WHERE IS  GOD  WHEN  I  AM  DYING?

The Dalai Lama stated: "I believe deeply that we must find, all of us together, a new spirituality.  This new concept ought to be elaborated alongside the religions, in such a way that all people of good will could adhere to it."

Some truly sincere people believe that when a patient is facing death, in preparation for that event, the subject of religion should be presented in some manner. An individual's faith is very personal and has been distilled from life experiences.  It has been the basis for how that person has lived. Unfamiliar, intrusive beliefs should not be introduced, especially to one who is ill.  It very well may be considered an affront, especially if the patient is pressured to make a change in relationship to God.  For some, their religious faith is a strong support; but we have found that religion, per se, is unlikely to have more significance to those who are approaching death than it had during their lifetime. It is surprising how many of the clergy, though well-meaning, rely mostly on printed prayers or Scripture readings for the comfort of the dying patient. The following are examples we present of how a lack of understanding of the patient's genuine emotional needs left those needs largely unmet.                                                                                                                                  

Bill was a hospice patient of Cliff’s.  He had chosen to remain at home absolutely as long as possible.  No hospital for him if he could help it!  He had been only remotely interested in religion during his lifetime and we never really discussed it.  Perhaps his name was on a church roll somewhere.  But he had been a good, responsible citizen, and an interesting person to spend time with.  He never alluded to the probability that his cancer was terminal.  It was something that we both knew implicitly.

We each looked forward to our afternoons together. Bill had loved to go fishing, and since he was confined to either his bed or a wheelchair, we would sometimes take a word-picture journey in his boat to his favorite location out on the canal.                                                                                            

As Bill’s condition deteriorated, word must have reached the church where his name was listed.  The minister came one day when I was with Bill.  I absented myself to the next room, sensing some discomfort on Bill’s part.  After a few brief words, the minister said a prayer and left.  It sounded perfunctory, or rote to me.  Bill was visibly irritated.  When he said to me, “I really think that I’m an atheist," I wasn’t shocked.  My response was “That’s all right, Bill.  It may be that you just don’t believe in his God.” He made no comment.  I felt that the minister had interjected religion into a sensitive situation with no attempt on his part to discover what Bill's attitude was or anticipate how he might respond.  It appeared insensitive and intrusive.  Bill had not at any time indicated any desire to discuss religious beliefs, so we had left that subject alone.  We both were comfortable with leaving it that way.  Rudyard Kipling expressed it interestingly, “When a man comes to the Turnstiles of Night, all the creeds in the world seem to him wonderfully alike and colorless.”                            

In our hospice and palliative care training, we were instructed not to introduce doctrinal or religious beliefs to the patient.  In any discussion with a patient, God must be described as inclusive and accepting, and the subject of God must always be initiated by the patient.  The caregiver must develop a heightened sensitivity to the emotional needs of the patient and recognize the meaning of underlying or non-verbal messages, especially when it comes to a religious belief.                                                                                                                              

As the patient's physical strength diminishes, there is also a loss of one’s mental and emotional energy.  Therefore, introducing a theological premise or requirement of faith is placing an unasked-for and unneeded burden on the one who is facing death.  To do so can be both thoughtless and may add to stress.  Witnessing the emotional pain that Meg endured as she approached death, was disquieting to me.                          

Meg had lived a full life.  She was a delightful lady to talk to, and she loved to tell about her life in years gone by.  Her family farm was by a scenic river.  Along the shore were cottages the family rented to vacationing tourists in the summer.  Several of the vacationers had become lifelong friends and she loved to tell about them.  Over the months that I saw her, she told of her happy, rewarding life.  Now her son lived on the family farm and he regularly came to the Hospital to see his mother.  Occasionally he would take her out to visit the old home where she had spent so many years.        

Meg’s cancer was disfiguring, but she was always cheerful.  Often I would find her in the sun-room playing cards with another patient or crocheting.  Always there would be something to smile or laugh about.  Eventually she was confined to her bed, but she was still cheerful, a delight to be with.  I never sensed that she was interested in discussing her religious beliefs.                                       

The last time when I came to see Meg, she was near death and in deep distress.  One of the pastoral care workers was at her bedside.  Meg was weeping and kept repeating, “ I lied to my husband, I lied to my husband.”  The worker was doing her best to comfort her and kept telling her that Jesus would forgive her, but it didn’t seem to ease Meg’s pain.  She continued to weep and I left the scene in utter dismay.  In spite of the pastoral care worker’s good intentions, it didn’t seem to me that the assurance of the forgiveness of Jesus was what she needed just then.  I would much rather have encouraged her to tell her story so that she could gain some perspective and then, hopefully, she could forgive herself and find relief from her guilt 

A few days later I was again on that ward.  A young nurse that I knew, told me of Meg’s last moments.  As Meg was dying, the nurse had persuaded her to accept Christ as her personal Saviour!  I hope that acceptance brought Meg peace, but I’m not convinced it did!

 The lack of discernment that was so evident in the way religion was presented to Bill and Meg points out some obvious problems.  Consideration for the patient and understanding of their emotional needs should take precedence over any religious beliefs, especially over any pre-conceived faith agenda.                                                                              

Another time, it was scarcely daybreak when the phone rang.  It was a head nurse from the hospital.  “Mrs. Holmes is close to death, could you come?”  The name was not familiar, but I agreed anyhow. Both of our names had been on the list of those who would come at any hour, just to be there at a time of need.  This was a daytime call, which would not be so tiring.  Most of the urgent calls came at night-time and the all-night stints we found demanding, sitting at a bedside till the morning shift of nurses came in.                                                   

When I entered the room, a young man was sitting by the bedside.  I introduced myself and asked him if he might be a relative or friend of the patient. “No.” Then perhaps he was a new member of our group of palliative/hospice care volunteers?  “No,” again.  He said he was a seminary student.  I then asked if he had been assigned to spend time with patients in palliative care as part of his training for the priesthood.  The answer again was negative.  It seemed to me that the young man was a bit uncomfortable by my having intimated that experience in palliative/hospice care might be valuable in the training for the priesthood.  That was all I learned about him.  He was a mystery and I never discovered why he happened to be at this particular bedside at that early hour.                                                        

When he left me alone with Mrs.Holmes, I felt sad for the young man.  I, too had spent time in religious schools, but that was long, long ago.  I began to think of some of the patients I had spent time with and I recalled some of the moving experiences and how much I had learned from them.  Often I had a sense of wonder and awe at the ability of the human spirit to transcend suffering and even death itself.  I thought, “Wouldn’t it be wonderful for the young candidates for the priesthood or the ministry, such as the young man I had just met, to be sent out to spend time with the dying!  And be told to forget all the dogma and preconceptions and learn to listen with the heart, to share feelings, to learn to suffer and shed tears with the patient.”                                           

Palliative/hospice care is always understaffed.  Wouldn’t it be a tremendous boost for the volunteers to have recruits from the seminaries?  For those “clerics who would the steep and thorny path to heaven show,”-- ( Shakespeare),-- serving the dying would be an effective reality check and help them to become more aware and authentic pastors. True spirituality, the kind the Dalai Lama alludes to, is more often than not found in our involvement in the human drama of living and dying!  This essay asks in essence, “Where is God, when the patient is dying?”  Well, surely if indeed, “God Is Love,” then God is truly present in the loving care and compassionate understanding of any fellow human being as death approaches.                                                                                                                                                       

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