Tag Archives: chaplaincy

Readiness in dying

In my work in the hospital, dying is such a common theme. Something about being in the hospital, whether one has a terminal illness or not, brings about questions of one’s mortality and readiness to die. It really is amazing that something that people think about so often, or resist with such stubbornness is such an avoided subject by many medical professionals. I have been in so many conversations with medical teams, families, and patients talking about end of life, comfort care, and palliative care where the words “death” and “dying” are never mentioned. Why the awkwardness, why the fear? I think there is definitely something going with the doctors and nurses that I will address in other posts, but I would start with what I have been offering patients and family members these days.

I think there are three areas people become ready to go about their dying: their mind, their heart, and their body. Often times, especially when someone is younger and dying of cancer, their body might be saying, “It’s time,” but in their heart and mind, thinking and emotionally, they are far from ready. They have things to do, kids and grand kids to spend more time with, fears of the unknown that they hold on to. This so often makes for a lot of suffering. They pursue extreme treatment, their family members get alongside their efforts for more time, and doctors very readily do everything can to keep someone alive. But their body is saying it’s time.

The other, and perhaps less common situation, is when someone’s body is strong and in their heart and mind they really want to die. I see this with women and men in their 90’s who have no one left. Their parents died half a century ago, their spouses have died, some of their children have died, and all their friends have died. They ask me to pray that they would die soon. And yet they keep on living. I think this is getting to be more and more common with so many life-extending practices that we have now. This is a different kind of suffering, and I see doctors and nurses responding often with, “This patient is depressed.” I often remind patients (and staff) that wanting to die is not necessarily being “depressed.” It is not always “giving up.” Assuming this desire as such, minimizes the experience.

So ideally, our heart, mind, and body would be in sync when it comes to our dying time. How do we as those who may or may not be dying get to this place? Stephen Jenkinson writes that someone must be very out of touch with their life if they have to be told that they are dying. If we are paying attention and unafraid, we will know. The body has a wisdom of its own and knows when it has had enough. We would also do well to begin contemplating our dying and preparing for it as soon as possible. Why not now? I will tell patients it’s never too early to begin thinking about how we want our dying time to be. If only we can include our loved ones in this conversation, wondering and dreaming with them, recognizing that it is a part of life, not a bad thing. And one of the greatest gifts we can offer our children and grand children is a gracious and honest look at death so they have something to hold on to when it is their turn. This is a sacred thing to pass on. It is legacy. It is holy. And in this act we will be remembered.

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Death defines me

The title should perhaps read, Death (Re)defines Me and Us. As a chaplain, and perhaps more specifically, as a human with my particular “Soulcraft,” I think about death daily. It happens to be my road in life to walk alongside those who are dying, wonder with them what death asks of them and of us, and to seek to understand death as best I can. As Stephen Jenkinson teaches, if we didn’t have death, we wouldn’t have life as we experience it. Our appreciation for a flower is very much affected by the knowledge that this particular flower will not be here forever. Our appreciation of the summer is only in the context that summer will change into fall and then into winter. Death does not have to equal trauma, death does not have to equal “giving up,” and death does not have to equal bad. Death IS real and we all will come to our time when it is our time.

My body will nourish the earth one day. I will become the literal compost of new and becoming life.

The difficulty of describing how this lands in my life is palpable. Living and dying is such an individual experience. Each of us has our own take… and to assume I know what it is like for another is ludicrous.And yet, we are so connected. So connected. We as humans have done the earth wrong in a million different ways by forgetting this, by living as if our living and dying is not part of the bigger thing.

For me, I want my to be as aware of my dying as possible. I will tell any who will listen (and perhaps some who won’t) what it is like and how it is to die. Especially my children, and those who I am blessed to elder in their growing and learning. Perhaps one of the greatest gifts I can leave behind is what it is like to go through this particularly individual and uncharted territory, so that when they go through their dying time, they might remember one who has been there before.

I forget sometimes, in any given moment, that I might not be alive in the next moment. Unlikely, perhaps, but things can change in an instant and we do ourselves and others we are blessed to journey with, a deep service to remember this. Life and death, both are good and beautiful things. As Richard Rohr says, “Everything belongs.”

My body will nourish the earth one day. I will become the literal compost of new and becoming life. This is where I belong in the circle of life. The earth gives me life and one day I will give her life. What does this do to us to feel this? To know it deep in our bones as we walk this land? In the depth of our lungs as we breath into our being? To eat our food, each plant and animal having had to die to sustain us?

Why I’ve started to dislike Easter

I think Easter is supposed to be the cornerstone holiday of Christianity, at least that’s what I grew up thinking in my Evangelical upbringing. After all, Jesus died to pay the price for all our sins and then he rose again, finalizing it and making it clear that God approved of the sacrifice. It’s a great opportunity to remind us all how important it is remember our sins and to commit our lives to him and to believe that he really did do this for us.

I don’t really like going to church on Easter anymore. I mean, I’ve heard this same message a hundred times… Easter doesn’t make it any more real to me. I just end up feeling like the pastor is using the opportunity of a packed church and a suffering savior to get more commitments to follow Jesus. But I don’t think there was anything in Jesus’ death and resurrection that was saying believe that I did this and you will go to heaven. There was nothing in his death and resurrection accounts where he said follow me and make me your God.

I also don’t really like working in the hospital on Easter. I have done this the last two years. Last year, I spent most of the day with a family of 30 or more relatives waiting to hear whether a 14 year old boy, who had a completely unexpected stroke, was going to die. And prayed with a man who held his newborn child who had died in delivery. This year, I had to talk with a family whose father and husband, most likely dying from full body shut down, after the doctors found a softball size tumor on his last day of checkups after pushing through metastasized melanoma. We talked about letting go, about grieving, about the fact that he might not go home.

If I had to choose between the hospital and church on Easter, I think I would choose the hospital. To me it feels closer to real life and rings truer to what Easter is all about. Granted, God’s presence is as present at church as it is in the hospital, but in the hospital people have to wrestle with it more… and God’s presence, the work of Christ in the universe, the person of Jesus should be wrestled with. Always, and without exception. I guess I’m just not into “Hurray for Jesus” anymore. I’m not into easy answers, or sealed in blood, or done-deal salvation. If Jesus is the “blue-print,” as Richard Rohr often mentions, if he is the full representation of God, or the ultimate archetype of truth in the universe, his death and resurrection are not a series of facts that must be believed for eternal salvation. His death and resurrection are not a story to be told with much theatrics and passion with the hopes of getting a few more Christians to add to the Book of Life.

If Jesus truly is the revelation of the Divine in humanity, his death and resurrection are a cosmological statement that says, “See, this is what God is like. Death happens. It is a necessary part of human life, it is a necessary part of the spiritual life. And when we die, God comes through with hope and new life. It has been this way, it is this way, and it always will be this way. If you are afraid to die, you will not face the new life.” My sin did not put Jesus on the cross. The reality of life put Jesus on the cross, just as reality of life raised him from the grave. And is it a unquestionable proven fact that he rose? No. But then again, sometimes archetypes say more about truth than fact does anyway.

How I changed my name in residency

2014-07-03 12.04.30When I started this last year, I was faced quite painfully with many of the forgotten and unexpressed emotions that I had for such a long time resisted. I was a boy once with dreams, an imagination, an innocence, and a carefree-ness.

I began to believe things, one way or another, about myself. Things that were not true. Things that made that boy “grow up.”

Shame, guilt, competence, fitting in, having the right answers, not getting caught… these were things that I didn’t know or care anything about. But I began to believe things, one way or another, about myself. Things that were not true. Things that

2014-07-03 12.08.28made that boy “grow up” and push down feelings of loneliness, sadness, anger, and confusion. My supervisor told me one day, “Nate, I want to know that little boy’s name.” For a long time, I just called him “the Little Swedish Baptist boy.” He was the one who was hurt, the one who was not quite ok just the way he was.

And then one day, or over the course of a few days (I don’t remember how the process fits together), I realized that I have always been known as Nate. At least since our family moved to Michigan and I first experienced what it was like to be bullied by my peers. There was another Nathan in the class, a mean little guy, who was so cruel to some of us. I was the new kid so I accepted the name change. And Nate was the self I crafted. Nate became, to an extent, a false self. Not to say there weren’t glimpses of my true self coming through, and often, but I’ve experienced a lot of “hedging in” in my 34 years. A natural and good curiosity told that this or that was outside the realms of orthodoxy or was “new age” or was silly or an embarrassment… the list could go on. I realized that around the time of using “Nate” as my name, I first began experiencing tangible shame.

2014-07-03 12.06.51So I tried introducing myself as Nathan. It was a reminder to myself that my true self can do this job. My true self is ok to be present here. Often speaking of this significance brought me to tears. So Nathan is sticking. As my supervisor noted one day, “It’s almost as though you are realizing that Nate can’t authentically do this work of chaplaincy, but Nathan can.” How true, how true. It becomes easier and easier for me to speak of myself as Nathan, a name that for many, many years didn’t seem like it fit me any more. Each time, part of my true self is brought into the relationship and I am reminded of who I am.

cropped-img_3359.jpgTraditional rites of passage for men almost always involved some sort of naming. A boy would go into the wilderness, leaving his family and his community, to connect with Spirit and with self. It was in the wilderness that he would find what his true gift to give to the community was. And he would be given his new name. He would then re-enter the the world of his people with his new responsibility (Bill Plotkin calls it the “soulcraft”) and his new name. It is in a legacy such as this that I will often say that this time has been a year-long rite of passage. For I have my soulcraft, my sacred dance, and I have my name.

How do I deal with devastating tragedy?

After almost nine months of working in the hospital, facing tragedy, death, suffering, I am recently coming to a more clear understanding of how I face it, how I can continually encounter it. The temptation for me, and I would imagine for many, is to come up with a reason, an explanation, or even some way of being prepared for the devastation of life lost suddenly or illness. Visualizing how I might be, getting my skills in the grief process honed in, numbing… there are lots of ways to be prepared, some better than others, many that I regularly utilize.

I am now saying I never am “prepared” for this. I wish and hope and pray on everything I know that it doesn’t happen, on my shift or anyone’s shift. I get a call and the first thought that goes through my head is, “Oh dear God. Not again.” For me, there is not a pretending that it doesn’t happen, or that it won’t, but a desperate hoping that individuals, families, or communities will not have to suffer today. And when they do, I am hit in the gut with the sadness, the devastation, the agony that they still do, despite my deepest wishes. I never want to be “prepared” for this. Because most of the people I meet are not. And i want to be near to them in their pain, to try to understand, even in the slightest, what it might be like for them.

And when I leave a family, or someone leaves the hospital, I have to say goodbye and do it all again. And the thing that helps me is to recognize that this really did happen and it happens countless times every. single. day. There is no pretending, no numbing (as much as I am able), just acceptance and a continuing hope that it won’t happen again.