Careful! Metaphor Ahead

Sure, the metaphor hounds are well-meaning when they try to soften the blow of a calamitous diagnosis. The two top contending  metaphors for facing disease are (1) doing battle with it, and (2) going on a journey. Yes, I get it, war imagery can be energizing and drive the patient and family to do diligent research and pursue any treatments that bear a reasonable promise. And yes, a journey might comfort some who think of joining others who are on the same trajectory, especially if the endpoint involves arriving home to a congenial God. But for some people, these particular images are as off putting as the bromides they have to endure from family, friends and medical professionals.

Think about the military imagery for a moment. Our bodies do have natural defenses, with our antibodies doing their best as the good little soldiers they are. Medicine acts as reinforcements to join the fight. But we ourselves do not have to employ our mental faculties in a certain fashion to add money to the war chest. The effort itself to do so can be draining, as we feign cheerfulness and optimism. And what if the war effort results in a long drawn out inconclusive struggle with the disease, like so many wars in our world like the conflict with Afghanistan? Or even worse, what if “our side” starts to lose or even face final defeat? Then the patient will feel they lost the battle, and God forbid think they did not try hard enough or that they failed their loved ones. You get the idea how this might be a risky metaphor. And even apart from that, wars are a negative phenomenon to dwell upon anyways.

Given the inherent negativity of war and the image of division within our bodies, it is tempting to think of a journey as oh such a sweet and nonviolent alternative. But journey to what? Even if the journey is to God, or if not so dramatic, a journey to physical or mental limitations, what if you do not want to undertake such a journey just yet?  (Excuse me, Sir, I’d like to get off at the next station and I want my money back.) In the image of a mandatory journey, there is no sense of control, and this can be scary.  I think too, it obscures the idea of our whole lives as being a journey, which we do play a part in shaping. We  have some control, making choices that shape the subsequent stages of the journey, creating as many pleasant or at least educational stopovers as possible. In contrast, the disease journey image may make the patient feel the disease is boss and that they have no say in what will happen.

For those readers who do relate to these images, that is terrific. My concern is when people foist these metaphors upon those who might feel distressed by them, or when the  timing is wrong. So what to do? Whether you are the one who is sick or you know someone who is, the picture is complex. Let us take the latter. I think when a health professional is searching for metaphors it should be more towards the end of the process of offering help rather than at the beginning. One has to know a lot about the person in question to ascertain what might fit, and that takes time. One has to know the sick one’s attitudes toward disease, how they’ve coped in the past, what in life has given them meaning, and what they most care about. If the patient takes a scientific approach and is agnostic at best, the journey metaphor might strike them as pure hocus-pocus. A pacifist might not appreciate the war metaphor, and so on.

Just like a bromide, the proffered metaphor can be the lazy and anxious way to attempt a quick salve (or salvation). Real help takes an investment in time (oh, that!) and attentive eliciting of concerns and attitudes and beliefs. Real help is making way for the sick person to create or co-create with you their own metaphors if any. If you are currently chronically sick, do you have your own image for making sense of it? Do you have your favorite “pet peeve” images?

Since I want to leave the reader with at least one example of another sort of metaphor aside from battles and journeys, I will offer my own. I am not now chronically sick much less facing the end, but I can imagine what might work for me: I find nature, when it is peaceful, a great source of solace, and I subscribe to the notion of God as a Presence. So I think for me, as a part of nature myself, that my metaphor of  choice will stem from that. Perhaps I will feel more and more blended into it and more at one with it and with the Presence that dwells there and dwells within me as well.

Second In Line

I based this dark humor short story on what one of my hospice patients actually did:

Retired go-go dancer and hospice patient Victoria kept her spirits up by upending people’s assumptions, and the more she mixed people up the better. She startled even the most jaded staff when she announced she was using a dating app. Without revealing that she lived in a hospice residence, she wrote in her profile, “Short-term relationship highly desirable with freewheeling man attracted to the unexpected.” (She smiled and snickered as she wrote that.)

Retired antiques salesman Nathan, looking for a mutual carefree romp, felt he found the right match when he chanced upon Victoria’s profile. Her suggestive comment about men looking for novelties did the trick. He responded, “You mischievous gal! You sound like my type,” and straightaway offered to meet her at the address she gave. Her eyes gleaming with sweet victory, she wrote back yes.

As he neared what he took to be an apartment building, he saw a sign up front that read “Heavenly Hospice” in the most welcoming lettering possible. He stopped dead in his tracks, and wanted to sprint back to his car from that house of horrors. But he did not have it in him to break a promise, even though he was less than exemplary in other ways when it came to romance.

He got buzzed in and fearfully made his way to her room, located–wouldn’t you know it–all the way down at the very end of the hallway. The door to her room was closed, and as he put his ear to it, he could hear sighing and one deep breath after another. He said to himself, “Is this poor thing already drawing her last breaths? Is it already too late for that ‘short-term fling’ Victoria hinted at?”

He was too late, but not because of that. A male nurse had succumbed to her charms just as Nathan was forming his first seductive imaginings during his hurried drive over.


Which part of the story do you think is true? Do you think you will act like Victoria in your last months? For more of my writing, both micro-fiction and micro-nonfiction, see me at

The Happiness Equation

Case #1: A young man is a live-in caregiver for his stepmom, going on now for three years, with no time off except two hours a day and the occasional bonus of several hours on a weekend. Our hospice gives him the opportunity for free, every three months, to have his mom stay at our residence for four days with twenty-four hour care but the son never takes us up on it. I used to think it was because he was afraid of freedom, being at a loss of what to do with it. But one day he figured out for himself why he has hesitated, saying, “Once the door is opened, I just won’t be able to go back. I’ll never be able to bathe her again and stay home for hours on end. I’d rather wait until I’m free all at once.”

Case #2: A lady at our hospice residence was about to turn ninety. She loved activities of any kind and the stimulation of gossiping to me about the other patients and families. Her family wanted her to leave the residence for a day trip to celebrate her big day. “At first,” she confided, “I didn’t want to go, because after having a great time away from this place, I’d be sad about having to return here and be lonely again. But then I decided I would go.”

On the face of it, there is something missing in our reasoning about not wanting a break or enjoying an event because it would force us to rub our noses in the drearier aspects of our routine once we resume it. Maybe that is partly why so many United States workers don’t use up their vacation time. Thus, these cases are highly relevant to all of us in situations where less is at stake than in hospice. Are you more like the young man or the lady? Each of them went through their own cost-benefit analysis of how much sadness would ultimately be subtracted from the happiness gained. The man thought it would be too much a cost, and the lady thought it was worth the price. I say nay to Case #1, and yay to Case #2.

So let’s think about this for a minute. There is a reductio ad absurdum here. Are we never to let ourselves be happy by leaving our routine because we will be sadder upon our return than if we had never left it? This means we would always be a little sad and never be happy. It would also spell out a dull life. And what’s more, this cost-benefit analysis is flawed, because the relationship between happier-than-usual times to our routine times is not all zero-sum.

I went on a vacation to Stockholm last June and I noticed the glorious architecture and I ate in a health-food Japanese restaurant among other unexpected cuisines, and saw how Swedes behave differently than Americans such as their concern whether my country knows about and likes them. Once home, I faced more laundry than usual and had to catch up on work, but then I had lively stories to tell, and thought more about some beautiful architecture right in my own neighborhood I had not noticed before. From the trip I became sensitized to new aspects of my routine life, stored some memories, and had some assumptions challenged about what is important. I also appreciated certain things that I missed while gone, such as the relative ease of walking on smooth pavement as opposed to the beautiful but uneven cobblestone streets of downtown Stockholm.

In sum, the answer to the happiness equation goes back to the platitudes to “enjoy the moment” and “seize the day”. But let’s remove the corollary that states that enjoying Moment X necessarily entails less enjoyment of Moment Y.

An Alligator Tale

Have you ever read about alligators on a blog like mine? Didn’t think so. But my hospice patient Fernando (not his real name) told me something about them that keeps sticking in my mind, which was but one of many offbeat subjects he brought up during his very long talk with me:“I like to stay here in New Jersey because it’s safe and I like cold weather. Out there in Florida you know what happens? During the dry season, gators go into people’s swimming pools.” I could not help but say, “Come now. How could that be?” Fernando replied, “No, no, it’s true. In the dry weather there is less water and so they look for it wherever they can find it.” I vowed that I would look this up after the visit.

Sure enough, the Internet yielded many stories about alligators in swimming pools, especially gators nine feet or longer. (You can see the videos for yourself on Youtube and elsewhere.) Well, okay, if you really insist on seeing one of them, here’s a sample link:

At any rate, since I wanted to know not only if this were true but why, I got an answer from a CBS News article published in May 2017 called, “Look Before You Leap: Massive Alligator Lurks at Bottom of Florida Pool”. As to why the alligator wanted to be there, “a public information officer for the Sarasota County Sheriff’s Office said, ‘Let this be a reminder that it’s mating season in Florida and these creatures, especially the females, are on the move looking for areas to lay eggs.’” Okay, I get it. There isn’t much water available during a dry spell and the pregnant or pregnant-to-be gators are desperate for any body of water, no matter how small.

Now you know. And now you know how I can still do hospice work after eleven years on the job. It’s not all about dying and funerals I look forward to talking with Fernando again, especially because at the end of that most recent conversation, he asked if I could have a volunteer come visit and read out loud Don Quixote to him. I can’t wait to hear why he asked for that particular book. If the answer  is um “novel”  I’ll let you know.

Hubby Survives Death Cafe

Being the husband of a hospice chaplain can have its odd and trying moments, as you will see in Steve’s darkly comical anecdote below:

 A few years ago my wife told me about a nearby event called a “Death Cafe.” I was instinctively leery of anything with such an ominous-sounding name, but she seemed enthusiastic about being able to promote her hospice book there so I decided to try it out. Even though it was already evening, it was considerably warmer and more humid than the average summer day. The event was on Park Street in Montclair, New Jersey in a fairly upscale neighborhood, so I wasn’t too concerned about a lack of amenities. Unfortunately, my original fears proved to be justified as the meeting was on the top floor of a house in what would be called an attic in a less swanky town–and which had no air conditioning. One of the primary topics of discussion was whether assisted suicide should be legalized in New Jersey, but I was distracted from concentrating on that matter. The temperature in that packed single room was near 120 degrees with almost zero ventilation, so I tuned out whatever weighty issues were being discussed and quietly lay on the floor. I looked up to a majestic vaulted ceiling with outsized musical notes, and realized to my surprise that it was the beginning of the song: “You must remember this, a kiss is still a kiss, a sigh is just a sigh.” I remembered that Herman Hupfeld, the composer of this catchy tune featured in Casablanca, had lived in Montclair. I had no idea that I would ever be in his attic, or why he never had air conditioning installed.

I concluded soon afterward that I didn’t want to remain in the house, so I went outdoors to walk around the back yard. The old construction hadn’t been modernized, and as it was getting dark, I didn’t realize that there were some sharp black iron pipes located in unexpected places. I banged my head against one of them and soon began bleeding profusely. Not knowing what to do, I remembered that in the uncomfortable attic were several tubs of ice cubes for the drinks, so I went back to put ice on my skull. When I walked in several people screamed when they saw me: blood was pouring out of my head down my body and looked much worse than it actually was. Fortunately more than one physician was present; two of them poured water over the wound and applied ice with towels, and within a short while the flow had mostly subsided. When they saw that I was recovering, a few people remarked that it would have been ironic to have an actual death at the Death Cafe. My wife never got the opportunity to mention her book to the other attendees. I had mostly blocked this experience from my mind until I heard on the radio that assisted suicide just became legal in New Jersey a few days ago, when I immediately recalled the details of that sweltering evening. The fundamental things apply as time goes by.


Steven Jon Kaplan regularly writes quirky stories on his website, true contrarian, as a side show to his main focus on contrarian investing, which is about unfollowing herd behavior in the financial markets.  He is a financial planner. The link to his site is

For more of my own writing, check out  my microblogging on

Adam’s Bad Reputation

Adam just had one simple rule,” Milt was saying, “and he screwed it up. Just one little rule.” Milt was a patient of mine sitting up in bed, who wanted me to debate with him as he summoned each of his phrases with a mighty effort. He often interrupted himself with queries about where his glasses and phone were, and inserted vast stretches of silence between each phrase as I awaited the next stage of the conversation.

Eve and at first the snake had something to do with that too,” I replied. Shaking his head Milt said,“Passing the buck. That’s what everybody does.” I thought to myself, the buck should stop with God at least sometimes. Milt went on, “Adam caused all of us to have serious sin. I have done serious sin.” During the next pause I thought about what a Christian told me about her tradition blaming Eve for humankind’s most colossal goof. At least Milt wasn’t blaming the woman.

After talking about sin for a bit, I then decided to challenge him as he had requested: “Milt, the Adam and Eve business is a strange story. If no one had eaten the apple (I thought to myself it must have been a fig or date or something because the Hebrew says “fruit” and we’re talking the Middle East here, but no matter; I didn’t want to confuse him.) then we’d have Adam and Eve still in the Garden, all happy and innocent and everything for all eternity, but then nothing would go forward. Only those two would be around, and you and I would not exist.”

Milt took this in and then replied, “Yeah, nobody would propagate.” Another long silence. I wondered what he would say next, and then there it was: “Karen, God put us here for a purpose.” He must have known this basic theology clashed with the reading of the Adam and Eve story as being all about sin. As he just said, nobody would have had children if the infamous fruit had sat around untasted, and then nobody would have been around to carry out God’s purpose.

Milt then went on to bemoan the religious conflict between himself and his son. Milt said the only part of religion that he doesn’t like is the proselytizing aspect. His son was involved with some missionary work which entailed being far away. Later I had spoken with the son, who said over and over that he felt called to that work.

I do think that in part, Adam and Eve flubbing up is about our imperfect world. We hold self-contradictory beliefs, and our beliefs are not always congruent with those of our loved ones. Both father and son did agree that God put us here for a purpose. But it is too bad that neither interpreted it to mean that his father’s final days was sacred time for them to make use of together. If father and son could have transcended their differences, they would have fulfilled God’s purpose for them to grow in love and understanding, the holiest and most purposeful task of all.

To see my microblogging, go to

Hooked On Hospice

Working for hospice is like following the progression of about forty different plays at once. What unexpected or surprising thing will one of my forty or so patients casually drop in her conversation with me today? What new realization will I come away with? What will I learn this week about the country the patient is from or what new Spanish expression will they teach me? Which staff members will suddenly materialize at my side as I start to sing to a patient as he sways his foot in rhythm to the music?

No question hospice can be sad, but I am always a sucker for the drama involved among my patients. I get to cut to the chase and see the final act play out all the time! You might say the final act is always known so what is there to be curious about? But that would be like saying the same about any serious opera and therefore not see them. And when the patients or families reminisce, I even get to hear flashbacks of other climactic moments in the earlier “acts” of their lives.

I am not sure why this is so, but I am so dreadfully curious in comparison with most people. I always wonder what the next patient admitted will be like. I might meet a fellow writer. I might meet someone with a career I never heard of before. I definitely will meet people from all backgrounds, from people who have heard of my home town of Erie, Pennsylvania, to someone whose country I myself have not heard of. From the most vocal atheist to the most ardent fundamentalist, to a white American Muslim to a Hindu. From the straightest couple to the gayest, the whitest to the blackest, the one with no children to one with fourteen of them. I will come across the patient who wants solitude and the one who craves society; the one who is agitated and resentful and the one who is calm and humorous.

The staff members who end up staying with hospice have their stories too. One nurse has worked at hospices for over thirty years. Hospice staff have traversed the paths that have brought them to this offbeat career. Best of all, they understand why in the world I would do this kind of work. I do not have to explain. We fit in with each other even as we are seen by some people outside of our circle as misfits to shudder at.

If nothing else, this job gives me so much to think about. Mortality and spiritual values, sure, but so much more, as readers familiar with this blog have seen for the past six years. If you are new to offbeatcompassion, have a look at the past few posts. If by any chance you are pondering an unconventional direction in your career, by all means make a comment here or contact me with questions. My email is, and my twitter link is