Michael Eselun, Clearity’s Oncology Chaplain, sat down with our Director of Education, Danielle Peterson, to discuss what occasions like the Jewish New Year Celebration, Rosh Hashanah, and Día de los Muertos can teach us about the role the contemplation of death has on the celebration of life.

(Danielle) Michael, thank you so much for taking time out of your schedule to meet with me and share some of your wisdom and insights with our Clearity family. Before meeting, I sent you a link to an article from the New York Times about the meaning of the Jewish New Year celebration, Rosh Hashanah, which took place this year between sundown on September 15th through sundown on September 17th (readers can get the link to this article here). Now that it’s October, I also realize Día de los Muertos is in a few weeks.

Could you start us off by talking a little bit about the opportunities honoring sacred spaces (either individually or in community) offers to us?

 

(Michael) Absolutely, and one thing I love about the Jewish tradition is that these holidays marking new beginnings are very much linked to an awareness that life is fleeting and temporary. One may pray to be written into the Book of Life in the year to come while remembering those that have died before them. I am not Jewish, and I am not at all implying that I can say what is intended by these things, but for me, the reminder of impermanence is very potent and possibly a pathway toward peace.

I find a lot of patients dread the holidays because there is all this cultural demand that we be grateful and celebratory. Even the music is all, “joy to the world.” What if we do not feel grateful? Or there is nothing about us that is grateful for a cancer diagnosis? In my view, that has to be OK. It is OK to resist this demand to be grateful and to be positive. Perhaps there is a doorway to create a more personal sense of the sacred at holiday time.

I find for folks with cancer, what maybe was sacred yesterday, or for their whole lives, does not feel so sacred for them after the diagnosis. Celebrations and holidays can be particularly painful after one’s or a loved one’s cancer diagnosis. So, although your emotions might not match those around you, in some cases, the tradition itself might in fact matter more than the peace of mind in the moment. In some ways, honoring the tradition may be an anchor to the past, or to one’s faith, offering another kind of peace, as painful as it may be. Attending celebrations and holidays exactly as one is: sorrowful, tearful, unable to talk. This can be its own version of sacred, too. Or if you cannot be around your family at Thanksgiving because you don’t want to be quizzed about your diagnosis, maybe you just want to go to the beach by yourself with a pizza and watch the sunset. What we call sacred might need a new definition, and it is always a creative choice on our part.

(Danielle) Our culture tends to shy away from conversations of death. It’s a topic that often brings fear and is avoided at great costs. That’s one of the reasons why the article piqued our interest because, unlike other New Year’s Celebrations, Rosh Hashanah calls those who observe it to contemplate endings while celebrating beginnings.

Why might it be important, no matter what faith background you come from, to think about life while thinking about death, and vice versa?

 

(Michael) Because, like in Eastern faith traditions, it is a dance of opposites. We do not know what day is unless we know what night is. If it were light all the time, we would not be able to understand darkness, and vice versa. It is the same reason we like fresh flowers more than artificial ones. Artificial flowers might be just as beautiful, but they are not special. Why are fresh flowers special? Because they are going to die, and they are only here for a very short time. In other words, they are more precious.

I see it all the time with patients when they realize their days are numbered. It’s like when you’re on vacation and as the vacation comes to an end, you do not want to be thinking about what you have to do for work. You want to squeeze every bit of sweetness you can out of those last days because the end is near. I see a lot of folks nearing the end of life who struggle spiritually with this idea. They wanted a peaceful death. They wanted to be at peace with God, and they are not, and their day is coming. Some imagine somehow they are just going to just get sleepy and lie down with a flower on their chest with pretty music in the background, and then they will just close their eyes. To them, this is a good death. Nobody dies like that. We’re all going to die with lists of things to do that didn’t get done, apologies that were not made, passwords that were not given to our families – we will leave a mess. Somehow, I think a deeper peace can be found in coming to terms with the untidiness of life and death – and instead, to stay open and curious without such unrealistic expectations.

Very seldom does it happen that one says, “God, take me now, I’ve lived a full life.” More likely, one pleads, “Please let me see my kids or grandkids grow up. I wanted to get to Paris. I still have that bookcase to build.” Whatever the thing is, somehow it has to be OK. We carry sorrow our whole lives, we carry joy our whole lives at the same time. Can I meet my end in the same way, with the ability to hold both sorrow and joy?

(Danielle) It is such a normalizing message that I think we all need to be reminded of – that it is OK, like you said, to have things undone or not completely wrapped up in a bow when our time comes. I very much appreciate the message that this is a common experience, and that we are not alone in that.

I’m wondering if in your time working with individuals and families facing cancer, you’ve encountered people wanting to honor their sadness and grief, but find themselves keeping quiet due to the pressure from our culture to be positive and grateful.

If you do, how do you help them give themselves permission to grieve and share their emotions fully?

 

(Michael) The core expression, and I do not mean to sound glib, is self-compassion. It’s important to honor the grief first. If I say to myself that I need to be positive or need to be grateful, I am not honoring my pain. Instead, I am judging myself, and that judgment is only going to cause more suffering. Compassion, from the Latin, compati, means “to be with suffering.” To be with it, not fix it, correct it, advise it or compare it …  just be with it. It is not a small or simple thing.

And yes, a lot of loved ones who mean well in our world say, “But look, the cancer has not metastasized.” And, “Look, you got through that treatment, and you are OK.” However, these statements really miss the mark. They are not congruent with how you are feeling on the inside. Unfortunately, nobody is coming next to you and sitting down with your suffering. And yet, that is what a compassionate response would look like.

(Danielle) Such wonderful advice to caregivers, Michael. Even just listening to you talk, I feel a lightness and a kind of permission to be truthful. The New York Times article was written by a professor of psychology at Northeastern University, Dr. David DeSteno, and he stated that contemplating death helps people make decisions about their future that bring them more happiness.

Can you help us understand what he means by this?

 

(Michael) I cannot speak for him, but what I feel and believe when I hear him say this is the Latin expression, memento mori, “remember that you will die.” In the Christian tradition, there is Ash Wednesday. “Remember, from ashes you came, and to ashes you will return.” There is an app out there called We Croak that I subscribe to that sends you a quote five times a day that reminds you that you are going to die. This is in the Buddhist tradition as well, that we should be mindful of our impermanence all day long, and remember that this life is going to be over.

(Danielle) Part of the message seems to be that contemplating our deaths can be a catalyst to help us find more joy in the here and now. We know that people think about their deaths within mere minutes after a cancer diagnosis is given to them.

In your experience, what is the process like for someone with cancer to go from fearing their death to a place of acceptance, peace, and even joy?

 

(Michael) As I said earlier, the scary and terrifying must be honored. A lot of folks who are newly diagnosed seem pretty put-together, and I will ask something like, “Do you want to talk about any feelings you might be having about the future, or what might be ahead for you?” And their response is, “Oh, no, no. If I feel those feelings, I will go down a dark hole, and I will never come out.” This is quite an understandable response; however, my experience and observations tell me just the opposite is true. When we allow ourselves to feel those feelings and give voice to them, they have less power over us. I can acknowledge it is just a thought, it is a feeling. But when I am pushing it all away, it takes a lot of energy. It’s exhausting to keep a secret shoved in a closet when I could just say, “Yeah, I am scared to death.” Let’s just get it out and talk about it.

“No feeling is final.” That is a quote from a line of a poem by Rilke. We cannot hold on to a good feeling when we have one, and we cannot hold on to a bad feeling, either. Do you see a movie that makes your heart sing? You just do not want it to end, or for the lights to come back on in the theater. But it does end. Your phone rings with a problem or bad news, and the feeling is gone. If I cannot hold on to a good feeling, I cannot hold on to a bad one, either. It might feel so solid in this moment, or like it will feel this way forever. It can be terrifying in the moment, but remind yourself that it is just a feeling, and it will change. That is one guarantee. Nothing will stay the same.

So, when that fear comes over you, when the diagnosis has turned your whole life upside down, treat yourself with tenderness. It takes a long time sometimes to get your bearings in this new reality. Once you hear that news, it reminds me of people who have survived an earthquake or tsunami. They wander around their villages, and not only is their house gone, their village is gone, their street is gone. One cannot even comprehend the loss. It takes time to wander around the rubble and say, “Did this really happen?” “Is this my home?” “Am I going to rebuild here?” “Am I going to go somewhere else?” All of this is true for the person diagnosed with cancer, too. Everything is upside down; you need time to sift through the rubble.

As far as I see, this process gives you the opportunity to pick out, from what survived, what really mattered. It allows someone to think about how they want to live their life going forward. That can take months, even years, so the key is not to rush it.

(Danielle) This has been an enlightening and hope-filled conversation, Michael. Thank you, on behalf of Clearity, for giving us all permission to hold both the dark and the light, and to meet ourselves and our emotions fully. Until next time.

 

Michael Eselun is the chaplain for the Simms/Mann-UCLA Center for Integrative Oncology. He has an extensive background in providing spiritual care in oncology, hospice, and palliative care settings, and has traveled across the country to speak to healthcare professionals, patient populations, and faith communities. Michael has served as a consultant with our Steps Through OC team since 2019. Learn more about Michael here.

Did you miss it? Clearity’s Executive Director, Hillary Theakston, had a related conversation with Palliative Care Physician, BJ Miller, in our Cancer Connections Podcast, ‘Can a Conversation About Death Bring Joy?’