Brushes with Mortality: 5 Lessons On Dealing with Hard Times

“When we come close to those things that break us down, we touch those things that also break us open. And in that breaking open, we uncover our true nature.” ~Wayne Muller

As someone with a serious chronic medical condition, I have danced with mortality. Many times. It wasn’t until our most recent pas de deux, however, that I truly understood just how much this dance could impact me.

Nowhere was this more apparent than in my work as a hospice volunteer.

The mission of the San Francisco-based Zen Hospice Project—a Buddhist-inspired organization where I have volunteered for five years—is to bring kindness and compassion to those facing loss and death.

I trained to be a volunteer out of a deep longing to explore and evolve my comfort level with my own illness and mortality, as well as the mortality of those close to me.

Zen Hospice Project trains volunteers to practice the Five Precepts Of Hospice Care developed by its founder.

They are:

  1. Bring your whole self to the bedside.
  2. Welcome everything; push away nothing.
  3. Find a place of rest in the middle of things.
  4. Cultivate the “don’t know mind.”
  5. Don’t wait.

While I have attempted to integrate these precepts at bedside (and in my life in general), I am also aware that I have remained somewhat disconnected from them.

For example, though I have always been able to easily listen with compassion as patients and family members voiced their feelings about dying; to hold a hand; provide a gentle foot massage; bring hot tea and fresh flowers; and sing to patients, I could not (or more aptly did not want to) fully feel the devastating grief that accompanies loss.

Until, that is, I returned to hospice work last year after undergoing emergency brain surgery.

Some background: As a child, I was diagnosed with a neurological condition called hydrocephalus that prevents the cerebrospinal fluid from circulating correctly in my brain. As such, a device called a shunt lives in my brain’s ventricles, keeping the fluid circulating properly.

I had my initial shunt inserted at twelve years old and have had my share of shunt revisions, the last occurring twenty years ago.

But on a clear, crisp day last April, I was starkly reminded of my medical issue when, with little warning, my shunt malfunctioned and I was rushed to the hospital in excruciating pain and told I would need immediate surgery to revise the apparatus.

Despite knowing that I always bounce back from surgeries, and despite my training and practice as an end-of-life volunteer, I felt little solace. The fact was I might not wake up. I did not want to die.

I did wake up and within three days, was back home recovering. My nurse practitioner commented that I was “the poster child for healing” because of my tenacity, positive attitude, and fit body (a stellar medical team and sheer luck no doubt also played a part).

When I returned to hospice work only a few months post-surgery, I noticed a subtle yet powerful internal energetic shift.

My 2.0 body and spirit felt much more integrated. Whatever disconnection I had previously felt bedside had dissolved and was replaced with an intimacy that can only develop out of shared experience.

It quickly became clear that my brush with mortality had unlocked the door to a richer, more meaningful and transparent connection with the precepts, the patients, and myself.

While I am still integrating all that has happened, I’ve come to understand the following about the five hospice precepts as they relate to me—and possibly, to others facing health or other challenges.

1. Bring your whole self to the bedside.

If patients share something that I have also been through, I now give myself permission to tell them a bit of my own health story—how it felt to be stuck in a bed, feeling like my body was failing me, existentially alone and angry. This almost always allows for a more intimate connection.

For so many years I felt ashamed of my condition. Would people unfairly judge me for having a brain-related condition? Would people think I am “less than”? I owe it to myself to show up more honestly. My condition is just a part of the fabric of who I am, all threads woven together.

Sometimes, revealing some of our own messiness, our own fallibility, can bring us much closer to others.

2. Welcome everything; push away nothing.

We can’t always choose our circumstances. Sometimes they choose us. My condition is chronic. While this can feel unfair and overwhelming at times, I have come to welcome everything and push away nothing that shows up in my life.

There are times when I drop to my knees, sobbing, terrified, and rageful at the possibility of more surgeries and their physical and emotional aftermath. I also accept that I am not always able to gracefully befriend the raw envy that I sometimes feel witnessing those with radiant health, especially when, from my perspective, some seem to so easily take it for granted.

Welcoming everything tenderizes me to my own and others’ suffering. And joy. I now see that by welcoming everything (or at least attempting to whenever I can), I am living life more wholeheartedly, even when the challenges feel daunting.

3. Find a place of rest in the middle of things.

Serving as a hospice volunteer I can offer warmth and compassion, but as much as I might want to, I cannot fix another’s circumstances.

My ability to serve at bedside and beyond depends upon holding that distinction. I know that no one can take away my own fears about having a life-threatening condition. But it sure helps to remind myself that I am not the only one who goes through life feeling fear and uncertainty.

4. Cultivate the “don’t know mind.”

While I used to crave answers to why things happen as they do, I am now cultivating a deeper sense of wonder, curiosity, and surrender to life’s mysteries. One can never truly know what’s going on inside another’s head, heart, and body, nor do any of us know exactly what our own future holds or when we will be saying our final goodbyes.

We can only stay present, respond to what arises in each moment, and act from the most genuine place.

5. Don’t wait.

If we are aware, pay attention, and do our best in this moment—fully, passionately, and courageously—that is what truly matters.

While at first I was angry and distraught that I had to dance with mortality yet again, the experience ended up being a great teacher and transformational gift. Yes, I’m still learning to dance, and perhaps I never will totally “get it right.”

Since my surgery I approach the Five Precepts of Hospice Care much more wholeheartedly. No longer are they simply intellectual guideposts but rather a dynamic life force within me.

It is possible for us all to make the choice, moment by moment, to be fully here and not move away from the difficult feelings.

And when we do want to escape the moment, we can sit down, close our eyes, ground our feet firmly on the floor, take slow, deep breaths, and when our body, mind, and soul feel calm and focused, softly whisper “yes!”

Photo by h.koppdelaney

About Rachel Katz

Rachel Katz is a spiritual director, volunteer end-of-life caregiver, singer, and proud mom to her beloved dog Charlie and hospice therapy cat Bodhi, her two greatest, most playful teachers. She also enjoys wandering the streets of San Francisco in search of urban adventures, great thrift finds, and anything shark related. Learn more about Rachel at

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  • Beautiful insightful piece of sharing…thank you so much for this. It is so difficult at times to see the blessings when we are in the middle of an event, particularly when that event entails disappointment or loss. Often it is only with the benifit of hindsight that we are able to realize the gifts that we have received by being broken open.

  • Carina

    I’m crying quietly at my desk as I read this. Thank you Miss Rachel for the eye and heart opening message~

  • Kaylin Lydia

    Love love love this post. It is so great to read this article. I have worked as a hospice social worker in New Jersey for a few years now and have always admired the Zen Hospice. Thank you for the service your provide – it is invaluable.

  • Thank you for sharing your story, and for being a volunteer angel, Rachel. Years ago, I volunteered for an AIDS organization whose sole purpose was to provide comfort to bedridden men and women bed in the final stages of the disease.

    While a wimp at many things, I somehow knew I had to bring it fully: mind, body, spirit, and guts. It was about the lovely souls about to leave this earth, ministering to their needs, and nothing else.

    It was one of the best experiences of my life.

  • Karen E.

    Thank you, Rachel, for this beautiful posting. I am inspired by this reminder about how our own experiences with suffering and vulnerability can be transformed into moments of grace. You are teaching us all to be more open-hearted, and to allow ourselves to truly see one another.

  • amazing perspectives. living with a chronic illness, in no way to the extent of your own, i can appreciate this message. And the work you do…the volunteering… thank you, what a gift.

  • Rachel

    Thank you so much Carina. I appreciate it!

  • Rachel

    Thank you for your kind words Stephen! I agree– it certainly can be so difficult at times to see the blessings when we are in the thick of things!

  • Rachel

    Thank you Katie! Believe me– I get so much more than I can possibly give companioning the dying. They are my greatest teachers…

  • rachel

    Thank you so much Karen. Your words mean so much to me.

  • rachel

    Linda, thank you so much. I can so relate to what you said. Being a hospice volunteer is truly on of the greatest and most powerful experiences of my life. So grateful to be able to do it.

  • Rachel

    Hi Kaylin. I am so thrilled to hear that you know about the Zen Hospice Project. It really is such an honor to be a part of it. Your work is amazing. Blessings to you…

  • Katie

    Rachel, this post could not have been more timely for me. As a fellow Bay Arean, I hope we cross paths some day…thank you so much.