“Sooner or later, the way in which you die is going to be
the most important thing in your life.” —Michael Shapiro
By Cat Saunders
In the early 1990s, I attended a lecture at a local clinic. Afterward, a man walked over to me and extended his hand. He said he’d been reading my work in The New Times for years, and that he was one of the doctors at the clinic. He introduced himself as Steve Hall.
At some point in 1995, I began looking for an M.D. as wonderful as my alternative helpers, someone who would treat me as an equal. I remembered Steve Hall, and I wrote him a letter. He called me back personally, and we agreed to try it. I’ve been spoiled ever since.
Cat: I’ve heard that doctors are often afraid of death. How do you feel about it?
Steve: When I was a medical student, I noticed that many students acted as if they’d failed when a patient died. I never understood that. All the jokes aside, I don’t think doctors are God.
Obviously, if someone dies, I take a very serious look at what happened, but I don’t feel guilty about a patient dying, as long as I’ve done my best. Whether people live or die has more to do with grace, and what’s in their cards.
When I was in training nearly twenty years ago, the issue of death was in transition. No one really talked about death. It was hidden away in the back wards of the hospital. The idea of someone dying at home was unheard of.
Cat: Was home death common in your practice as a country doctor years ago?
Steve: Yes, and also as a student doing rural rotations in Utah. Grandma would be dying in the back bedroom, while her daughter was cooking dinner and the kids were playing. They’d pop in and visit. Death was a part of life. People grieved and mourned, but they didn’t run from death.
Cat: How does this contrast with hospital death?
Steve: It depends on how much warning people have. If people have been sick for a time, and complications arise that can’t be treated at home, they might die in the hospital. They can still have a family-oriented experience, depending on the hospital.
Many nursing staffs are more supportive of families staying around the clock, and the hospice movement has helped raise awareness about conscious dying. Also, more people are realizing that no matter what you do, you’re still going to die sometime.
Once you acknowledge that death is inevitable, it can be approached with more awareness.
One thing I’ve been doing, as an orienting exercise, is to try to see things through the spirit’s eyes instead of human eyes. When I do this, things look very different.
From the spirit’s perspective, we actually do things backwards. We should be sad at birth, when the spirit is leaving the God-light and unconditional love to come down here and muck around for a while. On the other hand, the spirit would celebrate death!
But we look at life from human eyes, so all we see is the pain of our own loss when someone dies. There’s no question that it’s painful to lose someone you love, but again, orienting can help.
Cat: You used to facilitate groups for people with life-threatening illness. Would you talk about that?
Steve: I worked with a group of men and women, most of whom were HIV-positive. We ran the group for several years, until everybody with HIV died.
One man in the group, William (not his real name), was an actor and a therapist. He was very good with words, and he thought deeply about things.
William stayed healthy and vigorous for many years. Ten or twelve years after he was diagnosed, he was still muscular and fit. But then he got an infection in his intestines for which there was no cure. He got bad diarrhea, and turned into a skeleton within two months.
We tried various treatments, and he was also seeing a conventional physician, who put him on an experimental drug. I guess his other doctor didn’t read the labeling, because that drug was not to be used when there were intestinal problems, because it could kill the kidneys.
That’s exactly what happened. William’s doctors came in and told him his kidneys were dead. They stopped his fluids and IV feedings, pulled out all the plugs, and basically said, “You’re going to go into a coma in three days and die.” Then everybody left the room.
Steve: We happened to have a group the next day, so we met in the hospital. William came down in his wheelchair and talked to us about what happened. He said that when everyone left and he was alone, the full realization of his situation hit him.
What he saw was that he’d always had the overpowering belief that if he just tried hard enough, he could beat HIV. Then he realized this pattern had consumed his whole life. If he just tried hard enough, he’d get the part he wanted in the play. If he just tried hard enough, his mother would accept him.
William realized that his whole life had been this efforting, and it hadn’t worked. He was going to die.
When he saw this, he felt a rush come into his head, like bulldozers were pushing him to the edge of a cliff. He knew he was going to get pushed over the edge and be dashed to pieces. That was his metaphor for letting go of efforting.
As he fell off the cliff, the most amazing thing happened. He said, “I sprouted wings and started to fly!”
William went home later that day, after the group meeting. He was surrounded by his friends and family. Three days later, he quietly went to sleep, went into a coma, and died.
William helped me see how — when someone really does their work — their death helps heal the whole world. That’s what Christ’s death did, and that’s what happens when gurus die.
Cat: That’s what everybody’s death can do.
Steve: Yes, exactly!
Cat: Have you ever been asked to help someone die?
Steve: No, but I’ve thought about what I would say. I’d have to consider each individual case. When I think about terminally ill people committing suicide, I think about falling off that cliff and growing wings.
If you kill yourself before that happens, you’ll never know what might have been possible. Even a millisecond of being healed is worth your whole lifetime. You can heal and still die.
For me personally, I wouldn’t want to be involved in someone’s suicide. I think anyone considering suicide should definitely seek the counsel of people they trust.
Cat: Often with suicide, there’s an avoidance of pain or suffering. There’s more information now to help people be with pain in ways that make it less terrifying. The experience of pain changes when your relationship with it changes.
Steve: Yes. People often think that pain and suffering are synonymous. Not necessarily. I don’t think there is always an answer to pain, but I honestly believe there is an answer to suffering.
Cat: How would you help a patient explore the difference between pain and suffering?
Steve: I’d encourage the person to image the pain and talk with it. What does the pain look like? What color is it? How big is it? What shape? How long has it been there? How did it get there? Once people get a sense of their pain, they can ask it questions.
One of the biggest stumbling blocks to this technique is a person’s intention. When people are in pain, often the only thing they can think of is to get rid of it. That’s normal. But if that’s someone’s intention, the pain usually won’t cooperate. It may even feel insulted!
The pain says, “Hey, I’m sitting here bustin’ my butt for you, and you don’t appreciate me at all!”
When people hear their own pain say this, they’ll step back and say, “Whoa! There is something going on here!”
I say, “Yes. Now take a deep breath, and put your dukes down. Let’s just sit with the pain, and see what we see. If the pain was your teacher, what do you think it might be saying to you?”
Cat: What about people with chronic pain or illness? Some people think chronic illness means you must be doing something wrong.
Steve: People who say those things have thought about the situation to a degree, but in my opinion, they have more thinking to do.
Sometimes people who go through a lot on the physical level are actually the best students. They’re really learning! You know how much you’ve learned from your own physical issues.
Cat: My body is one of my main teachers.
Steve: Yes. Those who blame people for illness are focusing on results. This may come from living in a culture that looks at results in order to judge your worth.
In the Bhagavad Gita, Krishna tells Arjuna over and over, “Labor. Let go of the fruits of your labor.”
The fruits of our labor are up to God, or Spirit. In a way, this is in alignment with chaos theory. You can work and work and work and not predict the outcome.
Cat: You just get to learn.
Steve: Yes. You do your work, and the work is to figure out what is in your heart. I want to know what’s in my heart and act from that place, remembering that the results are out of my hands.
It’s hard for Euro-Americans to hear this, because we’re all such control freaks. Our egos want to be in control. Although I think we’ve barely begun to tap our co-creative potential, co-creation is very different from control. It’s hard to get out of the driver’s seat.
Other cultures are different. Take the Eastern discipline of yoga. The word “yoga” means “yoke.” The goal is to yoke yourself to God’s will for you. But how do you know what that is?
In my opinion, one of the best ways to know God’s will for you, to find what is in your heart, is to really be with your body and listen to it. I’ve come to see that one true path to Spirit is through the body. I really believe that.
This interview is from a series on death originally published by The New Times (1998-99) and updated in June 2017.
Cat Saunders, Ph.D., is a counselor in private practice in Seattle, Washington. She is also the author of Dr. Cat’s Helping Handbook: A Compassionate Guide for Being Human (available through Amazon). Contact Cat by emailing her or by calling 206-329-0125 (24-hour voicemail).