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Archive for the ‘Emotional & Spiritual Issues’ Category

“He coded, but God brought him back to us!”

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Can we “know” what God wants?

His last days were filled with great suffering, played out publicly on social media and in the national news from March until his death on May 19th. Here are the descriptions of the patient’s condition in the last weeks of life:

  • April 26th, GoFundMe post: “He has now lost 80 pounds and subsequently continues to struggle with extreme weakness.He’s on strong IV antibiotics three times a day.… He has intermittently also suffered [from] kidney issues and [has] been on dialysis. In addition to this, he is having heart and lung concerns, sores from being in bed for 4 months and depression.”
  • April 30th, Facebook post: “He was admitted to the hospital tonight with acute kidney failure and dehydration.”
  • May 9th, Facebook post: “He will be having emergency surgery tomorrow. Still in ICU fighting the infection and organ failure.”

Later, his wife refused to withdraw life support, claiming on Facebook, “He’s a fighter, and his will is strong even if his body isn’t. God is our hope.”

What does God want in a VERY serious illness?

Can we know what God wants? I was drawn to this story reading the pleas for people of faith to pray for a miracle when one could read between the lines and understand that this man was dying.

Let me be clear: If I were the chaplain in this story, I would approach this patient and his family compassionately and without judgment. As their chaplain, my role would be to meet this family where they are, not where I want them to be.

But I was not their chaplain and now have the luxury of pondering this situation from afar after it ended.

Is God ONLY for saving a life?

I find many things curious about the language and theology expressed publicly.

  • Let’s start with an earlier GoFundMe post from March: “He coded, but God decided that it was not his time to go and brought him back to us.” Evidently, the patient’s heart failed, yet he continued to live after the intervention of CPR.

The family saw this as a sign of God’s intervention. The skeptic might say, “God did not decide the patient should not die during that code. Human intervention went against what seemed to be God’s plan.”

Who am I to say God did or did not intervene? I stopped speaking for God years ago.

I believe it is a slippery slope to claim that God is saving the life of someone in multiple system failure when the death expectancy rate for all of us is 100%.

Perhaps “God called him home?” Acceptance or crisis of faith?

There is another way people of faith might approach such circumstances. Other families I have ministered to chose to forgo heroic medical interventions. When the patient died, they said, “God called them home.”

I am guessing that this patient’s wife probably accepted “God’s timing” when her husband finally died. I hope that is true. People who feel God is in control of everything can often shift to acceptance when death eventually occurs.

But for some who expect a miracle, death can cause a crisis of faith. I wrote about this in a previous blog, “God has a lot of explaining to do.”

What is keeping this patient alive? The machines or God?

  • May 7th, Update! “The doctors are continuing to try and prepare me for the worst. And I continue to explain to them that [we] are people of faith and that our God has the final say. I am not in denial about what’s happening to him or blind to what the medical reports say…. I just know that the God I serve is greater than any infection and more powerful than any organ failure.”

There would have been a time long ago when death was not optional. Antibiotics and other medical interventions can now cure many who would have died in another time and place.

These same modern medical treatments can also prolong the dying process, sometimes at the cost of great pain and suffering for the patient.

Other hopes besides “not dying”

I try to help families see that there are other outcomes to hope for other than “not dying.” Having a peaceful death, being pain-free, or spending quality time with family. This is what I did with the man who told me, “God has told me my wife is not going to die.”

I don’t know how the end came for this man. I only saw the announcement of his death and an obituary in the New York Times, after which the Facebook and GoFundMe pages went silent.

Hopefully, all involved, living and dead, are now at peace.

[Cover photo by Richard Catabay on Unsplash]

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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.

Finding Meaning in Suffering is Difficult — But Can be Done

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Why do terminally ill patients choose to end their lives early?

As I have done for the last 25 years, I quickly opened the most recent annual “Oregon Death with Dignity Act: 2022 Data Summary.” Yes, it has been 25 years since Oregon made “medical aid in dying” (MAID) legal. At the time, this was often referred to as “physician assisted suicide” (PAS). In Oregon, and other jurisdictions, a physician can prescribe a lethal medication for terminally ill patients who request it and who appear to be within six months of dying. There are safeguards to assure patient safety and to address other concerns.

For 25 years this list has been part of my lectures

My interest, each year, is drawn to the list of “End-of-life concerns.” I added this list to my lectures and writings as I went about the country speaking on making end-of-life decisions. These responses are the answers to the question, “Why did the patient want MAID?”

Photo by Claudia Wolff on Unsplash

Of the seven “concerns” listed, “Losing autonomy” is mentioned by 90.3% and “Less able to engage in activities making life enjoyable” is second at 90.0%. Next to last is “Inadequate pain control, or concern about it” (28%). You would think that pain would be one of the main reasons people want to end their lives sooner — to avoid pain. (See below for the whole list.)

The piece that has made it into my lectures and writings is the concern about “losing autonomy.” Understandably, people want to be in control. I am all in for controlling the things that can be controlled like physical pain. We often think about “pain and suffering” as two related issues as in, “Pain is inevitable, suffering is optional.” Suffering is the emotional and spiritual struggle that can accompany pain.

Seeking autonomy and avoiding suffering

At the risk of over simplifying, these patients are choosing an early exit to avoid suffering. Their greatest fear is losing the ability to make autonomous choices. I honestly do not know what I will do when I face my last days, so I have no judgement of these patients who hasten their deaths.

I have never lived in nor worked in a jurisdiction that allows for MAID. A few times, I ministered to a patient who was considering suicide. We asked, “What is it that makes you want to end your life?” We found that once we addressed their concern, be it pain or care of the family, the patient no longer wanted an early exit.

I write this on Good Friday, as Christians remember the sufferings of Jesus. Over the centuries Christians have found meaning in His death. Reducing pain and suffering in dying patients can be pursued while, at the same time, looking for ways to find meaning in the midst of suffering.

Here are some quotes I have gathered to share with you to make sense of suffering, and hopefully prepare both you and me for own future suffering.

  • “Suffering is the state of severe distress associated with events that threaten the intactness of person.” Eric Cassell, MD. The Nature of Suffering and the Goals of Medicine
  • “If there is a meaning in life at all, then there must be a meaning in suffering. Suffering is an ineradicable part of life, even as fate and death. Without suffering and death human life cannot be complete.… Suffering ceases to be suffering at the moment it finds a meaning, such as the meaning of a sacrifice.” Viktor E. Frankl (1905-1997) Holocaust survivor and author of Man’s Search for Meaning
  • “Our avoidance instinct is also due to the fact that our culture has decided that suffering has no value.” Frank Ostaseski, Buddhist teacher and founder of the Zen Hospice Project
  • “You must remember that no one lives a life free from pain and suffering.” Sophocles (497-406 BCE)
  • “Whoever got this idea that we could have pleasure without pain? It’s promoted rather widely in this world, and we buy it.” Pema Chödrön, Tibetan-Buddhist teacher and author.
  • Flannery O’Connor

    “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.” Flannery O’Connor (1925-1964) died after living 13 years with Lupus.

  • “The idol of control holds out to us the hope that suffering and death can be eliminated. If we just get smart enough, we will gain control of pain and even of death. That false hope, in turn, has the effect of setting suffering up as an enemy to be avoided at all costs. We can choose never to suffer!” Elaine M. Prevallet, S.L., Benedictine Nun
  • “Terry, dying doesn’t cause suffering. Resistance to dying causes suffering.”  Terry Tempest Williams quoting her dying mother in the book Refuge.

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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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End-of-life concerns                                                                                 Number (%)

  • Losing autonomy                                                                     2,216 (90.3)
  • Less able to engage in activities making life enjoyable    2,208 (90.0)
  • Loss of dignity                                                                           1,666 (71.7)
  • Burden on family, friends/caregivers                                   1,179 (48.0)
  • Losing control of bodily functions                                         1,077 (43.9)
  • Inadequate pain control, or concern about it                         686 (28.0)
  • Financial implications of treatment                                           125 (5.1)

How Come so Much Aggressive End-of-Life Care?

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Photo by Vidal Balielo Jr. via Pexels.com

The man was riddled with cancer. The paramedics continued CPR as they wheeled him out of his nursing home room. I drove his wife to the emergency room. This is what the family wanted, although I am not sure the patient would have chosen it. When the doc came to the waiting room to tell the family he died, they congratulated themselves on “trying everything.”

Sadly, aggressive care in the last days of life is all too common. Perhaps, my experience with this patient was an extreme example. Aggressive care can include an ICU stay, surgery, chemotherapy or radiotherapy. New research shows that about 60% of elderly Americans with metastatic cancer receive some sort of aggressive care in the last 30 days of life.

60% of elderly, advanced cancer patients receive aggressive life-saving attempts in the last month of life

Photo by Matej via Pexels.com

This research was recently published in JAMA Network Open and looked at the last 30 days in the lives of 146,329 people who were over 65 and had a diagnosis of metastatic cancer, in other words, very sick, frail elderly folks with an average age of 78.2 years.

I was put onto this research by a great article from Paula Span in the New York Times. She writes a regular piece called, “The New Old Age,” and this was one in her series. What is not clear from the research is “Why?” Why are so many, obviously dying old folks being dragged through more treatments which are normally reserved for those seeking cure?

Some may want this treatment, but I doubt it

Photo by Kampus Production via Pexels.com

It is true that some of these aggressive treatments can be considered palliative, for example, radiation to reduce the size of a tumor and hopefully reduce pain. It is also true, that some of this aggressive treatment is actually what the patient wanted. Perhaps, they were made fully aware of their grave condition but chose treatment that had little chance of helping them. Both of these possibilities are probably in a small minority of this aggressive care.

Spirituality raises its head again

The JAMA study concluded, “The reasons for aggressive end-of-life care are multifactorial, including family involvement, religion and spirituality, patient preferences, patient-clinician communication, and health care delivery systems.” I would add, the default mode in our healthcare system is to do stuff, when faced with a problem. That “stuff” is usually doing more of the same rather than shifting to comfort care only.

My chaplain antennae always perk up when I see “religion and spirituality” mentioned in any medical journal article. I am back to my oft-repeated premise — for patients and families, end-of-life decisions are primarily emotional and spiritual. People need to learn when it is time to let go and just let things be.

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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.

Grief Outside the Bounds of Normal

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“Maybe now you will pay attention to me,” read the suicide note.

Grief never goes away. Significant losses come to mind throughout a lifetime.

I have often said we all grieve in different ways. Some may cry a lot after the death of their person, others very little. Some can’t part with the clothes of the departed, others clean out the house within weeks of the death. Grief expresses itself in a wide range of actions, thoughts, and feelings that would be considered “normal grieving.”

I had a brother who died a week after being born when I was six years old. It wasn’t until I was in my 40s that I asked my mother about Randy’s death. When I did, she burst into tears and said, “My father wouldn’t let me go to his graveside burial service.” I never knew she kept such grief just below the surface. I told this story in more detail in a previous blog.

Although my mother carried that grief all those years, she functioned fully engaged in our family’s life. She had found a new normal as a mother who lost a child. She was in this range of “normal grieving.”

But there are ways of grieving that could be considered abnormal – check out the podcast titled, “Prolonged Grief Disorder.” You can listen to it or read the transcript at Geripal.org. In the podcast Holly Prigerson, Ph.D., describes prolonged grief disorder:

Photo by Meruyert Gonullu:

“So those symptoms were symptoms of yearning after 12 months post-loss and or preoccupation with thoughts of the deceased, but it’s really yearning.… You feel like you don’t know who you are anymore, where you fit in to the world. You feel disbelief. You feel a sense of meaninglessness. You feel extreme loneliness. You feel bitter and pangs of sorrow, emotional pain is how they they’ve phrased it.… It’s mostly meaninglessness, purposelessness, disbelief, yearning, loneliness. These symptoms in and of themselves are very distressing. They feel detached from others. The only person they felt they really could connect with is the dead.… So, they have to have these distressing symptoms and they have to be significantly impaired by those symptoms. So, by definition, their dysfunctional symptoms, this isn’t normal level grief.”

I’ve witnessed this type of grief firsthand. I was a nursing home chaplain; a co-worker lost a teenage son to a hit-and-run accident. She believed it was murder, but the driver was acquitted at trial. She, understandably, became obsessed with this loss. She even bought a house next to the cemetery so she could always look out on her son’s grave.

Tragically, after some time passed, her younger teenage son died by suicide. He left a note, “Maybe now you will pay attention to me.”

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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.

Don’t Tell Me, “God protected you!”

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Morning paddle the day before the disaster.

I had a nearly fatal accident last week. In the end, I just got soaked from a capsize of my kayak and lost some items. I thank God I am alive. After reading my story, some very well-meaning people may say, “God protected you!” Being a very devout man and former healthcare chaplain…that is the LAST thing I’d want to hear.

Setting the stage for disaster

Access to take-out through high water

I took advantage of a break in my schedule, and several good weather days ahead, to go camping, kayaking, and biking. I was off to a new place for me, Bogue Chitto State Park in Louisiana, not far from the Gulf Coast. The park stretches out over several miles of the Bogue Chitto River.

The river was at flood stage, and moving very fast. I scouted it out for two days and estimated that it would take me an hour to paddle from the put-in to the take-out. The only unknown was what exactly the take-out would look like.

I took two trips there to assess it, by car and by bike. I could see the river, but I couldn’t see the riverbank where I had to take out because of the high water. So, I dropped a pin on the map on my phone so I’d know when to look for it and set off to start the paddle.

Disaster strikes

Pleasant, sunny break on sandbar on Bogue Chitto River, LA

It was a sunny but cool day. I had no problem navigating the high, swift water, and even took a pleasant break on a sandbar.

As I approached the take-out and got closer to the bank, the strong current slammed me sideways into a downed tree and I flipped over and went totally under. I was in my sit-on-top kayak so there was no popping back upright. There was also no righting the kayak because I have no idea how to do an Eskimo roll. Once I came above water again, I found my boat and paddle.

The next task was to get out of the fast-moving water. Swimming with considerable effort, I found a fallen tree near the bank and was able to hold onto it. I spent several

At this place on the bank I made my self-rescue.

minutes, still in the water, just catching my breath. Was it two minutes or five minutes? Those few minutes also gave me time to think, “This is not a good situation.” When I left, I had told no one I was paddling and when to expect me back.

Again, with much effort, I swam in water that was mostly over my head, pulling my boat from tree to tree until I found solid ground. I knew I was close to the take-out, so I walked through the woods dragging my boat until I got to the road and eventually to the take-out. I had left my bike there earlier, and was able to ride the several miles back to my car.

Some things went right…

Fortunately, I did a lot of things right. I had on my life jacket, cinched up tight. It literally saved my life. I have always worn a fanny pack attached to my body for things I did not want to lose. In it was my car key.

I also had secured my phone in my life jacket. I had it out moments before to check for the take-out and set it on the floor of the kayak. Then I thought, “Maybe I ought to secure this puppy.” I am so glad I did.

Journal was baptized after the capsize.

Because of the cool temperature, I wore wet suit pants and socks. My t-shirt and turtleneck were synthetic material, which retains some warmth even when wet. I never felt cold, partly because I was working so hard.

My biggest regret, besides getting too close to that fallen tree, was I did not secure my cochlear implant processor. I lost it in the tumble. Fortunately, I had my old processor in the car as a backup. I lost my hat and a bottle of water, too.

I never had a fear that I would die. I could have, but my life jacket saved me. There was a moment when I got separated from my boat that I feared I would not be able to get back to it and be dragged down river to who knows where. Thankfully, I was able to use my paddle to pull the boat back toward me.

It’s “No problem”

Sitting at camp that night, I was glad to be alive and warm by the fire before me. I reviewed the events of the day. I thought about my friend, Wayne, who once reframed life’s challenges for me simply using the phrase, “No problem.”

For a situation in which you have no control: “No problem, there is nothing you can do about it.” For a situation in which you CAN do something about it: “No problem, take steps to figure it out.”

For me, this mishap was the latter, and I got through it with a series of “no problems.” Submerged in the water? No problem, get above water. Lost my boat? No problem, pull it back with my paddle. Need to avoid being swept downstream? No problem, swim to shore, relax, catch my breath. Got to get back to the car? No problem, get into the woods and find the road.

That’s not what I was thinking during the unfolding disaster, everything happened so fast I had no time to think of anything but the task at hand. But you know what they say about hindsight.

A real miracle

In my 45 years of paddling, I have never swamped. I always prepare for the possibility, thus the attached and secure fanny pack, the life jacket, and wet suit. But I also always thought it was a remote possibility, thus I did not secure my cochlear device. The next morning, I typed a long journal entry on my computer (my journal got soaked in the spill). Here is an excerpt:

“I have thought about what a disaster yesterday could have been. Had I been swept underwater and pinned in a sieve of the branches of the tree, I would have been dead in minutes. They might not have found my body for weeks as the flood waters receded. A similar accident took the life of a very skilled kayaker in Great Falls, Virginia in 2013. She got pinned under water and drowned.

“So many random, chance happenings prevented the capsize from becoming a disaster. When I first started paddling years ago I asked canoe guide, Ralph Shaw, why flood waters on whitewater rivers are so dangerous. After all, when the water rises all the rapids disappear. He said it is the volume of water that is the danger. That is what toppled me yesterday. Once the massive flood caught the edge of my boat, I was at the mercy of those waters….

“…I can hear some well-meaning people saying to me, ‘God protected you.’ I don’t want to hear that. The reason being is the terrible implication for all those who do drown in similar situations. Or what about hundreds of my patients who died while I was a nursing home and hospice chaplain? Following this reasoning, God did not protect them. It is a view that God picks winners and losers.

“I CAN say, ‘I thank God I am alive.’ But not that God saved me last week. I think of Cheryl Strayed, whom I wrote about in my blog, when she just said, ‘Thank you,’ at the end of her 1,000+ mile hike on the Pacific Crest Trail. I am simply glad to be alive every day.”

The miracle is not that I did not die last week — the real miracle it is that I am alive in the first place.

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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.

She Fasted to Hasten Death — VSED

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Rosemary Bowen was not terminally ill. She hastened her death by fasting. It took seven days.

Ten states and the District of Columbia allow for “medical aid in dying” (MAID). In those jurisdictions, terminally ill people with six months or less prognosis can get a prescription for a lethal medication in order to hasten their deaths. But what about patients not in one of these states or those whose life expectancy is greater than six months? VSED is an option.

Voluntarily Stopping Eating and Drinking (VSED) can be practiced by those seeking an earlier death. It’s what Rosemary did.

Rosemary Bowen, at 94, was living independently. She said she had had a wonderful life and did not look forward to a long, slow decline toward death. For years, she had been telling her children, “That her life would not be worth living if she had to depend on caretakers to feed her, dress her, and take her to the toilet.” Then, it happened. She fractured her back and went to rehab but was unable to live independently. That was enough for her.

Rosemary asked her daughter to video her so she could show others how to take control of their dying with VSED. The 16-minute video is available on YouTube.

VSED is a legal and, in my view, a morally acceptable way to end one’s life. It is based on several established principles in medical ethics. Affirming “autonomy” we allow patients to make decisions to reject any medical treatment — even treatments that could potentially save one’s life. Also, medically-supplied nutrition and hydration (for example, by a feeding tube) have long been understood to be a treatment that could be refused.

What Rosemary did was take these one step further as she choose to refuse food and water. She did this basing her decision on her own values:

  1. She valued independence above all else. Being dependent on others was an unacceptable quality of life.
  2. She did not want to be a burden on her family.
  3. She did not want to go the route of many of her friends who spent years declining in assisted living or nursing homes, facing one medical setback after another.

The importance of medical support during the process

Do not try this without medical support. Rosemary was able to get a hospice to care for her in her last days. Palliative care is also available to ease burdensome symptoms like pain and thirst. See “VSED Resources Northwest” for help with choosing this option.

“I am leaving life with great joy,” she says in the video. “I can’t tell you how content I am. I recommend it highly to do it this way.… The price of staying alive is having to live without quality and joy.… I feel so privileged to be exiting life like this and think of all the people who are wringing their hands and saying if only God would take you and all they need to do is give God a little help by holding back eating and drinking.”

At one point in the video, she is on the phone saying goodbye to friend. As she signs off, she says, “I’ll see you in heaven.”

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.

“How effective is chemotherapy?” — That is the Question

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Would you spend $100,000 on a cancer treatment with many painful side effects that might help you survive 6.24 months as opposed to 5.91? That is 10 days longer in greater pain and suffering?

What if the doctor told you just that “this treatment will help you survive longer”? This is a true statement even though you might only survive 5.6% longer. That IS longer.

I have just discovered two great videos with Dr. Michael Greger discussing this very topic. Each video is less than seven minutes and worth every minute of your time. One is called “How Effective is Chemotherapy?” and the other is “How Much Does Chemotherapy Improve Survival?”

Let me be clear. I have no idea what I would do if I had a cancer diagnosis. I have close friends and family members who had advanced cancers and have been treated very successfully and are living active lives years after their treatments.

On the other hand, I have had patients, and, again, close friends and family members who received brutal chemotherapies and died. Many of those seemed to have received no benefit from their treatments and suffered great burdens. Many patients go bankrupt in order to pay for treatments.

Dr. Greger, in the first video says, “A large proportion of cancer patients reported their willingness to declare bankruptcy or sell their homes to pay for treatment. I mean, look, aren’t the high prices justified if new and innovative treatments offer significant benefits to patients? But you may be shocked to find out that many FDA-approved cancer drugs might lack clinical benefit.”

In his second video he referred to a study reported in the Journal of the National Cancer Institute. “In fact, the most expensive drug they looked at, the one costing $169,836 a year, did not improve overall survival at all, and actually worsened quality of life. That’s $169,000 just to make you feel worse with no benefit. Why pay a penny for a treatment that doesn’t actually help?”

I am NOT giving medical advice here. I am encouraging all of us to ask questions of our physicians. If a recommended therapy is said to improve survival, ask, “How much improvement?” Is it just 10 days over six months while suffering uncomfortable side effects? Ask about cost. Would I be willing to spend my financial legacy for those 10 days?

This all reminds me of the importance of our own emotional and spiritual preparation for dying. When “our time” comes we will be ready to die… or be healed. Either way, we’re okay.

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Cover Photo by Marcelo Leal on Unsplash

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.

Alone into the Alone — “A Grief Observed” Revisited

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Why?

Why, late in his career, would an internationally famous Christian author publish a personal memoir under a pseudonym? He hid both his identity and that of his beloved wife. Why?

I was leaving on one of my daily bike rides recently and needed to pick a new book to listen to. I selected a reread — A Grief Observed (1961). But, the author was identified as N.W. Clerk in the original rendering. Only after his death in 1963, was it published as by C.S. Lewis.

So, I am peddling the hills of Oxford, Mississippi, and I am being reminded just how good this book is. Between 1940 and his marriage in 1956, this confirmed bachelor wrote his greatest works including The Screwtape Letters (1942), The Chronicles of Narnia (1950-56), and Mere Christianity (1952). His brief four-year marriage to the terminally ill Joy led to A Grief Observed.

Lewis traced his wife’s life with cancer, then death and then his grief in this very thin volume (my copy has 53 pages of text.) Only, she is not “Joy,” who became his wife when he was 57 and she 41. In A Grief she is “H.” Her full name was Helen Joy Davidman, thus the “H.” They were actually married in the hospital where she was receiving treatment.

Here is a sampling of this grief journal by one of the 20th century’s greatest writers and Christian apologists.

“No one ever told me that grief felt so much like fear. I am not afraid, but the sensation is like being afraid.”

Years ago, I had memorized this first line of the book. C.S. Lewis starts his journaling describing how grief feels to him. He keeps this up on every page.

“For in grief nothing ‘stays put.’ One keeps on emerging from a phase, but it always recurs.”… “Grief is like a long valley, a winding valley where any bend may reveal a totally new landscape.”

How many times have I heard this? I have to remind grievers “you never ‘get over’ grieving.” Lewis sees it as a series of emerging phases always recurring. He likens it to a hike through a valley.

“Meanwhile, where is God?… But go to Him when your need is desperate, when all other help is vain, and what do you find? A door slammed in your face, and a sound of bolting and double bolting on the inside. After that, silence.” 

This might come as a surprise to those who found Lewis’ writings on Christianity so helpful. He had doubts. He didn’t doubt the existence of God but that his beliefs did not take away the pain of grief. He had no time for the “trust God and all will be good” line of thinking. Perhaps, this is why he wrote under a pseudonym. Doubt was so far from the assured Lewis.

“It is incredible how much happiness, even how much gaiety, we sometimes had together after all hope was gone.” 

Here seems to be a great contradiction. In the midst of no hope for cure, Lewis and his wife had great happiness. There is a scene in Shadowlands, the biopic about their life together and her death. Lewis tells Joy not to talk about her impending death. He doesn’t want to spoil their good time together. She says, “It doesn’t spoil it, it makes it real.… I’m going to die and I want to be with you.… The pain then is part of the happiness now. That’s the deal.”

“She said not to me but to the chaplain, ‘I am at peace with God.’ She smiled, but not at me. Poi si torno all’ eterna fontana.” 

These are the last words in A Grief Observed. He was able to witness the exchange between his dying wife and a chaplain. She was at peace. He closed with a Latin line from Dante’s Divine Comedy. In English, “Then she returned to the eternal source.”

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Cover Photo by Ricardo Gomez Angel on Unsplash

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.

More Nothing than Something — True Solace is Finding None

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I was such a scaredy-cat at 8 years old. All I can remember of two particular movies in 1956 was that I kept my eyes closed during the entirety of each film. I have just discovered, through Wikipedia, that Earth Vs. The Flying Saucers and The Werewolf were released together as a double feature that summer. Who knew?

Bingo. Those were the two movies of my childhood fears. I was sitting through 160+ minutes of terror.

From my youth, outer space and the heavens brought a recuring sense of awe. Yes, the fear of flying saucers invading was real. But, there was also a sense of reverence as I gazed into the night sky. I was pretty small in the vastness of the stars above.

I just placed the latest “deep field” photo from the new James Webb Space Telescope to my home screen on my iPhone. This is a time exposure photo of a portion of the night sky the size of a grain of sand held at arms-length. Thousands of galaxies appear as we look back billions of years. Each galaxy has billions of stars — each star is not unlike our sun.

We come out of childhood, hopefully, putting away childhood fears. We gain a sense of control of our own lives. I am somebody. That is, until….

That is, until something reminds of how small we really are — how we really are not in control. Serious illness ranks up there with things that shake us to our core.

The Deep Field photo brings so many thoughts to my mind. What is really amazing is that there is more of nothing than there is of something. More empty space than stars. Perhaps “nothingness” is more important than “something.”

Even down at the microscopic level, scientists tell us that the is more empty space in each atom than solid matter. Doesn’t make sense when you fall on asphalt after a spill off your bike, but, I have to take the experts at their word.

The point is that emptiness and nothingness are where we live. Yes, I am glad I have family, friends, community, and this beautiful earth to enjoy. But, I also feel at home in the vastness of empty space or the silence which is a space empty of sound.

It is the message of the mystics and the dying have been telling us since the dawn of time. I am reminded of Gretel Ehrlich’s comment, “True solace is finding none. Then, of course, it is everywhere.”

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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.

“During covid… I think that was my favorite time in life”

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Imagine my surprise at getting a text from my youngest daughter, Katie, that started and ended this way: “During COVID… I think that was my favorite time in life.” Of course, it was everything in between that beginning and ending that tells the story.

Most of Generation Z spent their last year of college (2020-21) attending class in front of a computer screen. Katie was included in that cohort. It was our good fortune, in 2019, to have moved to Oxford, Mississippi, where she was going to school. Although she shared a townhouse with some friends, she and Charlie, her Cavalier Spaniel,spent a great deal of time in our home.

My wife and I tend to be news junkies. Each evening we record the ABC World News Tonight and the PBS NewsHour. And, each evening, we watch both, mercifully skipping the commercials. Katie did not share our news addiction and turned us on to a “new drug” — Grey’s Anatomy.

Thanks to COVID, we were not going out, so it was a binge of 17 seasons and close to 400 episodes. We took a pass on our basketball and baseball season tickets and went to med school. Twice, late in 2020, I blogged about Grey’sGrey’s Anatomy and CPR on Television” and “The Spiritual Side of Grey’s Anatomy.”

I started that first blog, “True confession: I have joined my 22-year-old daughter in binge-watching Grey’s Anatomy during the pandemic. Over 300 episodes viewed and counting. I now know about ‘10-blade,’ ‘clear!’ and the importance of declaring ‘time of death.’ Also, I never knew there was so much romance and sex going on in hospital supply closets and on-call sleeping rooms. Now I know.”

Last week, out of the blue, Katie texted us, “During covid when we watched every season of Grey’s Anatomy and you both didn’t fall asleep and paid attention I think that was my favorite time in life.” (I will not comment on the falling asleep or paying attention part, but I really did enjoy the series.)

I know, for many people, the pandemic was horrible. People died. People were exhausted. There was NO silver lining for them. To be clear, Katie did not qualify the family-watching-Grey’s as the best thing about COVID. She was more expansive — watching Grey’s with us was her “favorite time in life.”

Regardless, I’m grateful we got to make the best of a bad situation. We salvaged some uninterrupted family time and made memories with our daughter. Binge-watching TV was the silver lining of the pandemic. At least, it was for us.

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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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