Thanatopia: Daily Meditations For Conscious Aging & A Good Death will alter the reader’s perspectives on aging and death, by promoting healthy and conscious conversations around these sensitive topics. Bringing death out of the shadows and making it part of our daily contemplations reduces suffering and leads to a more mindful approach to our inevitable demise. As a daily meditation guide, Thanatopia offers the quotable wisdom of many diverse minds coupled with relevant, thoughtful reflections by a physician who has spent many years examining these issues. A final section of each day is devoted to simple, accessible practices the reader can employ as they learn how to face aging and dying with courage and grace.

Eight Sample Days 

January 1

I’m not afraid of dying, just of living too long. Anonymous

A gentle, quick death at a ripe old age­­ – with most faculties still intact and the zest for life still vibrant – might seem the most desirable way to die. Yet this is not the reality many experience as they enter the final frontier. For a majority of people, it is the illness and suffering preceding death that generates the most concern. Fear raises its ugly head as we find ourselves losing mental and bodily functions, missing contact with family and friends, and lacking the confidence that we are “good enough” to traverse the challenging territory of life’s ending with courage and grace. But these kinds of unpleasant and irritating moments have always been part of the fabric of everyday life, as are some body discomforts, especially as we age. We must somehow make peace with them. So, rather than pushing them away, we can adjust and adapt. We can gradually get unstuck from our notions of how life is supposed to be. Such liberation is possible with the small stuff as well as the larger challenges. If we can open our hearts and trust that whatever is unfolding is okay, that we can indeed handle whatever comes, then the notion that we will live “too long” evaporates like dew in the morning sun.

I practice embracing each moment, even the difficult ones, as preparation for the more challenging times ahead that we all must face.

January 2

That which is subject to old age, sickness and death shall experience old age sickness and death. Buddha (Siddhartha Gautama)

I often live my daily life as if I have all the time in the world—to express my love, to accomplish what I hold most dear, to wake up and truly live a life congruent with my highest values. Somehow, a part of me believes I will be an exception to the travails of aging and dying. It seems easier to remain asleep than to examine what my mortality really means in terms of the choices I make each day. But if there is nowhere to run or hide, is it possible to contemplate dis-ease, aging and death without being morbid or depressed? By shining the light of awareness on these inevitabilities, we can illuminate a path to truly living our best life now. It is certainly easier to hold this enlightened perspective when things are going well. Much more challenging when the pain and discomfort and fears are all in our face! Yet accepting those very difficult moments allows us to rest in the reality that all around us, life grows, blossoms, then withers and dies. We are comforted knowing we are part of that great circle. We can see our place in the flow of existence.

I can hold the intention to meet my experiences of old age, sickness and death with awareness.

January 5

Grief is universal. At the same time it is extremely personal. Heal in your own way. Earl A. Grollman

Being with someone who is grieving can be extremely challenging. As we gradually learn to meet our own pain without aversion, it allows us to be present with another’s distress. There is a continuum of caring, from pity and sympathy to empathy and compassion. With pity and sympathy, we are still wrapped up in our emotions, and we try to make others feel better, or fill them with stories to please or distract them, rather than allowing the full expression of their emotions. The feeling of empathy involves the capacity to empty the mind and just be present with our whole being for someone else’s needs. Giving advice, consoling, educating, interrogating, making judgments or comparisons, or explaining our own version of what occurred, are all barriers to empathy. We instinctively want to remove their suffering by offering them some assistance. But if we are simply open to sharing their pain, compassion arises naturally. We might ask the grieving person what they need in this moment, and give them what they want if we can. Grief has its own rhythms for each person. Just being present is often enough. By focusing on attentive listening and demonstrative caring, we nurture rather than attempt to “fix” anything.

Being fully present to the sorrows another human being is experiencing enriches me.

January 6

Maybe the only enemy is that we don’t like the way reality is now and therefore wish it would go away fast. But what we find as practitioners is that nothing ever goes away until it has taught us what we need to know. Pema Chödrön

On some fundamental level, life is about learning lessons, even when we may think some of them are stupid or irrelevant. A lesson is repeated until learned, despite all our attempts to resist it. So what is there to possibly master from the limitations of aging, the suffering of disease and the pangs of dying? Why not just medicate these away to the extent possible and focus on experiencing what few pleasures remain to us? We can learn to be gentle with ourselves for expressing whatever is happening during a hard time. We don’t need to live up to some destructive standard of perfection that precludes completely falling apart. Most of us have spent our lives complying with family, social and cultural expectations—sometimes to our personal detriment. Isn’t it time to remove the masks hiding how we really feel? To grow old and die the way we would like? Perhaps a major lesson of aging is learning how to speak our truth firmly, yet kindly, especially to those who would have their own way with us, even till our last breath. 

I am an eager student of whatever lesson life seems intent on teaching me at the moment.

January 8

As children we welcomed the aging process excitedly, wondering when we would grow and what we would look like. We quickly lose this wonder as we become seduced by an anti-aging culture into disavowing, denying and resisting aging. We’re pressured to see aging as a villain to be stopped, to be restrained. Kayríe Carpenter

The notion that growing old might offer its own gifts runs counter to a culture obsessed with remaining young. Seventy is the new fifty! The fountain of youth beckons with Botox, Viagra, robotic hair transplants, rejuvenating supplements and facial creams, and soon come grow your own organ replacements! Whatever it takes to keep the forces of aging at bay, sign us up! But the sand in the hourglass continues to run out, and with it the realization that the journey to healthy, wealthy and wise is not paved with an inexhaustible fount of time and energy. For me, aging has often been a journey from grief to relief and back again, falling apart and coming together, over and over. The initial inklings that aging is now literally in my face marvelously focuses my attention on what I have always wanted to experience. It has provided the spaciousness for afternoon naps or lovemaking, for devoting relaxed time to exploring some compelling interest, and incessantly invites me to clarify my deepest unfulfilled desires. 

As the years accumulate, I can maintain my sense of wonder and curiosity about the whole process of aging. 

January 9 

How we squander our hours of pain. How we gaze beyond them into the bitter duration to see if they have an end. Though they are really seasons of us, our winter-enduring foliage, ponds, meadows, our inborn landscape, where birds and reed-dwelling creatures are at home. Rainer Maria Rilke

It is a natural human impulse to want to avoid suffering and experience happiness. The devil is in the details of how we go about it. Denial, suppression, repression, or escape via one’s favorite addiction, are unhealthy mechanisms to reduce pain or grief. When we are willing to create spaciousness around the seasons of our pain, knowing that this too shall pass, we stand on firmer ground in our attempts to find equanimity. Even though the physical discomfort of an illness may not go away completely, or the emotional torrents of grief threaten to drown us, we can still soften the rough edges of our hurt. We can forge a more stable, harmonious journey, by resisting both clinging to the shore of pleasure, or avoiding that of pain. There is room for the whole landscape. An unshakable balance of mind develops, rooted in the insight that pain is inevitable, but suffering is optional. It arises only when we resist what is. Feeling our grief, releasing it through tears or trembling conversations of the heart, leads to not just enduring our pain, but growing through it. 

Pain can be the key that unlocks the door to a greater depth of understanding. 

January 17

An interesting way to practice dying is by opening to illness. Each time you get a cold or the flu use it as an opportunity to soften around the unpleasant and investigate how resistance turns pain into suffering, the unpleasant into the unbearable. Watch the shadows gather in the aching body. Stephen Levine

There is a commonly used Italian expression, “meno male,” that roughly translates as “less bad.” Meno male, you broke only one leg instead of two! Meno male, you just have a cold instead of pneumonia! It is a subtle form of expressing gratitude. Being ill is a wonderful opportunity to observe that death lurks just around the corner. We feel so fragile, so vulnerable, so afraid of suffering. While sick with the flu, I find myself reflecting on how it might be to battle the illness if I were a refugee, in danger, without adequate food, medicine or shelter. Finding a scrap of gratitude in the midst of such aches helps me soften the unpleasant. Opening to whatever sensation is present, even for just a few moments, allows our suffering to diminish. We can find rest and comfort right now, without waiting for the light at the end of the tunnel to appear. And just as with meditation, our breath can guide us, remind us, that this moment, with all its discomfort, is ours to live with awareness and gratitude.

With practice, I can rest in gratitude, even in the most painful moments of aging and sickness. 

January 18

To live in this world, you must be able to do three things: to love what is mortal; to hold it against your bones knowing your own life depends on it; and, when the time comes to let it go, to let it go. Mary Oliver

Giving permission to someone we love to die requires enormous awareness. To actually say the words, “it’s okay, just let go,” requires that we also do the same, and participate with the dying person in their final act of surrender. It is simply amazing how tenaciously we cling to what we beg to be released from. Perhaps a peaceful death is not marked by the amount of struggle brought to it, but by the capacity for surrender, trusting the inner wisdom that it is the moment to fully let go. To let go is not the same as giving up, but rather a deeper form of acceptance. Surrender is full attention with appreciation, non-judgment and opening to what is right in front of us. No need to be anywhere but here and now. To let it go really means to just let it be—the thoughts, the emotions, even the pain. We don’t have to do anything. Everything comes and goes by itself. Just let it be with a sense of spaciousness and expansiveness.

All the little moments of surrender in my life can support me when my death comes.