"There is no greater gift of charity than helping a person die well," said Sogyal Rinpoche, the author of The Tibetan Book of Living and Dying. The volunteers at the Heart Lotus Ward have probably never thought about whether the service they provide is a kind of giving. They only wish to help terminally ill patients die in peace.

Part I: Playing the Heartstrings

By Fan Yu-wen

Chen Yao-wen, the son of a patient who had died of cancer at the Tzu Chi Hospital, came to work as a volunteer in the Heart Lotus Ward to show his gratitude and love. Using his musical talent, he fills the quiet ward with musical rhythms.

"Last year, 30,000 people died of cancer in Taiwan. One out of every five will be afflicted with cancer. Out of every four beds in every hospital, one is occupied by a cancer patient." Chen Yao-wen never forgets to mention these figures to each visitor to the Heart Lotus Ward. His purpose is to help people understand how terrible cancer is. Actually, most people are concerned about cancer. Understanding a cancer patient and his or her family often helps people appreciate even more the happiness they have.

Chen's father passed away in the Heart Lotus Ward. During his last days at Tzu Chi Hospital, he was well taken care of. Chen was extremely touched by the way people in the hospital treated his father. With gratitude in his heart and armed with the desire to do something in return, he and his wife moved from Taipei and settled down in Hualien so that he could devote himself to volunteer work at the Heart Lotus Ward. He often relates his own experience as a family member of a terminally ill cancer patient, and he actively promotes the idea of palliative care.

"Father spent only seven days in the Heart Lotus Ward. In those seven days, he was well taken care of by all the members of the medical team. On the day he passed away, thirty or forty volunteers took turns continuously chanting the holy name of 'Amitabha' for him for over eight hours. I feel extremely grateful to these volunteers. When I do volunteer work here, there is no need for me to adjust myself like the other volunteers, who are coming into contact with cancer patients for the first time. Therefore, I have no fear to overcome." In addition to promoting the concept of palliative care, Chen makes good use of his musical talent in the Heart Lotus Ward. He performs for patients and their families in the social room and fills the silent ward with musical rhythms. Under his supervision, a family concert group was organized to perform in the Heart Lotus Ward each month.

Chang Hung-ching, a volunteer who is not very good at expressing himself, is a member of the family concert group. He is learning to play the flute with Chen Yao-wen. In order to perform as well as he can for the audience, he frequently drives out into the country after work to practice. In his first performance with the family concert group, his rendition of "The Song of the Beach" moved one old woman to tears.

Part II: Devoutly Venerating the Buddha

By Fan Yu-wen

It is only a short distance from the ward to the little Buddhist shrine at the hospital. But for terminally ill patients, it is still a difficult journey, one which has left a deep impression on Wang Yun-ching. In that shrine, he leads patients and their families in chanting Buddhist sutras each evening.

One day, Wang Yun-ching was cracking nuts for a female patient. The benevolent eyes of that motherly patient became engraved in his mind. A week later, he went back to the ward and found an empty bed. His heart sank.

Wang did not feel that he could cope with other patients at that moment, and he walked slowly toward the shrine to pull himself back together. There he saw a very feeble male patient leading other patients in chanting sutras and venerating the Buddha.

"My situation is getting worse and worse. I just got the flu. I'm afraid I can't lead you in the evening gathering." His words shocked Wang. He saw that this patient's condition was critical, yet the thing that bothered this patient the most was not his illness, but the thought that others might not be able to chant the sutras if he were unable to lead them. Wang felt so small compared to him.

The following day, Wang decided to learn how to lead the chants. Unfortunately, that patient was too weak to teach him. Wang decided to go ahead anyway and volunteer his services by leading the evening chants, even though he was not familiar with them. He could only lead everyone by playing a tape. However, the chanting on the tape was too fast for the patients to keep up with, so one of them suggested, "Brother Wang, you might as well sing yourself." Wang could only nod with a wry smile.

"Once I agreed to do it, I was under so much pressure. During both lunch and dinner breaks the following day, I had to listen to the tape again and again in order to familiarize myself with the chants." Wang recalled one particularly impressive scene that happened while he was leading the chants. A female patient bent over for a long time and did not straighten herself up. When he went over to help her, he found she was breathing hard. With much difficulty, he helped her sit down on a prayer cushion. She slowly crossed her legs into a meditation posture, gasping deeply the whole time.

"From that moment on, I realized how difficult it was for a terminally ill patient to walk from the ward to the shrine. Why did she want to prostrate herself to venerate the Buddha? Because she was near the end of her life, she felt that was the only way to obtain blessings for her family and herself." Wang realized that once terminally ill patients know they are coming near the end, they want to make the most of every minute and second. What about healthy people? What do they do?

Since Wang started doing volunteer work, he has gained a deeper understanding of the meaning of life. To him, life is like riding on a train. If we don't know where we will get off, we don't appreciate the journey. If we know where the end of our life's journey is, we make good use of our time on the train. If people were always prepared for death and appreciated the life they still had, they would get along much better.

Part III: The Line between Volunteer and Patient

By Huang Hsiu-hua

"We volunteers should do what the patients want us to do, not what we want to do for them," says Shih Shih-ming, a volunteer in the Heart Lotus Ward.

In graduate school, Shih was very much interested in psychology. He was invited by a good friend to take part in the volunteers' training program, and he later became a volunteer in the Heart Lotus Ward. Being with patients in the last part of their life journeys has helped him to learn more about the true meaning of life. "As volunteers, we should do what the patients want us to do, not what we want to do for them."

One day, a patient asked him to buy some letter paper. Out of curiosity, he asked, "Who are you going to write to?" When the patient didn't respond, he sensed that it must be something the patient didn't want him to know, so he said, "Never mind, if you don't want to tell." The more familiar with the patients you are, the easier it is to forget about the line between volunteer and patient. The distinction between "caring" and "invading privacy" becomes very vague.

The volunteers are generally very enthusiastic. However, this enthusiasm might easily offend a patient. Shih remembers that a concerned volunteer once asked a patient, "Why doesn't your family come to see you?" Volunteers often start a conversation with a patient with such a question. However, that question infringed upon the privacy of that particular patient because it was a sensitive issue which he didn't want to discuss.

Learning from this observation, Shih built up a close, trusting relationship between himself and Ah-chiang, a patient who had kept his heart shut from other volunteers.

"Actually, Ah-chiang and I seldom talk to each other. I don't know how to describe my feelings. People don't plan out beforehand how they are going to relate to each other. You have to feel things out carefully every moment you are together. The most important thing is sincerity. Being asked questions one after another can be agony for a patient. When I am together with Ah-chiang, I seldom disturb him. I don't pry into his privacy. Simply speaking, I just keep him company." Sometimes, they can go for half a day together without exchanging a word.

Shih has a lot to say even on the issue of tidying up a patient's belongings. "It is more than just intruding on the patient's privacy. At a deeper level, you may even damage the patient's self-respect because everyone wants to put their own things where they want them."

Patients are very sensitive. Once Shih saw a trainee nurse pushing a patient in a wheelchair very quickly down the hall. "It really scared me! Both the direction and the speed were out of the patient's control. Any small action we take may affect the feelings of a patient. Therefore, we have to be very careful. Later on I found out that that patient had pushed his own wheelchair so much that there were blisters on both of his hands. But I could tell that was the last bit of dignity he could keep for himself."

Sick and healthy people have greatly different concepts of time. A patient's pace is usually slower, so volunteers must be patient. They must not be distracted by something else because they cannot bear to wait for the patient. "When a patient is painfully moving his body, he will feel bad if you begin to do something else." Shih pointed out that a patient could tell the deterioration in his own health by observing the agile movements of the able-bodied or the pitying expressions of visitors.

That should be a reminder to volunteers. They must never push their own values onto a patient. "How can we make a patient let go of things? The physical suffering of a sick person is beyond the imagination of a healthy person." Shih said that a devoutly religious volunteer might suggest that a patient believe in Jesus Christ or the Buddha, thinking it would be good to give him some options to consider. The problem is that not everyone can accept religion. Sometimes, just to be polite, a patient has to say "Thank you" with a forced smile. Just think of how much pressure it puts on patients when they have to give the expected responses to the people they meet.