Disappearing Act

One of the things I enjoy about hospice work as a spiritual care counselor is what I like to call the disappearing act. Every day I disappear. Multiple times. When I am with another at the end of life I do not pray for the person if they do not believe in prayer. We do not discuss the divine, if that is not a part of the individual’s worldview. I might play someone a chant, like the metta sutta if he or she is Buddhist and rhythmic sound is going to be a greater consolation than any level of conversation. Or we might discuss star families, and the comforts afforded by astrological ancestors visiting in the final days, if a person belongs to a stargate community and espouses a more eclectic spirituality. When I show up for others at the end of life “I” disappear for the most part because my role is to be there for them, what they cherish, what they love, what they lament, and what they are going to miss. Sure, there is the occasional and appropriate use of self (myself) in the course of a visit, for rapport building, or perhaps by way of providing patients with a reassuring ministry of presence. But hospice work is about patient-centered care. It’s not about me. So, I vanish. And there is something wonderfully refreshing and liberating about this daily disappearing act. It’s like becoming… “nobody” as Ram Dass might have said, in the best sense of that word, where the ego falls away, just a little bit more with each encounter, and something beautiful is born for another in the midst of the ultimate vanishing act we all experience one day.

After I complete a visit, leaving a person’s home or residential care facility, I hop back in my car and reappear. On the other side of these interactions I sometimes reappear for the worse, if the person’s distress, character, mood, or beliefs somehow created a deep dissonance with my own. Sometimes, perhaps most often I would like to think, I reappear for the better, blessed by the encounter. This pendulation, between disappearing and reappearing, gives me gratitude and greater clarity about who and what actually matters to me. And, simultaneously, if my work is done well, I honor the dignity of others and offer simple comfort to those exiting the world. My role is not entirely parasitic or altruistic but a blending of the two, what is sometimes called jita-kyoei in Japanese or “mutual benefit.” There is a kind of harmony and resonance that emerges for both parties in the wake of this self-emptying and vanishing. Living as we do in a highly image-driven culture, where so many of us are intent on crafting and presenting a certain self to others, this way of existing in hospice work may come across as odd. But in the natural world it is actually commonplace, a phenomenon called crypsis, where creatures of various kinds will meld and mesh with their surroundings, becoming invisibly present, unobserved and undetected. “Nature is full of such advocates for the inconspicuous life,” writes Aikiko Busch, “arctic foxes that turn white before snowfall, glamorous Indonesian crabs with baroque patterning on their shells that mimics the choral in which they live, octopi with cells beneath their skin that can change color to simulate that of the surrounding marine life.” Nature loves to hide, and this hiding is highly intelligent, not to be confused with nonexistence, nor a relinquishing of the unique and creatives aspects of being individuals. “Invisibility is a strategy,” Busch observes, “for attracting a mate, protecting home and habitat, hunting, and defense.” For those providing spiritual care in hospice work, too, invisibility is a strategy, a compassionate but also commonsense disappearing act by a clinician, for those at the end of life who want to be seen and heard for who they are, what they believe, and how they wish to celebrate the precious time that remains.