What Really Matters
by Dr. Karen Wyatt, MD

Why This Book Matters

As we enter the second decade of the 21st century, uneasiness abounds and a sense of doom is prevalent everywhere we turn. Scholars, philoso- phers, seers, sages, and prophets all tell us that our planet is on the verge of some sort of cataclysmic global shift, predicted to occur within the next ten years. No one knows how this turning point will unfold or what impact this shift will have upon each of us, but it is likely to be a profound transition, sending ripples of volatility across the entire world.

Meanwhile, global disturbances, such as acts of terrorism, natural disasters, military hostilities, the world economic crisis, climate change, and even the political unrest in the Middle East, are all harbingers of the changes to come. Throughout history a pattern has developed that the “old” established and stable structures, whether they are societies, cities, cultures, beliefs, buildings, or forests, must break down in order to allow the growth of something new. In a similar manner, the destructive pro- cesses that seem to be taking hold all around us are actually preparing the way for future transformations.

However, our American society has been caught in a selfish and materialistic phase of development for several decades, as evidenced by the “me generation” of the 1980s and the rapid rise of consumerism since that time. As a result, many of us are not equipped to cope with sudden disruption and disintegration in our world. We have neglected to develop the emotional and spiritual tools that will be required in order to rise above crisis and continue to thrive. This fact has been evident during the recent global economic downturn, as in a recent U.S. national survey on drug use and mental health services one in ten adults reported having been prescribed a mental health medication in the past year.4 In addition, the most frequently prescribed medication in the country is now Vicodin, a narcotic pain-reliever.5 It appears that the pain of our everyday lives is causing us to turn to pharmaceutical agents for relief because we lack the internal resources to cope with our struggles. If this current economic situation is just a foreshadowing of a future crisis, how are we going to survive when there is far more suf- fering at hand?

The hoped-for role of this book is that it provides a framework through which to view the coming shift as well as a crash course in the spiritual skills necessary to navigate disaster. It is time now to turn our energy and attention away from the self-absorbed pursuits of the past toward a goal of awakening and maturing as conscious beings. The lessons presented here form a foundation from which spiritual growth can occur. While these teachings represent ancient and timeless wisdom, the urgency behind the message is contemporary and unique to our current situation. We stand upon a precipice between dissolution and transcendence. Do not under- estimate the fact that our next steps have the potential to determine the course of the future.

The Dying as Teachers

After my father’s death I was left floundering, having lost my belief that this world is a safe place in which to exist. While I desperately searched for answers, I was able to find solace and guidance in the stories of the dying patients I cared for in my work with hospice. These patients and their families shared with me not only the intimate details of their final days, but also the collective wisdom they had gathered throughout this lifetime. In some cases, patients attained phenomenal insight and clar- ity in their spiritual vision during the crisis of dying and were eager to share this knowledge. For others, the transformation was evident in their behavior or appearance rather than conveyed through their words. And at times the caregivers of the patient experienced profound evolution as they participated in their loved one’s last moments. In every case these stories of how we live and die on this planet are inspirational, poignant, and uplifting. On many occasions the patients themselves asked me to tell their stories, regretting that they would not have enough time to share their newly recognized wisdom with others. I have carried their histo- ries with me, awaiting this opportunity to fulfill my promise to them at last. Therefore, this book is a tribute to those patients who so generously taught me the lessons of life and death.

It is important to understand why we, who are very much alive right now, have anything to learn from those who have already faced their mortality and passed on from this existence. As will be shown, these hospice stories come from individuals who died from chronic, terminal illnesses and spent a great deal of time anticipating and confronting their own death. They lived within a state of crisis for prolonged peri- ods, learning all the while how to cope with tragedy and continue to find meaning in every remaining day. As we look ahead to uncertain times and potential threats to the comforts of life as we know it, we can benefit from the wisdom of those who have already negotiated a dangerous passage and who desperately wanted us to grasp the knowl- edge they had finally attained. We honor them by learning from their histories and using their lessons to magnify our own spiritual growth in preparation for what lies ahead. It is time to gather our courage and face our own mortality.

Denial of Death

There is no place on Earth we can look without seeing death. In the transition from one season to the next, in the tangle of the spider’s web, in the falling of a star across the night sky—we behold the Truth of Life: that matter disintegrates, that life dies. Our mortality is the one most fundamental characteristic we share with every life form on earth—from plankton to platypus, from amoeba to aspen grove—all will die. Considering the abundant evidence that exists all around us, it is an unequivocal certainty that our current lives are going to come to an end. And yet, it seems that our modern society has forgotten this fundamental truth of human existence: death is unavoidable.

At the beginning of the last century most people died at home. They were tended to in their final days by family members who also prepared their bodies for burial, perhaps “laying them out” on the kitchen table where they were bathed and dressed one last time.6 Death was a constant presence in daily life then, resulting often from infections and injuries for which there were few effective treatments. Even children were exposed to the normality of death from an early age. But following the rise of modern medicine, with advancing technology and miraculous, life-saving drugs such as penicillin, death became an outcome that seemed to be temporarily avoidable. We began to feel some confidence in our ability to fend off the “grim reaper” and concurrently began to lose awareness of the connection of death to life. As a consequence, we have forgotten the truth that our earthly mortality ultimately gives meaning and value to our physical life on this planet. To our detriment, the fear of death has consumed us and led us to expend increasing effort and healthcare dollars toward preserving life at all costs. For example, approximately 25% of the annual Medicare budget is spent on aggressive, life-sustaining care during the final month of life, much of which is futile and may actually prolong suffering rather than enhance life.

The Gift of Mortality

As we delve further into the study of life and death, acceptance of a fundamental belief will help us interpret and prioritize the lessons being presented here. This belief holds that our life on this planet is a spiri- tual journey taking place in a physical realm. In other words, we exist as physical beings precisely for the purpose of learning certain spiritual truths during our time on Earth. There is no question that our human bodies are sublime vehicles for gathering information and absorbing the wisdom of life with five senses to experience the diversity of nature manifested through smells, sounds, sights, tastes, and textures; with multifunctional limbs to allow us to move and take action; with various organs to help us encounter pleasure and take in sustenance; with neurological linkages for acquiring knowledge, dreaming, and reasoning; and with built-in systems for growth, repair, and healing. What an amazing gift is this physical exis- tence we have inherited. Yet life is a gift that will not last. These bodies of ours are destined to fade and wear down as we proceed through time, using up the physical learning potential that was bestowed upon us at birth.

Then, in the latter days of life, a gradual shift in focus must occur, away from the pursuits of the physical world toward the truths of the spiritual realm.8 As we lose certain functions and capacities on the physi- cal level, we have an opportunity to gain even more intangible wisdom and understanding. In fact, the soul shines through ever more brightly as the physical body fades. Many times during my home visits with the dying, I observed a beautiful, soft light surrounding the patient in their bed. I would first look around for a hidden lamp or some other source of the illumination until I realized that I was seeing the light of the soul, unobscured by the physical body, which was rapidly dissolving away. From this perspective it is perfect that we are mortal beings. For if we could maintain youthful, strong bodies forever, no shift of attention toward the spiritual would be likely to occur. We might stay perma- nently stalled at the materialistic, egocentric level of development with no impetus to move ahead.

No Time to Waste

However, we might argue, if we can anticipate learning these lessons at the end of life, why bother to study them now? Why not wait until our final moments to focus in on the spiritual aspect of existence? The answer is that the rate of change in every area of life is accelerating as we speak. Technology is advancing faster than most of us can keep pace and so, too, are the challenges we face on this planet. In order to be pre- pared for the transitions of the future we must master certain spiritual tasks now. We cannot delay the necessary steps of our growth any longer.

In fact, as the dying patients themselves recognized, these lessons should be learned earlier in our existence so that they can be utilized for the good of all life. Again, as we stand upon this precipice between transcendence and dissolution, there is no time to waste.
Another obvious reason to learn the lessons from the dying now is that there are no guarantees in this life. Not one of us knows when or how we might depart this existence and we have no assurance that we will be granted a slow course toward death during our elder years. We would each be wise to make the most of every learning opportunity now since we do not know if it will become available to us again in the future.

The View from The Garden

The process of spiritual growth can be compared to raising a garden: planting seeds and harvesting the crops that result. Imagine that you were given at birth a small patch of land and a few seeds. You have no control over the location of your garden plot, whether it is in a fertile valley or on a rocky mountainside, and you are unable to change the quality of the soil it contains. Also, you cannot determine the amount of sun, rain, wind, or hail that falls upon your garden. But you are responsible for planting the seeds you have been given, seeking addi- tional seeds to grow, nurturing and tending what you have planted, and bringing in the harvest when it is ready. According to this metaphor some aspects of your existence in this life are out of your control: your birthplace, family members, culture and society, and your inherited qualities and assets. But you do have a responsibility to utilize the fac- tors that can be altered, such as your effort and intentions, to create the best possible life from the raw material presented to you at your birth. This is the essence of spiritual growth: to employ all that has been given in this life (including both the positive and the negative factors), manifest the greatest potential available, and recognize that everything, including the Self, is sacred.
In keeping with this metaphor of the garden, the Lessons for living from the stories of the dying can supply you with additional seeds to sow in your own plot of land so that you might one day harvest the fruits they provide. Perhaps it is too soon for some of these seeds to grow right now, but they can always blossom at a later time when the conditions are favor- able. Just hold on to them until you know that you are ready to begin cultivating the lessons and being transformed by the truths they contain. But don’t forget that toiling in the garden—that is, working on your spiri- tual growth—is actually the only reason you are here, the only thing that really matters in this lifetime.

The View from The Galaxy

The metaphor of a garden requiring constant attention and care is a helpful way to think about the day-to-day events of your life and the work that is necessary in order to grow spiritually. The garden represents the “small picture” view of life that informs most of your actions and decisions every day. However, there is another perspective that you should try to develop, as well. This is the “big picture” view of human existence which requires you to look beyond your own individual concerns to recognize that there is something greater going on in this life, something that encompasses the entire planet and all of mankind. You can achieve this perspective by taking a step back from the small details and trying to see the complete panorama of existence, as if you were looking down from a point high above the Earth.

Astronauts have described the moment they caught sight of Earth through the small porthole window of their spaceship as filled with won- der—a sudden realization of a higher purpose, of what really matters. Edgar Mitchell, who walked on the moon during the Apollo 14 space mission, wrote about seeing the Earth become visible from behind the rim of the moon as “a sparkling blue and white jewel, a light, delicate sky- blue sphere laced with slowly swirling veils of white, rising gradually like a small pearl in a thick sea of black mystery.” Mitchell went on to describe the epiphany that occurred for him at that moment: “The presence of divinity became almost palpable, and I knew that life in the universe was not just an accident based on random processes … the knowledge came to me directly.” The power of this vision so deeply inspired Mitchell that after retiring from the space program he founded the Institute of Noetic Sciences, dedicated to advancing the science of consciousness in order to promote transformation.

But this amazing and enlightening view from above is not just available to space travelers who have escaped the Earth’s gravity. A hospice patient once described to me a very similar vision that came to him one night in a dream.

Eugene was in his seventies and close to death from severe heart disease that had affected him for most of his adult life. His first heart attack had occurred thirty years earlier and caused extensive dam- age to his heart muscle. He and his wife Beth had been told then that his lifespan might be shortened because his cardiac function was so critically compromised. And so, the couple had prepared themselves for this possible future. They talked at length about what life might be like for Beth as a widow and planned ahead financially so that she would have some security when that day came. Over the next fifteen years, Beth made herself ready to face her old age alone while Eugene worked to make peace with his past.

But then, an unexpected tragedy struck. Beth died suddenly at home of a ruptured aneurysm in her brain. Eugene held her in his arms, awaiting the arrival of an ambulance, as she slipped away from him. He was devastated and totally bewildered by this devel- opment. Beth was not the one who was supposed to die young! She had always been totally healthy—there had never been a reason for them to prepare for HER death. He felt bitter and betrayed by God and life itself as he sank into depression. All of his preparatory work had been in anticipation of his own death; he had no idea how to go on living alone without his beloved wife. For the next twelve years Eugene floundered in despair and depression, hating every moment of his life and listing in his mind all of the joys that had been denied to Beth by her untimely death. “It’s not fair!” became his mantra, repeated angrily over and over again to everyone he knew.

But just a few days before I first met Eugene, everything changed for him because of a dream. He described that in the dream he had been transported through space to a star far away in the galaxy. From there he was able to look down at the Earth and see all the details of his and Beth’s lives as they had unfolded. At once, from that lofty perspective, Eugene recognized that somehow everything had been perfect, just as it had occurred. He saw that there was a purpose and a plan for each event that had taken place, including Beth’s death from the aneurysm. With light sparkling in his eyes and an angelic smile on his face, Eugene said to me, “We think that life is unfair to us, but that’s just because we can only see it from the Earth. If we could always see what life looks like from up above we would know that it’s ALL fair! I know this is true: Everything that happens to us is fair in God’s eyes. We just don’t understand how it all works.” Eugene would live out the next few months in peace and contentment, once again preparing to leave this life. Free of the bitterness that had haunted him for twelve years, he talked to every- one he saw about his revelation, explaining to the best of his ability the true meaning of fairness and the power of changing one’s point
of view.

Multiple Perspectives

From Eugene’s story we can see that our interpretation of life and its occurrences can change depending on how we look at it. The view from the perspective of one individual life tends to focus on details and be tossed by emotional ups and downs, just like the storms that play havoc with our planted crops. The concerns and wellbeing of that one person take priority at this “garden” level. Thus, Eugene could see the death of his wife only as senseless and unfair when he looked at it from the small perspective of his tiny garden. However, when he was shown a bigger view he recognized that all the individual aspects of life, whether they seemed “good” or “bad” to him actually fit together in a perfect pattern. When we are able to step back and look at life from the “big picture” van- tage point of the galaxy, we can see that there are actually no individual concerns that are not part of the whole of life. Everything is connected and everything is one. This view provides a sense of calmness and equa- nimity toward the challenges of life, almost turning our attitudes upside down. What seems to be unfair is really fair, what hurts us actually helps us, what we cling to is not what really matters.
The process of growing spiritually, of becoming more fully conscious and aware, consists of being able to view life from the galaxy even while you toil in the garden. You must be able to put all your effort into the day- to-day tasks of planting, cultivating, and harvesting in your garden while simultaneously holding in your awareness the fact that from a higher perspective the details of the soil, the seeds, and even the crops you yield, are not really important. It is your awareness—your ability to take the highest possible perspective toward everything—that really matters. This sounds confusing and paradoxical and it is—which is why it takes a life- time to truly grasp the nature of spiritual growth.

However, you need only to remember this: the process begins with your own garden and the seeds to be sown from the Lessons from the dying. Start wherever you are and trust that growth will come, as surely as each tiny blade of grass thrusts itself through the soil every spring.

The Dance of Life

“Let your life lightly dance on the edges of time
like dew on the tip of a leaf.”
-Rabindranath Tagore

If you spend time observing a flower garden you will quickly recognize the continual dance of life that is unfolding there. A shimmering drop of dew falls upon a leaf, setting the entire stem in delicate motion; a faintly whispered breeze stirs brightly colored blossoms into an elegant waltz; a tiny ladybug flies away leaving a trembling petal in its wake. The compo- nents necessary for this dance to occur are the same elements that emerge over and over again in the 7 Lessons learned from the dying: timing, balance, rhythm, and grace. Timing refers to the clock of infinity where change requires a lifetime of work, but transformation occurs in an instant. Balance is the equal joining of two seemingly opposite forces that enable one another to survive. Rhythm is the flow of life and energy that perme- ates everything around us. Grace is the generosity of abundance, like the garden that freely bestows its blossoms and fruits upon us. As you read these lessons, keep in mind the perpetual dance that moves throughout each story; the significance of timing, balance, rhythm, and grace as they each unfold; and the two partners, Life and Death, holding one another closely, swaying eternally to the music of the Universe.

About the Author:

Karen Wyatt, MD is a family physician who has spent much of her 25 year career as a hospice medical director, caring for dying patients in their homes.  The author of What Really Matters: 7 Lessons for Living from the Stories of the Dying, Dr. Wyatt has lectured and written extensively on end-of-life issues with an emphasis on the spiritual aspect of illness and dying. www.karenwyattmd.com