On the morning of February 15th, on the way to the hospice center I had been volunteering at, I remembered a story the abbot of Mettavaranam Monastery told. He recounts that when he made his last visit to the Venerable Suvaco, who was nearing death and suffering from dementia due to brain damage, Ven. Suvaco had never forgotten the religious practice he had dedicated his life to, saying “that thing I got from the meditation: That hasn’t changed. That’s always there.” That morning, I went to see a patient with severe Alzheimer’s disease. The first few times I had visited her, she had been exhausted and frightened, sending out anyone who came to see her. I worried that this morning would be similar, but I resolved to visit her regardless. When I stepped into her room, the smiling faces in her family photos caught my attention.
When we sat down next to her, she seemed far more peaceful than we had seen before. I played some music for her, choral works that always remind me of the intimacy of singing with others. As I sang along quietly, remembering singing with my own friends, she seemed to radiate a quiet contentment. Then suddenly, she spoke to the corner of the room, saying “he’s our friend.” I hoped at that moment, piercing the haze of forgetting and confusion that so often comes with Alzheimer’s disease, a memory of a dear friend was firm in her mind, just as my memories bent the timbre of my voice slightly as I sang for her.
Hospice volunteering has caused me to question my views on what a “good death” might be. What gives many people peace and happiness at the end is being able to recollect one’s commitments. For Ven. Suvaco, it was his faith and religious practice. For the patient I saw that morning, I believe it may have been her family and friends. Despite their ailments, neither lost touch with what they loved, and the impermanence of their lives and love did nothing to stop their happiness from blooming. I think I may know the monk who painted Dr. Puri’s maṇḍala; there are only so many trained sand painters in the country. If they are the same, then I know him to also be someone who will die well, because the impermanence of his work will not change how he values it.
Later that day, I went to temple and formally took the bodhisattva vow, given by that very sand painter as the preceptor. In Mahāyāna Buddhism, the bodhisattva vow is a commitment taken by those seeking to attain enlightenment for the benefit of others. The Lord Buddha is called the Unsurpassed Physician, for these vows are like those of a physician who vows to treat all. In the Sermon on Patients (AN 3.22), Śākyamuni Buddha taught that there are some patients who cannot be saved, just as there are some who cannot be taught, but still one should be undaunted in serving all. The fleeting life of a Buddhist sand painting, like the life of a human being, changes nothing for the painter or for the unsurpassed physician. Both are things to be treated with care, to joyously commit to despite the fact that neither lasts forever. In this way, I hope to become a physician who dies well, happily remembering that I acted as I vowed. By learning what makes a good death from my experience in hospice, I have learned about what makes a good life: the kind a physician would be fortunate to live.