Why, Why Now, How, and So What?

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I’ve come to the end of my short essays on the Five Remembrances, though I have certainly not completed my contemplation of aging, ill health, death, impermanence, and karma.

Several of my readers have expressed concern that such an intense focus on these subjects might be mentally and emotionally unhealthy. For some, reading these reflections has been a downer; for others, it has provided an opportunity to face fears and cultural taboos and to explore new emotional territory. Some are curious about why I undertook this focus and what effect it has had on my life over the last six months. So, here are some answers.

Why do this? Why now? How?

It has been my lifelong inclination to face difficult truths about myself and the world around me, rather than avoiding or deflecting them. My fascination with death stems from a natural curiosity about a mystery that no one seems to have solved. It feels rebellious and even somewhat subversive to look directly at something that most people would rather look away from. Those who know me well are not surprised when I raise uncomfortable truths.

Several factors contributed to the decision to focus my attention on death in 2026. I have previously mentioned that for the last couple of years I have participated with several other women in an online discussion group focused on aging. This group provided an outlet and support for facing common problems as we age. However, we seemed to shy away from discussion of our mortality.

Then, last fall, my church sponsored a series of discussions about death, focusing on advance directives, end-of-life planning discussions with family, funeral arrangements, and dealing with grief. It was a good introduction but seemed to me and a few others to dance around the subject of our mortality. A smaller facilitated discussion hosted by the church this spring came closest to exploring feelings about our own deaths and our experiences with the deaths of those closest to us.

Meanwhile, my retirement community is currently hosting a program on death led by Leona Oceania, founder of Die Well Death Education, comprised of thirteen two-hour sessions conducted over thirteen months. The room is packed for every session!

This trifecta of opportunities intersected with my personal realization that my time is short. I’m 74; both parents died of pancreatic cancer at 84 and 90, so my life expectancy is about 12-15 years. That’s a relatively short time in my lifespan. It is possible, even likely, that I may experience serious pain and discomfort leading up to death. Suddenly, the questions of how I want to spend my remaining healthy years, and how I might deal with illness when it arrives, became urgent.

I asked myself how I would approach the exploration of these questions, and my Buddhist practice provided a ready suggestion. My reading had made me aware of the Five Remembrances and the practice of Maranasati, which I introduced in the first article in this series. The Remembrances would provide the structure and arc for my reflections.  

So what? What difference has it made?

Looking back on the last six months of meditating on and writing about the Remembrances, I ask myself whether this practice has affected how I live daily life. Are there practical and transformative impacts to pondering aging, ill-health, death, impermanence and karma?

For me, there have been several.

During this period, I’ve often found myself stopping in the middle of a walk with my dog or on my way to an early-morning workout, looking around me with fresh eyes, listening intently to the silence of falling snow, the sound of birds, or the rain. In those moments, I felt deeply aware of the world’s beauty and the intense joy of being alive. I recognized and experienced my place in nature. The ability to stop, tune in to the reality of the moment, and feel grateful to be alive has grown over the months.

While accepting the inevitable—whether it be wrinkles, sickness, death, change, loss, or consequences—takes a certain degree of daring, determination, and discipline, the most compelling motivation for coming to terms with all of these is this: the sages of all ages and religions have promised that doing so wakes you up to the essence of life. I still have much to see, do, and understand. I want to heighten my awareness to have the best possible chance of experiencing everything. So, it is now common for me to silently say to myself several times throughout the day, “Moriah, you are going to die? This may be the last time you see, hear, taste, smell, or feel this. Pay attention, appreciate it fully.” And, I do.

Contemplation of death has revealed what I truly fear: pain, disfigurement, suffocation, cold, hunger, sleeplessness, and shame. Recognizing and naming those fears is the first step in relaxing their grip. It has been revelatory that death is not one of them.

Rather than fearing death, I’ve come to realize that contemplating it brings a deep feeling of sadness and loss—sadness at the loss of my most precious possession, my consciousness, my awareness. I wonder if mourning this loss now is a facet of my personal death work.

Contemplating impermanence has made me more conscious of the things I cling to. So, I have become more aware of the ordinary things I am challenged to let go of—my desire to see a situation resolved, my need for my contribution to be recognized, my wish to remain in a friend’s good graces, my plan for the day. The frequency with which I am required to let go convinces me of how much I am holding onto. Though intellectually, I recognize that control is an illusion, practically, I’m still operating in control mode. I have more work to do.

A powerful “letting go” metaphor emerged recently in a vivid dream. I stood beside a sheer cliff with the ocean at its base. I was aware of an intense desire to reach a destination beyond the cliff, one that felt like home. The only way to get there was to climb along the almost smooth rock, clinging to the few tiny hand and foot holds carved into it. Crossing without falling seemed impossible. But I had no other choice, so I began the climb, gripping each crevice with all my strength and concentration. About halfway across, I looked ahead and saw that there were no more cracks to cling to; the surface was completely smooth. I could not proceed. I knew I had two choices: to go back or to let go. I let go. And then I woke up.

Life in a retirement community surrounds me with the realities of aging and death daily. It’s impossible to avoid them. Death comes often to my friends and neighbors, and because it is such a frequent occurrence, it is always top of mind. This, for me, is a plus, enabling me to learn from my peers how to age and die gracefully and peacefully, and how to cope with separation from those we love. Observation is an excellent teacher.

Also, I have recently wrapped up a five-year stint as a hospice volunteer and had the privilege of accompanying many clients on their end-of-life journeys. Being near folks who are dying, especially sitting at their bedsides for long hours in the middle of the night, has familiarized me with the signs and stages of dying. It has formed my understanding of the work of dying, the solitariness of the process, and the range of death experiences. All of this has encouraged me to consider my own last wishes and prepare the appropriate associated documents.

The last of the Five Remembrances has prompted me to ponder the importance of the energy I emit into the world, the footprint I make and will leave behind, the things I can and cannot change, and the healing power of forgiveness.

So, I’ve begun to consider the next decade as my end-of-life journey, and 2026 as the first steps on that path.

A spiritual companion suggested the image of a threshold to mark the transition into this journey. I used it in meditation, imagining myself approaching, contemplating, leaving behind the old, stepping through, and hovering just inside the threshold of this new season of life. I created a slideshow of photographs I’ve taken over the years that suggest the crossing of thresholds—movement through an opening, leading towards something new—set it to music and meditated on the photos as they cycled through their sequence. This became a ritual marking the transition to a new reality, one where I embrace death as the culmination rather than the end of life.

I will wrap up with a koan from the Tao Te Ching, Chapter 33, Stephen Mitchell’s translation.

“If you stay in the center and embrace death with your whole heart, you will endure forever.”

A koan is a paradoxical anecdote or riddle without a solution, used in Zen Buddhism to demonstrate the inadequacy of logical reasoning and provoke enlightenment. Koans are meant to be repeated, pondered, forgotten, remembered, abandoned, despaired of, and rediscovered until their meaning is written in the heart, not the head.

As I step into this new season of life, I find myself opening to the koan’s invitation: to stay in the center, to meet death wholeheartedly as a profound teacher. The Remembrances have challenged me to stay at the center of awareness, tenderness, and the intent to live fully in the time that remains. If accepting impermanence softens our grip on what cannot be held, it may also enhance our appreciation for what is passing through right now. So, I offer these reflections not as conclusions but as invitations to step across the threshold into the next season of your life, and ultimately, into forever.

Questions for Reflection:

  • How does acknowledging my mortality change the way I move through an ordinary day?
  • What fears arise when I imagine the end of my life, and what happens when I name them honestly?
  • In what moments do I feel most vividly alive, and how might awareness of impermanence sharpen those moments?
  • How do I want to show up in the final season of my life, and what small practices today might prepare me for that?
  • Where do I sense a threshold in my own life, and what might it mean to step through it with intention?

~~~~~~

I mentioned that I have been taking a death education course from Die Well Death Education. A few weeks ago, I interviewed the founder of this organization, Leona Oceania, intending to introduce her and her work as the final article in this series on death and the other Remembrances. She is a kindred spirit in her fascination with and respect for death, and I hope that her story will add some perspective to my own. Look for that in my next blog post. Then I will move on to other topics, though I can’t promise I will not return to death before 2026 is over.

Of the Nature to Grow Old–B

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The First Remembrance: I am of the nature to grow old.  There is no way to escape growing old.

. . .

Aging comes inevitably, step by slower step—inviting us to slow down and move inward, toward acceptance, simplicity, and the essence of love.

I can no longer walk up a hill, heck, even a small incline, without feeling out of breath.

The ghosts of old pains live in my body as diminished fantoms—sciatica in my left leg, rotator cuff pain in my left shoulder, occasional pain in my left lower abdomen.

Unexplained neuralgia has made my feet and hands numb and tingly.  In the winter, I am in danger of frostbite when I walk the dog on days when the temperature is below freezing.  I’ve purchased rechargeable hand warmers.  I haven’t found a solution for my toes, which are perpetually inflamed on the tips. My numb fingers are clumsy.  I’m surprised when things slip through them. I live in fear of dropping a knife on the cat.

My nose runs continuously.  I could single-nosedly keep Puffs Plus Lotion in business.  I drool embarrassingly, noticing only when it is too late.

My neck is constantly stiff; it’s painful when I turn left or right.  Thank goodness for the backup camera on my car!

All this diminishment, though I exercise five days a week: swimming, cardio, weights, and yoga; now and then a little Qigong, and have done so for 30 years.  I eat and drink in moderation.  Sleeping is another matter. 

I feel exhausted doing half of what I used to do.  I used to work in the yard all day long on weekends.  Now, after an hour, I need a nap. When I shovel snow, I must stop to catch my breath every three or four shovelfuls.

All these symptoms of aging require new and creative workarounds. If I can find none, I must let go.  No more mountain climbing, even small ones like Bradbury. I can’t walk the dog or hurry on foot to a meeting after breakfast or lunch.  If I try, I’ll have to stop multiple times along the way to catch my breath. I stopped going out after dinner in the evenings long ago. Many physical activities require planning, asking, “Is it safe, doable, can you sustain it?  What will be the effects the following day?” Travel is complicated: time changes throw my medication schedule off whack, I have to lug my CPAP machine with me, I can’t always find easily digestible food, and bowel irregularity is a problem. Staying home becomes increasingly attractive.

I counsel myself: bundle up, slow down, plan, embrace the inner journey. Celebrate the possible.  One hour of gardening is a cause for delight. Simplify. Rest. Draw the circle closer in, nearer the core of life. At the same time, let your tenderness and compassion ripple further out into the universe. Drill down to the essence of love. Stay there; make it home.

Questions for reflection:  Are you grateful for what remains possible?  Has slowing down deepened your experience of life?  What does it mean to make love your home?

Of the Nature to Grow Old-A

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The First Remembrance: I am of the nature to grow old.  There is no way to escape growing old.

The first of the Five Remembrances invites us to face the truth of growing old, and to recognize it as a path toward humility, authenticity, and coming home.

The First Remembrance: I am of the nature to grow old.  There is no way to escape growing old.

Let’s start with the body.  And let’s be ordinary and practical. As the years pass, I change physically. What a cliché—and yet, how true!

My internal organs—heart, kidneys, liver, etc.—wear out from constant work, 24/7/365. Joints need to be replaced. Plaque builds up in arteries, and skeletal injuries worsen.  Sun, wind, water, and chemicals all take their toll. Wrinkles and age spots appear, skin sags, and tears.  My prescription lenses grow thicker; cataracts form and must be removed. Though my hearing continues above average, I watch others struggling, even with hearing aids. My balance is compromised, and I’m slower and less steady. I forget names, words, and appointments, and I can’t express myself as fluently as I once could. I may not have dementia yet, but I’m not as sharp as I used to be.

 If I’ve eaten well, exercised, slept well, have a healthy social network, and engage in meaningful work and activities, I may put off the worst effects of aging until my nineties or even one hundred. But while aging can be managed or delayed, it cannot be escaped. The years stack up inexorably.

Aging is not only physical.  I am seen differently now. No longer am I identified by my education, career, or accomplishments.  Instead, I’m classified as “retired” and viewed as vulnerable, dependent, and without purpose. I’m seen as a liability rather than an asset, a drain on resources rather than a contributor. Not surprisingly, if I’m wealthy, this ageist judgment may be mitigated slightly.

Sometimes, not too often to be a bore, I hope, I may catch myself reciting my resume—former jobs, publications, achievements—or, if I have children and grandchildren, their successes, as if to reassure myself that I mattered; that I still do.   

I may resist becoming dependent and fear being a burden. Perhaps that’s why I keep driving longer than I should, put off using a cane or walker, and don’t admit that I can no longer bend over to clean the bathtub or see the thick layer of dust on the baseboards.  Asking for help makes me feel diminished.

Others might notice that I need assistance and might even offer it, but perhaps I’m stubborn. Help can be expensive, whether one pays for it or asks for it, and refusing it can become its own burden.  If I have the resources to purchase assistance, I can preserve my dignity a little longer. Acknowledging dependence changes relationships. 

Friends drift away, not always by choice. They can’t see to write, can’t hear to call, can’t drive; energy fades, or they die. I may feel lonely and isolated. I could fix that by moving to a retirement community if I have the resources and the courage. Living in community as we age is probably the best option, but the aging process continues relentlessly.  

Aging is not only erosion, though; that’s only half of the story. The glass-half-empty part.

There’s another half to the glass.  I can accept that I am of the nature to grow old.  Acknowledge the drawbacks of aging but embrace the benefits.

I am happier now than when I was young; more content, less competitive and ambitious. I have more time to indulge my creative urges and nurture my friendships.  The inevitable physical decline and the social transformation shaped by cultural norms are offset by a new openness to gratitude, simplicity, and authenticity.

I may feel freer, more comfortable in my skin, and confident. Paradoxically, my physical diminishment is accompanied by an inner expansion, a movement away from the material and toward the spiritual. I may now have the courage to face challenges I once found threatening and therefore resisted or rejected. At the same time, simplicity is more attractive, and rest beckons. 

I have time—glorious time—to sit still, stare into space, do nothing, nap without apology, and love what is right in front of me. I know intuitively that the past can be redeemed by forgiveness and love. The future? Well, it’s unknown, and I waste less time imagining or trying to control it.  Because I know my time is limited, I can more clearly recognize and choose the opportunity that this moment offers.  I’m on a journey home, and I’m getting closer and less afraid of arriving.

My many experiences, both painful and joyous, have mellowed and moderated me. The middle way is more appealing than the extremes. My intuitions have proven true repeatedly, so I increasingly trust myself.  But my failures have humbled me, and I’ve learned that self-compassion is the only path to empathy for others.

These are the graces of growing old—the invitations that aging offers each of us.

So yes, I am frail, vulnerable, and dependent, but I’m also grounded, grateful, authentic, and vibrantly alive. All of these are my nature.  Why should I want to escape?

Question for reflection:   How are you experiencing aging—loss, expansion, or both?

There is no escape

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The Five Remembrances (Plum Village Version, Thich Nhat Hanh)

  • I am of the nature to grow old. There is no way to escape growing old.
  • I am of the nature to have ill health. There is no way to escape ill health.
  • I am of the nature to die. There is no way to escape death.
  • All that is dear to me and everyone I love are of the nature to change. There is no way to escape being separated from them.
  • My actions are my only true belongings. I cannot escape the consequences of my actions.

For the past five or six years, every January, I have chosen—or been chosen by—a single word as a linchpin for the year ahead.  It’s called the One-Word practice.  The chosen word becomes the subject of intense reflection, aspiration, and intention.  My One-Words have included: slowly, rest, flow, love, write, and Wu Wei (non-forcing).

My word for 2026 is Death.

“Why do you want to focus so intensely on death?” a friend asked.  I responded that in Buddhist practice, meditation on death is recommended to foster the fullest possible experience of life.  Maranasati, or “mindfulness of death,” reminds us that life is transient and precious and we must live with intention and purpose.

My time is limited, I explained, and I want to live as fully and consciously as possible. My friend and I both admire Mary Oliver, and, particularly, her poem “When Death Comes.”

When it's over, I want to say all my life
I was a bride married to amazement.
I was the bridegroom, taking the world into my arms.
When it's over, I don't want to wonder
if I have made of my life something particular, and real.
I don't want to find myself sighing and frightened,
or full of argument.
I don't want to end up simply having visited this world.

Like Mary Oliver, I don’t want to just pass through life as a visitor.  I want to embrace and inhabit it with amazement.

One way I am practicing mindfulness of death this year is by meditating daily on The Five Remembrances, Buddhist contemplations that acknowledge the inevitability of aging, illness, and death, the reality of impermanence, and the consequences of every action (karma).

I’ve been doing so since the beginning of January: reciting the words of each remembrance, looking deeply into their meaning, reflecting on my experience of each, and writing those reflections in my journal.  The following series of brief articles is based on those journal entries. These posts are not a scholarly exploration of Buddhist philosophy. They are personal and experiential.  I offer them in the hope that they will resonate with others—especially those who are no longer young and are approaching “The Big Let Go,” Death.

Practicing for the Big Let Go: Love

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I have mentioned here before that I meet monthly on Zoom with a group of women who talk about our experiences of aging and our musings on death. We explore our stories, insights, discomfort, and fear about the inevitable decline of our bodies and the certain end for us all. A few weeks ago, we had a courageous discussion about dying, our own and that of those we love. Not surprisingly, most of us expressed more fear about the possibility of a painful, demeaning, drawn-out dying process than about the moment of death and what, if anything, comes after it. We ventured onto the delicate topics of Death with Dignity and Physician-Assisted Death, which is legal in some countries, including Canada, where I was born.

I told the story of my Canadian cousin’s husband’s death. I’ll call him Leigh and her Meredith. He suffered for years from debilitating cancer, which was diagnosed just after his retirement when they had planned finally to begin their travel adventures together. Leigh, supporting and delighting in Meredith’s wanderlust and love of natural beauty, encouraged her to go exploring on her own and with their daughters. He enjoyed her travels vicariously and enthusiastically. However, as time went on, she traveled less as he needed more care and experienced frequent hospitalizations for treatment and long energy-less periods confined at home.

Though he tried his best not to be a burden for his family and patiently bore the symptoms of his disease, it troubled him that Meredith’s life centered around him and his ups and downs. He recognized her profound sadness as she watched him suffer, helpless to alleviate it, and worried about how she would cope with what they had good reason to believe would be a painful and degrading end. As the pain increased and his energy ebbed, recognizing his own and Meredith’s exhaustion and the toll his suffering was taking on her, he decided to apply for MAID, Medical Assistance in Dying. Canadian law provides this option for individuals who are terminally ill or in intolerable pain.

Together, Leigh and Meredith navigated all the legal requirements and preparations and finally arrived at the day of his death. Meredith and both of their adult children gathered around his hospital bed, said their goodbyes, and expressed their love and gratefulness for each other. Medical personnel administered the necessary medications, and quietly and peacefully, Leigh went to sleep and then ceased to breathe. Meredith experienced the meticulously planned and compassionately orchestrated end as a gift of love Leigh gave to himself, her, and their daughters. Years later, she still speaks movingly of this gift and her memories of their last intimate moments together. She says Leigh was right; a horrible end would have been much more difficult for both of them to endure and for her to recover from. Instead of her beloved in agony, her last memory of him is tender and peaceful.

I did not tell the story of my mother’s death in that morning’s discussion group. In her early eighties, she was diagnosed with pancreatic cancer after a long period of ignored symptoms and then months of waiting for tests and doctors’ appointments. The specialists said that her only hope of survival was a drastic surgery in which her abdominal organs would be removed from her body to make the tumor on her pancreas accessible for excision. Then, they would replace the organs, and everyone hoped everything would work properly again. It was a risky option back then for even a younger, more fit person, but it was a long shot for someone in their early eighties. By demonstrating determination and pestering her doctors, she got them to agree to perform the surgery, even though success was extremely uncertain. She wowed them on the pre-surgery stress tests, proving that she was strong enough to withstand the operation, but as the day approached, she was anxious and irritable. 

One evening, I asked her why she was willing to put herself through such trauma for perhaps just a few more years of extended life when she could not count on a full recovery or high-quality health. She responded without hesitation, as though she had already asked herself that very question and was certain of the answer. “It’s for your father,” she said. “He will be too lonely when I die. But don’t tell him.” I didn’t press her further. She and my dad did not have an overtly romantic relationship. I can’t remember her ever expressing feelings of love to anyone. On the contrary, she tossed criticism liberally in all directions. But they had been married for more than fifty years, and their lives were so intertwined that she knew her death would be his undoing. 

She had the surgery. The team opened her up and saw an abdomen riddled with cancer, so they closed her and sent her to recovery. The surgeon told us the outcome and gave a prognosis of one to three months. She lived through the night and, early the next morning, experienced massive internal bleeding, was taken back to surgery, and died of heart failure. My father’s sobbing heartbreak is seared into my memory, as is the sight of his forlorn, defeated figure standing outside her empty bedroom at home that evening.

I’m not sure if my mother ever told my father that she loved him, but she knew how much he loved her, and she was willing to endure a horrendous surgery out of compassion for him—her gift of love. He lived for five lonely years after her death, making the best of each day but missing her profoundly. It was tough to watch.

Another member of the aging-and-death discussion group shared a glimpse into a recent awakening. She’s been seeking understanding of love, what it is, how it feels, how it manifests, for quite some time. Recently, she and her husband were walking during an outing. He is older than she and is slowing down slightly. She found herself dropping back to match his slower pace and wondering at the tender willingness she felt as she did so. Could this be love, she asked herself—some facet of love? 

As I draw nearer to my own inevitable death—The Big Let Go—I ask myself what will be most important to me, and I know instantaneously and completely that it will be love. Everything else will fall away, and the only important activity will be loving—giving and receiving it. Knowing this, shall I start to practice now? Let go of all but love, in every moment and situation, and lean into loving—fall into it, and trust it utterly.

Dignity or Indignity

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I frequently visit a long-term care facility near my home. My dog and I go once a week to offer pet therapy to the residents. We walk from room to room, greeting the patients who pet the dog, smile at his simple tricks, and feed him treats as a reward. Occasionally, I also serve as a hospice volunteer in this facility, watching with someone who is dying through the dark hours of the night. For one reason or another, I’ve spent a good deal of time visiting nursing homes in Maine and Massachusetts, and this facility, in my experience, is one of the best. From an outsider’s point of view, it is clean and well-managed, with a full complement of services and a clientele that seems satisfied with their care. The staff is friendly to my dog and me, speaks kindly to the patients and treats them with gentleness.

            Still, even in this seemingly best-case scenario, there are sometimes heart-breaking and gut-wrenching situations. Recently, nearing the end of a morning visit with my dog, I approached a patient we know well, who loves the little pup and whose attention he welcomes. She was sitting in her wheelchair in the hallway outside her room, looking anxious. I asked her what was bothering her, and she said she had been waiting for a long time for someone to take her to the bathroom. The young social worker who had just left her side had gone in search of a nursing aide to assist her. “It’s so hard,” she said, “when one gets old and bladder control is not what it used to be, and you call and call, and no one comes. Things have gotten worse,” she said. “One waits longer and longer now.” I expressed my sympathy and felt frustration rising in my chest. I also noticed a high-pitched wailing coming from the room opposite hers.

Someone else was also in distress. The room had a barrier across the door with a large stop sign in the center, indicating that only authorized personnel could enter. These detachable and portable barriers became common at the height of Covid outbreaks. “Help! Please help!” came the weak plea from the bathroom inside the room, but I could not go in to see what the matter was. I surmised the resident, whom we also know well, had been sitting on the toilet for a long time and was in discomfort or pain. The social worker approached again and reported that a nurse would be along shortly, after she finished putting another patient in bed. Timidly, I pointed toward the Stop sign and asked if she knew someone else needed help. She looked daggers at me, I guessed, for interfering, so I said goodbye to our friend in the wheelchair and walked on, frustrated, sad, and embarrassed for all of us.

The next day, when talking about aging with a group of healthy women in their sixties and seventies, I told this story and commented that this sort of indignity may await us all. I believe this common occurrence in senior care facilities is not the fault of nurses or other staff, social workers, or families, I argued, but the result of an ageist society that does not value the lives of those who are no longer financially or physically productive. An uncomfortable silence, a few somber nods of recognition, and a change of subject followed my candid expression of opinion. Understandably, no one wanted to discuss toileting in nursing homes or dwell on the possibility of finding ourselves in similar situations down the aging road.

I wrote about the indignities of the senior healthcare system in an extended series on The Elderly and End-of-life Care in 2017 when I launched this blog. Things have not changed since then, and because of further staffing shortages, they have worsened in many ways.

This kind of indignity may await all of us. More and more of us are living into our nineties because of medical advances producing life-prolonging disease treatments and cures. The healthcare system is stretched beyond measure, caring for an ever-increasing percentage of seniors in our population. We take advantage of every possible means to prolong our lives. Covid has decimated the ranks of healthcare professionals, and the greed of insurance and drug companies complicates matters further. I frequently hear my contemporaries say that the system is broken. They can’t get direct face time with their primary care doctors, or appointments with specialists, or get their prescriptions promptly. Doctors and nurses are quitting in frustration or from burnout. In-home care is exorbitantly expensive, and the agencies that deploy homecare workers are limping along with a few staff members. Of course, the financially secure have it far better than low-income people. That goes without saying, but no matter how financially secure you are, your dignity will be in jeopardy if you can’t get someone to take you to the bathroom.

Or will it? In these recent posts, I’ve been encouraging us to think about practicing for The Big Let Go—death. I’ve been recommending we consider learning to let go in small ways in ordinary daily situations to be ready to let go in a big way at the end of our lives. Am I suggesting that we must let go of our dignity? No. I am proposing that we consider where our dignity truly resides.

Does our dignity depend on how others treat us, or is it reflected in and demonstrated by how we treat others? My friend waiting for assistance to go to the bathroom was calm, polite, and sad but not angry, even though she faced the indignity of potentially soiling herself while she waited. The other patient, pleading for assistance from her bathroom, said, “Please.” Can we learn to relinquish the external signs of dignity while holding on to our inner poise, beauty, and self-esteem? And how can we practice doing that today?

How do we respond when someone wounds our dignity in small or large ways? Can we still insist upon the outward recognition of everyone’s dignity while more highly valuing intrinsic worthiness, integrity, humility, and courage as the essence of our humanity?

We may not all end up in situations like the patient in the wheelchair waiting for assistance with toileting. We may be lucky enough to die suddenly or in the comfort of our homes, surrounded by those who love us and tend promptly and respectfully to all our needs. We may live an active and independent life, avoiding physical dependency on others to the end. But if we don’t practice letting go of external signs of respect while holding fast to inner dignity, we may lack the necessary interior resources to draw upon as we approach The Big Let Go.