash my face?

Will you help me get up and go to the toilet?"

the vulnerability teaches you so much.

You know when we're vulnerable, we're less defended, Yeah.

so vulnerability is the gateway, actually.

It's the gateway to seeing what's true.

The--the--the phrase "the tension of opposites" I find pretty haunting.

Do you confront that very often?

Um, sure.

I mean, this whole process is filled with paradox, you know?

There is the beauty that we've been discussing and the possibilities for transformation that we've been talking about, and there's also the ugliness of it.

There's the things that don't work out so well.

Dying can't be tied up in a neat bow, yeah?

It--it's not all beautiful.

What we're describing that the contradictions are is that in that moment of total chaos, they may reach out and ask for your help, and you may be there in that moment, and it's 10 seconds that defines the culminating moment of their biography.

That, to me, is what is so extraordinary, so there's no tendency to Pollyanna or romanticize the hemorrhaging, the loss of body parts, the disfiguration, the fear of abandonment, nothing like that, but--but there-- it's also full of these moments where we reach out to one another.

How can everyday life help us prepare for death, or can it?

Ostaseski: Yeah.

I think there's something in our everyday life that can help us prepare for dying, and that is a willingness to turn toward the everyday losses of our life, the times that things don't turn out the way we wished they turned out, the ways that we lose people, objects, experiences in our life.

This has a way of preparing us for the great loss of our life.

Yeah.

Thank you, Frank.

I think we have time for one more segment here that we would like to show, and then come back and discuss between ourselves.

Ostaseski, voice-over: At the entrance of most Zen meditation halls, there is something we call a han.

It's a large, wooden block... that is hit with a wooden mallet to call the students into the zendo.

Written across this block in black sumi ink is a teaching that says something to the effect of, "Life and death are serious business.

"Life passes quickly and then is gone.

"Awaken, awaken, everyone.

Do not waste this life."

Over time, the words fade, and the block itself becomes the teaching until the block itself becomes fragile and falls apart.

Everything is coming and going.

This is the nature of life.

Do not be troubled.

You've both spoken beautifully and heartfully about the transformation potential for those who are dying.

What about the potential for transformation from tragedy to joy in families, in yourselves when you're doing this work?

I think we walk into the dying process expecting it to be mostly about tragedy.

We don't always recognize the possibilities for transformation that are part of the process.

The families that I know that have stayed with their dying relatives have later described it to me as the greatest gift Yeah.

and the greatest opportunity for growth that they have ever witnessed.

We can encourage the movement from tragedy to transformation by being a calm presence in the room.

Yes.

I--I agree, and the other thing, by inviting the participation of either the friends or the family or the caregivers... part of what is being transformed is any old notion, like Frank's saying, of tragedy but also, "I'm not a victim.

"I'm a participant in this amazing process in which we are all changing."

The presence of one or the absence of one changes all of us, and it's coming to the surface right before my eyes, and so it's a--it's like a waking up in the heart.

The heart becomes an organ of seeing.

Mm.

What I find to be the most miraculous is that ordinary people, people like you and I, open to an experience of dying that they have always been frightened of their whole lives, and that opening, that willingness to simply open to that which we have been most frightened of is indeed the greatest transformation.

This is gonna be a very valuable show for many people.

Uh, this is a process we all have to deal with eventually, isn't it, though, so thank you for helping us wake up.

Thanks, Phil.

Thanks very much.

Thank you.

Thanks, Therese.

Thank you.

I am Carlos Santana, and I hope you connected and return to this series "Global Spirit," the first internal travel series.