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Exploring our Intention
in Service
by Frank Ostaseski (continued)

Prior to any action of the body, thought, or speech, there is a moment of intention that we need to be aware of because clarity about our intention gives us choice about how we can proceed. A moment of contact with our intention can break our habitual patterns and keep us from operating on automatic pilot.

In the Zen tradition there is a practice called dokusan. It is an interview with the teacher. The student is instructed to wait outside the teacher's door, where they must gather themselves completely into the moment. They have no idea what is waiting for them on the other side of the door, they have no idea what their teacher will ask them, so they have to be ready, flexible and open. Going into a dying patient's room is like going for dokusan. Ideally, our bodies and minds should enter the room at the same time. Sometimes that's not the case, is it? We leave our minds way behind sometimes we even leave our bodies behind! Or we enter the room days before we ever got there.

There was a volunteer I know who did this. He went to a patient's bed and the patient got very excited saying, "Oh I'm so glad you're here. I finally have someone to talk with about my dying." The volunteer got very excited and said, "Yes, yes, yes. I'm going to get books by Elisabeth Kübler-Ross and Steven Levine and I will be back next week and we will talk all about it." Of course the next week he came back with piles of books and the patient said, "Yes. We're watching the football game on TV, please come in. Watch the football game with us."

Too often in care-giving, we're not so much looking to see what serves but to confirm some idea we have about ourselves. We want to be somebody. We say, 'I work with the dying/ with the emphasis on 'I', and invest in the role, not the function. I sometimes call this 'helper's disease', and it is a much more rampant epidemic than AIDS or cancer. We try to set ourselves apart from other people's suffering. We set ourselves apart through our pity, our fear, our professional warmth and even our charitable acts. This work has nothing to do with charity.

A few years ago a woman at our hospice was just a few days from her death, and she was quite sad and depressed. This seemed natural to me; she was dying. But a nurse suggested that we start her on Elavil, which is a medication used to enhance people's moods and usually takes about three weeks to start working. I asked the nurse, 'Why do you want to prescribe this medication?" She replied, 'Well, she's suffering, and it's so hard to watch her suffer." So I said, "Maybe you should take the Elavil."

This attachment to the role of helper is old in most of us; helping others provides a needed sense of power or respectability that we collect at the end of the week like a pay cheque. But if we're not careful, this identity will imprison us as well as those we serve. After all, if I'm going to be a helper, somebody has to be helpless!

My friend Rachel Remen, who runs the Commonweal Cancer Centre in California, speaks very beautifully about this. She says:
"service is not the same as helping. Helping is based on inequality, it's not a relationship between equals. When you help, you use your own strength to help someone with less strength. It's a one up, one down relationship, and people feel this inequality. When we help, we may inadvertently take away more than we give, diminishing the person's sense of self-worth and self-esteem. Now, when I help I am very aware of my own strength, but we don't serve with our strength, we serve with ourselves. We draw from all our experiences: our wounds serve, our limitations serve, even our darkness serves. The wholeness in us serves the wholeness in the other, and the wholeness in life. Helping incurs debt: when you help someone, they owe you. But service is mutual. When I help I have a feeling of satisfaction, but when I serve I have a feeling of gratitude. Serving is also different to fixing. We fix broken pipes, we don't fix people. When I set about fixing another person, it's because I see them as broken. Fixing is a form of judgment that separates us from one another; it creates a distance.

"So, fundamentally, helping, fixing and serving are ways of seeing life. When you help, you see life as weak; when you fix, you see life as broken; and when you serve, you see life as whole. When we serve in this way, we understand that this person's suffering is also my suffering, that their joy is also my joy and then the impulse to serve arises naturally - our natural wisdom and compassion presents itself quite simply. A server knows that they're being used and has the willingness to be used in the service of something greater. We may help or fix many things in our lives, but when we serve, we are always in the service of wholeness."

Caring for those who are suffering, whether or not they are dying, wakes us up. It opens up our hearts and our minds. It opens us up to the experience of this wholeness that I speak of. More often than not, though, we are caught in the habitual roles and ideas that keep us separate from each other. Lost in some reactive mind state, busy trying to protect our selfimage, we cut ourselves off and isolate ourselves from that which would really serve and inform our work. To be people who heal we have to be willing to bring our passion to the bedside; our own wounds, our fear, our full selves. Yes, it is the exploration of our own suffering that forms a bridge to the person, we're serving.

This is how it works. A few years ago a very, very dear friend of mine, someone I loved very much, was quite sick with AIDS. I had known him for many years. In just one afternoon he lost his ability to speak, hold a fork, stand and to formulate a coherent sentence, and it happened during the afternoon that I was taking care of him. It scared the hell out of me. Me! 'Mr. Hospice'!

I did everything I could to take care of him. He had enormous fistulas and anal tumours, and constant diarrhoea. We moved incessantly from the toilet to the bathtub and back to the toilet again. It went on all night. I was exhausted and all I wanted to do was get him to bed so I could sleep. I tried every trick I knew. I was cajoling, I was manipulative, I was paternalistic. I changed wardrobe more often than Madonna.

In the middle of one of these moves from the bathtub to the toilet, he spoke. From his garbled mind he said, "You're trying too hard." And indeed I was. I stopped right there, sat down beside the toilet and started to cry. It was the most exquisite meeting of our whole relationship. We were completely helpless together. No separation. No professional warmth.


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