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Book Reviews
Christine Longaker. Facing Death and Finding
Hope: A Guide to the Emotional and Spiritual
Care of the Dying. New York: Doubleday, 1997.
ISBN 0-385-48331-7, 262 pp.
T
h e spiritual care of the dying is one of the
greatest challenges in palliative care. There is little agreement on what is meant by the various terms
used to describe the spiritual domain of human existence and even less agreement on what is meant by
spiritual care in the context of palliative care. By its
very nature the spiritual domain does not lend itself
easily to study or analysis. Most authors include spiritual care along with the physical, emotional, and
social elements of caregiving in the common mantra
they invoke for palliative care, but spiritual issues
have yet to receive the same analytical, descriptive, or
research attention as the other three areas. Nonetheless, spiritual distress needs to be addressed in providing palliative care to the whole individual. And, as
we become better at controlling physical and emotional symptoms, spiritual concerns increasingly
come to the fore. The current infatuation with euthanasia and assisted suicide as options for the terminally ill speaks to the spiritual void in our society. It
is ironic that because we are not able to control or
understand life in the face of death, many would
rather end life prematurely and on their own terms
than squarely face the spiritual or existential concerns
that are at the heart of their distress. The lack of a
comprehensive approach to spiritual care has hampered progress in confronting these issues. Thus this
new book by Christine Longaker is very welcome.
Christine Longaker is a longtime student of Sogyal
Rinpoche, author of The Tibetan Book of Living and
Dying, who has also written a fine introduction to this
text. Longaker writes with a strong Buddhist perspective, though she takes pains to show how the practices of Tibetan Buddhism may be applied from the
perspective of other religious traditions. An experienced hospice worker who helped to establish the
Hospice of Santa Cruz County in California over 20
years ago, she is now working with Sogyal Rinpoche
to develop a Spiritual Care for the Living and Dying
Program, which aims to bring about "a quiet revolution in the whole way we look at death and care for
the dying and the whole way we look at life and care
for the living."
This book is written for patients facing death, for
their families, and for professional and volunteer
caregivers involved in the care of the dying. Yet it also
has a great deal to say to the wider audience of those
who wish to live more fully in the present and better
prepare for their own eventual death. As Rinpoche
writes in the foreword: "If we can only learn how to
face death, then we'll have learned the most important lesson of life: how to face ourselves and so come
to terms with ourselves, in the deepest possible sense,
as human beings."
The heart of the book is Longaker's description of
what she calls the "four tasks of living and dying":
• understanding and transforming suffering
• making a connection, healing relationships, and
letting go
• preparing spiritually for death
• finding meaning in life
Longaker explores each task in detail, giving practical advice on how to be more sensitive to the needs
of the dying, to help patients seeking to make sense of
what is happening to them, and to help patients and
families find healing in the face of death. Further,
recognizing that these tasks apply equally to our ability to face changes or losses in life provides a powerful stimulus to begin living authentically in the
present.
Two specific practices of Buddhism are described
in detail: tonglen and phoioa. Tonglen, which means
"giving and receiving", is a practice designed to develop the capacity to take in suffering and give out
love and compassion. This is compassion on a
grander scale than we normally conceive; what makes
it distinctly Buddhist is the notion of being able to
expand one's capacity and natural sense of compassion for those who are suffering. Phowa is considered
one of the most important practices in the Tibetan
Buddhist tradition by which spiritual support is provided to the dying. Longaker explains these practices
and shows how they may be adapted to other religious faiths.
She emphasizes that in order to provide spiritual
care to the dying, caregivers must themselves embody
a spiritual commitment in their lives. Through our
manner of being with patients we caregivers are able
to help them on their spiritual journey. "Spiritual care
is an expression of our inherent compassion and wisdom; thus it is our entire way of being." Developing
a "good heart throughout life enables us to heal our
relationships with others, bring peace into this troubled world, and meet death without fear".
Spiritual practice in the context of this book is
about ways of demonstrating support and compassion and about ways of incorporating Buddhist practices such as tonglen into the clinical area to benefit
ourselves and our patients. As Longaker points out,
the spiritual caregiver must also help patients and
families to find meaning and heal relationships. She
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sidesteps the issue of providing a precise definition of
spiritual care, emphasizing instead that spiritual care
involves both a traditional religious approach to spirituality and an existential approach focused on finding meaning.
Facing Death and Finding Hope is not about generalities, wishful thinking, or good intentions. It is an intensely practical book with sound clinical advice.
Longaker avoids formulas for quick fixes to existential and spiritual problems. Rather, she expands readers' understanding of the suffering of the dying while
providing examples of methods that they can try to
become more effective caregivers. The book is
strongly recommended for all who are working with
or interested in improving care of the terminally ill.
Reviewed by JOHN F. SEELY, MD, University of
Ottawa Institute of Palliative Care, Ottawa, Ontario,
Canada
[aroslav Havelka. Musings of an Inquisitive
Mind. London, Ontario: King's College, 1997.
ISBN 0-921543-11-8, 149 pp.
hat an anthology! I am seldom given to superlatives, but this is one book that will seldom be out of my reach. My sincere gratitude to Mr.
Havelka's widow and King's College for rescuing this
project and seeing it through to publication.
jaroslav Havelka's "musings" are much more than
that. They explore subjects as diverse as the Tao, Zen
koans - even mankind itself. Each chapter is prefaced with a drawing by the author and accompanied
by quotes from sages from all civilizations and across
history. The drawings are fascinating and moving. I
hope that a full collection of drawings by Havelka
will one day find their way into a book.
This is the type of book that upon awakening you
open to any page and, through the Tao, land on a
musing that offers insights and reflections or maybe
even the opportunity for personal inner work which
is pertinent to that day and your personal space. As
well, it offers many lessons that you can tease out and
delve into during the day in the knowledge that you
will come out a wiser and more balanced person. And
perhaps you will want to take a last peak at night so
that you can rest your head on the pillow and dwe.ll
on a beautiful image, painted by the words of this
mastermind.
Over the past 10 days I have read Musings of an
Inquisitive Mind from cover to cover, but I certainly do
not recommend this approach. Rather, I suggest you
rely on the Tao to pick a topic and delve into one of
the chapters under it. On each day of my reading I
have found many musings to reflect upon and to
share with others. Whether exploring "Nature", "Angels and Animals", "Living and Dying", "Creative
Intelligence", "Symbols and Imagination", or any of
the other five chapter groupings, I found a passage, a
musing, which brought me peace.
How cheated I feel that on my visits to King's
College I did not have the fortune to encounter Dr.
W
Havelka. How joyous I am that his legacy lives on in
this gem of a book. Do yourself a favor. Go out and
purchase a copy, now. You will never regret it.
Reviewed by STAN B. HENEN, Consultant, Member
of the International Work Group on Death, Dying and
Bereavement, London, England
Joey O'Connor. Heaven's Not a Crying Place:
Teaching Your Child about Funerals, Death,
and the Life Beyond. Grand Rapids, Michigan:
Fleming H. Revell Co., 1997. ISBN 0-800756-436
paperback, 208 pp., US $11.99
his .boo~ is intended to assist parents in helping
.their children to develop a healthy understanding
of life and death, through the ability to celebrate life,
trust God, and have hope in the face of death. Joey
O'Connor has a background in funeral service and
writes as a Christian. These two facts are key in attempting to evaluate Heaven's Not a Crying Place. This
is not just another book about the questions that children ask about death and dying. It is one that takes a
clear Christian perspective. Otherwise the author
makes statements that might be difficult for nonChristians to read; it is clear that, for O'Connor, a
belief in Jesus is an essential part of the healing aspects of the grieving process.
As O'Connor tackles this difficult topic, he identifies many important points. He does this in a clear,
straightforward manner. His open, empathetic style
of communicating may well have come from seeing
his father, a funeral director, help people who had
lost loved ones.
O'Connor uses movie references throughout, beginning with a discussion of C.S. Lewis's Shadotolands.
Hollywood, according to the author, confronts us
with what we are afraid to face alone, and
Sliadotolands gives us permission to cry. This and the
other films he refers to provide "teachable moments"
through which parents can teach a child about life
and death.
O'Connor provides useful annotated lists on a variety of topics: what death is and what it is not; damaging religious platitudes - called "spiritual sound
bites" by the author; the emotions of grief; benefits of
helping children grieve; fears a child may face when
a loved one dies; helping children deal with fear;
helping a family when a member has a terminal illness; helping grieving teenagers; making "memories";
components of grief (from Cendra Lynn); and do's
and don'ts for helping grieving persons. Other lists
are clearly intended for Christian parents only:
"Teaching what the Bible says about life and death";
and"Are there any questions?"
These lists often include recommendations that are
broadly applicable: begin explanations with a story,
talk about suffering and conflict, talk about sadness
and grief, help children choose life. The explanations
of terms related to funerals are excellent.
T