By Dr. Tan Kheng Khoo
"On the day when death will knock at thy door
What wilt thou offer him?
I will set before my guest the full vessel of my life.
I will never let him go with empty hands"
“……so few know the art of dying. For dying, like living,
is an art and if only most of us mastered the art of dying as much as we
seek to master the art of living, there be many more happy deaths.
The Western world, the developing and developed world are all death denying. We do not talk or discuss death. The subject of death is taboo. Even in death we dress up the corpses as if they are healthy and alive. We lie to the children that grandma has gone for a long holiday. In the developed world with modern medicine we make belief that death can be conquered. The richer we are the more we believe that that conquest appears more probable. Most of the time we hear or read about death of other people with whom we have no close relationship or we do not know them at all. Most of us have not really sat down to contemplate or pontificate our own death. Even if we consider the impending death of the one dearest to us, it is not quite the same. To face and confront our own death is a very healthy exercise, but few of us exercise it.
From the second we are born, we are inexorably marching towards our death. Death is with us like a shadow. We cannot shed it off. If we can live life with the comfortable accompaniment of death, then we can begin to live. After all we are the ones that fix our own date of death in our G-plan in the spirit world. No amount of superstition or avoidance can alter that date. Unless one has just embarked on a momentous project, which will benefit hundreds of thousands of people that date remains fixed. All the religious steps to prevent death or meritorious acts will not stop the onset of death. Even modern science will fail. Ecclesiates said, " To every thing there is a season . . a time to be born and a time to die. . ."
Reasons for fearing death
Death is a biological process, a function of the body, whilst dying is a psychological process, a function of the mind. Only humans fear to die. Animals do not. Of course animals will struggle to avoid the ultimate deathblow, but they do not plan to thwart the advent of death. There are reasons for this. Animals do not possess an ego and they live only in the present. They do not foresee the future as humans do. In old age, animals naturally retire to die somewhere secluded. Ernest Becker in the ‘Denial of Death’ says the fear of death is ‘the basic fear that influences all others, a fear from which no one is immune. . .’ Humans fear it so much that they become too afraid to live. Everything they do is to avoid death. In their ignorance they use all means to escape death. Humans try to instill immortality by accumulating money, build tall buildings in their own names and acquire or create works of art to deny death. With wealth they hope that medical science could put off death indefinitely. How deluded we are! Death must follow life as night must follow day. Up to date nobody has escape death: not even Jesus, Buddha or Mohamed.
As humans can anticipate the future, they tend to project the most undesirable aspects of death in their mind. In the Western world, in reinforcing of the ego one identifies with the body and mind. So the demise of the body is equivalent to total extinction. In the Eastern tradition especially with meditation practise the ego is being reduced with each meditation practise. There is also less fear of death because of the belief in reincarnation.
Should the physician inform the patient the truth of his diagnosis?
The physician should never lie to the patient. The physician should inform the patient the seriousness of his disease and that the patient will be given the best treatment available. Prognosis as to how long the patient will live should never be given to the patient or close relatives. Nobody can ever foretell the outcome of a terminal illness. Nobody is ever sure of the degree of malignancy, the resistance of the patient and when will there be the discovery of new drugs. Always demonstrate an optimistic demeanour and a positive outlook. Be sincere and be involved. Be sympathetic and compassionate.
The Five Stages of Coping Mechanism in the Terminal Ill
The five stages are:
The above are the 5 stages classified by Elisabeth Kubler-Ross after she has interviewed over 200 terminal ill patients. The interviews were made after they have been told about their disease. She is a psychiatrist who has pioneered the reactions to death and dying and put the plight of terminal ill patients on the medical agenda. Without her work we would not be in the present state of knowledge on this subject of death and dying.
The patients have either been explicitly told or they will inevitably find out about their condition. Not all will go through the entire 5 stages sequentially. Not all the 5 stages will be gone through in the grief process. Some will be stuck at one stage and remain until death. Some will remain at one stage, but will move to resolution after some time. Some will skip a stage. If the medical or family supporters are not conducive, there may be regression back from an advanced stage to an earlier one. The close relatives or love ones will also undergo these 5 stages together with the patient during the illness or experience them after the demise of the patient.
First Stage of Denial and Isolation
The shock of the news of the terminal illness will drive the patient into loneliness and guilt. The shock will result in internal conflict and meaninglessness. Usually denial is a temporary defence and then they move on to the next stage. Out of the 200 cases of Dr. Ross, only 3 held on to their denial till the end. Most patients need to use denial at the beginning of the disease. As time goes on, the patient starts to look at the brighter side of things and may even daydream about much happier occasions. Much later the patient may start to use isolation as a compensatory defence. He may use contradictory statements as health and illness to express his ambivalence of facing despair and hope at the same time. Soon the patient may drop the ‘No, not me’ syndrome and become more realistic and begin to accept the inevitable outcome of the disease. The supporting medical and social staff should themselves acknowledge the outcome of the disease and the stages that the patient is undergoing.
The Second Stage of Anger
Having gone through all the years of study at the university and slogging away at a Ph.D., a man has finally begun to enjoy the benefits and profits of his self-own company. Being a CEO of the company has rewarded him with full control of everything. His family of 3 children has also turned out beautifully. And now suddenly, the diagnosis of a terminal cancer has been handed down to him. "Why me?" is the natural exclamation. "Why not that bum of a beggar at the corner of the street? He has been embarrassing everybody in the street and is of no use to humankind." These are expostulations that are quite natural for someone who has been stricken down at one fell swoop at the height of his career. This is definitely unfair. If there is a God, he must be a blind one! The denial of the 1st stage is now being replaced by the 2nd stage of anger and rage when one has realised that the diagnosis is accurate. The important thing is that the medical and nursing staff should not take these outbursts personally. It is just a reaction of a desperate victim. He should be helped with understanding and compassion. The best way is to sit down calmly and listen to the patient and let him spell it all out. Interject very occasionally with some wise and rational explanation. Be sympathetic and do not lose one’s cool on the patient. If you listen carefully, you may detect the reason for the patient’s anger from his childhood days. An angry person will end up as an angry patient in the 2nd stage. He will end up as an angry spirit when he dies!
The Third Stage of Bargaining
Gradually the patient will realise that if the terminal illness is true, it is quite useless in trying to deny it, and getting angry does not help the situation. Perhaps trying another tack like bargaining may help. Like a child, can he postpone the inevitable if he behaves himself? Can he have some pain-free days if he promises to dedicate the remainder of his life to the service of God? Can God wait until his son is married if he goes to church every week from now onwards? All these bargaining pleas are either made in secret or privately with the chaplain or priest. If he donates all his organs for transplantation can the physician help in prolonging his life? When the priest or physician comes to know about these bargaining pleas, there is mostly some underlying guilt for neglecting the church or not donating money to charities. This stage is usually short-lived and does not last long. However these promises are usually not kept. After promising that this is the last time, another bargaining plea will arise if another occasion warrants it.
The Fourth Stage of Depression
After repeated surgery, radiotherapy and chemotherapy, the patient now realises that he is weaker and can function less ably. Two types of depression will set in. The first is a reactionary one. This type embraces cases that deem themselves as incapable of functioning as a female or a male. It includes those who have lost their jobs and are unable to support the family. Or the mother is now not able to look after the children and has to depend on the neighbours. These reactionary cases may be remedied by prosthesis of the breast or suitable makeup. Social workers can come in to help with the loss of jobs and earnings. Something can always come to alleviate the hardship or loss of self-image.
However the second type of depression is the preparatory stage for the final outcome. This is quite a different kettle of fish. Not only is he losing a job, he is losing everything that he has: all relationships and all things material. Where will he end up? Is he ending up in hell? Or will he be annihilated into nothingness? His whole life is going to end up as a total meaningless journey: he is not needed and unloved. All these are preparing him for the final exit from this world. This type of depression cannot be erased by the usual encouragement to cheerfulness. This depression is a silent one and the patient wants time and space to plan out his demise. It is better not to be garrulous, but a holding of a hand or a stroking of the hair or sitting quietly with the patient is a correct approach. He might ask for a prayer or to read some passages from a favourite poem of his. Of course if he were to bring out all his ‘failures’ of his past life, listen to him. If she cries with sadness, give her a long hug, which will be the most therapeutic gesture you can offer. Once the patient is prepared to say farewell to all his friends and relatives, this preparatory stage should be communicated to the medical and nursing staff and the close relatives and friends. They must be told how to behave and react to the patient’s sadness. They must be told that this stage is necessary for the patient to move on to the next stage of acceptance and peace.
The Fifth Stage of Acceptance
The patient always needs time to arrive at this last stage of acceptance. With the help of an understanding medical profession, he is now not angry anymore. Neither is he depressed. He is now tired and weak and keeps on dozing off to sleep, the reverse situation of a new-born baby. He has come to accept the ending of his journey. There is peace, but it is not a happy one. There is now just numbness with very little feeling left. There is no pain and the struggle is over. This is the rest before the final flight to another realm. The relatives must now be made to realise the patient’s position. He has now not much interest in anything. He does not want too many visitors, and only a few may be allowed to stay, but on the condition that there is no chattering. He is not interested in newspapers or the television. He may just want to hold your hand in silence. The moments of wakefulness are getting less and less. A welcome visitor is most wanted at the end of the day, when the hustle and bustle of the hospital are all over. The patient can also demonstrate to the loving visitor that dying is not so frightening after all. Of course, an occasional case may try to ‘fight to the end’, but these cases may not arrive at this stage of acceptance easily. Do not mistake this last stage of acceptance as giving up too early. Allow the patient to die peacefully without frustrations. Do not fuss. Do not ask the physician to try harder.
There is always a strand of hope that underpins the 5 stages. There is hope that a new drug would be found for the particular illness. Or the doctor has discovered that another operation will do just the trick. A miracle might come about with the visit of a well-known healer. A miracle may come about by spontaneous remission. No matter how dire the circumstances are, a glimmer of hope is always in the background. Without hope there is no will to live. This hope is not overtly expressed, but secretly nurtured in most cases.
By-products of Dying
The two phenomena that occur in the dying are:
In the first instance, the patient normally has no clairvoyant or predictive powers. However some of them will very accurately predict the exact date and time of his own demise. He would then make all the necessary arrangements (legal and domestic) before the oncoming date of death. These predictions are very rarely wrong. These are not to be confused with the predictions of highly developed adepts, who may predict their dates of death years ahead. I knew a Tibetan lama who was looking after a temple in Singapore. He predicted that he would die in 3 years’ time, and that he would die in India. His prediction came true to the month! He died in India in December.
These are of two varieties.
The patient in both the above phenomena would have no more fear or depression after experiencing them. They now have accepted their situations and are looking forward to the impending journey. However, they may still be prevented to embark on their last passage by a close relative (wife, son or mother), who continues to cling to the patient unwilling to let the patient go. The attending physician or nurse then should explain to these close relatives and exhort them to let go of the dying patient. When the close and loving relative complies, the patient will then joyfully leave his or her body to sojourn to a happier realm.
Death of my brother in 1941
I would like to relate the death of my brother 60 years ago. He and I had typhoid before the 2nd world war in 1941. In the last hour of his life, he shouted 3 predictions, which all came true. The predictions were repeated several times. They were:
The Death Process
In order to understand and complete the entire process of dying unto death, we have now to discuss what happens when the spirit leaves the body. As we know from my essay on G-plan, our date of death is fixed by us before we are born (there are rare circumstances when death maybe postponed). So when our cosmic clock intimates to the person that his time is almost up, his heart seed atom will release atomic particles of impending death into the bloodstream. These atoms will stimulate the glands to manufacture a death hormone, which is carried by the blood to all over the body. This death hormone will loosen the electromagnetic hold of the physical atoms upon the atoms of the higher bodies, e.g. subtle bodies or auras. This is the beginning of the soul release. While the physical atoms are losing their grip, the spiritual body is strengthening and the liberation of the soul is being initiated. With old people an illness will appear (part of G-plan) and this is the beginning of the end of the body. Near this end stage, the patient should be allowed to return home to die, and drugs that blur the consciousness should be disallowed. Analgesics that reduce pain are permitted, but the patient must be kept aware as much as possible. When the patient is dying at home, he is being lovingly cared for and this alone will make him more relax. As death approaches, the patient experiences less pain because the death hormone blocks the sensation of pain via the sympathetic nervous system.
The Science of Death
The elderly person with a terminal illness knows that his time is up. With the circulation of the death hormone and the escaping of the soul electricity, the threads of the silver cord begin to loosen. The soul is now more attracted to the spiritual body and it begins its journey towards the brain. The crown chakra (through which the spirit enters the foetus) now begins to open up for the reverse process of death. This is in preparation for the release of the spirit-soul in due course.
The patient’s life force starts to retreat towards the brain from the feet. As the life force leaves the feet they turn cold and pale. The hands and arms are similarly affected with the nails turning purple. The breathing is now laboured and the eyes are dimmed with a far-away look. The pineal gland is becoming extremely active. As the crown chakra expands in its opening, the porous brain is going to allow the soul to pass upwards through silver cord. The kundalini wakens for the upward journey, and the three permanent seed atoms prepare for their departure. The emotional seed atom sits in the 3rd chakra and is responsible for all the emotions of the patient. The mental seed atom sits at the 6th chakra and is responsible for all the activities of the mind. These 2 seed atoms are influenced by free will. The heart seed atom sits at the heart chakra and contains the akashic records, the samskaras, karma and the G-plan. Ramana Maharshi said that this Heart, which is the Self, is situated in the right chest next to the lower sternum. This heart seed atom and its contents are fixed and are not controlled or influenced by free will. It is the destiny of the individual.
As the kundalini moves upwards, the emotional seed atom in the solar plexus departs first after the life force in its up wards movement reaches the solar plexus. After the emotional seed atom leaves through the silver cord, pain is no more felt. Since the mental and heart seed atoms are still in the physical body, the patient may lie in a death coma for some time, but normally it is only for a few moments.
As the kundalini and the life force move further upwards, the patient becomes more psychic and his consciousness and awareness are both expanding. When the kundalini hits the pituitary-pineal centre at the crown chakra, the third eye is opened and the Clear Light of the Void appears. At this juncture many dying patients become very psychic. They are able to:
Even before the emotional seed atom is transferred upwards, an etheric form emanates from the crown chakra. Pain ceases to hurt the patient after the emotional seed atom moves into the etheric (spiritual) form. At this point clairvoyants can see a cloud of smoke arising through the opening of the crown chakra and this smoke configures into a form very similar to the physical body lying on the bed. It takes the form of waves of varying colours rippling upwards to take shape as a human form. After the death hormone has saturated the pineal gland, the mental seed atom will travel through the silver cord through the crown chakra to the brain area of the spiritual (etheric) body. The silver cord is attached to the third eye of the patient at one end and joined to the back of the lower neck or between the shoulder blades of the etheric form at the other end. After the exit of the mental seed atom, the patient will go into a coma. The physical form is undergoing clinical death, but the spiritual awareness is much sharper. This death process will last from six minutes to half an hour.
At this point, the patient is clinically dead, but the heart seed atom has not yet vacated the physical body yet. The silver cord is still intact. Normally the heart seed atom follows shortly after the departure of the mental seed atom. Before the heart seed atom departs from the body a luminous glow can be seen by clairvoyants over the heart chakra. Now that all the three seed atoms have escaped into the etheric form, the spiritual body begins to take the exact replica of the physical body. The facial features are now minutely sculptured onto the etheric form. The face is the same as that of the corpse, but the lines of worry and tension have disappeared, and the etheric form looks younger and serene. Half an hour after clinical death, another white light will appear to the deceased spirit sometimes after a buzzing journey through a dark tunnel, sometimes after climbing a flight of stairs. Mostly the heart seed atom would have left the physical body, but very occasionally it is still stuck in the physical body. This is because in some individuals it takes a longer time to form an etheric form. It is at this time that the physical organs begin to deteriorate and decay. The death of the organs takes between one to fifteen hours. The silver cord now begins to shred. Once the silver cord is totally severed, no healer in the world can revive the patient. This is the sign of final death. That is why we advocate at least three days before burial, because the heart seed atom is not released until the etheric form is more or less perfect. Then comes the breakdown of the silver cord. All these may take 2 to 3 days to complete.
The etheric form will be built according to your lowest desires of the deceased. If there is a lot of hatred or evil, the etheric form will assume these features. Smoking, drinking and drug habits will be imbued into the vibrations of the etheric form. The same goes with carnal desires. This explains why spirits of drug addicts and alcoholics tend to remain earthbound in dens of drug addicts and pubs. Earthbound spirits cannot progress spiritually and this thwarts their development.
Deaths of accidents and violence
The procedure as described above for an elderly person with a terminal disease is the same as in cases of violence and accidents. Just remember that the body must be kept in a quiet and cool place after the violent or accidental death before embalming or burial. This is because it may take three days for the departure of the heart seed atom and the severing of the silver cord in some individuals.
Death of a mystic or adept
In this instance the adept will depart immediately when he dies. All the 3 seed atoms will depart at the same time and the silver cord is shredded straightaway. The adept’s spirit will merge into the Clear Light of the Void immediately after the death of the body.
Death of suicides
A suicide death is viewed with a very different complexion today compared to 20-30 years ago. Today, there is more understanding and tolerance. It has not the stigma of yesteryear when it was viewed with shock, shame and horror. This is especially so with the young and healthy bodies. Suicides of the old and sickly can be more understood and therefore less condemned. Most onlookers do not understand the melancholia and suffering of a manic-depressive. It that state of deep depression, it takes very little to tip the patient into suicide. At this point, a psychiatrist is the best person to prevent the suicide by giving the right drugs. If a psychiatrist has been consulted, he is totally responsible for the suicide.
Michael Newton in the section on suicide in his book, Destiny of Souls, classified those who say that they do not belong on earth into 3 categories:
Michael Newton’s cases are only a proportion of all suicides. A suicide, who shortened his life span say by ten years, will spend the equivalent time earthbound. During this period he is able to watch the pain and suffering of those relatives that he left behind. He is behoved to help and service these friends and relatives from the other side of the veil. When the time of penance is over he will then be able move up to his earned pigeonhole in the astral world. His chief guide would then reprimand him for repeating this suicide act and ask him what he wants to do now. He can return to earth in a short while (maybe as short as five years) or mark time in his pigeonhole. Some volunteer to be sent to a beautiful but extremely lonely place with water, trees and mountains with no souls are present. There will only be an occasional visit by his guides to assist him in his reflections and self-evaluation. They are not sent to bleak and horrible places of purgatory.
In fact, the spirit friends, relatives and guides are all very sympathetic to the recently bereaved suicide, who is being looked after with tender care. This is because all of them including the suicide know that the next incarnation for him is going to be rough; the conditions and circumstances are going to be worst than in the life just completed.
In every case the intending suicide had a choice to take his own life. A high percentage of suicides are repeats: they had done it before. They are so used to take the easy way out that they have this tendency to opt out when things go bad. It is selfish, because relatives that are left behind suffer the shame and agony of losing a loved one.
The Soul Weighs One Ounce
In 1907, a Harvard psychologist, Dr. William McDougall found that dying body lost about an ounce at the moment of death. Recently, an English doctor and separately a West German doctor confirm this same observation. This ounce is more than the air that is in the lungs. So their conclusions are that this is what the soul weighs. This soul-spirit has been photographed by a Frenchman who took several photographs of his dying son and later of his dying wife. Both sets of pictures show a misty cloud hovering above the bodies around the time of death. This cloud represents the spiritual body that clairvoyants see during the time of death.
Other researchers have worked out that the soul of a person is about one thousandth of that person’s weight. For example a person weighing 154 pounds has a soul which weighs 2.5 ounces.
How to reduce the fear of dying
After discoursing above on coping with the emotions of dying and the process of death, we must now discuss the steps to reduce the fear of dying. Firstly we must find out why we fear dying. This topic is explored in John White in his book on ‘A Practical Guide to Death and Dying’. He enumerated five principal aspects to the fear of dying:
Armed with the knowledge that only the body dies and not the soul, one can then reduce the fear of pain. Firstly, analgesics are now easily and abundantly available and therefore physical pain can almost be totally eradicated. This fact alone should allay fear of future torture to the body. Believe that there is no such thing as hell or eternal damnation. With proper knowledge of the journeys of the souls there should not be any fear of self-annihilation. The above mental preparations should also increase the threshold of pain, especially if one can learn to self-hypnotise oneself. In other words, there may be pain, but there should not be any mental suffering. In the Eastern spiritual practices the yogi who is proficient in meditation will be able to die a good death, as he is merely discarding the physical body, which has outlived its usefulness. Saying goodbye to the body is a practice that an adept looks forward to, and literature abounds of anecdotes of these cases. There is no pain or anxiety or fear. There is only peace, tranquillity and joyful expectations! The adept’s disciples are asked to rejoice at the event of his passing.
Forums on Subjects of Death
In the background, one must breakdown the taboo on the subject of death. This subject must be openly discussed in schools, universities and public forums. All superstitions and religious opinions should not be allowed to enter the discussions. One must bring out only scientific facts. For instance we know for a fact that the following prove the survival of the personality or the soul:
Even if you do not believe in every one of the above, at least one or two of the above should bring one to a strong belief of the survival the soul. We exist beyond death. Death is merely a transformation of consciousness, from one in the flesh to one in spirit. Immortality of the soul is confirmed in those who had experienced near-death-experience and out-of-body experience. When one has seen a ghost, this fact should also reinforce our belief in the immortality of the soul. Mystics who have realised the Self will tell you that there is really no death. The transition from personal consciousness to cosmic consciousness is similar to going to sleep at night. It is our habitual waking up in each morning that assures us that sleep is harmless, although in deep sleep our soul visits the astral world nightly. So death is not really as fearful as we have been indoctrinated. It is merely a long sleep.
So what are the steps to take to reduce the fear of dying?
Death is the last Stage of Growth
According to Elizabeth Kubler-Ross, Laurie and Joseph Braga, death is the final stage of growth. Death is only the end of the physical body, but our spirit still lives on. It is trying to conform to the external definitions of who we are that spells our spiritual death. Each of us is unique, but we try to fit into stereotypes, culturally defined for us. That is the rub.
Death is the key to the door of life. When we fully realise that our life span is limited, we are able to reject all the extrinsic roles and expectations put upon us by society. It is due to the denial of death that makes people lead purposeless lives. Thinking that we do not die is the reason we postpone all the essential things that make us grow. Live as if you have only today to live, and do not fret about tomorrow or regret about yesterday.
In order to grow in these last months or years, commit yourself to serve and help other people to grow. Serve to eliminate the suffering of others and help others to recover from their depression, but always towards growth. Only when we understand that death is the touchstone to human evolution that we have the courage to act out our destiny.
One must give up everything to gain everything. Give up all that is not you. Erase that self-doubt in order to love and trust your self, and you will become your true Self. In this way you become peaceful and you truly love and be loved. Do not look for approval from outside. You will know yourself. Practise life with compassion, love and wisdom for the sake of others.
Seeing that death means only the destruction of the body and not your Self, it can be viewed as raising the curtain separating the physical from the spiritual world. In these last days, we would know the purpose of life only too vividly. Our purpose is to grow with wisdom and love and to service others. In this goal, we use action and communication. Silence is not enough.