Yes, have the priest anoint me !
I don't want to die alone !
Play a harp for my father !
No, don't talk to me about God !
But when this perishable [ body] will have put on [ what
is ] imperishable…then will come about the saying…
'O death, where is your sting ? ' ( the Apostle Paul,
1 Corinthians, 15: 54, 55 )
By Robert R. Schwarz
This report is about last words and thoughts of patients, people like you and me— dying in a hospice. It is also about the necessary compassion and fortitude of two chaplains and a physician who care for these patients. Your Exodus Trekker reporter recently interviewed these three dedicated caregivers at different hospices; though having varied backgrounds ,they share two strong beliefs :
Ø Dying and suffering of patients often evoke joyful life-defining moments from changed relationships with loved ones and hospice caregivers.
Ø Much of the medical profession and public is ignorant of the true hospice mission; equally important is that both doctors and family members of the dying should stop being shy or overly tactful when talking to each other about a patient's impending death
We'll start with Joseph…
During our interview, Joseph often expressed himself as an evangelist might ; he believes that "Jesus invites all of us day by day to grow through dying and rising . " This is especially true, he said, of hospice patients who, along with their caregivers , need to be aware of this cycle . " I'm honored and privileged to hear my patients share their life stories." His check- list for patient care-giving includes : listening with empathy, easing anxiety in times of their uncertainty, encouraging courage, and reminding them that God loves them. He emphasized, "People need to know that they are being cared for , "
Joseph's expresses other spiritual beliefs by painting them . On his office walls are abstract renderings of paintings depicting God, Jesus, and the Holy Spirit . Several have cosmic or nature backgrounds .
" Every One Should Die Well "
Dr. Mackie was born in Stroger hospital, did her internship here, and daily sees as many at 12 patients ; most are low income or indigent Afro-Americans and Hispanics . She considers her entire 20 years here as one life milestone . As an aside, she added, '' My role is also to make sure that the Afro-American community is educated [ about dying ] so it can be empowered . "
Joe , our other chaplain, is three years older than Joseph, and has seen suffering and dying of nearly 150 patients since coming 2 ½ years ago to Vista Hospice in Waukegan, Illinois. He had been director of medical information and review at a pharmaceutical company, and has been a registered pharmacist since 1971 . Joe was ordained a deacon in 2013 at Holy Name Cathedral in Chicago.
Vista is not a faith-based hospital , but Joe sees patients of all of denominations and once had to find a rabbi for a patient. Joe's core beliefs are his three P's: pulse, presence , and prayers. Pulse means Joe has to be a live person. "Sometimes it’s more of a matter of bringing comfort to the family," he said , especially when "the patient is journeying to this sacred period in his life, when they're getting ready to transition from their earthly life to their eternal life. "
For Dr. Mackie , who is a practicing Roman Catholic , her most important life lesson came from a 103-year-old Baptist woman for whom she was caring. Though her patient was dying, "she had a "very positive attitude until the end , " Dr, Mackie related. " What she taught me was to be grateful for every situation we have in life, whether good or bad . The key is to look at the situation and process it. If a mistake, it doesn’t have to be a mistake for the entire day. "
From some dying patients, this physician occasionally hears a "confession" , like that of a narcotic addict who told her he had "broken bonds and bridges to his family ." He admitted , " I did this all to myself," and now wanted his family to take him back home . But he doubted if they would forgive him. Dr. Mackie told him, " You know, we can blow up bridges but that doesn't mean they can never be repaired. "
" I'm Dying. What Is God Doing for Me ? "
|Dr.Mackie in her examining room at Stroger hospital|
" I then asked him," Dr. Mackie said, " if it was important for him to have the anointing of the sick by a priest ? , and he said 'yes. ' A priest came in and we left it at that."
Another patient of hers died an atheist . "I had told him I wasn't there to change his perception about God, that is not my skill set. But I respected his belief. " ( Hospital chaplains cannot minister to patients unless the patient has requested it. ) Do her patients ever talk about heaven? " I have to be honest with you," she said. " We move them out as quick as we can. They don't even have time to process a lot of things. Some die quickly because we get patients so advanced and so late. " (Stroger does not have an actual hospice unit but relies on four hospice stations outside the hospital. )
Religious faith has always played a role in her medical practice, Dr. Mackie said. "When dealing with people who are impoverished, you have to have the energy to more forward and sometimes just leaning on your faith is what makes it happen. " When she is down, her favorite prayer is Psalm 23. "Yet, sometimes I don't have anything to offer my patients except kind words. "
Dr. Mackie is the youngest of four brothers and three sisters and was raised in the Chicago Afro-American community of Englewood , where she became aware that a "lot of people were dying there yet nobody was talking about it. And I said, let's change some of this and let's have a conversation. So that 's what led me into palliative care . " Today Orlanda is an advocate of open , honest "conversation " between hospice patients, their families, and especially doctors , many of whom she maintains are "afraid " to have an honest , no-holds-barred dialogue about death and dying. One of her biggest challenges is "to make people understand what I actually do. It's not all about dying. Not all my patients die. " Before graduating from a medical school on the West Indies island of Dominica, Dr. Mackie taught special education classes in a Chicago public school.
What Motivated Them to Be a Hospice Chaplain ?
Obviously, a chaplain like Joseph or Joe needs more that comfort skills to be steadfast with compassion for the suffering and dying day after day. Joe and Joseph would agree that some aspects of hospice care money cannot buy. Is it something the caregiver is born with, an attribute which develops from self- discipline and experience ? I asked Joseph.
|Joseph with two chaplain colleagues: The Rev. Janet Frystak|
of Christ Victor Lutheran Church in Elk Grove, IL, and
The Rev. John Bushi, a Mennonite from St. Peter Lutheran
Church in Schaumburg, IL.
Joseph satisfied my curiosity by relating two events .The first was his surviving triple heart bypass surgery in late 2015 . "The doctor told me [ afterwards ] , 'Joseph, you're a miracle ' You survived it ! ' "
"And now, Bob, I'm a changed person as a result of that experience ! I look at life now in a much more hope-filled way. I really wasn't meant to survive this .There must be something that the Lord wants me to do. And so now I've been given a second chance , and so I'm not going to waste it because every minute of my time now is very valuable and important. I' m devoting my life and all my energies to those people who are grieving and suffering and dying. "
The other inciting experience which strengthened the calling of Joseph's ministry occurred at Lourdes, France, known for decades for testimonials from people who claimed they had been healed there of various illnesses and disabilities . Joseph was standing at the cave site where the Virgin Mary was seen by Saint Bernadette in 1858 , an apparition known today as Our Lady of Lourdes. He said that the minute he touched the rock and the flowing water from the spring from which Bernadette had drunk, he had goose bumps. " I knew I was in a holy place. "
Joseph then help lift up the arm of a frail woman with an oxygen tank at her side so she could touch what he had just touched. "I looked at the expression on that sick person's face and sensed that a peace, an indescribable transformation had taken place in her. And this was affirming to me that the hospice work I was doing is what I'm supposed to be doing. " Though the woman walked away with her oxygen tank with no outward appearance of being healed, Joseph said , "I knew that she was healed emotionally and spiritually. "
Dying to Harp Music ( really )
A few days after our interview, I visited Joseph to check on a few facts. He was still feeling the emotions of an event two days earlier in the room of dying man whose two daughters One of the daughters was thanking Joseph having brought a priest in to anoint her father before he died. She started to cry when she recalled that father had hired a harpist for her wedding . " "Then she said," Joseph told me, " ' I want to pay my father back and have a harp player here when he is dying.'"
" We do this at times; harp music gives a calming presence ." Joseph said.
Joseph left to room to fetch a harpist named Tony , who soon arrived and started to play his harp. Hospice harp music, Joseph explained, keeps rhythm with the patient's breathing. The father could not speak, but Joseph noticed he had been "tracking their conversation. "
The father died the next day. His wife had died in this same hospice.
|Joseph's favorite painting, The Goodness|
of Life . Light does shine through our darkness
and difficulties, he believes.
There often is no way to explain why our creator permits
some things to happen.
To give meaning to life, to make sense out of it all, is only
possible through the eyes of faith in a God who never
ceases to love us.
God of day and night, you journey with us through
darkness into light.
Your are love that dispels the suffering of our heart
You are healing for the body.
Your are peaceful light that helps us live in the
hopefulness of life.
"It's the Sort of Thing
the Spirit Leads You Into "
|Deacon Joe outside a McDonald's after coffee with Bob|
We had met for coffee at a McDonald's oasis on a toll way near Lake Forest, Illinois. Joe is six feet tall , has white hair and brown eyes, and was wearing blue jeans and a long-sleeved red and black check shirt. Joe is a mild- mannered man whose personality often includes a smile when he talks to you. Unlike Joseph, he is frugal with words; this begs a journalist for follow-up questions . He is married, has two sons, and was one of ten children . After his father died at age 36, leaving Joe's mother to raise five of them at pre-school age , Joe , then only ten, began paying room and board to his mother by working in a drug store .
When asked what events in life shaped his the most, Joe had to paused and reflect. He went through a list of events: One of his brothers was still- born; three of his high school classmates died ; and, unbelievably, his father , uncle, and grandfather all died on a Dec. 19. It all made Joe realize "that we are going to face a death and, because of that fact, I'm not uncomfortable about talking about death . " Today he finds that many of his patients , though not uncomfortable when talking about death to a stranger, are so when speaking to a family member.
Unforgettable patients ? Joe had just made a home visit to a World War II infantry veteran , a cancer patient , when much later he remembered that he had never thanked him for this veteran's service. Joe learned that his patient had been a German soldier in the war and was a "very strong Christian " who emigrated to America . "I didn't harbor any bitter feeling about him ," Joe said, upon realizing this man could have been shooting at his father, who had been an American combat soldier in Germany during the war.
Joe, who is also a deacon in his church, also recalled an elderly patient dying from cancer, who " made it absolutely clear he was an atheist " . ( Medicare requires that hospice patients be given an option to accept or decline chaplain visits ; Joe and Joseph made it clear that giving religious care to a patient who has declined it can do more harm than good. ) Joe's patient said he could deal with dying but not pain. His wife was a Catholic Christian. Nevertheless, he agreed to seeing Joe every other week. Said Joe, " We developed a friendship . We had a mutual respect for each other and didn't get into deep discussions but he would talk a bit about why he was convinced there was no God. I did not argue with him, nor try to convert him. "
One day Joe's atheist friend , with his wife in the room, asked Joe to arrange a funeral service for him " His bones were deteriorating and he was becoming slowly paralyzed," Joe said. . " He told me , ' at one time I hoped I would have no pain but now I have no feeling whatsoever ' "
One week before his death the man was unable to speak, and Joe read to him a chapter from a book written by the noted Catholic author, Fr. James Martin , S.J.. Joe told him to signal any time he wanted Joe to stop reading. Joe read the entire chapter .
What was his reaction ? I asked Joe. " He showed me two thumbs up . " Joe does not know if his patient at the end had refused or accepted Christian beliefs, though at the man's funeral Joe saw a crucifix above his casket.
" We are dealing with people with denial and disbelief "
|Joseph giving communion in the hospital chapel to Eucharistic|
ministers he has trained for their visits to shut-ins.
Joseph's comment prompted the question of " is this a good thing? " Replied Joseph, "Yes, if it's good for them and it helps them dealing with suffering and dying. What I've learned is that we need to be present with these people in a loving way, to accept them in the moment wherever they are, and bring them love, a listening presence, and compassion. Every day we are dealing with people who are dealing with denial and disbelief. 'Why do I have cancer, why is this happening to me? ' They are dealing with a lot of heavy stuff, and if I can bring a listening ear and a compassionate heart to them, then that's good. That's what any wonderful hospice program should be all about, and that 's what we do there. "
Joseph's words made me recall holding my mother's hand as she died while I prayed Psalm 23 , and talking to my brother during his last few, pitiful days on a hospice respirator .
We talked about doubt and heaven and hell. Joseph agreed that the last weapon of the devil is to sow doubt in the patient about God and heaven. He believes that at the very end of life of a person who has lived a wicked life and now still denies God's existence, that God "gives him a second chance " to convert. Joseph offered no comment on hell , but did say "we need to be accountable for the mistakes we have made if life. " Family members of patients have asked Joseph questions about heaven and hell many times . Joseph tells them: "There are a lot of things we don't understand " . He assures them, however, that " the Lord is in the midst of the suffering of their loved one. "
At 9:15 a.m. each morning Joseph leads a group of six or more Catholic Eucharistic ministers from nearby parishes, in a communion service in the hospital chapel. One of the ministers told this reporter that " Joseph has a real passion for what he does. He tries to train the best people for the job. "
The act of leaving his office at day's end sometimes saddens Joseph. To restore himself, he says he then needs to be alone in his condominium. After long moments of silence, he might turn on television and watch "political stuff "—he says he's on the liberal and of things—or go out with his "supportive family of friends " for a pizza.
On the wall today in the hospice social worker's off ice hangs a colorful piece of art done by crayons by a woman while dying of cancer. Knowing the woman was artistic, the staff had brought her a coloring book, and she went to work on it. "It was beautiful !" Joseph exclaimed. "It looked like a stain glass window. It was one of the very few behaviors she had not lost. "
Patients Dying Alone Make This Physician Sad
|Dr. Orlanda Mackie, hours away from a joyful trip to Disney|
Land , a birthday present to herself and nieces, and nephews
When patients die alone sadden Dr. Mackie . "Sometimes I just can’t change that, " she says with a sigh. Listening to jazz, particularly that of deceased pianist Thelonias Monk , in the apartment she shares with her sister, picks her up. " I listen to music all the time." She also reads mysteries and books about Afro-American history. There is no television set in her apartment. The doctor's favorite dish is baked chicken with rice and vegetables . " I eat that just about every day. " He sister does the cooking. Perhaps Orlanda's greatest pleasure is that trip on her birthdays with nephews and nieces to Disneyland . That's where she was headed a few hours after our interview.
Chaplain Joe sees an occasional movie and reads religious books, giving some away as gifts such as the classic The Imitation of Christ. He tries to forget that "worst experience " of his life: watching his adult son bury his own three-week-old son. But the tears which were welling up as Joe related this at McDonald's , disappeared when our talk ended and he told me of his plans to drive 12 hours to see his three grandchildren in Nashville, Tennessee.
When asked about his own death, Joe replied —smiling , of course—"I will not have any epitaph on my tombstone. I'm being cremated. I've already purchased a columbarium . It's just a ten-by-ten."
All comments are welcome.
© 2017 Robert R. Schwarz