Compassionate, informed advice about healthcare decision making

Archive for the ‘Death & Dying’ Category

The Lonely, Difficult Journey of COVID Grievers

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“Oh my god, they are going to blame overweight people for their own deaths.” This was my first thought in the winter or spring of 2020 when I initially heard about the risk factors leading to death by COVID. The list included obesity, diabetes, old age, compromised immune systems, and being Black.

Photo by Ben White on Unsplash

My mind revisited those first weeks of the pandemic as I saw an interview with Ed Yong of The Atlantic on the PBS News Hour. For two years, he has been talking to COVID grievers. You can read his most recent article, “The Final Pandemic Betrayal,” here or watch the seven-minute PBS interview here.

I wrote blogs about the grief rituals after the death of my mother-in-law during COVID and public displays of remembrance of those who died. Now Ed Yong has written and talked in the most moving fashion about the more than 9 million fellow Americans who have lost a close relative to the virus.

COVID Grievers Face an Unprecedented Time to Grieve

Photo by Claudia Wolff on Unsplash

We who have NOT lost someone to COVID have little concept of the unique, profound, and enduring grief now being visited upon these grievers. Here is the story of a mother who watched her son die on her phone:

“Teresita Horne had spent more than a week on a breathing machine when her 13-year-old son, Donovan, died in a different hospital; she watched him die on her phone. ‘I remember screaming,’ she told me. ‘When your kids are sick, they need you, but I couldn’t be there to comfort him. I couldn’t hold his hand one last time.’”

Don’t ask, “Were they vaccinated?”

Then there was the tone in our questions to those who lost a loved one to COVID. “Did they get the vaccine?” What does that have to do with our attempt to reach out to someone caught up in grief? The mere question implies that there was something the dead person should have done or, worse yet, the griever should have done to prevent the death. Aside from appeasing our curiosity about if they got the vaccine, how does that question comfort the bereaved?

Photo by Pierre Bamin on Unsplash

Again, Yong writes, “Many grievers end up blaming themselves. Should I have pulled them out of that nursing home? Should I have pushed them harder to get vaccinated? And worst of all: Did I give them COVID?“

He concludes: In her book, The Myth of Closure, Pauline Boss, a therapist and pioneer in the study of ambiguous loss, offers some advice for pandemic grievers: ‘It is not closure you need but certainty that your loved one is gone, that they understood why you could not be there to comfort them, that they loved you and forgave you in their last moments of life,’ she wrote. Instead of waiting for a clean but mythical endpoint to one’s loss, it is better to search for ‘meaning and purpose in our lives after this horrific time in history,’” she said.

Do yourself a favor. Read Yong’s article or listen to the short interview. I was moved by the stories of these COVID grievers

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

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Cover Photo by Shane on Unsplash

The Rise of Cremations and Our Need to be with the Dead

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While we were planning a funeral for her 22-year-old son, Scott, she put down her beer, took the cigarette from her lips, and said, “So, I remind you of the Virgin Mary?” A lighter moment amid grief. Scott died from a long and debilitating illness. He may have weighed 80 pounds in the end.

I lived a few doors down from Scott and his family for four years. His sisters babysat my kids. I was Scott’s den leader in Cub Scouts. As disease ravaged his young body, Scott graduated from college in a wheelchair. I was so privileged to be a part of his care.

In Scott’s last days, one of my fellow chaplains called me as he was preparing to leave town on vacation. He was aware I was an old friend of Scott and his family. He asked if I could check in on Scott and even do the funeral if he died. I was glad to do it.

On my second visit to see Scott in our hospice in-patient unit, I could tell he was taking his last breaths. His mom and sisters were at his side. He had been in such great pain that he was totally sedated. His breathing stopped. The tears flowed after months of anticipating this moment.

I summoned the nurse. She asked Scott’s mother, “Would you like to hold him?” Of course, she would. It had been months since she could even touch him because of the pain.

The nurse gathered the sheet around Scott’s body and placed him in his mother’s lap. She held him tenderly, stroking his face, and telling him of her love. I later told a friend of the scene and he said it reminded him of Michelangelo’s Pietà. It was indeed a very similar scene, a mother cradling the body of her broken son.

A few days later, I told Scott’s mother about my friend’s comment. That’s when, beer and cigarette in hand, she said, “So, I remind you of the Virgin Mary?”

This experience came to mind as I read a Washington Post story about the stunning rise in the use of cremation. Now, 57% of our dead are cremated compared to 27% just two decades ago. Along with the traditional casket burials, Americans are having less to do with the dead. Many have no rituals at all surrounding the death of one they love.

Undertaker Author Thomas Lynch

Many want to avoid the greater expense of a traditional funeral and burial. But, perhaps, many want to avoid being around the dead body or the emotional strain of the rituals. Thomas Lynch, a Michigan poet and funeral director of 50 years said in the Post article, “People want the body disappeared, pretty much. I think it reminds us of what we lost.” In the United States, Lynch notes, “this is the first generation of our species that tries to deal with death without dealing with the dead.”

I will say, there is another trend that runs counter to this criticism that we Americans are avoiding the dead. More and more people are dying at home which gives the family the opportunity to be with the departed. A century ago, almost everyone died at home. This can provide that ritual lost with the demise of the traditional funeral.

Rest in peace.

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

You Can Never Make a Wrong Decision

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“I made a mistake. I made the wrong decision,” the wife of the recently deceased man said.

Several years ago, I spoke at the Centra Hospital in Lynchburg, Virginia. There were about 50 people in the room, including members of the clergy, physicians, nurses, social workers, and just plain folks. I divided my presentation, the first half devoted to helping patients and families make end-of-life decisions, and the second half to the emotional and spiritual issues at the end of life.

When I invited the audience to speak, a lady raised her hand and told her friend’s story. Her friend’s husband had been in a nursing home and on a feeding tube. He was not considered to have the capacity to make his own medical decisions, so all the medical treatment decisions rested on his wife.

On more than one occasion, the patient pulled out the feeding tube. This lady suggested to her friend that perhaps her husband was saying he did not want the feeding tube. Her friend always responded, “He doesn’t know what he is doing.” They always reinserted the tube and resumed the feedings.

“I should have left the tube out and let him die sooner.”

About six months after the patient died, the lady visited her friend. The now-widow said, “I made a mistake. I made the wrong decision. I should have left the tube out and let him die sooner.”

At times, I have heard other family caregivers express similar regrets about decisions made. “We shouldn’t have sent mom back to the ICU.” “I wish we had never started the feeding tube.” “We kept the chemo going way too long.”

You can never make the wrong decision

When I hear remorse like this, I always tell people, “You can never make the wrong decision. You make the best decision you can with the information you have at the time.” In my 28 years of being close to decision-makers, I have never thought someone made a decision intending to harm a patient. People always want the best for the patient. It is only in looking back that they say a decision was a mistake.

I even say “you can’t make a wrong decision” to people in the throes of a decision-making process. I hope to ease the burden they are placing on themselves. These choices can be hard enough. I want to assure these burdened families they can’t make the wrong decision. You just do the best you can with the information you have at the time.

[A version of this blog post appeared in 2011.]

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

Photo by Nik Shuliahin on Unsplash

“God has a lot of explaining to do.”

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The daughter started her eulogy, “I am so angry. God has a lot of explaining to do….” I sat there, stunned, now wondering how in the world I could follow such a performance.

I’ve had the opportunity to officiate many funerals over the years. This was supposed to be one of the “easy” ones. The dead man’s family had a relative who once was a member of my church in Vienna, Virginia, back in the day. None of the family attended that church now — or any church. So, when the man died suddenly of a heart attack at 64, they turned to us for a minister to conduct the service — kind of a rent-a-preacher.

Our pastor was out of town, and it fell to me to fill in. It sounded straightforward enough. They just needed me to be an emcee, so to speak. The daughter would do a eulogy, and we would open the floor for others to give tribute to the recently departed.

As I met with the daughter and granddaughter to plan the funeral, they made it clear that this family was not religious and did not want a lot of God-talk. They agreed to a prayer and Psalm 23. That was that. No sermon. Little religion. I would just show up at the funeral home, conduct the service, get paid, and go home.

I walked into a whole new world

When I entered the funeral home before the service, I walked into a whole new world (for me, at least). At the front of the chapel, a NASCAR flag draped the casket. The deceased’s helmet sat on top — a tribute to his years as a driver on the small-town racing circuit. Scores of people milled around, some laughed, some cried.

Vince Gill

Overhead speakers pumped in country music. Vince Gill sang, “I know your life on earth was troubled / And only you could know the pain… Go rest high on that mountain / Son, your work on earth is done.”

People took their seats in the pews, and I started the service with a few opening remarks. Then it was the daughter’s turn. “I am so angry. God has a lot of explaining to do. My father was a good man. He had no enemies. He loved his children and grandkids. He worked hard and provided for us. God has a lot of explaining to do.”

This was no time for theological argument

As she spoke, I sat there running through my mind things to say to offer another view of her father’s sudden, unexpected death. I thought about referencing Rabbi Kushner’s When Bad Things Happen to Good People. Kushner believed some things, including some deaths of people we love, just happen at random — a belief I share. But obviously, this was not the time nor place to get in a theological argument.

Then the wisdom of Fr. Seamus O’Reilly came to mind. As he talked to his parishioners about the AIDS epidemic in the 1980s, which some Catholics believed was punishment for sin, the wise priest said:

“God always forgives.
“Humans sometimes forgive.
“Nature never forgives.”

The man had died from a malfunction of his heart. Nature requires that our hearts pump life-giving blood in our veins. This man died of natural causes. “Nature never forgives”? No, that wouldn’t do.

Bless her heart — she was deeply grieving

The daughter’s angry tone did soften partway through her speech. It was clear she was an adoring daughter. She gave a touching and loving tribute to her father, as good a eulogy as I had ever heard from a family member. But she ended where she began, “God has a lot of explaining to do.”

When my turn came, I know I started with, “Death is always a mystery…” and kept it brief. I was speechless after witnessing this woman’s pain. I think everyone else was speechless, too, because few spoke when I opened the floor.

I’m always amazed when those who claim not to be religious will often blame God for tragedy. The funeral could have been a wonderful opportunity to be thankful for the great gift of the time she had with her father. But, bless her heart, she was deeply grieving the loss of her beloved father. I felt so sorry for her that her hurt had turned to anger.

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

Having a “Happy Death” — How weird is THAT?

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Recently, Roman Catholic Pope Francis referred to Saint Joseph as the “patron of a happy death.” Here’s the problem: I usually associate happiness with smiles, laughter, and a sense of the lightness of life. “Happy” and “death” are hard for me to connect.

The Pope stood before a General Audience and introduced the phrase “happy death” in the first words he spoke about Joseph (you know, Joseph, the husband of Mary and earthly father of Jesus). He never again used the word “happy” in his brief remarks.

What is it about the word “happy”? Why is it so hard to associate it with death and dying?

I want to drop off a “happy”

Three years ago, we moved to the Deep South in the hill country of Oxford, Mississippi. Here we might get a call from a friend, “Y’all going to be home? I want to drop off a happy.” That means she’s going to bring over a gift. It might be fresh-made pimento cheese or a potted plant. Let me tell you — in Oxford, if you tell someone you are feeling sick, you will get more hospitality than you can imagine. People will be dropping off happys all day.

Then, of course, “happy” is enshrined in the Declaration of Independence with the words, “inalienable rights of life, liberty and the pursuit of happiness.” An earlier draft had the words “pursuit of property.” Even today, many people assume accumulating worldly treasures and wealth will make you happy. From surveys, we find out the very wealthy are not any happier than those of more modest means. Once you move out of poverty into a stable financial situation, you are as happy as you will get.

Jesus and Mary as the “hospice team”

So how did Pope Francis associate Joseph with a happy death? As far as we know, he died while Jesus still lived at home before starting his ministry. The assumption is that the dying Joseph was cared for by Jesus and Mary. They were on his “hospice team,” so to speak. I guess you could also assume you’d have a happy death having Jesus and Mary as your caregivers.

Then Pope Francis goes on to discourage prolonging dying with overtreatment. He encourages relieving suffering with pain medications and mentions palliative care. These are elements of what we today call a “good death.”

Maybe not a “happy” death but a “good” death

Recently, I wrote a blog and shot a brief video where I explored the components of a good death in the 19thcentury. For obvious reasons, the elements of a good death in first-century Palestine, on an American Civil War battlefield, and today in a hospital have changed. We may have more tools now to control pain, but at the same time, dying can be unnecessarily prolonged by being hooked up to machines.

It doesn’t matter whether you call it “happy death” or “good death.” The hope is that we can have the best death we could imagine. Most likely, that will involve having family gathered around, being free of pain, and in a place of our choosing.

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

Ending Cancer Screenings at MY Age

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I have entered a medical-screening twilight zone. When I was in my 60s, I always got colon and prostate cancer screenings. Now, at 74, I am thinking about stopping the screenings.

Photo by Hush Naidoo Jade Photography on Unsplash

JAMA Internal Medicine recently published a research letter — “Comparison of US Cancer Center Recommendations for Prostate Cancer Screening With Evidence-Based Guidelines.” The guidelines recommend that all men 50–70 years old have an annual screening, regardless of their risk factors for prostate cancer. They suggest the patient and clinician share the decision to do this screening.

The clinician should also inform the patient of both the risks and benefits of the screening. There are downsides to prostate cancer screenings at any age — false positives, misdiagnoses, and overtreatment. Treatment can cause urinary, bowel, or sexual function problems — things I would rather avoid.

Why stop at 70? Turns out, the research shows that annual screenings of men with no other risk factors for prostate cancer do NOT reduce their chance of dying of all causes. In other words, both men who did and did not get screened lived about the same number of years.

My greatest fear is dementia

My greatest fear is that I spend my last years with Alzheimer’s, fully demented and a great burden to my family. Once I get that diagnosis, I would welcome an earlier death by cancer.

Years ago, I heard the story of a woman in a nursing home who no longer recognized her family because of dementia, and she had a mastectomy. They saved her life so she could get more demented.

I did not know this woman and her family well enough to hear about their decision-making process. Perhaps, the patient had stated before losing her mind that she wanted everything done to keep her alive. Maybe, her physicians told the family they had to do the surgery and gave them little choice.

I do not judge this family and their decisions. I take it as a warning for my family and me.

In my case, let the cancer grow

If I live to my 90s but am confined to a wheelchair in a memory-care unit, I do NOT want to be checked for cancer. We do not allow euthanasia in this country, but we do respect a patient’s right to refuse treatment. For me, in the presence of dementia, I would want cancer to run its course. Perhaps this could save my family years of heartaches.

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

When a Wartime Death Brings Complicated Grief

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FORT BLAKELEY, ALA. March 1, 2022: What if your teenage son went off to war — fought in one battle — died in that battle — and then you find out his death was actually after the war had ended — AND your side lost the war? Today, we would say parents of these dead soldiers would have complicated grief. Indeed.

Alabama built a state park surrounding the site of the Battle of Fort Blakeley. Tonight, while camping, I will be sleeping in that park on the earth that received the blood of hundreds of dead and wounded Americans. That was in April, 1865, and this fort was the last line of defense for the vital port city of Mobile.

“Boy Brigade”

Display at battlefield

Late in the war, the Confederate States expanded the draft to include younger and older men. So, men in their forties and fifties were conscripted next to teenagers. There were so many teens in two Alabama infantries that some referred to them as the “Boy Brigade.”

Outnumbered 16,000 to 4,000, the Southern troops, including the Boy Brigade, built breastworks still visible today. April 9th was the first – and last – day of combat many young soldiers faced.

The final assault of the U.S. Army on the fort began at 5:30 PM on April 9th. But the Civil War effectively ended about two hours earlier when Lee surrendered to Grant at Appomattox in Virginia. News traveled slower then, and those poor souls fought a battle that had nothing to do with the outcome of the Civil War.

Complicated Grief

Many factors can complicate grief. Even in today’s world, many ponder the meaning of the death of someone they loved. Deaths by suicide, murder, drunk driving, or other accidents complicate the grief process that is painful even in the most “normal” circumstances.

Then there are the deaths of people with whom we have a conflicted relationship. The passing of a physically abusive father, a sexually exploitive uncle, or a verbally abusive mother can make the grief process most difficult.

I remember the daughter of a patient once said, “My mother never said, ‘I love you’ to me.” She told me that as we were making preparations for the mother’s funeral. Any chance of hearing, “I love you,” also died. We truly don’t know what goes into another’s grief.

All of a sudden, her story made sense

Another family comes to mind when I think about complicated grief. I was sitting vigil at a nursing home patient’s bedside with her daughter. The patient seemed like so many of these sweet old ladies who came to us with advanced dementia. Over the months that the patient was with us, I gathered her daughter’s story on her daily visits.

Photo by Ben White on Unsplash

At age 16, fifty years earlier, the daughter and her husband-to-be eloped under cover of darkness. She hid a packed suitcase under the front porch as she made her plans. Her younger brother happened upon the suitcase but kept the secret.

In the silence of our vigil, the daughter blurted out, “God. She was a hard woman.” Immediately, I thought to myself, “Now, I understand. The woman was abusive. THAT explains everything.”

When the daughter broke the silence as we sat by her mother, this story finally made sense. She was abused. The brother knew it. He conspired to help his sister make her escape. Yet fifty years later, here she was, sitting beside her mother as she lay dying. Complicated.

My mind comes back to those Confederate parents whose teenage sons went off to war, fought in one battle, and died in that battle after the war was over…and their side lost. Talk about complicated grief.

Grief can be complicated, indeed.

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

 

Curious After Seven Decades Above Ground

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Hank and his sister Janice with their brother Dennis two weeks before he died

My birthday passed last week. Number 74. Now, a bitter-sweet day.

Bitter-sweet because I miss my younger brother, Dennis. He died on my birthday five years ago. When his wife called my sister to tell her Dennis had died, she said, “Don’t tell Hank. It will ruin his birthday.” She was right. My sister immediately called me, and it ruined my birthday.

The day now brings the appropriate mix of gratitude for another year of life and grief that my brother is no longer here to call me with birthday wishes. Bitter-sweet.

I find I’m getting more curious about myself as I settle into over seven decades above ground.  What am I curious about? About me. My thinking. My spiritual beliefs. I’m curious how can I still find new ways of thinking about and experiencing things spiritual. Curious how I find new ways of verbalizing these experiences.

An old man listening to books

Hank’s 74-year-old self

Last week, I told the story of an old man at the nursing home where I was the chaplain. I was in my 30s and he was in his 90s. The story was about his loveless marriage (according to his wife), but I mentioned that he listened to recorded books.

Every day, he’d be bent over in his wheelchair, leaning down, straining to hear history books being read on a record player. As a young man, I thought, “What is he doing? What is this 90-year-old man going to do with this new knowledge?” He talked very little. He was years past teaching children, or anyone for that matter. He just sat in his room and listened as the day crept slowly by. Now, I think, “I am the old man!”

You start dying slowly

Late last year I was introduced to the poem “You Start Dying Slowly” by Martha Medeiros. In Portuguese it is A Morte Devagar — “A slow death”. This poem meant so much to me that I printed it out and glued it to the inside of the journal I just started in November.

Here are a few lines:

You start dying slowly…
If you do not risk what is safe for the uncertain,
If you do not go after a dream,
If you do not allow yourself,
At least once in your lifetime,
To run away from sensible advice…

Referring to the poem, I wrote in the journal on November 21, 2021, “I am profoundly moved by this piece. I still marvel that, at my age, I am still wanting to make something of my life. I still struggle with taking risks.” Weeks later, on January 4th I wrote, “‘Who are you God and who am I?’ St. Francis said and I BOTH say. I am almost 74 and have not settled this.”

My 24-year-old self meets my 74-year-old self — it is not pretty

Hank’s 24-year-old self

Fifty years ago, if my 24-year-old self met my now 74-year-old self, he would have called me a heretic. I was so certain about things at 24. Now, being “right” is less important. Rather, following the teaching of Jesus, right action is more important that right theology.

Now, questions are more important than answers. Curiosity feels better than certainty. I am the old man listening to books. I listen not to know more but to be comfortable with not knowing. The mystics are my favorite guides. Thomas Merton summed up, for me, the mystery of knowing and not knowing God:

 

Thomas Merton

“Your brightness is my darkness. I know nothing of You and, by myself, I cannot even imagine how to go about knowing You. If I imagine You, I am mistaken. If I understand You, I am deluded. If I am conscious and certain I know You, I am crazy. The darkness is enough.”

 

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

Can a POW have a “Good Death” Hundreds of Miles from Home?

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A young soldier named William Gaston Barringer turned 18 on October 5, 1862. Less than three months later, he was wounded and died as a prisoner of war 200 miles from home. Yet, there is evidence he had a good death. How could this be?

Barringer’s marker caught my eye as I wandered around St. Peter’s Cemetery in Oxford, Mississippi. The epitaph, “I was not afraid to die; my Mother taught me to pray in early life,” got me thinking about what it means to have a good death. (See my “Hank’s Deep Thoughts” video at the monument.)

Let me clarify; a “good death” does not mean that it was good that William died. Death to the young is, of course, a tragedy. And, as a POW, he likely did not die in ideal conditions.

Being a prisoner of war was not mentioned on the monument. I did an internet search and found him on a list of soldiers who died in captivity, hundreds of miles away in Murfreesboro, Tennessee.

A “good death” through the centuries

Plagues in the 1300s killed 40-60% of the European population. Such widespread death led to the release of a couple of books known as the Ars moriendi (“The Art of Dying”). These were Christian instructions on how to have a good death. There were accompanying woodcuts, like one showing demons tempting the dying man with crowns symbolizing earthly pride.

 

By the American Civil War (1861-65), the dying and their families knew what was expected. Drew Gilpin Faust identified four elements of a good death in her moving book, This Republic of Suffering: Death and The American Civil War. According to Faust, a good death in the 19th century was one where the dying person:

  1. Was conscious
  2. Was not afraid of dying
  3. Was prepared spiritually to meet their maker
  4. Left dying words for the family

 

Even the atheist Charles Darwin, who died in 1882 in England, kept to this script. He told his wife on his deathbed, “I am not the least afraid of death—Remember what a good wife you have been to me—Tell all my children to remember how good they have been to me.”

Though a reference to spiritual things was conspicuously absent, Darwin was conscious, was not afraid of dying, and left last words for his family. In my interpretation, he wanted to emphasize that even though he had no spiritual leanings, he was still “not the least afraid of death.”

Much has changed since the Civil War, including our expectations about our deaths. Today, medical literaturedescribes what many now consider a good death: being in control, being comfortable and free of pain, having a sense of closure, etc.

This sense of control has recently manifested itself through eleven U.S. jurisdictions adopting medical aid in dying. In those places, patients can ask a physician to give them medication to hasten their dying.

Back to Mr. Barringer

The words on Barringer’s marker were an assurance to his family that he died a good death: “I was not afraid to die; my Mother taught me to pray in early life.” These seem like the dying words of a conscious man.

And there it is. William was conscious, he was not afraid of dying, he was prepared spiritually (thanks to his mother), and these are the words he left for others. I can imagine his mother visiting this monument often in her grief and being consoled, “At least he had a good death.”

 

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

“Watching” the Super Bowl on Life Support

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“I know he would never want to be kept alive like this,” she said to me over the sound of a machine forcing air into her husband’s lungs. He lay motionless, eyes closed. He had been like this for months after arriving at the nursing home from the hospital.

She was holding out for the miracle that seemed unlikely. She was raised Catholic but converted to Judaism when they married some forty years before. One day I came into the room on my chaplain rounds, and she had both a Jewish prayer book and a Rosary in her hands. She figured it couldn’t hurt covering all the bases.

“Why is he like this?” she asked more than once, about him being in a nonresponsive state. Doctors told her he would never regain consciousness. “There must be a reason.”

When bad things happen to good people

Since she was Jewish and asked this question, I gave her a copy of Rabbi Harold Kushner’s When Bad Things Happen to Good People. After the rabbi’s three-year-old son was diagnosed with a rare disease that would take his life by his teens, he pondered the question that became his best-selling book. Rabbi Kushner believes that although God is good and loving, nature randomly metes out bad things. God does not send bad things. They “just happen.”

I dropped in again a few days later, and she thrust the book at me. “I didn’t like it,” she said. “He says some things ‘just happen’ with no reason. I can’t accept that. There has to be a reason my husband is like this.”

Withdraw life support — but first…

Just as these situations usually progress, she and her three adult sons began to ask the staff and physician about withdrawing the life support. They were told it would be quite appropriate and could be managed in a way to provide comfort.

Washington fans during the Super Bowl years

It came down to an impromptu meeting with me in the hall outside the patient’s room. “Dad would hate this,” said one of the sons. They all agreed it was time.

Then another son spoke up. “Wait a minute. We are all headed to the Super Bowl to cheer for the Redskins.” (Of course, he was referring to the Washington Football Team once known by that name.) The patient and his sons all had season tickets, a prized possession back in the day when the team won three Super Bowls in nine years.

“It would be really sad to go to the game in Minneapolis right after dad dies. Let’s do it after the game.” They all agreed.

“Watching” the Super Bowl on life support

I had heard a lot of reasons for delaying withdrawal of life support — waiting for a sibling from California to arrive at the bedside or waiting until someone gets married. Waiting for a football game was a new one for me. I could imagine the patient would have been fully behind the delay. Football means that much to some people.

I did see the compassion in this act. Perhaps having the game on in the patient’s room just might get through to this poor soul. I didn’t really believe it would, but what do I know.

The plan worked. They took the man home days after the game, where they withdrew life support, and he died peacefully.

And the Washington Football Team beat the Buffalo Bills that year, 37-24, in Super Bowl XXVI.

__________________________________________

Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

 

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