Checkpoint – Month 9: April in Review

Redwoods in Rotorua

Unironically, Closing Time by Semisonic has been stuck in my head the past couple of days, giving me a strange sense of foreboding. ¾ of my Watson has gone. I submitted my last report to the foundation that I will submit while I am still abroad, just a few days ago. I leave Aotearoa so soon. The other day, I was reflecting on my ability to cope with saying goodbye, which has increased exponentially over the past few months. Back in October, I wrote about the irony of memory work – pre-bereavement projects that enable a dying person and their loved ones to create tangible objects representative of memory – and the fact that I have a consistent fear of forgetting. My camera roll is chock-full because I panic-snap pictures of just about everything in case I forget a detail. I have taken a picture of every ‘key’ I have used to enter places I have lived this year because that feels significant. I like the idea of some artist putting them all together on a key ring in a drawing that I can frame or tattoo or something commemorative like that. But recently, in the past several months, I’ve found that this panic has faded. It’s not that I don’t grieve the moments or places I have left, but the grief has become more welcome. In the past month, I’ve reflected on how spending a year with the dying has brought me immense comfort; birth and death are the two things we have absolute certainty of. This year, there’s been another certainty, though: I’ll travel to new places, make a home there, and then depart, often leaving a piece of myself behind. I’ve been thinking recently that the Watson is made more beautiful by the fact that there is a ticking clock, much like life is made more beautiful, more imminent, more insistent by the fact that we get X amount of days.

This is all to say, of course, I’m sad my time in Aotearoa is ending. I’m sad I’m leaving for the final leg of my Watson. I’m sad it’s beginning to look a lot like closing time. But because of that, this month has meant so much more, just like the last month meant so much more at the time. I’m soaking it all in – my project, my surroundings, the people – more.

Project Reflections 

April was a busy month, only adding to the illusion that time is slipping through my fingers (shoutout to Talia, my favorite ABBA fan). I began the month with a move to Rotorua, a small town on the North Island that is known both for its vibrant Māori culture as well as its geothermal hotspots. And by hotspots, I mean the whole town; new geysers or hot pools are formed regularly. There are warnings posted to those living in Rotorua that if the ground starts turning white, you may have the beginnings of a new hotspot on your land. Houses have had to be torn down or condemned while people were living in them because a hotspot starts forming beneath the foundation. It’s truly otherworldly. Equally amazing, though, are the vibrant maraes (Māori meeting grounds) that are seen throughout Rotorua and surrounding areas. I even had the chance to be taken through Whakarewarewa, a living Māori village where Māori families still live and uphold the tikanga (customs) that were once the norm in Aotearoa before colonization and the destruction of many marae and villages.

I came to Rotorua because of its rich Māori culture, which differed from my experience in Auckland, where Māori culture was heavily subjected to urbanization. However, much like my time in Auckland, I partnered with a compassionate community trust, Te Atawhai Aroha. Under the guidance of the amazing Dr. Denise Aitken, the palliative care consultant at Rotorua’s hospital, as well as a founding member of Te Atawhai, I spent my time in Rotorua connecting with many community groups or individuals concerned with protecting Māori tikanga at the end of life. During a day at the hospital, I had the chance to meet with Te Aka Matua, the Māori health support service. The role of Te Aka Matua is to ensure that Māori members of the community who interact with the health system are culturally safe, which is, as I’ve learned during my time here, far different than the promotion of cultural competency. Cultural safety is active and taught through the Hui and Meihana model, which emphasizes the Māori principle of whakawhanaungatanga or the means of establishing a relationship through the sharing of stories. The Hui and Meihana model encourages healthcare workers to share parts of themselves, to connect and build community with their patients, both Māori and non-Māori. This process, taught now in medical schools in Aotearoa, is the interview style of American healthcare’s complete opposite; it disparages the sterile, distant style of medicine that would encourage passive cultural ‘competency’ and centers instead on cultural safety, a joint endeavor. Te Aka Matua’s values uphold and spread the Hui and Meihana model. Te Aka Matua liaisons are split between departments, acting as advocates and supporting the wishes of Māori community members. Their activities are endless, from saying karakia (invocations) at the bedside of the sick, to speaking with healthcare workers about the needs of their Māori patients, to even driving someone’s child to and from school so that their mother could attend their weekly doctor’s appointment.

Te Aka Matua is the highest example of imbuing culture within care in a protected manner, and it was clear to me that the attitude that Te Aka Matua teaches has spread throughout all of Rotorua Hospital. Twice a week, waiata (singing) is held in the atrium of the hospital for healthcare workers and patients to join. I had the privilege of being a part of the waiata during my visit, and it was unlike anything I had experienced in a hospital. The voices of the healthcare workers, pakeha (non-Māori) and Māori alike, joined together and echoed throughout the corners of the hospital. The idea is to cleanse specifically the healthcare workers, mentally and spiritually, and uplift them to do the difficult and emotionally challenging work they are faced with. The only word to describe the experience is ethereal. Immediately, I imagined what it might look like and how much it would aid in creating a different hospital experience for staff and patients alike, to be cleansed in this way. For the healthcare workers specifically, it was incredibly impactful to see the effect of knowing that their challenges were being acknowledged, that they were being cared for. The burnout we see in American medicine is one of a kind; In the United States of America, an estimated 300 to 400 doctors die by suicide each year, a rate of 28 to 40 per 100,000 or more than double that of the general population. We do not care for the people who are caring for people. Māori know that to heal, you must be healed yourself. It is not possible to do one if you do not do the other. Despite the American perception, healthcare workers are not gods; they are not invincible, and we must do a better job of caring for them. Rotorua could be an example for all.

And it is an example for all in more than just how they take care of their staff and their Māori patients. Rotorua has the highest success rate in all of Aotearoa in getting their patients home to die. That number did not just come about by accident – there is a consistent and constant recognized effort, particularly among junior doctors and younger staff, to raise the topic of end-of-life care early to facilitate autonomous decision making about where someone wants to die. Much of this drive to return people home can be traced back to Māori tikanga. It is vital for Māori to be returned to their marae, their iwi (tribe) and hapu (kinship group), the place of their whakapapa (genealogy), when they die. The tangihanga will be hosted at this marae, and the body will return home as the spirit journeys to Hawaiki (the place of eternal rest, the Māori ancestral homeland). Now, Western culture in Aotearoa has also taken on this call to return people home. At Rotorua Hospital, they have their system down; hospital beds can be delivered in hours, hospice can be notified to be the community check-in component, and equipment can be delivered. All of this begins with the willingness to have that conversation, to say to a patient and their family, you are dying and we can’t stop that, but we certainly can decide what that will look like. One of the most astounding parts of witnessing this work so successfully done was seeing young doctors speak about death with such grace and nuance. It seemed to me as if many of the junior doctors were leading the palliative care charge, expressing the earnest need to get people home who want to be home, and in part, shifting the culture of death and dying. I am awed, inspired, and energized to see that my thoughts about investing in education concerning death and dying from the start of medical school could potentially have merit in practice.

Finally, during my time in Rotorua, I had the chance to attend a tangi. For the sake of privacy for the person who died and their family, I will focus on witnessing the structure of Māori tangis (funerals). I had read a ton on tangis, but nothing compared to seeing the process in person; it is grief embodied most healthily and the antithesis to the funeral environment we have come to know at home. I attended day one of the three to five-day process of tangi. On this day, the body is brought back onto the marae for the first time by the family. As the body passes through the entryway of the marae grounds, the ‘calling’ begins, performed by kaikaranga, senior women of the hosting marae who were often raised in this tradition from a very young age. The calling is a wail of absolute grief. It’s grief so loud that it welcomes and envelopes your own. It frees up space so that the family or loved ones to feel their grief without any reserve. The kaikaranga call on the grief of losses throughout their whakapapa, generations of losses and sadness are channeled into this one call. The message is simple: your grief is welcome here, use it to connect with the deceased, use it to say goodbye. This is not the Western way. This is not the ‘hold back your tears until you are alone’ refrain seen amongst grieving families at home. It’s a hauntingly beautiful expression of love.

What follows is a cyclical conversation between the hosting marae and visitors in which stories are told about the deceased in te reo (Māori language). There will be much acknowledgement to whakapapa (genealogy) both in the deceased’s connection to others of the iwi who have passed and to the whenua (the land) that the marae sits on. The connection to land reverberates throughout the entirety of the tangi, leading to a feeling of incredible permanence that contrasts with the fact that someone has died. This land has been here for all time; it’s transformed, sprouting new trees, creating new mountains and rivers, but it is a constant. The deceased and everyone else on this Earth have been here for all time too, in different forms, in different spiritual planes, but connected because of the Earth and because of their whakapapa. You get the sense that death is just another transformation, an untethering to this plane, but a journey to the next, all the time remaining connected to the Earth itself. When the conversation ends, after you great each member of the hosting marae in a hongi (touching of noises, breathing the breath of life into one another), after the feast that follows, the women of the bereaved family, from the youngest child to the oldest matriarch, will sleep in the meeting house with the body of the dead. The women protect the dead, they share these last sleeps with them. They will sleep amongst their loved one for all the days the tangi continues. Only after, on the final day, will the body be buried. To witness a tangi is to witness a reconnection to self, to grief, to the Earth, all of which to me flow into one another.

Geothermal pool in Rotorua

Personal Reflections

I write to you as I stare out at the secluded Mahau Sounds in the South Island of Aotearoa. From the deck of Poroporoaki, a house used for people who opt to use assisted dying, you have an unbelievable view of the Sound framed by pine-covered mountains. It’s silent except for the most beautiful bird song and the buzzing of bees. So silent that I can hear the wind rustling nearby leaves and waves lapping lazily against the shore below me. I’ve started every day this way, sitting and staring with my coffee. I understand why people would come here to die. Not a bad last thing to see.

Though I’ve made the executive decision to speak about Farewell Trust in my May summary to give it proper space, I couldn’t not bring up this view because to me it is emblematic of the wonder I’ve experienced throughout this year, but specifically in Aotearoa. The nature in Aotearoa is captivating. This year has made me fall so deeply in love with the Earth, not because I wasn’t appreciative of its beauty before, but because it feels inextricably tied to my happiness. A day where I don’t get to sit with nature, at least for a little is a bad day. Most days, I wake up feeling like a little kid, overjoyed at the prospect of knowing I will see or explore something so astounding that it moves something in you.

I’ve been thinking about something I read a couple of months ago. More people, when asked about what the future looks like, speak about an apocalypse or the end of the world as we know it than they do about a possible future in which we persist or save Earth. Our imaginations have been hard-wired to easily access doom rather than a dreamscape. I get stuck in the dreadful news scroll as much as the next person, finding myself texting someone terrible, hopeless sentiments about the future of our country and our world. Sometimes it feels like every conversation comes back to “the state of things” that are overwhelmingly poor. I think this type of thinking has existed since I can remember, partly due to science fiction becoming more and more like non-fiction every single day. But I also think the current administration has weaponized this cycle of dread, leaving a majority of people, at home and globally, paralyzed with fear, proliferating this image of doomsday as if it’s the only future we have.

Recently, I’ve been thinking that this power that’s wielded over us stems directly from a loss of wonder. We spend so little time imagining a future that doesn’t include the implosion of everything we know. We’ve all stopped thinking like little kids. During my Watson interview, I was asked what I would do if I had a magic wand that could fix five things about the healthcare system. A monster of a question. When I was reflecting on the interview afterward, I was particularly stuck on my answer, not because I didn’t think I picked “five good things” but because I was stuck on the whole magic wand thing. The interviewer, for the first time in a while, got me to wonder, “Well, what if I could change these things?” So often, in conversation or academic discourse, we approach issues from the negative. What’s wrong with this system? So little do we get asked, “Imagine you could do anything. What would you do?” I have to think it’s this type of thinking that will get us anywhere in the next four years and beyond.

But I also think it’s deeper than that. This year has given me the freedom to dream again, to connect with the Earth and to be filled with awe, to crave global connection and see a possible way to escape isolationism. I’m not naïve enough to think that everyone will have the privilege to travel, but I don’t think we need to travel to experience this. I think we just need to view where we are with different eyes. To let the wonder in and to be buoyed by the millions of possibilities it brings.

All of this thinking has made me curious about what it says about me that when I think of hope for the future, I think of death. Well, death reform, changing the culture around death, etc. Recently, amongst a group of people my age, I was explaining my project. One of them told me I was “an angel” before another chuckled and said, “yeah sure, the angel of death.” For a minute, I was offended, but then I thought that was a pretty perfect way to describe my hope, at least in the way that I interpret death. I would be lucky to be known as someone who brought the type of peace, connection, love, and raw emotion that comes with dying.

More and more, I find myself finding signs that confirm I am on the right path, that I am doing exactly what I was meant to do. In Aotearoa, there is a bird called the piwakawaka or the New Zealand Fantail. For such a tiny bird, there are many Māori legends about the piwakawaka. In the present day, the piwakawaka is often regarded as a messenger of death because they are one of the only creatures that can go between Earth and the spiritual realm. These birds often fly into people’s homes. Most people think that if a piwakawaka hangs around you or enters your home, it means someone in your life is close to death. Talk to anyone in Aotearoa and they will have a story about someone who had a piwakawaka fly into their home in the days leading up to a loved one’s death. However, it depends on how the piwakawaka presents in your home. If they are acting erratically, they are giving a warning. If they come and are just around you, many believe they are carrying a message from spirits. I spoke to someone who told me that a piwakawaka visited her every day in the months following her mother’s death. Because of its association with death, the piwakawaka has been misconstrued as a bad omen. However, when you take a look at one of the prominent Māori legends about the piwakawaka, it tells a different story. Maui, a prominent demigod in Māori legend, was set on making humanity immortal. To do so, he would have to pass through the goddess of death, Hine-nui-te-pō. Maui transformed himself into a worm in the hopes of traversing Hine-nui-te-pō while she was sleeping. However, the piwakawaka saw this all occurring and laughed at the image below, awakening Hine-nui-te-pō, who killed Maui. From this legend, many interpret the piwakawaka as a reminder of the sanctity of death, without which life would be meaningless. The piwakawaka isn’t a grim reaper, it’s a messenger of this tale, a reminder that death is sacred. Piwakakwaka work tirelessly, carrying the messages of loved ones to us here as a reward for sending their souls on, for honoring death.

While in Aotearoa, I’ve had the pleasure of being greeted by several piwakawaka. In all seriousness, there is one sitting next to me on the balcony right now. I seem to have a weird affinity for this bird, which, of course, freaked me out at first when I was only told the version where they are harbingers of death. However, as I learned more about the piwakawaka and their job, I thought it was quite fitting. This bird that acts as a reminder of the necessity, beauty, and sacred nature of death, of course, would find me. I find a ton of comfort in the possibility of being worthy enough to be visited so frequently by these birds. Moreover, I like the idea that when they sing, as they do so often when they fly near me, it’s messages from all the people I’ve had the honor of meeting this year, as they died.

I’m not sure if I believe in reincarnation, but if that is what’s next, I’m officially submitting my request to come back as a piwakawaka.

Two Piwakawaka following me on my hike