By Giriraja Swami

A talk presented to the doctors and nurses of San Diego Hospice and The Institute for Palliative Medicine in San Diego, California.

It is a great pleasure for me to address you all here, especially because this hospice is recognized as one of the best and largest in the world and as the global leader in hospice education.

In the Bhagavad-gita, which is considered the essence of the Vedas, Lord Krishna informs us:

yam yam vapi smaran bhavam
tyajaty ante kalevaram
tam tam evaiti kaunteya
sada tad-bhava-bhavitah

“Whatever state of being one remembers when he quits his body, O son of Kunti, that state he will attain without fail.” (Gita 8.6)

anta-kale cha mam eva
smaran muktva kalevaram
yah prayati sa mad-bhavam
yati nasty atra samshayah

“And whoever, at the end of his life, quits his body remembering Me alone at once attains My nature. Of this there is no doubt.” (Gita 8.5)

In 1969, when I was a student of psychology at Brandeis University, I met my spiritual teacher, Srila A. C. Bhaktivedanta Swami Prabhupada. In 1970, after studying with him for a year and a half, I accompanied him to India. And in 1977, he taught us by his example how to leave the world in proper, pure consciousness. He retired to Vrindavan, a holy place in India, and surrounded himself with devotees who were always chanting or reading to him from sacred literature. Being in such a holy place was itself conducive to spiritual consciousness, to God consciousness. And the atmosphere was enhanced by loving disciples singing songs of the Lord and reading books about Him.

Some years later, one of my students, who was older than me, was diagnosed with cancer. She was a renowned artist from South Africa who would travel all over the world to find subjects for painting. At one point, she decided that she wanted to combine her spiritual interests with her artwork, and so she bought a plot of land in the same holy place, Vrindavan, to establish a studio, and she was kind enough to build a floor upstairs for me, for when I would visit. Although the doctors had given her six months, she actually lived for three years. For the last two or three months of her life, I was with her almost constantly, because the goal – not just in the Vedic tradition but in others as well – is to think of God, to chant the name of God or at least hear the name chanted, at the time of death, and I wanted to help her do that.

During the thirty years that I was based in India, I would travel frequently to Pakistan and Sri Lanka, and in Pakistan I came across a book calledThe Ninety-nine Names of Allah. There is a similar work in Sanskrit called The Thousand Names of Vishnu (another name for Krishna) , the Vishnu-sahasra-nama. So, in The Ninety-nine Names of Allah there is a section about how a pious Muslim should meet death. The best thing a dying Muslim’s friends and relatives can do, the book states, is chant the names of God and help the loved one to either chant or at least hear others chant the name of God at the final moment. There is a similar tradition in the Jewish religion, where the ideal is that at the time of death the family and friends are chanting the name of God, or reciting a prayer that contains the name of God. I saw that the same tradition that we have in Vedic philosophy, in Krishna consciousness, is also there in Islam and Judaism, and it is there in other traditions as well.

With my student, we followed the same practice that we had seen with our spiritual master, and devotees would come and chant. The chanting can be done individually in a quiet, meditative way or communally and more loudly, with musical instruments. The whole idea is to help the person fix his or her consciousness on the Supreme and keep it fixed on the Supreme at the time of death. And along with the chanting is the reading and talking about God consciousness.

In Vedic culture, the time of death is considered life’s final test. In school we attend lectures, complete assignments, take quizzes, and write the midterm, but whether or not we graduate depends on whether we pass the final examination. In life, passing the final examination means thinking of God. That is why the whole focus at the time of death is to help the person remember God. And the other activities that we perform during our lives, besides freeing us from activities that will result in our taking birth again, are practice for thinking of God. And we get little tests along the way – sicknesses, setbacks, and various hardships. When we face them, do we remember God, or do we look only for material solutions? These are the tests along the way. And then the time of death is the final examination, and if we can remember God then, we graduate. We are free: no more material bodies, no more repetition of birth and death.

Dealing with Physical Pain

Lady (1): In the work we do we are often looking at physical pain. Should medication to alleviate physical pain and suffering be discouraged? Would it interfere with consciousness at the time of death?

Giriraja Swami: Very good question. The goal is to remember God at the time of death. So our general approach is that we want to take enough medication so that the pain is not so excruciating that our consciousness is just absorbed in the pain. But at the same time, we do not want to take so much medication that it dulls us to the point that we cannot really think of God. That is the delicate balance we try to achieve.

Gentleman (1): Is remembering God just saying the name or thinking the name of God, or is it something else – coming back into a state of divine consciousness where one actually feels a connection with God?

Giriraja Swami: All right, so what do we mean when we talk about remembering God? Now, God is a person – that is the first point. He is not a person like you and me, with a body made of flesh and bones. He is spiritual, transcendent. But He is a person. The Bible says, “Man is made in the image of God.” We are persons, and so our supreme father or mother must also be a person. This is a difficult point, because we are so conditioned by the material concept of personality that when we hear about God’s personality we think in terms of our material experience. Sometimes people think, “If you say that God is a person, you are limiting Him.” For example, I am sitting here. Because I am sitting here, I cannot be in the temple at Pacific Beach; I cannot be at my ashram in Santa Barbara. But God – He is a person, but He is in this room, He is in the temple in Pacific Beach, He is in Santa Barbara, He is in our hearts, He is in every molecule and every atom. But He is still a person.

Let us take the example of a person who holds a high office, say the president of a country. The term president describes his office. But there is also the person who occupies the office. And that person has a name, an appearance, and personal qualities; he or she engages in certain activities. When we remember the president . . . yes, there are things about the office that we consider, but to really remember the president means to know his name, his form, his features, his qualities, his activities. So, God, too, has a name – He has many names. And He has a form – many forms. And He has many qualities and engages in many activities.

The real goal is to love God, because when you love someone, you naturally think of the person. When we develop love for God, we will naturally remember Him and think of how beautiful His form is, how sublime His qualities are, how wonderful His activities are. We will like repeating His name, just as one would repeat the name of a loved one, and we will think how best we can serve Him and please Him.

But how can we know God well enough that we can actually come to love Him? Well, one distinction between Vedic literatures and other scriptures is that the Vedas give more details about the Personality of Godhead. They describe not just that He is the supreme authority, the creator, the maintainer, the destroyer, and the protector, omniscient, omnipresent, and omnipotent – which He is – but also His personal attributes: His names, His forms, His qualities, and His activities. And when one comes to know Him in a more personal way and develops affection and attachment – love – for Him in a personal relationship, it is very easy to think of Him all the time, and very natural to think of Him at the time of death.

Comfort for Family Members

Gentleman (2): As hospice workers we work with the families of patients and deal a lot with the grief, the loss of the soul in this body that they have enjoyed in the physical context. It seems that after a loved one’s death, a family member could hear the name of God or think of the name of God, but because we’re outside of that person, we don’t know what he or she is actually feeling. So in what ways can we bring comfort and assurance to the family members? How can we support them in their grief and the loss of their loved one?

Giriraja Swami: The first instruction of the Bhagavad-gita, which is also a central principle in many other traditions, is that the person is not the body. The person is the soul living in the body. When the person leaves the body, we say that the person is dead, but actually the body was never really alive; it was just animated by the presence of the soul. At the moment the soul leaves the body, all the elements of the body are still there, lying on the bed. You may lament: “Oh, my husband is gone.” “My wife is gone.” But why do you say they are gone? The body is lying on the bed. You might have thought that the body was your husband or your wife or your father or your mother, but when they pass away, you say, “Oh, my father is gone.” “My mother is gone.” But the body is still there. So why do you say they are gone? Intuitively, we know that the person was not the body. That loved one is something other than the body that he or she now has left; that person is the soul.

When a person has led a good life, and even more so when he or she has tried to develop a relationship with God and hear the name of God and think of God at the time of death, we can be assured that the person will go to a better destination. There are many emotions. There is the sense of personal loss, that the person whom we loved and shared so many good times with is gone. Out of love, there is also concern. Where is the person now? But if we know that the person has gone to a better place, we feel solace. And in painful illnesses such as cancer, we may also think, “All right. The soul has left this body, and I am sad, but this body had become very difficult; it had become a painful place for the soul to inhabit, so it is actually better that the person has gone elsewhere.” The person, the soul, continues to exist. He or she has gone to live somewhere else, where there will be less pain and suffering.

Still, we do not deny the sense of personal loss. Even among transcendentalists there are various emotions. When a perfect yogi leaves the body, we know that the person is qualified to enter the kingdom of God, so we are happy. We are both – happy and sad. We are happy because we know that the person has gone to God, to serve God, but we are sad because we will miss the person’s association. Still, such departed souls, we believe, can inspire and guide their loved ones who remain behind.

Then there is also the idea that God is responsive to prayer. When a loved one leaves the body, we know that the soul exists somewhere. We don’t know where, but we want to help the soul, because we love that person. So we can pray to God, “Wherever my mother is now” – or my father or whoever – “please be merciful. Please help her come closer to You.” And I believe that those prayers will not only help the departed soul but will also give us a chance to continue the relationship and to try to help our loved one even after he or she has left the body.

Then there are the bereaved’s own spiritual practices – chanting or meditation or prayer or whatever. Yes, we are attached to and miss our loved one, but through genuine spiritual practice we come in contact with the Supreme. Of course, in the initial stage the bereaved may be too distraught. But then when we do engage in some practice that brings us in touch with God, we feel, “God is there. It is all right. God is taking care. My real relationship is with God. By God’s grace I can gain His shelter in the future.”

When the Dying Ask “Why?”

Dr. Bharadwaj: Many patients ask, “Why is this happening to me? Is God punishing me?” and this causes a lot of spiritual suffering. How would you approach this?

Giriraja Swami: If someone is suffering from a terminal disease, I would not get into the idea that God is angry with the person or is punishing him. Rather, I would say, “Anyone who takes birth in a material body has to die.” That is the point. “Birth, disease, old age, and death are inevitable for every conditioned soul. It may be this disease or that, it may be this symptom of old age or that, or it may be this or that way to death. But these factors are there for everyone. And now that you are in this position, you should use what time you have to develop your relationship with God, so that you do not have to take birth in another material body and suffer through the same cycle again.” And if patients feel some specific spiritual regret or guilt, we can hear them with empathy and help them work it out – perhaps take some practical measures to resolve it – and go beyond it.

As for the suffering, on the material platform its value is that it burns up bad karma. That is why many Hindus prefer to tolerate rather than protest, because they know that by tolerating their suffering they are exhausting their sinful reactions, and they feel that they would rather get it over with than try to postpone it and then have to suffer the bad karma later, in some other form. That is on the material platform. On the spiritual platform, the benefit is that suffering can serve to make us more detached from the body and from the world. We are trying to become transcendentalists, yet we still have material attachments. But when there is some upheaval or calamity, we can realize, “Yes, actually the material world is not a happy place. I should not be spending my energy trying to make it happy, because by nature it is not a happy place. I should be using my energy to realize the Supreme and get out of here.” Lord Krishna confirms in the Bhagavad-gita, duhkhalayam ashashvatam: “This material world is a place of misery, and it is temporary.”

Dr. Bharadwaj: A lot of patients fear that bad karma is causing their suffering.

Giriraja Swami: Well, it may be. Still, our teacher gave the example of someone drowning and another person coming in a boat to rescue him. The drowning person says, “Now, wait a minute. How did I get here?” But that is not the point. The rescuer would say, “Don’t worry about the past; we can talk about that later. You are drowning. Just get in the boat!” So, we are drowning in this body, in this samsara, this ocean of repeated birth, death, old age, and disease. Let’s not worry how we got here. Let’s try to get out. And it is never too late. That is the power of God’s name and God’s mercy. There are stories in the Vedic literature of people who were very sinful but at the last moment chanted God’s name and were delivered. So it is never too late.

Dying Young

Lady (2): A lot of our patients never make it to old age, and it’s very difficult for everybody – the patient’s family and us – when they seem to not complete, in our perception, their life. What’s the approach to that?

Giriraja Swami : Their destiny is caused by their activity, their karma. For whatever reason, they did something that is causing them to leave the body before the normal time. But the positive side – we always have to see the positive, the spiritual side – is that, depending on the circumstance, a younger person may be better equipped to think of God at the time of death than an older one who has lost more of his or her faculties. In fact, there is a Sanskrit prayer:

krishna tvadiya-pada-pankaja-panjarantam
adyaiva me vishatu manasa-raja-hamsah
prana-prayana-samaye kapha-vata-pittaih
kanthavarodhana-vidhau smaranam kutas te

The devotee prays to the Lord, “My dear Krishna, please let me die immediately so that the swan of my mind may be encircled by the stem of Your lotus feet. Otherwise, at the time of my final breath, when my throat is choked up, how will it be possible for me to remember You and chant Your holy name?” This may seem contrary to our materialistic culture, which is so preoccupied with pampering and preserving the body, with staying in the body as long as possible and squeezing out of it the last possible drop of pleasure. This prayer, in opposition to that mad, vain pursuit, offers a more philosophical perspective. It is a different perspective on dying, even before old age – one that is positive and spiritual.

Footnote on the opening page: Adapted from Life’s Final Exam: Death and Dying from the Vedic Perspective, edited by Giriraja Swami.