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Archive for the ‘Emotional & Spiritual Issues’ Category

The Vietnam War and the Wall of Grief

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The lone figure of a man at sunrise leaned in and touched a name. Was this a daily or weekly ritual? Was it the first time or one of many? Why at first light?

I had come to the Vietnam Veterans Memorial in Washington with my own agenda. I wanted to film one of my “Hank’s Deep Thoughts” videos at dawn. I was hoping to beat the crowds, and I like how the early morning light brings long shadows.

I was here to ponder how one place can hold so much grief and healing.

The Vietnam War, to me, was personal. I had come of age as my friends were going off to war. Mass demonstrations, draft card burnings, and men fleeing to Canada marked the era. The war drove one president from office and marred the legacy to two others. I got my draft induction orders in 1969 but was spared from service by staying in college and getting a high lottery number.

The Wall of Grief

By chance, I ended up with a backstage view of the design of “The Wall,” as it has become known. It was a long and winding road for me from Gainesville, Florida, through Louisville, Kentucky, and Macon, Georgia to therapy group in a church on Embassy Row near Dupont Circle in D.C. We all came to the group with our own issues and often reminded each other, “We’re all Bozos on this bus.”

Hank asked his friend who was not in the group, David Wear, to draw the therapy group motto, “We’re all Bozos on this bus!”

One of the group members was an artist and Vietnam vet who submitted a design for the memorial. His was one of 1,421 designs entered in the competition to honor more than 57,000 Americans who died in a war that divided the nation.

The winning design came from a 21-year-old architecture student from Athens, Ohio, Maya Ying Lin. Her idea was quite simple: Two polished black granite walls below ground level forming a V-shape in the earth. The names of the dead and missing were each listed in chronological order — 1959-1975.

A firestorm of opposition to the design quickly arose. The artist-vet, of course, felt his idea of showing soldiers’ courage in battle was better. Others said the black of the wall was the color of shame. They saw it as a “wall of shame” — a ditch in the ground. Lin’s view was that it represented a gash, a wound in the earth that needed healing.

A place of grief and healing

It turns out her idea was masterful. The Wall has become a place of reflection and healing, a public place to grieve privately. Annually, millions walk the path by the wall in silence, as if in a sacred space — indeed it is. Grown men weep as they touch the name of a fallen comrade. Children visit the names of fathers they never knew.

That lone man who touched the wall silently at dawn — what’s his story? I don’t know. It was too private of a moment for me to interrupt. He walked past me into the morning light.

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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.

Just Plain “Thank You” Period

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[NOTE: This is an update of a blog first published in 2013.]

Can we be overwhelmed with gratitude but have no need to thank anyone or anything?

This question came to me as I finished the last pages of Wild: From Lost to Found on the Pacific Crest Trail by Cheryl Strayed. This 2012 memoir was reviewed in The New York Times and made into a movie starring Reese Witherspoon in 2014.

She took her grief on a 1,100-mile backpacking trip

The story is about loss and backpacking, two abiding interests in my life. I’d probably write favorably of anyone who takes their grief on a 1,100-mile backpacking trip. Cheryl Strayed did and wrote about it.

Strayed has an abusive father, her beloved mother dies prematurely, and her stepfather and siblings later drift away. After Strayed’s destructive behavior ends her marriage and leads her to addiction, she decides to hike the Pacific Crest Trail, inexperienced and alone. She encounters the elements, animals, people, and her own demons and angels on her months-long journey.

Reese Witherspoon in the movie version of “Wild”

I have never attempted long-distance backpacking. The most I have ever lasted was four nights. So, I only have a hint of what Strayed went through on her arduous journey. I met many through-hikers on the Appalachian Trail within a half-hour of my home in Virginia. The people I met on the AT had completed one thousand miles on their way to Maine, another thousand miles to the north. Strayed’s stories of the people she hikes with for a few days at a time ring true.

In the end, GRATITUDE was the feeling at her core

At bottom, Strayed’s story is about her spiritual journey to emotional wholeness from what was once the wreck of her life. She never portrayed herself as a religious person in any sense of the word. But, in the end, gratitude was the feeling at her core.

There are many moving passages in the book, but I was caught by one line on the next-to-last page of the book. Cheryl touches the bridge on the Columbia River, the site at the end of her journey. She walks back to an ice cream stand to buy herself a treat with the last two dollars she has to her name. She enjoys her ice cream, chatting with a lawyer from Portland who stops for ice cream, too. She says goodbye to him and

“I leaned my head back and closed my eyes against the sun as the tears I’d expected earlier at the bridge began to seep from my eyes. Thank you, I thought over and over again. Thank you. Not just for the long walk, but for everything I could feel finally gathered up inside of me; for everything the trail had taught me and everything I couldn’t yet know, though I felt it somehow already contained within me.”

Religious types thank God. Others thank a “higher power” or “the universe.” Strayed felt no need to tell us who the “you” was in her “thank you.” In my life-long quest to understand the spiritual journey, I have never encountered a simpler yet profound expression of gratitude for being a recipient of the graciousness of life. Most of the dying people I met in my 30 years as a chaplain had that same humility and gratitude.

Thank you.

Just “thank you,” period.

Cheryl Strayed ends her book acknowledging the truth I try to capture in my poem “Giving Up, Letting Go, and Letting Be” with the words,

“How wild it was, to let it be.”

Thank you,

Hank

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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.

 

The “Serenity Prayer” Both In and Out of Jail

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What word could I possibly bring to the men in jail? That was the question.

Each Wednesday afternoon, I join three other men from my church, and we sit in silent meditation with a group of inmates. These men at the Lafayette County Detention Center are awaiting trial or sentencing or transfer to another, more “permanent” place of incarceration.

Prayer on Alcoholics Anonymous medallion

Both our leaders were going to be out of town, and so leadership had fallen to me. We always start the group with a reading, usually from the Psalms. Surely, the psalms of lament ring true to those behind bars — “My God, why have you forsaken me?”

I could have defaulted to the oft-quoted and ever-favorite Psalm 23, “The Lord is my shepherd,” but I wanted to go a different route.

I have no idea what it is like to sit in jail. Guilty or not, these men face uncertain futures and life challenges of which I know nothing. The “Serenity Prayer” came to mind. Long a favorite of those in A.A., this simple prayer has given guidance to alcoholics and addicts for generations. Heck — it has given me guidance.

Originally, it was written as a prayer for worship at a small Christian congregation in Heath, Massachusetts, in the 1930s. Theologian Reinhold Niebuhr wrote it as part of a sermon for his flock. The most common version is just three lines asking for “serenity,” “courage,” and “wisdom.” I included these words in my book, Hard Choices for Loving People, to help those facing the end of life.

In the full prayer below you can see the influence of eastern thought with suffering as a “pathway to peace” and accepting the world “as it is.” This reminds me of the current cliché, “it is what it is.” These are words for all of us, jailed or free.

Here is the complete prayer:

Prayer for Serenity

by Reinhold Niebuhr

God, give us grace

to accept with serenity the things that cannot be changed,

courage to change the things which should be changed,

and the wisdom to distinguish the one from the other;

living one day at a time, enjoying one moment at a time;

accepting hardship as a pathway to peace;

taking, as Jesus did, this sinful world as it is,

not as I would have it;

trusting that You will make all things right if

I surrender to Your will;

so that I may be reasonably happy in this life and

supremely happy with You forever in the next. Amen

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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.

 

The “Thin Places” Between the Physical and the Spiritual

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Do you ever notice how often people post photos of sunrises or sunsets on social media? “Inspiring,” they say. Or the religious types write, “Good morning from God.”

In my personal photo collection, I have scads of dawns and dusks. Sunrise in the swamp. Sunset from a mountaintop.

Then there was the sunrise etched in my memory when I found myself without a camera. I spent the night alone on a platform in the Blue Ridge Mountains in North Carolina. It was chilly, so I braced myself against the cold covered up in my sleeping bag. At first light, I sensed something special was about to happen.

Indeed, it did. I sat up with a start and looked east. Moments before the sun inched above the distant ridge of mountains, a deep purple line separated the night sky from the ridgeline. It couldn’t have lasted more than a few minutes. I had never seen such a beautiful mountain dawn before. I haven’t since.

The “Thin Place” between physical and spiritual worlds

Iona Abbey, Scotland

That mountain was a “thin place.” The term is used to describe places of sacred power, where the separation between physical and spiritual worlds seems “thin.” There are sermons about thin places, like in the story of the Transfiguration.

In that story, Jesus shines with bright light on a mountaintop before his disciples. The mountain becomes a symbol of the meeting point between humans and God – between the physical and spiritual – with Jesus representing the connection between both worlds. Long before cameras or social media, Peter wanted to capture the moment and build three shrines to contain this heavenly appearance. Jesus would have none of it.

Thin places are most often associated with spiritual retreats, like the Scottish island of Iona, which I visited while on a Celtic Christianity pilgrimage. Being in places like this invites thoughts of things spiritual.

Hank’s “thin place” – campsite on The Big Schloss

There’s also a thin place, for me, on The Big Schloss, a rock outcrop on the Virginia-West Virginia border. I have probably spent thirty nights sleeping near the peak of this mountain, watching the sun rise and set. My children slept up there with me. We saw Halley’s comet there.

Even atheist author Sam Harris speaks of his own thin place experience. In his book, he describes how he was touched by a walk in Jesus’ footsteps. This happened on “an afternoon on the northwestern shore of the Sea of Galilee, atop the mount where Jesus is believed to have preached his most famous sermon,” Harris writes. “As I gazed at the surrounding hills, a feeling of peace came over me. It soon grew to a blissful stillness that silenced my thoughts. In an instant, the sense of being a separate self — an ‘I’ or a ‘me’ — vanished.” (Waking Up: A Guide to Spirituality Without Religion, p. 81)

“Thin Moments”

Photo by RODRIGO GONZALEZ on Unsplash

There are also “thin moments,” or moments in time that are transformed into a spiritual experience. In an earlier blog, I wrote about my sense of connection with others at the post office the first time I wore a mask inside. I quoted the monk (and sometimes hermit), Thomas Merton, and his sense of connection to all the busy shoppers at an intersection in Louisville.

Photo by Filip Mroz on Unsplash

More thin moments: Gazing into the face of an infant who is smiling for the first time. Walking outside at night and hearing an owl or a whip-poor-will. Listening to music that moves you. Then of course, there is always watching those sunsets and sunrises.

Thin moments could happen more often if we just paused long enough or weren’t so distracted or busy taking pictures to post. We don’t have to be at the top of a mountain or by the seashore. The promise from scripture is, “I am with you always.”

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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.

Our Struggle with Dying Starts When We’re Toddlers

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[Adapted from a chapter in Light in the Shadows by Hank.]

“This is where our struggle with dying starts,” was my first thought.

“Putting It Together”, J.D. Hillberry www.jdhillberry.com

Many summers ago, I was wandering through an arts festival in Crested Butte, Colorado, when I came across the works of an artist who made pencil drawings. I was fascinated by a sketch he had made of his two-year-old son, depicting him as an unfinished jigsaw puzzle.

The child is looking down at his hand, which appears to be emerging from the flat surface of the paper. There is a puzzle piece in his grasp. He is searching for the place where that piece of himself fits. The artist titled the picture “Putting It Together.”

This memory of that Colorado summer came as I am now, once again, hanging out with a toddler and his infant sibling. This is my third tour of duty caring for little humans. First, there were my children. Later, I provided daycare once a week for two of my grandchildren through their early years. Now, we occasionally watch a friend’s two sons, who are 18 months and four months old.

Toddlers and the “Denial of Death”

I was watching my two grands after reading Ernest Becker’s Pulitzer-Prize winning

Hank’s grandson learning control at the light switch

book, The Denial of Death. Now, under the influence of these two new little ones in my life, I am rereading Becker. His main thesis is that the prospect of death is THE driving force in human behavior. Both the building of our individual ego or self and our culture’s attempt to shield us from the horror of death’s finality. Here’s a sample:

“[A child] avoids [despair] by building defenses; and these defenses allow him to feel a basic sense of self-worth, of meaningfulness, of power. They allow him to feel that he controls his life and his death, that he really does live and act as a willful and free individual, that he has a unique and self-fashioned identity, that he is somebody.… We don’t want to admit that we are fundamentally dishonest about reality, that we do not really control our own lives.” (Ernest Becker, The Denial of Death. p 55.)

Play and learning to take control

The toddlers in my life have shown this behavior. I remember my grandson discovering the light switch. I would stand him on a chair, and he would play with the switch. He would flip it up and then jerk his head toward the ceiling to see the light appear. Then, down and the light goes off. His actions were affecting his environment.

Hank’s granddaughter and the “singing bowl”

Let a child play with a musical instrument. My grandchildren both loved to bang on the piano or hit my singing bowl with the mallet. Any noise accomplished their unconscious goal of finding out they could influence the world around them.

Even the delight I recently observed of our friend’s toddler playing with the garden hose in our backyard revealed a growing sense of self. He put his fingers in the nozzle and felt the water. He found he could direct the flow of water into the air or on me. He was gaining control.

Fortunately, gaining control of one’s life can be beneficial to everyone concerned. Eventually, the child learns that studying improves your grades. Exercise makes you feel better. Treating people kindly encourages them to return the kindness.

Even toward the end of life we can practice some control, choosing to seek a cure for a terminal disease or focus more on easing physical and spiritual pain.

Letting go of the illusions we created

Third tour of duty with little humans

Every child makes their own progress toward gaining a feeling of control. This positive self-image that gives us a sense of meaningfulness, safety, and stability, allows us to grow and thrive. What is truly happening is that WE are creating this ego with the material that is handed to us genetically and emotionally. If we do the job adequately, we can live a life enjoying emotional and spiritual health.

So why did the sketch of the child make me think, “This is where our struggle with dying starts”? One day, in the last phase of life, all this meticulously constructed personality we spent our whole lives creating is revealed for what it is — a mask. The root meaning of the words “person” and “personality” is from the Latin persona, a mask worn by actors in a play.

Last week I wrote about dying without illusions. Watch a toddler and see those illusions being created.

 

 

Dying Without Illusions: A Tribute to Susie De Porry

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[NOTE: Hank wrote this tribute in 1995 when he was chaplain at the Fairfax Nursing Center, Virginia.]

She died with no family around. No wealth. Few possessions. No children, grandchildren, or great-grandchildren. She was never married. No obituary in the Washington Post. Not even a death announcement. The world will not miss her. Few will grieve her passing save for her niece, brother, and sister.

And yet, she died without illusion.

She was just a lovable human being

Susie

Susie De Porry was one of the wonderful souls who had graced our lives at Fairfax Nursing Center. There was no brighter smile. There was no one more enthusiastic about rides and activities. There was no one more devout in the practice of her faith. And no one more content to sit and read for hours.

She had a special place in the hearts of those of us who cared for her. Maybe it was because she had no family living nearby. We were almost all she had. But more than that, she was just a lovable human being.

She was born in New York City in 1903. Her father died while Susie was quite young. She studied music, including some training in France. Susie delighted in telling of her time on the Continent and playing the organ at the Notre Dame Cathedral in Paris. She taught music but mostly cared for her aging mother and other elderly people. After her last client died, Susie moved directly into a home for adults in Vienna. Two years later, in 1986, she came here to the nursing home.

During her last days and hours, several of us spent some special time alone with Susie. She was barely responsive. She would hold my hand. I wasn’t sure she recognized me. Though at one moment, she looked at me and smiled. I asked how she was feeling, and she said, “I’m doing fine.” Those were the last words I heard her say.

She is more heroic than most of us

As I sat next to her only hours before she died, I could not help but try to gain some sense out of Susie’s life and death. Susie’s story is not tragic at all. In a sense, she is more heroic than most of us. She was free from the illusions most of us work at gathering during our lifetimes. We work at accumulating financial resources, excelling in our careers, or perpetuating our lives through our children and grandchildren.

Susie De Porry had none of the above. She was just Susie. Alone she approached the ending of her mortal days. Alone and without illusion.

I will have to make a conscious decision to see myself in this light. It would be an illusion to see myself as anything but one man passing from a human race that spans millennia in length and billions of people in width. Susie taught me that this could be done and done quite serenely.

Thanks, Susie.

“God has told me my wife is not going to die!”

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“God has told me my wife is not going to die!” That’s how my new hospice patient’s husband greeted me.

The nurse warned me that this was coming. The patient had breast cancer that had metastasized to the bone — a usually fatal prognosis.

Photo by National Cancer Institute on Unsplash

He went on to say, “I don’t want any talk about death or dying, only hope and healing.” Months before, I was asked not to return to a home where I had pushed a family to discuss possible death before they were ready.

I was wrong then, and I did not want to blow it again. As a chaplain, I was a guest in their home, so I would abide by his rules. I did say that if the topic of death came up, I would pursue it but would leave it up to them to introduce it. Until then, hope and healing.

Hope and optimism are all around us

There is hope at weddings. I have led many couples to repeat the phrase, “Till death do us part.” One pair deleted this phrase from their vows. It was his third marriage and her second. Another bride asked me to remove, “for richer, for poorer.”

The couples who didn’t edit their vows were being optimistic. The truth is half of all marriages end in divorce.

There’s hope in business. Would entrepreneurs start new ventures if they were not hopeful? Sure, they have a business plan and capital. Yet, there has got to be some self-deception, a bit of hopefulness in the face of long odds.

People who study such things call this self-deception the optimism bias. “The optimism bias is defined as the difference between a person’s expectation and the outcome that follows. If expectations are better than reality, the bias is optimistic; if reality is better than expected, the bias is pessimistic.”

Diversifying hope

It turns out optimists are happier and live longer than pessimists. I wrote in a previous blog about how the self-deception of the placebo effect can take away pain. With these kinds of benefits, so what if an optimist’s expectations are better than reality?

The Journal of the American Medical Association recently published an opinion piece, “Holding Hope for Patients With Serious Illness.” It is about doctors who encounter patients or family members who are hopeful for a happy outcome in the face of a fatal illness. What do they do? They don’t take away the hope but diversify it. Here is their summary:

“How can clinicians help patients hold multiple hopes? One approach may be to ask patients what they have heard about their prognosis from their clinical team. Patients could then be asked, ‘Given what is coming, what are you hoping for?’ It is not necessary to contest the answers nor convince patients to consider other futures. Instead, the clinician could acknowledge the response and ask, ‘What else are you hoping for?’ And then again, ‘What else?’ The point is to help patients balance and diversify their hopes, providing flexible future directions and possibilities.”

“Satan is trying to get me to doubt it.”

I stumbled onto this idea of diversifying hope on my own with the husband who heard a message from God. As I arrived for one visit, he was about to leave for work. He said, “Hank. You know how I said, ‘God told me my wife is not going to die’? Well, I still believe that, but Satan is trying to get me to doubt it. Would you pray for me?” I said I would, and he left.

I turned to the wife, who had just found out the cancer had spread to her liver. “Do you have as much confidence as your husband that you will not die?” She burst into tears and said, “I am afraid if I die, my husband will be disappointed in me.” My heart sank for them both.

Photo by Gus Moretta on Unsplash

On the next visit, I sat with the two of them. I told the husband about my conversation with his sick wife. He immediately got up from his chair, took this poor woman’s hand, and said, “I would never be disappointed in you. You have done all you can to fight this.”

I told them I had two concerns about people in their situation not contemplating the possibility of death. One was some people, believing a patient is not dying, refuse narcotics for extreme pain. (This was not the case with these two.) My other concern was that they might miss some crucial conversations. Conversations about their love for one another, saying good-bye, or finding ways to live fully in the limited time she had left.

The couple assured me they had been doing that, too. They were still hoping for a cure, but they also hoped for enough time to say all that needed to be said. They hoped for freedom from pain by accepting pain medication.

They had already diversified their hopes.

Aging as a Spiritualizing Process — Part Two

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The aging Presbyterian minister prayed, “…God, forgive us for our anger when the nurses do not answer the call bell. And for our annoyance when the food is cold. And for…” This went on for a few minutes. OH MY.

I thought it was a good idea. I was preparing to lead the nursing home’s Sunday morning worship service. I asked one of the residents, Horace, to give the morning prayer. He had pastored for well over 50 years and even performed a wedding for a nurses’ aid while he was a resident. Always the pastor.

So, I stood next to his wheelchair and handed him the wireless microphone at the proper time. He started well enough, “Dear Lord,” followed by some nice things to say about the day and the good Lord. Then the more honest prayer kicked in.

This was not what I had planned.

Then again, I had no idea what it was like to be so dependent on others, especially when those others let you down.

Aging forces us to grow spiritually

Last week, I started exploring “aging as a spiritualizing process.” My plan this week was to unpack an article in theJournal of Religion & Aging on this very topic. I first read that article around the time of the above-mentioned “honest prayer.”

That piece, “Aging as a Spiritualizing Process,” suggests that aging forces some spiritual practices and virtues on us that we should have learned years before. Here are a few bullets from that article:

  • Doing vs. Being: When physical limitations restrict our activities, we finally learn this lesson of the importance of just “being” rather than always “doing.”
  • Contingency: Intellectually, we all know we are going to die. As we age and more of our contemporaries die, it starts to sink in that this fact of death is beyond our control. We “take nothing for granted—thankful for even the next breath.”
  • Enfleshment: Aches, pain, and disabilities bring home the most basic Hebraic biblical understanding that “We do not have a body, we are a body.”

Not Pollyanna

This is no “Pollyanna approach” to aging and disability — no unflagging optimism, no “let’s see what we can be glad about.” And that’s okay. We can also express the honesty of my friend, the praying pastor, who was having trouble with the tardiness of nurses and cold food. Elisabeth Kübler-Ross did list “anger” and “depression” as aspects of dying.

No one put this more eloquently than Flannery O’Connor, the great writer of Southern fiction, who suffered from lupus for 13 years before she died at age 39 in 1964:

“I have never been anywhere but sick. In a sense, sickness is a place, more instructive than a long trip to Europe, and it’s always a place where there’s no company; where nobody can follow. Sickness before death is a very appropriate thing and I think those who don’t have it miss one of God’s mercies.”

Aging as a Spiritualizing Process — Part One

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“Growing old is no good,” the 95-year-old nursing home resident told me. I asked her when it got to being “no good.” She thought for a moment and then said, “About 80.”

“What made it ‘no good’ at that time?” I wanted to know. Without hesitation she said, “When I couldn’t do things for myself anymore.”

I told her daughter of this conversation and she said, “Oh yeah, it was about that time I came into her home, and she was standing on the kitchen table changing a light bulb in the ceiling fixture.”

This resident perfectly summarized the fear of aging; the issue is really the loss of independence. Who wants that? But decline and dependence is the future for most of us, except for the few who will die suddenly while still active.

The minister’s role of “presence and witness”

That conversation, which I also recount in my book, happened over thirty years ago. The young(ish) chaplain who heard those words is now part of the “elderly class.”

So I thought of my own elderly status and that long ago conversation as I read a recent article from Kaiser Health News, “Minister for Seniors at Famed Church Confronts Ageism and the Shame It Brings.”

Rev. Lynn Casteel Harper of the Riverside Church in New York City, sees her role with congregants in their decline as one of “presence and witness.” “Sometimes if people are going through really difficult experiences, especially medically, it’s easy for the story of the illness and the suffering to take over,” Rev. Harper said. “Part of my role is to affirm the other dimensions.”

Harper is right — it’s about presence. I found it was the same in ministering to nursing home residents and hospice patients. I could not take away the pain of loss of independence. I could not lighten the heavy weight that serious illness put on my patients’ psyches. But I could be present.

It was, in a way, easy. I just had to show up.

Acceptance of death without fear — why wait?

I was drawn to another of Harper’s comments. Yes, old folks do worry about what their last days will be like — whether there will be suffering. But she “rarely encounter[ed] a fearfulness about what will happen when someone dies.”

This acceptance of death without fear is common. It may or may not have a religious element to it but, in general, those approaching death have reached a degree of serenity. Acceptance without fear.

I say this acceptance is a spiritual process whether one expresses it in religious terms or not. In a sense, aging forces this spiritual acceptance upon us all. We could do it earlier in life, and many do, but toward the end, after losing independence, we tend to accept and just let things be.

If we could learn how to accept the certainty of death earlier in life, our whole life could be more peaceful. Growing old forces this spiritual practice upon us. This is just one facet of aging as a spiritualizing process.

The Health Risks of Loneliness

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“Oh. It’s the chaplain. How nice,” she greeted me as I entered her room at the nursing home. Mable was often alone in her room by choice. She was blind and over 100 years old.

This is the same Mable from my book, who, when I asked her, “How do you live to be 102?” responded, “Just keep breathing!”

I thought of Mable as I listened to a recent GeriPal podcast titled “Loneliness and Social Isolation: Podcast with Carla Perissinotto and Ashwin Kotwal.” (“GeriPal,” as in, Geriatrics and Palliative Care.)

As I said, Mable was often alone in her room, isolated. But was she lonely? I don’t recall if I ever asked her. The researchers on the podcast did point out that some elderly folks may be isolated but not lonely.*

Listening to the podcast, one particular visit with Mable came to mind. When I walked into her room, she was in bed, her eyes closed. I gently touched her hand and quietly said her name, “Mable.” She opened her blind eyes suddenly, startled.

“I didn’t mean to scare you,” I assured her.

“That’s okay. I was in my dream world,” Mable said.

“What’s it like in your dream world?” I asked.

“It’s wonderful!”

A couple of quotes from the podcast:

“Loneliness is different than isolation and solitude. Loneliness is a subjective feeling where the connections we need are greater than the connections we have. In the gap, we experience loneliness. It’s distinct from the objective state of isolation, which is determined by the number of people around you.” – Vivek Murthy, two-time (and current) U.S. Surgeon General.

“Loneliness and isolation…are linked with pretty serious health outcomes.… [We] demonstrated that over a six-year period, people that reported higher rates of loneliness had higher risk of dying, 45% increased risk of dying, and 59% increased risk of loss of independence and functional decline, outcomes that are significant and important to our patients.”

Fighting Covid AND loneliness

Photo by Hank Dunn, Fairfax Nursing Center

Now keep in mind, the researchers completed their findings BEFORE the pandemic. COVID made their research even more relevant. Nursing homes kept residents in their rooms, and facilities were closed to visitors to prevent the spread of the virus. This isolation may have reduced deaths by COVID but, perhaps, invited death by loneliness.

There must be a better way to mitigate the risk of both these health threats. Yes, we need to avoid the spread of COVID among residents and staff. And, so too, loneliness.

*“Loneliness in Older Persons: A Predictor of Functional Decline and Death,” JAMA Internal Medicine; July 23, 2012. “The epidemiology of social isolation and loneliness among older adults during the last years of life, ” Journal of the American Geriatrics Society; July 11, 2021.

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