The Reluctant Hospice Chaplain




It's amazing how often my elderly hospice patients advise me to live without fear, love with everything I have, enjoy life while I'm still young, and do what makes me happy. They say this so often I've come to believe they are collectively speaking Truth with a capital T and that these are some of the only evangelists in this world worth listening to.

Many of my patients were already senior citizens when I was born. So it humbles me how often they graciously invite this time-untested youngster into the privacy of their lives. Recently, a 95-year-old patient asked me how old I am. When I told her, she said, "You don't look 36."

"Well, thank you, I guess."

"But then, you've never had the responsibility of having a husband or looking after children."

I feel a heart pang as the truth is that I once had a husband. But she doesn't know there is a crater in my heart where there once was a marriage. She doesn't know my particular story, my personal pain. But to explain it to her now would be selfishly asking her to look at me when what she is really asking at that moment is for me to look at her--to really look at her, to study the deep lines on her face and to read the story of sacrifice written there.

"This is true," I say, choosing my words carefully. "I've never had to sacrifice the way that mothers do for their children."

"No, you haven't," she said, looking directly at me.

"I bet to you I still look like a baby."

"You do!" And she grabs me by the chin.

A few minutes pass. We talk some more. And then she says: "I wish you were my neighbor."

I agree. But then again, in some ways we already are.

In visits like this one--and there are many--I find I lose track of who is the patient and who is the chaplain. Yes, yes, I know my professional boundaries. But in many moments those boundaries are simply the fences where neighbors meet and chat and I remember that at the very center of who we are there is no such thing as patient or chaplain. Nor any other role we play. Roles are just the vehicles by which our hearts meet.

Another day, I ask this same patient if there is anything I can do for her before I leave. From her bed, she says, "Do a little dance for me." So I do. I love my job.

It didn't begin this way. When people ask how I became a hospice chaplain, I tell them the truth: I didn't want to be one. I needed a job and hospice was the first to hire me out of my chaplaincy training program. At the time, it was designed as a part-time, eight-month temporary position. I convinced myself I could do almost anything part-time for eight months. Even if it scared the shit out of me.

It's hard to believe nearly eight years have passed since I gracelessly fell into this work. I am the last person I expected to take this path. I avoided death and dying classes in seminary like the Plague and was secretly relieved that the hospice rotation during my chaplaincy residency was off-limits to newbies like myself. People who talked about the beauty of dying sounded floaty and stupid and they made me mad. So when I later asked my hospice supervisor, a woman I would soon learn was one of the most gifted, skilled spiritual midwives to the dying I will ever know, why she hired someone like me--young, inexperienced, afraid--she said that from the moment I sat across from her in my interview she knew I was someone willing to learn and that's what mattered the most.

I may have had a general willingness to learn but without her intensive mentoring and hand-holding those first couple of years, I would have been a lot less willing to learn and a lot more likely to run away with my hands over my ears shouting na-na-na-na. It's common knowledge among hospice workers that the first year can serve more as initiation rite than job orientation. My initiation first manifested in an uncomfortable period of completely irrational hypochondria as my own denial and resistance to death began to be chipped away by the daily tending to it. Every gas pain, unseasonal cough, and mole on my freckled body declared cancer. And my relatively tame sexual history became fraught with danger and death. Aside from losing my virginity, I'd only been with one other man and he later became my husband--except for that one time two years earlier when I gave an old high school friend a blow job not too long after running into him at our hometown IHOP. (Seriously, are you supposed to count that?) At the time, the whole fellatio episode seemed completely benign--if only regrettable. But sitting in the presence of death every day at work, every questionable life decision and potential consequence was put under a microscope. Suddenly sure that my mouth had retroactively contracted every STD known to the World Health Organization, I made a beeline to my doctor's.

A grip of unnecessary co-payments later, the hypochondria began to subside. But then came the uncomfortable period of coming home from work every night, flopping myself on the bed where I would cry for an hour then watch four hours of reality television before falling asleep. I already struggled with depression. But now the transformation into weeping manatee was complete.

Over time--a lot of time--I began to find my footing, like a landlubber with rubbery legs and a propensity to wretch over the side of the boat eventually learns to stand again despite the ceaseless rocking and pushing of the current.

What took the ground out from underneath my feet was getting knocked down every day by the most basic of truths: everything living must die. Now, I'm sure I have your average human resistance to death. But I'm also a white American--not exactly a demographic known for its comfort with death--who grew up in a church so certain Jesus was returning soon--like next week soon--that death from old age seemed improbable for almost everyone, including old people. Not only did we find comfort in what many people of faith do--that there is, in some form, life beyond death--we believed that some of us would actually escape death all together. There were many of us who anticipated being alive at the Second Coming and watching joyfully the resurrection of our deceased loved ones, all of whom had been "asleep in Christ," and being reunited with them in the sky. On one hand, I am deeply grateful for the training I received by my family and community to orient my life towards hope, to know that death did not have the final say over our lives, and that we did not have to live in fear of the future.

On the other hand, diminishing death to a state of sleep that you may or may not experience made the massiveness of other human states like grief and doubt harder to navigate. Because losing someone to death sure as hell doesn't feel like losing them to a nap. And it wasn't like our lives were protected from death or tragedy. My family and church knew both like all other human beings. But our experience of loss was always buffered by the belief that death wasn't really death--only a temporary condition of being "asleep in Christ." This played out in ways that may not have served any of us. I remember once attending the funeral of a teacher who died suddenly in his early forties, leaving behind a young wife and baby. And the pastor who officiated the service was so intent on drawing our minds towards hope that he gave very little breathing and crying room for the immensity of the loss itself. He walked up and down the aisle telling jokes, saying at one point, in the actual presence of the man's widow and baby, that we didn't have to be sad for our friend's death because we knew he was simply asleep in Jesus and that one day soon he would awaken into the most beautiful family reunion ever. Talking so easily about hope that day, I believe, made hope toothless.

But there is a childlike innocence to that kind of hope that can be forgiven in children. One of my earliest memories from childhood is standing with my mother on the backyard patio of a woman whose teenage son had been tragically, accidentally killed. I remember looking up at these two women talking and crying with each other and not understanding what was wrong. At the age of five, I couldn't yet understand the permanence of death. Mascara streamed down my mother's friend's face and in my childlike confusion and faith, I asked her: "Why are you sad? Jesus is coming back. You'll see him again."

Some part of me stayed five-years-old for a long time. When I was nineteen, a friend was killed driving home after a late summer party. A few hours later, at dawn, I sat on a front porch in his hometown trying to absorb the news with a handful of other friends. Watching the sun rise over the horizon, the shock of his death uprooted in my mind the magical thinking a small child. I thought to myself: "This must be the day that Jesus comes back. This must be a test. Jesus couldn't expect us to bear his death." Of course, in retrospect, I am aware of how  self-centered such a response is, as though any of us have some special protection from tragedy and loss. But I understand now, too, that when you lose someone you love it can feel as though the sun itself has been extinguished. Remembering that each person is carrying such apocalyptic loss at some point in their lives should be enough knowledge for the whole world to handle each other with tenderness. But it's not. Mostly, I think, because we forget.

Memento Mori. Remember you will die. Amnesia about death runs deep. Years of working at hospice confirm it--not only from my experience of patients and their families but from self-observation. The strangest thing I still hear myself say, along with my hospice colleagues, is when we finally lose a patient whose decline progressed so slowly, over many, many months that it appeared they were suspended in time. They never are. But in those moments, when they have finally taken their last breath and we stand in the reality that they are now gone, it is not uncommon to hear one of us say: "I thought she was going to live forever."

Once, after hearing myself express disbelief that a beloved elderly patient had died after having been on hospice for well over a year, my entire being--mind/body/soul--was filled with this realization: we all go through that same door. None of us get to stay here forever. In that moment, I fell in love with every living thing, treasuring their remarkable, unrepeatable beauty and the fragile, fleeting gift of life itself. I felt the urgency to live more deeply into my own life and to experience everything I possibly could with the brief time I have on this earth. But then life became routine again and I forgot about the door. Of course, as death is wont to do, death surprised me again and then I remembered. But then I forgot again. And so it goes. I'm like Drew Barrymore in the movie "50 First Dates" except in my version Adam Sandler is the Grim Reaper.

Last spring, my room temporarily became a hospice house for mosquito hawks. I did not want to be their hospice chaplain but apparently the word had gotten out that I was one so they formed a line. Now, I love mosquito hawks. (You might call them crane flies). I even loved them after I found out they do absolutely nothing hawkish about mosquitos. I love their graceful, thin, gangly legs. I love how they land like fairies on my wall. I love how they fly like tiny, transparent spacecraft hovering over me. Gentle and harmless, they are the Cocker Spaniels of the insect world.

So I would never do anything to hurt them. But for whatever reason, they kept using my room as their deathbed. One morning, I woke up to find one close to death on my desk. And can I tell you? I was a terrible hospice chaplain about it. The absolute worst. Instead of sitting with it and holding a loving, sacred space around it to support its little soul in the work of letting go, I went into "Live, dammit, live!" mode instead. Scooping it up onto an envelope, I rushed outside, desperately trying to find a place in the garden where I imagined a little bit of sunshine and fresh air would help it get its strength. I'm sure if I had fainting salts, I would have tried to wave them under that same little tubular appendage that had caught the leaf. I was doing all of this at the very moment--the actual second--the mosquito hawk was flipping over onto its back, tucking in its legs, preparing to die with the grace of the Buddha himself. But instead of accepting this, I fought it, pleading with the little fairy insect to stay. And Lord forgive me, I flipped it back over at the very moment it died. I realized then what I had done--can you imagine the violence of doing this to a human being in their last moments?--and then I began to apologize profusely to it, praying to God for having disturbed this beautiful creature's dying process, and sitting in the stark morning light absorbing one more lesson in how seriously unready I still am to accept life and death on their own terms.

Yet, despite my amnesia and resistance and fear of death and occasional downright lousiness as a hospice chaplain, I cannot tell you how many days I return home dumbfounded that I get paid real non-Monopoly money to basically fall in love over and over with people and to bear witness to the exquisite light that shines from each of us--often without our knowing it and often in storms of great suffering. Many times, we lose contact with that light. Some times, we don't even know it exists. My first mentor at hospice taught that our job as chaplains was to "look for the beauty." No matter what. No matter the stench, no matter the tragedy, no matter the awful new epiphanies about suffering there are still to be gained, our job was to do our best to seek the beauty that is also present and to hold to that truth even if only silently.  And what I am slowly learning is this: the beauty never leaves. The light is always there even at its faintest. The hardest thing you may ever do in your life is to see it. But it is still there. Sometimes we need a little help to reflect back the light to us. So on my best days as a chaplain, I do what I can to find that light in a person or situation and say, see, the light is here in you, in this place, and you will find your way.

And the effect is mutual. My heart is filled with so much love and gratitude for the people I have been honored to help care for. Because of them, my heart continues to open to deeper truths about the magnitude of suffering in this world as well as the transcendent presence and healing power of beauty and love. The wisdom they have shared with me is imprinted on my heart, even when I do not remember their precise words. And I treasure each soul that has invited me into their journey of life and death for how they have taught me to better live and die.

In a similar way, I do not have words to express my gratitude for my hospice colleagues. When I have lost contact with my own light, they have often been my chaplain, reflecting back to me light and beauty I could not see for myself. Almost two years ago, we helped midwife the death of one of our own and I realized in a new way how we are not only colleagues but a tribe of love and support that I could always count on. Without them, I would have lost heart and strength a long time ago and I would have backed away from the edge of being utterly, totally broken, transformed, and re-made by this work.

My journey to become a hospice chaplain then was not one of clear inspiration. But perhaps it is a truer reflection of how we are not born ready-made for the work of our lives. Rather, I am staking my faith in the prospect that we are made by Life to become the people who can do the work.

When my day comes to step through that door, I expect my trip over the threshold to be a messy one. I do not expect to "go gentle into that good night."  At least, not at first. Experiencing my own brief cancer scare a couple of years ago confirmed this fact.  But that little five-year-old girl who once fought the very idea of that door, who once believed that death was simply taking a nap on this side of it, who was terrified to accept a world in which God doesn't appear positioned to swoop in and rescue us from our human condition anytime soon, has borne witness to hundreds--perhaps thousands now--of others preparing to step through that very door. Whatever happens on the other side--nothingness, resurrection, reincarnation--I cannot know for sure. But the door is there all the same. And that knowledge is re-orienting the way I live my life. Of course, I forget this like ten times a minute. But still, I know the door is there now in a way that I didn't before.

So when I hear someone with their hand on the doorknob tell me something about how they have found their own way to make peace with where they are, I listen very carefully. Even to those people who may not seem like likely candidates for this kind of conversation. Recently, I was sitting with one of my patients who has advanced dementia. Often, she goes for days without saying more than a few words. But in the same way that the sun will break through a cloudy day, there are days when she can become downright eloquent. And in those moments I feel like I am sitting at the foot of an oracle. On this day, the light broke through and she began to talk about how we are all parts of the whole and though we don't know what role we are playing that we don't have to worry about it because in the end it's all going to be okay. She said that she'd forgotten what she had come here to do but wasn't worried, either. Looking at her own body like it was a piece of clothing, she said "I could be almost anything now. And they could throw me away." And though the words were strange, even sad, she laughed at the absurdity of it all. And I laughed with her. She said, "Whatever I am, I will be." Over and over again, she talked about waiting, how we simply need to wait. She told me, "Take a breath. Relax. And wait to see what happens." And looking at a plush toy bird hanging above her bed, she said, "I wish it could spread its wings and fly away. But it is waiting, too."

Not everyone makes peace. And I also learn from them. Some of the hardest, most necessary lessons of my life I have learned from them. But over time, I have begun to hear, like a song with endless variations, the repetition of  themes and patterns winding their way through particularities of lives which on the surface may seem completely dissimilar but which hold to the same bright wisdom that will not die. Most often, I hear this wisdom from the elderly. But I have learned that you can die old without it. And that you can die young with it. But wherever I find it in people, I try to know that this wisdom is not only true for them. It is true to the experience of being human. When I see someone releasing into love and mystery with the grace of a mosquito hawk and they tell me that it helps to learn to live without fear, love with everything you have, enjoy life while you still can, do what makes you happy, I am learning that I shouldn't fight back or try to flip reality on its head at the very moment I am being asked to surrender. I am learning to listen. With every cell of my being. Even if I forget it all tomorrow.