 I'm Marcia Joyner, your host for Navigating the Journey. Navigating the Journey is dedicated to exploring the options and choices for end-of-life care. And to assist people talking about their wishes, it's time to transform our culture so we shift from not talking about dying to talking about it. It's time to share the way we want to live our lives at the end of our lives. It's time to communicate about the kind of care we want and don't want for ourselves. We believe that the place for this to begin is not in the intensive care unit, but together we can explore the various paths to lives ending. Together we can make these difficult conversations easier. Together we can make sure that our wishes and those of our loved ones are expressed and respected. If you're ready to join us, we ask, navigate the journey, explore the options and choices at the end of life. This is a conversation that every one of us needs to have, yet very few people are prepared. Too many people in our society have no idea how to properly help a loved one who is at the end of life. We don't know what to say, how to act, or what their needs are. Today's guest is, of course you know, my friend, my dear friend, Bishop Eric Matsumoto. Hong Kong, Hong Wanzhi, Mission Hawaii. Eric, aloha. First of all, now, you are Buddhist. Tell us, there are so many types and kinds of Buddhism. There is Tibetan Buddhism, the Vietnamese have Buddhism, the Chinese have Buddhism, the Japanese. What's the difference? That's right. You're absolutely right. There are many traditions and denominations of Buddhism, and each seems to have, does have their perspective or approach to death and dying. So today I'm very happy to join you because I do totally agree with what you just mentioned, and the conversation has to start, and it is so important that we do so, that we all do so. So I would preface today by saying that this is not a specialty as far as my area of study is concerned, so what I share today is very general, and mostly comes from what I would say, who referred to as the Pure Land tradition, the Hong Kongji tradition. And that's what we want, but I just ask a general question so we can, so if someone says, but that's not the Buddhism I thought, or that's not the Buddhism that I understand. So that's why I'm asking, let's separate some of these, and then, for instance, I have a very dear friend, Vietnamese, and I was asking her these same questions, and she said, well, we were originally Buddhist, and then the French came in, and they added Catholicism to Buddhism, and then the Americans came, and they added another one. So she was saying that they have to still move from under all of that. I think that's common for maybe many people that we do have our religious traditions, our spiritual traditions by which we're influenced, and we seek guidance, but at the same time there are, of course, other factors that also form, I guess, our thoughts and influence our thinking, and so I think in your friend's case, that's a very good example of that, and I think all of us are like that. But she says that they really had to work at keeping Buddhism with all of these other influences. I believe Buddhism does have a perspective, which I'm not sure if it's unique, but it's very different from the prevalent, perhaps, view in our Western societies, and that is concerning death and dying, that death and dying is a very natural part of life for existence, and so it's a natural part of life, and living on two sides, perhaps, of the same coin, and so death and dying is not something that should be feared or seen as being unnatural and so forth, but that's not to say that we might have some anxiety about it, and in Buddhism I think that's one of the goals in which we do always talk about birth, old age, sickness and death as being a very natural part of life again and living existence, and so we're encouraged to be aware of that and live our lives, realizing then, because life is impermanent, also at the same time how precious this moment we have with each other, with what another that I have is also. So that is kind of in a nutshell, perhaps, the Buddhist perspective. So now that would be a sort of basic in all of Buddhism, in spite of all of the different approaches to death and dying. So are there rituals, are there different when a person is at the end, not an accident or any of that kind of stuff, but when we know that the tumor is not going to get any better, the person is really at the end. How do you approach those type of things? Yes, I would say generally speaking, all the Buddhist traditions, I believe do have some ritual or procedure in which they would like to assist or be involved in as the person approaches the end of life. Depending on the tradition, the extent of what is done or performed can be very different. However, generally speaking, yes, there are rituals that help to bring about an awareness to calm the individual and also the family and friends and so forth. For example, and so again, it might differ depending on the tradition. Some traditions would emphasize more than a ritual at that very point at the end of life. It's more how you view your life in general, again, appreciating that the preciousness of life and the fact that life is impermanent, coming to fully grasp and understand that to the point that it's not knowledge anymore about it, but it's turned into wisdom which guides how one is dealing in that moment with death and dying. Other traditions do have rituals which help, like chanting of the sutras, for example, are part of, I think, many of the traditions in which the chanting is to remind us of the teachings, the Dharma of the Buddha. The Dharma? Yes. The Dharma is? Dharma, in the Buddhist tradition Dharma refers to the teachings of the Buddha. And generally we might say it also refers to ultimate reality or ultimate truth, which for Buddhists means the teachings of the Buddha. Yes. And so we go to the Dharma, the teachings for guidance in hopes that it is able to, again, guide us with understanding, again, to the point that it becomes wisdom in which it helps us then to guide myself and others. So you begin this process long before the person is at a critical... Yes, that is a Buddhist clergy. Yes. That is our wish, our aspiration, that people do, again, become aware of, again, birth, old age, sickness and death as a part of life. So this is a part of, this is an ongoing process. Yes, it is. This isn't something that happens at the end. As you mentioned earlier, right. We hope that people are not waiting till the end to begin the conversation. We hope that it's begun a long time ago. But I think the reality is that for many people it's a difficult subject to reach. Do you ever have a family, let's say, the person is... We know this person is not going, you know, whatever they have is not going to get any better. Do you have a family with them? Do you ever come together as a family with you or some other clergy to really talk about it? Yes, we're encouraging that at this time. We have, for example, in the Honpo Honganji Mission of Hawaii in the Honganji tradition, a compassionate care committee which seeks to promote, again, and encourage people to have the conversation and to begin talking about what are your wishes and have others also know about it. However, I would have to say that I think for the Buddhist tradition a lot of our involvement in a person's dying moments come after a person has passed away traditionally up until now. But there is an un-shift right now that we're trying to, especially here in America, sort of make emphasize how, no, we have to be involved earlier. And that's precisely again. We want to talk about it. We want to make it easier for people to talk about it so that we understand your wishes. Right, true. We hear so many horror stories of somebody says this is what I want, but then some other relatives says no, don't do this, no, don't do that. It is more common than I think people do realize. That's what I'm asking. Do you have the family together with your compassion? Yes, we are encouraging that at this moment. And we have that compassionate care committee that I just mentioned. It has in the past couple of years had several seminars and hosted gatherings in which we bring that awareness about and encourage people to do that with their family. And so we're hopeful that there will be more of seminars like those that we have hosted in the past again. And I know there is something coming up later this month. By Hospice Hawaii and Pacific Health Ministries that they're having a conference in which they're asking clergy and those in the medical profession to come together to be able to talk and discuss and share what to them is important for each other to know at the end of life. And what to say and what not to say. Exactly. And so I'm kind of looking forward to that. Do you know when that is? It's on January 12th. That's next week. Yes, over at one of the facilities at Queens, they're hosting this conference. And I see it as an important step towards, again, working together as you mentioned earlier as well and the medical profession and the religious spiritual community caring for the whole individual. The whole individual, yes. And the family is very much a part of the whole. Not only just the individual who's dying but yes, caring for family and friends. It's also very important. On being mortal, I think it was a PBS piece. And the doctor says he was trained to do, to save life. At a point you know that this treatment is not going to work but that part of you says I'm supposed to keep going. And so he had this real dilemma of what do I say? When do I say it? When do I tell the patient when I've been trained to do something else? So I think this is a good thing that they are talking about it. Right, I think so too. Yes, I think in the Western world the medical profession has been trained and of course to prolong life to save life at all costs and that has been the tradition I think. But there is another wisdom I think that is available to us which well we do realize how precious life is at the same time to realize the truth of impermanence that things do change and we are mortal and there is a point. There's a point, yes. And I think that that's a good thing that they're doing this seminar because of learning for the people to be able to say because the patient knows so to be able to say clearly and that this is a point with which we need to be clear with the patient and with compassion. You know, you don't say well this is it, I can't do anything else. There's got to be a way to say this, to be loving because the end is as sacred as the beginning. Exactly, yes. So they need to be able to do that. So let's talk again some more. We've got to go to break. We will be back in one minute. Hi, I'm Keeley Akina, president of the Grass Root Institute. I'd love you to join us every week Mondays at 2 o'clock p.m. for Ehana Kako. Let's work together. We report every week on the good things going on in our state as well as the better things that can go on in the future. We have guests covering everything from the economy, the government, and society. See you Mondays on Ehana Kako at 2 o'clock p.m. Until then, I'm Keeley Akina. Aloha. Hi, I'm Donna Blanchard. I'm the host of Center Stage, which is on Wednesdays at 2 o'clock here on Think Tech. On Center Stage, I talk with artists about not only what they do and how they do it, but the meat of the conversation for me is why they do it, why we go through this. A lot of us are not making our livings doing this, and a lot of us would do this with our last dying breath if we had that choice. And that's what I love to talk to people about. I hope you enjoy watching it, and I hope you get inspired because there's an artist inside G2. Join us on Center Stage at 2 o'clock on Wednesdays. Bye. Aloha. Thank you for staying with us. We are today talking with my dear friend, Bishop Eric Montzermoto. And I tell you, he is just the nicest man. At first, I was not... I didn't know anything about Buddhism, that I have spent so much time with the bishop and learning so much about Buddhism. And if you've not been to the temple, the temple is on Wano Avenue? Oh, no. Polly Highway. Our main temple, our largest temple, is on Polly Highway. 1727 Polly Highway. 1727 Polly Highway. And you're always welcome. Yes. And it is just a wonderful experience learning about the other traditions. In fact, that's the real beauty of living in Hawaii is that you get to meet people like Bishop Eric Montzermoto and other traditions, and everybody shares each other's culture and next week is the Martin Luther King holiday and the bishop will be in the parade every year. It's a wonderful way to live, to know people of different faiths and different traditions and different cultures. And that's why we are having this conversation to talk about the different cultures and the different ways that people handle the end of life. So now, stop me if I'm wrong. I understand that Buddhists don't even kill roaches. So... We try not to. We try to be compassionate. Try to be compassionate. So when you do reach the end of life and someone says, well, I really don't want to do this any longer, how do you feel about that? The Buddhist perspective, I believe, would be the best would be a natural death and to let things take its course, so to speak. Although that's not to say that one should not take advantage of palliative care, for example, and so forth. I think that's a wonderful contribution of medical science today that we have so much to offer someone who may be experiencing pain and discomfort and to be able to relieve that, I think it's something wonderful that everyone should seriously look at. But again, I guess, Buddhism, you know, the best is a natural kind of progression. Like you said, okay, now we're talking about people that are seriously, and we know that this is not going to get well. Yes, there's hospice and palliative care with compassion I think is what they call themselves because it's really about making people comfortable. What I understand about palliative care is that they do include the family and learning about what is going on and how to handle it. Hospice, of course, is absolutely wonderful, my experience with them. But when a family, you know, we have palliative care and we have hospice, but now enters another family person and says, oh no, no, no, no, no, no. How do we deal with that with Buddhism? Buddhism, I believe, we would ask all family and friends to focus on the individual who is dying. We may all have our own thoughts and what we think is important. However, I'm not the one who's dying. It's mom or dad or grandma or uncle or auntie. And so we need to be focused on the individual and their wishes. And that would be what I believe in the Buddhist tradition would say. And so we would encourage, of course, we want everybody to feel comfortable and feel like they're not being sort of shoved to the side. And so as you mentioned earlier, I think it's important that the family does talk to each other and come to some understanding. I fully realize at times it can be challenging again because of different perspectives and so forth. But that's maybe where it is important maybe to have someone of a spiritual nature to be a facilitator or even in this case, somebody from hospice or so forth who can act as a facilitator to have the conversation take place so that there is more understanding and focus around the person dying. Now my view is we should have this conversation with the family now while I'm healthy instead of getting the emotions at the end because emotions change at the end. Oh, don't leave me. Don't go. So that's my whole thing. And now you have to tell me again about the hospice seminar. Is it a seminar, you said? Yes, it's a seminar. Maybe it's making healthcare whole. Making healthcare whole. That's a great title. And it's when and where? On January 12th, again, I forget the exact facility but it's somewhere on the grounds near Queen's Hospital. Probably in the auditorium. For those of you that know where the auditorium is, it used to be the Mabel Smyth auditorium. I think so. That's usually where they have these lovely facilities. And that's the 12th. In the morning, after the event, is it open to the public? I believe it is. But mainly for doctors and clergy? Primarily, but I think it is open to the other individuals. Registration forms have been available for those who want to participate as individuals. So we could just call hospice in Hawaii? Yes, I believe that would be the best place. I believe if you go on to their website... Is it hospice in Hawaii? Yes, I believe it's hospice in Hawaii. I think we all should go. We should all take advantage of it. Quickly, the Dalai Lama is Buddhist. And that's Tibetan Buddhism? Yes, one of the Tibetan traditions. Is that different from yours? A little different. We are both Buddhists. However, there's a difference perhaps in emphasis on how to approach death and dying. Generally speaking, from my limited knowledge of the Tibetan tradition, they do have a very strong emphasis, I think, on a person's state of mind as a person is dying or approaches death. Tibetan tradition is a very important part where there is guidance provided and there are meditations and so forth, which hopefully before, this time, the person has already been sort of practicing, which helps the individual have that so-called right frame or state of mind, which is peace and calm and so forth, and not afraid of death and dying. Even after death, one thing that maybe I should also mention that maybe the Buddhist tradition might be unique is that the process of death and dying doesn't stop at the moment of death, but there is, after the physical death, there is still this process of death and dying, which is going on, so to speak, for many traditions, and so up to a 49-day period. So mourning and so forth does continue. The chanting of the sutras and so forth or caring for the person who has passed away does continue in many Buddhist traditions. The Jodo Shinshi or Shin Buddhist tradition, to which I belong, places this emphasis on how a person dies and instead emphasizes how, when we have already previously, hopefully previously, entrusted ourselves to the wisdom and compassion of the Buddha Amitabha, Amitayus, Amida Buddha in Japanese, is already vowed or promised our liberation or enlightenment, and so the exact moment of death and how we die is not as great a concern in that we're already embraced by great compassion, and so the emphasis here becomes now on being to say goodbye, being able to say thank you to all our family and friends who have been a big part of our life and really fuel a lot of appreciation and gratitude at the end of life, and so our emphasis is to have what we call today an appreciation service in which the person who's about to pass on and if they wish family and friends and preferably with family and friends all gather and there is a short service or a ritual that is performed and where we do acknowledge each other, we call it an appreciation service. I love that. That's what we wish or hope that more people will avail themselves of to have or to do, that not wait until a person has passed away, but to gather before. Again, so that there's something that's not feared or contains a lot of anxiety and instead we have this gratitude and compassion. I think we all should have an appreciation before, before, yes. You go to funerals and I say all these wonderful things about you, you should be able to say that before. Before, right? Before, yes. The person should know that they've been appreciated. Yes, they've been appreciated, yes. Now, do you have reincarnation? Is that part of... Or the Tibetan tradition, I believe, does place a heavy emphasis on reincarnation. So you move the spirit into... Yes, life, so to speak, maybe continues, so to speak. Although I would say in the Buddhist tradition because the Buddhist tradition the Buddhist teaching is that everything changes in the constant state of being, it's a little different from the idea that maybe the Christian, if I can use that to make it more understandable, idea of eternal, unchanging soul. Right. So it's a little different, yes, concept or principle. And so it's not quite that, but in the Tibetan tradition, for example, yes, they quite often do mention reincarnation and so forth. And many of the other Buddhist traditions also do speak of the next life, so to speak. Yes. And so there is an ongoing process here where life does continue, but it might... It's not necessary. It doesn't look like... Right, that you see me now, for example. And so... But in my tradition, there is less an emphasis on reincarnation, but more of the emphasis on being guided and embraced by great wisdom and compassion and being transformed into that so that more individuals can begin to appreciate... So when I come back, I'm going to come back as your friend. Thank you, so...