Life, Death, and What Really Matters by Karen Wyatt, MD

Throughout my career as a family physician, I have been a student of human suffering. I have had the opportunity through the lens of medical practice to observe and participate in various crisis points in my patients’ lives, and as a result, I have learned about the many ways in which we humans cope with the tragedies of our existence. In addition, my education in suffering was abruptly accelerated several years ago when my father took his own life, leaving me in an uncharted abyss of grief, guilt, and loss. I began working with hospice patients as a means of healing my devastation over his suicide, immersing myself in death and grief in order to find a way out of my pain. While I expected to encounter even more sadness and despair as I sat at the bedside of the dying, I discovered that some of those patients were actually more fully alive during their final moments than most people I knew.

Through my work with the dying, I was gradually transformed into a student of life, which ultimately led me to write my book, What Really Matters: 7 Lessons for Living from the Stories of the Dying. It is both a call to awaken to the spiritual aspect of this life on earth and a guidebook for navigating tragedy.

Without a doubt there has never in our history been a greater need for guidance than there is today. We are facing an unprecedented global economic crisis, degradation of our natural environment, widespread war and societal conflict, and human suffering that includes poverty, sickness, starvation, and exploitation. The threat of extinction looms large in this final year of the Mayan calendar. We have come face to face with the unknown and must focus our attention and energy on what really matters because time may be running short. Each moment is of great importance.

Yet the lessons learned from the dying have illustrated that all of life should be lived as if it could end at any moment. The true value and meaning of life are found when it is viewed from the perspective of its final days. So this precarious moment in time, when destruction hovers nearby, is a true gift. It is an opportunity to find our way back to what is most essential, to rediscover joy, and to rise to our highest potential. Because the dying have already navigated their difficult last days and found abundant life in the midst of decline, they are perfect teachers for us now as we face our uncertain future.

Embrace Your Difficulties

The first concept to learn from the dying is that suffering is a universal and necessary component of existence. In fact, every living thing suffers in its own way, and every living thing eventually dies. The reason suffering must be embraced is so that it can be used as a vehicle for learning the deeper lessons of life. To reject and resist pain is to prevent the growth suffering offers and actually results in more misery in the end. Yet our society teaches us that we are entitled to a life free of difficulty and struggle.

We expect to have things go our way and are deeply offended when that doesn’t happen, as evidenced by the plethora of personal injury lawsuits in this country. Some of the wasteful spending in healthcare occurs for the same reason, as costly diagnostic tests and unnecessary treatments are utilized in a futile attempt to eliminate all suffering and to forestall death.

Of course we should work to improve conditions for all of humanity—and for our own situation as well—whenever possible, but that work must be done from the perspective that life’s suffering is a teacher and that learning from it is the most important thing we can do. This is a tricky balance, requiring energy and focus to see the difference between embracing suffering and becoming apathetic to suffering. We must be open to feel the pain of our difficulties while we remain actively engaged to rise above them. On a practical level, we can utilize the following recommendations to embrace our difficulties:

Eliminate self-pity. Watch for responses such as “It’s not fair!” or “Why me?” when things don’t go well. Those reactions often reflect an attitude of entitlement that is common in our society. Consider instead that some of these situations are a gift, not a punishment.

Cultivate patience. During challenging times, allow circumstances to unfold before making judgments. The passage of time can bring about many changes. Use journaling, contemplation, meditation, or prayer to learn the virtues of patience and endurance.

Manage fear. Use deep breathing, yoga, guided imagery, or bodywork practices to decrease anxiety and pain. Uncontrolled fear can cause regression to unhealthy behaviors and worsen the experience of pain.

Let Your Heart Be Broken

This lesson taught by the dying is an admonition to experience true, deep, and heartbreaking love. In our society the word love is used in many superficial ways—such as to express our preference for one kind of hamburger over another or our devotion to a sports team—that do not represent the meaning of true love. From the perspective of the dying, love is the force that connects us deeply and vitally with other living things. Love breaks our hearts because inevitably we always lose those we genuinely love. But the essence of love is choosing to open ourselves to the pain and willingly becoming vulnerable to loss.

This is an important lesson because it pushes us to expand our capacity to give to others and to take risks in that giving, which is the source of our spiritual growth. So to let our hearts be broken by expressing true love to others exposes us to the possibility of more suffering and more learning. Step into the practice of genuine love in the coming year by adopting the following guidelines:

Give first. Focus your attention on what you can give to others rather than on what you are receiving from them. Journal about ways in which you can show love to those around you.

Be of service. Find volunteer work in an area that interests you in order to practice bringing love to every situation.

Join a group. Learn to work with others by participating in a shared process such as a support or therapy group or a spiritual or social organization. Strive to be authentic and fully committed to any projects you pursue.

Hold No Resentments

This is the lesson of forgiveness, which teaches us that it is necessary to let go of old resentments and bitterness in order to grow and face the challenges of life. The dying spend a great deal of time in their final days working on forgiveness and overcoming the negativity of past wounds. When we harbor anger toward others in our hearts, we are not truly free to move forward in our lives. We can become stuck and stagnant as our energy is consumed by negative thoughts and emotions. During difficult times, such as those our world is currently facing, it is necessary to make available as much energy as possible for creativity and problem solving. Forgiveness is the means for releasing the life force that has been bound up internally, keeping old anger and animosity alive. To jump-start the practice of forgiveness this year, try the following practices:

Acknowledge mistakes. One of the initial steps toward releasing others from your anger and blame is to focus first on your own behavior and take responsibility for your mistakes. Forgive yourself and recognize that everything that happens can be used as a source of growth.

Create a ritual. Sometimes performing a tangible act that signifies forgiveness can help you to accomplish this emotional task. Plant a forgiveness garden, write a poem, light a candle, build a small shrine, or draw a picture to symbolize the act of letting go of old negativity.

Clean the slate. Use meditation, journaling, guided imagery, or prayer to imagine wiping clean the tally sheet where you keep track of wrongs that have been done to you. Try each day to clear away any new resentments, while you also continue to work on the old wounds.

Dwell in the Present Moment

One of the gifts those who are dying experience is an enhanced ability to live in the present moment. Because the future does not exist for them, each moment is significant and every breath is precious. Many spiritual teachers have emphasized the importance of remaining in the present moment, for growth occurs only in the present. But this is an extremely difficult task because our minds are accustomed either to dwelling in the past, conjuring up old memories, or to projecting into the future, dreaming or worrying about possibilities.

We must learn to bring our energy and focus into the here and now, for creative solutions to our problems can only emerge in the present moment. Of all spiritual practices, those that help us remain in present time are likely to be the most productive toward our growth and awareness. Though it is a challenging lesson, any progress at all toward residing in the here and now is significant and helpful. Here are some suggestions for improving your ability to dwell in the present moment:

Heal grief.
Our old memories of loss and pain can keep us trapped in the past, so it is important to work actively to heal those wounds and free up the energy they store. Use journaling, counseling, group therapy, or a letting-go ritual to help release old grief.

Practice mindfulness. Use meditation to practice bringing your awareness over and over again to the present moment. While performing everyday tasks, such as washing dishes, doing laundry, or eating a meal, bring your full attention to the activity and notice every detail to improve your ability to remain in the present.

Spend time in nature. The rhythm of life constantly unfolds in the present moment, so spend time in the natural world, where you can tune out distractions and join with the flow of the present. Practice gardening, walking mindfully in the woods or a park, or simply meditating outdoors in the elements to find a connection with the energy of life.

Living from Within

These four core lessons—embrace your difficulties, let your heart be broken, hold no resentments, and dwell in the present moment—represent just some of the wisdom conveyed to us by those who are facing the end of life. When viewed together, these lessons actually describe for us a way of being in the world, a perspective on life that propels us toward wholeness, integrity, creativity, and awareness.

At a time when we stand at the edge of disaster, uncertain of our future, it is imperative that we listen to the teachers who have gone before us to brave the unknown. Their message is actually simple: focus only on the things that are most important while there is still time to make a difference. The solutions to the problems we face are already within us. We have only to bring our energy and attention to them. Let the lessons from the dying become our guidebook, our map for the uncharted territory that lies ahead.

Finally, these lessons have directed me on my own journey out of the abyss of grief and guilt over my father’s suicide. While I found no answers for his death, I did find the inner resources to live peacefully with my questions. I found the beautiful light that shines through my heart, broken open with love. I found the exhilaration of releasing every strand of tangled resentment I carried within me. I found the rhythm of a single breath and the stillness of this one and only present moment, and I found the deep meaning of our shared suffering, as it was transformed, word by word, into a tribute to life and death and what really matters.

Dr. Wyatt is a family physician who has spent much of her twenty-five-year career as a hospice medical director. The author of What Really Matters: 7 Lessons for Living from the Stories of the Dying (Select Books, 2012), Dr. Wyatt has lectured and written extensively on end-of-life issues with an emphasis on the spiritual aspect of illness and dying. To learn more, go to

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