The Buddha’s Dhamma—his teaching—is primarily focused on the question of how not to suffer from aging, illness, and death.

It answers this question by offering practical advice on two levels:

(1) how to experience aging, illness, and death without suffering from them; and

(2) how to find a dimension where aging, illness, and death are never experienced ever again.

As we will see, the two answers are closely related.

Some people, especially in the West, will be surprised to learn that these issues are the Dhamma’s central focus. After all, questions of aging, illness, and death deal with what will happen in the future, whereas modern versions of Buddhism focus almost exclusive attention on the present moment. In fact, modern Buddhism could, with little exaggeration, be called the cult of the here and now. It extols the present moment on two levels: as the exclusive focal point for the practice—the means to the goal—and as the goal itself. Meditation practice is portrayed as a means for keeping the mind fully alert to the present. Once this skill is mastered, you’ve arrived at the goal: The ability to stay fully in the present is all that’s needed to live life without suffering.

In this view of the Dhamma, questions of how to prepare for the inevitable aging, illness, and death of the body are usually put off to the side, on the grounds that they’re distractions from the real work at hand. When these questions are addressed, they’re often treated as if they were of interest only for people who are already old or sick, who should take the lessons for how to dwell easefully in the present moment and adjust them to fit their particular needs. Next to nothing is said about finding a dimension where aging, illness, and death don’t occur at all.

As for the question of what happens after death, it’s often treated as illegitimate or in bad taste: There’s no way anyone can know the answer to that question, we’re told, so it shouldn’t even be asked. Some teachers go so far as to teach that it’s best left as a mystery. The most that anyone can do is to stay mindfully alert, open to the wonder of the unknown in the present moment, all the way up to the moment of death. After that, who knows? You’re on your own.

But when we look at the Buddha’s early teachings, we’ll see that this state of affairs is very ironic, in that it has its priorities backwards. And it’s worse than ironic. It’s a serious mistake on two levels.

The first mistake concerns the primary motivation of the bodhisatta—the young Buddha-to-be—for finding the Dhamma in the first place. When he left home in his late twenties to go into the wilderness, it wasn’t to rest in the present moment under a tree. He left home to answer his questions about the problems of aging, illness, and death. Even as an alive and healthy young person, he saw that these problems colored his entire existence: Any answer to the question of how best to live your life would require answering the question of what happens at death. That way, you would know how much energy you have to devote to preparing for death, and how much can be devoted to enjoying the here and now. Any search that didn’t aim at finding what might lie beyond the reach of aging, illness, and death was, in his eyes, an ignoble search. As far as he was concerned, only a search that aimed at the deathless deserved to be called noble (MN 26).

So the problems of aging, illness, and death were the initial inspiration for his search for awakening. It was because of these three facts of life that he looked for the Dhamma to begin with. His defiant desire to triumph over them—to see what course of action (kamma) would lead to what didn’t age, grow ill, or die—is what kept him on the path, undaunted, despite repeated missteps and hardships.

When, on the night of his awakening, he was able to settle his mind in right concentration, he used the power of his concentration as a tool for gaining knowledge. The first questions he wanted answered were questions of aging and death: Is there survival after death? If so, what was it like and how does it happen? To what extent do one’s actions influence the process of rebirth, and to what extent is the process beyond one’s control? And because aging and death follow inevitably on birth, can the process be put to an end, so that birth would no longer take place?

He kept pursuing these questions without getting waylaid by other issues or giving up on his search for knowledge. In fact, it was because he remained focused on these issues that he found an answer that brought him what he was looking for: direct knowledge of total nibbāna, unbinding—freedom from aging, illness, and death, once and for all.

The answers he gained on the night of his awakening formed the framework of the Dhamma he later taught. And here again, the primary emphasis was on birth, aging, and death.

The two Dhamma teachings he talked about most in connection with his awakening were the four noble truths and dependent co-arising. We’ll examine these teachings in more detail in Chapter One, but here it’s enough to note that each of these teachings explains the causes for suffering, and the actions through which suffering can be ended by putting an end to the causes. In each case, when the Buddha explained what he meant by suffering, the first examples he listed were birth, aging, and death. In highlighting them, he was announcing to his listeners that the Dhamma didn’t shy away from the big questions of life. These were themes to which he would return again and again throughout his teaching career to his very last day.

So we owe the Dhamma both to the facts of aging, illness, and death, and to the bodhisatta’s audacious desire to gain total release from them. When he later taught meditation in a way that focused primarily on the present moment, it wasn’t to exalt the present moment as apart from time or as an end in itself. It was to see how the present moment connected with the past and the future, and to gain mastery over the processes of the mind occurring here and now that would determine the extent to which one would suffer from birth, aging, illness, and death. This means that he recommended using the present moment—together with the past and future—as means to a higher end, for developing skills that would, ideally, lead to a dimension that lay outside of past, present, and future entirely.

This relates to the second mistake in the modern interpretation of the Dhamma. If we regard the Dhamma simply as a means for accepting the present moment—learning to live comfortably in the present as things change with the passage of time—we’re not benefiting fully from what the Dhamma has to offer. Some people claim that they don’t need to know how to die; they want to know how to live their life—as if death were not a part of life, and as if the fact of death didn’t raise questions about what kind of life is the wisest life to live. From the Buddha’s point of view, though, trying to avoid those questions is to bury your head in the sand.

The Dhamma faces those questions head on. In answering them, it provides a framework for deciding what are the wisest and most worthwhile things to do with your life as a whole: which actions will be skillful in bringing long-term happiness, and which will bring long-term suffering and harm. As you go through life, calculating which actions are worth doing and which ones are not, you’ll want to know what counts as skillful, and how long “long-term” actually is.

For instance, if you believe that actions can have an impact on future rebirths, your calculations will be very different from what they would be if you believed that actions gave no results, or gave results that went no further than this lifetime. In giving clear answers to these larger questions, the Dhamma offers much more than a guide to the present. It explains how to recognize past mistakes so that you can learn from them, and how to plan for a satisfactory future.

In providing this framework, the Dhamma gives you standards for deciding which kinds of actions will be skillful and which ones won’t. As the Buddha said, the primary duty of any responsible teacher is to provide a student both with the confidence that there are such things as skillful and unskillful actions, and with standards for recognizing, in any given situation, which is which. Any interpretation of the Dhamma that neglects this framework—or treats the issue of what happens at death as a mystery—counts as irresponsible. It leaves the student without proper guidance in fully preparing for what will inevitably happen as aging, illness, and death come rolling in.

The fact that someday you’ll have to deal with these things in future present moments—perhaps sooner than you might expect—adds urgency to how you approach the present moment right now. To prepare for the time when these inevitabilities arrive, you have to develop skills that do much more than provide ease and acceptance of whatever is present. You need to learn more than just how to feel okay about yourself. You’ll require skills that will stand you in good stead when you can no longer stay in this body. This means that you’ll have to raise your standards for what counts as “okay” in your meditation.

It’s like learning a foreign language. If you think that you might someday make a short visit to Thailand, you’ll approach learning Thai much more casually than you would if you knew that, at any moment, you’ll be forced to emigrate and live there for the rest of your life. In the same way, if your motivation for inhabiting the present moment is simply to find a measure of peace, you’ll approach it much more casually than if you knew that your mastery of the mind’s habits, as they play out in the present moment, will determine how well you’ll handle the choices forced on you at the moment of death.

Take, for instance, the issue of craving. In the course of his awakening, the Buddha discovered a long list of mental actions that lead to suffering, in which craving plays a dominant role. People who teach ease in the present moment as the Buddhist goal have defined this craving simply as the desire for things to be different from what they are, on the grounds that this desire prevents the mind from being fully present and at ease right now. As a result, they teach that acceptance, contentment, equanimity, and patience are medicines strong enough to counteract the causes of suffering.

But even though acceptance, contentment, equanimity, and patience are virtues in some instances, they can actually stand in the way of developing other skills you need to deal with the cravings that will arise at death. The Buddha saw that those cravings fell into three types, and any of the three will come on raw and in full force when you realize that you can no longer stay in this body. He also saw that if you cling to any of these cravings, they’ll take you to a new rebirth, in the same way that a fire burning a house, if it latches on to the wind, will be carried to a neighboring house and continue burning there. Blind as the wind, craving can be wildly unpredictable as to where it will take you.

The technical names of those three cravings are sensuality-craving, becoming-craving, and non-becoming-craving.

Sensuality refers to the mind’s fascination with planning sensual pleasures. In the Buddha’s analysis, we’re often more attached to our fantasies about sensual pleasures than we are to the pleasures themselves. Thoughts of food, for instance, can entertain you for hours, whereas the amount of time the food is actually in your mouth can be very short. At the moment of death, the mind will easily focus on the fear that it can no longer engage in sensual fantasies, so it’ll latch on to any opportunity to continue pursuing them. If you’re in pain, and you have no experience in the higher pleasures of intense concentration, you’ll see sensuality as your only escape from pain. If you’re really desperate, you’ll take whatever pleasure you can get, no matter how coarse or at what price.

Becoming is a sense of identity in a world of experience. Becomings exist on two scales. There are becomings on the macro scale, such as the fact that you now have the identity of a human being in the human world. There are also becomings on the micro scale. These occur exclusively in the mind when you focus on a desire and, as a result, there appears in the mind an image of the world in which that desire might be fulfilled, and your identity as a being in that imagined world. The type of identity you assume—to obtain the desired object and to enjoy it—will be shaped by the desire that forms the kernel of that particular becoming. Becomings of this sort occur in the mind countless times in the course of even a day. And, especially at the moment of death, they’ll act as openings to becomings on the macro scale in which you can take a new birth.

When, at that moment, your identity in this world is threatened, along with all the pleasures you’ve been able to find here, there will be a strong craving to continue becoming—to be somebody somewhere—unless the mind has been thoroughly trained. Here again, if you fear annihilation, you’ll latch on to any opportunity for becoming, regardless of the cost. And a craving that’s willing to pay any cost can lead you to pay very dearly.

Non-becoming is the annihilation of one’s identity. It’s possible that after a life of disappointments, together with all the pain and hardships that accompany the dying process, the craving for total oblivion could become strong at the moment of death. But the bodhisatta discovered that this type of craving still dealt in terms of “self” and “world,” the basic terms of becoming: the “me” who wants oblivion, and the world you want to run away from. For that reason, instead of putting an end to becoming, this type of craving would lead to an oblivious new becoming that would last for a while—maybe even a long while—and then on to further becomings.

This means that the craving for non-becoming would not put an end to aging and death. Instead, it would simply keep the process going.

This presented the bodhisatta with a dilemma. He saw that the cravings that lead to suffering, if you cling to them, all lead to becoming. Becoming, in turn, is the underlying condition for birth. Once there’s birth, then aging and death will have to follow. So, to put an end to aging and death, you have to put an end to birth. This will require finding a path to the end of becoming that doesn’t involve either craving for becoming or craving for non-becoming.

We’ll explore the Buddha’s resolution of this dilemma in Chapter One, but here it’s enough to note that it involves, not trying to destroy becoming, but simply withdrawing from your identity in whatever becoming you’re inhabiting, at the same time learning to observe the processes that shape becoming and keep it in existence. When you look at the steps in these processes as nothing more than events, appearing and disappearing, you see that they could not possibly lead to anything of real or lasting value. As you develop dispassion for them, you no longer engage in them or try to identify with them. Becomings that have already formed will have nothing to keep them going; new becomings won’t have a chance to arise. This is how becoming—followed by birth, aging, and death—is brought to an end.

To take this approach requires tools more powerful than acceptance, contentment, equanimity, and patience. It requires very sharp discernment, which in turn has to be based on strong concentration. As the Buddha noted, if you simply develop equanimity without strong effort, the mind will never get rightly concentrated (AN 3:103). The discernment you need to put an end to craving won’t have a chance to arise.

This means that, in focusing on the present moment to develop the skills needed to overcome craving, you have to be motivated by more than a simple desire to accept whatever arises. At the same time, you can’t rest content with whatever peace you can find in the present. You need to be more heedful than that: seeing that the dangers of aging, illness, and death could come at any moment, but realizing that they can be avoided if you develop the discernment that will help you to succeed in negotiating the challenges they’ll bring.

We’ll discuss this discernment in more detail in Chapter One. There we’ll pinpoint the principles that the Buddha learned on the night of his awakening that explain what happens both before and during the moment of death. When we understand these principles, we’ll see why the best way to prepare for the realities of aging, illness, and death involves both planning for the future and focusing on present events in the mind. Then, in the remainder of the book, we’ll focus on the Buddha’s detailed recommendations for how to act while being mindful of this dual focus, so that you’ll know how to decide for yourself with confidence which actions are worth pursuing, and which ones are not.

Some people have asked how anyone can possibly know what happens after death, and so have labeled the Buddha’s teachings on this subject pure speculation. They have also asked how any human being could possibly discover a dimension free from the conditions of aging, illness, and death. These questions, though, come from a poorly examined assumption about what a human being is—a being limited by space, time, culture, and the constraints of the body—and then from that assumption draw conclusions about what such a being can know.

The Buddha, however, took the opposite tack. Rather than start with a definition of what a human being is, he explored what a human being can do—and then know based on those actions. On the night of his awakening, he discovered that it was possible to act in a way that led to an experience of a deathless dimension. As he later said, if you define yourself, you limit yourself (SN 23:2; SN 22:36). So instead of teaching a doctrine of what a human being is, he taught a path of practice that, he said, lies within capabilities of what a human being can do, and would lead anyone who followed it to the same experience.

This statement is both a promise and a challenge. This book is for those who don’t want to be limited by preconceived notions of what they are, and who feel inspired by the Buddha’s promise and challenge to see if they, too, can benefit from the path of practice he taught.

This path is more daunting than the path that takes ease in the present moment as its goal, and for that reason it requires conviction. After all, the Buddha’s claim to knowledge is not proof enough for others that he really knew—and he realized that. That’s why he told his listeners that conviction in his awakening was one of the attitudes necessary for following the path.

It’s needed because, as he himself noted, there’s no way for you to really know the truth of what he learned about the power of human action to see what happens at death or to reach the deathless until you’ve followed the path and seen that it actually does lead you to genuine knowledge of these things. But, at the same time, you won’t be able to follow the path unless you’re convinced that it’s worth the effort. If you waited for an empirical proof of these truths before you were willing to practice, you’d die first. What you need are good working hypotheses that you’re willing to test.

After all, any position you might take on these issues would have to be a working hypothesis. The belief that death is followed by annihilation is no less an article of faith than the belief that it’s followed by rebirth. No one who has yet to see the deathless can rightly claim knowledge as to whether it does or doesn’t exist. And because you’re always choosing how to act, you need working hypotheses as to how the results of your actions will play out in any event. So as long as you have to formulate working hypotheses about the nature of action, if you want to put an end to suffering, you need to adopt hypotheses that allow the idea of a path of action to the end of suffering to make sense. This is where conviction comes into Buddhist practice: when you’re convinced that the hypotheses proposed by the Buddha make sense and are worth testing.

The Buddha never tried to offer his listeners an empirical proof for his discoveries on rebirth, kamma, and the deathless. As he said, even though a person could demonstrate that these principles are reasonable, that’s no proof that they’re true. For instance, one of the basic principles of his teaching on kamma is that you have freedom to choose a course of action in the present moment and that it will give some of its results in the present moment. Even though the principle is reasonable, there’s no empirical way, prior to awakening, to prove whether that freedom is true or false. However, the Buddha did offer what might be called pragmatic proofs for accepting his teachings on rebirth, kamma, and the deathless as working hypotheses.

Those pragmatic proofs come in two forms: The first is based on the observation that if you believe that your choices are real—for instance, you’re not being forced to act by an occult power or brute physical processes—and that they’ll have long-term consequences, you’ll be more likely to act in skillful, harmless ways. Your behavior will be more honorable. If, on the other hand, you don’t believe that your choices are real and consequential, you’ll tend to be more careless in how you treat yourself and others. If you care about finding a path to the end of suffering, you’d want to choose the assumption that would inspire you to be more careful in your actions.

The second type of pragmatic proof is based on the principle that if you don’t know if a desirable goal is possible, and reasonable people are telling you that it is, you could either (1) adopt the assumption that it’s not, which would effectively close off any path leading there, or you could (2) adopt the assumption that it is, and at least keep the possibility open. Again, if you care about finding a path to the end of suffering, the second assumption is the one you have to adopt. You wouldn’t want to close off such a desirable possibility out of sheer ignorance.

Both of these sorts of pragmatic proofs are presented as wagers—as is any teaching on the question of whether choice is real and the deathless is possible. In fact, because we’re constantly acting and making choices, we’re making wagers all the time as to what assumptions to adopt about how far the consequences of our actions will go and what sorts of happiness lie within our powers.

As the Buddha himself noted, if you have conviction in his awakening and act on that conviction, you’re making a safe bet. If it turns out that the principles of rebirth, kamma, and the deathless are not true, then at the very least you can enjoy a clear conscience, because you’ve learned to behave in compassionate and honorable ways. When reflecting on your behavior, you have solid reasons for self-esteem. And, of course, if it turns out that the discoveries of his awakening are true, then you’ve found an undying happiness.

So conviction, in the Buddha’s sense of the term, is not blind faith. It’s the act of adopting reasonable working hypotheses that open the possibility of long-term happiness and ultimately the deathless.

Now, the path to the deathless may seem daunting. Many people, on learning what it entails, can easily wonder if they’re up for the challenge. But as the Pali Canon—the oldest extant record of the Buddha’s teachings—reports, people from all walks of life—young, old, sick, healthy, religious seekers, householders, and even criminals—have followed the path all the way to awakening.

As Ven. Ānanda, one of the Buddha’s disciples, said, the proper response to learning that others have found full awakening is: “Then why not me?” (AN 4:159) The compilers of the Canon frequently described the Buddha’s teaching style as one of “instructing, urging, rousing, and encouraging”—in other words, one part information to three parts encouragement. I hope that this book will not only instruct you, but also encourage you to urge, rouse, and encourage yourself in following, undaunted, the path to the deathless.

How to Read this Book

As we will see, the Buddha’s recommended approach for gaining victory over aging, illness, and death was to develop strength of heart and strength of mind. The Pali Canon lists many types of mental strength, but two of its lists stand out. In the first, the strengths are:




concentration, and


In the second, the strengths are:




persistence, and


Given the overlap between the two lists, this yields seven strengths in all. These seven strengths will form the basic structure for Chapter Four, devoted to issues around aging; Chapter Five, devoted to issues around illness; Chapter Six, devoted to issues around death; Chapter Seven, devoted to advice for those who are caring for people who are ill or dying; and Chapter Eight, devoted to advice for those who are grieving from the aging, illness, or death of a loved one.

However, of the two lists of strengths, the first one is more prominent in the Canon, and is treated as more fundamental. It’s included in a set of teachings called the Wings to Awakening (bodhi-pakkhiya-dhamma), which the Buddha identified as his most central teachings.

This first list provides the general framework for the introductory chapters.

Conviction is defined as conviction in the truth of the Buddha’s awakening. For this reason, Chapter One discusses the central discoveries of that awakening, how the Buddha arrived at them, and how they apply in general to questions of aging, illness, and death.

The remaining four strengths are developed through meditation. Thus Chapter Two discusses how, in terms of theory, the insights the Buddha gained in his awakening shaped the way he taught meditation. Chapter Three then discusses how these theoretical principles actually play out in the practice of meditation to develop persistence, mindfulness, concentration, and discernment.

If you find the history and theory in the first two chapters too distant or abstract, you may want to start with Chapter Three, because—as I note there—the practice of meditation is central to all the Buddha’s other instructions for how best to approach aging, illness, and death. The next three chapters should be read consecutively because the issue of physical weakness, treated in most detail in connection with aging in Chapter Four, is also involved in confronting illness and death. Similarly, the issue of pain, treated in most detail in connection with illness in Chapter Five, is also involved in confronting death, the topic of Chapter Six.

As for the discussion in Chapter Seven—which touches both on how a caregiver should encourage a patient in developing the seven strengths, and on how the caregiver will benefit from developing those strengths him or herself—this assumes knowledge of the previous three chapters.

As does Chapter Eight, which treats the issue of how best to deal with grief when a loved one has grown old or sick or has died. This chapter shows how to apply the first four strengths to dealing with the symptoms of grief, and all seven strengths to effecting a total cure.

If you start with Chapter Three, then once you’re familiar with the practical discussions in the later parts of the book, you may find yourself better prepared to tackle the more theoretical discussions in Chapters One and Two. That way, you’ll have a larger framework for understanding where the practical instructions come from. This framework will then help give you a better sense of how you can adapt the practical instructions so that they best fit with the specifics of your particular case, while at the same time staying true to the principles of what the Buddha taught.