Questions and Answers

Dear ones,

Many of you are asking wonderful, insightful questions by email and in person. Boswell has been answering your questions individually, and thought it would be helpful to everyone to post those answers here. Leave more questions in the comments or send them via Boswell-mail: rebecca-dot-lafond-at-gmail.com.

How is Mimi doing?
Mimi's health is pretty much the same since the last post three days ago. Her status probably won't change suddenly, it'll be more of a gradual decline - more on that below. If any sudden changes occur, they'll be posted asap here. This blog server seems to take several hours to send out updates by email, so you might want to check the blog link regularly. You will hopefully see at least a brief update every three or four days. Always, always feel free to email Boswell at any time. You may not receive a long reply, but the more detailed your question is, the more likely you'll get a detailed answer. If you don't hear back within a day, it's totally ok to send another message. Your caring and concern are appreciated!

What spiritual practice is Mimi relying on?
Right now Mimi is especially drawn to Avalokiteshvara and Vajrayogini. Tech-savvy friends have created recorded loops of mantra recitations (OM MANI PÄME HUM and the three-OM mantra) to be played when Mimi's physical and mental activity decline further. From Boswell's perspective, Mimi also seems to be relying on the minds of patient acceptance and cherishing others that she has developed over her years of Buddhist practice and her cancer journey. You can read all about her experience with this on other blog posts. As mentioned in the post prior to this one, Offering to the Spiritual Guide was a particularly energizing practice for Mimi at the beginning of this week. Perhaps another puja will happen here again on August 10th.

Can I come visit Mimi?
Of course! As reported in the last blog post, Mimi's energy is up and down. A few times over the last couple of weeks a visit has had to be rescheduled because she was too worn out to receive visitors. But even though they might not have a chance to see Mimi, visitors are nonetheless most welcome! (The best way to set that up is to send an email to rebecca.lafond@gmail.com.) Kind local friends have been stopping by to help with chores and provide respite care so that Richard can have breaks. Family members are here from out of town this weekend and next week to visit and help. Even if you're not able to be here in person, there is nonetheless a very important way for you to help! Here's what Mimi asked for in a group email she sent a few weeks ago after receiving her prognosis: "Please pray that I continue to have a peaceful mind throughout this dying process, deeply connected to Geshe-la at my heart."

What is Mimi's prognosis?
In the same email quoted above, Mimi says, "Apparently I've come to the last lap of this current 'race' (but not at all at a fast pace for me)." One could read that last part in parentheses in a couple of different ways. It's true that Mimi is spending quite a bit of time in physical inactivity as the cancer and side effects of medications drain her energy, and when she does get up she definitely doesn't move very fast. But she also doesn't seem to be heading very quickly toward the deadline (pardon the gallows humor) she received from her doctor. Five-and-a-half years ago, Mimi was first diagnosed with and treated for leptomeningeal disease, or cancer of the brain lining, which is commonly considered to be a marker of end stage cancer. Mimi's doctors have been astounded by the amazing good health she's experienced over the last 5+ years. (In fact, they call her a medical miracle, to which Mimi's response in a 2013 blog post is, "That probably isn't technically correct: I don't think I've ever heard any Buddhist use the word 'miracle,' but maybe I can get away with 'miraculous' as in extraordinary, as in emanated by the Buddhas.") It seems that her latest prognosis is not at all a departure from the miraculous story of Mimi's cancer adventure. Today is close to the approximate day Mimi was given for when she could expect her life to end, and she's still full of vitality and love! Ordinary prognoses don't appear to apply here - prayers and Mimi's mind of faith have truly worked to sustain her.

What happens next?
As mentioned above, Mimi's health will probably continue on the gradual (very gradual) decline it's been on over the last few weeks. Now that pain and other physical symptoms are under control, there probably won't be any further medical emergencies to contend with. If symptom control becomes an issue, there's a very responsive hospice team only a phone call away, and the hospice nurse provided an arsenal of medications to help with common end-of-life symptoms. The hospice social worker provided a booklet called Gone from My Sight: the Dying Experience, written by award-winning hospice nurse Barbara Karnes. The booklet describes the physical changes that can be expected during the dying process. If you're interested, the booklet can be downloaded in Kindle or purchased on Amazon, and you can also find helpful information at Barbara Karnes' website. Boswell has also been reading a book called Final Journeys by long-time hospice nurse Maggie Callanan, which uses real-life (real-death?) examples of hospice patients to highlight important end-of-life considerations and issues. This book is also available on Kindle/Amazon, or you can link to it here.


Hope this is helpful and that you enjoy this quote from a humorous post by Mimi from a few years ago: "It's kinda fun, and interesting, to write about yourself in the 3rd person. I've never thought of this before in terms of writing, but it seems useful as another way of looking at the emptiness of our self. We commonly, instinctively, think of ourself in the 1st person, as me or I. So what happens when we put ourself into a character of she or he? It's a bit like becoming That Mountain, looking back at This Mountain. You see yourself from the outside, as others might view you, but of course everyone's view is different."

To Contentment and Beyond

Hello Friends of Mimi,

Boswell here.  All of your love and wishes are coming through and are deeply appreciated.  Mimi is still looking over her email occasionally so she has seen your kind messages.  In Mimi's own words from a post last April: "I deeply appreciate your prayers for me. You can see that they work. Makes it so easy to have faith."  As always, please feel free to add a comment to this blog post, send a reply message to Mimi, or email me at rebecca-dot-lafond-at-gmail.com.

Just wanted to give you an update on Mimi's current state of health.  As a background, here's a wrap-up of the last 7 years of Mimi's cancer adventure in one sentence: she was diagnosed with ovarian cancer and underwent treatment; has had chemo on and off to address recurring abdominal tumors; had a metastasis to the brain a few years ago and was treated with surgery, radiation and chemo; and was most recently advised by her doctor that curative care is no longer an option.  And so she is now on hospice and preparing for a peaceful death.  The tumors in Mimi's abdomen are growing noticeably, and a recent brain scan indicates that she has cancerous lesions on the meninges of the brain, also known as leptomeningeal carcinomatosis, carcinomatous meningitis, and a host of other long-syllabled medical terms.  The brain cancer causes inflammation, so Mimi is once again taking a steroid called dexamethasone to keep the swelling down.  She's written about taking this medication in previous blog posts - it's the one that makes her really talkative, energetic and HUNGRY!  We can maybe consider these side effects to be a blessing as she has been receiving many visitors from near and far, and she has sufficient energy to engage in conversation.  She's also eating really well which is helping her to keep up her strength.  Many friends are bringing food to share during their visits - in fact, we're expecting Sally with dinner any minute now.  It's a gift for Mimi (and for us all) for her to be able to share these moments with friends and family.  The last few days have brought a poetry reading (Lynn Ann), an industrious cleaning of the master bedroom (Linda L), a tidying up of the garden (Linda S), and many kind and friendly ears to listen to Mimi's thoughts about the end of her life (Heather, Brian, Laurie, Eve, Kit, Noreen).  As the weekend approaches, her social calendar continues to be full and family arrives on Monday morning.

Anyway, to continue the "state of the union" regarding Mimi's current health situation, she's on a transdermal patch to control pain, two medications for nausea, and a variety of other meds to deal with the side effects of the main medications.  As we all know from our interactions with Mimi, she's an amazing example of practicing contentment in the face of adversity.  In a post from January of this year she wrote, "Thankfully I know my body is *not* "me," so I am still happy … and hope you are too."  It's an inspiration to witness how her positive habits of mind continue to sustain her happiness, even as she encounters these challenges.  May we all have such courage and strength!

The brain cancer, the many years of chemotherapy drugs, and the current medications are causing unavoidable cognitive decline.  About this phenomenon, she said in a post from June 2015 that, "my mind is good, my brain not so much."  She seems to lose a little bit of energy each day and yet she's a gracious hostess, always looking after the comfort of her guests.  I'll end this post with her expression of gratitude from a couple of years ago:
"Thank you, Buddha.
Thank you, Sangha.
Thank you to everyone who's been making prayers and offering good thoughts."

Drafting My Obituary

We know we're going to die but believe it will be in the distant future. In truth, it may happen much sooner. It may seem harsh to bring up that reality - I'm not trying to ruin your day - but it's one of the main way Buddhists make their lives meaningful right now, and overcome our procrastination, waiting for retirement to do the things that are important to us. In meditation, after repeatedly considering "I may die today," we focus on the feeling that arises. As with all our Lamrim (Stages of the Path to Enlightenment) meditations, we carry our sitting meditation into our daily life.

Some of you have heard me suggest one meditation-break activity for this meditation is to write a will and an advance directive. It's a kindness for those you leave behind, whether you have a lot of resources or not. You can spell out all your wishes about what kind of medical care you want or don't want when you're "actively dying," as well as what you want done with your body after you're done with it. More importantly, that activity shows you have more than an intellectual understanding that something could kill you today, even if you're young and healthy. Think of a car accident or a natural disaster, for example.

I wasn't going to have an obituary, but now I'm thinking that composing one would be another meditation-break practice, whether it's published or not. I often read the obituaries in our local paper, particularly for younger people, as another way of remembering death. Writing my own forces me to think about what I've done with my life.

I don't want the usual format. You know the one I mean. For fun, I made it into a kind of MadLibs (MadObits?):

_________ [full name of person] who was born in _____ [4-digit number] was _________ [3 superlative adjectives]. She attended _________ [President's name, of any country] High School, then _________ [name of state, in any country] University. _________ [first name of person from line 1] went on to become a _________ [adverb] _________ [job] and raised _________ [number] of kids, some of whom were named _________ [noun] and _________ [noun]. She was _________ [past-tense verb] by all who crossed her path, unless she was in a _________ [adjective] mood.
In lieu of flowers, buy yourself something _________ [adjective].

I do want people to hear how much Kadampa Buddhist teachings and meditations helped me in my adventures with cancer. I'd like to add the URL for our local Temple.

R and I recently saw a exhibit called "Terminal" where some of the photos of dying or deceased people were washed out or blurry. I wasn't planning to have a photo with my obit, but I would consider having one like that, or a blurry  black and white drawing of me.
I'm also tempted to say I'm "survived by friends and family ... and you."

Quizzes, Tests and the Final Exam

Some students are hesitant to join FP when they hear that there's a test. We used to lose a student or two right before the test, although of course you don't even have to pass.

But we get tested all the time ...

We get regular Dharma quizzes, for example, from the people who bother us at work, and we get pop quizzes when something goes wrong that we weren't expecting. How'd you do? Peaceful mind?

Whenever I get cut off on the highway, I practice immediately going for refuge, because a few inches the other way and it could have been the end of me. I want the Three Jewels to be at the front of  my mind, always, but especially then.

When I'm focusing on the advantages of cherishing others, I try to give myself repeated quizzes, asking myself throughout the day, "Who were you thinking about?" Sad to say, it's usually me.

Of course, the final exam is death.