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Difference between revisions of "Introduction to the Essential Phowa"

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What is [[Essential]] [[Phowa]]?
 
  
  
The [[Essential]] [[Phowa]] [[meditation]], introduced in [[The Tibetan Book of Living and Dying]]
+
 
by [[Sogyal Rinpoche]], is adapted from a [[Buddhist meditation]] normally used for the time of
+
==What is [[Essential Phowa]]?==
dying and [[death]]. This [[meditation]] is written in a way that anyone can relate with, whether or
+
 
not they are affiliated with a [[faith]] [[tradition]]. However, it can also be used to support [[physical]]
+
 
and [[emotional]] [[healing]] and to [[transform]] [[suffering]], [[guilt]] or [[grief]]. If we have a loved one who
+
 
is ill, or in [[pain]], or facing [[death]], we can quietly do this [[meditation]] to help bring them [[peace]].
+
The [[Essential Phowa meditation]], introduced in [[The Tibetan Book of Living and Dying]] by [[Sogyal Rinpoche]], is adapted from a [[Buddhist meditation]] normally used for the time of dying and [[death]]. This [[meditation]] is written in a way that anyone can relate with, whether or not they are affiliated with a  
[[Essential]] [[Phowa]] is an effective [[spiritual]] guidance for [[people]] at the [[moment of death]], to
+
 
 +
[[faith tradition]]. However, it can also be used to support [[physical]] and [[emotional]] [[healing]] and to [[transform]] [[suffering]], [[guilt]] or [[grief]]. If we have a loved one who is ill, or in [[pain]], or facing [[death]], we can quietly do this [[meditation]] to help bring them [[peace]].
 +
[[Essential Phowa]] is an effective [[spiritual]] guidance for [[people]] at the [[moment of death]], to
 
guide their [[consciousness]] to a [[state]] of [[peace]], clarity, and freedom.
 
guide their [[consciousness]] to a [[state]] of [[peace]], clarity, and freedom.
There are recordings of two versions: [[Essential]] [[Phowa]] for Oneself, and [[Essential]]
 
[[Phowa]] for Others.
 
  
  
Why is the [[Essential]] [[Phowa]] valuable to do?
+
There are recordings of two versions: [[Essential]] [[Phowa]] for Oneself, and [[Essential]] [[Phowa]] for Others.
  
  
 +
==Why is the [[Essential Phowa]] valuable to do?==
  
According to [[Buddhist teachings]], what counts at the [[moment]] of our [[death]] is how
 
we lived our [[life]], and the [[state]] of our [[mind]] and [[heart]] in that [[moment]]. Of course, we cannot
 
change the way someone lived, but this [[meditation]] has the power to {{Wiki|purify}} a person’s [[mind]]
 
and [[heart]] while they are dying. If the dying [[person]] is confused or in a coma, we may see
 
[[signs]] that the [[meditation]] is still having an effect on their [[mind]] and [[heart]].
 
By doing the [[Essential]] [[Phowa]] regularly and observing the effect, our [[confidence]]
 
grows in its power to [[benefit]] [[people]] at such a crucial [[moment]]. And, we come to realize that
 
this [[meditation]] is a meaningful way of communicating heart-to-heart with others. Even
 
[[visualizing]] a [[loving]] presence while we’re working or sitting in a hospital room creates an
 
{{Wiki|atmosphere}} of [[peace]] or sacredness.
 
  
  
This [[meditation]] is especially effective in the first days or weeks after someone has
+
According to [[Buddhist teachings]], what counts at the [[moment of our death]] is how we lived our [[life]], and the [[state of our mind]] and [[heart]] in that [[moment]]. Of course, we cannot change the way someone lived, but this [[meditation]] has the power to [[purify a person’s mind]]
[[died]] and, it can be [[offered]] any time afterwards, even years later.
+
and [[heart]] while they are dying. If the [[dying person]] is confused or in a coma, we may see [[signs]] that the [[meditation]] is still having an effect on their [[mind]] and [[heart]].
If you have a [[friend]] or [[family]] member who is open to {{Wiki|learning}} this [[meditation]], you
 
can share this with them. [[People]] adapt it in all sorts of ways to make it work for them. Some
 
[[people]], for example, just resonate with the first part: [[visualizing]] a [[loving]] presence in the
 
room with them.
 
  
 +
By doing the [[Essential Phowa]] regularly and observing the effect, our [[confidence]] grows in its power to [[benefit]] [[people]] at such a crucial [[moment]]. And, we come to realize that this [[meditation]] is a meaningful way of communicating heart-to-heart with others. Even [[visualizing]] a [[loving]] presence while we’re working or sitting in a hospital room creates an {{Wiki|atmosphere}} of [[peace]] or sacredness.
  
A [[nun]] told me once that she spent the night monitoring at the bedside of a man
+
This [[meditation]] is especially effective in the first days or weeks after someone has [[died]] and, it can be [[offered]] any time afterwards, even years later.
who was {{Wiki|comatose}} following a [[suicide]] attempt. All night long, she silently [[offered]] her
+
 
[[spiritual practice]] for him, which is called The {{Wiki|Jesus}} [[prayer]]: “Lord, {{Wiki|Jesus Christ}}, have [[mercy]] on
+
If you have a [[friend]] or [[family]] member who is open to {{Wiki|learning}} this [[meditation]], you can share this with them. [[People]] adapt it in all sorts of ways to make it work for them.  
me.” In the morning, the man came out of his coma and thanked her profusely. She asked
+
 
him why he was thanking her. He told her,
+
Some  [[people]], for example, just resonate with the first part: [[visualizing]] a [[loving]] presence in the room with them.
“All night long, I kept falling into a deep [[Wikipedia:Abyss (religion)|abyss]], and when I heard your [[prayer]], it
 
pulled me out.
 
  
Doing the [[Essential]] [[Phowa]] after someone [[dies]] brings [[benefit]] for both the deceased
 
and for the survivors. A Palliative Care director guides this [[meditation]] in a nondenominational way at the center's 6-month memorial service. She gets many grateful
 
responses. The {{Wiki|Medical}} Director introduces it this way: “Different cultures around the [[world]]
 
have ways of [[offering]] [[spiritual]] support after someone has [[died]], and here's a very beautiful
 
one I would like to share with you.”
 
  
 +
A [[nun]] told me once that she spent the night monitoring at the bedside of a man who was {{Wiki|comatose}} following a [[suicide]] attempt. All night long, she silently [[offered]] her [[spiritual practice]] for him, which is called The {{Wiki|Jesus}} [[prayer]]: “Lord, {{Wiki|Jesus Christ}}, have [[mercy]] on
  
[[Visualizing]] as a support for {{Wiki|medical}} professionals
+
me.” In the morning, the man came out of his coma and thanked her profusely. She asked him why he was thanking her. He told her, “All night long, I kept falling into a deep [[Wikipedia:Abyss (religion)|abyss]], and when I heard your [[prayer]], it pulled me out.”
  
The technique of [[visualization]] can be an invaluable support for caregivers who want
+
Doing the [[Essential]] [[Phowa]] after someone [[dies]] brings [[benefit]] for both the deceased and for the survivors. A Palliative Care director guides this [[meditation]] in a nondenominational way at the center's 6-month memorial service. She gets many grateful responses. The {{Wiki|Medical}} Director introduces it this way: “Different cultures around the [[world]] have ways of [[offering]] [[spiritual]] support after someone has [[died]], and here's a very beautiful
to embody [[compassionate]] presence. Especially when facing really difficult or challenging
+
one I would like to share with you.”
situations, [[visualizing]] a [[loving]] or [[divine]] presence can help you stay centered, [[peaceful]] and at
 
ease. Dame Cicely Saunders, the founder of the {{Wiki|modern}} hospice {{Wiki|movement}}, said,
 
“Always remember, when you are at the bedside of a dying [[person]], you are never
 
alone.”
 
  
When you are serving [[people]] who are in great {{Wiki|distress}}, you can [[visualize]] a [[loving]]
 
presence and ask, “Please help this [[person]] with your [[compassion]] and [[blessings]]. Please guide
 
me, so I know how to help.”
 
Especially, the practice of [[Essential]] [[Phowa]] can help nourish and inspire you, thus
 
preventing burnout.
 
  
 +
[[Visualizing]] as a support for {{Wiki|medical}} professionals
  
Integrating the [[Essential]] [[Phowa]] Practice
+
The technique of [[visualization]] can be an invaluable support for caregivers who want to embody [[compassionate]] presence. Especially when facing really difficult or challenging situations, [[visualizing]] a [[loving]] or [[divine]] presence can help you stay centered, [[peaceful]] and at ease. Dame Cicely Saunders, the founder of the {{Wiki|modern}} hospice {{Wiki|movement}}, said, “Always remember, when you are at the bedside of a dying [[person]], you are never alone.”
  
 +
When you are serving [[people]] who are in great {{Wiki|distress}}, you can [[visualize]] a [[loving]] presence and ask, “Please help this [[person]] with your [[compassion]] and [[blessings]]. Please guide me, so I know how to help.” Especially, the practice of [[Essential]] [[Phowa]] can help nourish and inspire you, thus preventing burnout.
  
  
 +
Integrating the [[Essential Phowa Practice]]
  
There are two [[reasons]] the [[Essential]] [[Phowa]] can bring invaluable [[spiritual]] support to
+
There are two [[reasons]] the [[Essential Phowa]] can bring invaluable [[spiritual]] support to those who [[suffer]]: first, the dire circumstances the [[person]] is in, and second, the ability of an [[enlightened being]] to bring their [[compassion]] and [[blessings]] to the [[person]] for whom we are
those who [[suffer]]: first, the dire circumstances the [[person]] is in, and second, the ability of an
 
[[enlightened being]] to bring their [[compassion]] and [[blessings]] to the [[person]] for whom we are
 
 
praying.
 
praying.
  
Even though an [[enlightened being]] is {{Wiki|present}} as soon as we invoke them, the power
+
Even though an [[enlightened being]] is {{Wiki|present}} as soon as we invoke them, the power of their presence and [[blessings]] is heightened by the strength of our genuine [[devotion]]. Whichever presence you choose to invoke, it’s important to establish a relationship of [[openness]], longing and [[respect]], and to sincerely ask, from the depths of your being, for the [[blessings]] streaming from this Presence to fully enter you and [[awaken]] your [[wisdom nature]].
of their presence and [[blessings]] is heightened by the strength of our genuine [[devotion]].
 
Whichever presence you choose to invoke, it’s important to establish a relationship of
 
[[openness]], longing and [[respect]], and to sincerely ask, from the depths of your being, for the
 
[[blessings]] streaming from this Presence to fully enter you and [[awaken]] your [[wisdom nature]].
 
After concluding your practice of [[Essential]] [[Phowa]], resolve to sustain this [[Divine]]
 
presence in the [[space]] above you, and consider that it’s above the head of everyone you
 
meet. Then your every [[action]], [[word]], or [[thought]] becomes a living [[prayer]].
 
  
If we generate such a deep and {{Wiki|sincere}} [[devotion]] in our daily practice, then when we
+
After concluding your practice of [[Essential]] [[Phowa]], resolve to sustain this [[Divine]] presence in the [[space]] above you, and consider that it’s above the head of everyone you meet. Then your every [[action]], [[word]], or [[thought]] becomes a living [[prayer]].
do the [[Essential]] [[Phowa]] for a [[person]] who is [[suffering]] or dying, it will be easier to invoke this
 
[[Divine]] Presence and bring their [[compassionate]] [[blessings]] to the [[person]] in {{Wiki|distress}}.
 
David, an emergency-room doctor in a major city hospital, told me how stressful his
 
job used to be, and how he was getting close to burnout.  
 
  
He told me, “Families panic at the time of [[death]], call 911, and bring their loved one to the emergency room to [[die]]. When they
+
If we generate such a deep and {{Wiki|sincere}} [[devotion]] in our daily practice, then when we do the [[Essential]] [[Phowa]] for a [[person]] who is [[suffering]] or dying, it will be easier to invoke this [[Divine Presence]] and bring their [[compassionate]] [[blessings]] to the [[person]] in {{Wiki|distress}}.
arrive, they're not prepared in any way for what is about to happen. What I see is enormous
 
{{Wiki|fear}}, [[confusion]], [[anxiety]] and helplessness. The way I used to deal with the situation was
 
through [[detachment]]. Outside of doing my best for the {{Wiki|patient}}, I figured there was no way I
 
could impact their situation at all.
 
  
“Then, telling a [[family]] that their loved one has [[died]] or is dying was one of the things
+
David, an emergency-room doctor in a major city hospital, told me how stressful his job used to be, and how he was getting close to burnout. He told me, “Families panic at the time of [[death]], call 911, and bring their loved one to the emergency room to [[die]]. When they arrive, they're not prepared in any way for what is about to happen. What I see is enormous {{Wiki|fear}}, [[confusion]], [[anxiety]] and helplessness. The way I used to deal with the situation was
I hated most about my job. Often the [[family]] reacted to me with {{Wiki|hostility}} and [[anger]]. The
 
work was {{Wiki|fearful}} and [[unpleasant]] for me.
 
  
David asked me: “How can I offer [[spiritual]] [[care]] for [[people]] who are dying, in the
+
through [[detachment]]. Outside of doing my best for the {{Wiki|patient}}, I figured there was no way I could impact their situation at all. “Then, telling a [[family]] that their loved one has [[died]] or is dying was one of the thing I hated most about my job. Often the [[family]] reacted to me with {{Wiki|hostility}} and [[anger]]. The work was {{Wiki|fearful}} and [[unpleasant]] for me.”
midst of a {{Wiki|medical}} crisis? I am doing my best to save one person's [[life]], but right after they
 
[[die]] I have to rush over and work on the next {{Wiki|patient}}. Even when it's not so busy, if we’ve
 
failed to save a person's [[life]], everyone just walks away from the [[body]].”
 
  
When you train in [[medicine]], especially emergency resuscitation, you learn and
 
repeatedly practice many lifesaving [[techniques]], so that in a crisis situation you’ll be able to
 
act reflexively, without [[thinking]]. You can train in your [[spiritual practice]] the same way, so
 
you’re able to bring its benefits spontaneously to every situation.
 
  
 +
David asked me: “How can I offer [[spiritual]] [[care]] for [[people]] who are dying, in the midst of a {{Wiki|medical}} crisis? I am doing my best to save one person's [[life]], but right after they [[die]] I have to rush over and work on the next {{Wiki|patient}}. Even when it's not so busy, if we’ve failed to save a person's [[life]], everyone just walks away from the [[body]].”
  
 +
When you train in [[medicine]], especially emergency resuscitation, you learn and repeatedly practice many lifesaving [[techniques]], so that in a crisis situation you’ll be able to act reflexively, without [[thinking]]. You can train in your [[spiritual practice]] the same way, so
 +
you’re able to bring its benefits spontaneously to every situation.
  
Practice the [[Essential]] [[Phowa]] every day before going to work, with a [[compassionate]]
+
Practice the [[Essential]] [[Phowa]] every day before going to work, with a [[compassionate]] [[intention]] that the [[meditation]] may truly [[benefit]] and help those who [[suffer]]. At the conclusion, dissolve your being into the [[Buddha]], {{Wiki|Christ}}, or whichever [[enlightened being]] you have invoked, and  
[[intention]] that the [[meditation]] may truly [[benefit]] and help those who [[suffer]]. At the
 
conclusion, dissolve your being into the [[Buddha]], {{Wiki|Christ}}, or whichever [[enlightened being]] you
 
have invoked, and once again enter your daily [[activities]]. Then, you can bring this [[Divine]]
 
Presence with you into the hospital or your workplace, continually praying to the Presence
 
as you [[care]] for your patients or clients.
 
  
 +
once again enter your daily [[activities]]. Then, you can bring this [[Divine Presence]] with you into the hospital or your workplace, continually praying to the Presenceas you [[care]] for your patients or clients.
  
If you have a {{Wiki|patient}} on the edge of [[life]] and [[death]], pray fervently to the [[Divine]]
 
Presence to help him or her. [[Visualize]] that the [[Divine]] Presence shines powerful {{Wiki|light}} rays of
 
[[compassion]] and [[blessing]] onto the [[person]], purifying any {{Wiki|fear}} or anguish in his [[heart]] and
 
[[mind]]. Pray that, if possible, he or she may be healed and survive this crisis. If they [[die]] in
 
spite of your {{Wiki|medical}} intervention, then [[visualize]] your patient’s [[consciousness]] in the [[form]] of
 
a small [[sphere]] of {{Wiki|light}} flashing out from their [[body]] like a shooting [[star]] and dissolving
 
completely into the [[heart]] of the [[Divine]] Presence. Later, after coming home from work, you
 
may want to do the [[Essential]] [[Phowa practice]] in a more complete way for all the patients you
 
attended during the day.
 
  
 +
If you have a {{Wiki|patient}} on the edge of [[life]] and [[death]], pray fervently to the [[Divine]] Presence to help him or her. [[Visualize]] that the [[Divine]] Presence shines powerful {{Wiki|light}} rays of [[compassion]] and [[blessing]] onto the [[person]], purifying any {{Wiki|fear}} or anguish in his [[heart]] and [[mind]]. Pray that, if possible, he or she may be healed and survive this crisis. If they [[die]] in spite of your {{Wiki|medical}} intervention,
  
David wrote me later to describe how his [[experience]] has changed since he began
+
then [[visualize]] your patient’s [[consciousness]] in the [[form]] of a small [[sphere]] of {{Wiki|light}} flashing out from their [[body]] like a shooting [[star]] and dissolving completely into the [[heart]] of the [[Divine]] Presence. Later, after coming home from work, you may want to do the [[Essential]] [[Phowa practice]] in a more complete way for all the patients you attended during the day.
integrating his [[spiritual practice]] at work.
 
  
 +
David wrote me later to describe how his [[experience]] has changed since he began integrating his [[spiritual practice]] at work. “Since I started doing [[spiritual practice]] in the emergency room, I've watched the person's expression in the final few minutes of [[life]] change to one of [[acceptance]], sometimes even a gentle [[smile]], replacing the {{Wiki|fear}} and [[anxiety]]. It looks like an opening, a [[release]]. Then, when I have to go and tell a
  
“Since I started doing [[spiritual practice]] in the emergency room, I've watched the
+
[[family]] that their loved one has [[died]], I notice an enormous difference in their {{Wiki|reaction}}. [[Family]] members often will thank me and even come up and hug me. This new [[experience]] I'm having since doing my [[spiritual practice]] in the hospital has
person's expression in the final few minutes of [[life]] change to one of [[acceptance]], sometimes
 
even a gentle [[smile]], replacing the {{Wiki|fear}} and [[anxiety]]. It looks like an opening, a [[release]]. Then,
 
when I have to go and tell a [[family]] that their loved one has [[died]], I notice an enormous
 
difference in their {{Wiki|reaction}}. [[Family]] members often will thank me and even come up and hug
 
me. This new [[experience]] I'm having since doing my [[spiritual practice]] in the hospital has
 
 
[[transformed]] my [[life]] and my {{Wiki|medical}} practice.”
 
[[transformed]] my [[life]] and my {{Wiki|medical}} practice.”
  

Latest revision as of 11:23, 10 June 2024






What is Essential Phowa?

The Essential Phowa meditation, introduced in The Tibetan Book of Living and Dying by Sogyal Rinpoche, is adapted from a Buddhist meditation normally used for the time of dying and death. This meditation is written in a way that anyone can relate with, whether or not they are affiliated with a

faith tradition. However, it can also be used to support physical and emotional healing and to transform suffering, guilt or grief. If we have a loved one who is ill, or in pain, or facing death, we can quietly do this meditation to help bring them peace. Essential Phowa is an effective spiritual guidance for people at the moment of death, to guide their consciousness to a state of peace, clarity, and freedom.


There are recordings of two versions: Essential Phowa for Oneself, and Essential Phowa for Others.


Why is the Essential Phowa valuable to do?

According to Buddhist teachings, what counts at the moment of our death is how we lived our life, and the state of our mind and heart in that moment. Of course, we cannot change the way someone lived, but this meditation has the power to purify a person’s mind and heart while they are dying. If the dying person is confused or in a coma, we may see signs that the meditation is still having an effect on their mind and heart.

By doing the Essential Phowa regularly and observing the effect, our confidence grows in its power to benefit people at such a crucial moment. And, we come to realize that this meditation is a meaningful way of communicating heart-to-heart with others. Even visualizing a loving presence while we’re working or sitting in a hospital room creates an atmosphere of peace or sacredness.

This meditation is especially effective in the first days or weeks after someone has died and, it can be offered any time afterwards, even years later.

If you have a friend or family member who is open to learning this meditation, you can share this with them. People adapt it in all sorts of ways to make it work for them.

Some people, for example, just resonate with the first part: visualizing a loving presence in the room with them.


A nun told me once that she spent the night monitoring at the bedside of a man who was comatose following a suicide attempt. All night long, she silently offered her spiritual practice for him, which is called The Jesus prayer: “Lord, Jesus Christ, have mercy on

me.” In the morning, the man came out of his coma and thanked her profusely. She asked him why he was thanking her. He told her, “All night long, I kept falling into a deep abyss, and when I heard your prayer, it pulled me out.”

Doing the Essential Phowa after someone dies brings benefit for both the deceased and for the survivors. A Palliative Care director guides this meditation in a nondenominational way at the center's 6-month memorial service. She gets many grateful responses. The Medical Director introduces it this way: “Different cultures around the world have ways of offering spiritual support after someone has died, and here's a very beautiful one I would like to share with you.”


Visualizing as a support for medical professionals

The technique of visualization can be an invaluable support for caregivers who want to embody compassionate presence. Especially when facing really difficult or challenging situations, visualizing a loving or divine presence can help you stay centered, peaceful and at ease. Dame Cicely Saunders, the founder of the modern hospice movement, said, “Always remember, when you are at the bedside of a dying person, you are never alone.”

When you are serving people who are in great distress, you can visualize a loving presence and ask, “Please help this person with your compassion and blessings. Please guide me, so I know how to help.” Especially, the practice of Essential Phowa can help nourish and inspire you, thus preventing burnout.


Integrating the Essential Phowa Practice

There are two reasons the Essential Phowa can bring invaluable spiritual support to those who suffer: first, the dire circumstances the person is in, and second, the ability of an enlightened being to bring their compassion and blessings to the person for whom we are praying.

Even though an enlightened being is present as soon as we invoke them, the power of their presence and blessings is heightened by the strength of our genuine devotion. Whichever presence you choose to invoke, it’s important to establish a relationship of openness, longing and respect, and to sincerely ask, from the depths of your being, for the blessings streaming from this Presence to fully enter you and awaken your wisdom nature.

After concluding your practice of Essential Phowa, resolve to sustain this Divine presence in the space above you, and consider that it’s above the head of everyone you meet. Then your every action, word, or thought becomes a living prayer.

If we generate such a deep and sincere devotion in our daily practice, then when we do the Essential Phowa for a person who is suffering or dying, it will be easier to invoke this Divine Presence and bring their compassionate blessings to the person in distress.

David, an emergency-room doctor in a major city hospital, told me how stressful his job used to be, and how he was getting close to burnout. He told me, “Families panic at the time of death, call 911, and bring their loved one to the emergency room to die. When they arrive, they're not prepared in any way for what is about to happen. What I see is enormous fear, confusion, anxiety and helplessness. The way I used to deal with the situation was

through detachment. Outside of doing my best for the patient, I figured there was no way I could impact their situation at all. “Then, telling a family that their loved one has died or is dying was one of the thing I hated most about my job. Often the family reacted to me with hostility and anger. The work was fearful and unpleasant for me.”


David asked me: “How can I offer spiritual care for people who are dying, in the midst of a medical crisis? I am doing my best to save one person's life, but right after they die I have to rush over and work on the next patient. Even when it's not so busy, if we’ve failed to save a person's life, everyone just walks away from the body.”

When you train in medicine, especially emergency resuscitation, you learn and repeatedly practice many lifesaving techniques, so that in a crisis situation you’ll be able to act reflexively, without thinking. You can train in your spiritual practice the same way, so you’re able to bring its benefits spontaneously to every situation.

Practice the Essential Phowa every day before going to work, with a compassionate intention that the meditation may truly benefit and help those who suffer. At the conclusion, dissolve your being into the Buddha, Christ, or whichever enlightened being you have invoked, and

once again enter your daily activities. Then, you can bring this Divine Presence with you into the hospital or your workplace, continually praying to the Presenceas you care for your patients or clients.


If you have a patient on the edge of life and death, pray fervently to the Divine Presence to help him or her. Visualize that the Divine Presence shines powerful light rays of compassion and blessing onto the person, purifying any fear or anguish in his heart and mind. Pray that, if possible, he or she may be healed and survive this crisis. If they die in spite of your medical intervention,

then visualize your patient’s consciousness in the form of a small sphere of light flashing out from their body like a shooting star and dissolving completely into the heart of the Divine Presence. Later, after coming home from work, you may want to do the Essential Phowa practice in a more complete way for all the patients you attended during the day.

David wrote me later to describe how his experience has changed since he began integrating his spiritual practice at work. “Since I started doing spiritual practice in the emergency room, I've watched the person's expression in the final few minutes of life change to one of acceptance, sometimes even a gentle smile, replacing the fear and anxiety. It looks like an opening, a release. Then, when I have to go and tell a

family that their loved one has died, I notice an enormous difference in their reaction. Family members often will thank me and even come up and hug me. This new experience I'm having since doing my spiritual practice in the hospital has transformed my life and my medical practice.”