Contemplative Caregivers and the Four Noble Truths
A Talk by Trudi Jinpu Hirsch-Abramson

Buddhism began with the Buddha’s enlightenment and realization that each one of us is already “perfect and complete lacking nothing.” At the same time he understood that this could not be taught, and that each of us must realize this truth for her/himself.

The story of Buddhism begins with the famous journey Shakyamuni (Gautama) took as he left his Kingdom, where he had been comfortable and completely protected from the world and its problems. He journeyed outside the gate into the everyday world of sickness, old age and death. This “face-to-face” teaching of the reality of suffering transformed him. He searched for the meaning of life and eventually, after many years of sitting, struggling, and despairing, realized the fundamental truths about life and death. Part of his teachings came to be known as the “Four Noble Truths.” These truths point to the reality that we’re already sitting in the perfection of who we already are…we just, as yet, don’t realize it.

In the hospital, CPE (clinical pastoral education) students and the Buddhist Foundation students come face-to-face with patient after patient. “Life is suffering” (the first Noble Truth) will no longer be a simple idea that students contemplate and meditate on…but the actual day-to-day reality of their lives.

There is a cause of suffering (the second Noble Truth), which will take on a new meaning as the student explores, along with the patient, the spiritual pain built around the desire to keep things the way they are/were, or the way we would like them to be. We learn to reflect on our need to hold onto life and to push away death. “The cessation of suffering” (the third Noble Truth) will be sought for with fervor and urgency as the student becomes inwardly motivated to explore who she/he is and the meaning of life and death for themselves and for their patients.

Looking at mortality has always been an essential part of Buddhist practice. We sit for hours, years, lifetimes, looking at the nature of death. Our struggle for clarity and enlightenment form our authentic “Way/Path” (the forth Noble Truth). Students of Chaplaincy and caregivers of the Foundation program have the opportunity to engage their practice…to test it in the fires of life.

Buddhism abides in impermanence and points to the interconnectedness of all things. These teachings and practice guide us toward being awake and aware in every moment. Each moment ultimately contains and is the whole. One makes vows to not only practice striving to become a Bodhisattva, but to actually realize oneself as a Bodhisattva. Contemplative Care giving practitioners actually learn to live their lives filled with loving compassion for all suffering beings…without exception.

Buddhist teachings state that there is no separation between oneself and others and at the same time understanding that “I am not you and you are not me”. By participating in an intimate relationship with one’s patients, we learn to break down the ideas we carry around “self and other”. We bear witness again and again to the miracle of life and death. We stand with, and in, our patients’ suffering. With each death we let go of some of our own attachments, and with each birth we experience the possibility of reawakening to the present…to our lives incarnate. We have been granted the miracle of aliveness…we experience humility and gratitude. Our patients become our teachers and touch our hearts and minds directly. We hear their cry…which is none other than our own!

We begin to understand Sangha/community. At first the community includes just us and our struggles. Soon it embraces our peers, patients, staff, floors…and eventually we learn to swallow the ocean itself…we slowly begin to realize our perfection and the perfection of others. We explore the unknown “now-ness” and come to realize that the only block to this present moment is what we cling to (which includes this very life itself). We begin to look directly at death…face-to-face… and find it is our own image that is reflected back. We begin to explore the fear that arises when we feel helpless, hopeless and separate in any way. We reflect on the concreteness of some of our held notions and ideas and learn about the ultimate power of impermanence and change.

Many students have found that they return to their sitting practice with a vital intensity as a result of the intimacies they have shared with patients.

It is thrilling to watch someone’s practice come alive, and realize the Four Noble truths as a living and breathing reality.

Trudi Jinpu Hirsch-Abramson