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Maitri Hospice San Francisco

Maitri Hospice

Ken Ireland & Morgan Zo Callahan

Morgan Zo Callahan

I met Ken Ireland in 2002 after sitting in a Zen meditation group he led at the YMCA in San Francisco’s Tenderloin. He invited me to visit Maitri (Sanskrit for “compassionate friendship”), a hospice for people with AIDS in San Francisco. (Maitri Hospice San Francisco). In 1987 Maitri was founded in San Francisco’s Castro district by Issan Dorsey, a Zen priest, and several friends, among them Steve Allen and David Sunseri. “The Castro was a place for the gay revolution with its arts, its parties, its style and its joie de vivre, and Issan was part of these happenings. Then, in the early 1980s, AIDS started to appear and, at first, no one knew what to make of it.” (John Tarrant, Bring Me the Rhinoceros, p.77) Issan Dorsey had been ordained a Zen priest in 1975. By 1980, he was part of an informal group of gay Buddhists, and was invited to become the head teacher at the Hartford Street Zen Center in the Castro. Issan was appointed abbot in 1989, and his teacher, Richard Baker Roshi, named him a lineage holder: he became Issan Roshi. In 1987 Issan invited a homeless student dying of AIDS into the Zen center, and Maitri was born. Issan himself died from AIDS in 1990. (Cf. Street Zen: The Life and Work of Issan Dorsey by David Schneider)

I was impressed that Maitri was a warm, “at home” environment where both caregiver and patient deeply listened to each other. The ample kitchen had a signed, framed photo of Elizabeth Taylor who had visited and encouraged the residents. Golden light danced on the fresh green plants in the hallways and communal areas. I was reminded of Camus: “The great courage is still to gaze squarely at the light as it is at death.” Maitri is the first Buddhist residential hospice in the U.S. Over more than 20 years Maitri has been the final home for more than 900 people with AIDS. “We strive to provide the type of care that each of us would like to receive at the end of our lives—care that is dignified, non-judgmental, and unconditional. We hold dear the principle that each resident has the right to determine the degree of choice and awareness with which to experience life and death.” (Maitri’s Mission Statement)

Issan and his friends, Ken among them, didn’t set out to found a Buddhist Hospice. Rather he was creating a way to respond to the deadly epidemic that was ravaging his community. He was also creating a place to practice with his own death fast approaching. The result was Maitri.

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Ken Ireland has practiced Buddhism for more than four decades, first with Master C.M. Chen, then Issan Dorsey Roshi and Philip Zenshin Whalen at HSZC. In 1994 he began koan practice with Robert Aitken, and continued with John Tarrant and David Weinstein. Ken was Maitri’s executive director from 1989 through 1993. He and his partner currently spend half the year in northern India with the community gathered around H.H. the Dalai Lama.

I first interviewed Ken more than 20 years ago. I have allowed him to let his words reflect how that experience has remained with him and changed him over the years. This interview appears in A Thousand Hands, A Guidebook to Caring for your Buddhist Community, edited by Nathan Jishin Michon & Daniel Clarkson Fisher.

 

Morgan Zo Callahan: Wonderful talking with you. Ken, how do you relate with someone who's dying?

Ken Ireland: The short answer is “as normally as possible.” But right away as soon as I began to live with people who had a grave diagnosis and who were very close to death, I noticed that their world, and by extension mine, was quite different. It is both slower and much more immediate. I saw theorizing fall away--intellectual considerations like “What's going to happen after death? Am I going to be around?” Conversations got real and something else came forward. I heard requests such as “I want to have my relationship with my family straightened out before I die. I want to make peace with my ex before I die. I want to die on my own terms.” Somehow, even when they seemed impossible, all of us who were part of Maitri tried to fulfill those requests. What we crafted was far from perfect, but life and living life to the end changed on its own accord.

MZC: Apart from the interpersonal relationships, how do you respond to the inevitable natural laws of the process of dying? How do you stay focused and mindful without expectations about how it is all supposed to be?

KI: As hard as we, in cahoots with our medical professionals, try to fight nature and stave off death, nature always wins. All I can do is try to stay present with that process. The body begins to shut down in its own way; physiological, mental, and psychological changes move into place and take over. We're also at the mercy of those processes. We may try to defend ourselves. We experience a variety of natural human reactions in the face of uncertainty, fear, grief, anxiety, but we have no real control. We will eventually have to give up that kind of control whether we want to or not.

What I’ve seen over and over is that our normal reaction to postpone the inevitable proves useless. There’s no way out. There’s no tomorrow. I can only take care of my own mental state--an iffy job at best--but I just say to myself, okay, I'm with this particular person at this very moment. I've decided to be here. I've committed myself to be of service, to alleviate the pain, to ease the transition.

MZC: In what ways is your work a natural expression of your Buddhist practice?

KI: I can’t lie and pretend that it was all hunky dory. Living through the AIDS epidemic, being with so many people, mostly gay men who were my age or younger, was extremely painful. From the point of view of my own cherished ideas about how things should be, it was an impossible task. But on the other hand, in terms of training, in terms of deepening my own meditation, and in terms of personal rewards, it was, and is, great practice.

MZC: How were your teachers helpful in preparing you to engage hospice work?

KI: When I met Yogi Chen in Berkeley in the early 70’s, he introduced me to the meditation on impermanence and the suffering arising from clinging. In Tibet he’d lived for three years in the charnel grounds where dead bodies were brought to have vultures strip the flesh from their bones before they were gathered up. Very specially, highly trained practitioners undertook this practice. When I first became involved at Maitri, partially I’m sure to assure myself that I was not entirely crazy, I tried to tell myself that we were trying to adapt this practice for our times. (There’s always a need for practice manuals I suppose, both as a record of the experience of our ancestors and a kind of reassurance that we’re on the right track.) But in time I gave that up, and realized that we were just responding to the circumstances of our lives in a way that made sense and arose from our own practice. I learned from Issan Dorsey and the many people we took care of. They taught me to relate to humans in any circumstance with respect and love, getting out of the way as much as possible. Over the years I’ve noticed that the experience changed something in me in terms of my relationship to people, my own life, my growing older, the physical breakdowns of my body. It's not just acceptance, and certainly not resignation. It’s more like a transformation, a noticeable change in the air we breathe.

MZC: So meditations on impermanence and encounters in hospice have changed the way you live your life?

KI: Of course. I am definitely not the same man who moved into Maitri and cared for more than 80 people who died. I have the same questions that I had when I was a Jesuit: What are our lives about? What do we want to make our lives about? What do we want to do with our lives in the time that we have? How can I do something that's of value? But for me this is where my Buddhist practice comes in: I'm going to do something that aims to benefit all beings because I'm not alone in the universe. If I consider how I can really take care of a person in the way in which he or she would like while at the same time taking care of myself, the world becomes different. At least that was my experience. When the point is to be of service to somebody when they're at the end of their lives, then the question becomes something like, instead of avoiding the end of life, how does life become full and complete from beginning to end? The whole process is alive and well; it breathes and pulsates, as we breathe from beginning to end.

MZC: One night I received a call at one o’clock in the morning; it was from a member of our school board who very desperately related to me that a Japanese gentleman, a devoted Buddhist, was dying; the family wanted to take the man off life support. I was asked to call the Rosemead Buddhist Monastery and come with a monk to the hospital. I said, my gosh, it's one o’clock in the morning. But I said I'd do it. So I called the monastery; the monks were very upset at first. But it ended up that three monks happily went to the bedside, and chanted. “We transfer the effects of the good that we’ve done in our lives for whatever journey this dying person is going on.”

KI: That's what we do. The monks got out of bed to be of service to the family and dying person. They sat with them, and chanted, performing the rituals of the end of life. They were present with him when all this was going on. It's a profound matter.

 




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