Compassionate, informed advice about healthcare decision making

Archive for the ‘Spirituality’ Category

“Can I do this again?” — Men, Aging, and Performance

Posted by

“They” say men of a certain age are concerned about performance. Last week, while hiking the Big Schloss in 97-degree heat, this crossed my mind as I asked myself, “Can I do this again?”

Sundown on the Big Schloss

My bladder cancer surgery in May canceled a long-planned trip to see my adult children and my teenaged grands. I missed my grandson’s high school graduation and my youngest daughter’s engagement party. Unfortunately, those events can never be duplicated, but I hoped this trip would compensate for lost time.

In the last two weeks, I made the delayed trip to the D.C. suburbs of Virginia, my home from 1978 to 2017. Just like when I traveled the country speaking, once I had a destination, I looked into how I could spend some time in the great outdoors — preferably including wilderness travel.

“Grandpa, how did you get into hiking and backpacking?”

Hank & grands on 2016 hike

I used to take my three grands on overnight backpacking or car camping trips. They have slept with bugs, spiders, mice, snakes, and other inconveniences and even encountered a bear. They were always good sports at the time but have declined invitations to repeat any of these adventures in recent years.

So now on my trips to visit family, I try to plan a meal with just my grandkids and me to get some quality time and have an “ask-me-anything” session. This time, we went to Chili’s right after I returned from an overnight in the woods.

Out to eat with the grands.

Over hamburgers and fries, my grandson asked, “Grandpa, how did you get into hiking and backpacking?” I thought back. It was actually a chance reading of a Redbook magazine article. In 1971, while I was in seminary, I had taken their grandmother to the doctor’s office. This was back before we could occupy ourselves with phones when waiting rooms were piled with old magazines.

Hank, left, and Charles. First backpack trip, 1974

The Redbook article was about a five-day backpacking trip into the backcountry of Yellowstone National Park. The writer was in one of the most visited parks in the country, and they never encountered another human during the whole trip. I said to myself, “I want that.”

Thus, my love of wilderness camping was born in the waiting room of a doctor’s office. It took a while, but my first overnight carry-everything-on-my-back-away-from-roads-and-the-grid trip was on March 1, 1974.

My most recent trip was July 16, 2024.

“Can I do this again?”

As I mentioned, while planning this last trip, I wanted to add a night in the woods amid visits to family and friends. The Big Schloss was an ideal choice, less than a two-hour drive from Northern Virginia. “Schloss” is the German word for castle, and the rocks on the summit indeed look like a castle from below.

No tent, just a tarp, priceless

It is only a two-mile hike and 850 feet of elevation gain to the campsite near the summit. I have probably slept on this mountain thirty times since my first trip there in 1980, when I introduced my then-six-year-old son to backpacking.

While I was a hospice chaplain, I even figured out a way to hike the Big Schloss on a workday in the summer. Because of the long daylight hours, I could leave my last patient at 5 PM, arrive at the trailhead by 7, and set camp by sundown around 9. Then, I would wake at first light in the morning, pack up, drive home, shower, and be at work by 10.

I invited my future son-in-law, Will, to join me on last week’s trip. Though he never backpacked or spent much time in the woods, he said yes. So, we left the trailhead and headed up the mountain together. The first half mile is all uphill, about 600 feet. Next, an up-and-down walk along the ridge that forms the Virginia and West Virginia border. Finally, the last quarter of a mile is all uphill, about 200 feet.

The 97-degree heat, the incline, and the 35 pounds on my back all made this a brutal hike. We made it, but to be honest, it took me several hours to recover. While recovering, we set up our tarps to sleep under and cooked dinner. After dinner we had an enjoyable campfire with some “deep thoughts” conversation.

Who was I trying to convince, “Yes, I CAN do this again”? Will, who is a strong twentysomething? You, who are reading this blog? Myself? The Universe? All the above?

A surprise test

Hank & Will, on the way down from the Big Schloss

It is not just my bladder cancer but my age that thrusts this question upon me. I will NOT be able to do this forever. Stroke, heart failure, or cancer could disable or kill me. Did I just take my last backpacking trip? Perhaps.

I don’t want to make this sound morbid. Au contraire, this is a moment to be thankful for all those wilderness outings, particularly for this most recent one.

Before returning to Arlington, Will and I stopped for breakfast at a diner on Route 11 in Woodstock, Virginia. I congratulated him over coffee, eggs, sausage, biscuits, and grits. “Will, you passed the test. You can marry my daughter.”

Surprised, he said, “TEST? I didn’t know this backpacking trip was a test!”

Oh yeah. It was. For both of us.

[NOTE: I did a short video while backpacking, talking all this. CLICK HERE]

__________________

Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving People and Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

Book Review: Nothing to Fear: Demystifying Death to Live More Fully by @hospicenursejulie

Posted by

Perhaps Hospice Nurse Julie’s book should come with a TRIGGER WARNING: Do not read this book if you do not like the words “Clean, Safe, and Comfortable.” More on that in a minute.

Nothing to Fear: Demystifying Death to Live More by Julie McFadden, RN, is the latest in a long line of books showing the way to a more peaceful and more meaningful dying experience. Why another death and dying book? Why not? Sitting at #8 on the New York Times “Advice” best-seller list, Nothing to Fear is full of advice about navigating the last six months of life under hospice care.

McFadden is better known as @hospicenursejulie to her followers on Instagram (357K), YouTube (432K) and TikTok (1.5M). An influencer with numbers like that has a ready-made public to drive her book sales. It works the other way too. In a way, her fans helped write the book. She often refers to questions she received from followers or experiences they shared with her. Here’s an example:

“Some people ask me, ‘Why is it so important for people to know that they’re going to die?’ It’s a great question. When people choose to learn about their particular illness and what their death might look like, their fears often are eased as they acknowledge what’s happening. The people who are willing to discuss end-of-life issues and to accept that they’re going to die seem to carry about them a certain type of freedom, and they truly live their last days well. Their fear tends to decrease, and they tend to be freer and more full of life, even though they’re dying.”

I listened to McFadden read the text on Audible my first time through. She comes across as the same nurse Julie we know on social media. I don’t think any actress could have captured the conviction, empathy, and compassion we hear in Julie’s own voice. Typical of me, I liked this book so much I bought it a second time in print form. There were too many quotes I JUST HAD to have.

A Very Practical Book

At bottom, Nothing to Fear is a very practical book — a sort of “how to” guide to a peaceful death on hospice. It is user-friendly with lots of lists with numbers or bullets. Here’s one of my favorites from the “Grief” chapter:

THINGS NOT TO SAY WHEN SOMEONE IS GRIEVING

  • “At least she had a long life.”
  • “God needed her in heaven more than we needed her here.”
  • “Everything works together for good for those who love God.”
  • “He’s in a better place.”
  • “There’s a reason for everything.”

Three Themes Stand Out

  1. @hospicenursejulie

    Is the patient “clean, safe, and comfortable”? The answers to this question are always on minds of those on the hospice team. Julie reminds family members to strive to always make sure the patient is clean, safe, and comfortable.

  2. Dying peacefully can be like the process of childbirth. Nurse Julie is not the first to make this comparison. The hospice movement grew out of the same mindset as the “natural childbirth” revolution in the 1960s. Probably the first book to start us thinking about death positively, Elisabeth Kübler-Ross’s On Death and Dying, came out in 1969. Just like a baby “knows” how to be born, the dying body knows how to die. “Listen to the body” we read often in these pages. Again, from nurse Julie:

 

“After years as a hospice nurse, I can share this strange but true fact: our bodies are biologically built to die.

  1. We need to talk about death and dying for a peaceful death to occur. The quote above about why it is important for people to know they are going to die comes from the chapter titled, “Death Is Not a Dirty Word.” In another chapter titled “Advice for the Dying” we find:

 

“When you look death in the face, it loses its power to bully you. If your death has not yet been part of the conversation in your family or in your home, then your loved ones may not know it’s okay to talk about it with you. Bring it up first, so they know you’re okay with it, and when you do, don’t sanitize it. Use all the d-words: dying, death, dead, died.”

Spirituality in Nothing to Fear

As a hospice chaplain, I am always on the lookout for how an author handles things spiritual. Nurse Julie seems to be so typical of the scores of hospice nurses I have worked with. It varies widely, but 25% to 75% of hospice patients decline visits from the hospice chaplain. Therefore, often patients and their families get spiritual support from the nurse.

Throughout Nothing to Fear we see nurse Julie addressing spiritual concerns of her patients and their families. She devotes a whole chapter, “Deathbed Phenomena,” to stories about patients having visions of long dead relatives. Here’s her understanding of these experiences returning to her theme of the metaphor of birth:

“As much as we’d like to, we simply don’t understand everything about these encounters. They’re mysteries. For my part, I can say that my own few experiences have given me nothing but confidence that a better world awaits us. I do believe that there’s an afterlife because of experiences like these.… In many ways, it feels a lot like the wonder of birth. When I get to see a baby being born, I weep from joy. I look at that baby and wonder, ‘Where did you come from?’ When someone dies, I have that same feeling I get when babies are born. It’s a feeling of home. Of comfort.”

In the chapter titled “What the Dying Process Looks Like,” Julie encourages families to pause just after their person dies and allow this “sacred” moment to sink in. In a section headed, “Death Is Not an Emergency,” we find this:

“Whether you’re with your loved one when they die or you discover that they have died after the fact, there is nothing you have to do immediately. Simply notice that what has happened is sacred. Death is a natural part of life, and you have, in whatever way, participated in your loved one’s journey toward this sacred moment.”

This Book Is Just That Good

I place Nothing to Fear up there with Dr. Ira Byock’s Dying Well (1998), Dr. Atul Gawande’s Being Mortal (2017), and Katy Butler’s The Art of Dying Well (2020). This book is just that good. Nurse Julie combines the powerful bedside stories of Ira Byock and the boatloads of practical advice of Katy Butler.

Even with all these wonderful books, we still see a lot of unnecessary suffering at the end of life. Hopefully by exposing the TikTok generation to a more peaceful way of dying, Nurse Julie can help relieve more of that suffering.

___________________

Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving People and Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

“God’s Child” Holding Still in Jail

Posted by

“Before every person there marches an angel proclaiming, ‘Behold, the image of God.’” —Jewish Proverb

It’s Wednesday. Any Wednesday. 2:00 PM.

Photo by RDNE Stock project:

I am sitting in silence with inmates at the Lafayette County Detention Center in Oxford, Mississippi. The local pronunciation of the name is “la-FAY-et.” The men are here awaiting trial, sentencing, or their “more permanent home” in the Mississippi or federal prison systems.

You can stand at the front door of my church, St. Peter’s Episcopal, and see the jail less than a half-block away. Some men in the church have been coming here for years, doing various outreach like starting a library or bringing Christmas cards for the inmates to send to friends and families.

Weekly Centering Prayer

About four years ago, I joined the group in a weekly “centering prayer” session, a form of silent meditation. Twice a month, we bring communion. I previously wrote a blog about me offering “The Serenity Prayer” to those gathered.

Our gathering was modeled after a group at Folsom Prison in California. The Prison Contemplative Fellowshiphas a great website with resources for those who take on a project like ours. They have also posted a 22-minute documentary video about the Folsom work titled Holding Still.

“God’s Child”

Ken begins every session here in Oxford by saying, “We want you to know that we know you are here. You are not forgotten.” In my mind, I recall the words of Jesus, “I was in prison, and you visited me.”

As the men gather each week, we hand everyone a name badge. Instead of “Hello, My Name is Hank,” each one says simply, “God’s Child.” We all wear one. Incarcerated and free.

The Jewish proverb says it best: “Before every person there marches an angel proclaiming, ‘Behold, the image of God.’” It refers to the story in the Hebrew scriptures about how humans were created in the image of God. All of us. Us do-gooder Episcopalian men and those jailed men — all the same image of God.

On the weeks we bring communion, we read from the Book of Common Prayer as part of the service:

“Lord Jesus, for our sake you were condemned as a criminal: Visit our jails and prisons with your pity and judgment. Remember all prisoners and bring the guilty to repentance and amendment of life according to your will and give them hope for their future. When any are held unjustly, bring them release; forgive us, and teach us to improve our justice. Remember those who work in these institutions, keep them humane and compassionate, and save them from becoming brutal or callous. And since what we do for those in prison, O Lord, we do for you, constrain us to improve their lot. All this we ask for your mercy’s sake. Amen.”

_____________________

Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving Peopleand Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

Milestones

Posted by

Let’s start with a trivia question. What do the following words or phrases have in common?:

bomb, chronic disease, demonic, homework, influencer, milestone, remix, Roman Catholicism, swampland, unattainable, worthwhile

Milestone: 100K on 2017 VW Passat

The answer in just a moment. I emphasized “milestone” because I hit one last week. Our 2017 VW Passat passed 100,000 miles. I go into buying a new car with the hope of getting 200,000 miles out of it. We’re halfway there.

It’s funny how we have so many “milestones” in our lives are related to automobiles. Think of getting a driver’s license (for me, at 16) or that first car (for me, a 1969 Camaro). Heck, getting the Passat in September 2017 was marked by another milestone — Hurricane Irma in Florida.

My wife and I were signing papers in the VW sales office when we noticed a long line of people holding propane tanks across the street. My wife commented, “Look at all the people getting ready to grill on Labor Day.” The salesman responded, “Are you crazy? They’re getting ready for the hurricane.”

We were new arrivals in the state and failed to make the connection with the approaching hurricane. That memory is now a milestone — or rather two milestones: our first hurricane and the purchase of our ’17 Passat.

Defining milestones

Photo by Steven Brown on Unsplash

The best I can tell, the Romans were the first to use milestones along their roads. I found a photo of a milestone after the Roman era marking the distance to “London.”

There are two definitions of “milestone,” according to Apple Dictionary:

1) A stone set up beside a road to mark the distance in miles to a particular place.

2) An action or event marking a significant change or stage in development.

Synonyms of “milestone” include climacteric, climax, corner, landmark, milepost, turning point, andwatershed.

1990 – Fairfax Nursing Center. Photo by Hank Dunn

As a hospice and nursing home chaplain, I observed many milestones in people’s lives. The most obvious milestone for the patient and their family is the event of the death itself. But there were also milestones leading up to the death.

I would hear about the milestone of someone’s diagnosis, “I will never forget sitting in the doctor’s office and hearing ‘You have cancer.’” Or the milestone of the day someone entered a nursing home. A turning point at which the patient loses their freedom, and the caregiver is freed from the burden of constant caregiving.

Use rituals instead of stones

Milestones: A new Tampa home in 1961 for the Dunn family and upon selling it in 2000

I am a fan of using rituals to mark milestones in our lives. For a chaplain, of course, that can include a prayer at the bedside after the patient takes their last breath.

When my parents sold the home they had lived in for almost 40 years, I felt it was important to mark the milestone. Mom and I picked up Dad at the nursing home and went to the house before the closing to sell it.

I pushed Dad in his wheelchair from room to room, and we recalled the people and events that took place in each. We had a prayer of thanksgiving. We wept.

So, what does “milestone” have in common with “homework,” “influencer,” “swampland,” and those other words I listed above? The first known use of each in the English language occurred in 1662. Who knew someone could be an “influencer” hundreds of years before the internet existed?

_____________________

Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving Peopleand Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

Halloween AND The Advent of the Cowboy

Posted by

[This essay first appeared in a 1992 winter issue of Fairfacts, the newsletter of the Fairfax Nursing Center in Virginia, where Hank served as chaplain.]

 

Photo by Ardian Lumi on Unsplash

I am terminally practical and CHEAP. As l thought of dressing up for the annual Halloween costume parade at the nursing center, l had hoped to find something I could wear again. Then I realized I had been getting into Country and Western dancing since last spring. Bingo! I’d dress up as a cowboy.

I already had a pair of $19 boots (well, that’s what I paid for them while I was a freshman at the University of Florida in 1967). l bought my black jeans on sale at Sears for $10. I still needed a shirt and hat. I’ll spare you the details of shopping for these items, but my whole outfit did not cost over $50 and did l look good.

I was pleasantly surprised by the effect the costume had on women. A week after I put my cowboy ensemble together, I was dancing with a young woman from my church at a country dancing spot we both frequent. She said she liked my hat, then added, “I can’t wait to tell my mother I was dancing with a Southern Baptist minister.”

I guess her mother remembered the days when Southern Baptists didn’t dance because it might lead to worse forms of evil. I’m glad those days are past. I would hate to have my spirituality put into question just because I enjoy dancing.

The costume parade

From the Fairfax Nursing Center newsletter

The day of the costume parade at the nursing center arrived. I sauntered down the halls in my boots, black hat, and black attire. (I am guessing that is what cowboys do — “saunter.”) Once again, the cowboy outfit got attention in ways my normal work clothing never did. All was going well until, halfway through the parade, one of the elderly, female residents saw me and exclaimed, “Hank? Is that you? Dressed like THAT? And you’re a minister?”

At the time, I let it pass. But as soon as I saw this dear, old friend the following Monday she called me over and said, “I’m really sorry for what I said on Friday.” I couldn’t remember until she reminded me. She added, “It’s okay for ministers to dress like that. Will you forgive me?”

I said, “Oh, that was nothing. I didn’t let it bother me. Yet, I do think it is unfair that ministers are not expected to have a little fun and dress up on Halloween, even if it is a cowboy dressed in all black.” I told her I just wanted to be a real person. Approachable and down to earth.

Here’s the Advent part

Photo by Andreas Rasmussen on Unsplash

My breaking the rules of convention of what is expected of a minister has its theological grounding in the Christmas story. In the Christian tradition, God broke many of the rules in becoming embodied in Jesus, starting in Bethlehem. A savior born to a peasant? In a stable? Welcomed by lower-class shepherds?

This child would grow up and break the sacred Sabbath laws. He would say to live you must die. To receive, you must give away. And to be welcomed into the kingdom, you must welcome those rejected by the conventional religious wisdom.

The thought that God was in Christ suddenly lifts our humanity into the very presence of the divine. Cowboy boots and all.

________________________

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 “Comfort” of Nothingness

Posted by

“When I’m dead, I’m dead.… and I just sail off into nothingness, and that brings me a lot of comfort. That doesn’t bring everyone comfort but it brings me comfort.”  —Caitlin Doughty, author of Smoke Get in Your Eyes, from an interview on the documentary “Into The Night: Portraits of Life and Death.”

Some people are okay with death being the end.

Their dead father sent a snowstorm

I haven’t run into too many people like that because I have spent so much of my life around folks who believe just the opposite. Many, if not most people, both religious and nonreligious, have some sense that their lives will continue in some form after death. I even had one family insist their dead father sent a snowstorm.

Photo by Ethan Hu on Unsplash

This family had asked me to conduct the funeral service for this man who was one of our hospice patients. I had never met the man nor his family before, since they all claimed they were not religious and did not want a visit from the chaplain. So, he dies and they have no relationship with any church but needed someone to lead the service. Happens a lot in hospice. I was glad to help out.

Through a phone conversation with family members I planned the service which was to take place at the funeral home. They described the recently departed man as very shy and private. He was also a giving and generous man who loved his family dearly.

The night before the scheduled service we had a major snowstorm. I felt I could make it to the funeral home, as did the family, so the service was held as planned. No burial was needed since the man had been cremated.

Only one person showed up for the service besides the few family members.

This lack of turnout did not bother the family in the least. They said, “It’s just like Dad. He was so private that he sent a snowstorm to keep people away.”

“Okay,” I thought.

What do I know? Maybe the recently departed do have the power to send snowstorms. My point is that the belief in living beyond the grave is pervasive whether or not it has a religious aspect to it.

Yet, in my years at the bedsides of the dying and their families, I have gathered enough evidence that some people can be okay with the idea that the last breath is the end. I have seen scores of people face their deaths peacefully even while they have no belief that they are “going to a better place” or are going to be reunited with departed family members.

Many people agree with Caitlin Doughty that death is the end. But, I did find her use of the word “comfort” something I have not heard a lot from those who accept that there is nothingness after death.

I do hear “comfort” from those expecting to see deceased relatives or to be in the presence of God. I can’t tell you the number of times I sat with a family around the bed of a dying relative and someone says, “I don’t know how people do this without faith in God?” Caitlin seems to have an answer to that question.

How is the thought of nothingness “comforting”?

Another way of asking that question is, “How is the thought of nothingness ‘comforting’?”

Photo by Ankit Sood on Unsplash

We know humans, at some point, became conscious beings in our prehistoric past. A major hint of this emerging consciousness is the fact that we buried our dead with tools and other items to help the departed in the next life. This becomes a sign of consciousness because we know our ancient ancestors had the brain capacity to understand that they were going to die and they had figured out a way to deal with it.

Religions grew and flourished as they offered an answer to the mystery of death. What happens to us when we die? The religious answers of life after death do offer many people great comfort.

Let me suggest a two ways that, perhaps, the thought of nothingness is comforting:

  1. For Caitlin Doughty to say that knowing there is nothing after death, “brings me a lot of comfort,” first shows that she, too, has found an answer to this mystery of death and its meaning. There is comfort in settling the question in one’s own mind and heart. Mystery solved. Of course, it is different than a more traditional religious answer but having the question settled is comforting nonetheless.
  2. The second way nothingness after death is comforting grows out of that first reason. If there is nothing after death, that means this life is all there is. And if this is all there is then that makes this life all the more meaningful. This is it. This is not preparation for another life. Therefore, we must live this life abundantly. Enjoy it to the fullest and help our fellow humans by relieving their suffering and contributing to their joy. After all, this is all there is, they say. The incredible wonder and joy of living this one life brings the comfort.

 

As Doughty points out, “That doesn’t bring everyone comfort but it brings me comfort.” I have to take her at her word.

________________________

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

Photo by Greg Rakozy on Unsplash

A Cave, A Deathbed, and “How You Made Them Feel”

Posted by

“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” —Maya Angelou

1975 – Vineville Baptist, Macon, GA, youth group on retreat at Toccoa, GA. Photo by Hank Dunn

My theory about what matters most in the ministry is based directly on Angelou’s quote: It wasn’t so much what I said or did during my 50 years in the ministry. It was more about that certain “something” that made the people I worked with feel a particular way.

I was a youth minister for the first five years after seminary. I loved the work and loved “my kids.” We keep in touch in a Facebook group. I asked the group about our ministry and the Angelou quote.

Interestingly, a few noted specific things I said or some teaching from the books we read. Okay, so maybe people DO remember the things you say. One fellow, who eventually became a teacher and hospice chaplain, commented, “I don’t see it as an either/or but a combination.”

1977 – High school student on a backpacking trip into the Shining Rock Wilderness, NC. Photo by Hank Dunn

Others confirmed my theory that how people felt was most important. Another one of my kids (who also went into the ministry and travels the world training substance abuse counselors) commented:

“Absolutely. Experiences of pleasure, pain, joy, and shame have the biggest impact on the wiring of our brains and, therefore, how our souls interpret and interact with the world. Hank, you created a safe space where we could experience the joy of God and His love for us in nature, community, and individually.”

Sitting alone in a dark cave

I would sometimes take the teenagers into the wilderness as a place of ministry. We rafted on the Chattooga River, where the movie Deliverance was shot. We backpacked all over the north Georgia and western North Carolina mountains. We paddled and camped for three days in the Okefenokee Swamp. And, my favorite, we explored caves.

Part of every caving experience always included time for silent introspection. I would separate the kids along a passageway, take their lights, and have them sit alone in the darkness for 30 minutes. Recently, a participant on one of those trips shared with me the journal he kept at the time. The now-retired pharmacist wrote in 1975:

“I was really nervous before entering the cave. I never really liked the idea from the start. But when all lights were put out, I felt one of the greatest feelings of inner peacefulness and calm.”

1977 – “The Squeeze” in Johnson Crook Cave, AL. Photo by Hank Dunn

Here’s part of a report I wrote about another caving trip with junior high kids, also in 1975:

“There was one girl who was very much afraid to sit alone. I sat her down at the end of the line, where I would be close to her. After approximately five minutes in the dark, she began crying and eventually called me. I went to her, comforted her, told her I was near, and asked her to continue to sit, think, and pray as she remained in her place. She calmed down and completed the half-hour in darkness. She later revealed that it was not so much that she was afraid of the darkness but afraid to face up some of the own things in her life.”

“…people will never forget how you made them feel.”

A deathbed and the gift of presence

1990 – Fairfax Nursing Center. Photo by Hank Dunn

Fast forward 25 years, when I was a hospice chaplain. I was called to the home of a woman dying of cancer. I had made several attempts to schedule a time to see her and her family, but they were always busy and put off letting me in. Now, she was in her last hours. It was time to let the chaplain in.

When I arrived, a family friend sat with me in the living room and explained what was happening. We then went into the bedroom where the woman lay dying. Her husband sat beside her, and a nurse was not far away. I said very few words. There was little to say. I asked the husband if I could offer a prayer. He said, “Please do.” I finished my prayer, and he asked, “Can we say the Lord’s Prayer?” “Of course,” I replied, and we all prayed.

I left the bedside, and the friend followed me to the living room. I stopped to say goodbye, and this woman threw her arms around me, hugged my neck, and said, “You are so wonderful. That is just what we needed.” My first thought was, “Boy, is this job easy.” Anyone who could recite the Lord’s Prayer could have done what I did in that room. But then, I was so grateful to be invited into this moment in this family’s life.

I think Maya Angelou and I are on to something. People always remember how you made them feel.

________________________

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.

“Grace” From Prehistory to Today

Posted by

“All human nature vigorously resists grace because grace changes us, and the change is painful.” Flannery O’Connor

“Grace is always available to us, only we are not always ready to receive it.” Kabir Helminski, The Knowing Heart: A Sufi Path of Transformation

Photo by NEOM on Unsplash

“Grace” found in the wilderness

How did early humans sense the world they inhabited?

I have spent hundreds of nights sleeping in the wilderness. I have bedded down in caves, on mountaintops, on beaches, in the woods, on platforms in swamps, on riverbanks, and on prairie grasslands where the buffalo roam. I have had to narrow down my equipment to essentials I can carry on my back or in my kayak. I have had a few near misses with disaster that left me grateful just to be alive. But more often, I am incredibly moved by the beauty surrounding me — or rather, the beauty that I am immersed in.

1999— Hank on Mr. Democrat, Colorado

In 1999, at 9 AM on a September morning, after hours of climbing, I had reached the summit of the 14,148-foot Mt. Democrat in Colorado. I was alone. I wrote the following about this moment:

“I stood alone, drinking in the vastness of the alpine scene before me. I stood alone and thought there is nothing in my life that challenges me so physically — pushes my endurance and determination. I stood alone, knowing I receive more nourishment for my soul in the out-of-doors than any other place I could stand. I stood alone and felt a joy come up from inside of me. And the words that came out were, ‘Thank you, Jesus. Thank you, Jesus, for my life. Thank you for this wonderful world. This wonderful world.’”

To sum up these thoughts, I was overwhelmed by GRACE.

Did early humans have a similar sense of wonder and gratitude?

1976— Sleeping in a cave, Alabama

I may spend an inordinate amount of time contemplating the early hominids’ transition from lower animals into modern humans or homo sapiens. I even made a two-minute video while kayaking on a lake, pondering whether ancient humans thought the universe was to be feared or grace-filled.

I say “inordinate” because it is what it is. Or rather, we are what we are — thinking beings who walk upright, possess an opposable thumb, know we will die, etc. Why waste intellectual energy on something that happened hundreds of thousands or millions of years ago?

Yet I can’t help imagining our early ancestors had a sense of gratitude. I can imagine they were taken by the beauty of the natural world, not unlike how a beautiful sunset moves us today. I can imagine them being grateful for the bounty of the earth that sustained them, whether it was for the fruits and nuts hanging on trees or the small game near their dwellings.

Did they experience the world as I did on Mt. Democrat? Did they marvel at the gift of a newborn baby? What did they feel when a tree fell to the ground, just missing where they stood? Were they grateful to be alive, thankful they were granted grace?

But, perhaps, early human creative minds didn’t stop at just feeling grateful. Maybe we asked questions. Why was I not killed? How did I receive bounty from the earth? One possibility we came up with was there must be Someone responsible for our good fortune — Someone GREATER than us but sort of like us.

Why are we alive in the first place? How are we surviving so much that could kill us? “God” was our answer.

God or no God, grace abounds

Try this thought experiment: Suspend your traditional religious beliefs for a few moments and contemplate what drove our species to start thinking about God. Without the religious explanation, we might conclude that our ancestors did not believe in God. Heck, at one point, they did not even know they existed in the sense that humans are now self-aware.

Believers will say, “Those early humans were just becoming aware of the God who started it all ‘In the beginning.’” That may well be. But God or no God, grace abounds — then and now.

“Amazing Grace” sung by all

2023— Sipsey Wilderness, Alabama

A curious phenomenon in our time is the popularity of the hymn “Amazing Grace.” Secular nonbelievers and devout Christians can sing the words and be moved. Written in 1779 by John Newton, a former captain of slave ships who would become an abolitionist, the song speaks of “grace that saved.”

Interestingly, “God” or the “Lord” is not mentioned until the fourth verse. It is grace that saves, as we see in the second verse of the hymn:

Thro’ many dangers, toils, and snares, I have already come;

‘Tis grace hath brought me safe thus far, And grace will lead me home.

No wonder the song has such widespread appeal. Grace is universal. Some say that grace comes from God. For others, grace comes from simply being part of this wonderful world. Grace is present either way. My theory, in summary, is that humans started considering the existence of GOD to explain the GRACE of life itself.

(Cover Photo by NEOM 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.

A Death Expert on His Own Deathbed: “Joy and Hope and Trust”

Posted by

Two months after he died, Ernest Becker won the 1974 Pulitzer Prize for General Nonfiction for his book The Denial of Death. I guess, since he was dead, he was not a winner, but his book was.

I’ve been thinking lately about Becker and his book and the profound influence they both have had on my life. I referenced his thoughts in a previous blog titled, “Our Struggle with Dying Starts When We’re Toddlers.

Best-selling author, Mark Manson* includes The Denial of Death as one of “7 Books That Will Change How You See the World.” In Manson’s playful way he writes:

If This Book Could Be Summarized in An Image, That Image Would Be: The grim reaper silently laughing to himself watching you build an elaborate Lego set called “Life,” and you turning around and saying, “Stop laughing, this is important!”

The Denial of Death 

I’ll get to Becker’s deathbed below but first a few quotes from his classic. Note that Becker wrote in 1973 just as we were becoming aware that we no longer refer to all humans as “man.” I know better now but I will let his original words stand.

  • “The main thesis of this book is…: the idea of death, the fear of it, haunts the human animal like nothing else; it is a mainspring of human activity—activity designed largely to avoid the fatality of death, to overcome it by denying in some way that it is the final destiny for man.” (p. ix)
  • “The irony of man’s condition is that the deepest need is to be free of the anxiety of death and annihilation; but it is life itself which awakens it, and so we must shrink from being fully alive. (p. 66)
  • “In the prison of one’s character one can pretend and feel that he is somebody, that the world is manageable.” (p. 87)
  • “Modern man is drinking and drugging himself out of awareness, or he spends his time shopping, which is the same thing.” (p. 284)

You may argue, “I DON’T spend any of my time thinking about my certain death.” I think Becker would say, “You just proved my point.”

 Psychology Today and the deathbed conversation

Soon after The Denial of Death arrived in late 1973, Sam Keen, one of the editors at the prestigious Psychology Today magazine, called Becker’s home hoping to set up an interview. Keen explained how the deathbed interview came about: “I called his home in Vancouver to see if he would be willing to tape a conversation. His wife Marie informed me that he had just been taken to the hospital and was in the terminal stage of cancer. The next day she called to say that Ernest would very much like to do the conversation if I could get there while he still had strength and clarity. So I went to Vancouver with speed and trembling, knowing that the only thing more presumptuous than intruding into the private world of the dying would be to refuse the invitation.”

Here are a few quotes from THE expert on death as he lay dying:

  • “Each of us constructs a personality, a style of life or, as Reich said, a character armor in a vain effort to deny the fundamental fact of our animality. We don’t want to admit that we stand alone.
  • “We do anything to keep ourselves from the knowledge that there is nothing we can do.… Well, this is the control aspect of character armor which is so vital to the human being.”
  • “Joy and hope and trust are things one achieves after one has been through the forlornness.”

Keen noticed that Becker kept referring to “God” when divine transcendence had not previously been part of Becker’s writings. The dying man responded:

  • “I don’t feel more religious because I am dying. I would want to insist that my wakening to the divine had to do with the loss of character armor.
  • “At the very highest point of faith there is joy because one understands that it is God’s world, and since everything is in His hands what right have we to be sad—the sin of sadness. But it is very hard to live that.”

Ernest Becker died in March 1974 at age 49. Two months later his book was awarded the Pulitzer Prize.

*Manson is author of The Subtle Art of Not Giving a F*ck, over 8 million books sold.

________________________

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 First Stage is “Denial”

Posted by

“Denial is a protective device, a shock absorber for the soul. It prevents us from acknowledging reality until we feel prepared to cope with that particular reality.…  We do not let go of our need to deny by beating ourselves into acceptance; we let go of our need to deny by allowing ourselves to become safe and strong enough to cope with the truth.”  Melody Beattie, The Language of Letting Go

“Denial is a sacred place. Denial allows us to stay in control. It is a ledge we sit on above a cliff. Sometimes we need to stay there a little longer.” Chaplain Rev. John, quoted in “Finding Faith Through Listening,” by Andrea L. Merrill, MD, JAMA Online, July 13, 2023

Denial can cut off meaningful conversations

We were told to take off our hospice name tags before entering the home because the wife didn’t want her husband to know he was dying. On my one and only visit into the home, the man appeared yellow because of the progression of liver cancer. Even his eyes were yellow, and it turned out he was within days of dying.

When I first walked into the home, I sat alone with the wife in the living room. She was very comfortable talking about her husband’s impending death. I asked her, “What is all this about not wearing our pins or talking about death? Does your husband know he is dying?” She said, “Oh, yes, he knows he is dying.” I asked, “How do you know he knows?” She responded, “Because he asked me.” I asked how she responded to him and she had told him, “Not while I’m around.”

I suggested, “What if you had said, ‘Yes, you are dying and I’m going to miss you. We have had a wonderful marriage and I love you.’” She said, “I couldn’t do that. That would be too painful.”

Living in the shadow of a life-threatening illness is difficult. Worse yet, when it becomes clear that there is going to be no recovery, we naturally resist any thought of what really lies ahead. Understandably, this wife wanted to avoid such a painful discussion. That is why we have such a strong urge to deny the reality of the incurable nature of the disease. We want to avoid the emotional pain of saying good-bye. The man died while his wife was at the grocery store—remember she said, “Not while I’m around.”

Denial is normal

Photo by Ben White on Unsplash

Denying the reality of the terminal phase of a disease is normal, expected, and perhaps even necessary. It gets us through the initial shock of such a fate. Acknowledging the truth may cause anger and depression, which are, again, normal responses.

The father of a twenty-nine-year-old son who died of leukemia told me, “I lived in denial of the certainty of my son’s death to the very end. I was completely surprised when he died. I feel so guilty about that denial.” I thought guilt was a strange feeling for such a natural response as denial, so I asked him about that. He said, “I felt guilty because if I had accepted that he was dying, there were so many other things I would have said to him, but I lost that opportunity.”

[This blog post was adapted from my Light in the Shadows: Meditations While Living with a Life-Threating Illness.]

________________________

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.

Quality of Life Publishing Logo

Quality of Life Publishing Co. is the proud publisher of Hank’s books, as well as other branded educational materials for health care & end-of-life care.

www.QOLpublishing.com

Copyright 2024, Hank Dunn. All rights reserved. Website design by Brian Joseph Studios

Volume Discounts for Branded Book Orders

Minimum quantity for branded books is 100. English and Spanish branded books are sold separately. Click here for more information or contact us with questions.

Black

  • 100 to 249 copies: $4.50 each
  • 250 to 499 copies: $3.50 each
  • 500 to 999 copies: $3.00 each
  • 1000 to 1499 copies: $2.25 each
  • 1500 to 1999 copies: $1.75 each
  • 2000 to 3999 copies: $1.60 each
  • 4000+ copies: $1.45 each

Color

  • 100 to 249 copies: $7.00 each
  • 250 to 499 copies: $4.50 each
  • 500 to 999 copies: $3.50 each
  • 1000 to 1499 copies: $2.50 each
  • 1500 to 1999 copies: $2.00 each
  • 2000 to 3999 copies: $1.85 each
  • 4000+ copies: $1.70 each


Volume Discounts for Unbranded Book Orders

Each title/language sold separately.

  • 1 to 9 copies: $8.00 each
  • 10 to 24 copies: $5.75 each
  • 25 to 49 copies: $4.50 each
  • 50 to 99 copies: $4.00 each
  • 100 to 249 copies: $3.50 each
  • 250 to 499 copies: $3.00 each
  • 500 to 999 copies: $2.50 each
  • 1000 to 1499 copies: $2.00 each
  • 1500 to 1999 copies: $1.50 each
  • 2000 to 3999 copies: $1.35 each
  • 4000+ copies: $1.20 each