When the situation allows, Sr. Joan Sobala brings a small bottle of rosemary oil, her own blend, to the dying and asks if she can rub their feet.
“Then we begin a little conversation,” says the recently retired pastoral administrator for the Roman Catholic Diocese of Rochester.
The conversation that takes place during the non-sacramental anointing, the 73-year-old nun continues, typically goes like this:
“I’m preparing your feet to take you on this next part of your journey. Is this OK to do?”
“Do you feel this is soothing to you?”
“How do you feel about moving forward? Are you afraid?”
Sr. Joan pauses after relaying the exchange in a soft voice.
“It’s interesting,” she says, her voice still low. “More people than not that I have worked with say no.”
The fear of death is as old as history itself. Egyptian pharaohs had pyramids built to give themselves portals to life after death. The Epic of Gilgamesh, one of the earliest surviving works of literature, deals extensively with the protagonist’s quest for immortality. The ancient philosopher Epicurus, in his famous Letter to Menoeceus, argued that fear of death is foolish. “Death, therefore, the most awful of evils,” he wrote, “is nothing to us, seeing that, when we are, death is not come, and, when death is come, we are not.”
Today, the fear of death has spawned research projects around the world as study subjects grapple with age-old questions: When will it come? Will there be pain and suffering? Is there an afterlife? Is there eternal punishment?
Death is inevitable and unpredictable: an anxiety-inducing combination.
But research has shown, and anecdotal evidence corroborates, that people with a strong spiritual life have more peace and comfort as they approach the end. Religion is another matter. In fact, a growing body of evidence supports that religious people tend to be more afraid of death and are more likely to seek out aggressive medical treatment to extend their lives than nonreligious people. Experts say that sounds counterintuitive until you factor in the significance of eternal fate. Spirituality, on the other hand, which may or may not be associated with a particular religion, has been proven to help dying patients cope better, rely less on health professionals, and find meaning in the midst of suffering.
“When people feel like there’s an order to the world, when they believe there’s a master plan and that there’s a rhyme and reason things happen, they generally do better,” notes Dr. Daniel Mendelson, director of palliative care at Highland Hospital and associate professor of medicine in the Division of Geriatrics at the University of Rochester. “On the other hand, patients in serious conflict with that, those who have a lot of existential suffering and feel God is letting them down by letting them die, tend to go through the process more dramatically.”
That’s why it’s critical for palliative care physicians to provide exceptional pain management for people who are stuck in doubt and dealing with severe depression or anxiety over what comes next, adds Mendelson, “so they can do the rest of the work that brings them peace.”
Of his own potential fears around death, he muses, “It would be very hard to do what I do and be afraid to die. I think I have a lot of peace because I focus on the beauty and wonders of life, not the randomness and tragedies. So I hope when my time comes, it’s gentle and easy.”
Practicing mindfulness — being calmly aware of the present moment, mainly through meditation and conscious thought — may help with feelings of vulnerability. A 2011 study from George Mason University found that being mindful not only helps raise tolerance and mitigate defensiveness, it neutralizes fears of dying and death.
Faith isn’t always about God, of course. In Buddhism, for instance, there is no concept of God, although there is a faith “in things as they are,” says Bodhin Kjolhede, the abbot and director of the Rochester Zen Center on Arnold Park. “There is an intelligence working in all that occurs.”
When it comes to death, “The essence of dying well is to be fully present,” he says, “not clinging to ideas or emotions, not grasping at regrets or memories or images of what comes next. It may sound like I’m oversimplifying, but I’m not. It really is just about letting go.”
Kjolhede recognizes that it takes time — “years or decades” — to train the mind to get to that point. Through deep, intense meditation, he explains, we’re confronted by states of fear, anxiety, anger, sorrow, and regret. In time, through what Kjoldhede calls an “excavating process,” we learn that those states eventually pass. And with that hard-earned freedom comes the key to dying without fear.
“The fear will pass on its own if you don’t create a story about it,” he says. “It’s just a thought.”
Kjolhede’s personal belief is that “death is not an end and birth is not a beginning.” However, when he has been with people who are dying and they’ve asked for his opinion on the afterlife, he has been careful not to preach.
By way of explanation, he points to an oft-told story in ancient Zen literature: A samurai asks a Zen master where he will go after he dies. The master answers, “I don’t know.” The samurai exclaims, “Well, why not? You’re a Zen master!” The master says, “Yes, but not a dead one.”
“Zen is very practical,” notes Kjolhede. “We never want to claim to know something we don’t. But the way to live the most rewarding, joyous life is exactly the way to die in peace. As I see it, it’s all about having the mind wide open.”
Just as Buddhism has various doctrines, some of which place a stronger emphasis on preparing for death than others, Judaism is also far from a monolithic tradition — one based on asking questions and finding multiple interpretations to life’s most profound challenges, according to Rabbi Rebecca F. Gutterman of Temple B’rith Kodesh in Brighton.
“I try to meet the person where they are and not offer false comfort,” she says of her time with the dying, time sometimes spent singing or reading sacred texts that hold special meaning. “In our tradition, it really is OK to feel that things sometimes aren’t fair, because sometimes they’re not.”
Gutterman recalls visits two years ago to an elderly woman in hospice. The woman would reminisce about her life, her dogs, the milestones in her extended family that she hoped to witness. One day she asked Gutterman to sing a Hebrew folk song. Gutterman obliged.
“In the midst of this complicated experience, where she was really struggling with different feelings she was having, this sense of peace and calm spread over her,” Gutterman says. “It was very moving, and so simple. I think what Judaism tries to teach is that we shouldn’t take away the suffering, but we should use ourselves and our ability to be present to bring some light at times of darkness.”
At the Sisters of St. Joseph of Rochester Motherhouse in Pittsford, Sr. Bernadine Freida calmly waits for her last moments.
“I’m 95,” she says. “Therefore, each time I go to bed at night, I’m not quite sure I have another day. I’ve resigned myself to that.”
She shrugs her shoulders. “Whatever God wants.”
Sr. Bernadine and Sr. Maria Kellner, another resident, have been visiting the ailing and dying together in their community since 2003. Sr. Maria, 81, has witnessed the joy that can come just before the last breath. “So many of them look up in the corner and smile,” she says. “You can tell they’re not conscious of us being there anymore. Some have said, ‘Oh, it’s beautiful.’ ”
Given her background as a pastoral administrator, Sr. Joan has been by the side of both laypeople and sisters as they were dying, and she says death can be “a beautiful thing.” Careful to point out she’s not talking about sudden loss, she elaborates, “There’s a difference between dying and death. Dying is a process. It’s messy and smelly and there could be pain. Death is an achievement. For those of us who believe that life everlasting is our gift, it means that everything is done. And we have done our best.”
So what does this all mean for an atheist?
Brian Abbamonte, a 28-year-old graphic designer from Brighton who was raised Catholic and became an atheist in middle school, says he’d fear death only if he looked back and saw that the life he led wasn’t the life he’d wanted to lead.
“When I’m gone, there will be no sadness or pain for me because those emotions are all in my head,” he says. “And I’ve built such strong relationships with family and friends, the impression that I leave on other people will impact their lives even after I’m dead. As long as I’m proud of what I’ve done, then I don’t worry about it.”
On a clear July afternoon at the Motherhouse, Sr. Maria joins more than 100 others in the chapel to say goodbye to 85-year-old Sr. Juliana O’Hara, a nurse, teacher, and advocate for the elderly who once sang in her sleep and was known for responding to “How are you today?” with “Just as beautiful as ever.” Less than a handful wear black.
Sr. Maria was with Sr. Juliana the day before she died, holding her hand and offering a blessing. Earlier today, with a group of sisters, she’d sung familiar hymns “that brought back happy memories.” Now, she retains a smile as she takes a final look at her bespectacled friend, gorgeous harmonies reach the pitched roof rimmed with stained-glass windows, and the gathering joins together in the gospel acclamation: “I am the resurrection and the life; those who believe in me shall never die.”
“To us, this is a joyful occasion,” Sr. Maria says after the funeral, the smell of incense still lingering, “because she has reached her final goal, which is to be united with God for eternity.”