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For the past twenty-five years I have been compelled to use everything I know from my Zen training to understand how we can best face the suffering of others

Given a choice between Heaven and Hell…

I got a phone call from a long-time Zen student, one who knows how to cut to the chase in most conversations. He asked, “Does suffering end?”

Without thought, I answered, “No.” We then got into the story of his suffering and I explained more of my “no.”

But later I was reflecting on why that “no” came so easily. In most descriptions of Buddhism in America, one usually finds something along the lines of “It’s a religion focused on finding the end to suffering by living according to certain principles.” That’s a straightforward contradiction of what I told my student.

Introductions to Buddhism usually outline one of the core teachings of the Buddha – the Four Noble Truths. In English at least, these Truths are usually presented in sentence form, expressing something like:

  1. The first truth is the existence of suffering for all humans.
  2. The second truth is that suffering is caused by ignorance of the true nature of existence.
  3. The third truth is that suffering ends when you understand the nature of existence.
  4. The fourth truth is that the there is a method to ending suffering called the “Eightfold Path.”

In my own lineage of Zen, we would say that expressing these things in this manner doesn’t cut to the core of suffering. We would say these things more simply and we would not call them “truths” because that implies something to believe. For a Zen person, these things only have meaning once experienced, and experienced in your bones. We might say:

  1. To be alive is to experience suffering.
  2. The experience of suffering occurs because we are attached. Attached to ideas, to things, to illusions and delusions, to people, to a sense of who and what we are.
  3. To become detached from any of those does not lead to an end of suffering. Rather it is transcending the duality of attachment/ detachment that leads to an end of suffering.
  4. The method of transcending duality is through severe mind-body training.

Coming back to my student, what would it have meant if I answered his painful question with a “yes”? For one thing, I would have reinforced a duality – the sense in which he could end suffering without ending himself. Another duality I would have reinforced is that it would be possible for him to not suffer while those around him are suffering. I don’t understand how that would be possible – how can my well-being be separate from that of other people? Hence my “no” to a Zen student.

That’s where I get the title for this entry. In my lineage of Zen, the traditional instruction for a priest is, “Given a choice between Heaven and Hell, go straight to Hell.”

Now, I also work at times as a hospital chaplain and can easily imagine a patient asking me the same question, “Does suffering end”? It would be heartless in that context to say “no.” What do they care about duality? But that doesn’t mean I would easily say, “Yes, it does.” More often than not, I ask them to tell me about this suffering. I’m listening for the story of this suffering. And sometimes, given the right conditions, the suffering starts to ease. Not because any of the objective causes of the pain have ended but because I have now stepped into the suffering with them and they are no longer alone.

When Breath Becomes Air

I saw a man in the intensive care unit last night, close to brain death. Tubes and monitors all around. The hospitalist on duty is carefully explaining to the family of this forty-three-year-old man the sequence of events likely to take place over the next several hours as his skull continues to fill with blood following a fall earlier in the day. The blood at some point will put so much pressure on his brain stem that too many of the brain cells that support his breath and heartbeat will die. Determining the point of death in such circumstances seems to be an imprecise art as the patient is tested for the presence of several key reflexes. The final check, however, seems to be the delivery of pure oxygen into his lungs as the ventilator is shut off. By testing his blood in the minutes that follow, it is possible to see if his body is doing anything useful with that oxygen. If not, he is said to be dead and the ventilator is restarted in order to keep his organs in the condition needed if they are to be “harvested” for possible transplant.

All said carefully with care and compassion to the family. But I’m watching them trying to figure out when in this progression of events their brother, nephew, son actually dies.

Here’s what is filling me as I watch and listen. Go back a few years ago. It’s early evening and the rooms and corridors of my mother’s nursing home are still and quiet. Mother is dying, her hospice nurse earlier saying, “maybe tonight, maybe tomorrow.” I’m alone with her, singing what I can remember of “Swing Low, Sweet Chariot.” I’ve been counting her breaths ever since arriving at her bedside that morning. My brother-in-law calls to ask how she is doing. To give him some form of a quantifiable answer I say, “I’ll count her breaths for you. There’s one…” I wait. There are no more. Her nurse comes in, listens to her heart and chest and says, “I’m sorry.” It’s 8:45 pm. And she is dead. I say goodbye to my brother-in-law, not quite absorbing that her death would be so distinct. This said by a hospital chaplain who has watched many dozens of last breaths.

I’m alone now, still hearing the sound of her last breath, coming as it did from far off down the arroyo she knew so well in Santa Fe and then sweeping onward, up the slopes of the Pecos Mountains to the east. A breath of air that never really had a beginning or an ending, just a puff that filled her for the moment and then was gone. Death was clear and certain. Clear in a way that was not to be available to that family in the ICU that night.

(with thanks to Paul Kalanithi for the title phrase)

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