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Zen and the Art of Living & Dying by Seikan Cech

This is the extended transcript of Charlotte Young’s interview with Seikan Cech from the Melbourne Zen Hospice. The shortened version is in Barefoot Magazine’s Winter 2009 issue.

Please can you explain about your work and what it is that you do.

You mean with the Melbourne Zen Hospice (MZH)? Well, the organisation is in its infancy now, you might say like a baby or toddler. It may have been nice to stop everything else and just be able to devote myself full-time to raising MZH, but this hasn’t been possible. So currently I also work part-time as a therapist and group leader for the Gawler Foundation, which is mostly work with cancer patients and as such very important and rewarding. And I also do some work with, well, people at different crossroads or in situations that require change—drug dependence, chronic anxiety or depression, ways of coping with chronic pain. So I suppose I am involved in different things, but you could also say that it’s actually one thing. Presently I’m able to use about half of my time for MZH, and over the next few years, I look forward to being able to just do MZH work. It’s a gradual process of transition.

So what is it that MZH does?

Well, we’re an organisation working with people who are dying, and this also includes their carers and families. Perhaps more accurately, our approach is less about working with the dying and more about just being with them, which necessarily means also just being with ourselves. The realm of death and dying is often most appropriately one of being, rather than doing, but it’s easy to forget this because we’re so used to “fixing” things.

Being a very young organisation, at this stage we specialize in visiting patients at home or in hospitals. In other words, so far we offer outreach support only. Setting up a residential service, a physical hospice, is a medium-term vision for MZH, something that we hope to realize within the next two to three years, depending on how soon we can raise the money. For now, we see patients in their homes, in hospices, and hospitals around Melbourne. Our catchment presently includes the city and something like a 10km radius around it. There’s some flexibility there, but because we’re providing outreach, and having to do so on the smell of an oily rag, we do have to take into account travel costs and travel time. As much as we’d like to be able to reach out to the outer suburbs as well, at this stage it is not yet practicable. This is likely to change over time, as we keep growing and our volunteer network expands.

Basically my role within MZH has been as its first volunteer, and I’m still a volunteer, and I’m also the director, which brings additional responsibilities. My professional background and experience as a therapist and clinician has obviously been useful in many ways. Nevertheless, my main point of reference in my involvement with MZH is as a Zen monk, that is, the path of it and my commitment to that path. I don’t mean this in a religious way, because Zen is not necessarily a very religious pursuit, at least not in terms of what’s normally associated with religions. It’s really a practice of discovering the present, and of becoming more fully at one with it. As such, it’s a practice of not ‘knowing’. For example, there’s no motivation of converting people to some kind of new idea or belief. Just being in the present moment is fine. And with it, some of our experience of suffering, discontent, or restlessness becomes a little lighter. Certainly the role of a Zen monk is not other-worldly, but rather here and now.

MZH receives referrals from various sources—word of mouth, other palliative care services, more of which are now becoming aware of us. Referrals can also be made via our website, which happens from time to time. Basically we are open to receiving referrals from anyone and anywhere. Having said that, our purpose is of course to support people who’ve been diagnosed as nearing the end of their life, and so that’s obviously one of the main referral criteria. Also, we normally require that patients have adequate medical support, which will usually be through one of the medical palliative care services. We see our role as complementary palliative care providers, partly in the sense that we do not provide medical care, at least not at this stage. And we are very conscious of the duty of care aspect, so if someone basically doesn’t want to have anything to do with the medical system, which does happen very occasionally, then it makes it a little more difficult for us to negotiate the terms of our involvement—obviously we want patients to be safe and looked after in the best possible ways.

For the initial visit, depending on the circumstances, it may be just me visiting, or another volunteer may come along. At first it can be quite threatening, or challenging, for a family experiencing the dying process to just let a stranger come into their home. So the first visit is basically just to settle, and to clarify what the expectations of the patient and family might be, and also what we can offer. They might say, ’I’m interested in having reiki, and I understand that you’re offering that, and can I have that?’ But mostly people don’t really know, and don’t approach things that way. Dying is a new experience. There’s a lot of fear and apprehension around it, sometimes denial. The expectation is mostly on us to explain what it is that we do and what we can offer, which seems very reasonable. And so we do that, we say what we can and can’t do. For example, we are not able to provide primary care. Usually we suggest starting out with weekly appointments, and we let the patient and family know that we’re happy to just sit and talk, or do gentle massages, respite for the carer, or even do some shopping or cooking. We might also mention what we’re not able to do, say move house for them or remove toxic chemicals from their backyard, which obviously is to protect our volunteers and to clarify the nature of our service.

I think one of the main points about what we offer is that we don’t have an agenda. We’re not providing medical care. We have a lot of time so we don’t arrive rushing and time stressed. Sometimes these things don’t even need to be said; one can just kind of feel them. Our approach is caring and empathetic yet we’re not part of any family dynamics that might be there. With loved ones, there’s obviously grief, which can become quite complicated as a person is dying. It can be very comforting just to have an outsider who’s non-judgmental, compassionate and who’s just sitting there with very little expectation. And, over time, people start looking forward to it, funnily enough.

As the relationship is established and as the patient’s physical condition deteriorates and as carers become comfortable with us, there’s often a request for more frequent visits. So once a week may become twice a week, and then every other day, and in the last weeks it might even be daily. Usually we visit for an hour or two at a time and once there’s a sense of trust, the carers in particular are often very happy to just let us in, and they can go for a walk or whatever. It’s important for carers to take some regular time out, especially if the dying process is a protracted one.

Further information about the Melbourne Zen Hospice can be found at http://www.zenhospice.org.au/

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