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Posted: June 16, 2006

Spiritual Caregiving

Alive with Passion -- Part 1

(Editor’s Note: This is the first part of a 4-part feature -- one amazing woman’s triumph over our cultural habit of fear of illness and fear of death. This article received more mail than any other feature published by Spirituality & Health magazine. It appears, with illustrations, in the February 2006 issue, which is available by special order via email:


I am an anecdote. In the language of modern medicine, this means I don't count. Medical statistics disregard me because, in 2001, statistically given three to six months to live, I disregarded both the statistics and the recommendations for chemo and radiation therapy.

This morning, instead of lying in the predicted hospital bed or grave, I went surfing. Afterward, I cared for five dying patients whose cancers were less advanced than mine had been -- all of whom had been given a better chance of survival than I had.

Why am I still alive and surfing and volunteering at hospice with greater joy than ever before in my life, when so many other cancer patients with far better prognoses are suffering and dying?

I believe the answer can be found in two words: fear and passion.

Before my own diagnosis, I spent most of my working life in intensive care and emergency rooms, at the bedsides of critically ill and dying people. Decade after decade, I watched as men and women crumpled in fear as they realized that they were truly going to cease to exist in their bodies. Night after long, sleepless night, I listened to people as all their definitions of themselves -- job, home, family, possessions -- were ruthlessly stripped away by their fear of death. Some nights I heard whole corridors of agonized people screaming, "Why me?"

From these, the dying, I learned that fear of death rules our lives far more than passion for living. In The Balance Within, Dr. Esther Sternberg cites many scientific studies demonstrating the hormonal and neurochemical damage to bodies stressed by constant fear. Night after night, year after year, I watched fearful minds kill ailing bodies faster than any drug or disease.

Almost everything in modern culture creates fear of death. Almost everything that is bought and sold is marketed as a ticket to eternal youth; if only we spend enough money, buy the right treatment or drug, we will never age, never die. Death is the enemy, the villain, the gray-cloaked, grinning skull -- the symbol of our destruction. When we buy into this manipulation, we prime ourselves to become our own worst enemies when we're sick.

When we deny the unavoidable normality of illness, ageing, pain, and death, the amygdala, the fear center of our brain, sends out stress hormones and neurochemicals that over time undermine and weaken the already stressed body. We literally create our very own, highly personalized, physical and mental hells. What tools can we use to counteract such a juggernaut as our death-denying culture?


Thanks to my teachers, my knowledge of the passionate tango of life and death is so "to the bone" that, in 2001 when I stood before the lighted X-ray display panel and looked at the very large, very obvious cancer tumor that had arisen over only six weeks and was extending its crab claws through most of my left breast, and reaching straight down to strangle my heart in a matter of weeks, I was very calm. My thought was, "My turn up at bat."

It is possible that what has kept me alive is to be found in that calm moment. Here is what I knew and felt:

1. I knew I was going to die.

2. I was not afraid.

3. I did not cry.

4. I needed a little time to set my life in order and prepare my daughter.

5. I wasn't going to use chemotherapy or radiation, even if that meant I died within days.

No waiting in doctors' offices. No listening to someone else's opinions about what my body was doing or when it would stop doing it. Nothing was going to interfere with the fun I was going to have with my 13-year-old daughter. I had to get all the junk out of my head right now and LIVE, really live and savor each physical, sensual moment left to me.


(The second installment of this story will appear in next week’s Spiritual Caregiving column.)


Mandi Caruso is a passionate hospice volunteer, surfer, and author. This article is excerpted from her unpublished book Doors to Heaven. In addition to teaching her mammogram tech how to surf three months after her own surgery, she has taught other cancer patients how to surf. See for more.

This article originally appeared in Spirituality & Health magazine, For subscriptions call 1-800-876-8202 or see Editor Stephen Kiesling and his staff contribute weekly columns, features and articles published every Friday as "Spiritual Caregiving" at Contact staff directly via email at

© 2006 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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