Comfort in Transition: A Zen Monk’s Approach to Pediatric End-of-Life Care
I sat across from Gagan, the calm demeanor of a Zen monk radiating from him. This encounter was destined to weave through the intricate tapestry of life, love, and loss. With a gentle smile, Gagan greeted me, drawing in a deep breath as if grounded in the moment.
Our conversation began with a simple question: “How long have you been involved in hospice work?” Gagan’s response came wrapped in reflection. “About 25 years now,” he said, eyes softening as he recounted his journey. He reminisced about his early days at Memorial Sloan Kettering Cancer Center, where he found himself stationed in the pediatric ward. It didn’t take long for him to realize the gravity of the situation—many children were fighting battles they would not win. The need to provide comfort became an essential part of his role, even if the term ‘hospice’ seldom crossed the lips of those around him.
“It’s about palliative care,” he explained, “helping families and patients find ease in their difficult journey.” I nodded, keenly aware of the weight behind those words, and gently probed further into the nuances of his work—how it varied between children and the elderly.
Gagan spoke of the profound sadness that enveloped the families coping with the loss of a child, a sorrow unlike any other. With adults, there might be an understanding rooted in life’s cyclical nature, but losing a young one—a child—was an unbearable shock. He described the dynamics that unfolded in the hospital rooms, where families shared laughter and tears, wrestling with the healing and heartbreaking realities of life.
“Do families tell their children the truth about what’s happening?” I inquired. Gagan responded thoughtfully, “Most of the time, yes. But sometimes a child will express a desire to avoid the truth, and families honor that wish.”
The conversation flowed seamlessly to the peculiar nature of acceptance that children often embody. Gagan described how some children seemed to intrinsically grasp their fate, engaging in thoughtful conversations with family members about what mattered most to them in the time they had left. Others remained steadfast in their youthful innocence, playing games and finding joy in the moment, even as the end loomed.
As the dialogue evolved, I could sense Gagan’s deep compassion. “What have you learned from these children?” I asked. Gagan’s gaze turned reflective, and he spoke of the remarkable courage children displayed. “When you ask an adult about their pain, often it comes with layers of life’s burdens. But children are refreshingly direct. They can focus on the now, even amidst their suffering. They remind me how to stay present, to embrace life fully.”
A beat passed, and I could feel the weight of shared experiences linger in the air. Gagan then recounted a particularly challenging moment—when a family refused to sign a do-not-resuscitate order. The frustration it stirred within him was palpable, yet through time and contemplation, he learned an invaluable lesson about love and grief. He understood that every parent wanted to do everything they could for their child, even in dire circumstances.
He articulated a poignant realization: “Everyone has the right to navigate their pain in their own way, just as I learn from them. As a Buddhist, I recognize our interconnectedness in these moments.”
Curious about the children’s connection to their passing, I asked if Gagan believed unfinished business sometimes kept young people hanging on longer than expected. “Absolutely,” Gagan affirmed. He shared stories of children waiting to say goodbye to pets or resolve long-held feelings with family, moments filled with meaning that allowed their souls to let go when they were ready.
The monk’s analogies flowed naturally as I probed deeper into this sacred exploration of death. “Elizabeth Kubler-Ross likens death to a butterfly emerging from a cocoon,” I said, inviting Gagan to share his thoughts. “I appreciate that,” Gagan replied. “I’ve also heard Thich Nhat Hanh compare it to removing a tight shoe. In essence, we are consciousness dwelling in a body, and as we shed that body, we return to our true form.”
As the discussion wound on, we ventured into the realm of enlightenment. Gagan conveyed a belief in the transformative power of death—how, in those final moments, many people experience profound oneness, serene acceptance, and a glimpse of enlightenment. He spoke about being honored to witness such insights when families gathered around the dying, feeling a connection that transcended the physical.
“Does it weigh on you, doing this work?” I queried, genuinely intrigued. Gagan paused to consider the question. “I see it as a reflection of my journey. Life and death are intertwined; we are all vulnerable at both ends. I learn from each child and family, yet I, too, feel an attachment. When they pass, it’s challenging. I find solace in nature, engaging in activities that require my full attention—like running or snowboarding—to recharge.”
As I listened, I was struck by Gagan’s balance of empathy and realism; self-care was a necessary component, albeit challenging to uphold when consumed by the weight of another’s suffering. “You must find ways to ground yourself while caring for those in need,” he reflected, and Gagan nodded knowingly.
The closing sentiments drifted into the air like remnants of a sacred ceremony. Gagan shared a profound truth, inspired by Thich Nhat Hanh: to live fully is to navigate grief with an open heart, recognizing it as the depth of love for those who have departed. “The pain we feel is equal to the love we lost,” he mused, and through this lens, Gagan had transformed his own vulnerability into purpose.
“Thank you for engaging in this conversation, Dan,” he concluded, eyes bright with gratitude. “I am different, better even, because of those I’ve been honored to serve. I am deeply touched by the love shared in the midst of struggles, and it motivates me to continue this path for as long as I can.”
With heartfelt appreciation, I acknowledged the journey we had taken together, a journey through the profound landscape of life, love, and the poignant acceptance of loss.
