Going through the death process with patients over the course of his 50-year medical career taught Dr. Brad Stuart a lot about how to live.

After spending the first 25 years of his career in internal medicine and the second 25 as a hospice medical director, he wanted to explore the passion he felt for working with people at the end of their lives. His first book, "Facing Death: Spirituality, Science and Surrender at the End of Life," released two years ago, is the result of that reflection. It also helps readers explore their own ideas and feelings about death and why learning to recognize what Stuart calls our "core being" can help when we face our own death or the death of loved ones.

The book is available online at amazon.com, barnesandnoble.com and bradstuartmd.com.

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"The most important part of dealing with people who are seriously ill is the spiritual part," Stuart said from home in Northern California. "But when you use that word, it has layers of meaning. The deeper layers you can only discover through experience. I had to go through the whole 50 years before I could look back and write the book. I went through a lot of mistakes and discovered what I had to unlearn from training. Technical medicine is important to know, but there are times when you need to set that aside and go deeper in yourself and in the people you treat."

In the book he explores spirituality, the near death experiences of his patients and ways to become aware of our core being, which he believes is key in approaching death in a graceful way. He also delves into ancient teachings of mystics and visionaries and shows how meditation, near death experiences and the use of psychedelics demonstrate the connection between the brain and spirituality.

"When you're with someone who's dying, and you go through the process with them, you watch people get quieter and quieter and you realize you're watching them let go of everything," Stuart said. "That's why people are so afraid of dying, because it's about letting go of all you own and everyone you know. People go beyond that in their last days or hours or moments. You let go of yourself. Once you are with it enough, you see it happens in stages, until people let go of every aspect of self and are left with their bare essence and bare awareness."

For Stuart, spirituality is our relationship to who we really are, which is different than saying you know yourself.

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"Spirituality concerns the willingness to open up to the awareness of your own essence that underlies your awareness," Stuart said. "Being willing to be silent enough to experience your own pure awareness without any content. This is why people have trouble with meditation. They can't get away from the mind."

Vipassana meditation, which instructs practitioners to sit and observe their thoughts, is a good start, he says, but it's the part of you that's doing the observing that is your true essence.

"You get to a place where you observe thoughts and fall back into that part of self that just is. Your thoughts go away on their own and you're with who you actually are," Stuart said. "It's not yourself anymore and you can look at the person you think you are from that deeper place and it makes you laugh and cry because you realize yourself is just a construct. The Buddhists are right. Your real essence is something deeper than self. And when you get there you can experience the reality of who you are. How that connects to end-of-life care is what drove me to write the book."

We have a choice, Stuart says. We can either learn to find this awareness while we're still alive and have the ability to apply it to our lives, or we'll be forced into it during the dying process.

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"I haven't died myself so I can't say for sure, but you can prepare somewhat," he said. "If you do your homework, it's not quite as shocking or challenging. If you don't, you can be assured your dying will do it for you. You're forced to let go. And after being with a lot of people who are stubborn about staying here and not wanting to leave, it's an arduous process. Everyone succeeds, but while you're still in the body and have emotions it can be challenging."

If we do find this awareness in life, it changes how you relate to the world, Stuart says. You begin to extend what some religions call lovingkindness, or tenderness and consideration, to all living beings. He found it helpful in his medical practice.

"It sounds too ideal, but it's very practical," he said. "You look other people in the eyes, particularly if they have difficulties and suffering. Our job, should we choose to accept it, is to treat others in such a way they can see we see them and we want to see them and expect nothing back. That's lovingkindness. That's practical spirituality. Spirituality in the abstract is wonderful, but until you get out in the world and apply it in every encounter you have, that's what living spiritually means."