Pulse reflection~

When someone approaches death, it is common for the pulse to become Empty. What this means is that the more superficial aspects of the pulse feel full of excess qualities, like robust pounding and tense; sometimes there is the presence of slippery, and often a form of vibration appears, which feels rough to the fingertips. A vibrating pulse at this stage signifies tissue and organ breakdown, so it is fairly common to feel throughout the depths of the pulse. Medication that a dying person is on will also be reflected in this superficial layer, usually adding to the tension and pounding. It feels, literally, like stuff has floated up to that depth because it cannot be held down deep in the body any longer.

Beneath this layer, the Blood depth and then the Organ depth can feel vacuous. Resources at these deeper levels in the body are completely depleted.

Another quality that I have felt, of late, is a pulse Dr Shen and Dr Hammer termed Yielding Hollow Interrupted. I have felt it most commonly appearing in the middle (Guan) position, and I am certain has been there all along, I am just now sensitive to it.

The Interrupted piece is referring to the noticeable abnormality in the rate and rhythm of the heartbeat, and signifies severe Heart Yang deficiency. The fuller billowy qualities of this pulse are felt at the top of the impulse and yet yield away with any pressure, giving it the yielding and hollow quality. It is a death pulse. And for some reason, just recently, I finally felt it as a death pulse. It finally made direct experiential sense.

I have felt this quality on a pulse of someone who is days or even hours away from death, surely a clear display of Yin and Yang separating.

At this time, the pulse appears in bursts, and often can feel as if the impulse is in pieces. It rises up, appears, and is gone. The billowing up of the pulse feels to be the Shen rising up as it departs.

As we die, the Qi of the body transforms into Shen, moves up through the central channel in the body toward governing vessel 20 (crown) to leave, and is gone. It is a process, however, and this pulse quality demonstrates that.

It is a beautiful to experience. There is a lightning to the quality of the air surrounding everything in the room. A shift has occurred. A transformation.

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*** To learn more about pulse taking, please refer to Contemporary Chinese Pulse Diagnosis by Leon Hammer, MD

My meeting with Stella....how I do love that name.

I learned this from Marie de Hennezel, author of Intimate Death,

before you enter the room of one who is close to death, you pause ever so slightly.

You gather yourself up, or in, is more like it, and you just stop. 

Take a moment to consider what you are about to do, …

There is a big chance this is the only time you two will meet.

 Be gentle.

Stella is dying of ovarian cancer, just 54 years old, and the first thing i notice as I draw close to her, is that she has this frown on her face.  It appears to be a grimace but her husband says to me  that she holds her face that way often, and if her pain increases so does the frown.

Her eyes are shut, and it appears that she is sleeping.  But then I hear this slight murmuring, and it is her.  Almost like she is humming.

Both of her arms are drawn up close to her chin, they are stiff and contracted and held close to her body.  This too, demonstrates her current level of pain.

It is apparent, but I am informed by both her husband and her nurse that she has had a history of trauma and she may or may not want to be touched.  Be gentle.

I start with her legs and very slowly, with soft hands, comb down the channels of her legs.  The frown deepens at first but then I lighten my touch and move very slowly, and her mouth relaxes.  Her frown is my gauge, her body telling me how to proceed when she cannot speak the words.

I spend all the time it takes, to feel her body let me in.

One arm stays contracted and held close, but as I make my way to the other arm, I take her hand in mine and feel our palms touching.  Recently, all that I do with my hospice patients is Qi gong;  that seems to me the most gentle thing for me and them.  I like how it feels doing it, also.

I practice this now with her wrist while we hold hands.   My free hand holds her arm so that i can work to pulse her wrist joint, a subtle opening and closing movement.  A communion.

Her husband who is sitting at her bedside, reaches over and places his phone on her chest.  He says to her in a broken, sweet voice, that he is playing her favorite song.  And it is loud.

Her face, which has become increasingly tender and relaxed, starts to smile, but for a brief instant.

Her husband is singing the words and crying, and she begins to move the hand I am holding, as if to dance it.  I respond and we dance our arms together while the song blares away off of her chest. 

When I finish, she opens her eyes for the first time since we have met.  She murmurs words to me as she stares at me, and they are garbled and I reach closer but cannot make them out.  Her husband translates, and says she wants to know my name.  I tell her and she nods. 

I stand at the foot of her bed, and watch as she closes her eyes and slowly retreats back inside herself.  It is filled with grace.  Gently.