The Interconnectedness of Death

Last February neurologist and Awakenings author Oliver Sacks learned he had terminal liver cancer. He shared this news with the world in an op-ed piece in the New York Times. I was moved by his thoughts about dying and I wrote a blog entry about it. As you may already be aware, Sacks died Sunday. He was 82.

oliver-sacks3His cancer was metastatic, and I’ve read that liver metastases is considered an absolute contraindication for liver transplantation.  However, it was treated. Sacks stated in a July 24 Times piece that in February, the cancer was treated with embolization, a procedure where substances are injected to try to block or reduce the blood flow to cancer cells, and the metastasis was “wiped out.” But a July 7 CT scan showed the metastases had regrown and spread beyond the liver.

He’d started immunotherapy treatment, but it was only to buy him time, and obviously it did not buy much of it.

In an appraisal written for yesterday’s edition of the Times, Michiko Kakutani wrote that in his work, Sacks cast light on the interconnectedness of life. The interdependence of life is a well-known Buddhist doctrine.  There is, too, an interconnectedness of death,  as stated so well by John Donne:

any man’s death diminishes me,
because I am involved in mankind.
And therefore never send to know for whom
the bell tolls; it tolls for thee.

Life and death are interconnected. What Buddhism calls “the cycle of birth and death” is a continuum. Life is the active phase and death is the passive phase. It is said that the continuum of a human being, or more precisely consciousness, is beginningless. As to whether it is endless or not, there are divergent opinions.

From my perspective, finding myself in a situation very similar to that of Sacks,  beginningless and endlessness are not so important. What matters most is the indivisibility of life and death. Fear is one of the greatest sources of anxiety, particularly fear of one’s own death. When we realize the oneness of life and death, its interconnectedness, and the emptiness of all things, there is, as the Heart Sutra says, no fear and no illusion. This is wisdom and with this wisdom we enter into nirvana, which is nothing more than this mundane world of life and death.

That is from the ultimate truth. The relative truth was stated by Sacks himself: “I cannot pretend I am without fear.”

To my mind, “no fear” does not refer to the absence of fear, but rather to how we handle fear.  It means the absence of anxiety, or better, winning out over the anxiety that fear brings. It means facing even death with hope and confidence.

 

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What is a Buddhist?

Geshe Tsultim Gyeltsen was a leading Tibetan lama and a human rights activist. He founded the Gaden Shartse Thubten Dhargye Ling (“Land of Flourishing Dharma”), a center in Long Beach, CA for the study and practice of Tibetan Buddhism, in 1978.

gyeltsenI did not know him very well. I occasionally attended his dharma talks on Sunday mornings. He was very approachable. He often answered the phone at the center and you could engage him in a conversation. I always imagined that I could probably just show up any day and if he was available he would probably sit down with me and answer questions. I never did that. Long Beach is 30 miles away. It was a lousy excuse. I have always told people that for an opportunity to learn Buddha-dharma, you should be willing to travel as far as necessary. I should have practiced what I had preached.

He is gone now. He passed away in 2009. Fortunately we have audio tapes and videos of his teachings, and his books, although as far as I know he only published four. One of them is Mirror of Wisdom: Teachings on Emptiness. I was looking at it the other day and came across these words under the heading “What is a Buddhist”:

The Tibetan word for Buddhist is nang-pa, which literally means “one who is focused on inner reality.” This refers to someone who concentrates more on his or her inner world than on external phenomena. This is perhaps the most important point regarding Buddhist practice. Our primary goal is to subdue and transform our state of mind—our inner reality. In this way, we seek to improve all our actions of body and speech, but especially those of mind.”

The suffering within human beings cannot be transcended without the hard work of looking within and riding ourselves of delusions and attachments, work that heals and restores our original harmony with others and our environment.

I am afraid some people have the impression that Buddhism is all about transcending our mundane human existence to attain a supermundane state. It is to some extent understandable. In the past and even today, Buddha is presented as the “Perfect One,” superhuman, almost god-like, and the image that is predominate of a Buddhist is of the perfectly calm and uncommonly wise monk, who never craves for anything and never makes mistakes. But, that’s not it. A Buddhist, or a Buddha, is nothing more than an ordinary human being.

Another great teacher, Lama Anagarika Govinda, in A Living Buddhism for the West, put it this way:

The mere fact that the Buddha . . . led a full life in the world, with wife and child, and still attained enlightenment in that same life should teach us all not to obstruct our path through the enforced repression of normal human functions and capabilities. It is only through the fullness of experience and the living of a full human existence that we can attain to that turning within and transformation that alone can lead to the spontaneous experience of enlightenment.”

We talk a lot about emptiness, being a Buddhist is really about being full . . . a full human being.

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The Poet and the Rain

Friday’s post featured a quote from Japanese writer Kenji Miyazawa. I do not know the exact source of the quote, but have seen it around quite a bit and thought it fit. I’ve only read a few pieces of Miyazawa’s work online, and until now was only vaguely familiar with his life story, owing to his association with Nichiren Buddhism.

miyazawa2In the last few days, I’ve learned a bit more about Kenji Miyazawa and want to share some of it with you. In addition to poetry, he wrote children’s stories, and evidently, what could be called science fiction fantasy. He was a musician and educator, who chose to maintain a spartan existence living off the land.

As a student, he had an abiding interest in agriculture and geology. At the age of 25, he became a teacher at an agricultural school. At 30, he left the school to become a farmer. He established a Farmer’s Society and gave lectures on rice planting and fertilizer use. He advocated the use of natural fertilizers rather than fertilizers with chemicals.

After reading the Lotus Sutra, he took up Nichiren Buddhism and joined the Kokuchkai or “Pillar of the Nation Society”. The group based their name on several statements by Nichiren, the fiery 13th century Buddhist prophet, who declared himself “the pillar of Japan.” Tanaka Chigaku, a leading figure in the ultranationalist Nichiren movement at the beginning of the 20th century, and was associated with the Nichiren-shu sect, founded the Kokuchkai in 1914. One of Tanaka Chigaku’s students, Nissho Inoue, became head of the League of Blood (Ketsumeidan), a Nichiren-affiliated group that carried out the assassinations of former finance minister Junnosuke Inoue, Director General of the Mitsui financial group Baron Dan Takuma and Prime Minister Inukai Tsuyoshi in 1932.

There are Japanese scholars who believe Miyazawa may have had reservations about the fascistic nature of the Kokuchkai and eventually moved away from it. Others disagree with that view. Whatever the case, Nichiren Buddhism has been attractive to those in Japan with a nationalist agenda because Nichiren maintained that the fate of the country hinged on universal acceptance and devotion to the Lotus Sutra as the highest Buddhist teaching. The sutra is an important and popular text. Its cosmic imagery and mythic allegory of the Lotus captures the imagination of idealists. Miyazawa was certainly that, imagining in his stories a utopia called “Ihatov”, the named derived from Iwate, the prefecture of his birth. Regardless of how he felt about militant nationalism in his later life, he never swayed from his faith in Nichiren’s Buddhism. When he died at age 39 from pneumonia, complicated by malnutrition as a result of a strict vegetarian diet, his dying wish was that his father print and distribute 1,000 copies of the Lotus Sutra.

Miyazawa’s literary work was largely unappreciated during his brief life. Today, he is one of Japan’s most renowned writers. His most famous poem is Ame ni mo makezu, “Be Strong in the Rain.” It is one of his later poems and I read that it was found after his death in a black notebook, interspersed with repeated copying of Namu-myoho-renge-kyo (“Devotion to the Mystic Law of the Lotus Sutra”). The poem reflects one of the more positive themes in Nichiren Buddhism, which is perseverance in the face of obstacles and hindrances, as well as the spirit of compassion.

There are two translations of Ame ni mo makezu. One is called “Do not be defeated by the rain.” I feel the superior translation is this version by author and translator Roger Pulvers:

Strong in the Rain

Strong in the rain
Strong in the wind
Strong against the summer heat and snow
He is healthy and robust
Free of all desire
He never loses his generous spirit
Nor the quiet smile on his lips
He eats four go of unpolished rice
Miso and a few vegetables a day
He does not consider himself
In whatever occurs…his understanding
Comes from observation and experience
And he never loses sight of things
He lives in a little thatched-roof hut
In a field in the shadows of a pine tree grove
If there is a sick child in the east
He goes there to nurse the child
If there’s a tired mother in the west
He goes to her and carries her sheaves
If someone is near death in the south
He goes and says, ‘Don’t be afraid’
If there’s strife and lawsuits in the north
He demands that the people put an end to their pettiness
He weeps at the time of drought
He plods about at a loss during the cold summer
Everybody calls him ‘Blockhead’
No one sings his praises
Or takes him to heart…

That is the sort of person
I want to be

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Burning Pain for the Journey

I had the pleasure of meeting Jimmy Carter once. It was in 1982. He was in Los Angeles to promote his book Keeping Faith: Memoirs of a President and staying at the Beverly Wilshire Hotel where I worked. A few of us had copies of the book and one of the Secret Service guys took them up to Carter’s suite for him to sign. That evening we were asked stand outside the entrance to greet the former President as he left the hotel to attend some event. Flashing that famous grin, Carter shook all our hands. As he shook mine, I thanked him for signing the book and he replied, “My pleasure.” A brief but memorable encounter.

I have always admired Jimmy Carter. Many people believe his was a failed presidency. I don’t know. He made a number of tough, unpopular decisions. He followed his conscience, stayed true to his beliefs. I respect that. Most of all, he made a campaign promise never lie to the American people. As far as I know, he never did.

Now, Jimmy Carter is battling cancer. He had surgery on Aug. 3rd to remove a cancerous tumor from his liver. There are a number of different ways to deal with tumors on the liver. With me, it was with inter-arterial chemotherapy and radio frequency ablation – using chemo and high frequency radio waves to bombard a tumor and kill it. Carter had a resection where they cut out about one-tenth of his liver. A healthy liver, which I assume his is, will regenerate very quickly.

During a press conference, Carter said his doctors suspected the cancer had originated in another part of his body. Later, they discovered melanoma spots about “two millimeters” in size on his brain. Cancer that spreads from the place where it first started to another place in the body is metastatic cancer. That is what has also happened to me.

I had cancerous tumors on my liver but we thought my cancer was a thing of the past after I had a liver transplant in May 2014. For months, my scans looked fine, and then this past April my doctors found a malignant tumor in my left femur. It was metastatic. It came from somewhere else, probably my liver. How could this happen, I asked. It wasn’t a question that could be answered. Perhaps there were minute traces of cancer that got into the bone marrow. Perhaps the doctors simply missed it. Medicine is not an exact science.

They cut my leg open, drilled a hole in the bone, removed as much of the cancer as they could, and then put a rod in to give the bone support. After the surgery, I received ten radiation treatments to wipe out any remaining traces of the cancer. I believe Carter is also to have radiation treatments.

Since the surgery, I have had a couple of CT scans and a full bone scan at the end of June. Everything has looked good, but, very likely the cancer is still there, somewhere, hiding.

The problem with metastatic cancer is that evidently there is no effective way to control it. Eventually it will spread to some area of the body where there are vital organs and it will kill you. I don’t think Jimmy Carter’s case is any exception. From what my oncologist told me, mine is not, either.

Carter has one advantage I don’t. He has an immune system. He will be taking a drug called Keytruda to boost his immune system, supercharge it. My immune system is pretty much non-existent because of the medicines I take to suppress it. If I had a healthy immune system, my body would try to reject the transplanted liver.

At his news conference, Carter said, “I’m perfectly at ease with whatever comes.” I can’t say that I am perfectly at ease with the recent turn of events, but I have found it acceptable.

To paraphrase a passage in the 2nd chapter of Chuang Tzu, “Both the acceptable and unacceptable are acceptable.”

You can’t waste your life worrying about your death. When you accept that sufferings and death are both inevitable, you gain a certain amount of freedom. It is not that you resign yourself to a particular fate but rather you become liberated from it. The idea is to free your mind, to make it bamboo mind. Most bamboo is wind tolerant. Because it bends and yields to the wind, it is very stable. A purpose of Buddhist practice is to develop a mind that is stable, so that you can withstand the fierce winds of suffering.

Everyone knows they will die.  We usually think of death happening sometime far off in the future. To truly accept the reality that death may come sooner than you expected is one way you learn to flow and harmonize with life.

We must embrace pain and burn it as fuel for our journey.”

– Kenji Miyazawa (1896-1933), Japanese poet

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The End and the Means and the Killing In-between

The bombing in Bangkok that killed 22 people and wounded 120 took place at the Erawan Shrine, the most famous temple in Thailand and a popular attraction for tourists. Erawan Shrine was built during the mid 1950s, and its construction was plagued by so many problems that after consulting with an astrologer it was decided to dispel the bad karma by erecting a shrine to honor the Hindu deity Brahma, the god of creation. In Thailand, Brahma is known as Phra Phrom, the four-faced Buddha.

According to Monday evening’s news reports, it is not yet clear who placed the three kilograms of TNT stuffed in a pipe and wrapped with white cloth inside the shrine area or to what extent the statue of Phra Phrom was damaged.

ABC News says, “Previous to the August 17 blast, the statue had also come under attack in March 2006 by a lone man who smashed the statue with a hammer. The man was beaten to death by bystanders . . .”

On Hollywood Boulevard, just a few blocks from my apartment building, is Thailand Plaza (this part of Hollywood is Thai Town). It houses a Thai grocery store and a restaurant on the 2nd floor. Outside the plaza, next to the sidewalk, is a Phra Phrom shrine (see the photo rightFour Faced Buddha-1b). You can pass by almost any time of the day and you will probably see someone lighting incense and offering prayers to the four-faced Buddha.

Many years ago I heard about a study, I don’t recall the details, but a group of people were asked this hypothetical question: If the CIA asked you to kill a VIP, even if he or she were totally protected, would you agree to do it? An astounding 90% said yes.

Men and women have always been willing to kill for a cause, because they believe the end justifies the means, and I have always thought that to be one of the most evil concepts humanity has ever developed.

Traditional Buddhist teachings maintain that if you kill another human being, in your next existence you will have a short life. These days, I find that concept to be difficult to accept as well. However, I do believe there is something in the Buddhist view of the law of cause and effect, and that once you make a cause, someday, no matter what, a result from that cause will manifest. In that sense, killing is the worst cause.

Killing is a complicated issue because there are various ways to kill and different degrees of what we call murder. What I am discussing here is the killing of innocents with a bomb or beating a person to death out of anger, revenge, or for a cause. Buddhism does not have a perfect record of non-violence. Nevertheless, I feel its reputation as a philosophy of peace is justified. The First Precept in Buddhism is “Refrain from killing.” And if there were one mantra that transcends all the various Buddhist traditions, it would certainly be “Do no harm.”

Actually, to get through life without harming or killing is difficult, but I once heard someone say that when we become non-violence itself, when we become compassion itself, we embody those qualities in our world. Buddhism teaches that we accomplish that by looking within our mind to recognize and subdue the negative thought patterns that allow the potential for harm to arise.

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