Antidotes to Fear of Death
by Rebecca Elson
Sometimes as an antidote
To fear of death,
I eat the stars.
Those nights, lying on my back,
I suck them from the quenching dark
Til they are all, all inside me,
Pepper hot and sharp.
Sometimes, instead, I stir myself
Into a universe still young,
Still warm as blood:
No outer space, just space,
The light of all the not yet stars
Drifting like a bright mist,
And all of us, and everything
Already there
But unconstrained by form.
And sometime it’s enough
To lie down here on earth
Beside our long ancestral bones:
To walk across the cobble fields
Of our discarded skulls,
Each like a treasure, like a chrysalis,
Thinking: whatever left these husks
Flew off on bright wings.
Medicine, as it is currently taught and practiced, is largely disembodied. It operates conceptually, often detached from the lived experiences of individuals. To effectively address health, we need a cultural shift away from the disease model that dominated twentieth-century medicine.
Illness encompasses not only physical, emotional, and social consequences but also serves as a form of evolution and meaning making. The mechanistic disease model overlooks many truths. Our bodies’ ability to become ill is matched by their capacity to heal and adapt. By expanding our understanding of disease to include a deep exploration of the body’s felt sense, we empower ourselves to change and discover deeper meaning. While we address communal diseases and advocate for improved social conditions, health equity, and healthy environments, we also foster empathy, celebrate diversity, and strengthen our community.
Healing involves fully inhabiting our bodies’ inner sense of self and integrating the creative potential inherent in the experience of illness. If our lived experiences are encoded in our physical and emotional states—including autoimmune disorders and musculoskeletal issues—we need new bio-psycho-social therapeutic frameworks. In many ways, we have distanced ourselves from our inner knowing, losing touch with what our bodies need and how best to respond. Thus, healing begins with befriending our bodies and their sensory experiences. We must develop new methods to attune to our feelings, trusting they will provide accurate information, and take ownership of our bodies, emotions, and lives.
A crucial point is that illness and medicine often rob us of our sense of agency, control over our experiences, and the right to make our own decisions.
An important pathway to recovery involves actively rebuilding that sense of agency. We all need to collaborate in the presence of illness to foster trust, acknowledge our knowledge, and honor our feelings. As leaders in healthcare—and we are all leaders—we must show compassion for our patients (and ourselves), understanding when they feel overwhelmed, anxious, hopeless, or depressed. Even in challenging situations, we must avoid dismissing or abandoning them, ensuring they do not feel worthless or invisible. To facilitate healing, we need to cultivate trust, safety, curiosity, and creativity.
Unfortunately, abuse and trauma remain prevalent in our societies. They undermine secure attachment and the ability to attune to our bodies, creating fertile ground for physical and mental health issues. Consequently, our patients and clients often include individuals with histories of trauma and abuse. As healthcare providers, we must all become adept at addressing trauma and creating trauma-informed, safe environments.
There is no single recipe for healing. Healing is an individual and fluid process, dependent on personal context, history, and various other factors. Therefore, any suggestions made by me or any healthcare provider should be taken with caution, considering the individual’s personal journey. However, expert opinions can be significant, neglecting to follow their treatment recommendations can be harmful. Thus, addressing illness and healing is a complex process that requires serious consideration and time.
Illness marks the beginning of healing. Like unhappiness or any negative feeling, it signals that something is amiss. Running from it, pretending to be brave, or fighting against it only prolongs the discomfort. Just as denying negative emotions can make them more monstrous, denying the function of illness exacerbates the situation. The first question to ask is: what does this illness signify? What change does it bring? We must begin with a fundamental honesty about our experiences.
Sometimes, all we can do is bless someone or ourselves. We cannot change what we are going through, even if we wish we could. At times, we cannot alleviate suffering; all we can offer is compassion, holding both hope and despair while extending blessings.
Beannacht[1]
by John O’Donohue
On the day when
the weight deadens
on your shoulders
and you stumble,
may the clay dance
to balance you.
And when your eyes
freeze behind
the grey window
and the ghost of loss
gets into you,
may a flock of colors,
indigo, red, green
and azure blue,
come to awaken in you
a meadow of delight.
When the canvas frays
in the currach[2] of thought
and a stain of ocean
blackens beneath you,
may there come across the waters
a path of yellow moonlight
to bring you safely home.
May the nourishment of the earth be yours,
may the clarity of light be yours,
may the fluency of the ocean be yours,
may the protection of the ancestors be yours.
And so may a slow
wind work these words
of love around you,
an invisible cloak
to mind your life.
Life constantly shocks our systems, forcing us to confront loss. No life is whole or without lack, or all lives are whole despite their ‘failures.’ We can spend our entire lives longing for something that doesn’t exist. In his poem Cleave, David Whyte reflects on life’s cycles of comings and goings and the painful losses we endure.
Cleave
by David Whyte
To hold together and to split apart
at one and the same time,
like the shock of being born,
breathing in this world
while lamenting for the one we’ve left.
No one needs to tell us
we are already on our onward way,
no one has to remind us
of our everyday and intimate
embrace
with disappearance.
We were born saying goodbye
to what we love,
we were born
in a beautiful reluctance
to be here,
not quite ready
to breathe in this new world,
we are here and we are almost not,
we are present while still not
wanting to admit we have arrived.
Not quite arrived in our minds
yet always arriving in the body,
always growing older
while trying to grow younger,
always in the act
of catching up,
of saying hello
or saying goodbye
finding strangely
in each new and imagined future
the still-lived memory
of our previous life.
These poems teach us or remind us about our inner lives. Healing is both an outer pragmatic act and an inner experiential feeling. Healing can occur simultaneously on both levels or independently on either one. Our bodies may heal while our spirits remain wounded. Our inner experience can achieve wholeness even as our bodies continue to suffer.
Vulnerability and illness are not weaknesses, temporary indispositions, or something we can choose to avoid. Illness is a natural occurrence and experience from which we cannot escape. When we deny our vulnerability in illness, we reject the help we need—the existential support that is integral to our humanity.
To be ‘healthy’ and to experience a temporary, isolated sense of power and control over our lives is an illusory privilege. It represents an arrogance of youth, one we must relinquish as we confront illness, accidents, and our mortality.
As we learn to embrace our vulnerabilities and illnesses, we cultivate greater compassion for ourselves and others. This is a necessary risk that allows us to engage more fully with every facet of our human existence. Amid uncertainty, disorder, and imperfection, illness and its accompanying vulnerability awaken us to our inner gifts. Through the narrow crevice of illness, the light of curiosity and compassion pierces through, helping us curate our inner worlds and become more human.
When the outer world dominates our lives—when we are faced with trauma, survival, and other life challenges—our focus is often on addressing external issues, leaving little room to explore our inner lives.
Incapacitation and illness, however, can free us from the pressure to perform and achieve. A forced pause from the external world can be a gift, allowing us to reconnect with our inner selves. While we strive and fight for survival, we often neglect our inner lives. In denying illness and death, we cut ourselves off from the dead, the poor, and the ill; we distance ourselves from our vulnerability and fragility, and we become estranged from God, the Tao, Nature, and our process.
We know it is essential to cure disease, but we cannot prevent it entirely. We cannot eliminate suffering. Pain and death are inevitable. What I aim to promote with Process-oriented medicine is a way to transcend pain and suffering, finding learning and meaning in what is fundamentally part of our existence. Within the mystery of process and the enigmatic experience of our diseases lies a conversation and destination that extends beyond our current horizon. We navigate life with all its failures, one step at a time, addressing the next necessary task. Amid uncertainty, we attend to our health and illnesses, striving to prevent sickness and a shortened lifespan while hoping for the best. Yet, this is not the complete story or the whole truth. Within the experience of illness and pain lies a new opening, a fresh perspective beyond the horizon—a creative reality that offers meaning and direction. Buried within suffering is a profound ocean of soulful discovery and creation. Healing and health involve exploring a landscape hidden beneath the visible surface, diving into the universe that encompasses observable space and the creative forces of dark matter and energy.
To lament illness and death is to overlook our fortune, for any rejection of the possibility of these realities denies the mystery of life. In illness and suffering we are humanized and create meaning. A desire for health devoid of illness and death negates the creative force of entropy. The magical, bittersweet limitations of being healthy and alive grant us the opportunity to realize our true selves. Without illness and death, there is no becoming, no evolution, and no true healing.
Process-oriented medicine is an invitation to work in the ruins of health and life, fostering hope not only in our desire to escape illness and death but also in accepting the way things are. It encourages us to strengthen our capacity to “stomach” illness, injury, and suffering, allowing us to sit with both the good and the bad, the ugly and the beautiful, health and sickness. From the moment we are born, we are dying anyway. It is an invitation to weave new relationships with ourselves during times of sickness and vulnerability, enabling us to connect with our bodies and acknowledge all their experiences, strengths, and weaknesses.
Illness and death are not personal possessions to keep for ourselves; they are communal experiences that belong to everyone within our unique contexts. They do not interfere with the natural order of life; rather, they are integral to our existence in the moment. They represent the path we have always been on and provide an opportunity to reimagine our understanding of love—an acceptance of ourselves and our loved ones in health and sickness. Experiencing illness and dying is an integral part of life, but it does not define our existence; we are not ill and dying but living differently. Our illness- and death-phobic culture prevents us from embracing life in all its forms. Process-oriented medicine envisions an approach that is centered on illness and death, celebrating the mystery of life in both its darkness and beauty.
But we – who are we? The taoist say we are an uncarved block of wood, unconstrained by form, unrestrained by culture or ideas, a leaf carried by the flow of water, a state of pure potential, a process, all the time.
[1] Beannacht is the Gaelic word for ‘blessing.’
[2] A currach is a large boat used on the west coast of Ireland.