Living and dying across cultures

There’s one thing about cancer that is undeniable. And that is that it abruptly confronts you with your mortality. Which is interesting, because many cultures, have so many taboos around death. We don’t talk about it. We remain in denial, about our own deaths, and of those close to us. We use euphemisms when a person dies. We too often avoid the topic. We even hide it from our own minds.

However, when you step over the line in the sand when we learn we have cancer, or if someone close to us is diagnosed, that taboo seems to melt away. Being part of a close cancerhood which includes too many with metastatic cancer, means that the subject of death is always there.

I learned a great deal about death and grieving when my father in law died nine years ago in north eastern India where my husband’s family is from. The family belongs to the “Tamang” ethnic Himalayan hill people and are very devout Buddhists. As a foreigner (and new daughter in law) in such an intense situation there was the potential for a very difficult time. I had no understanding of the rituals, or what would happen and my own cultural block prevented me from asking. This was eased enormously for me, when one of my husband’s aunts took me to one side and passed me “The Tibetan Book of Living and Dying” and pointed me to the chapters on ritual and belief around death.

As well as being enormously helpful and enabling me to understand and engage as appropriate in the rituals, I learned a great deal from that book as well as from being with the family throughout these rituals. I recount this from my memory of that time and what I have retained from the explanations from family and the book which accompanied me throughout. This is my own understanding and I trust that it is accurate, and am happy to be corrected if I err at all.

I am a complete novice in the teachings of Buddhism, so please be gentle with me if I either over-simplify or misconstrue. It is well known that Buddhism is based on the principle of reincarnation. This is where the way we have acted in this life influences and shapes where we head in the next one. As such the process of death is one of the soul passing to the next life and very important. It is critical that the process is carried out properly.

I felt humbled and privileged to be part of this when my father in law died. I found this process enormously respectful and helpful in that it guides the bereaved through a process where they focus on the transition of their loved on in stages and helped me to understand how differently we deal with death in different contexts.

The time of death is believed to be very traumatic for the soul of the one who has died and there is a transition stage known as “bardo” which the soul passes through. It is very important that Buddhist monks guide the departing soul through this process, with rituals known as the “phowa”. This is intended to help the soul understand that they have died and to support them to gradually come to terms with this. Over these early hours and first days following death there is chanting to comfort the soul, and the family say kind things about their lost one, leaving out their favourite foods and drinks to make sure they feel loved and not distressed. The funeral takes place very soon after death, at a place and time identified by the monks.

The 49 days following death are very important in the Buddhist rituals and beliefs, representing seven periods of seven days each. At each seven day point, rituals will be held in the home, Buddhist monks chanting and carrying out the appropriate “puja” to support the soul on their journey towards their next incarnation or next life. At the third seven day period, that is on the 21st day, an important “puja” is held. At this point the soul moves from the stage where they are newly passed, to that where they are preparing for their next incarnation. While in the first 21 days, the soul is believed to be nearby and moving through this “adjustment” phase, after that it is believed that on one of the next seven day points, the soul will pass to the next life, therefore either at the 28th, 35th or the 42nd day.

When the 49th day comes, it is known that the soul has moved on and there is a major day of rituals and puja, with family and friends coming from far and wide to pay respects and to grieve. It is a painful and highly emotional day, for it is on the 49th day, the family and close ones know that their loved one has moved on and they grieve their loss.


Today marks the 49th day since my father’s death.

Post Script

Strangely I dreamed of my father last night, after I had written this.  Strangely, because this is unusual.  I do not dream often of my father, I never have.  I think of him frequently but rarely dream.  Last night, in my dream, he came to visit us in our home.  He was looking so well, was dressed in his usual everyday “countryside smart but casual” clothes and standing in the garden near our door.  I was pleased to see him standing and walking unaided, and out and about as he had been so frail when I last saw him. Memory was clearly blurring with reality.

He didn’t come into the house, but we stood outside and chatted.  Small talk.  Chit chat.  Nothing of substance, but pleasant and lighthearted.

Writing this post and thoughts of the 49 days perhaps prompted my subconscious to form this dream. Or perhaps not?

It slipped my mind

Christmas has been an oddly emotional and strange time for me since I was diagnosed. When I first found the lump in September 2009, the first thing which came to my mind was that I would not be alive to see the coming Christmas.  When Christmas 2009 came, not long after in weeks, but after a new lifetime of surgery, treatments, needles, appointments, a whole new vocabulary and learning to live with the cancer mindset, I was incredibly emotional.  I struggled to hold tears in check when carol singers were singing a version of Jingle Bells in Myanmar outside our gate.  I crumbled again last year, when the carollers came into our house and my composure was just to difficult to maintain.

So this year, I felt the first wobbles as we approached Christmas and I saw the carollers outside neighbouring gates.  However, I left Yangon on the 23 December for my Mrauk U adventure and immediately was caught up in the immediate, making plans and exploring.

I arrived in Mrauk U on Christmas Eve and spent the rest of the day exploring on foot and taking a ridiculous amount of photographs.  On Christmas Day I hired a bicyce and expored the nearly villages and temples, getting lost a number of times and having a wonderful time.  I seemed to provide a great source of entertainment, asking for directions and questions, stopping for a cold drink in a roadside stall and returning to my hotel dusty and hungry for Christmas Dinner.


On Boxing Day, I hired a pony and cart to explore the further away temples and minimise the getting lost portion of the activity.  Towards the end of the afternoon, after a day where I saw only three or four other temple tourists the whole day, I was exploring the atmospheric ruins of a temple complex when I remembered.  I suddenly remembered that I had been dreading the approaching Christmas and its memories of not surviving to see Christmas 2009.  I remembered that I had been extremely fragile the previous year.  But something had shifted in my mind which put cancer to the side more than I realised and it completely slipped my mind.

Cancer is still very much in the forefront of my mind, and I am sure it will continue to be.  However, the fact that this memory of being so emotional and connecting it so clearly with Christmas has faded so much shows me clearly that my mind is healing more than I had realised.  For once I am incredibly thankful that I forgot something!

Je ne regrette rien – reflections on mortality

A random click this weekend directed me towards this article about unfulfilled wishes of the dying.  It immediately sparked off a whole train of thought and reflection about regret.

Something I discovered early on about cancer is that it caused me to reflect on my mortality. Reflect being a euphemism for lying sleepless, with my mind racing into the most extreme scenarios. Being confronted head on with our mortality is really scary and the thoughts can be dark. That does not necessarily mean it is a bad thing though to reflect, and to be reminded of our transience.

I can clearly remember when I was first diagnosed, in that difficult space when you know you have cancer, but not any of the fine details. Before those critical pathology results such as the strain and aggressiveness of the cancer, the dimensions and characteristics of tumours, lymph node involvement, whether or not the cancer appears to have metastised…….. In other words, the vital clues about our stage and prognosis and what on earth the future might or might not hold.

I will never forget those thought paths. My mind would propel me into uncharted waters, places I realised that I had never ventured, and places that I had avoided visiting. I know I am not the only one who has spent time funeral planning in those early, frightening days.

When I read this article about regrets and unfulfilled wishes of the dying, it resonated with my own reflections when I was first diagnosed. I spent many night-time hour or so, unable to sleep, playing through the many possible different scenarios. I clearly remember talking with family at that time, alluding to the possibility of a stage 4 diagnosis. I remember trying to convey my belief that if my prognosis was indeed short, I wanted my loved ones to know that I had no regrets. This was understandably upsetting for family as they felt that it meant that I was “giving up” and would just sit back and let cancer take me away.

But that was not what I was trying to express. What I was trying to say was that, I truly and honestly say that I can look back over my past years with enormous gratitude for what the life I have lived. Don’t get me wrong, I have a HEAP of things on my wish list to do and see, in the decreasing amount of time available to us all, and as long as I am fit and able I intend to work my way through my wish list. But even if things changed tomorrow, and I had a recurrence, there is not really anything on that list that I would feel compelled to rush out and tick off.

I don’t intend for this to sound morbid, as it must have done to my family at diagnosis time. Not at all – it is a celebration and recognition that I have no significant regrets or unfulfilled wishes. And that’s not the same as having an empty set of plans and dreams.

It does not of course mean that I would not do or say some things differently if I had the chance again. Of course I have the benefit of maturity, experience, hindsight and a heck of a lot of learning the hard way to make me wise after the event. Facing my mortality, however, prompted and nudged me to share these thoughts with my nearest and dearest, so that they know that I can recognise that I have not always done what I would believe now would be best, and that I would trust that I would do things differently with the benefit of this experience. This has been very healing and brought resolution to matters which I probably would not otherwise have addressed. I have even found that incidents or actions which played large in my mind and conscience were not always as troubling to others as I believed they would be.

Reading the list of unfulfilled wishes has been another prompt, and a reminder to take opportunities when they appear – fulfilment, peace of mind and resolution are all the sweeter if we have longer to cherish them.