The Dance of Life


On Monday I buried one of my patients.

That is not so unusual given the nature of my work in healing and hospice. When I think about Fred, I am reminded that I work according to the principle of meeting people b’asher hu sham (where they are) as opposed to leading them somewhere, as the image of pastoral care might call up.

Fred was referred to me by his oncologist, who felt that he and his family could benefit from spiritual care — the patient was anxious, needy, demanding and somehow not settling into the reality that he was living with terminal cancer.

I was told to speak with his ex-wife and son first, as the patient would probably not welcome my call. I arranged a meeting with her, and she spoke of the difficulty of finding a balance for all three family members with the patient being so unhappy and demanding.

She described him as very bright; a college professor who didn’t trust most people and though they had divorced, they had remained amiable in the raising of their son. I later came to learn that Fred was born in France, an only child whose parents sent him to a convent to hide him from the Nazis. That was his early life.

I asked her what gave him pleasure or joy in life, and she didn’t hesitate for a moment: salsa dancing.

Bingo — I knew he would not hang up on me.

Fred and I shared several things in common: Cancer and salsa dancing.

I called him after my meeting with his ex-wife and asked him if he wanted to meet with me.

He said “no thank you,” he wasn’t feeling well. When I explained that was the usual condition of people that I meet with, he still declined. I then mentioned that I was a salsa dancer, and he took my number and said he would call.

Several weeks later, Fred called and asked to meet me. We arranged to have coffee at a neutral place; he was still a bit suspicious. I found him sitting, waiting for me, wearing a wig to cover his chemo baldness. My hair at this point had grown out and looked like a poodle’s.

We had an easy conversation; he talked about the numerous rounds of chemotherapy, the clinical trials, how the current one seemed to be working, and how he was getting a bit more energy and could see the road to recovery. We talked about our dancing history, same clubs, same people; we’d probably passed each other on the dance floor once upon a time.

I shared with him that my last dance was on my birthday a year and a half before, the day I was diagnosed with breast cancer. Technically, I had one quickie after that, in front of the PET scanner with a technician who had missed my veins three times before the scan and was making it up to me by showing me a fancy dip.

Fred suggested we might go dancing some time. I thought about boundaries, and client/clergy relationships, and realized that if this was the one thing that gave this man joy, who was I to step on his toes?

Besides, hadn’t I heard a colleague of mine — a hospital chaplain, herself a breast cancer survivor — tell me that, on a counseling visit with a pre-op mastectomy patient, she found herself, despite being armed with psalms and healing prayers, pulling her shirt up over her head to show this young woman her own reconstructed breast? B’asher hu sham.

Fred and I met at the club, both of us nervous about how rusty we were; how we had to face the fact that we were no longer the energetic, young dancers we had been in the past.

One of us had a wig and the other new curls, but we hit the dance floor, managing to make it through an evening of dance, with long breaks for club soda and to wipe the sweat from our brows. We vowed at the end of the evening to return and to keep practicing.

I spoke to Fred several days before he died. He didn’t want to be on hospice, didn’t want to think about dying — or to let me visit him in the hospital — but he said he thought that he had danced his last dance.

I was honored to have shared it with him — b’asher hu sham.

Rabbi Carla Howard is the founder/executive director of the Jewish Healing and Hospice Center of Los Angeles. She can be reached at Rabbihoward@jewishhealingcenterla.org.

Laugh at Death the Buchwald Way


Art Buchwald is living and dying in a Washington, D.C., hospice. If you don’t know his story, you could be forgiven for thinking this is a very sad time for the 80-year-old Jewish columnist.

Just the opposite, Buchwald says. “I am,” he announces, “having the time of my life.”

His family and friends, along with the political and artistic glitterati, are coming by to shmooze, reminisce and bring his favorite foods. He mentions that he likes corned beef sandwiches; the next day guests bring in 10.

He continues to write his column for the Washington Post and 50 other papers, but now the topics, still with his characteristic humor, are often about death, the hospice and making your own end-of-life decisions. Many people write to thank him for giving them alternatives to consider.

Here’s the story. Suffering from kidney disease, he entered a Washington, D.C., hospice in February after deciding that he didn’t want to prolong his life by having dialysis five hours a day, three days a week. He had already had his leg amputated for other reasons and he figured now: “I had two decisions. Continue dialysis, and that’s boring to do three times a week, and I don’t know where that’s going, or I can just enjoy life and see where it takes me.”

Life had already taken him, beginning at age 3, to two orphanages after his mother was institutionalized with mental illness from which she never recovered. Young Art ran away at age 17 in 1942 to join the Marines. After the war, he attended college and edited the campus magazine, but didn’t graduate because the school discovered his lack of a high school diploma.

So he went to Paris where a small job at the Herald Tribune morphed into a humor column, which in 1962 he took to Washington. During his heyday, he was writing three columns a week, syndicated in 700 papers.

His shtick was taking serious political and social issues and turning them into humor, which as we know, for whatever genetic, social or historic reasons, has always been a strong Jewish trait. Think Lenny Bruce, Mort Sahl and a 100 others. In Buchwald’s day, he was better known than Al Franken and Jon Stewart are today.

Through it all, he never lost his sense of his place in the whole story, which most of the time was outside laughing in.

“Just when you think there’s nothing to write about, Nixon says, ‘I am not a crook,'” Buchwald once wrote. “Jimmy Carter says, ‘I have lusted after women in my heart.’ President Reagan says, ‘I have just taken a urinalysis test, and I am not on dope.’ You can’t make up anything anymore. The world itself is a satire. All you’re doing is recording it.”

When President Eisenhower’s press secretary, James Hagerty, took a Buchwald column seriously and called it “unadulterated rot,” Buchwald responded with indignation: “He’s wrong. I write adulterated rot.”

Buchwald has undoubtedly earned a place in my pantheon of personal heroes, men and women whose actions in the face of impending death seem to me both inspiring and heroic: Hubert Humphrey, tennis great Arthur Ashe, professor Morrie Schwartz of “Tuesdays With Morrie,” Christopher and Dana Reeve, Lenny Zakim, to name a few.

Talk about dying with dignity. Their deaths may have come too early and been too hard, but not one of them ever lost his heart or soul or kindness, nor stopped performing good deeds in this world. Nor did they kvetch, complain, blame. Buchwald fits in well.

Should there ever — sometime, somewhere — be a meeting of these greats, along with all our friends and family members who have inspired us in life and in death, you can bet Buchwald will be there, too. And you can bet he’ll regale them all with how he beat the doctors’ forecasts of his survival by hundreds of percents, just as he regales us now when asked about the afterlife.

“I have no idea where I’m going but here’s the real question: What am I doing here in the first place?” Buchwald says, part humor columnist, part rabbi. “It’s what you do on earth and the good deeds you do on earth that are important.”

Shalom u’lehitraot, Art.

This article originally appeared in The Forward (dblevy@columnist.com

 

No Compassion?


The day my mother was transferred from a nursing home to a hospice, I raced from Baltimore to northeastern Pennsylvania. This 80-mph excursion into death — my mother’s death — might rescue me from whatever boredom and tedium had enveloped me, but it would also plunge me into a realm where I didn’t necessarily relish going. But go I went. For you see, there was no choice.

Arriving at the hospice, I finally found my mother’s room, then paused briefly in the doorway, not quite ready to enter. After a few minutes, I caught my mother’s eye. With a finger curved from years of arthritis, she motioned me toward her. Approaching her bed, I bent down. I didn’t want to miss what might be her final words, words of wisdom or longing or regret or love, words that could rival the most poignant deathbed scene of the most melodramatic (or the most cornball) film. Indeed, this could be a true moment of reconciliation, of empathy, of demolishing the walls of distance and reserve that had risen between us over the years — walls that belied all the enviable myths and fables about mothers and sons, stories that I knew were true (at some level) because I saw, occasionally, mothers and sons getting along as mothers and sons were intended to.

As I stooped at her bedside, I saw her summon her strength. I waited, and then came her last verdict of me.

“You have no compassion,” she rasped out, syllable by syllable, wagging her bent finger more or less in my direction. “All you care about is the money.”

That was the last I heard from her. Shutting her eyes, she slid into a coma. It was late afternoon. Hours later, I finally shooed my nephews out of the room, sat down next to my mother and delivered a two-hour monologue about our relationship and the pain of her parting words:

“You have no compassion” — This from a woman who saw me as an interloper and a destroyer: my birth had caused such damage to her interior that she couldn’t resume sex with my father until she had an operation 12 years later.

“You have no compassion” — This from a woman who saw me as so distant, so aloof, so inscrutable that we couldn’t talk to each other until I was about 8 because of my severe speech impediment. After I’d gone through years of speech therapy, she finally didn’t have to ask a cousin who lived near us to run over and “translate” my babble to her.

“You have no compassion” — This from a woman who had a hard time relating to my love of books and literature and ideas and always proclaimed, a bit too defensively, “I didn’t go to college, but you don’t need a college education to be smart.”

“You have no compassion” — This from a woman who elevated self-sacrifice to an art, self-effacement to a talent and scolding to a craft. That finger with which she motioned me to her bedside was no aberration. Throughout my life, when that finger pointed at me, I knew I was in trouble.

My mother was not in the same league as writer Mary Gordon. In fact, she probably never read anything by Gordon. But the same apprehension that gripped Gordon when her doctor told her she was having a boy probably gripped my mother for many years after giving birth to me: “Oh my God! What am I supposed to do with one of them?”

The problem is that I wasn’t just “one of them.” I was damaged, I had damaged her, and the breach between us was so wide and so antipodean that countenancing even the possibility of abridging it was almost the same as risking what might happen if we didn’t try. Either way, there was the probability of two strangers staring across an abyss. The gap between us was as corrosive and daunting as it was frightening, which may be why it had become permanent.

From Oedipus onward, all of us have seen moms through prisms that are as inaccurate as they are sometimes hopeful and dreamy: A king marries his mother and stabs his eyes out in shame; Harriet bakes brownies every damn day for Ricky and David (and, of course, for her husband, Ozzie), and everything’s right with the world or, at least, at 522 Sycamore Road in idyllic Hilldale.

But enough of Oedipus’ mother/wife. And enough of Harriet, famed chef of Sycamore Road. There are real-life moms and real-life problems and swirling around us are real “headwinds of darkness” — Sophocles’ words about Oedipus which, I pray, is all we have in common with that cursed son/husband.

“You have no compassion!” — It might be true. I hope not. I’ve lived my life with respect for others, volunteering for good causes and working for a few years at slave labor wages for a major public interest group. I also tried to have compassion for my mother. Maybe what’s most important now is not whether she was right or wrong, but the impulse that chose her particular parting words.

By mustering whatever compassion I truly have — compassion that I prefer to believe my mother didn’t know about — I can suggest that she was really trying to help me by deflating whatever myths I might harbor about mothers and sons: Begone, Harriet of Sycamore! Away with thee, June Cleaver! But I honestly don’t think that was her intention: Even she wasn’t that compassionate. No, I think she was a very angry woman — angry, literally, to the end. I also believe that I just happened to get in her way. And that was most unfortunate, for both of us.


Arthur Magida’s latest book, “The Rabbi and the Hit Man,” has just been released in paperback by HarperCollins. He is the University of Baltimore’s writer in residence.

Celebrating Length of Days


Fifteen years ago, in the city with the second-largest Jewish population in the world, the idea of a Jewish hospice service lived and died. The truth was that the Los Angeles Jewish community was not ready to support a spiritual service for the dying.

Rabbis Carla Howard and Sheldon Pennes, founders of the recently created Jewish Hospice Project, Los Angeles, think they know why.

The idea of hospice "is not very Jewish," Howard saidwhile sitting in the Skirball cafeteria after a day of teaching at Milken Community High School. "It’s giving up the fight; the commandment is to embrace life, so the misconception is that if you choose hospice, then you’re giving up on life."

"It’s not a sexy topic," said Pennes, rabbi of Montebello’s Temple B’nai Emet, "People don’t like to talk about it. Lots of money [from the Jewish community] goes into medical research … but research will not help those people who are dying, afraid and alone, every day."

In the past, hospice defined a safe house where pilgrims and the homeless were offered lodging, usually by a religious order. Today, we know of hospice as a place where terminally ill patients with less than six months to live go to end their days. Treatment is palliative, focusing on pain management rather than cures, and often includes spiritual counseling in preparation for death. The idea is to treat death with dignity, surrounding the patient with family and friends rather than machines.

Though support for hospice is apparent in the general public these days, the Los Angeles Jewish community must rely on other services, such as Trinity Care Hospice, a wing of Catholic Healthcare West, which serves Jewish Home for the Aging, rather than any Jewish hospice. (The Home recently released plans to open a 16-patient hospice, available to the communty, when their new facilities open at the beginning of May.) Until recently, even Cedars-Sinai had only a per-diem rabbi on call to serve Jewish clientele.

A year ago at a Purim carnival, Howard and Pennes began to talk about the need for a Jewish hospice in Los Angeles. For 11 years, Howard had studied Jewish healing and spirituality, and had served as associate rabbi for one year at Metivta, A Center for Contemplative Judaism. Pennes works as chaplain at Trinity Care Hospice, witnessing daily the need for Jewish spiritual end-of-life care. They both decided to go for it, despite the challenges they knew lay ahead.

"What bothered me the most," Pennes said, "was all the money … after a person dies, but there’s a lack of money for end-of-life care."

He cites the disparity in fees: a pulpit rabbi gets $350 for a funeral; a rabbi who visits the sick at a hospice gets $20 an hour. "There was nothing really there for those who needed this care," he lamented.

"The most important thing that we want to teach people is that to choose hospice is to choose life," Howard said. "When my pain is managed, then I can get down to the work of living. I get to say the things that I never said, make the connections to the relationships that are there, as opposed to getting the cure here, trying medical advances there. It’s how to live with dying."

Not every dying patient is ready to receive spiritual care, Howard acknowledged. She found that people very much die as they live: on their own terms.

"I was called to a woman [in hospice] whose body looked like she should have given up the ghost a long time before, but she was hanging on. She made no mention of death. We just had a nice conversation, weekly, for three months," Howard said. "Then one day a hospice nurse was changing her wound and I asked the patient if there was anything she wanted to say. ‘What will it be like at the end?’ she asked the nurse. I facilitated the conversation, and once the nurse explained what it would be like, the woman got down to the business of tying up relationships … and died a few weeks later."

Howard and Pennes have many similar stories of people, affiliated and nonaffiliated, who want a deeper connection toward the end. "There aren’t many of us around trained to do hospice work," Pennes said. "People think pulpit rabbis can do this kind of work, but they are already so stressed to the limit, they can’t give the time that hospice visits demand. Hospice care requires being with the family for months and intensive time at the end. So, basically, the work is not getting done."

Both Howard and Pennes base their work on bikkur cholim, God’s commandment to visit the sick. No person’s final journey should be alone, they believe. What they propose, and are doing on a limited basis now, is training medical care professionals and rabbinical students in the art of hospice.

"I teach people how to be present with people who are sick, how not to fill the space but make the space," Howard explained. "Jewish tradition teaches us that the divine presence hovers over the bed of a sick person. Our job is to reflect that divine presence [back to the person] and to help the patient, if they can, come to that spiritual experience.

"Each death is as unique as each person’s fingerprint. I walk in with a sense of awe and humility…. If I’m mindful of the situation and present, then God’s presence will do the healing," she said.

So far, Howard and Pennes have been struggling with "initial growing pains" (i.e., the difficulty of raising money in the Jewish community). They’ve had wonderful moral support, they say, and they’re most proud of the fact that they have an advisory board of rabbis from every denomination who unanimously support the need for a Jewish hospice. But funds are still lacking.

"We’ve raised a small amount of money for our nonprofit papers, applied for some grants and hired a grant writer," Pennes said. "We need $350,000 for the initial year, and then an additional $100,000 to $200,000 over the next couple years to pay for hospice chaplains, design curriculum and training, and outreach in the Jewish community."

Howard and Pennes, who also teaches at Milken Community High School,hold various other jobs as well. They would devote themselves full time to the Jewish Hospice Project, if they could. Through outreach and word-of-mouth, they hope to find the person who can help them put Jewish Hospice Project, Los Angeles, on the map. The work, they believe, may be the most important work a person can ever do.

"The dying process strips away every identity you have as a person, everything you know and hold, and what you are left with is your deepest self," Howard said, as she rose to go, late for a visit with a sick patient. "The divine presence will help the patient be in touch with their deepest self if we the visitor, we the rabbi … reflect back to the patient in hospice, and hold the space for them. They will do the work."

Journey’s End


Lunda Hoyle Gill sat in her spare room at a Westwood assisted-living center, the last stop on her remarkable life journey.

The artist once traveled to the remotest parts of the globe, racing to paint indigenous peoples before they disappeared. But that was before cancer ravaged her gut and Parkinson’s disease crippled her fingers. Today, at 72, the artist can no longer paint. She can barely walk or hold a spoon.

In the final months of her life, the Cedars-Sinai Hospice Program has helped Gill to achieve a longtime ambition: a retrospective of her work, to open Sunday at USC Hillel.

Gill’s international travels began in 1974, when she read about Stone Age tribesmen in the Philippines and thought they would make inspiring subjects. Over the next decade, she traveled from Tonga to Tibet, cramming as much food and medicine as she could fit in a duffel bag, often backpacking alone into the bush.

"My vulnerability allowed me to reach the native people more deeply," she explained.

Gill breakfasted with Genghis Kahn’s 23rd descendant in Mongolia, had a gun pulled on her in the Aleutian islands and painted Eskimo whale-hunters while precariously perched on an iceberg. Once, 40 miles from Siberia, she was stranded for a week on a fog-bound island that she called "a spit of gravel in the ocean."

Even more dangerous was painting the tribal executioner of a headhunting clan, whose menacing portrait looms from a corner of Gill’s room. His face is hidden by a mask: "If I had given away his identity, I would have been killed," Gill said.

Gill, whose work hangs in the Metropolitan Museum and who has had three exhibits at the Smithsonian, traveled throughout China to paint the country’s 55 minority cultures in the early to mid-1980s. Several years later, she traveled to Israel to paint ethnic groups of the Jewish state. An Ethiopian Jewish women proved a difficult subject: "She’d gone to the beauty parlor, so I had to study museum photographs to get the traditional hairstyle just right," Gill recalled.

When Gill was in her 60’s, her travels came to an end. In 1997, the artist was diagnosed with inoperable cancer.

Last year, she entered the Cedars-Sinai hospice with a final wish for a pictorial life review; hospice official Mary Hersh responded by mailing an urgent letter to some 15 museums and galleries.

USC Hillel program director Matt Davidson was one of those who replied. "It was an unbelievable chance to do a mitzvah for someone, so saying ‘yes’ was a no-brainer," he told The Journal.

In September, the Southwest Museum will also mount an exhibit of Gill’s work, though she is unsure she will live long enough to see it. "I didn’t think having any kind of exhibition was even close to possible while I was still alive," she said.

Sitting in her quiet room last week, Gill hoped she would feel well enough to attend her Hillel opening May 6. "I hope there will not be tears," she said. "But if they come, it’s fine."

For information about the Hillel show, call (213) 747-9135.