ผู้ป่วยที่บ่นอยากตายมักไม่เคยฝึกกำหนดรู้และเผชิญหน้ากับทุกข์มาก่อน การเยี่ยมผู้ป่วยจึงเป็นทั้งบทเรียนสอนตัวเราเองให้เห็นสัจธรรม และโอกาสฝึกผู้ป่วยให้กำหนดรู้ทุกข์ทีละน้อยผ่านการนึกถึงพระรัตนตรัยA patient who complains of wanting to die has typically never trained in facing suffering directly. Visiting the sick becomes both a lesson that teaches us to see the truth for ourselves, and a chance to train the patient — a little at a time — to recognize suffering, aided by keeping the Triple Gem in sight.
A student asked: when visiting patients or elderly people, if they're visited repeatedly and are already at an advanced age or burdened by illness, they often complain about wanting to die soon. What effect does repeating this complaint every day have on them, and how should one speak to help them stop saying it?
The teacher answered that when unwholesome states arise — boredom, distress, gloom, stress, irritation, exhaustion, discouragement, hopelessness, restlessness — the patient no longer wants to remain in that condition. What should be done is to teach them to recognize their own feelings. But if they've never trained in that recognition before, facing such heavy suffering becomes very difficult, because throughout life, whenever suffering arose, they always fled from it rather than facing it directly.
The teacher explained that the first thing to teach is ourselves: that aging is natural, death is natural. What we must train ourselves in is cultivating the Truth of Suffering (-sacca) — one of , the truth every enlightened one and every Buddha had to face and train fluently in — which is recognizing suffering as a state that must be endured and is hard to bear. Once we recognize suffering, we gain an initial form of spiritual heat (tapa) — a tool for pushing through the barrier of suffering in whatever challenge comes next.
Visiting the sick therefore benefits us first: we see the truth manifest right before our eyes — that we too must someday fall ill and die, just the same. When that time comes, we can return to ask ourselves, teaching ourselves to see birth, aging, illness, and death clearly — that being born means receiving karmic results, facing nature that aims to bring suffering and harm. We must teach ourselves to understand this first before we can teach others, because during a period when karmic results are actively ripening, it's very hard to teach anyone to do anything, since sin is guiding them at every moment, producing its effect every single instant, with states of suffering arising, sometimes more, sometimes less.
If a patient has previously trained in recognition and holds right view — meaning they already carried a high proportion of wholesomeness during ordinary times — they'll manage reasonably well when illness or old age comes. But if they never practiced during ordinary times and only begin trying once suffering becomes extreme, it becomes very difficult. Even playing them a recorded teaching may not help — if their proportion of unwholesomeness is high, the more they listen, the more tormented they may feel, since we don't know how much right view they actually hold. Teaching without knowing their level risks letting unwholesomeness create even more confusion. But if the patient respects and reveres a teacher, or has practiced meditation before, there's still something to help them. If someone at home has been trained and familiarized with this beforehand, then when illness comes, they can still manage some recognition and practice on their own.
Visiting the sick is therefore beneficial in two ways: first, it teaches us, preparing our own hearts before we ourselves must face the same condition; and second, it gives us something to teach others with. As for how much the patient themselves can be helped, it helps to keep objects nearby — a Buddha image or a picture of a revered teacher placed by the bedside — so that even in moments when they cannot speak, the Buddha image remains within sight. Even that small comfort is good; wholesomeness can still guide them toward something.