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A last brief thought before next weekend’s Hospice workshop

Often hospice work has a different and highly personal meaning for each one of us. Yet in our culture whose deep and hidden wound is loneliness, the meaning of our work to those who die may be far less individual. One of my favorite poems is Last Fragment, written by Raymond Carver in the days before his premature death……

And did you get what wanted from this life even so?
I did.
And what did you want?
To call myself beloved. To feel myself
beloved on the earth…….
Looking forward to seeing you next weekend. Bring your heart……….


P.S. Are you considering attending the workshop? There are still a few spaces available.

To Register Click Here

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Even more thoughts on Hospice Work

Dear All,

This week I am sending out a letter for those of you who be attending the Hospice Resiliency workshop in Mill Valley,  California on October 21- 23, asking you to bring with you a small object that represents for you the meaning of death.  This reminded me about one of the most beautiful poems I know about the mystery of death which was written by Vivekan Don Flint, the former Coordinator of The Institute of Health and Illness, who died far far too young. We miss you still, Vivekan. Here is your gift for us all……

( A poem about incarnation)

-Vivekan Flint

Is it
a simple rock
tumbling down the
slopes of gravity?

A fireball
vaulting through
the midnight sky?

A shiny needle
drawn through
black velvet?

Or none of these
but only a perceptual trick

in which the solution to
a simple math problem –
given velocity, mass
and direction –

is displayed in the sky
in such a way
that even smart people
wonder what it could
possibly mean?

All I know for sure
Is the belief
I hold about it in secret.

That, and the fact
the very last thing
it did in this world
was to turn into light.


Dr. Rachel Remen

P.S. There are still a few spaces available. Is one of them for you?

To Register Click Here

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Even more thoughts on Hospice Work

Entrances to Mystery are everywhere.
The possibility is all the time.
Even at unlikely times and through unlikely places.
Nothing is beneath the dignity of becoming an entrance.

Exodus 3:2

How long must someone look at a burning bush to know whether or not it is being consumed? Longer than most people look at anything. More than just to see it. Or to use it. Long enough to know if it will be for them an entrance. Such a man was Moses. And likewise anyone who is able to gaze on a place long enough without being distracted.

You do not need to go anywhere to witness Mystery. You do not have to become anyone other than yourself to find entrances. You are already there. You are already everything that you need to be. Entrances are everywhere and all the time.

Adapted from HONEY FROM THE ROCK, Rabbi L. Kushner
Jewish Lights Pub.1990

We have all encountered far more Mystery than we have noticed, more Mystery than we have allowed to nurture us, inspire us and transform us…. More Mystery than we have allowed to strengthen us. In the familiar setting of scientific expertise and cognitive explanation it is easy to trade mystery for mastery and allow “I don’t know” to become a statement of inadequacy and even shame. In such settings Mystery may even be considered unreal.

As a professional I was trained to view the unknown as a sort of emergency, like a hemorrhage and to respond with immediate action. But Mystery does not require action, Mystery requires our attention. It requires us to listen, to talk with one another, to wonder.

I first came to Hospice in 1981. At that time it was common for Hospice teams to set aside time each week for telling our stories, for wondering together about the things we could not explain and sharing a sense of gratitude for the opportunity to witness them. But that was 35 years ago. Over time the commitment to wonder together about the deep meaning of our work has gradually been replaced by more mundane concerns. We still meet weekly but now we discuss cost containment and compliance with Medicare regulations.

But what if sharing experiences of the Mystery in our work is a source of personal strength and a protection against compassion fatigue?
What if people who wonder together do not burn out?
What if the pursuit of knowledge and competence that dominates our culture has impoverished our lives?

In the presence of Mystery we grow not only in knowledge but also in wisdom. In my experience the questions I have found along the way and carry with me have enriched my life far more than any answers. Even the most profound answers have often turned out to be provisional, a temporary stopping place in an ongoing and infinitely mysterious journey

Stories are the ancient container for meaning. Recently educators have become aware that storytelling allows the deepening of personal meaning, calling and professional satisfaction and is a potent antidote to spiritual and emotional exhaustion. This upcoming workshop will be an opportunity to share our stories again, to wonder together at the things that are beyond explanation, to draw inspiration from them and from each other and to remember that witnessing and experiencing things that cannot be measured may be a doorway into what is most real and most enduring.

Looking forward to seeing you at the workshop. Still some places left!



More info and register here.

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More thoughts on Hospice Work

Dear Ones,

As a western trained physician, I was taught that the most important if not the only thing I had to offer to people was my expertise and my bag of techniques. I believed that I could easily be replaced in all of my patient relationships by any other physician well trained in my specialty and that my absence would have the same effect as drawing my finger from a bucket of water. For many years I believed that this was true.

But, what is real is often seen most clearly on the edges of things, in the places where our tools are no longer relevant and our book learning no longer matters. In the places beyond cure. In 1981 when I first began hospice work it was like stepping from an operating room into a church. The deep relational values and art of the healer, long buried by years of technical training slowly revealed themselves in all of their power and mystery until at last I recognized that medicine itself was not a work of science but a work of love.

To work in Hospice is to know yourself to be one of a kind, discover that your presence is the greatest gift you offer and that you can heal by touch and witness far more powerfully than by intellect alone.

The power to heal is a human birthright. This beautiful poem captures the coming home to ourselves and our birthright of healing that many of us have experienced in hospice work:

What I Learned From My Mother
-Julia Kasdorf

I learned from my mother how to love
the living, to have plenty of vases on hand
in case you have to rush to the hospital
with peonies cut from the lawn, black ants
still stuck to the buds. I learned to save jars
large enough to hold fruit salad for a whole
grieving household, to cube home-canned pears
and peaches, to slice through maroon grape skins
and flick out the seeds with a knife point.
I learned how to attend viewings even when I didn’t know
the deceased, to press moist hands
and offer sympathy, as though I understood loss, even then.
I learned that whatever we say means nothing,
what anyone will remember is that we came.
I learned I had the power
to ease pain, like an angel.
I learned to create
from another’s suffering my own usefulness,
and once you know how to do this,
to every house you enter, you offer healing:
a chocolate cake you baked yourself,
the blessing of your voice, your touch.

Copyright 1992 by Julia Kasdorf

Hope to see you at the workshop…..

More info and register here.

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Death Blog 1- My Grandfather

Dear Ones,

On October 21 to October 23, I am planning offer a workshop here in California for people who work with the dying and their families, called FINDING YOUR RESILIENCE: RECLAIMING MYSTERY AND MEANING IN HOSPICE WORK . Together we will explore the opportunity for greater resilience and renewal that emerges from openness to the mystery and deep meaning which is present daily in hospice work. In preparing for this exploration and sharing of thoughts and experience, I want to offer a series of poems and thoughts about death before this workshop.

I was almost seven when my beloved grandfather died. Shortly before he died my Grandpa told me that he would soon be going to be with God, that he would be close to me and hear me and I could talk to him in my heart as we had often talked to God together but that I could not come and visit him. Soon afterward my Grandfather died. I was not allowed to attend the funeral.

As he grew sicker my mother, concerned that I would be deeply affected by his death, began reading books about helping young children meet with death. All the books she read said it was important to wait until a child brought up the subject or shared their questions before talking to them about death. As days and weeks went by and I did not even mention my grandfather’s name she became more and more concerned. When she finally asked how it was for me now that grandpa had died, I had simply said “different”. When she asked me what had changed, I told her that now I could take him to school with me. I have no recollection of this conversation but I do remember talking to my grandpa for many years after he died and drawing much strength and courage from a deep sense of his closeness and presence. Years later, in a discussion of childhood phobias, my mother told me that after Grandpa died I was no longer afraid to sleep in the dark.

Here is the beautiful poem I came across as I began preparing for this new workshop, which reminded me of all of this.

Cataloging Mistakes
—Erik K. Mortenson

And then there was the time her father died and she asked me where I thought souls go afterwards and I said why do they have to go anywhere maybe they die too and are finally at peace and what makes you think we have a soul anyway maybe when we die we die and that’s it and that’s all and sometimes dead is better and wasn’t that true for him and then she just cried harder than before but quieter and I knew she would the whole time I was saying this but I couldn’t stop myself I don’t know what made me think that would be helpful that it would actually be a comfort to her I just couldn’t say what she wanted like that souls go to heaven and watch over us but even worse was what I never thought to say at all which was that his soul was in the way she held her chin just there and in the curls of her
hair and the gold flecks in the blue of her eyes and in her mouth when she peeled and cut and ate a pear with a slim knife and in her thumb and that his soul was in her heart when she asked me the question in the first place.

Hope to see you at the workshop…..

More info and register here.

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Walking the Path


Belief in the Giveaway can be traced back to the North American Indian nations of the high plains. Our personal, sacred Giveaway is what we alone have come to contribute to life, our reason for being. Knowing and honoring your Giveaway imbues life with a sense of meaning and belonging, a sense of direction.

Everything is born knowing its Giveaway: trees and birds, stars and flowers know their Giveaway. Nothing is here at random. Everything belongs. Only humans are born not knowing their Giveaway, not remembering why they are here and how they belong.

From earliest infancy the Giveaway of each child can be seen and discerned by others. Helping every child recognize its unique Giveaway, its unique place of belonging is one of the most important functions of The Elders and the tribe. They observe the baby with stillness and patience. They look for signs with caring and watchful eyes. What is the baby drawn to? What draws its interest, what calms it? What makes it laugh with joy and what causes it sorrow or pain? What gifts come easily to it, what qualities are natural to it? They dream dreams for the baby that offer insight about the baby’s nature and its Giveaway. There is much help to come home to yourself.

No one says “good job” to such a child, no one influences the recognition that can only come from within by their approval and praise or their disapproval and criticism. Everyone helps the child to listen. The Giveaway of each child is a shared discovery, different for every child, every man and every woman. All Giveaways matter.

Our western experience is, of course, quite different. I recently went to visit a young friend and meet her 3-month-old son. When I arrived I found the baby sitting in a cloth jumper seat on the kitchen table watching “BABY EINSTEIN” on a laptop. Around him on the table were many brightly colored and noisy toys. As we talked and had a cup of tea together the young mother presented her son with toy after toy, taking one away and offering him another every few minutes. At my questioning look she laughed “Its the newest theory.” she told me, “The forming brain is highly plastic and needs constant stimulation.” By the time our tea was over I had learned that the baby was already registered for a prestigious private high school, Class of 2029, and letters had been written in his behalf to Princeton by his grandfathers both alumni of that institution. Other august Princeton graduates had been asked to write letters as well, the young mother told me. Chances looked good. I looked at this little boy wondering why he had come. Hoping he might someday be able to discover his Giveaway despite the powerful messages he would be given about who he was and how he was to be from the very beginning.

The closer we are able to live to our own unique Giveaway the stronger and more resilient we are despite external pressures, the more passionately and joyfully we can live, the deeper the satisfaction we feel in our daily lives and the greater the difference we can make in the world.

These ideas hold a certain magnetism for me now. What if you could find and follow your Giveaway at any age? And what if you could find your tribe, the people who watch and listen and help you to give birth to yourself? What if you already knew many such people but had not recognized why you were drawn to them? What if you could help others in this way as well? What if you did not need some catastrophic event like an illness or the loss of a loved one to finally remember who you are and why you are here?

At 77 I have decided to do only what I am drawn to do. To discover what is my authentic path. I have learned something about it from these long years of living but I have never given myself permission to follow it with all of my heart. I had thought that my profession was my Giveaway but a profession is only one way to offer a Giveaway and often it is not the best way. There are many ways to offer your Giveaway.

The best way I know to learn something is to invite others to join into a search for the thing I am searching for. So I will be offering a new workshop this Fall, and I have asked one of the wisest people I know, my cousin Mark, a founding member of my Giveaway tribe to join me in teaching this workshop.

Walking the Path with Heart is simply an exploration of the nature of your Giveaway… a look at familiar events and choices with new eyes… a recognition of previously unseen threads which are not random or peripheral but are the path itself. A remembering.

I invite you to join Mark and I in this exploration of that which is your beginning.
October 1st -3rd, 2015
The Acqua Hotel
Mill Valley, California

More info and register here.

We shall not cease from exploration
And the end of all our exploring
Will be to arrive where we started
And know the place for the first time.
Through the unknown, remembered gate
When the last of earth left to discover
Is that which was the beginning.

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Interview with Charlie Rose (oldie but goodie)

A video of Rachel falling in love with Charlie Rose… You will too.
June, 2001.

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Seeing The Angel In The Room

It was a Wednesday evening during the third session of The Healer’s Art, the course for first year medical students I developed at UCSF’s medical school 22 years ago and still teach there every year. The topic of the evening was Allowing Awe and Mystery in Medicine and the 70 or so first year students and 13 faculty who had gathered had broken up into small groups of six and scattered into separate rooms to share and discuss their personal experiences of the topic.

I was sitting downstairs in the large living room of the Faculty Alumni House waiting for these small group discussions to end and the class to re-gather. With me on the couch was one of the donors whose generosity has made the course possible. We were chatting together, but with difficulty. The old house is wooden and the noise level was impressive. Submerged in the sound of almost 100 excited voices, we could barely hear one another speak.

Suddenly the small discussion group that was sharing the living room with us fell silent and within seconds the entire house was absolutely still. On the couch we looked at one another in shock. It was so quiet we could have been alone in the house. Instinctively I looked at my watch. Second after second went by without a sound. After four minutes 23 seconds, we heard a single voice from upstairs, clear through the wooden floor, offer a comment on the experience of Mystery. In the next breath the huge sound of almost 100 voices washed over us again. I was shaken. So was she. We stared at one another without words. Finally she spoke. “My mother used to say that when a large group of people falls silent like that, an angel is walking through the room.” I nodded. It was as good an explanation as any.

Ten minutes later I rang the bell that was the signal for everyone to return to the living room to share what they had discovered about the experience of mystery. Once they were settled I began by asking them what they had thought about the long silence. 83 pairs of eyes looked at me in confusion. Finally a student spoke up “What silence?” he asked.. No one had heard it but the two of us. If I had been alone, I might have thought that I had not heard it either.

4 minutes and 23 seconds is a long time. It made me wonder how many other things that cannot be explained pass us by, unaware. Perhaps we have all encountered far more Mystery than we have recognized or even wondered about. Pity. People who wonder rarely burn out.

So what does Mystery look like when it happens in the midst of a group of doctors? Check out this video…….

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