Remember all that talk last week about the slow down between CES and MWC? Not this week, man. No way. PlayStations, HTCs and a whole lot more dropped in the past seven days. Join us after the break at 5PM. We've got lots to talk about.
Filed under: Podcasts
Source: http://www.engadget.com/2013/02/21/engadget-podcast/
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Public release date: 20-Feb-2013
Share ] Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
ANN ARBOR, Mich. Two major health reform laws, enacted 25 years apart, both try to meet an ethical standard to provide broad access to basic health care. Neither quite gets there -- but it's not too late for modern health care reform to bring the nation closer to a goal of comprehensive and coordinated care for all.
That's the conclusion of a commentary published in the new issue of the Journal of the American Medical Association by a team of University of Michigan Health System physicians.
The authors a family physician, an emergency physician and a primary care pediatrician/internist take a hard look at the implications of the ethical standard set in 1986 by a law that mandated universal access to emergency care. They assess the ability of both that law, and the Affordable Care Act of 2010, to meet the standard of providing access to basic health care to all who live in the United States. They conclude that both laws fall short of that standard.
But, by learning from the quarter-century of the nation's experience with the emergency care law called EMTALA they say the current Congress and administration may still be able to implement and tweak the ACA so it comes closer to the public's ethical expectations.
The crux of the issue, they write, is that the ACA doesn't ensure access to preventive care for all, nor coordination among all types of health care. An estimated 30 million people will still be without insurance even after all of its provisions take effect.
"Health care in the U.S. is sometimes treated as a right and sometimes as a privilege," says U-M health care policy researcher Katherine Diaz Vickery, M.D., a Robert Wood Johnson Foundation Clinical Scholar who also sees patients at U-M's Ypsilanti Health Center. "When we compare EMTALA and the ACA, we see that while emergency care is treated as a right, primary care, it seems, is treated as a privilege."
EMTALA focused on taking care of individuals in urgent or emergent situations, and did not address how to make all people in the U.S. healthier, say the authors. They cite the need for a balanced health care system that focuses on both illness and wellness, and allows patients and providers the chance to work together to prevent illness and save money.
Co-author and U-M emergency medicine physician Kori Sauser, M.D., notes that while the ACA comes closer to changing that perspective, it does not go far enough.
"As the provisions of the ACA kick in, millions more people will have access to primary care providers and preventive services like vaccinations and routine screenings for high blood pressure and cancer," says Sauser, who is also a RWJF Clinical Scholar. "Even so, demonstration projects haven't convinced us that patients will choose primary care offices over the emergency department for their acute care. A major missing piece in the ACA is in failing to determine how to connect emergency care with primary care resources in ways that meet patients' needs."
EMTALA, which requires hospitals and providers to evaluate, stabilize and provide basic lifesaving treatment to any patient who comes to an emergency department or is in active labor, was passed during President Ronald Reagan's administration. It does not allow a patient's ability to pay to be considered during emergency care.
Its ethical core, to ensure access to care in medical emergencies, includes an acknowledgement of "community responsibility" and "historic standards" in health care.
But in the years since, it has led patients who do not have insurance or the ability to pay for care out of their pocket to rely on emergency rooms for care. That in turn has burdened hospitals and led to spending that doesn't take advantage of potentially cost-saving primary and preventive care.
The authors note that ACA does not expressly lay out the way to integrate the emergency and primary care worlds in a way that ensures access to care -- what the authors call a major oversight.
And, at the same time that the ACA is being implemented, payments to hospitals to fund care for the uninsured are being decreased -- in spite of estimates that 30 million people will remain uninsured in 2020.
The authors conclude: "Ultimately, the ability of the US health care system to satisfy the ethical obligation to ensure access to care -- first codified in EMTALA -- will be a core measuring stick for the success of the ACA and for any future reforms."
The article grew out of discussions that Vickery and Sauser had with Matthew Davis, M.D., M.A.P.P., who is co-director of the RWJF Clinical Scholars program at the University of Michigan and holds faculty positions in the U-M Medical School and U-M Gerald R. Ford School of Public Policy.
Vickery, who had previous experience treating undocumented immigrants at a Federally Qualified Health Center, notes that the issue of access to primary care for that population, and for others who will not become insured under the ACA, still needs to be addressed. She recalls instances where patients had to be hospitalized for severe complications of diabetes that had never been diagnosed or controlled, because their only health care access came through emergency rooms.
On the flip side, Sauser notes that not having to consider someone's insurance status in the ER feels like a "luxury" but that every day she sees a need for better ability to coordinate the care of a patient who has been seen for an emergency.
Both say that the accountable care organization, or ACO, model of care encouraged under the ACA may help patients within ACOs get access to more coordinated care.
By looking back at lessons from EMTALA which will continue to be the law of the land even under the ACA they hope to inform policy makers and health leaders who are working to implement or introduce potential changes to the ACA.
###
Reference: JAMA, Vol. 309, No. 7, pp. 665-666 http://jama.jamanetwork.com/article.aspx?articleid=1653529
[ | E-mail | Share ] ?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Public release date: 20-Feb-2013 Share ] Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
ANN ARBOR, Mich. Two major health reform laws, enacted 25 years apart, both try to meet an ethical standard to provide broad access to basic health care. Neither quite gets there -- but it's not too late for modern health care reform to bring the nation closer to a goal of comprehensive and coordinated care for all.
That's the conclusion of a commentary published in the new issue of the Journal of the American Medical Association by a team of University of Michigan Health System physicians.
The authors a family physician, an emergency physician and a primary care pediatrician/internist take a hard look at the implications of the ethical standard set in 1986 by a law that mandated universal access to emergency care. They assess the ability of both that law, and the Affordable Care Act of 2010, to meet the standard of providing access to basic health care to all who live in the United States. They conclude that both laws fall short of that standard.
But, by learning from the quarter-century of the nation's experience with the emergency care law called EMTALA they say the current Congress and administration may still be able to implement and tweak the ACA so it comes closer to the public's ethical expectations.
The crux of the issue, they write, is that the ACA doesn't ensure access to preventive care for all, nor coordination among all types of health care. An estimated 30 million people will still be without insurance even after all of its provisions take effect.
"Health care in the U.S. is sometimes treated as a right and sometimes as a privilege," says U-M health care policy researcher Katherine Diaz Vickery, M.D., a Robert Wood Johnson Foundation Clinical Scholar who also sees patients at U-M's Ypsilanti Health Center. "When we compare EMTALA and the ACA, we see that while emergency care is treated as a right, primary care, it seems, is treated as a privilege."
EMTALA focused on taking care of individuals in urgent or emergent situations, and did not address how to make all people in the U.S. healthier, say the authors. They cite the need for a balanced health care system that focuses on both illness and wellness, and allows patients and providers the chance to work together to prevent illness and save money.
Co-author and U-M emergency medicine physician Kori Sauser, M.D., notes that while the ACA comes closer to changing that perspective, it does not go far enough.
"As the provisions of the ACA kick in, millions more people will have access to primary care providers and preventive services like vaccinations and routine screenings for high blood pressure and cancer," says Sauser, who is also a RWJF Clinical Scholar. "Even so, demonstration projects haven't convinced us that patients will choose primary care offices over the emergency department for their acute care. A major missing piece in the ACA is in failing to determine how to connect emergency care with primary care resources in ways that meet patients' needs."
EMTALA, which requires hospitals and providers to evaluate, stabilize and provide basic lifesaving treatment to any patient who comes to an emergency department or is in active labor, was passed during President Ronald Reagan's administration. It does not allow a patient's ability to pay to be considered during emergency care.
Its ethical core, to ensure access to care in medical emergencies, includes an acknowledgement of "community responsibility" and "historic standards" in health care.
But in the years since, it has led patients who do not have insurance or the ability to pay for care out of their pocket to rely on emergency rooms for care. That in turn has burdened hospitals and led to spending that doesn't take advantage of potentially cost-saving primary and preventive care.
The authors note that ACA does not expressly lay out the way to integrate the emergency and primary care worlds in a way that ensures access to care -- what the authors call a major oversight.
And, at the same time that the ACA is being implemented, payments to hospitals to fund care for the uninsured are being decreased -- in spite of estimates that 30 million people will remain uninsured in 2020.
The authors conclude: "Ultimately, the ability of the US health care system to satisfy the ethical obligation to ensure access to care -- first codified in EMTALA -- will be a core measuring stick for the success of the ACA and for any future reforms."
The article grew out of discussions that Vickery and Sauser had with Matthew Davis, M.D., M.A.P.P., who is co-director of the RWJF Clinical Scholars program at the University of Michigan and holds faculty positions in the U-M Medical School and U-M Gerald R. Ford School of Public Policy.
Vickery, who had previous experience treating undocumented immigrants at a Federally Qualified Health Center, notes that the issue of access to primary care for that population, and for others who will not become insured under the ACA, still needs to be addressed. She recalls instances where patients had to be hospitalized for severe complications of diabetes that had never been diagnosed or controlled, because their only health care access came through emergency rooms.
On the flip side, Sauser notes that not having to consider someone's insurance status in the ER feels like a "luxury" but that every day she sees a need for better ability to coordinate the care of a patient who has been seen for an emergency.
Both say that the accountable care organization, or ACO, model of care encouraged under the ACA may help patients within ACOs get access to more coordinated care.
By looking back at lessons from EMTALA which will continue to be the law of the land even under the ACA they hope to inform policy makers and health leaders who are working to implement or introduce potential changes to the ACA.
###
Reference: JAMA, Vol. 309, No. 7, pp. 665-666 http://jama.jamanetwork.com/article.aspx?articleid=1653529
[ | E-mail | Share ] ?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Source: http://www.eurekalert.org/pub_releases/2013-02/uomh-teo022013.php
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Sorry, Readability was unable to parse this page for content.
Source: http://video.msnbc.msn.com/hardball/50879588/
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When NVIDIA officially pulled back the curtains on its new Tegra 4 SoC at CES, it had no shortage of praise for the thing -- the company referred to it as "the world's fastest mobile processor" -- but there was something missing from the announcement. Who would be using be using it? Sure, Vizio revealed a 10.1-inch, T4-powered tablet just a day later, but there was nary a phone partnership in sight until tonight. NVIDIA has just announced it is working with the folks ZTE to launch the first Tegra 4-powered smartphones in China during the first half of this year.Source: http://feedproxy.google.com/~r/Techcrunch/~3/42lexNCqpkM/
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President Barack Obama on Tuesday morning will stand with emergency responders at the White House, according to a White House official, to issue yet another warning to congressional Republicans ahead of across-the-board, automatic spending cuts known as the sequester. The cuts total $85 billion and are set to go into effect if a budget is not passed by March 1.
The president is scheduled to deliver his remarks at 10:45 a.m. ET. He will discuss the impact of federal cuts on emergency first responders, as well as the effect of the sequester on other jobs and the middle class, according to the official.
Obama has urged Congress to pass a short-term budget fix in the absence of a complete budget resolution. The alternative, the White House says, will derail the economy.
The White House accuses Republicans of preferring a sequester over closing tax loopholes for the nation's wealthiest. Many Republicans, including House Speaker John Boehner, have voiced their disapproval of the sequester (even though Boehner and a majority of Republicans voted for the fiscal cliff plan that maintained it), and have pushed the president and Democrats to offer a concrete alternative that tackles debt and deficit problems.
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I?m here to talk to you on behalf of our tiny sangha in rural Vermont and how
together we experienced the teachings of Anyen Rinpoche in a very immediate way as
we shared in the dying of one of our members. It?s our hope that reading this will give
you an idea of how amazing and beautiful and possible it is to die with confidence. We
should all aspire to be surrounded by trusted dharma friends. One of life?s greatest gifts
is to be a dharma friend; if you are asked to be one you should have no doubt as to
your good fortune. As the hours and days passed leading up to Bob?s death, tangible
benefits of each of our particular practices arose spontaneously and we came to a
greater understanding of how important the sangha truly is. No matter how large or
small, no matter the level of expertise of its members, the sangha holds things together.
?
I dedicate the merit of writing this story to Bob?s wife, Sally, who by selflessly
opening her heart as her beloved Bob was dying offered each of us the opportunity
to accrue astoundingly good karma and gain the depth of understanding that can
only come from experience. May she be strengthened and blessed with clear vision
for her future. It?s her wish and ours that continuous benefit radiate in ever widening
circles from our sangha to yours and beyond. On behalf of our sangha, I offer deepest
gratitude to Anyen Rinpoche for first accepting Bob and Sally?s invitation to come to
Vermont, and for supporting us from afar as he traveled to Bodhgaya at the time of
Bob?s passing; and to Ven. Konchog Norbu who committed to Sally in October that he
would return to Vermont to be with Bob in his final days and made good on his promise.
His gentle presence and pure honesty gave us all room to simply be.
?
As one friend wrote from Colorado upon Bob?s passing, ??I am so deeply touched
to see Rinpoche?s vision? for sangha to come together and transform the experience of death-
- happen for Bob and Sally. We may not have all the skills yet, but the compassion and loving
motivation to help is flowing from your hearts. Thank you all so much. Those of you who have
been with Bob and Sally this past week wrote such beautiful poetry about your experience?it
seemed quite magical. You were obviously surrounded with Buddha?s blessings. And Bob gave
us a gift from his heart as well. His practice over the years supported him even when his mental
faculties could not??
?
Bob was diagnosed with Alzheimer?s disease in 2010. By last fall he was failing
fast and yet still eagerly wished to be with Rinpoche and attend Level I Phowa training
in Manchester. Although he did not express it in words, it seems Bob had chosen to
prepare for death. Sally, ever devoted, set out purposefully to see him through.
At the retreat Bob?s open-hearted acceptance of the compassion we showed
toward him opened our hearts to receive his in return. It works that way. Those of us
who knew him, as well as those who traveled from all over the U.S. and Canada to
attend the training were blessed by his company. While he struggled to remember
names and faces, directions and schedules, Bob somehow remained more present
than seemed possible, more present at times than those of us consciously aiming to be.
Whenever I was with him, I understood bodhichitta in a way I never had before.
On the final day of the retreat, each of us came quietly forward with bowed heads
and folded hands to receive Rinpoche?s blessing. When it came time for Bob to step
up, he raised his head and approached Rinpoche with a determined step and an open
smile. Before Rinpoche could extend his colorfully wrapped bamboo staff to bless Bob
with a touch or a tap, Bob reached out with both hands, seized hold of the staff and held
fast. The long moment that followed enveloped us all as we were suspended in pure
dharma. It was as if Rinpoche and Bob formed the center of a great lotus while the rest
of us became in turn its many petals, fanned out in translucent light that could not be
contained by mere walls.
?
It was an image I returned to time and again in the weeks that followed the
retreat as Bob began to fragment into ever more random bits of being. Sally continued
to be his anchor but was at times fraught with despair and exhaustion. At times fearful,
agitated and confused, Bob could also become very angry, or simply seem to disappear
altogether. When he was hospitalized yet again in late December, it seemed logical to
use the time to figure out how to not bring him home this time, to find somewhere to
?place? him. People on all sides encouraged Sally to take this obvious next step. Sally
however, was not so sure. In fact, she was pretty much against it right along.
Over the next couple of weeks, as Sally agonized over what to do we shared
her uncertainty. We continued to meet as a sangha, to offer prayers and dedicate
merit. This was to prove especially crucial during this painful and tumultuous phase of Bob?s
dying. We Westerners are prone to getting into our heads, bypassing our hearts when
decisions have to be made until the balance is so skewed we abandon logic and swing
to the other side, often making rash choices based purely in emotion. Yet the teachings
remind us again and again to maintain mindfulness and discernment so as to balance
the logic of our heads with the loving kindness of our hearts.
?
This is why we take refuge in the sangha. It?s critical that we do this as
practitioners; otherwise confusion will reign, and lead inevitably to more uncertainty and
doubt. Sally needed support for her practice in order to keep her heart open and her
mind clear. The sangha needed to practice together to build confidence in our ability to
be present for Bob and Sally. Our busy lives somehow supported rather than thwarted
our endeavors, dishing up the sort of signs we needed that we were doing it, we were
being mindful, living our practice in the day-to-day, seeing how the dharma permeates
everything and everyone. Instead of falling further into doubt, one day in early January
Sally simply knew what she had to do. She took a leave of absence from work and
brought Bob home to die.
?
What we had talked about for months?the inevitability of Bob?s passing and our
sangha?s role in the process?was suddenly upon us. Sally prepared a room for Bob
based on what Rinpoche?s teachings said would support his passing. A fire burned
gently in the glass-fronted stove at the foot of the bed, candles and flowers adorned
the room and a small shrine upon which she placed photos of Bob?s teachers and other
personal dharma objects stood against the wall. Entering their home, one was met with
profound peace and a sense of everything being in right order and ready for what was
to come.
?
Jan. 16 ?
Sally (in an email to us):
? A soft snow is falling this morning; the wood stove is stoked, sending light and warmth into
the darkened room. I have again awakened with anxiety mixed with peace. I get up each
morning around five or six giving myself time to have coffee and some time alone. I try to sit on
the cushion each morning, either chanting the Heart Sutra or the Meditation on the
Compassionate One. Often my thoughts intrude, and getting down into that deeper state seems
impossible, I practice breathing in and out, feeling my heart pounding in my chest, I then wait to
hear sounds from Bob?s room. Yesterday he stood up by himself and opened the door, the day
before I had to wake him up around 8:30 and when I brought him out into the living room his
legs buckled underneath him. He is taking very little food at this point, preferring smoothies
and liquids; he seems to have lost all interest in solids. He spends a good portion of the day
sleeping. Yesterday and the day before he was only up about three hours each day. He is on very
little meds, whereas before we had him on 7.5 mg of an anti-psychotic twice a day, now I only
give him 3.25 once a day when he begins to get confused and seems a bit agitated. Most of the
?time when he is awake he seems to be very present responding to questions with a clear yes or
no, though he speaks only in a whisper and cannot really form more than a one or two word
sentence. Yesterday the visiting nurse came and has recommended that the
hospice nurse evaluate him. I struggle with my own thoughts of wanting this to be
over quickly, for both of our sakes. I have begun to put together a small team to help me and to
also research the legalities for my wishes to have the body home for 3 days after passing and I
have been assured by a funeral director that this is possible, I wish to make this journey as
seamless as possible and feel the prayers and support of all of you.
?
?Jan 16?
A sangha member replies:
?I am able to confirm what Sally feels certain of, that Bob is far more present than he has been
for months. It?s important to look with our hearts to see it?as Sally said in her note this morning,
Bob doesn?t speak above a whisper and spends a great deal of time whispering to himself and
gazing past us into the world that he can see and we cannot. It?s good to talk directly to him,
to not assume he doesn?t hear us?with our hearts we are able to sense what Bob is seeing and
hearing and it?s very peaceful where he is abiding. We can convey that energy to him when
we speak, or as we sit quietly with him we can send him love and clarity for the path. This is
what I wanted to tell you all, that Bob is in a state of grace right now that?s very good. His
eyes are clear and the lines in his face are gone. Although he is very thin, thinner than ever,
there?s ?more? of him than when I saw him last, he seems fuller, more put together. Sally spends
a lot of time chanting and praying with Bob and the energy in the house is sacred and lovely?as
Sally said, it would be a wonderful thing if this were to continue and Bob were able to die this
way without having the agitation and rage return that he was experiencing not long ago. We
have no way of knowing what will come, but can continue to pray and offer whatever we can to
the process; whether in person or from afar. Making Sally laugh felt really good, there needs to
be room for laughter and joy at such a time?remembering that it?s not irreverent to laugh in the
face of death.
?
Jan. 19?
Sally:
Dear all?on Wednesday afternoon Bob went to bed at 4:30 and the next day I was not able
to arouse him, he has been semi-comatose/sleeping since, and is now actively dying. Rinpoche
is in Bodhgaya and is offering prayers along with 3000 other monks and tulkus. I am piecing
together necessary details while supporting his process. I will keep you posted?
?
Jan. 20?
Sally:
?Konchog (Ven. Konchog Norbu) is here and is staying for the duration, he is in the room
with Bob chanting, we are so blessed, please come when you can, much love to all..Bob
still comfortable?hospice came this morning?
?
Jan. 20?
A sangha member:
This afternoon at Sally and Bob?s house, it was clear that Bob?s condition has declined
dramatically since I last saw him?The earth and water elements appear to have dissolved, Bob
continues his journey toward the bardos.
Konchog, who arrived last night, is staying at the house. I found him seated at Bob?s bedside,
reading aloud from the Tibetan Book of the Dead. During the afternoon, Bob and Sally?s
daughters and families arrived. While strong winds blow through the surrounding hills and
forest, the air within the house is still and rich with compassion, acceptance and strength. When
I told Bob that he was in Rinpoche?s prayers from Bhodgaya, his reaction was immediate and
unmistakable.
It?s clear that Bob is an extremely fortunate being. Sally?s immense courage, great heart, and
dedication to the dharma have allowed this gentle soul to leave this world with unmatched love
and support. We are privileged to be able to share in their journey.
?
Jan. 21
Konchog:
Bob passed so peacefully in the lion posture at 7:41pm EST, on this, the 10th day of Guru
Rinpoche. Just before he passed, his eyes, which had been closed for days, opened, directed
at the candle Rinpoche had told us to place in his view, set up as an offering to an image of
Amitabha in Dewachen. A light snow had just begun to fall. Sally and the two children they had
together were here, emotional, but holding it together pretty well. After his last breath, I lightly
tapped at his fontanel, said Amitabha?s name many times, and sang his mantra. I then read
the Heart Sutra and Karma Chagmed?s ?Prayer to be Reborn in Dewachen,? made incense and
light offerings with Atisha?s extensive light offering prayer, and all of us together did the simple
reading for the first three days of death. Now we are notifying various people while a lovely
recording of the Mani mantra plays for Bob.
?
Sally had already arranged for Bob?s body to remain undisturbed for 3 days
before being removed for cremation, so when he died the stove was shut down and the
window opened to invite the chill air. The vigil began. Over the next 3 days, Konchog
and Sally remained a steady presence while others from our sangha and from Sally
and Bob?s family came and went, taking turns snugged in a heavy coat or wrapped in
a blanket to sit with Bob?s body. The sacred space that Sally had prepared for Bob was
now fiercely cold and yet magically warm and inviting; lit with candles, fragrant with
incense. Bob?s body, too, was a comforting presence rather than something strange or
off-putting. Outside the open window, chimes hanging from the eaves lightly sounded in
the breeze. On Wednesday night, 2 days after his outer breath had ceased, our sangha
met at Sally and Bob?s house as a group and sat together with Bob?s body. Konchog led
us in the specific prayers that Rinpoche instructed us to use.
?
On Friday the body was removed for cremation and on Saturday, January 23,
a ceremony of remembrance was held for Bob at the Manchester Shambhala Center,
lovingly adorned for the occasion. The service was a simple, moving event filled with
prayers and ritual befitting the final days of Bob?s life. As with all aspects of Bob?s
passing, the day itself was auspicious, being the full moon Amitabha day. The room
was packed; some guests on cushions, others in chairs or standing, squeezed in
and familiar with one another if only for the hour. Many had never been to a Buddhist
ceremony of any kind; if they felt awkward upon arrival their awkwardness quickly gave
way to a sense of openness and peaceful acceptance. Toddlers wandered through
the crowd, laughing and chattering. Babies were held gently in loving arms. The sense
that we were all being held in fact, was much like the moment at the retreat when Bob
received his blessing from Rinpoche. When nothing separates who we are from what
we do, everything is sacred. Dharma readings and prayers, music, poetry and loving
words mingled as deeply as the styles and hearts of the people in attendance. People
remarked later on that it was like being suspended in time.
?
Bob and Sally?s daughter, Sam, read the words that Sally had written for the?ceremony:
?I would just like to share a little about these last weeks, which have been sad, but also peaceful
?and filled with love. When Bob was in the hospital I was told over and over that he needed to
?be in a nursing home. I got very, very close to putting him in one. I struggled daily with the
?decision but after visiting a nursing home, I realized I couldn?t do this, I couldn?t not bring
?Bob home. So on January third we brought him home, against doctors? advice. He was weak
?and disoriented and was brought home by ambulance. Bobby and I cuddled into bed with him;
?and we were smiling to each other, saying over and over ?you?re home.? Bob was so visibly
happy. Please understand that for someone with Alzheimer?s, it?s hard to show emotion. It?s
all blurred. He knew he was home, that is, he was safe, with family, with us. If he?d been in a
?nursing home, we would have lost him. We would have lost anything of him that we could pull
?back, that we could touch. It would?ve been gone.
?
In these last weeks he seemed to become more lucid, more present, even though
?his ability to communicate was diminished to only a word or two, he seemed softened.
?On Monday the 7th we laid in bed together and we talked; again, you have to understand
?he had lost the ability to speak in sentences of more than one or two words. We talked
?about Alzheimer?s and he said, ?it?s killing me?. I asked him whether he wanted to continue
?to fight this or whether he wanted to just be home, no more hospitals? He said home? I
?said to him a couple of times, ?do you understand what I am saying?? and he said ?yes.? I
?repeated, ?do you understand what I am saying?? and again he said ?yes.? ?later I helped
?him walk out into the living room and when we sat down Bob looked over at me and said, ?talk
?more?? I said to him, ?do you want to fight this, ?cause I will do anything in my power if that is
what you want,??. He nodded his head yes. He immediately looked alarmed and then said to me
?so very clearly ?other, other.? So I said, ?do you just want me to support you spiritually?? His
?face visibly relaxed and he said ?yes, yes??
?
Over the course of the next week Bob stopped eating solids. He slept more and more. On
Wednesday of last week he slipped into a semi-coma. We were told by hospice that he
?probably had less than a week. On Saturday night, Konchog came to be with us and began
?chanting and saying prayers throughout the day and late into the evening. On Monday night
?Bob peacefully died at home with Bobby, Sam, Konchog and I at his side. We continued to say
?prayers for him for the next three days after his passing.
?
This has been an incredible journey; one with acceptance, rawness, beauty, and love, I can?t
?put it all into words. When I was younger I loved Dylan Thomas?s poem ?Do Not Go Gentle into
?That Good Night?, but today?I stand here, older, and a little wiser. Death had always seemed
?a great mystery, full of fear and sadness. Bob has shown us grace, courage and a deep knowing.
?Together with my children and grandchildren we have cried, and laughed, and sobbed and
?prayed and we have learned that this great rite of passage holds unbridled compassion.?
?
After the service, Sally and her family threw a fine party. The Bob I knew was
fond of saying, ?I?m Irish.? He would attach this addendum to the increasingly abstract
things he came up with that nonetheless made perfect sense. We?d be pondering the
dharma and Bob would just come out with something so strangely yet perfectly put
together that we knew exactly what he meant but would be hard pressed to explain it. A
sort of Alzheimer?s koan, if you will. Then he?d get that twinkle in his eye and say, ?Hey,
I?m Irish.? So although he didn?t have the traditional Irish wake, Bob didn?t leave without
a celebration in his honor. Afterwards, we all went home, one by one, back to our lives,
leaving Sally to hers and yet not. The inevitable grace of the sangha remains because
that?s how it is, that?s how it works.
?
?and on January 28th, seven days after Bob?s passing, as I was sitting on the deck early
?one morning, after a deep snow, a small finch lit upon my shoulder. om mani padme hum.
?-Sally Leonard, East Dorset,?Vermont
?
Anyen Rinpoche?s book,?Dying with Confidence?includes Rinpoche?s heart advice to support practitioners through the dying process. ?The Dying with Confidence training program will give students the guidance and opportunity to master all the skills necessary for a practitioner to use death as an opportunity for enlightenment and to help all sentient beings.?The next Level I Training will be held September 26-30, 2013 in Denver, CO.
For more information and an application:?http://www.phowafoundation.org/PFCrestone%202012.php
This entry was posted on February 19, 2013, 2:59 PM and is filed under Uncategorized. You can follow any responses to this entry through RSS 2.0. You can leave a response, or trackback from your own site.
Source: http://www.anyenrinpoche.com/blog/2013/02/19/the-passing-of-a-dharma-friend/
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