Blinded at Birth
Brian was born in Vancouver in 1943. The pregnancy was unremarkable; he was a big newborn–about 8 lbs–and would have been a completely healthy “bouncing” baby boy, except for the fact that my mum laboured in a Catholic hospital that had a rule that a doctor had to be present for the birth. And so, while they waited for the tardy doctor to present himself, the nursing sisters held the baby back with their hands even while my mum was in the pushing stage. The doctor finally arrived, but by that time Baby Brian suffered a massive brain hemorrhage and consequent brain damage. It wasn’t until six weeks later that a pediatrician informed my parents that Brian was blind as well. The pediatrician told my mother that “these people” rarely lived past teen age so she should “just take him home and love him.”
In 1944 with World War 2 underway, my dad found a place in Boundary Bay (Maple Beach) USA, and sent my mother down there with Brian now one year old, and his older brother R. who was 4½ at the time. My mother was stuck in this deserted resort town in winter, by herself, in a non-winterized cabin. With a preschooler and a blind toddler, she had to scrounge beach logs for the woodstove, for their heat. Every day they used to go to the only store and the kind proprietress would give Brian a cookie when he arrived; thus Brian learned to walk.
After the war my parents moved to a remote island off the BC mainland. Things weren’t going very well in their marriage; in their case, having a blind and disabled child was not a strengthening factor. My dad evidently thought it was a judgment from God. Brian would often stay up all night making noises and banging a rock that he loved on the floor. My mum would stay up all night with him singing, trying to keep him quiet because my dad had to get up for work.
By the time Brian was about 2½ she was pregnant with me. Because there was no hospital on the little island, she had to make arrangements for Brian to go into foster care while she was in the hospital having me. It was January and the seas between the island and the mainland were rough in winter; she made arrangements to go over to the town where the hospital was six weeks ahead of my ETA (estimated time of arrival).
Unbeknownst to her, though, my dad and the family doctor conspired to have Brian committed to Woodlands . When she had me and came home some weeks later, she asked dad where Brian was? He finally told her. Then someone informed her of the day and time Brian would be passing by on the ferry on his way to Woodlands institute way down the coast in Vancouver. She could see the Strait of Georgia from the kitchen window over the sink. I was a few weeks old. She remembers feeling faint when she saw the ferry passing by. She handed me over to my older brother, and she passed out cold.
When I look back now, I think she must have had something like a nervous breakdown. For the previous 3+ years, she had had the sole care (no care workers coming in, no support, and a husband who was somewhere between indifferent and hostile to her disabled son) of Brian on her, another young son, and now a newborn, and then the basic “abduction” of Brian from the foster home.
A few weeks later, she took the ferry over to the mainland for my 6-week check-up. A strange met her at the ferry terminal and said, “I have something to show you.” She led my mother to her car – and there was Brian! Turns out she was a social worker married to a judge. For reasons she never explained, she had decided Brian’s commitment to Woodlands wasn’t right so she had hung onto him. (We theorize that her husband had presided at the hearing and she had convinced him somehow to give her temporary custody).
The woman kept Brian in her home for a couple of years, and my mum was able to go over and visit him but then, suddenly and inexplicably one day, my mum received a message from her that Brian would be coming over on the 3 o’clock ferry on such and such a day. This must have been about 1948. Blind little Brian, about 5 years old, was sent over—alone—on the ferry. Of course, mum met the boat.
So Brian came back home to live with us again. Our house was at the top of a tall cliff which led down by a steep path to the beach below. Our yard was fenced, and Brian spent most of his time outside with me and our older brother. He was able to navigate his way in and out of the house and around the yard. My mum recalls how he would come in, remove his overalls, go to the bathroom, put them on again and go outside. One day he came inside to her, and held his hand up to her. He kept touching a spot and grunting (he wasn’t verbal). Ultimately she realized he was trying to show her he had a sliver in his hand so she could remove it.
Mum remembers another time when someone moved a chair in the living room and Brian—who quite zoomed around, though blind—came through the living room and bumped his shin on the chair, hurting himself. Mum recalls how he spent the rest of the day walking from the chair to a wall, then back; then back again…..all over the room, somehow positioning the chair in his mind in relation to everything else in the room – and she said he never bumped into that chair again. She always felt that Brian was quite smart underneath his several disabilities. (We theorize that the judge’s wife discovered the same thing and that’s why she thought that a placement in Woodlands was not right.) But those were times when professionals like doctors and social workers, lawyers and judges, did and decided things without feeling they had to explain their actions to those involved, especially women.
When Brian was about 7 (I was about 3½, our older brother 10) my brother found him one day, outside our fenced yard, teetering on the cliff’s edge. It was then that my mum realized something had to be done around his safety. Meanwhile all this time, social workers had been “counselling” her that by keeping Brian at home she was not able to give proper attention to her husband and other children. Ultimately she agreed that he would go to Woodlands. There were no other choices.
Mum remembers how the doctor gave Brian some kind of sedative for the long boat trip down to Vancouver, but that far from sedating him, Brian reacted quite the opposite and was upset and active for the whole trip. I can’t say for sure, but I think Brian was very aware of the emotions of people around him, and he probably was aware that something was up. And not something good.
Brian went into Woodlands at 7 years old. I was about 3½ and I didn’t see him again until I was about 20 years old—by then we lived in Vancouver. In those days many families “put” their mentally disabled children in institutions and that was that; they were tucked away. That was certainly the British way. My dad never saw Brian again.
Residents of Woodlands School were children from communities all over the province. In most instances, their parents and guardians had been persuaded that this was their best option and that they would be cared for and helped.
BC Coalition of People With Disabilities – website – March 27, 2008.
After we moved to Vancouver mum was able to visit Brian more often. But even then it was sporadic. New Westminster was a far trip for someone without a car — but also she was so very upset the first time she went to see him in Woodlands when she saw that Brian, who had been toilet trained since he was two years old, was now at 8 years old in diapers again. And she always felt that when she went to visit him, that Brian was made very unhappy by the preparations for the visit and even by “seeing” her. Certainly, it broke her heart to see him in Woodlands and she would come home distraught and be miserable for a long time afterwards. She was by no means unique in this:
“Some residents had the opportunity to return to their family home for a visit but of the files reviewed the great majority appear to hve had little if any contact with family or rinds outside the facility. The lack of contact is frequently documented on residents files.”
(From “The Need to Know” – Woodlands School Report, Ombudsman Dulcie McCallum’s report to the MCFD, 2001, pg. 12.)
There was always a hole in our family where Brian had been. And even though I was only about 3½ when he went to Woodlands, I always felt the lack of him when I got a bit older.
Soon there was another hole in the family, when my dad left the family for good. He moved to another country. My mum, who had been a homemaker for 20 years by then and who had no job, was left with the care of their children.
I remember seeing Brian in Woodlands. Sitting beside him was his long time friend Jacquie who was blind, nonverbal, developmentally delayed, and in a wheelchair. They spent all their time together. The attendants “joked” that they were “Mr. & Mrs.” (I used to look at Jacquie and think that if things were different, she might have been my sister-in-law.) The staff would cue Brian with the “Mr. & Mrs.” thing and he would dutifully pick up Jacqui’s hand, bellow out loud, and kiss her hand.
Sitting near them was a young man, Bob, who was blind and mute. (I’m going to use ‘mute’ because I think it is more evocative and accurate than the politically-correct “non verbal” – since non-verbal could be a choice or could be autism, but in Bob’s case it was neither). I remember dropping in to see Brian once when I was passing by, without having made previous arrangements, and finding him mid-day still in his PJs, uncombed, unwashed, unshaved and smelling really awful; Jacquie too.
“Asylum: a long last look at Woodlands” – pictures and archives: http://www.michaeldecourcy.com/asylum/index.htm
***********************
Some time in the late 1980s my mum was invited to attend meetings about the transition for Brian from the institution, where he had lived the last 40 years, to “community living.” The two big institutions for people with developmental disabilities in BC – Woodlands in New Westminster and Tranquille in Kamloops – were being emptied out.
My mum was not keen on the idea. She felt that Woodlands was a safe and protected environment for Brian. (We hadn’t of the Woodlands abuse at that time). She didn’t like the idea of strangers staring at him in public. Still, she attended numerous planning meetings, which were also attended by all manner of bureaucrats and social workers. It wasn’t like there was going to be a choice about it anyway. And then the meetings stopped and we heard nothing for a long time.
One day in 1991, I received a phone call around Christmas from a gentleman with an accent so strong that I actually could not understand him. He seemed upset about something, but it took me quite a while to piece together what he was trying to tell me. What emerged was that he was a care worker at some place called Gladstone House – and Brian was living there! This worker was upset that nobody had visited him.
That’s how we found out that Brian had been sent out of Woodlands and was living in the community
The transition to community living was not a smooth one for Brian. He had lived in Woodlands for 42 years; he was 49 years old. He could not have had any idea what was happening to him—or where all his friends and customary staff had gone. Thank God, the Powers-That-Be had at least placed Jacquie and Bob in the same group home. They shared a 3 bedroom apartment on one floor, and there were two other guys upstairs, strangers.
What a time we went through in that transition! One of the guys upstairs must have been very unhappy. He was certainly very violent and the house was full of punched-in holes in the walls. We can only imagine how frightening it must have been for Brian to live with that kind of noise and violence in the house. Imagine being blind, and having wall-punching violence happen suddenly near and around you. Ultimately (but not for a very long time) that fellow, Gary, was moved out.
We went through so much there. At one point we visited on a Sunday evening, and when the care aide opened the fridge we saw that it contained only a wizened cabbage.
Mum and I did not understand “the system” at all then.
For all those planning meetings, some very basic things were left undone. There was no community medical or dental care in place. Many GPs do not want to take on people with developmental disabilities as patients, because they take more time, sometimes a lot more time.
“In particular, individuals with I/DD are vulnerable because a number of physicians already seem unwilling to assume responsibility for the care of persons with multiple disabilities for various reasons.”
(–from “Health Services to Adults with Intellectual and Developmental Disabilities in British Columbia: Building Partnerships in our Communities,” by Louise Le Cavalier, RN, BSN, MN, in the International Journal of Nursing in Intellectual and Developmental Disabilities 2005; 2(1):1
[from: http://journal.hsmc.org/ijnidd/articlestemplate.asp?id=102 March 27, 2008] )
“Unlike their counterparts from the institutions, many community-based nurses lacked the clinical experience and necessary knowledge and skills to care for individuals with I/DD, having had very little if any previous exposure to this client group. Hence, they felt inadequate and ill prepared. It was a slow, gradual and often painful process for these novices who worked tirelessly to familiarize themselves with this interesting service sector, where strong personalities, a complex maze of organizations and strange politics seemed to play prominent roles! A retrospective look makes it abundantly clear that a better coordinated approach to providing educational, administrative and clinical support to HSCL nurses and therapists would have benefited everyone concerned, as the HSCL program was being introduced in BC. Lesson number one had been learned, unbeknownst to us!”
- Ibid.
Gradually, and over quite a long period of time, the medical and dental got mainly sorted out, but it was Brian, and all the people wit intellectual disabilities like him, who paid the price in the beginning for a system that was incompletely conceived.
“Indeed, the idea of specialized services has been a highly sensitive issue that caused quite an “uproar” initially. Strong proponents of the community living movement, including some parents, opposed the idea of using specialized services. They preferred relying on already established generic services in the community.”
- Ibid.
These “generic” services just were not always available.
But something else was also very wrong – because Brian was taking his head and whacking it against walls and having to have multiple stitches in his head. He was having something the service providers called “outbursts” and nobody seemed to know why but they appeared to be blaming him, because they brought in behavioural-modification professionals.
We were really feeling our way in this system. Mum and I had no experience with social workers and committees and the strange language we would hear in meetings about “behaviour plans” and “PSPs” and such. We found it all quite intimidating.
Mum was also afraid if she said anything they would send Brian to live with her and by then she was in her 70s and could not have coped, nor did she have room in her tiny house, nor the money to adapt it for a blind person. (I don’t think they would have done that then; although I do think the would do that now in 2008).
I remember one meeting during the bad transition times, with literally about 20 professionals—and us. And they even had Brian in a chair there, but he seemed so drugged; he fell asleep. In those days, Brian had his own social worker. In those days there was an annual PSP meeting which the social worker would attend, and often the community nurse, and of course the home staff and us. His life and plans, medical and diet, would be reviewed, goals made for the coming year. Now we just meet with the house staff. There is virtually no more personal care monitoring (the only monitoring done now is the financials). In those days there were also social workers who were responsible for the house and how it was run. There were also the teams of “behaviour modification” people who were working on the “outbursts” and the self injury.
My mum is about 71 years old at this time, and was very worried about Brian’s future
In the first 5 years there was a constant changeover of staff. Brian had multiple key workers over the first years. Each new key worker had their own interpretation of how Brian should be and live, and with each he would have to adapt to their requirements.
For example, one decided he needed to exercise which was fine — but when we visited she would say, “Brian! do your exercises!” and he would have to snap-to and do his set until she said stop. “See!” she would say to us. He was like a performing seal. On his birthday that year, on a blistering hot afternoon in August, this same worker put on a huge outdoor barbeque party for his birthday – and invited all the home staff plus staff and residents from other group homes. I remember Jacqui eating cake then vomiting all over the table. Brian, who sweats profusely and is always acutely uncomfortable in hot weather, and who likes quiet and not too many people around him, had an “outburst.” It was just way too much commotion but his key worker was completely oblivious.
Also—amazingly given the downstairs had three blind people–new key workers would often rearrange the furniture or change where things were kept! Which led you to wonder about their levels of training in the care of people with complex needs.
Another set of workers decided unilaterally that Brian had too many stuffed animals, and that he should not be allowed to go out with his beloved “Teddy.” So the stuffed animals were whipped away and Brian, in his darkness and disability, had to try and make some kind of sense out of these trends and fancies of his parade of keepers.
In the early days of his transition to community living, during this time of so many changes, Brian was always blamed for his outbursts. It was seen as a “behaviour modification” issue – and teams of behaviour mod people examined him and came up with “behaviour protocols.” I never recall hearing these teams consider the fact that this man had been put out of Woodlands overnight into a very strange new place, with all new strange staff, new rules, strange rooms, strange furniture, strange voices—as well as being placed into a community living system that frankly was not very well set up at first. For the first five years he could not make his needs known to his caregivers; they didn’t understand his signals. And then he was blamed for his “outbursts” which, on reflection, I think were probably rages of utter frustration and despair (and, sometimes, undetected middle ear infections).
With one set of key workers, they came up with a plan that when Brian had an outburst, everyone in the house (staff and residents) would hide inside other rooms, leaving him out in the main living room — and he would be left alone to get over it. Imagine how frightening that must have been for a blind guy who could not verbalize his needs. To be left alone like that.
Brian had always loved swimming. But he once had an outburst at a community swimming pool, and the pool authorities him. (Also many community pools did not have family change rooms so female key workers cannot take an adult male into the women’s change room. When that happens, people with developmental disabilities are effectively denied the recreation). Later, with cutbacks, there simply was not enough staff to handle swim trips, so that was the end of his favourite activity.
Brian has always been subject to ear infections; he had mastoid surgery in Woodlands. In the early years in community, when he had an ear infection he had no way of letting people know, other than perhaps banging his head against the wall.
The worst part of the transition to community living was when the group home got its third new house manager. She decided on her own that it was not ‘appropriate’ for Jacquie to be living with Brian and Bob. Her biggest accomplishment during her term as manager was to have Jacquie moved out to another group home across town. Oh yes, Brian was taken to “visit” her in her new home, but that wasn’t the same for two people who loved each other very much and had lived together before this for at least 15 years and had spent every day together during that time. Jacquie died about a year later. Heart attack. (Heart break I remember wondering).
But that is the way of people with developmental disabilities in care – they are often moved around like chess pieces.
This group home manager refused to see or talk with family members. We were allowed to visit Brian but she would not see us. My mum and I did not know how to navigate the system. Finally a social worker hinted that what we needed to do was contact So & So and say that we had “concerns.” With great trepidation we did so. Within a few weeks that manager was gone. (We did not know but there had been other complaints and evidently they needed some kind of word from families in order to take action). What was unfortunate is that these situations are so political and sticky, that those who ought to have, did not speak plainly to us—and we had to somehow divine what we were supposed to do.
We discovered much later that, at that time, the home was put under some kind of official interdict – and the service provider was given some number of days to improve. Evidently they did not, for we were eventually told (months after it happened) that there was a new service provider.
Things changed for the better then, over time. The new service provider remained and is still managing that home. They are big believers in training. They had excellent managers, some of whom had their own family members with developmental disabilities. Within time, things came under calm control.
No longer was Brian left alone to flail around in the dark when he had an outburst: the new key workers developed ways to detect the coming of outbursts and to prevent them. But if Brian did have one, they would keep talking to him, ask him what was wrong, ask him if he would like a glass of water or tea. In other words the would move in, find out what was bothering him, and not just abandon him. Gradually over the years, the outbursts receded. His new key workers did things very gradually, but they eventually taught him to do his own laundry (hand over hand). He learned to make toast and, with special equipment, to butter it. He went grocery shopping with his key worker at Safeway. He learned to cut up vegetables and make salads for his lunch.
Lists were developed of what his own signals for things were, and new staff were oriented to his “language.” He was taught a few signs (he was never very keen on the white cane program but it was tried). He went for vigorous walks to the park every day. He was given frequent baths, to relieve his sweating and heat discomfort and with fragrant bath oils, since smell is so important to blind people.
Things improved and Brian and Bob continued to live on at the house. The government cutbacks had been ongoing since the Sage Report and there had been several big cuts which drastically affected services.
The latest round of cuts came to mean that the service provider could no longer provide a day program in the home, as had been the case all along. Suddenly at age 60 — when most men his age would be thinking “retirement” — Brian now had to be up at 7AM and out the door to a day program across town, with 25 other people with developmental disabilities. He was not a happy camper. Outbursts started up again. This time he would also would wake up in the middle of the night from a deep sleep into a full scale outburst. This caused problems for the night staff person in the home, because with cutbacks we were down to one night staff for 5 complex needs men.
I began to wonder how a person could wake up from a deep sleep into a full outburst. That struck me as very odd. I wondered about acid reflux? Of course he was on a truckload of medications; I wondered if one was turning on him, creating night terrors? Or if something was happening in his ears which got worse somehow when he lay down? Also, he’d had his gallbladder removed fairly recently and ever since had pressed his stomach in a way that seemed to indicate he was trying to say he was in pain; he had considerable flatulence. He used to rub his ear and indicate pain; he’d hold his head at an angle and rub his head and indicate pain. I wondered about a brain tumour or intestinal tumour of some kind. Brian could not tell us his symptoms except very rudimentarily. I’d heard about MRIs and thought what great technology to be able to use with people who are unable to tell you what’s wrong.
At Brian’s next meeting with his psychiatrist I raised the issue of getting an MRI done. He was okay with the idea but could not order it; he advised me to contact the community nurse. I did and she said she’d enquire. She later called me and said that, in the absence of specific symptoms, they could not order an MRI.
The psychiatrist had prescribed melatonin for Brian. He said that many blind people had melatonin production issues since they were in the “dark” most of the time. The melatonin did help with the night waking and the outbursts diminished as well. That was another factor in not getting the MRI, that the outbursts had decreased.
Meanwhile, Brian had to go to the day program 5 days a week, 52 weeks a year. No vacations were built into the plan. Imagine that at 60-63 years old. No provision had been made for his “retirement” either so in the current version of the plan, he’d be going out to a day program when he was 70, 80, 90. He was very unhappy with the day program, but the Ministry simply would not provide the funding that would have provided a care worker in the home from 9-3 so that he (and probably Bob) could have had their day program at home.
“Long Term Care (LTC) eligibility policies are outdated and make it difficult for individuals with I/DD to access the services, unless individuals require extended care. MOH and MCFD officials often disagree on whose primary responsibility it is to fund services for aging adults with I/DD. Community living service providers with limited resources to support aging individuals with I/DD disapprove of individuals’ placements in long-term care facilities (i.e., nursing homes). Generally speaking, they see these environments as unacceptable for individuals who were just deinstitutionalized in the past twenty-five years.”
Ibid.
After years of studies and “re-structurings,” a few years ago the Ministry for Children and Family Development cut adults with developmental disabilities loose. They were now to be managed by an agency called “Community Living BC” or CLBC.
CLBC stated they had no plans to close group homes, but in 2006 they launched the “Residential Options Review” and interviewed every single person living in a group home in BC, to find out whether they were happy in their placement. (The study cost $3 Million, and only 7% indicated they would like change). Meanwhile, the CLBC held seminars for people who might want to do “pri-care” (private care—in a private home, for money) or “family share” which basically is foster care.
When the “Residential Options Review” began my mother was about 93. Brian’s placement had not felt secure since at least ten years previously when the cutbacks had started, when over time we lost personal social workers and instead got generic CLBC “facilitators” (and a different facilitator every time you called the call centre.). So now, at 93 years old, my mum had to worry about where Brian might be sent. She still feared if she said anything they might send him home to her for which of course she would be completely able to cope.
We had our meeting with the CLBC “Residential Options Review” interviewer, but we did not believe the reassurances that CLBC was not trying to find a way to close group homes.
We heard stories about how beds were being left open in group homes. We knew that service providers could not afford to run homes with empty beds, so while it might be technically true that CLBC was not overtly closing group homes, it seemed as if they were setting things up so that beds did close in group homes — and group home service providers might have to decide that they could not keep open half-full group homes.
We could see that another upheaval in home might be coming for Brian who had such trouble adjusting to change (as most people with developmental disabilities, especially autism, do; and especially people with “complex needs” – meaning one or more physical or mental disabilities). We could envision foster placements breaking down and Brian being moved from place to place. You can imagine people thinking they were able to take on someone with complex needs, then finding out they could not cope. This was far from the safe place that my mum had thought Woodlands to be for Brian. All this uncertainty about Brian’s security was like a torture over the last ten years for a woman of 80 – 85 – 90+.
I have felt bad for 15 or 20 years that in her “golden years” my mum has had to worry about Brian’s security. Those many years ago the condescending pediatrician had told her to “take him home and love him” and that he probably would not survive the teen years. How wrong he had been.
One day in March of 2007, Brian dropped dead. Literally. He was 63.
The emergency doctor could not be sure if it was a heart issue or something in the abdomen. Brian had had his annual physical six weeks earlier at his family doctor. I wonder what that MRI I’d requested some six months before might have told us?
An autopsy is not routine in these cases unless someone like the GP or the family requests it; my mum did not request one. A psychiatrist later told me that having an autopsy would be useful in the case of the death of a person with a developmental disability because there is so little information, and it would be useful for research.
When Brian died, the CLBC said they would fund his bed for 4 months longer, which eventually stretched to 8 months – but they never referred anyone to it, though at that time they had a waiting list rumoured to be 3,000 people for various services. Anther bed came free in that house shortly thereafter, and that bed was left unfilled as well, and no referrals sent. Plans were made to close those two beds and reduce that home from a 5-bed to a 3-bed home. The thing is you need basically the same number of staff for 3 people as you do for 5. This is the kind of case where the CLBC can make it financially impossible for a service provider to continue operating a group home – so the service provider will close or combine group homes (same thing) – and technically CLBC can say they have not closed group homes.
Since Brian came into the community, I always felt that he was like a little twig floating on the ocean – sometimes on big stormy waves of cutbacks and threatened closures. It felt as if he was very vulnerable to the winds of politics and trends in the care of people with developmental disabilities (1950= institutions; 1990 = community living. 2000 = pri-care.) It feels now as if the care of people with developmental disabilities in BC is basically a “bottom line” exercise. “How can we do it bargain basement?” seems to be the byword. There seems to be no thought to how all this uncertainly affects not only the residents but how the lack of security affects the families. Infects the families with anxiety might be more like it…
Since the Allen Review/Sage Report, we families have had at least ten years now of uncertainty and anxiety over the wellbeing of our family members. And now in 2008 it is intense. Because we know that our government would like to get out of the care of its most vulnerable citizens, or at least do it on the cheap.
It was an unexpected and nasty shock when Brian died so suddenly. Yet, at the same time I think my mum and I both felt that at least now he would not end up out of the protection of the monitored group home system and warehoused in someone’s basement. He was no longer a twig floating on the stormy waves of political expediency, dragged along by the undercurrents of the “bottom line.” And I remember thinking that, at least in these last years of her life my 95 year my mum would not have to deal with that dark-themed background music of anxiety that plays just under your consciousness—the dirge of care and concern about how Brian would fare.
A sense of responsibility towards all others also means
that both as individuals and as a society of individuals,
we have a duty to care for each member of our society.
This is true irrespective of their physical capacity
or of their capacity for mental reflection.
Just like ourselves, such people have
a right to happiness and to avoid suffering.
We must therefore avoid, at all cost, the urge to shut away
those who are grievously afflicted as if they were a burden.
The same goes for those who are diseased or marginalized.
To push them away would be to heap suffering on suffering.
If we ourselves were in the same condition,
we would look to others for help.
We need, therefore, to ensure that the sick and afflicted person
never feels helpless, rejected or unprotected.
Indeed, the affection we show to such people is, in my opinion,
the measure of our spiritual health,
both at the level of the individual and at that of society.
– His Holiness the Dalai Lama in Ancient Widsom,
Modern World: Ethics for the New Millennium, p.176
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