Speed Visiting

On a short-term experimental basis the hospice I work for has decided to try out a new system for chaplain visits. It is called “speed visiting” (after the concept of “speed dating”). We know the advantages of speed dating, where we quickly screen out the folks we are not interested in and zero in on the most likely candidates. Why spend lots of time trying to unravel all sorts of deep and convoluted layers of meaning when a truly skilled chaplain can size up a person in a matter of seconds? After all, we know the signs of sadness, anger, disgust, ennui, denial and all the rest. And we know how to instantly respond to their need to be heard. We just have to urge them to express their distress in a sound-bite appropriate length, just as they do in other areas of their life. We just have to reassure them that we get what they are feeling almost as if we were inside their brains, so they don’t have to elaborate.  And why waste gobs of time with patients who really are not the least bit interested in seeing a chaplain just to have more to say in our medical record notes? And if we need to vent, we really are desperate if we have to do so in our clinical notes, I mean really!

Really? Speed visiting? April Fools!!

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New Zealand, New Jersey, And New Realizations

“Do we have to take off our shoes?” “What do we have to wear?” “Are the men and women separate during prayer?” Funny that those were the questions we interfaith leaders of my little Rockwellian town of Kearny in New Jersey preoccupied ourselves with. We were hastening through a conference call to get ready for the New Zealand memorial service at the local mosque.  All of a sudden, we Kearny Interfaith Network members felt our lack of knowledge, our fears of inadvertently giving offense, and yes, our curiosity, as we discussed how we could help at a place we were attending for the first time within a day of the Christchurch tragedy.

When we arrived, the mosque members were almost baffled at the number of Jews and Christians suddenly In their midst to offer solace; they have been so used to keeping hidden and quiet out of fear of anti-Muslim sentiment. Even their building, a white home I have passed on the way to work over and over, never gave off a hint that it was a house of worship, let alone a mosque. I never even had noticed it before on this heavily industrialized street. Now, an ample number of polite but watchful policemen stood at the entrance and waited in their cars on the street, and a sign sprouted up along their fence that proclaimed, “New Zealand Candlelight Vigil.” But the Muslim community was glad that a rabbi, priest and pastors along with members of our congregations came to be with them and make speeches of support. And I was comforted when one of their own leaders spoke about the Pittsburgh synagogue and the Texas Baptist church tragedies and how we of all faiths would all stand with each other for peace and freedom. The mosque members are isolated no longer, and they are already planning to invite us to their happier occasions as we prepare to host them at our own houses of worship.

Book Review: Words At The Threshold: What We Say As We’re Nearing Death

With all of the years of chaplain experience that I have, rare is the book about dying that raises my awareness of how to do my job better. The author Lisa Smartt is a linguist and the essence of the whole book is that the talk of persons who are going to die relatively soon, from a few hours to a few weeks, reflects “consistent patterns that emerge in language at the end of life.” Her data consist of 1,500 English utterances gathered over a period of four years. Some of the patterns she found include paradoxical statements such as, “I understood everything everyone said, but not a word was spoken,” metaphors such as “Yellow bus…lots of angels are driving that bus,” or visions such as seeing ancestors or spiritual figures.

After I read Smartt’s numerous categories and examples, I started to notice this special pre-death talk more often while doing my own hospice work. I then found myself responding to this special way of talking in a much more tuned-in manner than before, letting myself explore what the person was trying to convey. Just the other day a gentleman who only leaves his room in a recliner to relax in the sunroom informed me, “I have to go to a meeting.” I asked, “What is the meeting about?” (Other staff might have tried to “reorient” him by saying there was no meeting he had to attend.) He said, the meeting “is about everything.” I echoed, “Everything?” and then reflected, “That’s going to be a really really long meeting.” Chuckling, he agreed with that. I thought to myself, he might have been referring to what professionals call “life review,” i.e. the kind of run-through of our life story that some people do during the period of time before the very end as well as at other key moments of their lives.

Another characteristic this book includes is intensified language, or what I would call heightened sensitivity. I will never forget the time a patient said to me, hours before dying, that the water I gave her “was the most delicious thing I have ever tasted.”

If you find these examples engaging or touching, you will find anecdote after anecdote in Words At The Threshold, some of which are very poignant. One is about a woman who kept referring to five boxes she had to organize. Her daughter thought maybe the boxes stood for her and her four siblings, and at that her mother got agitated and exclaimed, “I need to find a place for them!”  She did not calm down when her daughter mentioned where each one of them lived.  Finally when the daughter said to her mother she could keep them in her heart, she became calm and relieved. A lesson here for all of us who may in our personal or professional lives be with someone talking near the end, is to not be too literal and instead get at deeper things such as love and other values.

Besides sensitizing me how to better connect with patients when they engage in “threshold talk”, this book also teaches me to recognize it as an indicator that patients may be nearing the end. So many times, as families struggle with uncertainty, they ask me how long their loved one has. Not even nurses always get this right, and we do not want to increase anyone’s distress by guessing wrong. Especially way wrong. But at least threshold talk can be a guide, and I can let families know that not a whole lot of time may be left. Another benefit of this book is that it  shows us how to make the most of a loved one’s end-of-life talk, for example by keeping a journal of all of the utterances to look for patterns of meaning among them, and by thinking of conversing with them as if we were learning a new language in a new land.

My only caveat is that at times, Lisa Smartt thinks that threshold talk hints at an afterlife, partly because the language is like what people who have had near-death experiences use. She thinks of these people as having died and returned, and that the similar language they use is suggestive of consciousness after death. But one could reason the reverse: that since people use such language on other occasions that do not have to do with their actual final death, that this disproves anything about threshold talk pointing to the existence of an afterlife, as comforting and moving as that would be. The author is a poet as well as a linguist, and so I take her comments about consciousness after death in that spirit.

The Winning Number Is…

It was Doug’s lucky day. He had bought a lottery ticket based on his mother’s three-digit room number at the hospice facility she was just admitted to. While he did not win the mega prize, he got a satisfying amount because his ticket bore the reverse of the actual winning number. But I was surprised to hear he had based his bet on anything related to hospice. Seems like he would have bet on something more desirable and “lucky” like his best friend’s phone number or the number of miles it took to reach his favorite sports arena from home. If anything if I were in his place I would bet that using a number related to hospice would jinx my chances, like using the number thirteen.

Or was Doug hoping that by using her room number, he would bring luck to his mom’s chances at survival?  I hope trying to avert her fate was not what he had in mind, because it just so happened that his mother died a handful of hours later. Perhaps he thought linking any number at all associated with his mother to that lottery ticket would tip the odds in his favor. Whatever the motive, he was certainly trying to turn something negative into something positive.

What we know for sure is that Doug will always remember this particular ticket, which did defeat enormous odds and win a prize. I hope its close association with his mother’s end will not distress him, but remind him of how lucky he was to have had such a mother, whose love had brought him so much good fortune throughout his life up to the absolute end of hers.

Living With My Desk Skull

In this guest post the “Spirited Crone” Sande Ramage tells us how she looks death straight in the eye with a real skull on her desk!

Amongst the debris on my desk sits a small skull. It’s just big enough to remind me that I’m not long for this world.

No, I don’t have a diagnosis that may make you feel awkward, other than being terminally human that is.

Keeping the end in sight instead of trying to clutch at immortality is life-enhancing; a way to live that enters into the soulfulness of our existence. Put another way, it’s a reality check, a way to figure out what really matters.

I’m not alone in this view. Philosopher Stephen Cave argues that striving for eternity shapes everything, even our choice of breakfast. But that leads us astray and stops us from facing up to the challenges of living life well.

In his book, Immortality, Cave suggests that humans have relentlessly pursued immortality through four paths:
1.      staying alive in the same body – keeping the existing body going
2.      biotech interventions – pills, potions and surgery
3.      resurrection – the religious idea of heaven someplace else
4.      legacy – we live on in our deeds and generations to come.

‘But aren’t you meant to believe in life after death,’ said my colleague, staring at me intently over his espresso.
‘Depends what you mean by that,’ I said, mindful of the physicists who reckon we emerged from stardust and to stardust we will return. Although it’s a sparkling improvement on mere dust, it’s still a hankering for immortality.

The religious writer Karen Armstrong said the afterlife was a red herring that kept us avoiding the real issue.’
‘What’s that mean?’
‘She thought religion was supposed to be about the loss of the ego, not about its eternal survival.’

‘So, when you say you’re about death as a priest you mean death of the ego?’
‘A bit of both, I think. I’m not so keen on destroying the ego, but absorbing it and getting it in better balance.   Moving past the need to be top dog, which is, when you think about it a bit, probably part of the quest for immortality.’

‘What about physically dying then?’
‘I think that’s the last great task of a human being, where all of our existence comes together in a process of reconciliation.’

‘Reconciliation? You mean getting right with God?’
‘If you mean God as a bloke in the sky with destruction on his mind then no. But if you mean God as the great mystery, the unknown, then I’m saying yes to that kind of reconciliation.’

‘How do you do that?’
‘Sometimes, it’s a process of putting things right with the living. That’s why it’s good for family and friends to gather whilst someone is dying. Other times, it’s just letting go of the need to stay alive, to allow it to be finished. Put another way, it’s to quit hunting down life at any cost.’……

Living with my desk skull is a daily spiritual practice. Like the medieval philosophers before me, it reminds me of my impermanence, the need to embrace that and, as a result, step soulfully into my mortality.

*******************

Sande Ramage, also known as The Spirited Crone, writes about spirituality one word at a time on her blog  https://spiritedcrone.co.nz/. She is a spiritual care practitioner in Aotearoa, New Zealand with a focus on the possibilities of spirituality beyond institutionalized religion. Sande also offers spiritual direction to people wanting to chart their own spiritual pathway.

 

Custom-Made Angels

An African-American patient’s daughter gestured to the angel topping a diminutive Christmas tree in the hospital room and said, “I hope you aren’t offended, but could we have a black angel?” While I as her chaplain hastened to assure her I was not offended, I first drew a blank on what she meant. Her mother was virtually on her way out of this existence, so my first thought, which I fortunately did not say out loud, is that she wanted black to represent grief or death. Then I understood: first I thought about my own stereotype about the color black, and then I realized the actual decoration was as white as you can get. She wanted an angel that was the same race as she.

I was so taken with this, because I have never thought about angels having race or gender. I never thought about their whiteness representing Caucasians. In the Jewish tradition, the idea of an angel is perhaps even more abstract than not having race or gender because we don’t think of them as a class of celestial beings. Rather, we think of them as humans who wittingly or unwittingly have a mission to deliver spiritual messages to others.  Such messengers impart an insight or prediction or warning of spiritual import to the person intended to receive that message. Many of you may be familiar with the story in Genesis where three mysterious strangers tell Sarah and Abraham that they will have a child despite Sarah being waaaay past menopause. And perhaps you have met someone who had a transformative effect upon you that has changed your view of things ever since or who has influenced you to make a life-altering decision.

A scholarly friend of mine named David Schwartz pointed out, however, that if angels can superficially assume race and other attributes similar to the person the message is intended for, the one getting the message might be more receptive to receiving it and letting it “penetrate the heart and spirit”.  I could see where an angel of color would comfort an African-American family and give them a celestial being or messenger they could identify with. (Just a curious note, another friend of mine informed me that until very recently, “angels were always portrayed as male, because the Bible consistently uses masculine names, male pronouns and male attributes.” Okay, one Black female angel for that daughter coming up!)

When the Black angel arrived at the tree I wondered what message it conveyed to that family.  Perhaps it was, “God is not a stranger, but the One who speaks your language, discerns your needs and accompanies you at every step of the way. Especially when your loved one is embarking on a path no longer intertwined with your own.”

Love Story, Hospice Style

An online fiction magazine editor said I could not reprint in its entirety a story of mine published there, but that I could summarize it. Summarize it?  How amusing since the story in question is only 101 words long! God forbid I would cross a publisher’s request and reprint it here, so I invite my readers to see “Beaten to It” in the place it was born (101words.org; November 27, 2018)) and raised (i.e. commented upon). The premise is true, but the rest is fiction:  https://101words.org/beaten-to-it/