In a dream we live seventy years and discover, on awakening, that it was a quarter of an hour. In our life, which passes like a dream, we live seventy years and then we awaken to a greater understanding which shows us that it was a quarter of an hour. 

— Martin Buber.  Ten Rungs – Hasidic Sayings

I met Sharon on weekend inpatient hospice unit rounds. She had been there a few days with advanced metastatic abdominal cancer, perhaps of ovarian origin. She was 48 years old and had two children, a 14-year-old daughter and a 16-year-old son. Efforts to keep her physically comfortable were fairly successful, dilaudid intermittently for pain and a triple suppository of Reglan, Decadron and Benadryl for nausea. Walking into her room, I was first struck by how young she looked: long black hair instead of the usual gray and her body, at least in bed, seemed well nourished and healthy. Her face was smooth, showing no obvious traces of either her disease or the effects of medication. Her daughter sat next to her, quiet, but alert with a kind of radiance.  A make shift altar had been created in the room by the daughter, a simple and moving gesture of love. A swath of burlap was taped to the wall and decorated with family photos, figurines, flowers and symbols pinned to it. I later learned that she went to a Waldorf School, a type of school which emphasizes not only artistic expression, but also a spiritual perspective.

We spoke only 15 minutes, first about her physical symptoms and the medications to control those symptoms. She was very calm and deliberate in all of this. Then she replied, “I guess I am just waiting for my various organs to shut down. What do you think will happen next?” Caught somewhat off guard by the directness of her question, I said, “I am not sure, but I suspect that you have a strong heart and your breathing seems fine, so I think that the next source of symptoms will come from your abdomen.” Feeling this clinically detached response inadequate, I spontaneously added, “I guess at this point you just have to stop identifying with your body and identify more with your soul.” I rarely speak to patients in that manner, but it was as if she pulled it out of me.

She agreed, commenting on the mysteriousness of life, and how four weeks earlier she had been fine – or so she thought. She had experienced some abdominal pains, initially thought to be gall bladder symptoms, but now, after some tests, she was waiting to die. She said that she had been going on in life assuming that nothing would everchange very much. Her son had given her a little Celtic sign for the previous Mother’s Day which said, “Life is too mysterious to be taken seriously.” She felt it was his was of telling her to “chill” out. In fact, there was a sense of disbelief in her whole story.

Though I said nothing at the time, I keenly recognized that feeling, having had three years before, a heart attack, cardiac arrest and near-death experience on a bright summer’s day. Lying on that gurney, and for a long time afterwards, I too, lived with that sense of disbelief, a sense of being a tourist in this world, more in touch with the impermanence of it all than I ever thought possible.

The next morning while meditating, a thought came to mind. It was a connection between Sharon and some passages I had read the previous day in a book, Transformation – The Emergence of the Self (Texas A & M Press, College Station: 1998) by Murray Stein, a Jungian analyst.  The book jacket has on it a picture of a butterfly. The book itself starts outwith a moving dream centered around abutterfly motif. Sharon, on her death bed, waiting for some organ system to shut down, with her edematous and swollen abdomen, reminded me of the caterpillar’s disintegration in the cocoon before it becomes a butterfly.  Indeed, the whole 12bedinpatient hospice unit seemed like a unit of cocoons: human beings transforming into souls.

When I rounded later that day, I pulled Sharon’s nurse Diana aside. I needed a reality check. Would this dream be something that could be helpful or not? Was she in the kind of state where I should bring it up or not? The hospice unit nurses are attuned not only to their patient’s physical symptoms but also to their inner states. Diana felt that she would really like it and asked if I had noticed the caterpillar on her altar. I hadn’t – at least not consciously, but I felt more confident that this was a good idea.

Sharon was on the telephone for some time before I went in to speak to her.  We discussed her symptoms again, especially the worsening nausea which seemed to come in cycles. She thought it might berelated to some “time release” phenomenon of the medications and kept repeating the term “time release.” As we spoke about this possibility causing the variation in her symptoms, she kept using the term “time release”. Only later did I think that she may have been thinking in a kind of waking dream state where complex concepts get concretized in objects, figures or activities that are more symbolic and have deeper meanings than we may be aware.

I told her that I had a book with a dream about the transformation of a caterpillar into a butterfly and that it reminded me of her. Her face lit up and she beamed. “How did you know that I love butterflies?” she asked excitedly. The butterfly was a central symbol in her life and to many she was known as the “butterfly woman”.  I said that I didn’t know that and that perhaps this was going to be a good dream for her.  I set the book on her nightstand intending for her to read it later; but instead she grasped my wrist and asked if I could read it to her. Though I began to sense that I was getting into deeper emotional waters than I wanted, a part of me also wanted to read it to her. She closed her eyes to concentrate, listening so attentively that I felt privileged just to be in her presence. I began to read:

I am walking along a road feeling depressed. Suddenly I stumble upon a gravestone and look down and see my name on it. At first, I am shocked, but then, strangely relieved. I find myself trying to get the corpse out of the coffin but realize that I am the corpse. It is becoming more and more difficult to hold myself together because there is nothing left to keep the body together anymore.

I go through the bottom of the coffin and enter a long dark tunnel.  I continue until I come to a small, very low door. I knock. An extremely old man appears and says: “So you have finally come.” (I notice that he is carrying a staff with two snakes entwined around it, facing one another.) Quietly but purposefully he brings out yards and yards of Egyptian linen and wraps me from head to foot in it, so I look like a mummy. Then he hangs me upside down from one of the many hooks on the low ceiling and says, “You must be patient, it is going to take a long time.”

Inside the cocoon it’s dark, and I can’t see anything that is happening. At first my bones hold together, but later I feel them coming apart. Then everything turns liquid. I know that the old man has put one snake in at the top and one at the bottom, and back and forth from side to side, make figure eights.

Meanwhile, I see the old man sitting at the window, looking out on the seasons as they pass. I see winter come and go; then spring, summer, fall and winter again. Many seasons go by.  In the room there is nothing but me in this cocoon with the snakes, the old man, and the window open to the seasons.

Finally, the old man unwraps the cocoon. There is a wet butterfly. I ask, “Is it very big or is it small?”

“Both,” he answers. “Now we must go to the sun room to dry you out.”

We go to a large room with a big circle cut out of the top. I lie on the circle of light under this to dry out, while the old man watches the process. He tells me that I am not to think of the past or the future but “just be there and be still.”

Finally, he leads me to the door and says, “When you leave you can go in all four directions, but you are to live in the middle.”

Now the butterfly flies up into the air. Then it descends to the earth and comes down on a dirt road. Gradually it takes on the head and body of a woman, and the butterfly is absorbed, and I can feel it inside my chest.

When I finished reading, she paused and then very slowly asked, “Why did you think of me when you read this?” I explained that I saw her as being in an in between state, lying in her bed, her body “dissolving” but getting prepared for the next step of her soul’s journey. I hastened to add this was only a symbol, as if to provide a rational, medical disclaimer so that no one could say that I had completely stepped out of the medical model. She nodded and then went on to tell a central story in her life.

It was the story of her family. Her father was a cabinet maker – an artist, who went bankrupt twice. Her mother suppressed all Sharon’s artistic aspirations, going so far as to take away her art materials and telling her that these aspirations were bad. Only later in life did she realize that her mother had been taking out her disappointment and hostility toward her father on her. In the last few years, she had found or rather rediscovered her creativity and was now studying to become an art therapist. She had wanted her daughter to be able to express herself creatively and thus, the Waldorf education.

The whole encounter took less than thirty minutes but during it we had entered a timeless space, a space where your whole life is suspendedbefore you. 

Just as I was about to leave, she again asked me if I thought the medications were responsible for these “time release” symptoms. I said that I didn’t and she asked if I thought it was her disease. I nodded.

She was released from time at 5 A.M. the next morning.