EPISODE 7: Just Be Present with Betsy Rapoport
This episode is a conversation with my longtime friend Betsy Rapoport. We discuss our recent experience at Dying School led by Dr. Martha Jo Atkins, Betsy's extensive background in end-of-life care, and deeply touching personal stories about walking loved ones through their final moments. Betsy and I reflect on the importance of surrendering to the process, the beauty of presence, and how these lessons apply to living life fully. We also explore shared death experiences, hospice work, and the transformative power of compassionate care.
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Betsy Rapoport
Sarah: [00:00:00] This is a conversation with my friend, Betsy Rapoport. We have known each other for 13 or 14 years. We just finished. Going through dying school led by Dr. Martha Jo Atkins, who you'll hear from in a few weeks on this podcast.
Betsy has had a lot of different experiences with walking people home. She has been in facilities. She has. Had loved ones that she helped. She has had close friends that she's been a part of. There are lots of different. Ways to walk somebody home and Betsy's experienced many of them. So I hope that you'll enjoy this wise, Compassionate,
silly irreverent, sometimes conversation that I had with Betsy.
Speaker 2: Hi friends, this is your host, master coach and teacher Sarah Yost. You are listening to the About [00:01:00] Death podcast, the show about living life on your own terms. Stick around if you want way more of what you want with way less anxiety.
Betsy: Hi. It's so good to see your face again. Didn't you love last night's movie?
Sarah: Oh, man, my partner and I watched it together and He was a really good sport for watching it. He lost his mom in December And so we say that we're in the dead moms club and you know It was it was just really sweet and tender.
We both cried and watched it and Rub each other's
Betsy: My partner watched with me too. . He was crying and for me, I'm a little more grounded because I've had more experience, but I just, yeah. It's so profoundly moving. Loved it. La last ecstatic days, everybody.
Sarah: Yes. So good. What struck you about that movie?
Betsy: It was exactly what I want hospice to be, I mean, warm, [00:02:00] nurturing, the way they created a safe, calm, loving container that these two divorced parents, who you and I learned in the, you know, in the chat after the movie, hadn't been in the same room for decades. That nurturing atmosphere enabled them to be there together for their son.
And I know that meant so much to him because, you know, we learned very little about his early life, except for the fact of the divorce really undid him. And there was
a lot of,
you know, arguing and fighting and he apparently would go into the basement just to sort of create a little safe place. And so everything about that movie reminded me how cyclical things are.
I mean, he, the parents were able to come together and making him and come together when he was dying, you know? It's beautiful.
Sarah: It was lovely. I was struck there was, you know, watching his mom see her kid out of this world. I was really struck by how lovely it is that she was there at the beginning of his life and also [00:03:00] there,
at the end, I was struck with my mom and I know that a lot of people have this experience, but just, you know, that she, she walked me in and I walked her out and that, that feels really sweet, but there's something even, I don't know, even more tender about a mom being on both ends.
Betsy: Yeah, I mean, I've given birth twice and what really struck me.
In both giving birth and, you know, attending people as they go out is you cannot sit out a contraction. You know, when you're giving birth you can't say, you know what, you guys go on without me. You know, I'll just lie back here. You either relax into it and let yourself be carried along the wave or you resist and it's much harder.
And that's what we saw Ethan do last night is really relaxed into the waves, the waves of discomfort. by his example over and around him, learn to surf those same waves. And, you know, it's really incredible. I feel very privileged to have had both sides of the experience. I mean, I loved my mom out [00:04:00] and I love my dad out.
My partner and I were with my mom as she went into the coma from which she would not be more actually there at the moment of death, but I wasn't
there
at the moment of my dad's death. It was very similar to the breathing pattern that Ethan showed last night. You know, when you really just work up this head of steam and then,
that's it. Yeah. No more.
Sarah: So you and I have known each other around the way for 13 or 14 years since I first went through Martha Beck's training. And then we were just in dying school again, together with Martha Atkins. Tell me about your experience with her, because I know that you've done quite a bit of work with her.
Betsy: With Martha Jo.
Sarah: Yeah.
Betsy: Yeah. Well, I met her. It's funny. I told her about this years later, I met her at a Martha Beck convention. And by then we were Facebook friends and the way the coaches had become, you know, and I liked the cut of her jib, but I didn't know her. And we were in one of those, you know, ugly grand ballrooms with all the tables and she's wending her [00:05:00] way diagonally across the room and I swear, Sarah, she was
bathed in magnificent light and I had to screw my courage to the sticking place and introduce myself to her. Was
in D School 1. 0, Dying School, the first iteration.
I've been helping Martha Jo, you know, organize her notes and her writing. She's writing this incredible book that's got memoir. It's got, you know, As you know, if you've read her newsletter, you know, cause you've been in her class, she's an exquisite storyteller. And she has divided the book into these different threshold points.
All the notes from the now four iterations that I've been facilitator for and help her think through, okay, what's the best way to This material across this book got a lot of practical information. It's got a beautiful spiritual thrum throughout. Most of all, it has her story. I feel really lucky to have a front [00:06:00] page,
you know.
And when she and I, she, the head of a team that I dubbed the coven of love and that helped love and Mark out,
Mark
had a beautiful farmhouse out in West Virginia. And he really wanted us to go there after he died and finish the book. And I said, Oh honey, I don't know if I can go back out there. Cause it's.
It's it's you listen, it's gonna remind me of you and he got very snappish. And we're like, OK. So last summer he died a year ago last November. So last summer we went out there and she and I and Rachel Gers jammed on the book. At his, you know, dining room table. And I walked around the property and just felt him everywhere.
I visited his grave because he had wanted to be buried there. Felt really, especially magical to be able to see through that promise to him. He was by far the, the death for which I was most intimately [00:07:00] connected. Like even with my father, you know, I was coming and going and my dad and I had a more complicated relationship.
And Mark, it was just, you know, he was, he could be super ornery, but he was just an absolute delight. And Martha Jo headed up the team. And there were many of us that gathered around him and it was It's really one of the hardest and most beautiful experiences of my life. I mean, my mom was the first person that I really attended through death.
I mean, she, got a cancer that was so virulent, it didn't even bother to differentiate. And it was actually only 10 weeks from diagnosis to death. And so my four siblings and I took turns going out to stay with her. And that was when I met a hospice volunteer for the first time. I didn't even know what hospice was.
I figured it was
a building, you know. And there was one time when I was caring for mom and I was just in absolute despair. She was going to die really soon. I didn't, I wasn't ready. She was ready. I was not.
Sarah: Yeah.
Betsy: And the hospice volunteer had stopped by. He [00:08:00] was a minister or chaplain rather. And Mom was not thrilled to see him like she she wasn't really into him, but I thought oh boy I need I need something and I didn't keep his card mom sort of performatively threw it out after And I went through the the tiny Sedona phone book that's how long ago it was 2005 we had phone books remember those
I was just sitting on the floor of the other bed, bedroom, just feeling as sad as can be.
And the phone rang and it was him and he said, you know what, I was just thinking about you and I wanted to check in on you. So a year after mom died, I got my own hospice training so I could be a volunteer too.
Sarah: Oh, wow. So she died in 2005 and then you started volunteering for hospice. And so have you been doing end of life work ever since?
Betsy: Yeah, I took a long break. I mean, my, it's funny, you go through training as you should and it was so bizarre because the day of [00:09:00] our graduation party, I came home and my beautiful cat came down the stairs, uttered a strength cry, fell over and died. And I thought, wait, what?
Sarah: Wow.
Betsy: I'm not, I'm not.
What a homecoming.
Sarah: Haha.
Betsy: Haha. And then my social worker called me and I had prepared what I thought of as a death go bag. It had, you know, my laptop. It had, I think one of those, oh my gosh, what are those? Books that everybody had of like fun little sayings and Nostroms. You know, my idea was I'll, I'm a writer and editor.
I'll help people write letters to people. I'll help with them right there, like whatever. So I have my go bag already and my social calls. And she says, okay, he's 90 something and he's dying of colon cancer. And he's asked for a babe. And I thought, Oh, I don't know if that applies. in my age cohort, I wouldn't characterize myself that way.
But if you're a 90 something dying, for sure, I'm a [00:10:00] babe. You and I are joking about it. And I said, Well, you know, should I should I wear something low cut? And we laugh and we'll laugh. And she says, lady minister, you know, with high neck collar and her crepe sole shoes coming down.
And I just felt like, well, I'm the whore of Babylon. And I got my go bag and I'm sitting him and you know, it's, I'm nervous. It's my first time. I don't know if I'm doing this right. And after about an hour, he says, Oh, to tell you something. And I said, What is it, honey? Well, your top is cut too low and I see too much of your breasts.
Sarah: Oh my goodness.
Betsy: I guess, the babe thing. So I called up his adult daughter that night and we both laughed ourselves literally off our chair.
I dressed like
a pilgrim when I visited him until he died three or four months later, but he was my first port of call and I loved him so much and he taught me so much because you don't need a go bag, you need a presence, you know.
I had, Yeah, I had Scrabble in case he wanted to play board games and we just end up [00:11:00] spelling out I love you to each other, you know, want to write his memoirs. He just wanted to hear what the Mets were up to. And, you know, I would take him out for ice cream. We never did get to the track. He really, really wanted to get to the racetrack.
We have horses with sulkies and that was the one thing we didn't pull off before he passed. But yeah, I learned so much about just. be there and feel into what he needs and wants. And whatever his worldview was, I was just happy to ratify it. So he was a great experience. And I, I cared for people through that hospice on and off for several years.
And then I had one client who, it was a very, very difficult situation. He had been on hospice for two years. The disease he'd gotten he'd contracted was most likely through doing something that his very religious wife did not approve of. And one child could accept that and the other child could not.
And so for the second year, he was [00:12:00] completely uncommunicative. He would just be lying on his back with his eyes shut. I would read the paper. I would talk to, you know, he wasn't, Replying and I thought to myself, what am I, what am I doing here? Getting anything out of this and then one day I met his wife and I understood.
Oh, I am here for her because she was in absolute despair. I mean he he had been going on and on and on. And she told me that her friends had suggested that she start to date again. Yeah. What am I supposed to say to the guy across the table from me? You know, funny thing, you know, my, my, my husband's still alive, but yeah, not doing great.
And so she said, I feel so awful. I just want him dead.
Sarah: Yeah.
Betsy: Well, of course, of course you do. He's not getting better. Of course you want him dead. You want him at peace. You don't want him suffering. So I realized, oh, I am here to ratify what's going on with her. And the next [00:13:00] week I came in and remember he'd been on his back seemingly unconscious for a year.
And all of a sudden I walk into his room and he's upright in a wheelchair. He is holding a balloon. He is aware that it is his wife's birthday.
Sarah: Wow.
Betsy: She is looking at me. From behind him in undisguised horror. Like, oh no. And I don't feel that there's a nun in the room. I didn't feel that I could give her a thumbs up in front of the nun.
But I recognized what was going on. He was having, you know, what is, what is called a rally. Right. Right before the end, people will, swim up out of unconsciousness.
Sarah: Yeah.
Betsy: See their beloveds. Maybe they have a final message. Maybe they need to hear a final, who knows? Anyhow, rallies are not uncommon. And he was dead two days later.
Sarah: Wow.
Betsy: But he really knocked the stuffing out of me. I need to take a break for a while. And then you know, Martha Jo and I sort of fell back together again.
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Betsy: And I'm really inspired now to go back more regularly. to hospice, you know, work. It's funny, my badge, my official title is Friendly Visitor.
Sarah: Huh. Like a, like a candy striper for a hospital.
Betsy: And because of HIPAA regulations, I was in a hospital once and I see a friend from my town and she was, what are you doing here? And I said, Oh, I I'm visiting a friend. She was, Oh, which is like a very normal question. Sure. Oh, you know, a friend. She goes, Yeah, who?
I said, Oh, well, you know, because I couldn't say I was a hospice volunteer [00:15:00] because you don't know what people do and don't certainly couldn't say his name because of HIPAA regulations. So, right. It was very weird.
Sarah: You know, thinking about what this guy that you were just talking about. So much of dying is tedious and boring and hard and uninteresting.
Betsy: Like life, right?
Sarah: Like life,
Betsy: yeah. Yeah, and it's a reminder that we don't need to be doing all the time. I mean, that was Something I did when I first started being a hospice volunteer is I felt the need to fill every second.
Sarah: Right.
Betsy: Honey, is there anything you'd like to talk about? Do you want to look through albums together?
Hey, are there any folks I can write letters to? Can I help you make any phone calls? I mean, like, just abide. Just be. It's a great lesson for presence in your everyday life too. I mean, how often do you and I just overdo and overthink everything, you know, just
Sarah: sure. And think we need to prepare and think we know what's going to happen.
[00:16:00] And
Betsy: I noticed I was on Facebook this morning. I saw that you called out a delightful piece of someone's bio that said like in her free time, she strives to do as little as possible. And I thought, with hospice more and more, I think of my work as energetic
rather than physical. I just Really sit there very quietly and try to feel into what does this person need in this moment and sometimes they really do need absolute silence.
Sometimes they just need to tell you about something, even if they told you the same story 10 times, who cares? I'm there to listen.
Sarah: Right.
Betsy: And, you know, I don't even touch people unless I really feel like, oh, that's wanted, you know?
There was an aspect of my volunteer work called 11th hour, which is when you go in to be at the bedside of someone who would otherwise just be alone.
They're actually in their active dying process. They have only hours to live this way. You know, you can tell whatever family eventually shows up. Oh, they, we were there. Your beloved did [00:17:00] not die alone. And so I'm with this person and disconcertingly, they're in a double hospital room with a, one of those sort of kidney colored curtains separating them from the other bed where a woman has just given birth and her friends and family are joyfully, you know, it couldn't have been a more contrast, above this poor woman's bed is a, Spitting, humming, fluorescent light, which I immediately turned off, to the right is a fully stacked breakfast tray.
This woman hasn't eaten in heaven knows how long, doesn't need a breakfast tray. And then while I'm there. A head nurse comes in with a student nurse and they wrestle a blood pressure cuff onto this woman to take her vitals, which I can't stress strongly enough, is completely unnecessary.
Sarah: Vitals are not good.
Yeah. The patient will
die.
Betsy: Exactly.
Sarah: Shortly.
Betsy: You'll know. Anyhow, the pressure of the cuff brought this poor woman up to [00:18:00] consciousness. And with great difficulty, she sank down again.
And then along came the hospice doctor. He did the exact same thing to check her vitals. And he gives me a look that I can't really read, but it seems of disapproval.
I'm thinking what, what's going later on. I ran into him at the elevator bank and he said, Oh, so and so she used to be one of my best patients. And now she's just given up. I thought she was giving up. I mean, she is trying to take her leave with as much grace and dignity as you all are affording her. I mean, she didn't even get a private room.
So yeah, we have a lot of learning and work to do on bringing hospice care, into full focus and really training people around when my father died in 2019, his independent living facility sort of created an ad hoc hospice room for him, you know, down in the sick bay, and it was a really inadequate situation.
It took me, [00:19:00] it was one of those cable TV situations where there are 500 channels and it was channel 495 was the classical music that he wanted.
And
so I, I wrote a sign saying, please keep this on this station. I made a sign for the door. This is please lower your energy as you come inside here. And I had to stop them from presenting him with full breakfast trays, moving him aggressively in his final day.
You know, understandably, people don't want bed sores, but also, like, he was really trying to and take his leave.
Sarah: It's interesting how the, you know, the medical model is so routinized. It's like we bring meals. Here's your meal. We check vitals.
Here's your vital. It's like, we're not looking at the patient. We're looking at what's the next thing to do.
Betsy: Well, I visited Martha Jo when she was Executive Director of Abode Hospice in San Antonio and there were four beds there and it was just such a magical place because there [00:20:00] was no routinized anything.
If you wanted a King Ranch castle and you wanted to train me how to make it under your inspection, sure, I'll do
that. Everything was about, this is what, and they didn't even call them patients, they called them guests, this is what our guest wants, this is what our guest needs, and it was, it was so guest centered instead of hospital routine centered, and you know, you and I get it, I mean hospitals are crazed and understaffed,
But I think the dying need
a peaceful environment and they need people to understand that this is a perfectly natural process and we don't have to intervene constantly. I mean, you don't have to keep checking my blood pressure.
Sarah: Well, and it's not something to be ashamed of, you know, that doctor's comment, I think echoes what a lot of us think that they've given up, but there's something weak about dying.
There's something wrong with dying, which, which makes sense because We're inherently wired not to for as long as possible and so for an entire system to be built [00:21:00] Around keeping us alive and then to add shame to the idea that that didn't work. Well, it can't be the doctor's fault I can't you know, it can't be it's somebody's fault and it it's certainly the patient's
Betsy: yeah And if all you've ever been trained to recognize is that death is a failure That's how you're going to see it,
I mean, I hope that med schools have changed. I remember, you know, not too long ago, palliative care and, death care were, maybe a couple of days
Sarah: and
Betsy: it's, it's the next revolution. I think that people like Martha Jo are really helping to bring it into relief and give it the attention it needs.
So grateful for that.
Sarah: I am too. I have been fascinated with the dying process for a really long time and wanted to work with Martha for a really long time, but I did not have any clue how much industry is built up around different aspects of dying well. I also was a hospice [00:22:00] volunteer and.
You know, have lots of, lots of experience with hospice and with dying and I am certainly oriented toward dying on your own terms, but there's so much that I didn't, that I just hadn't considered and I'm seeing more and more death doula trainings and end of life work and lots of people doing it in lots of ways.
And I think that's a very good thing.
Betsy: Looking back to the time I spent with mom when she was dying, and she was showing all the signs that Martha Jo taught, you know, teaches in dying, so I didn't know them. I remember one night, she had been in a lot of pain, and it took like an hour to get her out of pain, and all of a sudden, Her eyes were looking into a depth that I couldn't see.
She said, Oh, Oh, Betsy, do you see the bend in the road up ahead? What does it look like? She goes, Oh, Oh, it's so beautiful. And I asked her, well, do you want to go there? She goes, no, not yet. And I just kind of instinctively said, well, mom, [00:23:00] when it's time, you can go down the bend in the road. And she was, oh, oh, no, I can't see it anymore.
And then she looked at me and all of a sudden her, she was back behind her eyes and she looked at me very levelly and said, your road is straight, which is like, whoo, okay, there's no immediate bend in the road for me. But you know, that was the traveling back and forth that Martha Jo describes. Also had. Oh, so many travel metaphors and she would imagine that a red car was pulling up and when I read Final Gifts, you know that wonderful book by the two hospice nurses, they talked about travel metaphors and weirdly red, red cars are the most popular color.
for people to see.
Sarah: Really?
Betsy: Yeah, who knows? Very zippy, zippy up there, I guess.
Sarah: Did she talk about what kind of car or just a red one?
Betsy: It was just there to take her.
Sarah: Huh.
Betsy: She, and she wasn't ready yet. It was just what Martha Jo was teaching about, like, just one more thing. I haven't packed my bag. She [00:24:00] wasn't ready yet.
Sarah: Interesting. When you gave, you know, we talked about the movie and him letting go of his body
and how the practice was in, in letting go of his body and relaxing into that resistance and how scary that is, even if you want to go and it's time to go to actually do that last unhooking. Did you find when you gave birth, did you also have trouble letting go of? bringing them in. Did you have trouble with that threshold?
Betsy: I mean, you know what the end point is, right? The end point is the baby is no longer inside me. It's outside. But what you don't know is how much worse is this pain going to get? How much more physical stuff is my body going to have to endure? I won't get any more graphic than that. And so it does, it did keep me from Now that I reflect on it from investing completely in the surrender to it, because I was scared.[00:25:00]
And Katie, my second born, her birth was so much easier because I had an arc. I knew. More completely the contours of the experience.
I've watched people die and for some of them, it, it seemed like they really, really had a hard time letting go. And I remember talking, I went to one of my hospice guests funeral and the priest kept going on and on about, Oh my gosh, he fought the end with every ounce of his being.
I'm thinking, really? Because for six months, all he did was tell me how ready he was to go and
Sarah: how
Betsy: long to die. I mean, his. He was going to die and be reunited with his beloved wife who had died six years earlier and I was all about it. Oh my gosh, I can't wait.
I think the priest was there maybe in his final hour.
And I think that what the priest experienced was, you know, breathing is a really hard habit to break. You've been doing it, you know, for decades and now you're not going to? So I think that even when you want the experience I mean, my mother in law died at 101 [00:26:00] and she kept saying, why am I still here?
I get it.
Sarah: She used the direction last night in the movie that it's like, if you go underwater, you hold your breath, but then you just relax into it and you don't take another one. And I thought, boy, that sounds like the easiest way to wrap my mind around something around that.
That makes sense to me.
Betsy: Yeah, and there's something about being underwater, just a little bit more peaceful and flowing, you know?
Sarah: Right. Right. And then if you don't try to breathe again, then it is peaceful.
Betsy: Yeah. It is very funny to have been, you know, inches away from someone's face when they've taken their last breath.
And I realized, Oh, I'm holding mine. Waiting for them to take their, I guess that's it.
Sarah: Yeah.
Betsy: Yeah. And then you have all that energy afterwards, like, oh, it happened, you know, now what?
Sarah: Have you ever been with somebody who had the medicine to end their life on their own terms? Have you ever helped anybody like that?[00:27:00]
Betsy: Like Medical Aid in Dying although I watched that movie that Martha Jo recommended and I loved it. there are certain illnesses that if I or my partner get, we've already told the other person, yeah, I'm going to plan my exit, you know? And I read Amy Bloom's stunning memoir.
Oh,
Sarah: did you? Yeah.
Betsy: And they went, I'm blanking on the name of the. Swiss place that you can fly to and, end your life really, you know, with so much care and love, but it still requires, you know, jumping through 10, 000 flaming hoops, you know, it's, it's just to my mind, a very unnecessarily arduous process when you're already so compromised.
And I really hope that. You know, the 15, 20 years I have left
will
come far enough along that if I need to goose things along that I don't put anyone in legal jeopardy, you know, that just seems ridiculous.
Sarah: It really seems ridiculous. This is my fucking body and I can do what I want with it.
Betsy: [00:28:00] And I love the idea of having sort of concentric circles of like, okay, this is a friend, outer friend, inner friend, family, and then just my inner self.
And I'm not being able to plan that. I mean, when we did a video vigil for our friend, Mark, it was so beautiful to see who showed up from afar
and to
have some sense of control. Like, okay, from this day forward, only immediate family from this, just whoever's in the room, you know?
And.
I think any sort of assistance in dying gives you that kind of comforting control over the circumstances.
It's the last thing you want to do is having, you know, you're trying to die, have all these people sort of imposing their energy. Right. I mean, something I didn't even think about until Martha Jo pointed it out was, you know, as benign as it sounds to say to your beloved, you can go, we're ready, we'll all be fine without you.
Imagine 10 people coming at you, you know, [00:29:00] you're in a perfect compromise state. Everyone's saying, go, you can go now, you can go now, you know? And I was with someone and. One of his dear friends kept saying that. You can go now, you can go now, you can go now. And I had just been telling some of the other people there about the finale of The Good Place.
I don't know if you've seen
it.
Sarah: I have,
yeah.
Betsy: Do you remember the final episode?
Sarah: Vaguely.
Betsy: It's called Whenever You're Ready.
And it
happens to have a beautiful piece of classic music by Arvo Part called Spiegel im Spiegel. It's a very slow, elegiac song. And I was explaining that to, you know, the other people we were all doing.
vigil for this man who was dying. And I was just so struck by, you know, and I wanted to look up the name of the, of the composition because I couldn't remember it. And I was amazed to discover that the finale episode was actually called Whenever You're Ready. So whenever this man would tell our dying friend, you can go
now, you can go now,
I would like surreptitiously [00:30:00] sidle up and say, we're right here with you.
Whenever you're ready, we're right here with you. I think that's a, a, an easier thing, I hope, to sit with than. Okay!
Take off now!
Sarah: Well, and I feel like, I feel like that, you know, I don't know if there's any room for, for shame or disappointment at, at the end. It may all be stripped away in that moment, but certainly we have also internalized that we've, that we're weak or that we've lost or that we haven't fought well enough.
We all share that belief and I I don't know if it's still there in the end But if everybody's telling me to go and I can't I feel like maybe I'd It's a little performance anxiety, like.
Betsy: Great. One more thing. I'm flunking in the final moments.
Sarah: Quit, or like pee anxiety. Like, leave the fucking room and I'll pee.
Maybe that's why people wait for their family to leave, to die. Maybe that's why.
Betsy: Yeah. By the way, I've had that experience when my mom went into her coma, she lingered there for five days and the hospice doctor was [00:31:00] like, well, you know, wanting all of us to tell him, is there anything you think she's waiting for?
Sarah: Hmm.
Betsy: Well, my brother's wife is the only spouse of her, you know, five kids that didn't have a chance to say goodbye and she's not coming until the end of the week. And so they were able to come for literally. I think it was 18 hours because they fly across the country, quickly say hello and goodbye to mom, and then fly back home to take their daughter to college.
And my brother went in to mom and said, you know, mom, we have to turn right around and go back home.
I'm going to put the luggage in the car. Then I'm gonna come back and say goodbye. And it took him under a minute, and it was in that minute, You know, we've been keeping constant vigil in that minute that she died. She didn't want her firstborn, her eldest, her oldest son, to watch her die.
So she slipped away. And I've seen that happen a lot. Sometimes you, you know, it's helpful if you're hanging around someone [00:32:00] who's dying to sometimes step away, sometimes step away five feet, 10 feet, another floor, go out for a walk, give your beloved. a chance to feel into what works better for them.
Because sometimes it is, you know, that beautiful cozy circle of dear ones. And sometimes they just need to be alone.
You remember that William Peters class about shared crossings, shared death experiences.
Sarah: Yes.
Betsy: I believe I've had them.
Sarah: Tell us what, tell us what that is because I had never heard of that before he taught us.
So give us a brief overview.
Betsy: with dying people, you often see them traveling away and coming back. It's as if they're practicing being wherever we go when we die. They'll, you'll, you can see them looking distantly. Martha Joe has actually. categorized it as part of her PhD thesis, you know, when they're hearing people in a faraway room, if they're reaching straight out, straight up.
And so they're practicing [00:33:00] and a shared death experience is when suddenly you're on that little journey with them. The night before my beloved friend Mark died, I was, I was standing at the head of his bed and all of a sudden, we were totally telepathically connected. I can't even explain it, but all of a sudden, inside my head, I said, Mark, I can hear every word you're saying.
And he was always, I was nodding. I was, I can hear every word you're saying, you know, and he had been a very, he was kind of a Jim Dandy. He had been a very muscular guy. And by the end, you know, all his muscles had kind of melted, but I was reassuring him again, this is all telepathic. I said, Oh my God, I, I will never forget your magnificent biceps.
And I'm going to be right behind you. Meaning, you know, I won't die. You know, I, my concept of death, like who knows, is that time works very differently there. And so I said, I'll be right after you. We're going to dance our asses off. We're going to have so much fun and I'm going to miss you like crazy, but [00:34:00] I'm going to know I'm like the whole shebang and afterwards a friend who had been in the room came up to me and said, what just happened?
There was white light pouring between your forehead and his.
Sarah: Oh,
Betsy: and so I. I don't know what that was, but I am so grateful. And then when my mother in law was dying, you know, as I said, she was 101 and I was with her just holding her hand. You know, she was fully unconscious. I don't know whether she was sleeping or visiting another place.
I don't know. And all of a sudden, I am collapsed and shot through a pinpoint of white light and then blinding white light. And, you know, every cliche applies. It was. all surpassing love. We were all one, you know, it was like the most incredible experience of loving oneness ever. And then zats, I'm right out again.
Like, okay, what was that? And then three days later, I had this incredible [00:35:00] dream where my partner and I were visiting her in her assisted living place. And in the dream, Ken walks into the other room just to hang out with the people who are attending her. And I go into her bedroom, and she is, contrary to what she's doing, and look at Real life in this dreamer vision, she's frantically trying to get out of the bed and I'm just filled with dread.
Oh, my gosh, this poor woman is just bird bones herself. And what should I do? And suddenly she turns into a fox in this vision. She races out and the week before someone was telling me about their -ayahuasca experience where they turn into a fox and it was a symbol of liberation. So I don't know what my mind was making meaning that way.
In the dream, I race into the other room and everyone's trying to chase this fox, which is trying to escape, like, you know, cue the metaphors. And then I walk back into the bedroom. And she's there back in human form and there's no dread. All [00:36:00] of a sudden she is absolutely love embodied and she was fond of me, but she wasn't super effusive.
But in this vision, she flung her arms around me and said positively girlishly, Oh Betsy, I love you. I love you. And then her nightstand light gets glows brighter and brighter and brighter. And it envelops all of her being. And that's the end. And then I woke up. certain that this was the day she was going to die and she died two hours later.
And I always will believe that she sent me whatever you want to call it, a dream, a vision, my preferred imagination. I don't know. I think she sent it to me because my husband doesn't have, you know, any sort of, he just thinks you die and that's, you know, you're just dirt, you know,
I think that was a way that I could tell him.
I think she's. Passing peacefully.
Sarah: Yeah.
Betsy: It's going to be, it's going to be okay. And it was.
Sarah: Did, so that answered [00:37:00] my question. I wondered if, anybody else had a shared experience with her and, and that makes sense that, you did because you believe in that, or you're already open to that.
What about Mark? Did other people have experiences like that?
Betsy: Not that I know of. But he and I, you know, we talked a lot about those kinds of things. And he was a scientist by training and very skeptical, but he'd had experiences that he couldn't explain either.
I just find it so fascinating.
And I, I almost jumped out of my skin with weird mixture of fear and excitement when we were suddenly in telepathic communication, because he was. really sunk in. I mean, I couldn't believe he was still alive.
Sarah: Did it feel good?
Betsy: Oh my God, it felt amazing. Because I could reassure him, but I was very aware that I was also reassuring myself.
Like, I know he's about to die.
That's going to be mortally sad. And yet I really believe that he can never die.
Sarah: And did it hurt to [00:38:00] come out of that vision or that experience?
Betsy: No, I was. On the highest endorphin high of my life. Yeah. I couldn't believe it. And, you know, he died the next day. Martha Jo was, there were people who had spent time with dying people and other people for whom this was a very new experience.
I had decided not to sleep. on that floor that night because we had been sleeping next to him for days and I was just exhausted. So I was going to sleep in the downstairs basement apartment. And then she said, well, I'll text you if anything changes. We get a text at 8am. Come quickly. His breathing has changed.
We all ringed around the bed and we thought it would be 15 or 20 minutes. So it's eight o'clock, right? And then 10: 15, it was as if I could see his heart energy, this brilliant green spiral and this brilliant diamond white energy starts weaving itself into the spiral and I remember thinking, Oh, he's not, you know, I'm not saying anything a lot.
I'm just
imagining this.
But then it reversed itself, and it unwound, and it dissipated. [00:39:00] And later on, I asked Martha Jo, I said, Did you feel anything? She goes 10:15,
right?
And then at one o'clock, one of the other friends said Is there a backup player?
Which, and I can't tell you, it made everyone laugh. It was just what we needed because sometimes, you know, earnestness, despair, like all the really tough feelings need, you know, someone needs to pop that balloon with a really good crack. And that did it for me. And then he did actually die. at 2:11. And it ended up being, we all washed his body and thanked it.
We dressed him in, to this day, I wish I'd said, no, not that hoodie. I love that one. It makes him look like a little soft buddy. And can I have it? But nope.
Sarah: Nope, he got it.
Betsy: Yeah, he got it, and he was just, repose the whole afternoon, and a beam of sunlight came in, and I swear he was smiling.
Like, how? You know, but hospice didn't even come till after 9pm. [00:40:00] And the very sweet men didn't come to take his body away until, you know, 930, 945. And they were so respectful, you know, please, please take all the time you need. We're so sorry for your loss. And we're like, Oh, no, we're good. You know, you know, it was really, really beautiful.
And the best advice that Martha Jo gave us, you don't have to call anybody right away.
You can
take your time with your beloved, you can wash that body, you can sing songs, you can dress it, you know, you can put flowers or beautiful pebbles on it. And if they're young kids that are, you know, they're a part of the process, it's, it can be so beautiful to watch them.
They can put a little pebble or a flower on the body and it's, you know, it takes away the stigma. I mean, it wasn't until I think I was. looking it up. We used to call them parlors, right? And parlors was where you laid out the body. You know, you put a plank on [00:41:00] two stools and you lay the body on top of it.
And then after World War Two, I think that that's when they started renaming the parlors living rooms, you know, because there'd been a lot of dying.
Sarah: Interesting.
Betsy: So let's call this the living room. And like, very quickly we shift from dying, being in the home to dying in hospitals and people forget how normal it is.
Sarah: And that was just World War II that that changed?
Betsy: Yes. Like the 30s, 40s. Yeah, that was the beginning of the acceleration of dying in the hospital as opposed to dying at home. Yeah. And I love the movement to let people die at home or, you know, die in hospice. I love what people like Amy Cunningham are doing with natural burials.
I think it's, Such a beautiful part of people's education to know that these options are available and that we don't have to medicalize our beloved's deaths. And we can listen to them. Oh, the thing that really struck me last night was when Martha Jo was answering, you know, someone had a question [00:42:00] about pain relief because Yeah.
Ethan had really, really wanted to be present. Yeah. And they wanted to learn how to surf the pain. And it's hard to watch. You know, and Martha Jo was, I, I got this, she was kind of consoling that person who was really feeling a little wrenched. And
it's so hard for those of us who are with the dying, to be present to what they want, even if what they want isn't what we want.
I mean, I've had plenty of times, like I've had friends, like they continue, debilitating treatment. I'm thinking, Oh my God, are you insane? And I have to remember, like, this isn't my journey. This is theirs. And whether they want to be completely medicated so as not to feel any pain or whether they want no pain because they want to be present.
It's none of my business. It's theirs. And my business is to attend to whatever's going on in me so that I can shut that down gently and lovingly and really be present for them and be part of a safe container for them.
that's good practice for every [00:43:00] aspect of our living, right? Like how can I notice what you're bringing up in me, attend to what's going on in me so that I can co create the space between the two of us that we both want.
Sarah: Right. Well, her advice was. what you're saying to, to find the edges of you and find the edges of him and let there be edges, let there be space between you.
Betsy: Yeah. And it's really easy for the boundaries to get blurry, right? You know, you're, especially if it's a beloved parent or partner or child, like, All your life has been around giving to them completely.
And so it's easy to lose a sense of yourself. No,
Sarah: plus you're tired.
Betsy: Yeah. Oh my God. You know, and I've had, you know, I remember giving my mom some pain relief and thinking, did she need that much?
Sarah: Right.
Betsy: Or was it for me? You know what I say? But that once I gave my, one of my kids like children's Tylenol and all, I remember thinking, oh, now I'll get a good nap in too, you
[00:44:00] know,
I mean, I'm sure I'm not the only person who has ever done it, but Martha Jo reminds people repeatedly, like, you are never given enough medicine to actually end someone's life, you know?
Sarah: Right.
Betsy: And I just, I want to say that here just in case people are not aware. I mean, pain relief is a really tricky thing. Those of us who are hospice volunteers may not ever give any medication, but it's really important to know that it doesn't hasten someone's death. It allows them to be able to do the work that they want to do to tuck in, which I think is a great mercy and a great service.
Sarah: Well, and I, I hope that pain management allows them to be present with their process that allows them to be more conscious that it's difficult to be present when all of your attention is going to surfing the pain. And I understand there's a, you know, he wanted just enough. Just enough to stay conscious, just enough to keep the pain bearable.
Betsy: I have been with people, I didn't [00:45:00] realize that sometimes if your liver is too trashed, you can't metabolize morphine, for example, in a way that will let it do its work.
Sarah: Oh.
Betsy: Sometimes, no matter what we do, we can't always take away everyone's pain. You know, I think doctors can do their best to make people more comfortable, but I think it's a fallacy to say that, you know, when Mark was dying, he said, I now realize I can't get rid of all my pain.
You know? But,
mm-Hmm.
I think even him being able to claim that was empowering for him, like, okay, I'm gonna surrender to that. That is my new reaction. Right. I'm not gonna be with it. You know?
Sarah: Yeah. Like, if this is as much as I can do, okay, let me make peace here. Tell me about. Did you guys make his box?
Betsy: No, a friend did.
She was both. Professional chef and in construction. And so I was lucky enough to go to a final meal that she had. It was a seven course meal that she
made and [00:46:00] he ate every bite. And then I was so worried, like, Oh my gosh, he's, is he, is his pancreas going to go into revolt because he had a
pancreatic
cancer?
And, and no. And then. He had bought a Virginia farm with two dear friends and deeded it over to, I'm sorry, West Virginia. He deeded it over to the West Virginia Nature Conservancy so it could never be developed.
And
that farm was his home away from home. He lived in D. C. and every waking moment of his life he would go there and be there.
And there was, I think it was yellow pine that no longer exists. I may have this wrong. Not quite right, but it was definitely wood that have fallen on the property that this woman used to make his casket. And so I loved that she cooked him a meal and then made his casket.
Sarah: Oh, it's beautiful.
Betsy: The funeral service was at this church on the property that, that they were renovating.
And then they had a celebratory meal in the barn. You know, this place [00:47:00] had a lot of outbuildings. And I love that he guided us to, like, exactly the spot where he wanted to be buried. It's funny, I, I, when I visited it, The following June to work on it on his book. I want to work on Martha Jo's book.
I want to lay on it. But then I remembered, oh, yeah, there were lots of ticks here. Like maybe they stayed down on the ground. But it meant a lot to me that he wasn't able to die there. And oh, I want to mention something that's one of the reasons it's so important to like begin making a safe container for your person who's dying is that can take a You know, weeks or months like you don't want to have like one rush conversation and boom, we're in hospice and then I mean, there was, it was Mark's stated fervent desire to die on his farm, but he was so medically fragile that we were not able, even an ambulance, he probably would not have made it.
And so it was so difficult because half of the friends that were attending him, [00:48:00] you know, they knew this was so important to him. They wanted to make it happen so badly. And because Martha Jo had created such a safe and loving container, when she spoke to the people in medical charge and conveyed, we're so sorry, but we can't do that, I could feel everyone's adrenaline just instantly like, okay, we understand with this desire to move him came from a place and the desire to keep him where he is, is also loving and what could have been embittering or a battlefield just instantly, okay, this is our new reality.
So we're going to adjust to it. So I hope that people recognize that when you were thinking about hospice, you know, it's going to be many. Ideally, it's many, many conversations because it can take some time to get everybody on board for. different decisions and even getting on board for the reality, Oh, this person is dying.
I mean, I know when my dad was dying, not everybody was in agreement that he needed to go on [00:49:00] hospice. And I was thinking, Oh, are you kidding? Like across the country and you haven't seen him trust me. And only because of the middle of this conference call with my siblings, did we get a call from the doctor who said, yeah, he he's an end stage congestive heart failure and like 15 other things.
So it was like, Oh yeah. Okay. There's the validation we needed. But yeah, I mean, these were five of us all loved our dad very much and had five slightly different opinions about what his remaining time should roll out. So it's asking a lot of humans not to human at this particularly fraught time. Right.
Right. Right.
Sarah: Do you, have you seen that death brings out the best in people or that it brings out the worst in people?
Betsy: Yes. It's all the things, right? Like just as childbirth brought out my best and my worst, you know, I cannot say I always behaved in a loving fashion. Yeah. I mean, it's, I think it's fair to say that whatever is going on with you, Lack of sleep, lack [00:50:00] of clarity, anticipatory grief, you know, those are, can bring all the people's issues to the fore and it can, you know, magnify our worst qualities and our best qualities.
I mean, I, I found it comforting when my dad was dying to sort of call on the part of me. I'm like, I'm not a professional, obviously I'm just a volunteer, but to be able to call on my experience, just sort of step into that part of me as opposed to like, oh, wow, I'm the daughter You know,
he did actually have a great waking vision where he told me it's a very long story that I don't need to tell, but it had like the complicated transportation nexies and all that. And, oh, you've arrived at the venue too early. It's, you know, it was all metaphor. Not quite your time,
but he came
out of that vision and said, Betsy, I chose you to be my pilot.
Like that was, that was the signal. Yeah. And then two days later I was the one alone in the room with him with my hand. Yeah, it was beautiful. [00:51:00] I really.
I'm very grateful that he wanted me to pilot him out, you know, to be honest, I was very much a copilot. He was doing all that work. I was just, of course, of course.
Sarah: So what do you think, you know, I think we've talked about some things that are so prescient to, some things are so relevant to living about accepting what's here and surrendering to that, which, you know, what you talked about with Mark not being able to die on his farm is. It's. just like that decision that, Oh, this is my level of pain.
Let me surrender to that. Okay. This is the reality. Let me surrender to that. And that's a lesson for life. And we talked about being present with people for what they need and, and keeping our edges separate.
Betsy: I'm still, I still struggle with that. Yeah. And it doesn't, it suck that you actually have to surrender.
You can't just say I surrender. You actually have to do it.
Sarah: Yeah. Well, and I mean, surrendering is, it's, that's something I can actively do. Like, I'm always, I, I feel like, I always [00:52:00] explain, like, we could approximate surrender, but I always feel like what I'm doing is like, okay, I surrender. And then I like open one eye, like, did it work?
Did it take?
Betsy: Maybe my knuckles need to be whiter.
Sarah: Yeah, let me press real hard. I used to call it constipation prayer. But I do think that, that pointing in that direction, I have personally never been able to, to force myself into surrender, but I can, I can get myself in the room, which I guess is just like, like death.
We can't make them go and they can't make themselves go, but we can make the environment where. It's possible to surrender our body as well as whatever anxiety we're clinging to. I guess it's all the same practice, isn't it?
Betsy: It is. And it's, it has really helped me, you know, it's easy for me to focus on the dying person's, what looks like discomfort or outright pain, right?
It's so easy to focus on that. And I have found it really comforting. When she teaches us, you know, I, she says, I can't prove it, but it's my belief and she's attended hundreds, [00:53:00] if not thousands of deaths that by that time, the body and the soul have begun the work of separation. I've read many accounts of near death experiences where people died and then came back into their bodies and two of one, they reported not being in any pain, you know, even when they were in a frankly, really painful situation.
I'm going to go ahead and believe in that too. Why not? Presence and surrender have been the incredible life lessons. I mean, I, I'd be lying if I told you I had mastered them, but yeah, sure. I feel like I'm getting to be more in the room more often. So going for progress, not perfection.
Sarah: For sure.
For sure.
Okay, I'm gonna stop recording. Thank you.
Betsy: That was fun. Thank you.
Speaker 6: Thanks for listening to About Death, the podcast about living life on your own terms. Would you help me get our guest stories into the [00:54:00] hands of people who need to hear them? One thing you can do is think about who you know who would love this episode. Send it to them or leave a rating and review, especially if it's a good one.
And if you want community and coaching, go to sarahyost.com to get started. See you next time.
ABOUT BETSY:
Betsy is a master life coach, hospice volunteer, writer, and book editor
Learn more here:
Timestamps And Topics
00:00 Introduction to Betsy Rapoport
01:14 Reflecting on a Touching Movie
04:21 Experiences with Hospice and End-of-Life Care
04:41 Meeting Dr. Martha Jo Atkins
07:22 Volunteering and Personal Stories
11:38 Challenges and Lessons in Hospice Work
15:08 The Importance of Presence in Hospice Care
27:19 The Arduous Process of Assisted Dying
27:59 The Comfort of Control in Dying
28:44 The Impact of Words at the End of Life
32:19 Shared Death Experiences
41:55 The Role of Pain Management in Dying
51:10 The Importance of Surrender and Presence
53:44 Final Reflections and Gratitude
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