It would seem that the flow of care always moves from caregiver to patient. We have skills, they have needs, and assistance flows from us to them. We hover over them at the bedside like water coolers while they lay in the bed and drink from the tap. Seen this way, caregiving is an exhaustible commodity because there’s only so much in the tap and when our patients have drunk their fill, we retreat depleted. But must it be seen this way? Are there deeper truths that contemplative practice can reveal?
Meditation practice pulls back the curtain on the boundaries between self and other. We follow the breath moving in and out and accept whatever comes into our field of awareness, whether our awareness is of thoughts about our shopping list, memories of our triumphant Little League home run, pain in our knee. or the sound of the robin in the tulip box outside the window. Sitting like this, with open-hearted attention, chips away at our belief in a separate self. Try as we may, we can’t find the ‘me’ that thinks or remembers, feels or hears. We begin to experience the breath breathing us just as much as we breathe the breath. The boundary between self and other that once felt so solid reveals itself as nothing more than illusion, or as we say in Buddhism, nothing more than ignorance.
Seen in this way, the roles of caregiver and patient become less like self and other and more like the constant flow of in-breath and out-breath. We can look as hard as we’d like to find the precise moment when the in-breath becomes the out-breath but we won’t be able to find it any more than we can find the precise line between giver and receiver.
I discovered this permeable boundary while working with World War II veterans. I grew up during the Vietnam War and was greatly influenced by my pacifist grandmother. She took me to anti-war protests and helped me see the futility of violence. She also seeded my young mind with a pretty strong dose of judgment against all things military. I remember hearing daily body counts on the evening news and fearing that I’d be drafted into a frightening and pointless conflict. I prepared myself to be a contentious objector but the draft ended before I needed to press the issue.
Many years later, hospice work brought me into contact with several men who served in WWII. Many had swallowed their stories and only now, as death approached, did they whisper these painful memories to the Hospice Chaplain. One told of flying a fighter over the Pacific, where he was locked in a kill or be killed dog fight with a Japanese pilot. After a long battle, they headed straight towards each other with guns blazing until he, at last, saw the frightened, bloodied face of the Japanese pilot streak past and crash into boundless blue water. He carried the weight of killing that man for 70 years and finally unburdened himself to me.
Another pulled out a small metal ring attached to his keychain. He told me that, while approaching Normandy Beach on D-Day, a shell hit the fuel tank of his landing craft. Had it exploded, he and all aboard would have died. But it didn’t. One of his mates saved the projectile, cut it into small pieces and gave it to those who’d survived, and my patient had carried it all these years to remind him that every moment since Normandy was a gift.
And yet another shed tears at each visit because he felt frustrated that his service Skippering a sub-chaser in the Gulf of Mexico didn’t prevent the killing of 6 million Jews.
These men’s stories were a gift. But why me? Why did they choose a military-resistant pacifist to receive their long-locked stories? I cried with them as they let go of pain held for decades. But they also cried for me. My cynicism and judgment towards those in the military was healed by their sincerity, by their resolve, and by the bravery with which they withheld these stories to protect their loved ones from having to help carry unspeakable burdens.
Who was the patient and who was the caregiver? Our interactions certainly didn’t fit the model of hospice worker delivering care to needy patient. We all risked going into painful places – they by exposing long withheld pain and me by stepping into a world I found frightening and alien. And in our shared vulnerability, there was no separation between patient and caregiver.
We learn this willingness to let go of boundaries within our contemplative practices. We practice on the meditation cushion and in the cathedral, by walking in nature and becoming one with the warm dishwater. Every time we let go and allow things to be as they are, we give a gift to those we serve by becoming more adept at dropping the boundary between patient and caregiver until, quite naturally, we discover the joy of serving and being served in the very same encounter.