Serving Others, Transforming Ourselves

Frank Ostaseski reviews “Buddhist Care for the Dying and Bereaved” and “The Arts of Contemplative Care”, two books about Buddhist hospice.

Frank Ostaseski
14 February 2013
Photo by A. Jesse Jiryu Davis

The Arts of Contemplative Care: Pioneering Voice in Buddhist Chaplaincy and Pastoral Work
Edited by Cheryl A. Giles and Willa B. Miller
Wisdom publications, 2012
$34.95; 368 pages

Buddhist Care for the Dying and Bereaved
Edited by Jonathan S. Watts and Yoshiharu Tomatsu
Wisdom publications, 2012
$22.95; 312 pages

Once during a Mountain Seat ceremony at San Francisco Zen Center, a student asked the incoming abbot, “What can the dharma teach me about serving others?”

The abbot answered, “What others? Serve yourself!”

“How,” the student persisted, “can I serve myself?”

The new abbot responded, “Take care of others.”

True service is always mutually beneficial. When we care for others, we are also nurturing ourselves. This understanding fundamentally shifts the way we provide care.

Now two new collections from Wisdom Publications—Buddhist Care for the Dying and Bereaved and The Arts of Contemplative Care—offer working models of how to confront and transform the way we address suffering in the world today, models born from adaptations and interpretations of core Buddhist teachings. The contributors remind us that caring for one another is a natural expression of both our dharma practice and of simple human kindness. They encourage us to develop our capacity to embrace another’s suf­fering as our own, and their words and work will inspire anyone seeking to express dharma practice in the direct service of others.

Both books make substantial con­tributions to the wide field of contem­plative care, defined in The Arts of Contemplative Care as care “informed by…consistent contemplative or medita­tion practice.” They help us appreciate service as a spiritual practice integral to Buddhist wisdom teachings. Through their stories, we can see how modern-day practitioners are expressing that ancient wisdom by reclaiming the voca­tion of embodied social action.

Buddhist Care for the Dying and Bereaved offers the history, methodol­ogy, and implications of Buddhist ini­tiatives specific to end-of-life care. This collection emerged from a project by the Jodo Shu Research Institute (JSRI) to explore what it perceives as press­ing social issues in Japan, among them “the Japanese medical establishment’s outdated approach to patient care” and “the growing irrelevancy of Buddhist priests and temples in the lives of their lay followers.” That exploration led to international round tables and sympo­sia, and ultimately to these writings, culled from work with the dying and grieving in a variety countries, including Germany, the United States, and Thai­land, and drawing on a wide spectrum of Buddhist traditions.

Buddhist scriptures across tradi­tions detail practices surrounding both the moment of death and support for the dying. Jonathan S. Watts, in his introduction to Buddhist Care for the Dying and Bereaved, points out that our understanding of the Buddha has always included his roles as caregiver and coun­selor; he recalls stories of the Buddha washing the infected wounds of a fellow monk and guiding the grieving mother in the famous story of the mustard seed, helping her transform her sorrow and suffering into wisdom and compassion. Watts also reminds us that the Buddha was known as the “Great Physician” whose four noble truths examined “the nature of suffering as dis-ease, as well as its causes, its cure, and the course of cure.”

In these pages, we learn how con­temporary Buddhist practitioners and organizations inspired by the teachings of that Great Physician have dedicated themselves to serving the dying. From Japan, Yozo Taniyama explores how the Vihara terminal care movement is expanding the role of priests and offer­ing an alternative to “funeral Bud­dhism”; Beth Kanji Goldring details the evolution of AIDS care in Cambo­dia; and Joan Jiko Halifax outlines the intense and transformative effects of ter­minal care, both for the caregiver and the patient, and introduces the Upaya Institute’s Being With Dying professional training program as one model of how we might prepare people for that work. Other chapters range in scope from Bud­dhist chaplaincy training in the U.S. to a Theravadan explanation of “the seven factors of a peaceful death.” Practical in its recommendations and compassion­ate in its voice, Buddhist Care for the Dying and Bereaved stands both as an essential textbook on Buddhist hospice work and as an important reminder of Buddhism’s long history of providing social and medical care for the poor.

Taking a more local and systematic approach is The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Work, which brings together voices on six facets of contemplative care: foundations and training; hospital chaplaincy; prison ministry; college and military chap­laincy; end-of-life care; and pastoral work. The contributors’ first-person stories illustrate with raw honesty their efforts to meet and alleviate multiple forms of suffering in sometimes unex­pected environments.

This wide-ranging collection effec­tively announces a growing movement of “vocational Buddhists” who are mak­ing inroads into secular organizations or organizations traditionally served by Judeo-Christian ministries. Through Buddhist meditation and ethical prac­tices, these chaplains and ministers cultivate compassionate presence—the “chaplain’s art”—developing the calm­ness, nonjudgmental attention, clarity, altruism, empathy, and equanimity nec­essary to be skillful.

The contributors in this volume work primarily as “interfaith chaplains,” meaning that they are called upon to serve anyone in a particular environ­ment, regardless of religious affiliation (or lack thereof). Mark Power, a student of the Kagyu and Nyingma schools of Tibetan Buddhism and a board-certified chaplain, recalls that when he trained at a Catholic hospital, it was easier to let others assume he was a Protestant min­ister than to try to explain his Buddhist faith. Judith Simmer-Brown explains in her foreword that in fact most who do this work do not find it useful to label themselves as Buddhists.

So it is not surprising that The Arts of Contemplative Care stresses the benefit and necessity of additional study and related professional training beyond the scope of a caregiver’s Buddhist practice. Wakoh Shannon Hickey, who works as a hospital chaplain, aptly titles her chapter “Meditation is Not Enough.” She shares the painful story of praying with the wife of a Jehovah’s Witness who, because of the church doctrine prohibiting blood transfusions, is dying on the emergency room table in front of them, a moment that called on all her resources, profes­sionally and spiritually.

Certain domains of chaplaincy require still more than additional inter­religious or psychological study. Thomas Dyer, another contributor, was the first Buddhist chaplain in U.S. Army history, and he served alongside soldiers in Iraq. He explains that his skill set as a chap­lain includes, among other things, know­ing how to use a gas mask in a chemical attack. In “Compassion Radiates through Rock,” Margot Neuman and Gary Allen, both longtime Shambhala practitioners, describe navigating the labyrinthine intricacies of a maximum-security prison and the overwhelming chaos of offering meditation instruction in semi-lockdown conditions. And a chaplain serving in the midst of a natu­ral disaster faces unending needs and personal exhaustion, even while train­ing others and learning to work hand in hand with a complex system of relief agencies. In each case, the context dic­tates the tools required to respond—not only with compassion but also with skill.

An important inclusion in The Arts of Contemplative Care is a discussion of the need for such vocational train­ing within our own Buddhist sanghas. We have witnessed the controversy and harm caused when our teachers’ (or students’) emotional needs and psycho­logical development are overlooked, or when abuses of power are condoned. Many communities now recognize the importance of training future spiritual teachers not only in the buddhadharma but also in the skills necessary to address issues of transference, appropriate sex­ual boundaries, and group dynamics.

Vocational Buddhists, in part through their experience of service and care, are helping sanghas skillfully shine a light on racism, homophobia, and the unreg­ulated privileges of male power, as well as other destructive, often unconscious forces.

The contributors to The Arts of Con­templative Care also offer a sober and balanced view of the advantages and shortcomings of current seminary and chaplaincy trainings. Those seeking to become a board-certified chaplain must be prepared for years of academic study, training, and practice. Moreover, can­didates must be willing to adapt their Buddhist training to traditionally Judeo-Christian contexts. And after all that, opportunities for employment are still few and generally low paid.

They point to the value and place of non-degree certificate programs, such as the Shogaku Zen Institute’s SPOT train­ing, Upaya Zen Center’s Being with Dying Program, and the Metta Institute’s End-of-Life Practitioner Program, each offering both personal development and professional training. But in an evolving field, questions remain about how much training is needed, and what kind. There are issues of religious authority and of how to maintain the integrity of spiritual traditions and rituals in the context of service work. There are as yet no perfect models.

It is a commonly held view that the more training and education we have, the more tools and skills we have to help others. But as Lew Richmond and Grace Schireson, cofounders of Shogaku Zen Institute, remind us, “The Buddha encouraged practitioners not to cling to his words, but to translate his teachings into their own native language, to illumi­nate their own lives. We need to remem­ber this as our primary practice and not get caught in just following a formula or a recipe.” So we must also include the essential teachings of upaya (skill­ful means); we must discern the needs of the person or situation before us and to be of true service. As Metta Institute faculty member Charlie Garfield often says, “This work is not just about add­ing new skills to the same old you… it is about you transforming.”

Many of the contributors to these two collections seem to embody that transformation. They show us that spiri­tual support is not generally a matter of existential discussions or esoteric prac­tices. More often it is about staying in the room when the going gets tough and helping people discover their truth, even if that truth is one that you don’t believe in. It’s about staying present in the face of unanswerable questions.

Together, The Arts of Contemplative Care and Buddhist Care for the Dying and Bereaved make an undeniable claim for Buddhist-inspired service initiatives while highlighting the powerful practice and unique contributions of vocational Buddhists. Grounded in their humble and gritty work of service and care, the contributors to these two volumes have sparked a vital discussion about the implications both of their vocation and of Buddhist practice itself. They have raised the question: What can serving others teach us about the dharma?

Frank Ostaseski

Frank Ostaseski is the founder of the Metta institute, cofounder of the Zen Hospice Project, and a coordinating teacher for a new multiyear training program at spirit rock Meditation Center called Heavenly Messengers: awakening through illness, aging, and Death.