Yvonne Rand on Shunryu Suzuki's Death and her Entry into Hospice Work

Got the following from the SFZC archives. There was a note saying it was written by Yvonne with her husband Bill Sterling. - dc

Suzuki Roshi had cancer of the gall bladder

He was in Portland doing a combination of sittings and lectures in March of 1971, the year he died. He got sick very suddenly and it looked like he had a gall bladder attack and his gall bladder was taken out. As a matter of routine there was an autopsy of his gall bladder ‑‑ and it was cancerous. The doctor who did the operation was quite certain he'd gotten everything out ‑‑ the surrounding tissue was the right color and healthy looking. So Suzuki‑roshi didn't say anything to anybody and proceeded with life as usual.

In fact, Suzuki‑roshi became sick and didn't have much energy that spring. By summer it was very clear to him that he wasn't going to live much longer. He went to Tassajara that summer, and he was beginning to have physical signs that things weren't very good. He didn't say anything and the only other person who knew was his wife, who was at Tassajara with him.

People who were at Tassajara that summer talked a lot, especially afterwards, about the fierceness he had about everything he did. He did everything ‑‑ more rock work than usual ‑‑ lectures every night. There was this incredible energy in everything he did, and in late August, I went to Tassajara to drive him up here. On the way we stopped at San Juan Batista to join the last day of a sesshin that Soen‑roshi was leading. We got back to San Francisco and by then Suzuki‑roshi was beginning to be jaundiced and we made some terrible jokes about his getting to be more yellow.

He went to bed not feeling very well and basically never left his bed after that. That was in late August and he died in early December.

He declined physically very rapidly. It took about a month of tests and fiddling around for the doctor to determine that he had cancer. In fact, initially his doctor was quite certain he had hepatitis and so we did all the quarantine stuff that goes with it. None of the usual things happened. He didn't get better when he should have. So eventually he went to Mount Zion for some tests. By that time we had gone through several weeks of his having to eat on a separate plate and all the work of keeping his dishes separate. It was a drag. He didn't particularly like it ‑‑ he was used to a much easier atmosphere ‑‑ the practical details of getting food on the table, etc.

I went to see him after he'd been in the hospital a couple of days. When I got to his room the doctor and a couple of specialists had just left and he motioned me in and asked me to sit down on the bed next to him. He said, 'I have cancer.' He just mouthed the words as if he was telling me some good thing in a whisper. His lunch had just been brought in ‑‑ it was on a table by his bed. He patted the seat next to him and said, 'Now we can eat off the same plate,' and he began to feed me some of his lunch. He'd have a bite, then I'd have a bite ‑‑ which of course is what we couldn't do as long as we thought he had hepatitis. And he said, 'This cancer is my friend, and my practice will be to take care of this sickness.'

From that point on that was very much the feeling that I had from him ‑‑ about his sickness and about all of us who were a part of his life ‑‑ and in particular his doctor. It was very much a situation of his taking care of the doctor rather than the doctor taking care of him, so at one point the doctor brought him some pain medicine ‑‑ that was after we had brought him back to Page Street ‑‑ and at that time he was still in his bedroom upstairs ‑‑ and the doctor was quite concerned about his being uncomfortable and brought him a prescription for pain medication ‑‑ which Suzuki‑roshi let sit on the night stand for a few days. Eventually he took one of these pills. It was quite obvious he didn't want to take it, as he didn't like the way it made him feel. He was taking it basically because he knew the doctor wanted him to take it, and was worrying about him, and he decided the kindest thing he could do was to do what the doctor wanted him to do. I learned something from watching him do this with the doctor.

Anyway, he was basically in his own bed, and when he got weaker and weaker we got a hospital bed and moved him to the room that is now the Kaisando (Founder's Room) so that he could look out onto the courtyard, see the sun, hear the bells, and have a sense of the rhythm of people to and from the zendo, and a sense of being a part of the life of the building. He gradually became weaker and weaker and soon was not able to get out of bed.

The kinds of things he wanted to have done for him were very simple. He wanted his arms rubbed and his legs rubbed, and he enjoyed a glass of fresh orange juice. He enjoyed eating. There was a quality of being completely present with each person who came to talk with him or sit with him. This incredible vast space! There wasn't anything happening except what he was doing at that moment.

There was some dismay among some of his students that he wasn't going to live very long. The sadness he expressed was, 'It's too bad that you are hanging onto me.' Without talking about it very much he demonstrated a quality of just letting go. At the same time he was concerned with taking care of the situation so that things would continue after he died.

After he had finished the Mountain Seat ceremony, the installation ceremony for Baker‑roshi, which he did get out of bed to do ‑‑ about a week before he died ‑‑ he was very weak and basically couldn't walk by himself. He was supported by someone on either side of him ‑‑ although he did walk from the entrance of the Buddha Hall to the main altar ‑‑ he did that part of the ceremony and went to his seat ‑‑ he really made an incredible effort to do that. Up to that point he had been in bed continuously.

After the ceremony he stopped eating, and after about three days he stopped drinking, and he died within a couple of days after that. About the time he stopped eating he stopped talking. My experience since than has been that that sequence is rather characteristic if people are left alone. If there is a situation where they are not being fiddled with a lot ‑‑ and they are ready to die, and have somehow gotten their selves and their lives in order, so that there is some timeliness to the way they are dying ‑‑ in that situation there seems to be some characteristic rhythm, and it seems to cover some period between a week and ten days. The person will usually stop talking, stop eating, and then stop drinking, and then within a few days, will die.

I remember in that week ‑‑ Suzuki‑roshi would occasionally pull out his arms ‑‑ which at that time were incredibly thin ‑‑ he'd pull one arm out and stick it into the air. He wanted to have someone rub his arm. We'd rub it, he'd stick it back under, and a little while later out would come one of those skinny little arms. By that point his wife and I ‑‑ one of us ‑‑ was always with him. We had been with him such a long time that we were all in a shared rhythm. We didn't require much talking ‑‑ and we had been in the room together and breathing together for a long time, so there was some shared physical rhythm.

When I was with Judy this March I had almost exactly the same experience. Another woman and I took care of her together, and we actually slept in the room with her. One of us would take turns being more awake so the other one could rest. What happened, without arranging or saying it, 'This is what we are doing,' the three of us were breathing together for those five days. What I would notice when I was resting, is that without thinking about it, my body inclination was to join her breathing. And it would occur when she would get a little scared or panicky, and I would breathe in a particular way, and make a sound in my breathing. She would join my breathing and get a couple of breaths. That was a way of helping her be more calm.

Anyway, I don't know if that gives you some feeling of what I mean about my experience of being with Suzuki‑roshi. The other aspect of it is, I think, that I was struck by how little there was to do. It was possible to do a few things to keep him comfortable ‑‑ wipe his face, and when he stopped drinking to keep his lips and his mouth moist ‑‑ things of that sort that were pretty obvious. But at some level there really wasn't anything to do except sit there and keep him company.

That was in 1971. In '68 or '69 I met a woman who was a psychiatrist and worked in New York, and had worked with hospital staffs in several big hospitals in New York City. One of the things she stumbled on was that a very high percentage of people die unattended. That at the moment of dying the nurses and doctors were all somewhere else. So when she noticed how that seemed to be the case, she did a study, and discovered that the statistics were very high. She began working with nursing staffs in several big hospitals, working with them around their feelings of being with people when they die.

This was at a point before there was much of a hospice movement. In this country, particularly in hospitals with professional medical people, a fairly consistent attitude prescribed: once the patient is close to dying there's not much they can do, and the staff seemed to experience a sense of failure in the very process to which they were professionally committed. She and her husband and another man they were with were coming here to San Francisco and spending time at Tassajara every summer.

In the midst of doing this work, I met her and she told me a little about it. I hadn't thought much about the work she was doing until after Suzuki‑roshi died, and it was at that point that I became willing to sit with the dying. That seemed to be something that not so many people were interested in doing. In fact, my experience is that most people in America today have never been around death. In fact, it is one of those experience which once was very common, and no longer is in people's lives. At the turn of the century it wasn't at all unusual that by the time you were an adult you would have lived through several deaths in your family: your grandparents, some siblings, a neighbor. The person was very likely to have died at home, in bed. There would be a wake ‑‑ the practice of sitting with the body for some time ‑‑ usually three days. It's really within this century that this experience has become so rare.

One of the reasons I emphasize that ordinary quality is that one of the things I hear from people, particularly in Zen Center, when they are with someone who is dying, is feeling inadequate. Like, 'Gosh, I'm not doing something I should be doing.' They feel there is something they don't know. My bias is that the willingness to keep someone company, and stay with them while they are going through this transition, is quite a lot. Is enough. My own experience is that simply dropping that attitude has led me into situations where I have had the most intimate experience with another person that I have ever had under any circumstances. I say that without exception. It hasn't depended on a personal relationship. Out of the willingness simply to keep someone company, it has seemed sufficient for the other person, and it has consistently been without exception a situation in which I have learned something quite important for me. I think it is very related to zazen practice, to the whole field of mindfulness practice. I think that there may be something about what brings us to this practice that makes it possible for us to keep someone company in a way which I think is a real gift. I think we have something to offer in that willingness. It is that territory that I find very compelling, and that I am sharing and supporting all of you to explore for yourselves. That comes completely out of my experience in being in that space with people. And when I use the word 'intimacy' I mean the intimacy you have with your own child, or with a lover, a quality of closeness with a person that is very hard to describe.