Lake of Lotus (34) - The Profound Abstruseness of Life and Death-The Meaning of NDEs (34) - by Vajra Master Pema Lhadren-Dudjom Buddhist Association

The Profound Abstruseness of
Life and Death
The Meaning of
Near-Death
Experiences (34)
By Vajra Master Pema Lhadren
Translated by Simon S.H. Tang
How to Make the Best Arrangements on Leading Out of Pain and Guiding in Peacefulness
for Patients and Dying Persons
How to Prevent Wrong Decisions by Patients in Hurting Themselves
How to Help the Patients to Live More Positively and to Avoid Pointless Traumas
Excerpt of Last Chapter: Various

Reasons on the Formation of Different
Scenes at the Moment of Death
The scenes at the moment of death can be roughly classified in the following categories in accord with the varieties of
the main causes and auxiliary conditions:
1. The Separation of the Four Elements the main cause

(the internal consciousness and sub-consciousness,
including all kinds of memories) conjoins with the auxiliary conditions (the Separation of the Four Elements
in the external circumstances) in forming the scenes at
the moment of death (please refer to the articles on The
Meaning of Near-death Experiences in Issues 8 and 20
of the Lake of Lotus).
10
Issue no.34
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1. Protectors or avengers: (i) good ones saw kith and

kin who had passed away, unknown protectors,
deities or Buddhas coming to fetch for oneself
(ii) bad ones being besieged by a crowd of ferocious persons or beasts, and going along in
company with groups of people who looked
confused.
2. Strange places: (i) good ones saw pavilions, balconies, buildings, flower fields, rivers, light zones,
towns or cities.
2. The Endorphins Inside the Brain the main
(ii) bad ones saw wilderness, forests, darkness,
cause (the internal consciousness and sub-
caverns, hells.
consciousness) conjoins with the auxiliary conditions (the endorphins inside the brain of the
3. Messy Issues that cannot be recalled clearly.
external circumstances) in forming the scenes at

the moment of death (please refer to the article
How would the Buddhist point of view comment on
on The Meaning of Near-death Experiences in
these phenomena? According to the Buddhist teach-
Issue 21 of the Lake of Lotus).
ings, it was said that rebirth would take place within

forty-nine days after a person has passed away, then
3. The Karmic Forces the main cause (the in-
why would a dying person see the kith and kin who
ternal consciousness and sub-consciousness)
had passed away long time ago still coming to fetch
conjoins with the auxiliary conditions (the kar-
for him or her? Why had not the kith and kin taken
mic forces of the external circumstances) in form-
rebirths after so many years posthumously? Are the
ing the scenes at the moment of death. This can
appearances of these deceased persons merely the
be further classified into the following two kinds:
illusions of the person who is going to die? Or were

they really true? Are there any other reasons? Are
i. Wholesome Ones arising from: (a) virtuous
those strange places the destinations where they are
retributions (please refer to the article on The
going to be reborn into? Under what circumstances
Meaning of Near-death Experiences in Issue
would the normal rebirth of a dying person be nega-
21 of the Lake of Lotus); and (b) the efforts of
tively encumbered? Is there any way to help a de-
ones Dharma practice (the main theme of this
ceased person to avert sufferings and elevate to a
article in this issue).
better place of rebirth?
ii. Unwholesome Ones arising from: (a) vicious
Human beings have four kinds
retributions; and (b) the forces of karmic credi-
of conditions of conscious-
tors in seeking compensations on ones karmic
ness (please refer to the
debts.
article The Wisdom in

Directing Ones Dharma
According to the records of different surveys, most of
Practice in Issue 26 of the
the dying people had seen the following scenes:
Lake of Lotus) as follows:

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1. Beta waves the conscious condition of daily liv-
What is the Ultimate Assistance

in the First Stage of Approaching
Death?
ing;
2. Alpha a waves the relaxed consciousness condition, such as in entering into the elementary stage
The care-givers, kin and kith and professional
of visualization, or at the first stage of mental
counselors should perform the following steps when a
concentration; or the condition when the spiritual
dying person is approaching the first stage of death:
body is slowly separating from the physical body;

3. Theta O waves the peaceful conscious condition of having entered into higher levels of
visualization, or at the deeper levels of mental
concentration;
4. Deltawaves slow conscious condition of not
having any dreams, and in a stage of slow-wave
deep sleep.
In fact, how does the arising of
the different stages in approaching death and its transformation of consciousness affect the
thoughts and behaviors of dying
patients? What are their relationships with the scenes
1. Accepting and Understanding
at the moment of death? How should the fam-
2. Listening and Observing
ily and kin and kith who take care of the dy-
3. Analyzing and Adopting
ing patients respond to the transformation of con-
4. Leading Out and Guiding In
sciousness and change of scenes at the moment of
5. Accompanying with Unspoken Consensus
death for guiding the emotions and spiritual direction of the dying patients? Could the transformation
The key points of application and their importance
of consciousness and the change of scenes at the
on the issues of Accepting and Understanding and
moment of death be comple-
Listening and Observing had been clearly
mentary to each other? Further-
highlighted in the case studies of the pre-
more, the disintegration of the
vious chapters (please refer to the articles
Four Elements of the physical
on The Meaning of Near-death Experienc-
body also affects the trans-
es in Issues 29-30 of the Lake of Lotus),
formation
consciousness,
as well as on the issue of Analyzing and
as well as on the change of
Adopting by the dying persons (please re-
the scenes at the moment of
fer to the article on The Meaning of Near-
death. Hence, how should one
death Experiences in Issue 31 of the Lake
support and provide guidance
of Lotus) have been clearly explained. Yet,
to a dying patient in order to re-
even when these are done hundred percent,
duce or resolve the predicament
there are still many obscurations. In order
of
from these problems?
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that both the care-giving family
have tremendous negative im-
members and the dying patients
pacts upon the seriously-ill, or
do not have remorse which will
the dying, person.
be too late to repent later on, but

only ultimate offering in farewell
Seriously-ill persons, such as
with a heart-to-heart connection
terminal cancer patients, usu-
and having no trace of regret,
ally face the threat of death.
the above-mentioned third to fifth
Psychologically it is unbear-
steps should be included in the
able to them. Physically, they
issues that must be done when a
are frail, lack of appetite, mal-
dying patient is approaching the
nourished, and short of pro-
first stage of death.
tein. Edema is developed onto

the whole body due to poor
There are at least two parts to the
blood circulation.
issue of Analyzing and Adopting. The first part of Analyzing and Adopting is to
Care-givers and kith and kin who are responsible for
be directed by a dying patient, while the second part
provision of care, especially Chinese people, always
of Analyzing and Adopting is to be directed by the
consider it is fortunate to have an opportunity of
care-givers, kin and kith and professional counselors
dining. When they find the patient or dying person
have already been discussed in the last two chapters
gets frailer and frailer day by day, under the emotion-
(please refer to the articles on The Meaning of Near-
al torment of being unwilling to let go and self-reproof,
death Experiences in Issues 32 and 33 of the Lake
they always think of giving the most nutritional soup
of Lotus). Now we are going to discuss the fourth
or the patients favorite dishes to them. They push
step on Leading Out and Guiding In.
hard on the patient or dying person in expostulation

of taking the food. Usually the patient or dying per-
How to Make the Best Arrangements on Leading Out of Pain and

Guiding in Peacefulness for
Patients and Dying Persons
son would try hard to swallow the nutritional food as

it is ungracious not to accept the kindness and to
disappoint the family with hospitable wishes.
However, the fact is that since digestion of the serious-
In order to provide good caring for
ly ill patients or dying persons is very poor in health,
the patients or the dying per-
so they would become too full and uncomfortable if
sons, care-givers, kith and
they over dined. Consequently, they might even be
kin would generally endeavor
eating less and less. Eventually, even when nasogas-
their utmost to give the best
tric intubation is applied, due to poor digestion of the
things of what they sup-
patient, it is not feasible to carry out feeding and as a
pose to have for the patients.
result, one has to administer intravenous drip which is
However, would the best
commonly known to be nutritional injection. Besides
things that they are sup-
high protein, rest of the supplies is merely glucose
posed to have are really
water at large. These were taken to be nutritional sup-
suitable for the patients or
plies for the improvement of ones physical strength,
the dying persons? Im-
however, would turn out to be a burden to the terminal
proper caring could specially
cancer patients.
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them in serenity. The followings are a few facets that

Therefore, care-givers and kith and kin who are re-
need to be noted:
sponsible for caring of the patient must realize the

fact that eating more does not mean
1. Collection of relevant information centering on the
living longer, while having success
real benefits of the patients One should collect
in feeding into the body does not
relevant information about the physiological and
necessarily result in proper egest-
psychological changes at the end stage with
ing out. Feedbacks of some of the
respect to the diseases from the professionals or
physicians indicated that many rela-
information centers as soon as possible for a way
tives of the patients frequently
of proper caring and comforting for the patients
request them to administer
could be followed. For instances, physicians,
intravenous drip to the
patients associations, auxiliary hospital depart-
dying terminal cancer pa-
ments, social workers and etc are sources of infor-
tients for supply of nutrition
mation. One should not casually take the hearsays
and water. Relatives hope that the patients would
serious, and neither should one submit to de-
depart in the condition of being fed. A fed ghost is
mands of the patients. One must seek for profes-
better than a hungry ghost.
sional advices to attain balance between conflicts

and crashes. All decisions should be centered
Under such circumstances, the patients would be
on the real and genuine interests of the patients.
subject to unnecessary pains. Since the nutrition
Leading in professional information, while guid-
supplemented via intravenous drip could not be
ing out innocent damages.
absorbed, and so the excess water might cause increase of secretion in the respiratory tract, inability
2. Take care of ones body and mind for confronta-
in urination, worsening in pleural effusion or ascites.
tion with the long-lasting difficulties in the future
As such, the nurses also have a hard time to locate a
One should seek for reliable support to the
vein for syringing.
belief for taking good care of ones body. In order

to have adequate strength so that one would have
Intravenous drip would certainly improve the patients
good conditions of both body and mind to take
condition of the consciousness but at the same time,
care of the patient, care-givers and kith and kin
patients sensation of pain would also be enhanced.
must learn to take care of themselves first. One
Moreover, it would be more difficult in treatment of the
should not overlook to take care of oneself due
corpses in the future. For instance, it is usually dis-
to worries about the patient.
covered that water would infiltrate through the pores
Overlooking of caring about
gradually after the patients death because of excess
ones own self would not
storage of water due to unnecessary over injection
only weaken the ability of
while alive.
taking care of the patient

but also add the remorse to
Thus, the care-givers and kith and kin must have
the patient. Thus, care-givers
some medical knowledge and at the same time, they
and kith and kin should
have to be rational such that they would be able to
know that once they have
truly maximize the effect of leading out the pain from
endeavored the utmost then
the patients and the dying persons, while guiding
they would not have any fur14
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ther
regret.
The
care-givers
should
not
allow themselves collapse before the patient does.

Leading in the health of both body and mind,
while guiding out negligence and depression.
How to Prevent Wrong Decisions

by Patients in Hurting Themselves
3. Allow the patients to realize the actual conditions
for better cooperation in arrangements Most of
the time, patients do not know exactly their own
conditions. One of the main reasons is that once
the patients realize the seriousness of the disease,
they might have emotional reactions which can
be classified into several stages. In general, they
would go through the six stages of shock, denial, anger, grief, bargain and acceptance. They
heard of miracles through praying together with the
might even appear to be easily upset (like a child),
religious brethrens/ fraternity. He then refused to have
not resigned to, not letting go, fear, despair, apa-
surgical excision of the tumor. After totally immersing
thy and etc.
in the joy of praying with confidence for a pleasant period of half a year, the patient truly believed that if one
Care-givers and kith and kin should pay attention to
is in a mood of activeness and joy, miracles could be
the mood of the patients. Patients still in the stages of
made possible to cure the cancer. Nevertheless, after
shock, denial, anger, depression or bargain would
half a year, cancer cells metastasized to numerous
have their focus on the tangle of emotion so the issues
sites without reservation. The patient experienced
of seeking for appropriate medical treatments and
the pain of unmanageable symptoms and his life also
funeral arrangements might have been overlooked.
rapidly came to an end. Moreover, the aftermaths,
They would focus themselves on miracle cases. Any-
such as funeral arrangement, could not be organized
body who provides medical treatments such that the
in a timely manner. The deceased was forced to depart
patient could survive like a miracle would attract
with a heap of regrets. There are plenty of such cases
them to wholly devoting their hopes to it, regardless
about lapsing of critical moments for medical treat-
of whether this is the truth or not. They might even
ment. Most of the time, the patient and kith and kin do
endeavor all their resources on it, and thus might
not know the patients condition, which leads to a fault
have missed some of the opportunities for effective
that cannot be remedied.
medical treatments. Consequently, the symptoms

progress to an unmanageable
There are also patients who are more positive and
situation. The pain of wors-
optimistic. They might be in the moods of positive
ened symptoms accelerate
emotional response, a will to fight back, courage,

calm, hopefulness, confrontation, leading a more
the fall of death.
positive life, seeking for the meaning of life, preparFor instance, there has
ing for or handing over issues about the aftermath,
been a case about a
surrendering to ones destiny, and so on. In short, no
cancer patient who had
matter whatsoever emotional response that the

15
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would add to the weight of the already heavy burden

of the patient. It might even lead the patient to make a
regrettable decision. Leading in rational realization,
while guiding out wrong decisions.
How to Help the Patients to Live

More Positively and to Avoid
Pointless Traumas
4. Help the patients to live more positively and to
avoid pointless traumas Disclosure of the patients condition is a piece of art and it needs to
take utmost cautious attitude in handling. More
patient might have, it is normal. Dont anticipate
deadly is the disease more cautiously should one
that the patient would be confined to a stereotype of
make a plan for disclosure of the illness. Once the
response for emotional relief because the response
patient is diagnosed of cancer, one of the follow-
of each person differs from each other.
ing four situations may occur: It is, indeed, the first

time in the history of Hong Kong that such a large
What the care-givers and kith and kin need to do is
scale event on the topic on Scientific Evidence on
to seek for advice from the relevant professionals
Near-Death Experiences A General Discussion
or experienced people in accord with the emotional
of Life and Death will be explored and open to
stage of the patient. The objective is to let the patient
the general public. It is an unprecedented event
correctly realize his own condition so that he would
on the dissemination of high-level knowledge on
be able to precisely master his future situations at an
the topic of Life and Death and has never hap-
appropriate timing, appropriate circumstances and
pened before, such that it is most fortunate for our
appropriate conditions. When the worst outcome is
Hong Kong people to have such a rare opportu-
anticipated, one would then be able to finely map out
nity to broaden their vision and horizon on Life
the best and most thorough arrangement. Conquer
and Death.
the fear of death and you are put into possession of

your own life.
Correct realization is the best way of confrontation,
and it is also most likely to discover a method of best
arrangement. The responsibility of care-givers and
kith and kin is to assist the patient to be able to have
a rational attitude to correctly realize ones own condition. The patient is already fatigue in both aspects
of body and mind and the most unfortunate situation
is that the patient is surrounded by more confused
and frailer care-givers and kith and kin. Therefore,
as the care-givers and kin and kith, they must take
care of the condition of the body and mind first before
taking actions so to avoid further chaos, otherwise it
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(a) Sealing off the patients con-
(d) Disclosing the patients condition:
ditions: some family members
patient, family members, medical staff
may ask the medical staff not
openly face the fact of cancer and dis-
to mention anything about can-
cuss about all sorts of issues about
cer and deceive the patient as
the sickness and treatment. Moreover,
some other kind of disease.
everyone would share the feelings and
For instance, stomach cancer
thoughts.
might be said to be stomach

upset; or liver cancer is said to
Care-givers and kith and kin must real-
be fatty liver or cirrhosis. The
ize how deep the patient knows about
patient would be kept com-
the condition and in turn, in accordance
pletely in the dark.
with various sorts of conditions of the

patient, a plan of disclosure of detailed
(b) Partly know the situation, yet partly with suspicion: occurrence of symptoms due to illness and
contents of the condition would be made. The information of reference to the patients are as follows:
the need for medical tests. For instances, loss of

weight, appearance of tumor, purple spot on the
(i) Patterns of character
skin (purpura). Furthermore, procedures such
(ii) Background of knowledge
as biopsy for pathological examination, bone
(iii) Past crisis intervention and experience in painful
marrow puncture and etc may be employed. All
frustration
those would make the patient being suspicious
(iv) Philosophy of life and belief
about being contracted with cancer. Nevertheless,
(v) Number of support systems for backup
family members and medical staff do not tell the

patient the truth.
Taking such a cautious approach is to make the sick

person to live more positively, and not to be hurt un-
(c) Avoiding discussion: Everyone might have known
necessarily. Leading in cautious attitude of settling
the fact, but all people concern that the others
issues, while guiding out pointless traumas. Since
would feel hurt, so avoid discussing about the pa-
disclosure of patients condition is a kind of art, and
tients condition. Family members worry that the
so a cautious approach should be taken. As such,
patient cannot stand the impact, then result in sui-
what is the most appropriate way of planning for dis-
cide or abandonment of hope, and so on. And the
closure of the condition? This would be discussed in
patient worries that the family members feel hurt.
the area of accompanying with unspoken consen-
As such, everyone keeps it in heart and burdens
sus. This will be shared in the next issue of the Lake
the sorrow solely.
of Lotus.(To be Continued)
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Things that Care-givers Must Do in the First

Stage When the Patient is Approaching Death
Accepting and
Understanding
Listening and
Observing
Analyzing and
Adopting
Leading Out and

Guiding in
Accompanying with
Unspoken Consensus
Leading Out and Guiding In
Guiding in professional
information/ Leading
out the damages due to
ignorance
Guiding in physical and

mental health / Leading
out of negligence and
carelessness
Guiding in rational
realization/ leading
out wrong decisions
Guiding in cautious
handling / leading
out unnecessary
traumas
[Remarks:
1. The newly-released book on The Meanings of Near-Death Experiences (1) has been published. Its
contents include the articles on The Meanings of the Near-Death Experiences from Issues 1 to 10 of
the Lake of Lotus.
2. The newly-released book on The Meanings of Near-Death Experiences (2) The Key Points at the
Moment of Death and the Essential Revelations of the Tibetan Book of the Dead has been published.
Its contents include the articles on The Meaning of the Near-Death Experiences from Issues 11 to 20
of the Lake of Lotus.
3. The newly-released book on The Meaning of Near-Death Experiences (3) The Various Ways of
Realization and Rescue of Dying Kith and Kin has been published. Its contents include the articles on
The Meaning of Near-Death Experiences from Issues 21 to 30 of the Lake of Lotus.]
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The Profound Abstruseness of

Life and Death

Excerpt of Last Chapter: Various

1. The Separation of the Four Elements the main cause

4th Floor, Federal Centre, 77 Sheung On Street, Chaiwan, Hong Kong

1. Protectors or avengers: (i) good ones saw kith and

(ii) bad ones saw wilderness, forests, darkness,

cause (the internal consciousness and sub-

3. Messy Issues that cannot be recalled clearly.

external circumstances) in forming the scenes at

How would the Buddhist point of view comment on

on The Meaning of Near-death Experiences in

these phenomena? According to the Buddhist teach-

Issue 21 of the Lake of Lotus).

ings, it was said that rebirth would take place within

3. The Karmic Forces the main cause (the in-

ternal consciousness and sub-consciousness)

had passed away long time ago still coming to fetch

conjoins with the auxiliary conditions (the kar-

mic forces of the external circumstances) in form-

rebirths after so many years posthumously? Are the

ing the scenes at the moment of death. This can

appearances of these deceased persons merely the

be further classified into the following two kinds:

illusions of the person who is going to die? Or were

i. Wholesome Ones arising from: (a) virtuous

those strange places the destinations where they are

retributions (please refer to the article on The

going to be reborn into? Under what circumstances

Meaning of Near-death Experiences in Issue

would the normal rebirth of a dying person be nega-

21 of the Lake of Lotus); and (b) the efforts of

tively encumbered? Is there any way to help a de-

ones Dharma practice (the main theme of this

ceased person to avert sufferings and elevate to a

article in this issue).

better place of rebirth?

ii. Unwholesome Ones arising from: (a) vicious

Human beings have four kinds

retributions; and (b) the forces of karmic credi-

tors in seeking compensations on ones karmic

ness (please refer to the

article The Wisdom in

According to the records of different surveys, most of

Practice in Issue 26 of the

the dying people had seen the following scenes:

Lake of Lotus) as follows:

4th Floor, Federal Centre, 77 Sheung On Street, Chaiwan, Hong Kong

1. Beta waves the conscious condition of daily liv-

What is the Ultimate Assistance

The care-givers, kin and kith and professional

of visualization, or at the first stage of mental

counselors should perform the following steps when a

concentration; or the condition when the spiritual

dying person is approaching the first stage of death:

body is slowly separating from the physical body;

1. Accepting and Understanding