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The Art of Caring: An Interview with Frank Ostaseski

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Frank Ostaseski on boat

Credit Doug Ellis Photography

"In Buddhism, we often talk about enlightenment or awakening, but words like that feel far away to me. I speak about intimacy."

(We're reposting our interview with Frank Ostaseski from 2017 after we received news that he's recovering from a stroke. Our thoughts are with him and his loved ones.)

In his new book, The Five Invitations: Discovering What Death Can Teach Us About Living Fully, Frank Ostaseski shares the lessons he has learned through a lifetime of work with the dying. Ostaseski is the cofounder of the Zen Hospice Project and founder of the Metta Institute, and AARP has named him one of the America’s Fifty Most Innovative People. We spoke with him recently about how we might live in harmony with the truth of dying, the importance of recognizing that death is happening in every moment, and tuning in to what matters most.

S&H: In The Five Invitations you write, “We can’t be truly alive without maintaining an awareness of death.” Can you say more about that? 

Frank Ostaseski: Life is meaningful and valuable to us because it’s precarious. Death pulls us into what matters most by clarifying, whether you’re a prince or pauper, the fact that your life is temporary. Once you realize that your life is temporary, you can begin to reflect on what you want to do with it.

The book is organized around five lessons that you have learned sitting bedside with so many dying patients. These lessons also serve as invitations to the reader to live fully. Why don’t we go through each of the invitations briefly, starting with “Don’t wait”?

First, I’d like to say that I don’t think you can approach the five invitations as bullet points or slogans to stick on your refrigerator and hope that they’ll have value for you. You have to live into them in order for them to be realized.

The first invitation, “Don’t wait,” is an encouragement to live your life with a certain kind of constancy and presence. It’s about maintaining continuous contact with our experience and not getting caught up in expectation. When we’re stuck waiting for the next moment to arrive, we miss this one. How many times have I been with a family who asked, “When will Mom die?” In waiting for the moment of death, we miss all the moments in between. 

“Don’t wait” could be interpreted as encouraging people to do all of the wild and crazy things that they’ve always wanted to do—say, skydiving or drug experimentation—but have held back from doing for some reason or another.

There is an element of that to “Don’t wait,” but the invitation is to go much deeper than simply making sure you get all the toys and adventures that you want in your life. When we really start to lean into the transience of life, that’s when we start to appreciate its preciousness. Understanding the preciousness of life may or may not lead to skydiving.

I was recently in Portland, Oregon, and the dogwood trees and rhododendrons were exploding. How come the flowers on the dogwood trees are so much more beautiful than plastic flowers? I think it’s because of their temporary nature. You want to go outside and take a walk to see them, right? You don’t want to wait until they’re gone.

Useyourwings Credit Leigh Cypres
Use Your Wings by Leigh Cypres

That reminds me of a line from the poet Rainer Maria Rilke: “Ah, the knowledge of impermanence that haunts our days is their very fragrance.”

That’s right. There is the sense that transience is what really draws us fully into the present moment. Watching things change and become something new helps us understand that creation and destruction are two sides of the same coin. Things are falling out of being and coming into being all the time. When a tree falls in the woods, it rots and creates the conditions for something else to grow. 

“Don’t wait” is a reminder to step into that cycle of life. We’re not separate from the cycle of life, and knowing this leads to a greater sense of belonging. This is a really important thing to understand: Death is going to happen. It’s not if it happens, it’s when it happens—and it’s happening right now. Let’s not only think of death as this event at the end of a long road or after an accident. Instead let’s realize that this moment has died. Now this one has died. Have you caught up now? Are you here for this one or not? Dying can show us the way to think about moment-to-moment change.

How often have you had a situation in your life where you understood something without having to figure it out? Or perhaps you felt close to someone you had no history with at all.

Looking at life through the lens of moment-to-moment change can be very poignant. With the next invitation in mind, “Welcome everything, push away nothing,” how can we welcome the inevitable sadness that comes with death?

“Welcome everything, push nothing away” is not about agreeing with everything that comes your way; it’s about the willingness to meet it. The writer James Baldwin said, “Not everything that is faced can be changed, but nothing can be changed until it is faced.” It’s not that you have to like everything that comes, but, if you don’t have the willingness to meet it, you can’t change it. 

The other night I was doing a book reading and, after talking about “Welcome everything, push away nothing,” a guy in the audience asked, “What about welcoming Trump?” After sharing that quote from Baldwin, I said, “If we want to stand up against injustice, we have to be willing to meet it. We have to welcome it into the room.” 

Most often, we think of grief as an overwhelming response to a singular event, usually the death of someone we love. Yet when we look more closely, we see that grief has been our companion for a good part of our lives. I’m talking about everyday grief, the response to the multiple losses and little deaths that occur almost daily. Sometimes our grief is about what we’ve had and lost, and sometimes it is about what we never got to have in the first place.

I’d like to talk about the next invitation, “Bring your whole self to the experience,” in the context of your own life working with people at the end of their lives. How are you able to bring your whole self to the bedside time after time?

While a lot of people talk about mindfulness as a useful method to cultivate deep connections with others, I prefer to talk about intimacy. Learning to be intimate with ourselves and with the world around us brings a certain kind of attunement. First and foremost, attunement comes from the willingness to examine and turn toward our experience, even those parts of our experience that are difficult. When we become intimate with our inner life—every dimension of our being, every emotional state, and every face of our own suffering—we’re more likely to be available to other people when they are suffering. 

It’s just the simple recognition that when I’m hurting, I want somebody with me who can bear witness and be a compassionate companion to that pain. Knowing that is true for me, I want to be able to offer that support to other people. “Bring your whole self to the experience” is not about being perfect. It’s about showing up. 

Many of the stories you share in The Five Invitations demonstrate your attunement and intimacy with people at the end of their lives. To give us a sense of what intimacy in action actually looks like, can you tell the story of the woman who asked you to perform her wedding ceremony weeks before she died?

Before I do, I’d like to say that what we’re speaking about here is what we might call empathetic precision. It’s about being aware of the whole context of how a person is hurting, but also attuning ourselves to what matters most to this person in this particular moment. 

The woman you are referring to, whom I looked after as she was weeks from death, wanted to get married. She asked me if I would perform the ceremony and I said I’d be happy to, of course, but suggested that what she really needed was a wedding coordinator. 

I had the intuition that if she wanted to get married at this stage of life, the marriage was about something more than just planning a wedding. There was a deeper sense of belonging that she was seeking. So we started talking about the wedding—the cake, what dress she would wear, and whether she would be in bed or sit in her chair or wheelchair. She couldn’t stand up anymore. We talked about the guy she was getting married to. We did all the things that you might do with somebody who’s planning a wedding. Mostly I asked questions and listened. 

Then, one day, while we were in the middle of talking about chocolate cake, she burst into tears and said, “I just want my mom to be there.” Of course, in that moment I might have said, “Oh, I’m very sorry that your mom can’t be here.” Instead, I asked, “How could we bring your mom to the wedding?” That was a different way to engage with what was actually happening for her in that moment. She said, “My mom used to like to write poetry. Maybe we could have one of her poems at the wedding. Would you be willing to read one of her poems?” And I said, “I’d be honored to read one of her poems.” So we found a way to bring her mother to the wedding, so to speak. 

What was so beautiful about that exchange was that the most important thing in that moment wasn’t the fact that she was dying. In that moment, having terminal cancer was not the most important face of her suffering. She was getting married and she wanted her mom to be there: That’s what the empathy had to attune itself to, that particular face of loss. Compassion can begin with a precise attunement to exactly what hurts. 

Listening to that story I get the sense that intimacy is closely tied to keeping an open mind about what’s possible in the present moment. Would you say that’s accurate?

Yes, one of the ways that intimacy expresses itself is as a kind of attunement that can happen in a single moment. How often have you had a situation in your life where you understood something without having to figure it out? Or perhaps you felt close to someone you had no history with at all. In moments like that, there is something in the nature of your presence with another person that is very close, very tender. When you pay attention to other people, it happens often.

Sometimes I’m with people who are dying and, even though we’ve never met before, we find ourselves meeting each other in a way that’s incredibly intimate. 

In Buddhism, we often talk about enlightenment or awakening, but words like that feel far away to me. I speak about intimacy. By the way, Dogen, the founder of the Soto Zen School, often describes enlightenment as “becoming intimate with the 10,000 things.” 

Youareneveralone Credit Leigh Cypres
You Are Never Alone by Leigh Cypres

“The 10,000 things” provides a segue to talk about the fourth invitation, “Find a place of rest in the middle of things.” What does it mean to rest in the middle of things?

We’re always trying to manage the conditions of our lives so that we can get the rest we want. We go on vacation after we make sure that everything on our to-do list has been checked off. Finding a place to rest in the middle of things means that you bring your attention fully and completely to what you’re doing now. That’s where you will find the rest that you seek. Multitasking is a misnomer because we’re not actually getting a lot of tasks done; we’re just doing a lot of things with very little attention. 

In a way, paying close attention to the moment we’re in seems at odds with the fifth invitation, “Cultivate don’t know mind,” because I associate attention with knowledge. Can you talk about the relationship between “don’t know mind,” knowledge, and intimacy?

“Cultivate don’t know mind” is not an encouragement to be ignorant. It means to develop a mind that’s full of curiosity, wonder, and readiness. So “don’t know mind” is in a completely different arena from knowing and not knowing. It’s about not imposing our knowledge on the situation we’re in. It’s about a willingness to discover, be curious, and be surprised. 

“Don’t know mind” is important in both life and death because you can’t measure these experiences in how-to knowledge. There isn’t a formula you can apply to the dying process. It’s full of mystery. 

Of course, when I’m dying, I want somebody there who knows all of the answers to the how-to questions. I want my pain to be well taken care of. I want my symptoms to be addressed. But that won’t be enough. I will also need somebody who is comfortable meeting with me in the midst of that mystery, somebody who can help me figure out the purpose and value of my life. 

Can you say more about “meeting in the mystery”?

Mystery is the land of unanswerable questions because there are no answers. That’s the dying process. If we only ask how-to questions, we continue to think of dying strictly as a medical event. The medical model, while it’s brilliant, is too small to embrace the profundity of what happens in the dying process. 

Wanting to have mastery over death is an egoic function. We want to control the experience of death instead of turning to death like a great teacher and asking, “What can I learn from you?” To me, that question is so much more meaningful than asking, “How do I manage this?” 

I would guess that the things that are most valuable to you in your life were not found by asking how-to questions. Falling in love, the miracle of birthing a child, or intimacy with a stranger—How do these things happen? No one can explain that. 

Reality cannot be mapped. It is beyond description or any one view. It is not a single static truth. It is alive—an endless, dynamic, unfolding mystery. 

“Don’t wait” is a reminder to step into that cycle of life. We’re not separate from the cycle of life, and knowing this leads to a greater sense of belonging. 


Sam Mowe is a writer living in Portland, Oregon. His interviews have also appeared in Tricycle: The Buddhist Review, and The Sun. He is also the editor of Lineages, a publication of the Garrison Institute. Sam is a regular contributor to Spirituality & Health. 


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