In recent years controversies over the ethics of doctor-assisted death and suicide in the face of severe and painful illness have become prominent in the news. In the following article, former vipassana teacher Maria Monroe tells the story of a close friend with AIDS who chose his time to die. She explores varying Buddhist perspectives on the manner of his dying — in this essay, and in interviews with Chagdud Tulku Rinpoche, “A Tibetan Perspective” and George Bowman and Trudy Goodman, “A Zen Perspective.”
When Zen Master Fugai sensed that death was near, he had one of the monks dig a deep pit. Fugai then climbed into it, and standing there with immense dignity, directed the monk to cover him with earth.
Four years after he was diagnosed with AIDS, my dear friend Ric told me that he’d looked into ways to end his own life if, as the disease progressed, he wanted to take that option. I was accustomed to knowing he would die, but I didn’t want him to commit suicide. It rubbed against dharma teachings I’d taken very much to heart.
The dharma urges us to recognize the priceless opportunity for spiritual practice afforded by a human birth, and to take full advantage of this opportunity. The precepts, as the foundation of our practice, ask of us a commitment to honor all life and refrain from killing any being, including ourselves. From the point of view of Abhidhamma, taking life is seen as an unwholesome action arising out of the mental poison of aversion and resulting in karmic suffering for the one who kills. But I’d made a commitment to myself to offer Ric my unconditional support during his illness, so said nothing to indicate disapproval or to dissuade him from this possible choice.
My friendship with Ric began twenty-one years earlier when he arrived one day at the Burmese Vihara in Bodh Gaya, India, and joined me and the ten or twelve other Westerners taking teachings and vipassana meditation instructions from Munindra-ji. The more diligent among us, Joseph Goldstein, Larry, Angelo and others now forgotten, dressed in white with shaven heads, lived silently in the graceful rhythm of their practice, emerging from the solitude of sitting in their rooms to do walking meditation in the Vihara garden. I wasn’t ripe yet for disciplined practice and after two or three periods of sitting and walking each morning, I’d indulge my fascination with India by sitting in a tea shop with a glass of milk tea and a saucer of heavenly milk sweets, with a Hindi grammar or a dharma book, watching the ever colorful, ever changing flow of life around me.
Ric and I became instant friends and delighted in the discovery of the common and uncommon threads weaving through our lives: our common Mediterranean and Catholic heritage, the large cast of unforgettable priests and nuns that populated our school years, our travel adventures. Sweetest of all, we shared a longing to discover a truth that might fill the emptiness in our lives.
Ric spent many years in devoted and enthusiastic dharma practice, both in Asia and the United States. In Sri Lanka, he took temporary ordination as a Buddhist monk in the Theravada tradition. Our dharma circle expanded to include many practitioners who are now teachers and writers here in the West, among them Sharon Salzberg, Wes Nisker and Ram Dass. There was no rule of silence in those early retreats and Ric’s avid social nature thrived on the conversations that filled the monastery garden during breaks between sittings. Yet he also managed to spend time in an ashram where he could lock himself in a room and be undisturbed to carry on his practice. “I won’t have to see anyone,” he told me. “They’ll put my food on a shelf through a sliding door on the outside and I’ll open the sliding door on the inside to get it.” There was only one thing he craved in India, he said: “A jar of oregano.”
Returning from one of his trips to Asia, Ric was sitting in meditation on a mountain top in Crete one early morning and was suddenly filled with frustration at spending so much time sitting still with his eyes closed for a purpose that in that moment was forgotten and maddeningly elusive. He jumped up, snatched up his Buddha statue and hurled it down the mountain.
The flying Buddha is a compassionate and forgiving Buddha. I next saw Ric at the Insight Meditation Society in Barre, Massachusetts, where he joined me on staff as manager in the early days of the center. After serving on staff he trained and began his career as a therapist and I was told he was “an exceptional and excellent one.” Ric abandoned formal meditation practice, feeling confident and most comfortable with the teacher within. Yet he valued his years of dharma practice and shortly before his death told a close friend, “My lifelong interest in dharma has really paid off. I’ve watched so many people die without the dharma and it’s a very different thing. For me, it has been an incredible spiritual journey. Never doubt your own interest and dedication to the dharma we have practiced all these years.”
Ric’s letter telling me of his diagnosis came when I’d been struggling for years with a relapse of a chronic illness I’d brought home from India. With grueling physical and mental symptoms and no diagnosis, I felt I was walking hand-in-hand with death too. To my contracted and often depressed mind, Ric’s news wasn’t shattering. My whole world was dark and more darkness wasn’t remarkable. Ric was in good health then, and carried on with his life as usual, working as a therapist with gay men and a men’s AIDS group. Each time someone he knew died of AIDS he entered their name on a list in his computer. He stopped, he told me, when the count reached eighty. “I couldn’t take it anymore,” he said.
Eight months before he died, I went for what was to be my last visit with Ric, our first in six years and our first since his diagnosis. From the first moment at the airport I saw the fullness of spirit within his wasting body.
“I feel so grateful for my life,” he told me. “It’s been a blessed, blessed life. I feel I should be on my knees every moment thanking God for the gift of my life.”
“Buddhism answers my questions,” he told me, “but in my heart I feel closer to Jesus. There’s no contradiction for me anymore. I love talking to God. He holds me, comforts me. I’m not afraid to die.”
We had lighthearted talks with lots of laughter. We gossiped. His sister had sent a box of homemade Italian sweets that Ric had no appetite for, so I finished them off by myself. “It’s great having you as a guest, Maria. You get it when I need to take a nap,” Ric would tell me. Finally diagnosed with Chronic Fatigue Syndrome, I not only got it, I needed a nap too.
He burst into tears as he told me of the death of his closest friend and former lover from AIDS. “It makes me furious that they did a brain biopsy on him. They were looking for why he was confused, why he was losing his balance. Idiots! Don’t they know it’s the virus?” After the biopsy, his friend was never himself, never knew Ric again. “The Buddha sure got the First Noble Truth right,” we mused sadly, walking down the street with our arms around each other’s waists.
I’d brought Ric a Pierrot doll I’d made for him. “Oh, this is wonderful,” he said. “Do you think I could make a doll?” Over the days of our visit, he lost himself in the creation of a turquoise satin, long-eared rabbit with bloomers. Ric continued making dolls long after I was gone. “Though I miss my teacher,” he wrote.
Ric was my teacher, too, my death and dying teacher. I was inspired every day by his openness about AIDS and dying, his frankness, his clarity. He told me he was stockpiling the drugs he would use if he decided to take his life. Though he wasn’t sure he’d make that choice, it was comforting, he said, knowing that choosing the time to die was an option.
And in fact, soon after I left, Ric wrote saying the quality of his life was deteriorating by the day. Would I pray with him for a speedy end to his life? I couldn’t and told him so. I could pray for his well-being, that he be free from suffering. But no, I found I couldn’t pray that he would die. He laughed when I told him this and said it was okay, I didn’t have to.
When I got the call telling me he’d died, I asked if he’d ended his own life. Yes, he had, and as the story of Ric’s last days and hours and moments were filled in, to my surprise I felt my heart filling up with gladness, and shockingly, envy. The story of his death was one of mastery of the moment and as I listened a part of me was saying, “He’s gone off on his next great adventure without me.”
But I became suspicious of my unexpected comfort with his manner of dying and questioned Lama Inge, a Western teacher authorized by Chagdud Rinpoche. “Karmically,” she told me, “suicide is a seriously negative act and a habit of killing is formed in the mind. Certain actions need be done only once to form a habit, a propensity.” Why had I asked? Could anyone tell me truly that Ric had blown it? How could they know? For the first time I felt a profound discomfort with a dogmatism in Buddhism frighteningly reminiscent of the oppressive Catholic dogmatism of my youth. I truly cherish the dharma, its teachers, Lama Inge. What she told me was consistent with the traditional Buddhist view on taking life, but my heart was in revolt. Ric, a hungry ghost? Ric in the hell realms? Ric reborn a serial killer, or an animal, perhaps? I struggled to navigate my way through the quicksand of the unknowable.
I remembered that in the Channovadasutta of the Pali Canon the Buddha had exonerated the suicide of one of his monks, Channa, who was grievously ill and in great, increasing pain. Channa cut his windpipe, then immediately fell into the fear of dying, hastily applied insight, and mastering the samkara, attained arhatship and final nibanna. Sariputta, a fellow monk, asked the Buddha for wisdom on the matter. And the Buddha answered, “Sariputta, I do not say he was to be blamed. But whoever, Sariputta, lays down this body and grasps after another body, of him I say he is to be blamed. The monk Channa did not do this, the monk Channa took a knife to himself without incurring blame…”
I talked to Sharon Salzberg and Joseph Goldstein about Ric’s death; they had known him since our early days in India. They were in a retreat with a Tibetan lama when notified of Ric’s death, and they went to the lama to ask for his prayers for Ric and to discuss with him the manner of Ric’s dying. The lama’s response to the ethical dilemma was, “As a Buddhist, how can I say that a person should take their own life? On the other hand, how can I say a person should go on suffering so deeply?” Sharon told me, “U Pandita, my Burmese teacher, teaches the traditional view that taking one’s life can only be unwholesome, an action based on aversion disguised as compassion. The more you advance in practice, the more you see the reason for the traditional teaching. But friends’ descriptions of Ric’s death have made me confront my judging mind. Contemplating the possibility of AIDS-related dementia makes me realize the complexity of the issue.” Joseph added, “The interesting ethical dilemma arises if the mind is deteriorating. Is it better to die while the mind is still clear? None of us knows.”
Everyone I spoke with thought we needed a different name for what Ric had done; “suicide” didn’t fit. A friend of Ric’s, who is only eleven said, “Ric didn’t commit suicide because suicide is angry and is done to hurt people. When I heard Ric died, I thought he died of AIDS, and when I heard a few days later how he died, it didn’t change anything. He still died of AIDS. If he didn’t have AIDS, he wouldn’t have died.”
I called the friends who were with Ric when he was dying so I could get as close as I could to his death. They shared their impressions: He remained strong and energetic for years after his diagnosis, then began to lose weight and started getting weaker. He began to lose his sense of taste. At first food tasted metallic to him and that drove him crazy. He wept when he talked about how he could no longer enjoy food. He would yearn for a flavor and when he’d put the muffin, the banana, the tea in his mouth, it would “explode like poison.” He got down to just three things he could eat: melon, pomegranate and pasta.
Ric had diarrhea for months and was anxious about going out, never knowing when he’d have an attack. He messed himself once when he was out alone. He was finally wearing diapers. And he was so cold, always chilled to the bone. He longed to escape the cold weather and planned trips to Greece, Hawaii and Mexico. When the friend he planned to go to Mexico with wasn’t able to go, Ric set off alone. At an airport in Texas he got on a return flight home; he was too weak to go on. This devastated him. He wanted so much to feel warm and to make these last journeys.
He lost more and more control over his life. He couldn’t travel, he’d stopped making dolls. All he did finally was lie in bed and watch TV, waiting for friends to come visit him. Finally he wanted someone with him twenty-four hours a day. He gave keys to his friends, but would get angry when someone walked in. He needed someone to take care of him, but it eroded his privacy and independence.
He was afraid of losing his mind, of losing the consciousness of who he was. And it happened in his last days and weeks. He’d call friends in the middle of the night, terrified, leaving desperate messages on answering machines: “I don’t know who I am. I don’t know where I am.” As soon as they’d get the message someone would go over. “The angels are coming to get me,” he’d say. He needed to be reassured over and over again about who he was, who his friends were, and eventually his mind would clear again.
He was taking countless pills and there was constant medical intervention. He’d gotten his first opportunistic disease, pneumocystic pneumonia, and was on antibiotics that would dehydrate him. At the clinic they’d check him for dehydration by drawing blood out of an artery, not a vein. It was painful, and Ric had very low tolerance for pain. He was hydrated intravenously a couple of times, and he had a couple of blood transfusions. He finally felt he’d had it with medical support and stopped taking any medicines or going to the clinic. His life became more and more intolerable. He’d wake up in the middle of the night and would scream out his rage. He’d pace through his living room screaming at God, at life, at AIDS.
Throughout the weeks and months of this intense suffering, he never completely lost the observing mind. If he did for a time, he’d regain it later. He’d be angry and complaining on the one hand and on the other he’d see that this was all just part of the passage. He’d even see the joke in it. Once he said, “I used to pray to God to curb my strong sexuality. Boy! He sure found a way.” Sometimes he’d apologize for his behavior and sometimes he’d rant that it was “your stuff.” He asked his friends not to take his rantings personally. “I need the space to be crazy because this process is crazymaking.”
Finally one day Ric asked for the doctor who would help him die. His decision to end his life in three days brought a transformation. The rage, the frustration, the nastiness were gone. His decision and the ability to act on it allowed him to be back in charge, to reclaim his dignity. He’d faced his demons and done battle; he was spared nothing. He’d now come to the end of it. He was clear. He was ready.
Ric had sent some of his friends out for flowers. “Cost is no object,” he said. “Fill the room with flowers.” His words were recorded by his friends hours before he died:
“Today is the last day of my life. I never thought I’d be saying that because people don’t know when the last day of their life is. So I’m feeling very grateful for yet another gift I can be appreciative of, that God has allowed me, very graciously, to take his role over for a few minutes here. Yet I’m not taking over anything. He’s just sending me the means to get home to him. He might have wanted to wait a little longer to take me but I wasn’t willing to suffer like that. I know he loves me. He didn’t want me to suffer so he sent me a friend who could help me out. I’ve totally enjoyed being on the planet. The flowers in here are magnificent. Everywhere I look there are colors, flowers.
“I don’t feel anxious. I feel ready to meet my maker, and very, very curious. I need right now to be loved and respected and let go. Some friends have said, ‘I love you and want you to go naturally.’ It makes me very angry that they’re imposing their belief systems on me. Don’t imply that I’m doing something that’s morally wrong. To me what I’m doing is totally natural.”
Ric had asked five friends to be with him and help him die. Said one friend: “Two of us went to the pharmacy to fill the prescription for the drugs that would be used. He wasn’t using what he’d been stockpiling. Ric orchestrated a powerful rite of passage. He selected the music he wanted to listen to and chose Fauré’s ‘Requiem.’ The final drug was to be mixed into yogurt. He looked at us like a little boy and said, ‘Would you mind doing it?’ I was so nervous. My heart was pounding. But something happened; I found myself in an altered state of consciousness. All of a sudden I was a priestess in a temple preparing a sacrament, and when I walked upstairs and handed it to him, it was an offering. He took it like a sacrament.”
All the fighting and being nasty and controlling, all the dukkha, had been part of the journey. Some of his friends had expected this process to be more “spiritual.” And maybe Ric himself had expected that. “But,” said one friend, “this was a spiritual journey, all of it. This is what a spiritual journey looks like. It looks like a human journey. It was a very human death.”
I’m not a writer and often regretted that I’d taken on the telling of Ric’s story, of my story. But I’ve come to the end of the writing and feel more alive for the inquiry. I no longer feel the conflict, am comfortable in the embrace of the unknowable. Ric alone lived all the moments of his sincere and generous life, and alone arrived at its exquisite ending. I don’t have the answers and I’m glad I don’t. If I knew, that knowing would be a dead place in the living tissue of my being. Instead I celebrate the mystery.
“Interview with Chagdud Tulku Rinpoche, A Tibetan Perspective”
“Interview with George Bowman and Trudy Goodman, A Zen Perspective.”