Offering Deep Presence at the End of Life
When I started Upaya’s Buddhist Chaplaincy Training Program, I thought I was going to answer the question: what is a chaplain? Instead, at the first Core Training session, I started becoming aware of inner thoughts and feelings I didn’t know about. We were participating in an exercise that asked us to identify our North Star, that which is true for us, giving our life meaning. I couldn’t find my answer. I listened to the answers of my classmates, and I felt like a fraud—student after student describing their purpose, each some version of wanting to alleviate the suffering of others. A deep truth that I was hiding, even from myself, was that parts of me didn’t care about someone else’s suffering for their own sake. I cared about it because I thought their suffering would hurt me. And if I could alleviate someone else’s suffering, I was protecting myself. I worried the teachers would see what I was only just beginning to see about myself. I was afraid.
Over the course of the two-year program, I was given opportunity after opportunity to see places in myself that I hadn’t seen before. I was being cracked open, over and over, and I was healing; I was allowing myself to unfold in front of me, without pushing these awarenesses back into the dark.
And I still had this question: what is a chaplain? At this point, I had been working in social services for over 20 years, and if I was now going to be a chaplain, I needed to know what it was. I thought a good way to answer my question was to work among other chaplains in a hospital, where for generations they were a part of the day-to-day operations. Once I was accepted into a year-long, full-time program at Elmhurst Hospital, I was excited and couldn’t wait to start.
The first time I was called to a death, it was to support a grieving wife whose husband had just died, way before his time. I had been on shift for 23 hours already, and I had barely slept. I walked into the room, shaking on the inside, unsure of what to say, how to sit, or when to leave. This situation ended almost as soon as it started—a good thing for both of us, I imagine. While I felt pretty bad that she had just been visited by a newbie chaplain, I also knew this had been my first experience professionally supporting someone who’d just lost a loved one, and I was committed to learning how to be present with those in deep grief.

That’s when I realized I needed to apply what I’d practiced at Upaya—not just then, but when I could, in the encounters that followed, and still today.
I work to trust that I have what I need in any given moment, that all that’s left for me to do is to show up. Time after time, after time. To bring kind attention to what is stirring inside of me. To notice what thoughts are arising, what sensations I am experiencing, what feelings are here. It might not be easy, but it is simple. There’s nothing to do other than to place my attention. Which requires discipline. Because there is always so much clamoring for it. When I am able to place my attention on my experience, I’m allowing it to be just as it is. And almost spontaneously, I can be present with another.
This kind of presence was tested every day, often in ways I couldn’t have anticipated.
There was a time I was called to the Emergency Room, and a husband’s wife with no pulse was receiving CPR. He was pacing and entirely unraveled, begging into the space between us that his wife would come back. They had just been eating dinner. All of a sudden she fell over, and he called for an ambulance. There was nothing I could say—he wouldn’t have heard me anyway. So, I held his gaze when he would look at me. And the rest of the time, I stood there, waiting for the moment when he would again lock eyes with me in utter desperation. After his wife was pronounced dead, he asked me to join him at her bedside, and we offered a prayer that he thought she would want. Some time later, I walked him out to the exit. He had no choice but to leave without her. I couldn’t go with him; I couldn’t bring her back. I hadn’t done anything to change the situation, but I believe that my willingness to be with him in his experience, however momentarily, made a difference.
And yet, there were moments I was riddled with self-doubt as I watched all the medical professionals around me moving quickly and decisively. On the other hand, I stood still, doing only that—standing. I felt powerless, even ridiculous, and at times overwhelmed by the husband’s grief. I still thought somewhere in the recesses of my mind that I could do something to help him, if only I could figure out what that was! And instead, I pulled from my depths the only thing I really could do, which was to be right there with him, when he looked at me.
Once, in the middle of the night, I received a call from the Emergency Room that an elderly woman had fallen and hit her head. I joined her, and her eyes were filled with fear, dried blood on her face. She asked me to pray with her. The doctor said they urgently needed to take her for a scan. So, I asked if I could walk with them. He agreed. I held her hand, and as they wheeled her and I walked, we recited the Lord’s Prayer together.

The warmth and calm in her eyes as she smiled, saying thank-you, is something I will never forget. I went back to the sleep room, a mere few minutes later, having learned a deep life lesson. When we meet each other in our vulnerability, magic happens. While it was that woman who had fallen and was vulnerable, I too, in a different way, was also. Meeting her while she was afraid and not looking away required that I saw my own fear of death and fear of suffering, and did not attempt to chase it away. I also met the doctor in his urgency, finding a compromise so both urgency and prayer could live together.
There are many distractions I faced in the hospital—the high volume of patients, the over-worked medical professionals, the culture of western medicine always running from death, the sounds of the machines, the emergencies, the frustrations with insurance, and much more. I was distracted by the program itself: the 24-hour shifts, the annoyances with my colleagues, and the struggle I created when comparing hospital chaplaincy with the chaplaincy I learned at Upaya. And these noises took a back seat when I was called to a room.
One night, I received a call from a nurse on the Intensive Care Unit. He had a patient who was being kept alive with a medication drip. This patient was alert and aware of her situation. Her family had visited earlier, but they said they wouldn’t be coming back. The nurse was hoping I could come and sit with her.
Walking into her room, I was aware that when I walked into a patient’s room who was near death, it was never the patient I spoke to—it was always the family. This was another first. I noted my fear, my self-doubt, and looked at her. We talked about her family, her nieces and nephews, and her career. We touched on her medical situation a few times, but that wasn’t something she stayed with for very long. I let her guide us, offering light guidance every now and then. Mostly, we sat together. Helping her with her water was what I did most. And then, when she was tired, I left.
I am aware that I was one of the last people she spoke to before she died. For me, the next day everything was brighter. I took a bath and had a dance party. I celebrated life. Spending time in that vulnerable moment with her changed me. In my heart and mind, I promised her that I would live.
I routinely forget that promise. And I know, it is always somewhere inside of me.
I’m grateful for the life lessons I received while working at the hospital as a chaplain. I wouldn’t have received the same lessons anywhere else.
I also think I know now what a chaplain is. A chaplain isn’t a profession; it is a way of life. It is a person who is willing to be vulnerable with themselves and with others. It is a person who is willing to admit when they are afraid. It is a person who is willing to stand (or sit) in someone else’s fire with them—because that is what we can do for each other.