A non-existent sleep is no different for the on call chaplain than it is for the attending oncologist or ED surgeon. One routine and one code blue pager resting by my head and the anxious stirring in my stomach in fear that I will somehow miss the rapid beeps. No, there are no tangential episodic romances here and there like Grey’s Anatomy nor are there random moments where we break out into song in dance like Scrubs (although, Scrubs is fantastic!). The truth of the matter is that I still have nightmares about these things, today. Moments where I recall a patient’s story. Echoes of words shared with a spouse upon the news of a suicide. Images of spinal taps, bags filled with assorted bodily substances, and the all-too frequent adjustment of PICC lines or ports.
During my time as a pediatric oncology chaplain at Duke hospital, most of my kids were walking their own raw experience of the “valley of the shadow of death.” Their wrestling with God presses skin deep and the very nature of those valleys cease to be memorized words we say by the graveside. End of life is a sobering reminder of just how unsettled our faith can be when confronted with how fragile we are. And yet somehow, we are called to rationalize it as a resurrection people. But the reality is that most of us cannot arrive at that comfort when faced with family decisions, swamped with advanced directives, crushed by tasteless Christian cliches, or overcome with grief . These situations, rather, invite us into what some (including yours truly) might argue are the holiest of conversations. Holy in that they are set apart; for there is a point where the anticipation and fear the individual experiences lead us to consider the effects death has on the corporate body we call the Body of Christ.
It doesn’t seem like the phrase “dying well” should be a thing; the tubes, the fevers, the sterile feel of an ICU, and the sheer embarrassment that a bed sheet is the only thing that stands between your dignity and the eyes of many strangers certainly do not help with this (as many of my patients informed me). Here the chaplain walks into the room in a white coat no different than the others, outwardly supposed to communicate hope to a family when hope feels nowhere in sight. These are moments that readily come to mind time and time again when my own faith feels threatened because of the fear and loneliness expressed by those for whom God has felt far removed or otherwise, absent. My friend and former colleague at Duke, Dr. Ray Barfield, who is a pediatric oncologist and Professor of Pediatrics and Christian Philosophy, recently talked about the way many of us in the caring field take time to discover avenues by which we eventually encounter God in the midst of another’s physical or emotional struggle (in his case, with cancer patients). One of my learnings while serving in Peds Hem/Onc (Hematology/Oncology unit) with Ray is that you do more theological probing as opposed to theological asserting at the onset of end of life. In other words, lingering on the questions around why one suffers(as one begins to lose control of their body or asking where God is as one watches their child fighting some unfathomable disease) may be the only form of resolve we get. At least initially. Sometimes, it takes putting together a Lego Millennium Falcon with a young patient before he arrives at a point where he is ready to talk about God or his fears around dying. And in other cases, God may go unvocalized, but still radiates through presence and accountability.
Theology, our apprehension and ongoing understanding of God, does not skim the surface when God’s providence is at odds with human limitation; it, instead, seeps deep. It punctures our complacency to refrain from doing any deep wrestling with why we believe the things we profess. I will never forget the patient who always wanted to write down a prayer with me before I left for the night. It became habitual after several weeks, but one time stands out because it prodded me in such a way that I felt the needle was being plunged in my side for once. I asked him what we could pray for that night and he said these words: “You know what, don’t pray for me. Pray for Mom and Dad. They really need it.” This six year old boy, wise beyond his years, showed me in that moment the way understanding his own finality led him to recognize the fears we as the collective Body of Christ face when that Body ebbs and flows. Our theology in the face of death is an embodied one. It is tangible and felt. It exposes a fear that is both individual and collectively shared: How does one’s death refute or edify the faith of the Body of Christ?
Pastoral care at end of life can be a haunting art. Not in the horror film sort of way where our minds immediately hone in on some variation of impending doom, but in the way it thrives on an intermingling of stories with others. We remember the relationships that come with being in the most vulnerable of places with folks. We grieve. We recall. But then there is the looming worry that no one exists in the space of a dying individual’s story. I think of those who arrived to the hospital with no family, no neighbors, no friends. The nurse and I were their community. The social worker and I held the hands. The thought of dying alone disrupts a critical component of faithful discipleship, communion with the Body. The late Christian ethicist, Allen Verhey, and Brett McCarty write these thoughts:
“We must learn what it means to live and to
die together as fellow Christians…By transforming death and
dying into public acts, we open up space for further practices of the Church
to begin stitching together the dismembered body of Christ through the
healing power of the Spirit.”
The crux of our faith does not boil down to the first advent and teaching ministry of one who spout off nice-sounding things and who lifted many up out of their deepest pains and sorrows. We recognize God’s faithfulness in the birth pretty well through our common baptism, but I sometimes wonder if we have forgone God’s faithfulness as we approach our common death. We hold onto the moments in baptism of the pastor holding up a child before the smiles and tears of a congregation or the adult who has just professed her faith for the first time and receives the waters of God’s promise before echoes of applause. What for many feels nostalgic, however, reminds us that the family we thought we knew expands in that moment. I recently walked an all-too brief journey with a family in my congregation where the gentleman lost his battle with cancer after a period of remission. A vivid image I hold onto in that story is of the way the gift of one member of the body entered into the story of another by virtue of a shared understanding of God’s faithfulness at the end of life. Neither knew each other personally and yet, they learned one another’s names and her hand-knit blanket became the reminder to him, his wife, and kids of God’s ceaseless embrace of him through the outpouring of others. It is imperative to take the public nature of our baptism seriously because the individuals we celebrate through this act of God are not the only ones committing. In the UMC liturgy, the congregation responds with, “We will pray for them, that they may be true disciples who walk in the way that leads to life.” And so, we are entrusted in the raising and nurturing of a Body that from time to time will experience the wounds of this world. But in that nurturing, we collectively hold one another accountable to this way toward a life well beyond the contours of this world.