A talk given by Ven. Kirti Tsenshab Rinpoche to the staff and volunteers of the Karuna Hospice Service in Brisbane, Australia, on 29 September 1992. The interpreter is Dhawa Dhondup. Transcribed by Elizabeth Nielsen. Edited by Ven. Pende Hawter. Second light edit by Sandra Smith, September 2023.
Whether a person has great learning or is very famous or has great power through their social status, for all these different types of people, when they become sick and are dying it is a situation that is very poor, destitute, deserving of sympathy. This is equally so for everyone. This being the case, if we help people in such destitute situations, it is extremely beneficial and whoever helps others in such a situation is really a person to be wholeheartedly admired.
In the world there are many different religions, many different spiritual systems, and in their basic approach they all try their best to help others. This is especially for those who are sick, for those who are about to die and are in situations of extreme destitution or deserving of sympathy. And amongst different belief systems or religions, such as is apparent in Christianity, we see monks and nuns actively engaging in activities to help others, such as the sick and dying. They also set up clinics, hospitals and so forth.
In accordance with Buddhist practice, to actually help others becomes the practice of the bodhisattvas (beings who are totally dedicated to others). It becomes the practice of the bodhisattvas and it also becomes the actual implementation of the teachings of the Mahayana, the Great Vehicle path.
The Great Vehicle teachings and instructions have always been there to help others, especially when others have been in extremely destitute situations. But actively setting up an organized or structured system like a hospice, such as you have done, and then actually implementing the teachings of the Great Vehicle path is something which has not really happened in the past. It is an extremely admirable thing to do and Buddhists from around the world, especially practitioners of the Great Vehicle teachings, can look up to it as a good example to follow. It is a project which has great significance and is worthy and deserving of admiration.
So the actual implementation of the Great Vehicle instructions is being done here and would have come from the initiative, the thought or intention, of Lama Zopa Rinpoche. But even though it was Lama Zopa Rinpoche's intention to set up the hospice and so forth, it is actually you people who have taken responsibility for implementing the Great Vehicle practices to help others. It is admirable that the volunteers and other members [of Karuna] have voluntarily taken upon themselves the responsibility to help others because no one has forced you to do this. I extend my heartfelt thanks to all of you and I also request you all to continue this work in future.
From your side, you are implementing the Great Vehicle path, in which the main emphasis is to benefit others, especially with a good heart. The clinic or the hospice itself is called “Karuna Hospice” which means “Compassion Hospice.” The name of the institution corresponds to the work you do. The name and the meaning are identical, and it is therefore a magnificent thing to live up to.
Regarding how to help someone who is sick and who is going to die, I will briefly explain this in two parts—how to help before death and how to help after death.
There is a huge difference between helping others with the motivation of compassion, of a benevolent mind, and helping others without it. The difference is like the difference in size between space and the palm of the hand.
According to the practice of the Great Vehicle teachings, if we help others with a good heart, with the motivation of compassion, it becomes extremely meaningful. Through this we can also achieve our own interests or welfare, both for this life and for future lives, through the accumulation of merit, purification, etc. The impact is much bigger if our motivation is in accordance with the Great Vehicle path rather than just helping without such a motivation.
When we are helping someone who is dying, we need to maintain gentle behavior of all three doors, that is, in our physical handling of the dying person, through speech and through our mental attitude. We need to handle the person with as much care and gentleness as possible and that means helping with gentle physical actions.
The dying person may become frustrated and irritable and may say things which are quite likely to make us angry, but it is important not to become angry. We should treat the person with care and loving kindness, like parents do with their children. If the relationship between the parents and children is good, then no matter what the children say, the parents do not become angry but continue to be loving and kind toward them. So whatever sorts of things the dying person may be saying to us which may provoke anger or irritation, we must try to practice patience and speak in a very gentle voice. So that becomes helping through gentle speech.
Then through our mind we maintain the motivation of loving kindness and compassion, the enlightenment mind. On the basis of this gentle approach with the three doors [of body, speech and mind] we can offer additional help. If the dying person has the clarity of mind to respond, we can advise them according to the religious system they believe in or follow. If the dying person is a Buddhist, we advise them to rely on the Three Jewels, the Buddha, Dharma and Sangha. We try to direct the dying person's mind towards that object of refuge. If the dying person is responsive, we can also advise them to recite OM MANI PADME HUM [the mantra of Chenrezig, the Buddha of Compassion] or other profound mantras. The dying person can also be advised to make requests, prayers and so forth to various deities such as Chenrezig. Through this appropriate approach through the three doors, we try to benefit the dying person by pointing their mind in the right direction.
When death occurs, there is the dissolution or weakening of the elements in the body—the earth, water, fire, wind or air elements. At this time, when the signs of death are occurring and the person is definitely going to die, you can help the dying person by reciting profound mantras into their ear, such as the mantra of Chenrezig (OM MANI PADME HUM) or other profound mantras. Or you can put powa (transference of consciousness) substance on the dying person's crown. You already have some of these powa pills, which have been blessed by His Holiness the Dalai Lama and Lama Zopa Rinpoche, so you can put one of those on the person's crown. If any of you can do the transference of consciousness practice for others, you can also do that for the dying person. Both of these methods can help the dying person.
You can also tell the dying person, if their mind is clear and responsive, to please stay relaxed, because you are reciting these prayers and profound mantras for their happiness, for their benefit. They don't need to worry. If the dying person is aware and has a clear mind but is unable to recite the mantras and so forth themselves, you can advise them to maintain a faithful attitude while you are reciting the mantras into their ear.
There are other things which you can use to benefit the dying person. For instance, there are blessed pills called mani pills, “the precious compassion pill,” and these can be given to that person. If the dying person is a believer, you can tell them that such and such a precious pill is being given and will benefit them. If they are not a believer it is not necessary for them to know what is being given, that a very special blessed or precious pill is being given. The pill can be administered in a disguised way, by mixing it with water or with meals. In this way you can help at the time of death.
If the dying person is still not dying and remains chronically ill, you can advise them to say prayers or mantras. In most cases the person who is helping the dying person would form a relationship or some familiarity with that person. It is natural that the dying person likes the person who is helping and will therefore listen to or respond to whatever advice is given ... [change of tape]
[You can recite] the mantra of Chenrezig, the mantra of Buddha Amitabha or a brief going the the refuge mantra, such as Namo Buddha, Namo Dharma, Namo Sangha, and so forth. You can also show the dying person pictures, statues, paintings etc., of Chenrezig, Medicine Buddha and so forth, explaining that if there is visual contact with such profound objects of refuge, such deities and so forth, they will benefit from this. In these ways they can be helped.
If the person has still not died after a lengthy illness, both the person who is helping and the dying person will find the days long and tiring. If that happens the helper can read inspiringly beautiful life accounts of the Buddha and past teachers. As well as that, you can also occasionally say to the person, “I am going to recite this prayer or this profound mantra. How about you recite or sing it together with me?” In this way you can sort of play a trick and make the long day into a short day.
Sometimes the dying person may not like to engage in spiritual activities, such as the reading of life accounts and saying mantras. In such cases there is no point insisting that they do those things. The sickness and the torment of being close to death can cause them to be unhappy and by pushing unwanted things onto them it can cause additional unhappiness. In these cases, it is better to leave [spiritual matters] aside and try to adjust your help and approach in accordance with the likes and disposition of the person.
Sometimes you can go over the life account of the Buddha or of past teachers, telling the story based on an actual demonstration using thangkas or paintings, and through this, the dying person listens to such things. This may help to make the day seem much shorter.
The whole approach can be applied differently. For example, even an old person can sometimes have a childish mentality of wanting to have company and to play, which is natural. In such cases you can offer companionship, like when kids want to have a playmate. Such company helps the day go nicely and, in this way, you can help the dying person. You can also speak to the dying person in a funny or comical way, and this would be good because it would make the time entertaining.
That, then, is how you help a person who is about to die. For a person who has already died, you can help if you are able to perform purification rites. “Rites” is the meaning of the second part of the Tibetan word choga. If you are able to perform these purification rites you can do so, otherwise recite profound mantras, such as those of Chenrezig or Amitabha. Then for at least a few days after the death try and dedicate your activities to benefit the person who has died.
[Here in the West] most of the bodies are probably cremated. If possible, it is good to take some of the bones remaining after the cremation and recite profound mantras over them, such as the mantra of Buddha Mitukpa (Skt: Akshobya), also known as the Immovable Buddha. The mantra of Amitabha Buddha and so forth can also be recited over the bones. This practice can be very beneficial.
For the relatives and those connected to the deceased you can give them consolation and try to help them in any way you can, to stop them from feeling depressed, mourning and so forth.
In these ways it is very good to help others who have died as it becomes the practice of the Great Vehicle path, to actually help others. It is beneficial for us, as well as for others.
For people who have died it is good to keep records of their names, date of death, the help you gave, etc. Then at the end of each year you can send their names to sublime teachers such as Lama Zopa Rinpoche and His Holiness the Dalai Lama and request them to do special dedication prayers. For example, if at the end of the year you submit the names to His Holiness the Dalai Lama there is a two-fold benefit. First, the deceased have dedications and prayers done for them by His Holiness, and secondly, His Holiness becomes aware that you have done such meaningful and beneficial activities and have accumulated merit in this way. So it is extremely meaningful. At the end of the year, you can also submit a list [of names of the deceased] to the great monasteries and nunneries in India where there are many Sangha, ordained practitioners. If these practitioners say prayers for the welfare of the deceased it can be extremely helpful, beneficial.
It is also beneficial for you to dedicate for the deceased person, because of the karmic connection between you and this person. It is only due to the karmic connection that you have come into contact with the dying person in the first place and are there to help them. You are making the dedications for someone who you are [karmically] related to. In a similar way it is very good to think, when you submit the names and make requests for prayers for the deceased, as though it were your own partner who had died.
So you are giving great benefit to others who are in a situation of great destitution and from the teaching point of view it is the practice of the bodhisattvas, the great scions, the offspring or followers of the victors, the buddhas. This is because for bodhisattvas there is a special practice within the perfection of patience known as voluntarily accepting or bearing suffering. This is one kind of patience, so helping others [as you are doing] and bearing the hardship of taking this responsibility is the practice of voluntarily bearing suffering.
The name of this institution/hospital/clinic is “Nying je Hospice” in Tibetan, or “Karuna Hospice” in Sanskrit, meaning “Compassion Hospice.” This is very meaningful because what you are actually doing corresponds to the name. The real meaning can be understood as “the hospice of patience voluntarily bearing suffering,” so it has this profound meaning.
In summary, for the amazing work you are doing and the responsibility you are taking, I feel great admiration and I wholeheartedly praise your efforts.