A Time to Die

During my years of working in the hospital, I found it odd that some people seemed to be able choose the day they were going to die, and it happened, while others kept choosing to no avail. It made me wonder why people desperate to leave the misery of their illnesses often hung on for months, sometimes even years, unlike a few who seemed able to bypass the waiting by sheer determination.

Such was the case of one woman who was diagnosed with liver cancer. Her cancer was stage three – certainly worth a bit of a fight for some people – but she opted not to have treatment.

Her family was distressed at this decision, and I was called in during one particularly emotional moment when her son was begging her to reconsider. I have to admit that I didn’t agree with the woman’s decision. She was only in her early 70’s, healthy, and had a large, loving family. Given her circumstances, and the prognosis of several more good years, I thought she should give it a shot.

But that wasn’t my call. Nor was it her son’s. It was hers. So I had to help the family accept the decision.

Once they came to terms with that, she threw them another curve ball. She did not want to go home to die. She didn’t want to put them through the experience of having to care for her 24/7.

Again, I didn’t agree with that decision. Some beautiful things happen in families when they share a death journey, and I thought she was being thoughtless in denying her children something they obviously wanted. Besides all that, her cancer was not that far advanced. The oncologist thought she could live 6 months to a year.

But again, this was not my call. It was her decision, and as long as her insurance would pay for long-term care in our nursing home facility, she could go there. Our medical social worker arranged for her transfer, but indicated the woman only had coverage for 60 days.

Over the next two months, I visited the woman two or three times a week, and she continued to pray for a swift death. As the end of those 60 days drew near, she seemed unconcerned about possibly having to go home and finally told me that she was confident God would take her before that. The fact that medically she was no where near that moment didn’t deter her from that belief.

On the 61st day we had our discharge rounds in the Oncology Department and were informed that the woman had died shortly before midnight the night before.

We were shocked. No way should that woman have died. But once we recovered from the initial surprise, we realized it would be fruitless to try to figure out how that could have happened. We had all simply experienced too many mysteries to worry about one more.

And obviously she had some kind of pull somewhere.

Christmas Is

In this time of global interaction and political correctness, I know that focusing on a Christian holiday can be considered a social blunder, but would it be any different if I was Jewish and sharing my sentiments about Hanukkah? Or Muslim and wrote about the Hajj?

So in the spirit of that ecumenical thought, I share my Christmas reflection, and my wish for all of us, Christian or not,is peace and the blessings of good health and joyful lives in this Holiday season and the New Year.

Christmas is a time like no other in the lives of most people. From the wistful old lady who sits alone remembering Christmases past, to the starry-eyed kid who bounces around the house singing his own rendition of Silent Night, there is a place for each of us.

Sometimes for me, Christmas is the desperate race to get everything done in time. Every year I tell myself to start early. Make use of those lazy summer days to at least do the shopping, but somehow I don't often find my summer days all that lazy. Not to mention how hard it is to think "Christmas" when it's a hundred and five in the shade.

So invariably, I'll be running around the week before Christmas, trying to find something for Aunt Lucy and trying to balance the number of packages each of our kids will receive. (They will count them no matter how old they are.)

What bothers me most about last minute shopping isn't the mile long walk to get to the store from the parking lot. It isn't the lady who runs over my foot with her shopping cart. It isn't the clerk who can't possibly tell me where to find the ‘must have’ toy for this year. What bothers me most is wondering whether I'll make it through the check-out line before the kid I bought the tricycle for is ready for a car.

Sometimes I'd like to forget all about the Christmas Season and just spend two weeks in a rest home. Especially when the excitement starts to build in my kids, and I wish they'd just sit still and be quiet so I'd be more in the mood to be nice to them. It's hard to think kindly of a kid who's followed you around the house for a week reading his Christmas list.

Sometimes Christmas is the frustration of cookie crumbs mashed in the carpeting, candy canes stuck on the sofa cushions and the eighteen truckloads of trash strewn around the living room on Christmas morning. Sometimes it is a sense of futility as I wonder if we'll ever overcome our kids' basic selfishness and teach them the concept of giving as well as receiving. And sometimes it is a feeling of anxiety over whether we've maintained the proper balance between Santa Claus and Bethlehem.

But that's only sometimes.

Other times Christmas is a warm feeling of closeness when I share my daughter's wide-eyed wonder at the concept of Santa and all his magic. Or when I share my son's pride in the surprise he created for his dad out of a chaos of construction paper and glitter. Or when I share my daughter's satisfaction when she transforms our living room into a wonderland of tinsel and holly. Or when my other son asks me for the umpteenth time to get my guitar and play the Little Drummer Boy, and it reminds me mistily of another time, another place.

Somehow my dad could never refuse either.

And other times I think my heart will burst when I watch one of my kids spend their last dollar on a present for the brother I was sure they hated. Or when I find something totally impractical under the tree for me, and I look up to see my husband smiling in delight.

And other times I have a sense of awe when one of the kids wants to bake Jesus a Birthday cake and sing Happy Birthday. Other times I'm filled with an incredible sense of tenderness and love when I watch my oldest daughter set up the nativity scene and explain to the younger kids what happened that magical night two thousand years ago.

Yes indeed, CHRISTMAS IS a time like no other in my life!

Missing You

There is no good time to lose someone you love, but close to the holidays, grief has a sharper edge. Excitement is in the air like electricity as people bustle around preparing for visits by relatives and warm, family times, and for some there is a huge hole in the gathering.

People deal with that fact of life and death in different ways,. For us, the year that Mom Miller died just before Christmas, we all put on a smiling face and carried on with the normal family traditions. We tried to soothe our aching hearts with the knowledge that she had lived a long, wonderful life, and she had been more than ready to go to heaven for ten years. And surely she would want us all to enjoy our holidays and not let sadness over her death put a damper on that.

Mom sure loved a party.

That thinking worked just fine for a while, but the next summer when we took a trip, the grief took another stab at us. Mom had left us a little bit of money, so my husband and I used it to make a road trip from Texas to Michigan, and then take my mother to Makinaw Island for lunch at the Grand Hotel. My mother, sister and I had made several trips to the island in years past, and Mother would sit outside the hotel and say how much she wished she could afford to go inside. (Our meager vacation funds would never cover the admission charge for going on the grounds of the hotel.)

So I talked my husband into splurging part of our inheritance on lunch for my mother, my sister, and the two of us. I told him it would be one of the finest gifts we could give my mother, so he agreed.

When we were seated at an exquisitely set table with fine linen, silver and crystal, we raised a glass in toast to Mom, thanking her for the gift of this wonderful experience, and it was a bittersweet moment. I was thrilled for my mother who was actually flirting with her personal waiter and loving every moment of being treated like royalty, but I was also experiencing an overwhelming sense of loss. I had started to think of how much Mom would enjoy something like this and had to remind myself that it was an experience we would never share.

Having to remind ourselves that someone is really gone is a normal part of the grieving process, but knowing that didn’t make it hurt any less. At least not then. It took a few years for the pain to subside, and today, it hurts a little less when I remind myself that I won’t be buying a Christmas gift for Mom again this year.

We Should Not Die Alone

One of my specialties when I was working as a chaplain was dealing with crisis situations in ER or ICU. I have always been cool under pressure, which was an asset when dealing with grieving families or families facing tough choices.

Sometimes I would have to try to contain the wild, demonstrative grief that had people flailing over gurneys and falling to the floor. Other times, it would be standing quietly while someone died with no family present.

That happened often when family members had been keeping vigil for days and days, and just stepped out for a short break. Almost as if the dying person wanted to do it alone.

But on rare occasions it was because family members did not care to be present for whatever reason.

One of the ICU nurses had a particularly hard time dealing with that kind of situation and called me one day in tears. A patient, who had been on a ventilator for several weeks with no hope of ever breathing without it, wanted the vent removed. She had two sons, who had seldom visited in those weeks, and they had different reactions when the nurse called to tell them what their mother wanted.

The first son said that was fine, and no, he did not want to come to the hospital when the vent was removed.

The second son said that was not fine, and he would come to the hospital with a lawyer if need be to prevent his mother’s wishes from being carried out.

The woman was conscious and able to communicate and had already signed a Do Not Resuscitate (DNR) order. The legal department from the hospital drew up another document outlining her most recent request and that was read to her before she signed it.

Then there was another conference call to the second son in which the doctor again explained that there was no hope of recovery for his mother, and we now had a document signed by her that she wanted the vent removed.

Legally, there was nothing else the son could do, but as the nurse said, if he cared that much about his mother to fight the removal of the vent, he could have cared enough to come and be with her when she died.

Everything was done to make the woman comfortable and before the vent was removed, I had a little service for her that she had requested. Then she nodded and the respiratory therapist turned off the machine.

The nurse cried. The therapist cried. And I cried. Not for the fact the woman died. But for the fact that she had to die with strangers around her bed.

"Baby Grace"

This is a bit of a departure this week, but I simply cannot get my mind off of this tragic murder of a little girl in Texas. The body of two-year-old “Baby Grace” was found in a plastic container in Galveston Bay and was recently identified as Riley Trenor.

The mother, Kimberly Dawn Trenor has been arrested, along with her husband, Royce Clyde Zeigler II, and is in Galveston County's jail, charged with injury to a child and tampering with evidence. According to court documents, Trenor told police she and her husband killed the girl in July and hid her body in a shed before dumping the body in Galveston Bay.

What sickens me most about this story is not that it is merely another innocent child who suffered at the hands of adults, but the fact that she suffered horribly over a period of at least six hours. According to a statement by the mother, her husband beat Riley repeatedly with a belt because the girl failed to say “please” or use other forms of what he considered good manners.

According to the statement, this abuse continued each time the girl failed to respond appropriately and escalated into throwing her across the room and holding her head under water. When the stepfather became more enraged, he threw her so hard that she hit her head on a tile floor, sustaining severe head trauma. Allegedly, that is when the couple gave her some pain medication and she died.

Any parent can understand that flare of anger when a child misbehaves and you have the urge to slap him or her, but most parents, thankfully, take a deep breath and calm themselves before taking action. Sometimes they don’t stop in time, but certainly after that first slap, they stop and say, “What on earth am I doing?”

That these people could not do that, baffles me. There is simply no way that I can understand what drives people to abuse and murder children. It's got to be more than just anger. Anger flares and then dies down. It doesn't stay at a fever pitch for six hours.

Gone Fishin'

Sometimes ministry takes strange turns. One wouldn’t necessarily consider fishing a ministry, but in the case of Mr. Charles it was.

Mr. Charles, a retired Presbyterian minister, was our neighbor in Omaha and about a year after his wife died, he was diagnosed with leukemia. It was not the virulent leukemia that kills so many young people, He had Chronic Myelogenous Leukemia, which is a slow progressing form of the blood cancer and is very treatable for several years.

I first met Mr. Charles when I was out walking my dogs and would go by his yard. He was one of the few neighbors who would be outside no matter what the weather was like, and we would often chat for a few minutes. He was thrilled to find out that my husband is a minister and that I am a chaplain, finding a common bond in shared ministry.

When I would stop to visit, some of our other conversations revolved around fishing and the great walleyes that could be found in lakes north of us, although Mr. Charles preferred the trout at a lake much closer. One day he told me how much he missed fishing, and I was surprised to find out he was no longer going out. He explained that his children, both of whom lived some distance away, were afraid for him to go out alone now that he was sick, and the friend he used to fish with was no longer able to.

He talked about this a couple more times when I stopped on my daily walk, and finally it hit me that maybe he was really grieving for this loss in his life. I asked if he would like to go fishing with me sometime.

“Oh, I thought you would never ask,” he said.

“But why didn’t you just ask me?”

“Because a black man cannot invite a white woman to go fishing,” he said. “That is the way I was raised. I could never be that forward. But there is nothing in that code of conduct that says I cannot accept your invitation.”

So, for the next year, Mr. Charles and I went fishing about once a week in prime fishing times, stopping only when winter snowed us in.

Sometimes we would talk about the beauty and bounty of God, and other time we would talk about social issues, or books, or whatever topic struck our fancy. That would always be on the drive to and from the lake, however. The time at the lake was spent in quiet contemplation of the warmth of the sun, the gentle splash of water against the dock, the screech of a gull, or the drone of a curious bee circling our can of soda.

Actually catching a fish was never a criterion for measuring the success of a fishing trip.

The Magic of Music

One of the patients at Day Services was a young man who had been in an automobile accident and had a severe closed-head injury. He had been in a coma for weeks, followed by weeks of inpatient rehab. Since I can’t use his real name, I’ll call him Dave.

Prior to his accident, Dave had been in a band with some other high school buddies, and he wrote much of the music. According to friends, the band was quite good and had actually played a few gigs, with hopes of more to come. Unfortunately, the accident had dashed those hopes, but Dave still liked to sing and would occasionally attempt to play my guitar.

One day while I was playing the usual warm-up exercise I do right after I tune my guitar, Dave focused on the music. When I stopped, he asked me to keep playing the song. “It’s not a song,” I told him. “It’s just a little riff I do.”

“But it’s a song,” he said.

“Okay, sing it.”

He did, filling in with a melody and lyrics as if he was reading them off a piece of sheet music.

He sang that song every day for a week, with only slight variations in the music, but wide disparity in the words due to his short-term memory difficulties. So I got the idea to tape him singing and send the tape to my son who writes music. I asked my son if he could write out the music for Dave, smoothing the rough edges of the melody and filling in missing lyrics.

A few weeks later I was able to gift Dave with a tape of his song, as well as sheet music. He was thrilled. He still couldn't remember the song from day to day, but his father told me Dave listened to the tape every day on the way home from the hospital.

Others in Day Services had certain songs they wanted me to play week after week, and I thought that all I was doing was making them happy for a little while. I had no idea that the music was actually helping them physically.

I knew of music therapy programs in healing, but had always thought of them as good for the soul, more than the body. But the director of the Day Services said that the music was helping, especially in Dave’s case, the patients’ brains to make new synaptic connections to compensate for those broken in the accidents that caused their brain injuries.

Even today, over ten years later, it still thrills me to know that this meager musical talent was able to have such a positive impact.

Shall We Sing?

One of the areas I served when I was taking my CPE classes was Rehab Day Services, housed in a large room furnished like a home with comfy chairs, a dining table, flowers and artwork. Patients who had suffered head trauma from accidents or strokes and had completed the in-hospital rehabilitation would come for outpatient rehab and spend their down time in Day Services.

During lunch, there could be as many as ten patients gathered around the large table sharing a meal, and Jean, the Director would always encourage them to share their joys and frustrations with their rehab efforts.

Bob, my supervisor, thought it would be good for me to go to Day Services at noon to bring some spirituality to the gathering. Ha. There was so much spirituality already there, I wasn’t sure what I was supposed to do. They didn’t need me to lead them in prayer. They already did that. They didn’t need someone to listen to their fears and frustrations; they were already “chaplain” to each other.

So I sat and ate with them and visited. Then one day someone started to sing. Several others joined in on a sweet version of “Amazing Grace” When I saw how the music brightened the faces of those who were down that day and calmed the nervous jitter of others, I realized what I could do for them.

I could bring my guitar and we could sing.

So I did, and we did, to some amazing results. I thought it was all about brightening their day, making them feel better, but we accomplished so much more.

I’ll tell you about that next time.

Learning the Hard Way

When I moved to Omaha, Nebraska from the Dallas area, I wanted to continue my hospital ministry, so I called the closest hospital to see if I could volunteer there. They had a much larger Pastoral Care Department than the hospital I had been volunteering at, and it was also a training center for chaplains.

The very nice man, Bob, who took my call, told me that in order to work in any pastoral care capacity at the hospital, I would have to complete at least one unit of Clinical Pastoral Education (CPE). My informal training through the hospital ministry organization at my previous church didn’t count. Nor did my years of experience. Both of those, and the fact that my husband is an ordained Permanent Deacon in the Catholic church, would qualify me to enter the CPE program, but weren’t enough to let me volunteer.

I’ll admit it. I had a bit of an attitude about that. Who was he to discount what I had done? I was trained by a woman who had years of experience with Hospice. And didn’t he know I was a good person and only wanted to help people?

Actually, I think he did. And when I was able to let go of my attitude and sign up for that first unit of CPE, I started to understand. To be a chaplain, it takes more than being a good person, and we are not there to help people in the way most people think.

When I think about the first few months of that first unit, I cringe remembering all the poor people I tried to “help.” Bob was the CPE supervisor, so I met with him weekly to debrief and go over Verbatims. I would feel so smug because of things I did to help people, and Bob was quick to point out that wasn’t my role. “You aren’t here to ‘fix’ things,” became his typical response to me, until I finally started to get it.

I went on to take three more units, which then qualified me to work first as an on-call chaplain, then part-time and finally full-time for several years. That was an incredible experience, and I am so glad that Bob stood his ground.

Why Bad Things Happen

One of the questions I am inevitably asked when talking to people about situations like Rene’s is, “Why?” Why would a loving God take a young woman like that?

Well, actually, God didn’t do it. The tumor grew in her head without any help from Him at all. Good medicine and positive thinking kept it at bay for a while, but it was inevitable that it would come back.

But wait, what about miracles? Couldn’t God have done a miracle here? Well, actually, yes. I do believe in miracles. And maybe it was a miracle that Rene had 5 good years instead of only 6 months. But that is only speculation. I think we can put an interpretation to almost anything after the fact.

And the fact is, God doesn’t make things happen to people for whatever reason. He created us and the world we live in – at least some of us think so - but He turned control over that world to us. He could intervene on our behalf, and at time has done so, but most of the time He lets us chart our own course. He is not sitting up in heaven with a computer keeping track of how good we are – I think it’s only Santa and the Easter Bunny who do that – so he can bring down a terrible sickness on those who are sinning.

So many of us grew up in religious experiences where we learned that we had to be good to please God. And in some way that started to equate to “Be good so nothing terrible happens.” But as Rabbie Kushner points out in his book, “Why Bad Thing Happen to Good People”, personal tragedy is not linked to personal morality.

It is from Kushner that I learned about the workings of natural law that operates with no moral judgment. He believes that natural law is blind, and God does not interfere with it. God does not intervene to save good people from earthquake or disease, and does not send these misfortunes to punish the wicked.

Does that mean that we should stop being good? Or stop praying for miracles? Absolutely not. We should always be good to please ourselves. And I believe that God is dispensing miracles all the time. It’s just that sometimes it is not the miracle we asked for.

Blessings Are Sometimes Sad

While Rene was amazing me with her simple theology and delighting her family with her recovery, the doctors were cautious about celebrating. Even after weeks of radiation, followed by a CAT scan that showed the tumor was gone, the neurologist told the family that this could only be a temporary victory. The kind of tumor Rene had rarely disappears forever.

Rene dismissed the doctor’s negative prognosis and resumed her normal life, going to school, visiting with friends, and going to church. She had named the tumor “Herman” and said she was convinced the radiation worked because she had told Herman to “get the hell out of my head.”

Herman stayed away for five years - four and a half years longer than the doctor had predicted – and when he came back, it was with a vengeance. By the time Rene was showing any symptoms, the tumor was larger than it had been originally, and surgery was not even an option. They could try radiation again, but that might only buy her an extra few months.

She was pissed about that. She was also one of the few people I’ve met who openly expressed feelings of anger. She said a few nasty things to God about allowing this to happen to her, and her mother was horrified. “You can’t talk to God like that.”

“Actually, she can,” I said. Then I told Wilma what a very wise woman had said to my daughter when a close friend’s child had been killed. My daughter was angry, and this woman told her to go into her room, close the door, and tell God in no uncertain terms how she felt.

“But I’m mad,” my daughter said. “I want to say ugly things.”

“That’s okay,” the woman said. “God can take it. He’s got strong shoulders. And he’d rather you yell at him, than turn away.”

Over the next few weeks I helped Rene and her mother prepare a memorial service. Rene picked out a couple of readings from the bible, as well as asking for a particular song and a spiritual reading. The family wanted my husband to conduct the service, and his homily was focused on what a blessing Rene had been in our lives.

She was that.

I thought I Knew It All

After my last visit with Rene in the hospital, I thought that would be the end of our association, but something about her tugged at my heart, so when her mother asked if I would visit at home, I told her I would.

I went once a week so we could do some catechism classes in preparation for her to make a full profession of faith in the church. Not knowing how long she might live, our pastor recommended that I do a condensed version of a year-long journey that people take to become Catholic. We spent some time on the Bible, church history, and then I wanted to introduce her to a bit of theology. I told her in the simplest definition, theology is knowledge of God, and that one of the purposes of the practice of a religion is to deepen our knowledge and understanding of God. To be aware of His presence in our lives. So what would she like to learn about Jesus?

“Oh, I already know about him,” she said. “He was there in the hospital with me. We talked and He said I was going to be alright.”

I remember thinking, “Wow! What other lessons will this young lady teach me?”

Until next time….

Knocked Off My Horse

I was a few weeks into my “I’m never going to do this again” attitude about hospital ministry, when I received a phone call from the chaplain at the local hospital. There was a woman in ER who had just been told her daughter had a brain tumor and was going to die. Could I come? The lady was Catholic and needed someone from her faith.

Well, damn. How could I say no?

At the hospital, I walked into the exam room in the ER and saw a woman, Wilma, standing in the middle of the room. She was just standing there. Alone. The bed was gone. Oh, my God, I thought. I’m too late. The girl is dead.

I introduced myself and Wilma told me that they had taken her daughter, Rene, to surgery. The doctors were going to try to reduce the swelling in her brain caused by the tumor. There was only a slim chance she would make it through the surgery.

Faced with her fear and anguish, I wanted to run out the door, but I steeled myself and stayed. One of the biggest concerns that Wilma had was that Rene might die without baptism. She explained that Rene’s father was not Catholic and refused to have the kids baptized. Was it possible to have her baptized now? Not just the emergency baptism, but a real one with a priest?

Luckily, my pastor at the time had a real strong pastoral streak, so he agreed to come to the hospital. As soon as Rene came out of surgery, we went into the recovery room and had the rite. Because I was the only other Catholic in the room, I was named as her godmother.

Several days later, much to the doctor’s surprise, Rene woke up and appeared to be just fine. Wilma called to tell me the good news, so I went by to visit later. When I came into the room, Wilma started to introduce us, and Rene said. “I know who you are. You’re my godmother.”

I always think of that as my St. Paul moment. You know, knock me off my horse to get my attention. I guess like St. Paul, I needed more than just the gentle nudge that most folks get.

Until next time….

In the Beginning...

My first experience with the death of a patient when I was fresh into hospital ministry was a young man with leukemia. He and his family belonged to our parish and I was assigned to visit him in the hospital through our Hospital Ministry program. That wasn't too bad. I would stop by on Sunday and bring him communion and maybe visit a little if he was up to it. No fuss. No sweat. Easy on the emotions.

When I started visiting, he was receiving treatment that appeared to be working, so he would go home and rejoin his young wife and children in a couple of weeks. And I would have a positive story to share with the rest of the group when we met for support and debriefing. Maybe we could even invite Hallmark in to make a commercial.

Why is it that when we think we have it all figured out, God, in his or her infinite wisdom, throws the proverbial monkey wrench into the equation.

One day, the head of our Ministry program called me to ask if I would visit this man at home. The treatments had stopped working and he was dying. He had asked for someone to visit and bring him communion, and since I already had a connection to him it would be good for me to make the visit.

Gulp! What happened to the Hallmark moment?

I went. But I'm not sure I was a whole lot of help to the family. I wasn't prepared for this sudden turn of events, and I wasn't sure how I could represent a God that I was a bit pissed at. It was totally unfair that this man was dying, and I wondered about a God who would let that happen.

Looking back now, I have to smile. I'd forgotten how green I was at all this and how unwilling I was to enter into that tough arena of death. And I obviously had a whole lot to learn about why bad things happen to good people and God's part in all that.

This experience was almost the end of my association with hospital ministry. After the young man died, I swore I was not going to do it any more. It was too hard. I did not want to get attached to another patient and then watch them die.

That was my plan, but again, God had another one in mind. He/She introduced me to Rene, but more about that next time.