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Archive for the ‘Death & Dying’ Category

Grief Upon Grief, Upon Grief — A Funeral, FINALLY, 42 Years Later

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Can you have a funeral for someone who died 42 years ago? Last week, I wrote about having to delay the burial of my mother-in-law’s ashes for ten months because of COVID. Why not 42 years? In 1996, I officiated this long-delayed funeral, choking back tears.

The summer of 1996 turned out to be a terrible one for me. I went through an unspeakable loss that involved a major betrayal and abandonment. By August, I couldn’t get my dead brother, Randy, out of my mind amidst my grief and sadness. By that time, he had been gone over 41 years.

Randy only lived a week, and never left the hospital. He was born without functioning intestines. It was clear that he would die within days. This was back when children were not permitted to visit hospitals, and I was just six years old. I never saw Randy. I never held him. I did not know what it was like to look upon his face.

And yet, during that summer, I missed him. Fresh grief has a way of bringing up old grief you didn’t even know you had.

The backstory

Mom and Dad were visiting for our son’s high school graduation in 1993. After dinner one evening, Randy somehow came up in conversation. I said to my parents, “Tell me about Randy’s death.”

Instantly, Mom burst into tears. Once she could speak, she said, “My father would not let me go to Randy’s funeral.”

My grandfather was a funeral director and arranged to remove my brother’s body quickly from the hospital. Mom had already been sent home, leaving her newborn son behind to die alone. Dad attended the graveside service, but my grieving mother was not allowed. My controlling, alcoholic grandfather decided it would be better for Mom to avoid the pain of putting her child in the ground.

In somewhat of a defense of my grandfather, this was how things were done in 1954. Avoid the pain and go on with your life as if nothing happened. At the time, funeral directors were the only grief experts. Granddaddy was doing what he thought best.

Nowadays, we encourage the parents, and even siblings, to hold their lifeless child. Some families even wash their children, preparing them for burial. These rituals are such an important part of the grief process.

Fresh grief, old grief

Although I always was aware of Randy’s short life, I can never remember him coming up in conversation until my inquiry in 1993. Just mentioning his name opened the floodgates. My mother carried that huge ocean of grief just below the surface all these years.

Did thoughts about Randy painfully arise when Granddaddy died? Randy died on November 22nd. Did Mom think about Randy when President Kennedy was killed on that same day nine years later? Did she think about Randy at my graduation from high school? I am guessing she thought of Randy all the time. I never knew.

When my father was taking his last breath in 2002, Mom’s parting words to him were, “You’re going to see Randy before me.”

Grief never goes away

Although I was not conscious of it, the loss of my brother was always a part of me, too. It didn’t occur to me until I was in the depths of despair that summer of 1996.

As Thanksgiving approached that year, I got an idea. My daughter and I were going to spend it with my parents in Florida. I decided to go to Randy’s grave and conduct a personal graveside service — a ritual. I called Mom and Dad and told them my plan, inviting them to join me. Mom said, “I would love to. You know what I told you about my father.” Indeed, I did.

So, on Thanksgiving 1996, 42 years after his death, we had a funeral for my brother. Mom, Dad in his wheelchair, my brother, his wife, my daughter, and I gathered at the grave. I read the words of committal (“Ashes to ashes, dust to dust”) and Psalm 23 (“The Lord is my shepherd”), we said the Lord’s Prayer, and I stammered through a prayer about Randy.

We turned toward each other. We embraced. We wept deeply. Forty-two years of sorrow ran down our cheeks.

Better-Late-Than-Never Rituals

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I was talking to a friend whose husband died unexpectedly last year from a heart attack. No warning. He died in his sleep. Because of the pandemic, they had no wake, no visitation, no funeral, no public events. She told me, “It’s like he just vanished.”

My mother-in-law, Sue, also died last year amidst COVID. We were fortunate to have a church funeral at the time, although it was only for immediate family. We sat spread out in family “pods.” The priest said all the familiar words that get said at these things. He knew her well, so it was very personal too.

Family and friends gather to say “good-bye” in COVID-delayed ritual

As meaningful as that service was, there remained a huge hole missing. There would have been scores, if not hundreds, who would have come from near and far to be with us in normal times. Family and friends would have filled the church, hugged our necks, and told us meaningful and funny stories about Sue. It didn’t happen.

Fast forward to last week. We finally buried Sue’s ashes in a public ritual. Those friends and family members did indeed come from near and far — from Dallas, Seattle, New York, Arizona, Chicago, Virginia, Wisconsin, Minnesota, Cleveland, and from just a few blocks away. Necks got hugged, and stories got told. You never get over grieving, but these public rituals can be an important part of the process.

Rituals denied by choice of the dead

As I write this, I think back to my brother’s death four years ago and what we missed. My sister, brother-in-law, and I traveled from Colorado and Virginia to visit Dennis barely two weeks before he died. I cherish the photo taken during that visit. The three of us stood outside his “cracker house” home on farmland north of Tallahassee. We would not see him again.

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

Dennis was a very private person. As he knew his death approached, he told his wife he did not want any services to remember him. Our only ritual was the dreaded phone call from my sister, “He’s gone!” It was my birthday, and my now widowed sister-in-law suggested that my sister not call me until a day later. You know — “don’t ruin his birthday.”

So, my sister and I cried together over the phone. That was that. We are now the last two of the six in our family of origin.

It is curious that we give the deceased such control over survivors’ grief rituals. How did my now-dead brother get the right to deny me gathering with family and friends to remember him? He won’t even be there. It would have been about us and not him — our needs, not his.

“Thanks for all the laughs.”

So, last week, we gathered at the columbarium of St. Paul’s on the Lake Catholic Church in Grosse Pointe, Michigan. Sue’s 88-year-old, life-long best friend, going back to their childhood days, reached into the niche, touched the urn, and said, “Thanks for all the laughs.”

These rituals are so important. It really is “better late than never.”

You Can’t “Prevent” Alzheimer’s! But You Can “Reduce the Risk!”

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She was the most unhappy, most angry, and most sad dying person I ever worked with as a hospice chaplain.

She thought she had done everything to prevent cancer. She was a “fitness nut.” She meditated. She did yoga. She read books on spiritual and self-help topics. She ate the healthiest of diets. She got cancer anyway.

Once diagnosed, she turned to alternative medicine to save her life. She had heard so much about those miracle cures and she wanted that, too. She doubled down on her lifestyle she had adopted to prevent the cancer in the first place.

She never got to acceptance. In my view, her biggest mistake was believing she could “prevent” cancer rather than just “reduce the risk.” Even nonsmokers can get lung cancer.

Reducing Risk vs. Preventing

I thought of this patient as I was rereading an article I had found helpful about reducing the risk of dementia. I was surprised how it was titled — “The SHIELD Plan to Prevent Dementia.” (I referenced this “plan” in a previous blog about Alzheimer’s.) As with cancer, you can’t totally prevent getting Alzheimer’s. But you can reduce the risk.

Below is Dr. Oz’s spin on the research of Dr. Rudolph Tanzi (I would drop the word “prevent” and call it  The SHIELD Plan to Reduce the Risk of Alzheimer’s):

Sleep — Aim for at least eight hours of sleep each night.

Handle Stress — Tanzi recommends a short, one-minute meditation practice.

Interact With Others — Loneliness can lead to additional stress. Talking with friends and family members requires the brain to pay attention and builds new neural pathways.

Exercise — Walk at least three times a week for 30-45 minutes.

Learn New Things — “Leaning new skills can build new nerve connections that maintain optimal brain health. Try adopting a new hobby, learning a new language, or playing a new musical instrument.”

Diet — Drs. Oz and Tanzi recommend The Mediterranean diet. “On the diet, you’ll eat more fruits and vegetables, nuts and olive oil and then cut back on red meat consumption.”

There you have it.

The Collapse of Hope

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Here we are again. This time a beachside condo building near Miami has collapsed. Distraught families are praying for a miracle — praying that someone they love will be found alive. Others are only hoping for the recovery of a body so that they can say properly their goodbyes.

I write this five days after the tragic event. Much can change by the time you read this.

This tragedy feels familiar. Mass casualties in a seemingly random occurrence, like 9/11, mass shootings, or airplane crashes.

I remember writing a piece around September 11, 2002, a year after the terrorist attacks killed over 3,000 people. While I acknowledged that those deaths had huge implications for national security and our nation’s foreign policy, I disagreed with those who believed there to be some special meaning to the individual deaths. Those 3,000+ deaths were not unlike other random, sudden deaths I had seen countless times in my years in the ministry.

I admit, when things like this happen, I look for reasons why I am exempt from such randomness. I don’t own a condo on the beach in Miami. I don’t fly on airplanes in Africa. I don’t go to gay night clubs in Orlando. No wonder I am still living, and those unfortunate souls are not.

This doesn’t happen here

Even the mayor of the town where the condo high-rise is located sought refuge in the “this-doesn’t-happen-here” mentality.

“‘It would be like a lightning strike happening,’ said Charles W. Burkett, the mayor of Surfside, Fla., where the collapse occurred. ‘It’s not at all a common occurrence to have a building fall down in America,’ he said. ‘There was something very, very wrong with this situation.’” (New York Times, June 27)

Mr. Mayor, it does happen here. It DID happen here. And in your town, on your watch. (By the way, on average, 26 people die in the U.S. of lightning strikes each year.)

No trite platitudes for these stunned families

If I were called on to offer pastoral care for these worried families, I would try to meet them, and be with them, where they are in the process. If they were still praying for that most unlikely miracle that someone they love is alive — I can pray with them for that. If they had moved to mourning without a recovered body — I can be with them, too.

What I would NOT do is try to offer “solace” with such platitudes like, “God never gives you more than you can handle,” or “With God, there are no accidents,” or the absolute WORST, “Everything happens for a reason.”

So, once again, we all stand vigil. Indeed, most of us truly empathize with these poor families. We will watch with interest how they get through these coming days. Most will move into a normal, sad grieving process. An added pressure on these families, that most of us will never experience, is that many of them will mourn on national television. God help them.

 

 

Looking for a Sign… Calming Amidst Grief

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I had NEVER seen a street sign like it – “TRAFFIC CALMING AHEAD” – and I collect photos of unique street signs.

Like the one we saw driving home from the Memphis airport the other night: “THIS IS YOUR SIGN TO BUCKLE UP.” (The folks at the Department of Transportation do try to make us smile.)

Or the one I saw years ago when I was speaking in Boulder, Colorado. It was February. I went out one morning for a walk on a pedestrian path. I approached an underpass and could see some patches of ice in the shadows of the bridge.

Not to worry! This progressive, free-thinking university city put up a sign to warn me: “ICE MAY EXIST,” it read. I thought, “This is SO Boulder!”

The sign begged more questions. Ice may or may not exist, correct? Do I exist? If I do exist, how did I come into being? What is the nature of existence? What is the nature of non-being?? Goodness! I was just going out for a walk.

Obvious signs

It’s not just in Boulder that I pondered the meaning of life upon seeing a road sign. While driving home from church in Northern Virginia, I saw a sign that read, “ROUGH ROAD AHEAD.” Ya think? Here I imagined Buddhists writing the road signs with their idea that “life is suffering.”

Then there are the obvious signs. I saw a “WARNING — ALLIGATORS” sign as I put my kayak in the Hillsborough River outside Tampa. The authorities-that-be felt the need to put another sign right below: “NO SWIMMING.” Really? Who was thinking of swimming with the alligators? The people in Florida really are crazy.

 

I was a chaplain for a hospice in Ft. Pierce, Florida, which had a hospice house for patients to spend their last days. There were tables and benches on the grounds for patients, their families, and staff to take a break outdoors. Beside a nearby pond, there was a sign, “WARNING BEWARE OF VENOMOUS SNAKES.” Good Lord, these dying folks have enough to worry about.

Family calming ahead

The “TRAFFIC CALMING AHEAD” sign was on a quiet, tree-lined suburban street in Alexandria, Virginia. This sign was followed by one that said, “SPEED CUSHIONS AHEAD.” I’ve heard them called “speed bumps” or even “speed tables” but “cushions”?

My wife, Sally, and I were in town to attend a funeral for a friend who died after living with ALS for years. Sally had known his wife since before they were married. Over the weekend we twice visited the widow’s home — once the night before the funeral and then for a gathering afterward – and saw the signs.

As we drove to her home, the words on the sign morphed in my head to “FAMILY CALMING AHEAD.” Indeed, it was. The widow and her two college-age children welcomed mostly family into their home the night before the funeral. There was lots of hugging and laughter. The scene was repeated after the service with a larger gathering of friends, business colleagues, and more family.

The grief process can be a rough road for many, but these calming events in the first days are a good place to start the journey.

Randomness, Death, and Mystery… It’s Okay

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Do you ever do this while reading random obituaries?

I see some person, about my age, who died of cancer. I read on and see it was lung cancer. I’m relieved. Obviously, they smoked. I don’t smoke. I won’t die.

Then, I read, a healthy person about my age dies suddenly from an undiagnosed brain aneurysm. No warning. They just drop dead. A random chance occurrence like a victim of a mass shooting at a grocery store.

We humans look for patterns — for reasons “why.” Some find comfort in the idea (*SPOILER ALERT* — not me) that God is in control of everything and sends some people a quick, unexplained death.

There are no accidents… or not?

I conducted a graveside funeral service years ago as a hospice chaplain. A woman came up to me after the service and told me her story. “A couple of years ago, my eight-year-old son was playing on the swing set in our backyard,” she started. “He jumped off the swing, fell on his head, broke his neck and died instantly. In my grief someone sent me a card that said, ‘With God there are no accidents.’”

I thought (but didn’t say), What a horrible thing to tell a grieving mother. God killed your son. Before I responded, I studied her face to see if I could catch some glimpse of how she received this message. I didn’t have to guess. She told me, “Those words have been so helpful to me.”

I was almost speechless. This woman is a complete stranger and I have no pastoral relationship with her. I would never want to take away a word that was helpful to her. I must have said something like, “I am so thankful that was helpful to you. It must have been a horrible time.”

What do I know? The card may be right.

Everything happens for a reason?

Contrast this with best-selling author Kate Bowler and her book Everything Happens for A Reason: And Other Lies I’ve Loved. The book jacket describes her situation:

“At thirty-five, everything in her life seems to point toward ‘blessing.’ She is thriving in her job, married to her high school sweetheart, and loves life with her newborn son. Then she is diagnosed with stage IV colon cancer.”

Bowler is an academic who has studied the “prosperity gospel.” That would be the megachurch televangelists who teach that if you just believe hard enough (and make a contribution) only good things will come your way. In her research, she saw the downside of this belief is that when you’re thrown life’s random tragedies you are left feeling like a loser.

Do yourself a favor and watch her TED talk on YouTube. Over six million people have viewed this 15-minutes of wisdom. She has learned to live with mystery… with randomness… with not having a “reason.” And it is okay.

Don’t Say of Me, “He fought to the bitter end!”

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“Dad was a fighter. We never gave up on him!” they said to each other.

For me, it was one of the saddest scenes I had witnessed since I started working as a chaplain in 1983.

I must emphasize that my interpretation of this scene as being sad is my opinion. This entry is about how I want to be treated in the end…or not treated as the case may be.

Others do want to “fight to the very end” and I can support that. But this case seemed beyond all reason. You can decide for yourself.

On this particular day, I was in the emergency department waiting room with the family of one our nursing home residents who had been rushed to the hospital. The patient was riddled with cancer, literally. He had tumors breaking his skin in multiple places. His body was wasted.

Earlier at the nursing home, I sat with the wife outside the patient’s room while the paramedics were beating on the man’s chest. One EMT compassionately knelt by this woman to tell her that they did not have a pulse on her husband, but they were going to continue CPR and take him to the hospital. He said he was not hopeful that they could save the man’s life. He did an admirable job of breaking bad news.

When the ER doc came out to tell the family that they were unable to revive him they said to each other, “Dad was a fighter. We never gave up on him!”

Fighting battles

This story has so many things to unpack. Ethics. Compassion. Autonomy. “First, do no harm.” Surrogate decision-making. Moral distress of the professionals. Not to mention the patient’s adult children were not speaking to his wife, their stepmother. But I’ll focus now on the language of fighting to the bitter end.

“Keeping Away Death,” sculpture by Julian Hoke Harris, located near Grady Hospital in Atlanta.

We see it often in obituaries, “John died after a long battle with cancer.”

I’m sorry. In my view, this language makes John a loser. What a horrible thing to say about him. Everybody dies. In framing death as a battle lost, we ALL will be losers when it comes to the last act of our lives.

What does this say to the millions of us who read these words and feel ashamed when we have a disease which we know will kill us? We can only conclude, “It’s my fault I am dying.”

Did I allow too much stress to cause me to get sick? Did I not try hard enough? Did I lack faith?

Let me be clear. At this point in my life, if I get a fairly treatable cancer with a good prognosis, I will “fight” it, if you must use that language. I just do not like the battle metaphor when your enemy is death. Death is part of life not its enemy.

“He died peacefully…”

What got me thinking about this is a book I listened to recently as I drove from Oxford, Mississippi to Northern Virginia. Actually, it was two short books in one audio program — Susan Sontag’s Illness as Metaphor (1978) and AIDS and its Metaphors (1988).

What Sontag only barely mentioned in the more recent book was that she was being successfully treated for breast cancer when writing the earlier one and later “fought” and “defeated” uterine cancer. She finally died fighting a rare and very aggressive form of leukemia in 2004. And fight she did.

Her son, David Rieff, wrote a very moving memoir (Swimming in a Sea of Death) about what it is like for a family member to try to support a patient who was dragging herself through a painful dying in the false hope she would be cured.

If you must mention a cause of death in my obituary say, “He died peacefully while living with cancer” or “He died peacefully after months with palliative care and hospice.” Or, better still, “He didn’t give up, he let go and just let things be.”

Never Let a Good Plague Go to Waste

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“Come to terms with death. Thereafter, anything is possible.” —Albert Camus

First, I did. Then, I didn’t. Now I am back thinking about dying. Blame it on COVID…and my men’s group.

In a bygone era — say February or March — the word was people like me, 72 with asthma, were dying in greater numbers than others. Yet, some were going on ventilators and surviving. I told my wife at the time, “If I get COVID, try me on a ventilator for a while.” Then I updated my end-of-life paperwork and wrote a letter to my family about the disposition of my journals. Life got back to normal.… or what now passes for normal.

The news and I have shifted. Though you still hear stories of old people getting off vents and surviving, many do not. Some get off and face years of disability. There actually is some good news in the news, too. Docs are finding less aggressive ways to treat respiratory failure with some success. My new instructions — “No CPR and no vent for me.”

So, I am back to thinking about dying.

It really could happen in short order if I get COVID. And the men’s group? I have been in this group for 28 years. We meet every Thursday at 6AM Eastern time. We have decided to let each guy take a week and retell his life story. Revisiting my story has encouraged me to think like a hospice patient.

I’m going big this time thinking about dying — I’m in life review. Where have I been? What has been the meaning of my life? What is the purpose of human life? What are my regrets? I ask myself the question I have posed as a hospice chaplain to many dying souls: “If you were to die today is there anything that would be left undone?”

In 1585, Michel de Montaigne took his family and fled Bordeaux, France, where he was mayor, to avoid the bubonic plague. (How many mayors around the world today would like a vacation in the country right now?) His term in office was about to end and he had one last official duty in town, attending the transition ceremony. A recent piece in the New York Times continued, “He rode his horse to the city’s edge and wrote to the municipal council to ask whether his life was worth a transition ceremony. He did not seem to receive a reply and returned to his chateau. By the time the plague subsided, more than 14,000 people — about a third of the city’s population — had died horrible deaths. As for the former mayor, he returned to a far more pressing task: the writing of essays.”

He is now regarded as the originator of the modern form of literature we call “the essay.” Like any philosopher worth his salt, Montaigne contemplated death. Early on in my work with the dying, I kept finding him quoted in the literature on death and dying. He titled one piece, “To philosophize it to learn how to die.” Here’s an excerpt:

Knowing how to die gives us freedom

“To begin depriving death of its greatest advantage over us, let us adopt a way clean contrary to that common one; let us deprive death of its strangeness; let us frequent it, let us get used to it; let us have nothing more often in mind than death. At every instant let us evoke it in our imagination under all its aspects.… To practice death is to practice freedom. A man who has learned how to die has unlearned how to be a slave. Knowing how to die gives us freedom from subjection and constraint. Life has no evil for him who has thoroughly understood that loss of life is not an evil.” Michel de Montaigne, c. 1533-1595

Even before the plague, like anyone in the 16th century, he was quite familiar with death. Besides disease taking lives, Protestants and Catholics were killing each other periodically. It is curious to me that he even felt the need to encourage his readers to contemplate death. How could you NOT in a world surrounded by death? The human capacity to ignore or put off contemplation of death is huge.

I am convinced that I will never fully face my own death until I have a terminal diagnosis. Not only being given the diagnosis, but also having the felt sense in my body that I am checking out. But still, I am trying. COVID has helped move the process forward. I could die. I must be ready. I have decided not to let a good plague go to waste.

 

Photo by Veit Hammer on Unsplash

Life and Death as Metaphor – Part 2

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I continue to gather these quotes on life and death as metaphor. Most were found on the WeCroak app:

  • “Our life is a faint tracing on the surface of mystery.”  —Annie Dillard
  • For life and death are one, even as the river and the sea are one.”  —Kahlil Gibran
  • “Not success. Not growth. Not happiness. The cradle of your love of life … is death.”  —Stephen Jenkinson
  • “Life is a spark between two identical voids, the darkness before birth and the one after death.”  —Irvin D. Yalom
  • “Life is a succession of misunderstandings, leading us on to the final truth, the only truth.”  —Roberto Bolano
  • “We only get to be in our bodies for a limited time, why not celebrate the journey instead of merely riding it out until it’s over?”  —Jen Sincero
  • “Yet, in a bizarre, backwards way, death is the light by which the shadow of all of life’s meaning is measured. Without death, everything would feel inconsequential, all experience arbitrary, all metrics and values suddenly zero.”  —Mark Manson
  • “Death is our friend precisely because it brings us into absolute and passionate presence with all that is here, that is natural, that is love.”  —Rainer Maria Rilke
  • “Life’s but a walking shadow, a poor player, that struts and frets his hour upon the stage, and then is heard no more.”  —Shakespeare

Life and Death as Metaphor

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I am a collector of quotations about life and death. (BTW, I found a great source for these in an app called WeCroak.)

I was reading through my collection the other day and noticed many of the quotations contained metaphors for life and death. Here are a few of my favorites:

  • “Our lives are as bubbles in boiling water, which appear, rise to the surface, pop, and disappear.”  —Leo Tolstoy
  • “No matter how much you’ve been warned, Death always comes without knocking. Why now is the cry. Why so soon? It’s the cry of a child being called home at dusk.”  —Margaret Atwood
  • “Another way to get a sense of your life moving continuously towards death is to imagine being on a train, which is always traveling at a steady speed—it never slows down or stops, and there is no way that you can get off. This train is continuously bringing you closer and closer to its destination: the end of your life.”  —Sangye Khadro
  • “Death is the sound of distant thunder at a picnic.”  —W.H. Auden
  • “Death is not waiting for us at the end of a long road. Death is always with us, in the marrow of every passing moment. She is the secret teacher hiding in plain sight. She helps us discover what matters most.”  —Frank Ostaseski
  • “Dying is a wild night and a new road.”  —Emily Dickinson

Photo by Paul Jarvis on Unsplash

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