I Don’t Have Time to Write a Blog Post
One aspect of working with the dying that doesn't get the attention that it deserves is self-care. In our modern world, there is every incentive to go faster and do more. When faced with actual, honest-to-goodness life and death circumstances, caregivers and families can quickly go off the deep end and over-work, over-commit, or over-extend.
The funny thing is that when we hear the words "self care," we generally know what we should do, but we tend to not do it because we don't have time – a clearer example of irony would be hard to find. We know we should take a break, or go for a walk, or not eat that piece of candy, or count to ten, or take a deep breath, or get at least 30 minutes of moderate intensity aerobic exercise five days per week, or give 10 compliments per day, or have a regular spiritual practice, or have a creative outlet, or smile even when we feel like frowning. We know these things, but life (and especially death) get in the way of them.
My work of bringing music to the bedside of the dying has taught me many things over the past 20 years, but one of the most unexpected is a lesson that comes from the music itself. People comment all the time about how beautiful and restful the sound of the harp is; about the sense of peace that they feel when listening, and the serenity that they see in their loved one that is dying. I think that the reason for this abiding notion of tranquility is directly related to the space that the music carves out in the room.
The lesson that I've learned from the music is that there are many kinds of 'space,' and all are important. The first bit of space comes when I enter the room with the harp and sit down. The expectation is that the music is going to start, even though I explained that I need to check the patient's pulse and breath rates so that I can tailor the music to fit their circumstance. So we sit in silence (or perhaps chatting quietly) for a few minutes. Part of that time is letting go of whatever came before, but most of it is truly attending to what is happening in the moment.
The music on the harp tends to be unhurried. Each note is given its time, and each note will blossom forth, ring for a bit, and then slowly fade away. What a great metaphor for the journey through our day, or through a relationship, or through a whole lifespan; blossoming forth, ringing for a bit, and then fading into what comes next. So there is space between the notes. On good days, I have the awareness that half of what I do is not play.
There is also space between phrases of music. The melody takes a little journey, or the voice, having been filled with air, spills it out, reflecting what's there, or supplementing what's missing, but then the phrase is done and the lungs have to refill―but there is no rush. There is space at the ends of phrases.
Within the context of this music vigil, a particular theme will grow and develop over the course of several minutes, changing as the circumstances in the room and with the patient dictate, but after five or 10 or 15 minutes, the music will settle to silence. These pauses are bigger. Some families will try to offer silent applause because that is what they are conditioned to do. Others will sink into this silence. It is not like the break between songs on a CD or the three seconds that your iPod gives you while is shuffles from one track to the next. Instead, this silence between musical themes is a time to process what has just happened; the music is still going on in our heads, and yet in the silence we are released from the structure of the music. There is a freedom that people find in this pausing. This is when I see breaths deepen and shoulders relax and tension drain out of foreheads. The next phase of this silence is about attending to the patient, really watching and listening to get an idea about their experience of this stage of life. When music begins again, coming out of what has become an expectant silence, it arrives fresh. Perhaps it is informed by what has come before, but it is not an extension of the previous music. We have moved forward and are starting anew.
So I have learned that we require big spaces, when we go to the gym, or sit at the easel, or pick up a cherished book; and we need medium spaces, when we get up from our desks and stretch, or chat with the neighbor over the fence, or just close our eyes and put our heads down for five minutes; but we shouldn't forget about the small spaces; between each breath, smiling at a stranger, hearing the birdsong, marveling at the sunset or a falling leaf rushing before the wind, eager for its fleeting, newfound freedom, and always aware that the fallen leaf's time is a brief, ecstatic moment bracketed by the heady work of being green on one side, and the long silence of snow on the other.
We tell our families to pace themselves, that death doesn't happen like we see in the movies. The process can be long and there is much waiting, reminiscing, and wondering. Venturing into these waters, we can be guided by the concept of balance: Be at the bedside, and then take a break. Touch them―hold a hand, rub their feet – but then give a break. Draw the shades and let it be dark, but then, later, open them and let the light stream in. Let them hear your tears and your laughter. Have music―and have silence.