Zen priest and hospital chaplain Tenku Ruff shares an intimate bond of uncertainty with Covid patients. She knows what they’re going through — because she’d had it herself.
Photo by Biel Aliño
Dizang asked Fayan, “Where are you going?”
Fayan said, “Around on pilgrimage.”
Dizang said, “What is the purpose of pilgrimage?”
Fayan said, “I don’t know.”
Dizang said, “Not knowing is most intimate.”
—Zen koan
My intimacy with Covid-19 began in my own body. I got sick the first week of March 2020 after traveling from New York to a meeting in Los Angeles. As soon as I returned and got off the plane and into the car to drive home, I knew I didn’t feel well.
We didn’t know much of anything about Covid then. I moved my bed into my office, tried, and failed, to get help from my doctor’s office. Eventually I gave up and hunkered down. My husband, George, got sick a week later.
We were very sick, but had no plans to drive ourselves to the nearest hospital and wait in the long lines at the emergency department. People were afraid of us, but neighbors left food on our porch. The local rabbi left us a pot of hot soup. A friend who lives about an hour’s drive away bought us a carload of food. At night, I put a large rock on the floor next to my bed, with a plan to bang on the floor to alert George if I needed to go to the hospital immediately. Even so, we knew that if we got to that point, our chances were slim.
Suffering and not-knowing unite us. This is always true.
I began to do Buddhist practices to prepare for my own death, just in case. My breathing was rapid and shallow, my heart raced, and my lungs hurt, but muscle memory and ingrained habits from many years of practice carried me through. I had no breath with which to chant, concentration took effort, but at the same time distractions melted away and not-knowing felt like the most natural thing in the universe—complete ease.
If I look back now, using knowledge gained from years of end-of-life chaplaincy care, I can see that I was on an edge between life and death. Time dissolved. I accepted sleep when it came, but could not count on it in the evenings. Sometimes, I spent the entire night lightly awake and lightly asleep, balanced on a knife’s edge between the two. I had vivid, beautiful dreams. One night, my grandmother visited, holding me in her arms in front of her kitchen sink, and I felt safe, loved, accepted, and deeply content. I awoke with her smell in my nose, thinking, “Oh, this is Grandmotherly Heart.”
My own experience with Covid informs me now as I meet with patients in the hospital where I work as a professional chaplain. Even so, each person is unique. Unique bodies. Unique fears. Unique family systems, spirituality, language, financial resources. Unique responses to the exact same treatments. Some people seem like they’re getting better, then die in the night. For others, their families say a tearful goodbye, then they’re off the ventilator and speaking again the next day. Not-knowing holds us together, balanced delicately between hope and despair.
To go into Covid rooms, I don layers of PPE—a head covering, shoe coverings, gown, N-95 mask, regular mask, face shield, and gloves. All people can see of me is my eyes, behind two layers of clear plastic. I could be male or female, Buddhist or Catholic, old or young. I compensate for my lack of a visible face by making my eyes very expressive. The rooms are sealed and dimly lit, like caves. Machines hum loudly in the background, and sharp beeps permeate the foreground. This space is liminal space, sealed from the outside world, and sacred.
The patients are likewise anonymized. They wear hospital gowns, their hair is unkempt, their glasses sit on the table near the bed, and their hearing aides are often at home. Some cannot speak, and sometimes, as I sit with them in silence, their phones ring until I pick them up and speak to worried family members on the other end. The families want desperately to be with their loved ones, and I want desperately to offer them some comfort. Neither of us gets what we want, but we share a few moments of not-knowing together.
Some patients urgently need to speak, but when they try, their voices are too weak and their breath too shallow. When I speak, they can’t hear me well, because of the masks. I have no idea if they are Republican or Democrat, rich or poor, religious or non-, lonely, confused, or simply exhausted. In this moment it doesn’t matter. I look into their eyes, through the layers of plastic, and hold their hands. It is enough. It is beautifully, tenderly intimate.
To simply sit with the suffering of another human being may seem like it would take enormous energy, but it is actually a tremendous relief. How many times do we get to drop all of our pretenses and experience intimacy with a complete stranger? What if we could do this all the time, with everyone?
Once, several years ago, as I walked down a street in New York City, I passed a woman on her cellphone, sobbing. I stopped and said, “Can I give you a hug?” She said yes, we hugged, and then continued on our respective ways, each touched by this shooting star of intimacy with a complete stranger. My work as a chaplain, supported by Zen practice, taught me how to do this. The intimacy of not-knowing is something we can learn.
The author, Tenku Ruff, in full PPE.
If the patients can talk, I listen. They are firefighters and grandmothers and dads and nurses. They are not all elderly, but many of them are. Many are not white—Spanish speakers or African-American people. An old man told me the saddest thing for him was leaving his red sportscar, but when I held up an iPad so his family could speak with him via video chat, he stopped joking and teared up. “I just want them to be okay,” he said later.
A firefighter told me about his “brothers”—his ladder, also known as “the guys.” On September 11, 2001, he was at home in Brooklyn on that clear, beautiful September day when the planes hit the twin towers. His brothers were all on duty. As he lay sick with Covid, he thought only of them, burning in the second tower. His dream of heaven? “I don’t know. Maybe I’ll meet the guys—play ball, drink some beers, have a few laughs.”
Suffering and not-knowing unite us. This is always true, but perhaps it is a little truer right now. The patients and I both know they are very sick, that they can’t breathe, that they’re scared. What we don’t know could fill a stadium. How did I get it? Will I get better? I got the plasma antibodies—will they help? I don’t want to go on a ventilator—will I get scared and do it anyway? And will it save me? When will I see my family again? Will they get it? When will this all stop? Will it?
Last week, I learned my uncle was in the hospital with Covid. My aunt was unable to drive, so a cousin living on the next farm over took him. My uncle—my dear, sweet, kind, funny uncle whom I grew up living next to—is in the ICU, on a breathing machine. My uncle’s politics are different from mine, as is his religion, his lifestyle, and his perspective on wearing a mask. And all that matters at this moment is that I love him, and that I want him to be free from suffering.
His Holiness the Dalai Lama has said, repeatedly, that all living beings want to be happy and don’t want to suffer. I want my uncle to be happy and I don’t want him to suffer. I want for all of my hospital patients to be happy and not to suffer. I want for you to be happy and not to suffer. And I also want this for myself—to be happy and not to suffer. On this, we can all agree.
