What’s Your Hurry?

You would think that if you were nearing death but pain-free and not depressed, you first choice would be to stand anywhere but the head of the checkout line that the Angel of Death was in charge of. If anything, most of my hospice patients jostle to stay at the back of the line or pretend there is no line in the first place.

But every so often, a hospice patient says to me, “When I wake up each day, why am I still here?” Or more generally they will ask, “Why am I still alive?” Or more directly, “I have said all my goodbyes and accomplished everything I wanted. I am at peace with the end. I am ready.” In other words, the spirit is ready before the body. I suppose it is a bit like getting all ready to move out of a home, with the van all packed up to go, but then an unexpected delay at the new locale forces you to stay put indefinitely, and you even have to unpack a few things as you wait in limbo.

Since there is no way I can sneak them ahead in the line, as hospice “neither prolongs life nor hastens death,” what can I tell them? How can I as a chaplain respond to “Why am I still here?” As with any discussion where the answer lies within the individual asking it, all I can do is ponder along with them and wrestle with this existential question together. I may suggest answers I have heard elsewhere, which may in turn help them pull up their own concern. I may open with, “sometimes there are loose ends where something is not resolved. Social workers have told me that you cannot be finished until you have looked back on all the crucial things in your life, or until you have reconciled with someone important.” Usually I get a “no not that” to such remarks, but saying nothing can be even more unsatisfactory to them because I suppose a crummy answer beats nothing at all. So we go on brainstorming. What still gives them meaning now? What memories keep coming back? Is there something else your family needs to hear from you or you need to hear from them?

One time when I was with such a patient, she suddenly reached into herself and came up with her own answer: “Maybe I am still alive because there is some future good news in my family that will fill me with much peace and contentment.” Not only was that a magnificent answer for her, I think it is one that all of us should keep in mind.

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10 thoughts on “What’s Your Hurry?

  1. Sande Ramage says:

    Interesting. And maybe there is no reason at all why the person is still alive other than the body just won’t stop. Maybe it’s just random and dumb luck that keeps some people alive past the point at which they can easily make meaning. In some ways, it’s the same as being alive at any point. I think that’s why some people opt for choosing the time of their death so that when their ability to make meaning out of the situation has gone, they are also able to go. What are your thoughts..?

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    • You are right; it is the same as being alive at any point. The question, “Why am I still here?” is pretty close to the question we can always ask, which is, “Why am I here?” In both cases, there is always the potential to find new meaning, perhaps for the patient in something as simple as telling a joke to a caregiver to relieve the tedium of his day, or something more complex such as being able to give advice to a friend facing a dilemma. Since our lifespan is so brief, I hope I can make the most of all its phases before I fade or spring back out much as I faded (sprang?) into this existence.

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  2. Judith Henry says:

    Karen, what a beautiful response by your patient. It speaks deeply of her spirit and outlook on life.

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  3. Consuelo M Beck-Sague, MD says:

    I love your patient. What a cool analysis. Since we all are, in a sense (whether we realize it or not) in a sort of “hospice of the heart” in our “declining years”, there is sometimes (at least for me) an element of what (the heck) am I doing here at 62? Especially since I have seen such brilliant lights go out at much, much younger ages. My work is done. It just seems so unfair. I’m now armed with an answer: I’m here because there is something coming that I will not be allowed to miss!

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  4. “hospice of the heart?” I’d love to hear you unpack this poetic phrase. And that something coming that you won’t miss might be insights that you will be imparting to interns—thus working “wholesale” to help patients.

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  5. IRVING KAPLAN says:

    Karen,I liked this article.

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  6. I have a friend that God healed her 96 year old mother 2 months ago, now, my friend is fighting cancer. There’s a lot we don’t understand about that, but I believe that her mother will still be used for good. She still has a purpose. Her time in line hasn’t come. I pray my friend’s time hasn’t come either. She’s a blessing to me.

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  7. Janet,
    May she continue to be a blessing on this earth for a long time.

    We have ideas of what is “playing fair” in dying, and when a child dies before a parent or when very young, the “illogic” of the thing adds to our emotional pain,and therefore to our grief. I cannot explain this away. All I can say is that expressing this sense of injustice and the anger surrounding it is a necessary part of the grief work the mourners must undergo.

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  8. Thought-provoking, as usual, Karen: “Hanging on for possible good news” sounds a good and positive idea. I am aiming for 108 but, there again, we ‘know not the time or the place’ as the saying goes. I welcome anything that makes us more optimistic, especially at a difficult time of life.

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