Hospice Work and the Art of Meditation - An Interview with Arthur Jennings

Interviewed by Anne-Marie Keppel


Arthur Jennings is a registered nurse and hospice worker and has been helping families, friends and patients with end of life transition for more than twenty years.  For more than 35 years, he has been a part of the Shambhala Buddhist community. In a recent interview with Karmê Chöling, Arthur offers his experiences assisting the dying, as well as how death has influenced his Buddhist practice and career.

* For italicized terms, please refer to 'Key Terms' below.

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Karmê Chöling:  What were your impressions and feelings surrounding the first death you were present for?

Jennings:  The first time I saw someone die it blew me away and affected me for weeks. It really put things into perspective.  We can go any day and it really drives home the preciousness of life.  That has been really good for my [Buddhist] practice.

One thing about death I had not realized until I saw it – most people die after being in a coma-like state for at least a day or two.  They are pretty unresponsive, and at the very end the breaths become slower and slower - maybe even a minute or more between breaths. You think, “That’s it!” -- and then there’s another breath.  There is definitely a bardo period.

Karmê Chöling:  What do the family and friends of hospice patients expect or need from you?

Jennings:  Often, my job is to be a rock in the house and just let them fall apart.  Most of the families have not seen death up close and they are looking for someone who knows what he or she is doing. I help patients, who, oftentimes, are in pain or have wounds that need to be tended.  I help tidy the space and uplift the room a little or put on soft music . . . if there are people in another room talking or working, I invite them in to be with their loved one. There often is a lot of confusion in these situations, so I reassure everyone, “This is normal.”

Part of my job is to soak up blame.  It’s a perfect time to practice “Drive All Blames into One."  Sometimes people think that, if Hospice is involved, death should be painless and a lovely spiritual experience.  But often it is not so pretty.  Even with good care, the person dying may be throwing up, in pain and questioning whey he or she is still alive.

“For me, it’s an honor to be there at a time when families are in such need and to get to know them so quickly in their rawness.”

Karmê Chöling:  How does your Buddhist practice influence you hospice work and vice versa?

Jennings: Buddhist practice affects my work because mindfulness affects my work.  Buddhism is all about working with speed and distraction and cutting through to be present, even amidst chaos. The medical world is so speedy - this is getting worse all the time. So if you can go into the situation being present and efficient, but slowed-down, people really notice.

I do Tonglen, as well as mindfulness awareness practice to remain a steady presence. Sometimes families and friends, or the patient, are really struggling and I just want to do something. Tonglen helps in these situations . . . it really would be helpful for any medical practitioner.  Also, sometimes I do Phowa in my mind. Most families are not Buddhist. If the person dying is Christian, I visualize Jesus above his or her head and I visualize him or her moving towards Jesus.

Karmê Chöling:  Is there anything special or unique you have noticed being present with the dying?

Jennings:  More often than not, the dying see Jesus, or their grandmother or a childhood friend, and I try to warn the families about this.  I bring it up because a lot of time the patient does not want to be the first to talk about it. I’ll ask patients,  “Have you seen any angels?” -- and their faces will light up. They start using a lot of symbolic communication and they are confused.  They’ll say things like, “I need the key,” or “I have to go home, do you know the way home?”  I tell the families and friends to say empowering things, like “You know the way home,” or “Go the usual way,” or, “You have the key.” 

Karmê Chöling:  You were present for a death at Karmê Chöling, would you like to tell the story?

Jennings:  At Karmê Chöling, Ruthie Aster was head of practice and study and she also was my meditation instructor.  She was living at Ashoka Bavhan and I became her visiting nurse. Today, the Aster Suite is named after her. Towards the end of her life, I moved into the house, taking time off from work.

It was a perfect hospice situation- it’s the kind of situation you would want for everyone.  The Karmê Chöling community really rallied around her.  People would come to clean her up and take her to appointments and bring her lunch.  We had a scrabble day once a week and, even when she couldn’t play anymore, people would come and she would be there in the middle of this little, weekly party.

When she passed we already had talked to her doctor about performing a Sukhāvatī.  Lady Kunchok (the mother of Sakyong Mipham Rinphoche) was living on the property at the time and guided everyone through the three-day period. As Ruthie was dying, Lady Kunchok encouraged us to whisper in her ear and remind her about her practice and to remember Chögyam Trungpa Rinpoche.

The unusual thing was that Ruthie was in samadhi after death. Lady Kunchok advised us to leave her body totally undisturbed until this was over. Lady Kunchok felt Ruthie’s heart every day - she was really happy, because samadhi is a sign a person is a very good practitioner. Most people do not go through a samadhi state and heat leaves the heart center more quickly. Lady Kunchok showed a few of us where to put our hands at Ruthie’s heart center, to feel the heat. On the third day the heat was finally gone and we bathed the body and moved it into a casket.

The casket was made simply of plywood by a local community member, who installed a dry ice compartment underneath. Ruthie’s body was washed, lotioned and perfumed and it stayed at Ashoka Bavhan, in a shrine room for people to come to sit until we held the Sukhāvatī ceremony. There is nothing like meditating next to a corpse to drive home the reality of death, impermanence and precious human life.

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Key Terms

Ashoka Bavhan - a house for practitioners near Karmê Chöling.

Bardo period - a state of transition.

Drive All Blames into One - a Buddhist practice for working with blame to reduce harm to self and others.

Phowa - a practice to help another attain enlightenment.

Sukhāvatī - a traditional Buddhist death ceremony which involves cremating the body three days after death.

Tonglen - a practice of sending compassion and love to others and taking in their suffering.

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To learn more about Hospice, please visit: http://www.hospicenet.org/index.html