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End of Life Matters with Pippa White
556 Plays4 days ago
Shrug off the cloak of secrecy and awkwardness around death with palliative care nurse Pippa White. I’ve been wanting to bring a death convo to the airwaves for ages, because there’s a huge imbalance between light/dark, above/below, waxing/waning, growth/decay, possessing/relinquishing energies in our culture (and I'm the first person to perpetuate it). Shout out to everyone who sent frank and thoughtful questions for Pippa to answer – you’ll hear them towards the end of the ep.
Pippa White is a palliative care nurse and death care advocate and educator in the Anthroposophical tradition. We discuss:
🖤 What is Anthroposophic philosophy?
🖤 Death care rituals, balms and vigils
🖤 Windows into the reality of spirit from people in transition
🖤 Why to “do the work” at the eleventh hour
🖤 Soothing suffering without drugs
🖤 How painful is death?
🖤 Different ways to relate to pain
🖤 Small, slow solutions to dying (tiny local end of life retreats)
🖤 Pet euthanasia, yay or nay?
🖤 How to deal with loved ones in denial?
🖤 Can you make a living in end of life care?
🖤 How do you document/cherish a life?
🖤 What folks find difficult when dying?
🖤 Grieving to breathe and to love
🖤 Birth and death thresholds
LINKY POOS 🧙♀️
Anthroposophical Society Australia
What is Advance Care Planning?
[poem] Do Not Go Gentle into That Good Night by Dylan Thomas
Recommended
Transcript
Introduction and Setting
00:00:03
Speaker
race scallia Hey, this is Katie and you're tuned into Riskillians, a podcast about the hard, soft and surprising skills that'll help us stay afloat if our modern systems don't.
00:00:18
Speaker
There is quite a bit of traffic noise this morning, which I'm finding it very hard to escape, so i do apologise if you can hear the rumble of trucks and the whooshing of cars in the background of this introduction. Nevertheless, I am gratefully recording in Jarrah Country, central Victoria, where the gums are bespangled with winter blossoms, yellow, red, pink, peachy, bringing all sorts of sweet beaked birds to the region, including the critically endangered swift parrot.
00:00:45
Speaker
Happy winter solstice too. We've just passed the longest night and it feels quite right to be releasing this episode with palliative care nurse Pippa White about end-of-life matters and mysteries.
00:00:58
Speaker
But first, you know I love a good monologue, so gather round, etc, etc.
Hunting Reflections and Cultural Insights
00:01:03
Speaker
And if you don't feel like listening to me talk about hunting in this intro, maybe skip forward a few minutes till you reach the main part, which is only about death.
00:01:12
Speaker
So it has been crazy cold here in central Victoria. Like, turn off your fridge and put the food on the back step and it'll be fine. Cold. So it is tempting just to hibernate. But every once in a while, it's nice to get outside and walk the land, watch the sunset and wait for the moon to rise over the paddocks and spill its icy light, even if it's minus five degrees.
00:01:34
Speaker
There are so many wonderful sights on a winter's night. That's why two evenings last week I went out hunting with Jord, stumbling along in the dark as he marked bunnies.
00:01:45
Speaker
And to be clear, he hunts rabbits for food, not for fun. Which he'll be talking about in the next episode, incidentally. Jord usually hunts on our friends' properties, helping them with their bunny problems whilst gleaning food for our household. But last week we came home from both hunting trips empty-handed, which is quite unusual because rabbits are in plague proportions around here and normally George gets at least a couple.
00:02:10
Speaker
I wondered if my presence had anything to do with these results. Given that every time we saw a fluffy white butt in the distance, I whispered, run, little rabbit, run. Or once when Jord had a hair in his sights, my heart raced and I held my breath, sending an almighty shockwave of protective magic scutting across the hill, willing him to miss.
00:02:32
Speaker
This is the contradictory inner world of a person who values a direct connection with her food and wants to exist inside a fairy tale where everything lives forever. I did not want those rabbits to die, but I also greatly respect Jord for sourcing our protein in such a raw and real way.
00:02:50
Speaker
It is a conundrum. On the third night, I stayed home by the fire while Jord, relentless as ever, went out again and sure enough returned with two rabbits and a hare. It was particularly sad to see the hare because he was just such a beautiful creature, straight out of a storybook, with long, velveteen ears and a snow-white belly, soft eyes, elegant whiskers, and feet the size of cucumbers.
00:03:20
Speaker
Hairs are associated with myth and magic, good fortune and madness. This one was about the size of a cat, and after being meticulously skinned and butchered, the pelt and organs set aside for tanning and eating, as well as the wine-coloured meat, I noticed Jord was pretty quiet.
00:03:39
Speaker
I heard Arthur Haynes say recently on the Wild Beings podcast that he hunts animals so that he can personally apologise, so that he can be there to give both his gratitude and his grief to the beast who, more intimately than a lover, will infiltrate his cells to birth his continued existence.
00:03:58
Speaker
And I know that people see animal and human lives and deaths as hugely different, but I really don't. It's all the same excruciating mystery to me, the expiration of a sacred experience.
00:04:10
Speaker
An abject tragedy, a moment that I've raged and raged and raged against like that Dylan Thomas poem. But what if there's more to the cessation of life than meets the eye?
00:04:22
Speaker
Is there a place for gratitude amidst the grief? What is the role of grieving anyway? Has our cultural obsession with infinite growth and endless summers warped our relationship with the seasons, with the cycles, with the fertile dark of winter?
00:04:37
Speaker
I'm starting to wonder whether death's greatest gift might be to prize the Disney pills from our grip, the forever drugs, and shake us awake so that we can live the shit out of the time we have left.
Meet Pippa White, Palliative Care Nurse
00:04:48
Speaker
I say this as a person who doesn't want an ant to die, let alone a hare, let alone a loved one, let alone myself. I need this conversation with Pippa White, with a palliative care nurse more than anyone.
00:04:59
Speaker
And I hope it brings you courage and comfort and points of contemplation too. Pippa was recommended to me as a local knowledge keeper on end of life matters. And I have to say being in her presence was really special.
00:05:11
Speaker
She leaves space for things other than words to enter the conversation, which is so refreshing. We recorded in her home, warmed by wood fire and in the company of Greta, her old blind pup.
00:05:24
Speaker
Pippa also answers a bunch of your death FAQs at the end, so thank you to everyone on Patreon and Instagram who sent in such frank and thoughtful questions. I am oozing appreciation for everyone on Patreon who, as a collective, support the creation of this show.
00:05:41
Speaker
No ads for Riskillians, except these subtle plugs for the Patreon community, which you can check out at patreon.com forward slash riskillians. A huge hello and my warmest thanks to patrons Pippi, Harry and Melinda, who signed up in the last couple of weeks.
00:05:58
Speaker
And without further chit chat, here's our death chat with the wonderful Pippa White.
Children's Understanding of Death
00:06:08
Speaker
what age do you think it's appropriate or, um, don't know, worthwhile introducing the idea of endings to little kids?
00:06:19
Speaker
Do you talk with your grandkids about death? Well, they're party to conversations that I have with the adults. I don't talk specifically to them about something unless it's really part of their world.
00:06:34
Speaker
Yeah. Um, But, you know, in my work I see children handle death really well, generally speaking. It's part of life for them, and it's not a big scary thing, generally speaking.
00:06:48
Speaker
And the loss of a parent, that is huge. But the actual death side of things for children, it generally has taken...
00:07:01
Speaker
like everything else with a child, you know, with that innocence and just knowing that that's part of life. Yeah. It's almost like when when babies are born and they can breathe underwater and, i mean, um it's probably just such an ignorant thing to say, but I wonder how long could we do that for if we just stayed under there? How long could we be in that state of childlike surrender and acceptance of the facts of life? What happens...
00:07:31
Speaker
to sever us from that? Humans, I think. You know, the way we care for our children, the way we we do things unintentionally, but I think we we contribute to shutting the door on our children from that spiritual connection, I guess.
00:07:51
Speaker
But I guess it's part of being on this earth as well, that we forget. Yeah. Mm-hmm. But, you know, being with children is such a wonderful thing. As a grandparent, it's so beautiful that you spend time with these beautiful, innocent children and you can stand back and watch and observe.
00:08:14
Speaker
And, you know, I had my grandson, he was standing on the gate at the front the other day when he was here, and he looked out over everything and he said... I can see the whole wide world from here. And just that that beautiful openness and and you get such a sense of that kind of everything that a child brings and has.
00:08:40
Speaker
Yeah, such a delight. Well, I suppose and should do some kind of introductory...
Pippa's Career and Anthroposophy Journey
00:08:48
Speaker
context some framing for people listening because i mean even for myself people i think i put it out there on instagram and also to my community on patreon that i had the chance to speak with well you know what i was saying a death doula but i know that you're a palliative care nurse an educator so i wonder what the difference is between those things and what it is you do
00:09:13
Speaker
Initially working as a palliative nurse in a hospice, so that's very different to death doula, that I do all of the nursing work that's required in a hospital or hospice situation.
00:09:28
Speaker
and I feel like being a nurse has been a real privileged position. its It's meant that I can often go in places where sometimes doulas don't get a look in.
00:09:41
Speaker
I think the thing for me is where people go into being a death doula for a particular reason of wanting to support a person from that palliative time through to after death, which I also do But it was a real unfolding for me. i i became a nurse in my late forties mid late 40s i trained and i did it specifically to be a palliative nurse and then i worked in a hospice for some time and after quite a few years of working in hospice care for me i felt that some of the care that was given and just the institutional side of things i found very difficult to work in i then was asked to work at an integrative GP practice where there's there was a couple of anthroposophic doctors practicing there and i trained to be an anthroposophic nurse.
00:10:48
Speaker
So that that gave me the tools to give very different kind of care to what I was able to in a hospice. The other thing was that my daughter got cancer when she was 21.
00:11:03
Speaker
and that was my initial road into anthroposophic nursing. I was working in the hospice at that time, so death was something that had always been and of interest to me, as birth was as well, that both of those transition times, threshold times.
00:11:24
Speaker
There's a lot of similarities between a death doula and what I do, But I think just because I come from more of a nursing practice and I do therapeutic work and some death doulas do that too.
00:11:37
Speaker
I had to practice saying anthroposophic before this interview. It's quite a mouthful. And I do want to ask you a little bit more about that philosophy, what that entails. But I can't help but quiz you a little bit on that later in life career transition because I know...
00:11:55
Speaker
a lot of people feel like they might want to upend their existence and try something radically new but are limited by their sense of where they are in life and time. Anthroposophic, as you know, is Steiner's philosophy, anthroposophy, and I had already been quite steeped in that.
00:12:16
Speaker
as a 19-year-old, nineteen year old i was first introduced to that philosophy when I was working in what's called a curative home and it's for people with disabilities and there was one in Victoria and I started working there when I was 19 and that was my first introduction to anthroposophical thought and the biodynamic garden.
00:12:46
Speaker
Yes, biodynamics is part of that. It reminds me of how permaculture can be quite hard to articulate for someone who has a simple question around what is it? It's almost like you have to give a suite of examples to fill in the picture of what that looks like in practice.
00:13:02
Speaker
And I find that with Steiner's teachings and work, because they are oftentimes un-teachings in a sense. Maybe the question is why did that resonate with you? Because there must have been something that made sense.
00:13:16
Speaker
Absolutely. and The thing that I love about Anthroposophy is that education, agriculture, architecture, medicine, all of these things, they they all are based in a practical experience and yet they all have very much a relationship to the spirit as well.
00:13:37
Speaker
So it's very holistic in its approach and for me that was very appealing and felt right, absolutely right. so My introduction really was with education, with my children went to Steiner schools and the whole understanding of the development of the human being is very rich and it is very holistic.
00:14:02
Speaker
Same as with the biodynamic agriculture. I love that it has a very strong connection to the cosmos and with the children. The children, just through things like verses and myths and legends and all those things, it speaks in an archetypal way to children and to us as well, and very deep and rich.
00:14:28
Speaker
And so for me, my connection with anthroposophy, I'm a very practical person, And so it's all been through through doing practice, yeah.
00:14:41
Speaker
And what does it mean for you when you talk about spirit and spirituality? Because ah know it's almost like sometimes we take things apart to see them and then we need to put them back together again. Like even saying mind, body and spirit separates a human who is fundamentally whole. So what is this spirit piece? Is it something separate from our flesh and blood being, or is it simply a way of looking at something that's very essential to us and that is always present, whether we know it or not?
00:15:17
Speaker
Both of those.
00:15:20
Speaker
Both of those, because yes, it is ever-present. Like in the met medicine, we see the different bodies, and in anthroposophic medicine there's four four bodies. There's a physical, the etheric body, or the life body, the astral body, and then the eye.
00:15:39
Speaker
And in medicine, you know, you can see that some of these things are out of balance, so our whole approach is to help them to find a place of balance in those things so you can see it as you know it can be helpful to see those separate bodies and see where something might be out of whack and to help with that but but I think it's really important to see that we all have all of those things together all the time as well yeah and you see you know in the dying process you see some of these things fading like the physical part is
00:16:21
Speaker
is fading and the etheric you know that life body is fading and so you see the changes happening or an illness and those sorts of things oh it's so hard not to jump into all kinds of naive and fantastical questions about ghosts and near-death experiences and just know i'm controlling myself to for the good of the story progression <unk>s regulating i'm thinking about when you mentioned working in a hospice setting and feeling a bit disillusioned with with that structure and the limitations and i'm curious about how we do death in this society kind of conventionally typically generally and then what's possible and what you see is broken in that realm
00:17:14
Speaker
Well, in my experience, I think any institution um can't fulfil the needs of, you know, the medical institution, hospitals and hospices and aged care as well, that they can't fulfil the needs of a human being.
Holistic Approaches in End-of-Life Care
00:17:34
Speaker
You know, they it's all about economics.
00:17:38
Speaker
It's all about time. and we can't properly. we can't work in that way, in a fulfilling and holistic way with people.
00:17:50
Speaker
Just can't. And my experience of working in the hospice was that there wasn't the time to be able to give to people that they needed. The amount of drugs that were used to me were on overload.
00:18:05
Speaker
In palliative care, There are certain drugs that are used that is very, very common and seen as being part of palliative care.
00:18:17
Speaker
And with working with people at home, I see how different it can be. Often there's anxiety around death and dying. There are so many other ways of dealing with anxiety than giving a drug for it.
00:18:32
Speaker
The same as with pain. It's... looked at just as a bodily thing, often a physical thing. There is so much focus on the body and making someone comfortable in the body that all of the other things are not attended to in the way that they need to be.
00:18:52
Speaker
And for instance, someone who has a lot of pain, drugs ah work really well for for that, but in some instances it's so much more than than a physical thing.
00:19:06
Speaker
know Anxiety contributes to pain and positioning and warmth and so many factors can really help with pain that are not really looked at or attended to in an institutional care.
00:19:27
Speaker
Doing anthroposophic nursing is another step away from the traditional kind of nursing is that we were taught to give poultices and compresses and what's called rhythmical body oilings where it's like a very gentle massage with specific oils that are used for particular things we use the external remedies are really good for for pain as well but they the touch the warmth the relaxation that happens with that contributes so much to to the physical experiences of people as well must be so comforting and i know having been around two people who've
00:20:12
Speaker
been dying, in the process of dying. And it's funny noticing my awkwardness and the etiquette that doesn't really have a place in that setting. And what I mean is, remember with my grandfather, people far more experienced than me, like the nurses and even my older relatives, just knew to hold him, you know, hold his hand, stroke his arm. And this is a man who's not affectionate, very...
00:20:43
Speaker
intellectual and remote and I felt that it was it was jarring that I could suddenly touch grandpa's hand and and pat him and offer that sensory connection and I truly felt like I wasn't doing it right.
00:21:03
Speaker
What is your experience in that in that really liminal space with someone and what what else are you doing with a dying person? Well, I was just thinking about a woman i I attended to not that long ago who had gone through a huge amount of trauma in her life.
00:21:23
Speaker
And she carried a lot of guilt and she was working really hard on her journey to free herself of these things that held her back.
00:21:37
Speaker
When I went there and I gave her foot bath which is what we often give initially before we do other treatments, and giving her the foot bath. And she spoke about some of the things in her life, the guilt that she felt around that. and we we Having her feet in the foot bath is really warming.
00:22:02
Speaker
What it happens is that it brings someone into their body in a way that feels comfortable, And what happened? We were able to speak about these things.
00:22:15
Speaker
And then the tears erupted and she cried and cried. They're the sorts of things that I was talking about, that in institutional care you don't have the time to be able to do something like that.
00:22:28
Speaker
And that is so important. It's so important for people to come to that place of... letting go and peace, feeling at peace and ah living through that trauma. yeah It sounds really basic, but why is it important? I mean, the outcome is the same.
00:22:51
Speaker
death? Yeah. I think that you know a lot of deaths are not ah not peaceful, which doesn't mean they're a bad death. but people are working through stuff.
00:23:06
Speaker
And I guess from my perspective, you know i guess I come from a place where I believe that we come to this earth to learn and the challenging things are the things that we learn the most from it seems.
00:23:24
Speaker
And they're the deepening things. They're the things that we find love Love is very much a spiritual connectedness. And when people grieve, usually they come to that place of love and and depth.
00:23:44
Speaker
And it feels right. Yeah. on On your personal beliefs, and i love when people are willing to put words to these deeply held beliefs and not for any other reason than to share them, not to offer them as a prescription or some rule.
00:24:06
Speaker
But I wonder if you see a continuation beyond death, what you were describing about deepening and tapping into love and processing some of those things from our lives. Is that for any other reason than, as you say, it feels right? Or is it because there's a ramification or a ripple that carries beyond that physical body's ending.
00:24:31
Speaker
I'm one of these people who doesn't say, right, this is my definite belief because it changes all the time. But I'm very open to reincarnation. So I do believe that we come back and perhaps the work that we do, the more work we do, I guess the more whole we feel.
00:24:52
Speaker
and that spirit is strong. and And from my experience in life, when i when I go through challenging times and when I do the grief work that needs to be done, it's those times that the love is the strongest and and the empathy.
00:25:15
Speaker
And to me, they're the things that I value the most. and And to me, they're spirit-filled. And I can't explain that, you know. It's it's something that you feel.
00:25:28
Speaker
Yeah. I feel like ah I'm not so articulate in these things. Yeah. Or maybe words aren't really the right vehicle.
00:25:39
Speaker
Yeah. and And I think to some degree when you're talking about spiritual matters that it is a mystery. And it's not something that you can actually necessarily say this is it. You know, I listen to lots of people who who have experiences of things that I don't have experiences of. And, you know, I guess I'm very, very clear that we're not just a body and the that that spirit lives on.
00:26:14
Speaker
somewhere, somehow, and I'm really open to lots of different thoughts about that. But, you know, when you're working with people who are dying, they show you that the end of their life.
00:26:28
Speaker
You know, you get a ah little window into that there's relatives there waiting for them. With one woman who had been unwell for quite a long time in her life and She wanted to die, but she also wanted to live out her natural ah span of life.
00:26:52
Speaker
And so it was about a year after she'd said that, that she actually, in a couple of hours before she took her last breath, she had the biggest smile on her face and she said, oh, the spiritual gates have opened at last. Mm-hmm.
00:27:11
Speaker
So she could see into that. And so with people saying those things, you get such a sense of the beyond. Yeah.
00:27:23
Speaker
Do you think that it's... I feel like it's understandable that we are ah terrified of this is great mystery. And see that its different aspects of it inspire more or less terror for different people. And I'm quite afraid of...
00:27:41
Speaker
just Simply being in pain and suffering, not so much oblivion or an afterlife or whatever happens next. It's more just, you know, I have ginger hair. We have a lower pain threshold than other people. That's a scientifically proven fact. I like to be in pain.
00:27:58
Speaker
Do you have a sense that maybe our ideas of what death is like are a little bit off the mark and it might not be quite what we think and what we fear?
00:28:08
Speaker
Or eight is that bad? i mean, yeah, what is your reading on what it what it's like to go through that process?
Community and Family in the Dying Process
00:28:16
Speaker
I think for a lot of people it's not an easy it's not an easy journey. That's the reality. It's true. And for some people death is painful.
00:28:27
Speaker
It's absolutely true and and can be really difficult.
00:28:33
Speaker
But on the other hand, I also see that people going through that time of suffering, and often it's an existential kind of suffering, of you lose everything, so-called, when you're dying.
00:28:48
Speaker
You lose everything of this earthly plane anyway. and your relatives and people you love and the things that we are attached to. And what we were saying before, I think one of the biggest things that people are really attached to is that they believe that this is who we are, our physical is who we are.
00:29:11
Speaker
And so the focus is always on the body. focus is on symptom relief and that sort of thing. Whereas I guess if you have more of a holistic way of caring for people, then to do what I was saying before of giving something that opens up a space that people can actually express their grief.
00:29:36
Speaker
They can actually learn, keep learning and journeying through that time that it can often bring incredible learning and incredible love.
00:29:48
Speaker
Mm-hmm. And so there, you know, there's the both. There's both there. And for some people, it's not painful as well. There is a lot of focus on pain, and we do have good pain management with drugs.
00:30:03
Speaker
But yes, there's more to it. There's more to it than that physical pain, and that side of things is really scary, I guess, for a lot of people.
00:30:14
Speaker
But again, there isn't there doesn't tend to be... a focus on on growth or a focus on what the whole dying process can bring in a you know very positive way as well. I'm in this work because people are really authentic. they They really, even if they're not initially, they come to that place of authenticity.
00:30:43
Speaker
And the love, the love is huge. It's such a big part of it and boy, it's a really beautiful place too to be able to be a part of that.
00:30:55
Speaker
If the fear is there, you know, in life, if we're fearful of things, if we face those fears, then they usually become lessened or they go.
00:31:12
Speaker
And a big part of that, what we talked about before, is grieving. And that's not something that we in invite into our lives. It's not something that we see as a positive thing generally. It's not a place we want to go because it's uncomfortable.
00:31:28
Speaker
That's so important. Yeah.
00:31:32
Speaker
Yeah, we have so many of these assumptions. They're like scripts that run our civilization in a way and they beget all kinds of actions and I notice how many things we do are based on unquestioned assumptions and things would be entirely different if we looked at them differently or spun them around or flipped them.
00:31:59
Speaker
Death and and mystery and everything that is cast as dark and terrible and to be avoided at all costs, potentially there's there are so many opportunities there to...
00:32:13
Speaker
to really, as you say, face into those things and discover a surprise. Yeah, and even you know in the work that I do around after-death care as well, you know a lot of people see death as being really morbid.
00:32:28
Speaker
Getting old has become a bit like that too. When you have a vigil, for instance, with someone who's died, and you invite the community and the family, generally the family being part of that, but sometimes not,
00:32:44
Speaker
through fear and through it being something that you want to keep at arm's length. But when people step into that space, so often i am fed back, oh, so different to what I thought it was going to be to sit with that dead body.
00:33:05
Speaker
It's actually really beautiful and the atmosphere in the room is is really powerful and really wonderful. And it's often the case with our fear, isn't it? That that when when we're fearful about something, it's often the fear of that thing. It's much worse than the thing itself.
00:33:28
Speaker
Yeah. So what does the post-death care and vigil look like in your world? The first time i was asked to do that was with a friend of mine who was actually a midwife when my children were born.
00:33:43
Speaker
and i attended to her with nursing treatments for a couple of years before she died. And before she died she said to me, would you look after my body in a vigil at my home when I die?
00:34:00
Speaker
And I said yes, even though I'd never done it before. And I was um was a bit scared about it and didn't know anything and wondered how it would be and Anyway, we attended to her body with her daughter and it was a really beautiful experience and it was an extension of the care that that we'd already been giving her and it felt like a really beautiful, final, loving act to do that with her body.
00:34:36
Speaker
we go through a process of washing the body so we washed her in rosemary and we oiled her we used beautiful oils which are similar to what we used in Egyptian times as well we used frankincense and myrrh and we used gold as well and we laid her out in the lounge room of her house and The community was invited and her family came in from all over.
00:35:09
Speaker
And the feedback was really so wonderful. And after I'd done that, I thought, my goodness, why don't we do this with everybody? This feels actually so normal.
00:35:21
Speaker
The other feels so unnatural and weird, actually, if you have an experience of visual care the and the vigil itself. And the family, for the family, it was a wonderful time.
00:35:35
Speaker
ah grief was able to flow. People played music for Betty and they read to her from different beautiful texts and the whole idea within Anthroposophic Vigil is that you're supporting that person to cross over which can take a few days which is why the three day period is suggested and you see a change in the body over that time you see it becoming more kind of
00:36:12
Speaker
physical I guess you know that the life body has left by the end of that time and at first it feels like the body's breathing a little bit and still and yeah you just see a change happening and you see this incredible sculpturing happening with the face and nobility often with that person who's died it's so beautiful yeah It definitely struck me on the two occasions I've been sitting beside dying person just how beautiful that time can be, contrary to everything I might have thought.
00:36:50
Speaker
And it's actually the months and years and you know the time that spans out then once they've gone that can be very challenging. But during that process and even immediately afterward, just the sense...
00:37:05
Speaker
of love and even and joy that can surface maybe that's the the rawness and authenticity of people who come into that space too for once finally being able to connect on a deeper level family and friends and that kind of thing but those memories are to me like very very sweet and beautiful and I think you know some people don't want that they they're some people who are very private they don't want whole community around them.
00:37:36
Speaker
But even those people who don't want that, I still suggest to them, and it's only a suggestion, people do whatever they want to, but just because of that process, to allow that process to happen, at least that they have a time of being at home.
00:37:58
Speaker
So what is the role of community in one person's death? I know Stephen Jenkinson I'm not sure if you're familiar with his sort of work yeah and just love listening to him and he so strongly advocates for say you know our death my death being a gift to then the entire community and all those around me do you see that too I do I do, yeah,
00:38:28
Speaker
I think for some people it's too difficult, though, to make it a public thing, you know, and often with people who have got a lot that they're working with, that it can be really difficult.
00:38:42
Speaker
I think the actual dying time can be quite rigorous for people and to get people coming and visiting at that time can actually take away from the work that they're doing.
00:38:55
Speaker
So don't think necessarily the dying time is necessarily a public thing, but the death itself. Yeah, the more ah more we can have people feeling comfortable with that, the more exposure that people get, I think.
00:39:14
Speaker
Yeah, once upon a time it was very much a part of what happened. but i What i would see as one of the the gifts... in that treasure box of gifts is the facing into our own ending and limit and the cycle that we all inhabit that we mostly in this modern context deny or kind of separate distance ourselves from and that's one of the core reasons I'm so fascinated by this conversation and conversations about death because I see a huge connection between our apparent
00:39:55
Speaker
disregard for planetary limits and nature's cycles and law that's inbuilt. That means that everything returns to the earth and cycles through. Our phobia and taboo around death mirrors our obsession with growing and striving and getting to Mars. Like I see those things are so intertwined and despairingly I notice it in myself. I look I look in the mirror and the last couple of years, I'm just going through the time where you start to notice that you're getting older.
00:40:31
Speaker
And for a long time, you coast on this amazing illusion that that doesn't happen to you, that you're somehow above this this process that seems to afflict other people that you're not going to let happen to you.
00:40:44
Speaker
And I see the lines and I see the years and i rail against that. I think, no, ah need to put on a new cream. i need to cover that up. I need to be better and eat more collagen and drink more broths, like whatever I can do steal the hands of the clock, you know, and noticing that is so fascinating.
00:41:07
Speaker
I'm not okay with accepting the change in my life and the the waning of things. So yeah, I'd love to ask you, Pippa,
00:41:18
Speaker
what your relationship is with with death as a exiled you know in our culture and what the implications of that are. Yeah, I think what you're saying is absolutely right.
00:41:31
Speaker
That there is this more more attitude that we have and not the endings. And the endings are so important throughout our life.
00:41:42
Speaker
And, you know, that what you're talking about with getting older and... that we rail against that. We all you know find it very hard to let go of our youth, and yet how important is it to let go of our youth? and And rather than focusing on the physical side of what we look like, to to focus on what that actually brings as we get older. I mean, wow, when you think about what you knew in your youth and what you know now
00:42:18
Speaker
the riches that you have gained in that time in comparison to what you were in your youth is they're the things that we could focus on but we tend not to it's all about appearances and what's seen in our society as being important and yeah it's a big one and and I think it's one of those things again that we need to grieve that we need to grieve that we're not youthful any anymore I have arthritis and, you know, that I can't do what I used to. I don't have the energy that I used to have.
00:42:55
Speaker
All those sorts of things. And I find that I, periodically, I really shed tears about those things and have to let them go. And, yeah, life is all about endings, but we don't acknowledge that.
00:43:12
Speaker
And it it just is, actually. We do have endings, but we can deny it, but they're actually, they're always there. yeah And if we can engage with those endings, I think that's one of the biggest lessons about feeling comfortable with dying as well, is that if we engage with the endings in a deeper way, that sets us up for feeling more at peace with dying. Mm-hmm.
00:43:39
Speaker
Yeah, I think I've heard him talk about practicing losing things and not just misplacing them, not just putting them away for you to find later, actually losing them.
Accepting Loss and Planning for End-of-Life
00:43:49
Speaker
Yeah. and Or giving them away. It's challenging. Yeah.
00:43:53
Speaker
Giving them things that you love away. Yeah. I wasn't surprised that I was flooded with... questions when i put i put the question on instagram hey, what do you ask want to ask people why palliative care nurse?
00:44:06
Speaker
And I know we've probably touched on a lot of things that people brought up, but i just wanted to maybe run through some of those questions and if you have an answer, a short answer, speak to them, or if not, just say pass. But I really appreciate people's enthusiasm and and co-hosting the interview really is it's lovely for me to have a scaffolding so yeah a lot of these questions are kind of amalgamated together but thanks to everyone who sent questions in Tony who is a member of my patreon I had some beautiful questions and one of them was what system changes would need to happen for our society to have better deaths and lives and
00:44:54
Speaker
Quite a comprehensive one there, but do you have any thoughts on that? I can speak to a lot of different aspects of that. And I guess, you know, what we've been talking about, if people engage with their life in a really rich and deep way, then that will change the way they are in their death.
00:45:16
Speaker
You know, ah you often hear people say that people die the way they've lived their life, and it's absolutely true. So I think that that really makes a difference.
00:45:27
Speaker
I think if we engage with the questions around death, I always suggest people look at what is on offer with advanced care planning because it really makes you think about what you would like around dying.
00:45:42
Speaker
because we don't know when we're going to die and young people die too and people who are not ill die too. So with an advanced care plan, it really and makes you think about what it is that is important to you, what your values are and what you would like in your death time.
00:46:03
Speaker
Hospice care is the palliative care that we have at the moment.
00:46:09
Speaker
And it's institutional care. And it has very strict guidelines. You have to follow the government protocols and all that sort of thing.
00:46:20
Speaker
I visited a hospice in New South Wales, which is called Wedgetail Retreat. And it's a four-bed place. It's privately run.
00:46:30
Speaker
People don't have to pay who go there. It's all run through raising money through various means. and people do give money to the place in their wills. Anyway, i visited that place.
00:46:45
Speaker
It's run by an incredible woman who started out doing community care with people who are dying. But that place, it's small.
00:46:57
Speaker
Families can stay there. They have a resident dog there. They have a nurse on 24-7, and they have a visiting doctor who comes.
00:47:09
Speaker
So small places like that, to me, would be a much, much better way of going forward if you were wanting like a ah system that I think works in a more humane way.
Challenges in Hospice Care and Cultural Perspectives
00:47:24
Speaker
Not saying, I mean, hospice care, the nurses that work in hospice care generally are really warm, kind people and it's it is just generally in our medical system that things are done in a particular way there are certain protocols and it doesn't have a lot of room to move so yeah something smaller like that we've been having a lot of talks here in castle main about trying to get something like that happening yeah it sounds beautiful i can recommend a greyhound as the therapy dog
00:48:03
Speaker
you have one i do He actually, i mean just, yeah, random aside, he ended up being put to sleep with the lurid blue chemical cocktail that they pump into them that I really wasn't expecting. hadn't had an animal put down before like that.
00:48:22
Speaker
And it just, I just wondered, should i should I have done that, made that call and taken that from him? And then on the other hand, I couldn't bear seeing him in those throes of suffering. yeah It's kind of akin to what we're discussing with with the numbing and the drugs and yeah, our perspective on that I suppose and our, I mean especially with animals, unfathomable experience that they're having.
00:48:56
Speaker
Yeah, it's really difficult. It's a very challenging one for me too. I've had a couple of animals euthanized and
00:49:06
Speaker
ta I felt that I had taken their life, that I was like God taking their life maybe before. But like you say, it's this dichotomy of watching them suffering.
00:49:18
Speaker
and And I guess for me, the question is, well, how would that dog be in the wild? How far would that dog have gone?
00:49:32
Speaker
And I've extended this dog's life already. There's all these questions around it. I don't think it's a straightforward, easy... Well, greyhounds wouldn't exist in the wild. they're just They need jumpers and warm beds.
00:49:44
Speaker
Yeah, yeah, yeah. Well, I liked Lucy's question. Where is it? How do you support or manage family members who are in denial and finding it hard to face death?
00:49:59
Speaker
I'm in the fortunate position where I'm working with people in their homes so generally the family are pretty much on board. When I worked in hospice care sometimes that was really tricky and in some cultures it seemed to be unkind to speak to the person who's dying, ah that they're dying.
00:50:25
Speaker
So there's this whole denial or even cultural thing around, you know, that if you say someone's dying, it's almost like you're bringing on the death.
00:50:38
Speaker
And, yeah, I think, again, that's very much a cultural thing our society as well, that denial of death often is associated with if you...
00:50:54
Speaker
If you accept that person's going to die, then you're going to bring it on faster. I'm pretty straight with people. And often ah I'll talk to the person who's dying initially and ask them what they would like.
00:51:10
Speaker
And if they would like me to talk to that family member. And... If they don't, I respect that. I won't do that. But if they do, then I will speak with a person and tell them that that person who's dying actually wants to that to be acknowledged and that it's really important that that person would actually like to be able to talk about that.
00:51:38
Speaker
Yeah. So it's pretty simple, really. But you do have to be careful. about where you tread. And i always am working on behalf of the person who's dying.
00:51:54
Speaker
So it's really led by that person. What I experienced in hospice care was someone who's dying and their family were trying to force feed them.
00:52:05
Speaker
And I would step in at those times to just say that that's, you know, that's actually harming the person to do that.
00:52:17
Speaker
So yeah, depends on the situation. I haven't worked with children that much who are dying. in fact, I haven't really worked at all with children who are dying.
00:52:32
Speaker
have with younger people.
00:52:36
Speaker
And there's always this sort of attitude that if a young person dies, it's really unfair. that they haven't lived a full life and it's really unfair.
00:52:50
Speaker
And yes, it's terribly tragic for a parent or a brother or sister to lose a young child or a young person. But it's also, think it's really good to remember that that person, even though they may have been ah child or a young person, they actually did lead a full life, but it was a short life.
00:53:13
Speaker
And, yeah, I think it's actually really important to remember those things too.
00:53:20
Speaker
In amongst the grief.
00:53:25
Speaker
Yeah. I'm surprised there aren't more splashes on my notes here. I've got a couple, but that was from my drink bottle, but now there might be more genuine ink stains and blots.
00:53:37
Speaker
Let's see. Let's go for it. One or two more. A couple of people asked you more practical questions about themselves forging careers and pathways into either palliative care or doularing and how you make that work. One person, Christine, is asking very pointedly, how do you make it work financially or as a career?
00:54:00
Speaker
And then a couple of other people ah just generally curious about pathways you would recommend to be able to even hold this space for friends and family, if not officially.
00:54:12
Speaker
With the first one around how you make it work financially, that's been a tricky one. um I'm in a fortunate position where I don't have to earn money.
00:54:24
Speaker
So i have, like, working as a nurse is easier than getting the work than a death doula, I think. um And I've been able to work in in situations like I worked at the Melbourne Therapy Centre the GP practice and because we saw a lot of people there who had cancer who I would see giving treatments there I would follow into their homes so they were used to paying for the treatments and that would just continue on then when I went into doing private work when I stopped working at the therapy center because I was known in the community
00:55:04
Speaker
Again, people are expected to pay, but I had a system where it was ah by donation. So people would pay what they could, and sometimes that was very good money, and sometimes it wasn't very much.
00:55:20
Speaker
And because of my situation, being supported by my husband, it worked okay. It's worked fine for me. But I think that's been a question for a lot of death doulas.
00:55:33
Speaker
It is hard to know, and it's costly for people, for some people who just can't afford it. And so for me, coming into palliative care later in my life as well, for me, it was really out of a,
00:55:52
Speaker
a desire to do the work, not to make money necessarily. And ah it's really great for me because in that space, sometimes it's really hard to ask for money if people don't have it.
00:56:06
Speaker
So sometimes community is past the hat around just because that person has wanted that. But yeah, I don't put a lot of pressure on people in that way.
00:56:17
Speaker
Yeah. One question I really liked that a couple of people asked including Talia and i think Mia. It was about documenting, both documenting someone's life and then creating keepsakes and whether you had any ideas around offerings for friends and family or beautiful ways to honour someone's life, whether that's creatively or in a more practical kind of documentarian
Honoring the Lives of the Dying
00:56:48
Speaker
style. Is that something that your work covers?
00:56:51
Speaker
think that's really very individual. With documenting someone's life, That's something that many people do in someone's dying time where a biographer will sit down and do the biography of that person and then make it into a book with photos and that sort of thing as well sometimes.
00:57:14
Speaker
I think that's really lovely for the person who's dying as well. Because think one of the things that people often find very difficult when they're dying is feeling that their life has been worthy.
00:57:31
Speaker
And when people do a biography of their life, often it really points out the worthiness that that person has lived.
00:57:42
Speaker
Yeah. So it can be useful um in many ways. And it can also help people working through emotional stuff as well. Yes, I think that biography work can be wonderful.
00:57:57
Speaker
And keepsakes. I don't know what what you... I'm not quite sure of what the question is because often someone who is dying will actually want to give things of theirs to various people as a keepsake, something to remember them by.
00:58:22
Speaker
I know there's these things that people do with ashes, putting them in bottles and all that kind of stuff. That's not really my thing. So, ah you know, if that floats your boat, great, but that's not really my thing.
00:58:35
Speaker
Yeah.
00:58:37
Speaker
And suppose finally, out of curiosity, as someone who witnesses death and i assume has really reckoned with that as ah fundamental thing,
00:58:52
Speaker
human experience what has that taught you about living a good life well what i said before about having a little window in to the reality of spirit that's been fundamental to the way i live my life that that is a really important thing in my life And I think also very much the whole thing of how important it is to grieve.
00:59:25
Speaker
So important to grieve. So that we can breathe and love and feel things deeply. Because that's what's going to save our planet. That's what's going to save humanity.
00:59:42
Speaker
I don't know if you've come across a fellow called Martin Prachtel in the book that he's written on grief. I think that's a wonderful book. And Stephen Jenkinson's stuff, I recommend to everybody too to read both of those people or listen to them speaking because they go to the depths of things and they're very articulate.
01:00:05
Speaker
And the other thing is how the similarity oh birth and death as well. If we are open to those threshold times that, you know, one's entering and one's leaving.
01:00:27
Speaker
But if you feel the forces that are around those times, they are so similar.
01:00:35
Speaker
The first death that I was at was actually in a psychiatric hospital, ah Mont Park, which was a horrible place. I thought that I would be a psychiatric nurse.
01:00:46
Speaker
This was when I was in my 20s. And... and
01:00:52
Speaker
only lasted seven months. It was a horror house, actually. But this woman was dying, and it was in ah a big dormitory-style room, huge, so no privacy, nothing very clinical, very sterile, horrible.
01:01:10
Speaker
And i was able to sit with this woman while she was dying. And even in that atmosphere, the beauty that surrounded this woman was pivotal to me, my interest in in death. And I'd been to a number of home births and the atmosphere around her was exactly the same.
01:01:41
Speaker
I don't know, but i have the concept, I guess, that there are angelic forces that are around at that time. and it was very beautiful, yeah even in that horrible place.
01:01:55
Speaker
There was a question there that um I didn't answer, was someone who was asking about doing the death-doolering for family, and all I can say is there are death-doolering courses that you can do. um There's a few in Victoria, online, and to go to as many deaths, if there vigils to go to as many.
01:02:23
Speaker
um I do have workshops as well where I do demonstrate the whole laying out with people. um
01:02:36
Speaker
But yeah, the more more you associate yourself with death, the more you'll feel comfortable with doing that with a person. It's fairly simple.
01:02:48
Speaker
Sometimes it can be a bit tricky, but generally speaking, it's fairly straightforward. Ah, well, it's been so beautiful sitting in your home today for this conversation, Pippa, and it feels very cosy on this kind of...
01:03:04
Speaker
bleak winter day, being able sink in to this conversation. I really, really appreciate it. Thank you. Thank you. It's been great.
01:03:18
Speaker
That was Pippa White, who's based around Castle, Maine in central Victoria and is part of the Anthroposophical Society of Australia's Palliative Care Circle. I've linked her contact details in the show notes as well as everything else we referenced.
01:03:32
Speaker
Next episode, I will be chatting with Geordie Boy about sacred hunting, questionable renewables, forest vigils, multi-generational living and how to know when you're seeking novelty versus following your ticker.
01:03:44
Speaker
I think. We still need to record it, but that's what we're usually talking about at 8pm with a cup of rooibos tea and goat's milk. Catch you in a fortnight, and thanks for lending your ears to Raskillians.