Spirituality | Hank Dunn

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“Grace” From Prehistory to Today

Posted September 15, 2023 by [email protected]

“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)

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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.

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

Posted August 18, 2023 by [email protected]

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.

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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 First Stage is “Denial”

Posted August 11, 2023 by [email protected]

“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.]

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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.

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

Posted July 27, 2023 by [email protected]

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 19^th. 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.

25 Years for This?

Posted June 6, 2023 by [email protected]

[Note: I wrote this 25 years ago, reprinted here.]

June 3, 1998

This morning was little different at the office than other mornings. I am on the West Team of the Loudoun Region of the Hospice of Northern Virginia. The West Team occupies one room on the second floor of a two-story townhouse office in Leesburg.

Hank at Grief Camp for Children, 1998

Now, get this picture. On the West Team are five nurses, three social workers and one chaplain. In our room are six desks and five phones. No desks are assigned. First-come, first-served. We do not spend a lot of time in the office because we mainly are on the road visiting patients. Yet, most of us start our day there. Can you see where this is going?

I got there a little late today and I was lucky. I got a desk but, alas, it was the one without the phone. It does have a view — into the back yards of townhouses. I am close to my colleagues — Kelly was about two feet to my left and Pam equidistant to my right.

We all talked about Nelia, who had to pull her hair back because she was going to see Sara who didn’t like Nelia’s hair falling in her face as she cared for Sara. We are part of each other’s conversations, each other’s space, each other’s work lives.

Ordained June 3, 1973

Hank’s ordination Bible, 1973

It struck me this morning, and I announced to my friends at work, I was ordained to the gospel ministry twenty-five years ago today. It took place at the St. Matthews Baptist Church in Louisville, Kentucky on the same weekend as my graduation from seminary. The pastor who led the service left Louisville to pastor the largest church in North Carolina. He called me a year later and asked if I would come to be his youth minister. I didn’t. He eventually left the ministry. Something about an affair. Last I heard he was selling cars.

And me? After twenty-five years in the ministry? I have made it all the way to — sharing phones, sharing desks, views of townhouse backyards and having to turn in a time sheet every day with my documentation or I don’t get paid.

“Success” in the ministry

Hank (right) with seminary friends. In this photo are two future seminary presidents, one future pastor and one future hospice chaplain.

This is unlike one of my best friends during seminary days who went on to get a Ph.D. from Cambridge and is now president of the largest seminary in the world. Others from our class pastor big churches. I report to the senior social worker who reports to a vice president who reports to a president who reports to a board of directors. I am pretty far down on the food chain.

Here I am, a fifty-year-old, making less than many new college graduates earn. I have come all this way in the ministry, following my call only to find myself doing what any seminary student could do. I don’t know. I’m not feeling sorry for myself. I was just struck with the irony of the celebration of the 25th anniversary of my ordination and having to borrow a phone to make a call.

I think probably my classmates and I all imagined as we left seminary that in twenty-five years, we would have a private office with a secretary or at least a phone. That’s how we keep score in our society — how much money I make; how much of the trappings of success do I have, like a beautiful office; how many employees I supervise; or, what kind of car I drive.

Less is more

But, you know — this lack of having an office is so much better. I have had to narrow my essential papers down to two notebooks that I can carry anywhere. If I had an office, I would have piles of clutter everywhere. And not having an office says to me my work is not at a desk anyway — it is with the people — and sick and dying people at that.

I think I remember something Jesus said about foxes having holes, yet the Son of Man has nowhere to lay his head. I guess Jesus didn’t have an office either.

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.

Finding Meaning in Suffering is Difficult — But Can be Done

Posted April 7, 2023 by [email protected]

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)

Don’t Tell Me, “God protected you!”

Posted January 12, 2023 by [email protected]

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.

“To be wise is to be eternally curious.” — Buechner

Posted September 28, 2022 by [email protected]

Frederick Buechner died recently at 96. There is a generation of ministers, myself included, who sought “the Buechner quote” to spice up a sermon. Here are some samples from my files (bold emphasis mine):

“There is a difference between a happy life and in living a meaningful life.… Living a meaningful life has to do with being a giver.… If you want to find meaning in your life you have to begin reaching out.… Happiness and unhappiness does not predict suicide but living a life without meaning does.”

“The place God calls you to is the place where your deep gladness and the world’s deep hunger meet.”

“If you don’t have doubts, you’re either kidding yourself or asleep. Doubts are the ants-in-the-pants of faith. They keep it alive and moving.”

“It is as impossible for man to demonstrate the existence of God as it would be for even Sherlock Holmes to demonstrate the existence of Arthur Conan Doyle.”

“To be wise is to be eternally curious.”

“Thus, when you wake up in the morning, called by God to be a self again, if you want to know who you are, watch your feet. Because where your feet take you, that is who you are.”

“Believing in him is not the same as believing things about him such as that he was born of a virgin and raised Lazarus from the dead. Instead, it is a matter of giving our hearts to him, of come hell or high water putting our money on him, the way a child believes in a mother or a father, the way a mother or a father believes in a child.”

“God himself does not give answers. He gives himself.”

“Listen to your life. All moments are key moments.”

“Faith is stepping out into the unknown with nothing to guide us but a hand just beyond our grasp.”

“When you remember me, it means you have carried something of who I am with you, that I have left some mark of who I am on who you are. It means that you can summon me back to your mind even though countless years and miles may stand between us. It means that if we meet again, you will know me. It means that even after I die, you can still see my face and hear my voice and speak to me in your heart.”

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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.

Canada vs. U.S.A. at the End of Life

Posted September 22, 2022 by [email protected]

Me: “Hello, this is the chaplain, Hank. I would like to come by your home for a visit Tuesday, at 10. Would that work for you?”

Patient: “Oh, hi… (pause) No, not then. How ‘bout Thursday at 10?”

Me: “Great, see you then.”

I thought of this conversation as I was digging down into a Canadian governmental report.

Why are we so different than our Canadian neighbors? We share a 5,525-mile-long border yet, in response to one question, we are miles apart. Do we really live and die that differently?

I have this nerdy side of myself. I read through medical journal articles and government reports looking for insights into all things end-of-life. The government of Canada and the State of Oregon recently released their annual reports on Medical Assistance in Dying (MAID) or, in Oregon, Death with Dignity. These are the rebranded names for what used to be called Physician Assisted Suicide.

One number jumped out

End-of-life concerns: U.S.A.

End-of-life concerns: CANADA

I’m reading through these reports and one number jumped out at me. Physicians who aided these terminally ill patients in hastening their deaths with medications were asked, “Why did the patient want to end their life by taking a lethal medication?”

In Oregon, the number one reason out of seven choices that patients gave was concern over “Losing Autonomy.” 93.3% of these patients listed that as one of their end-of-life concerns. In Canada, at the BOTTOM of a list of eleven possible concerns, “Loss of control / autonomy / independence” is only mentioned by 1.7% patients.

My interest was piqued by that “autonomy” difference. So, I contacted my friend, Tim Ward, who is now writing about his travels in Europe. He and his wife are taking “senior gap year” as in “senior citizen gap year” traveling. Tim is a Canadian by birth and has recently become a U.S. citizen.

He emailed back from Paris, “It might be that in Canada, autonomy is less of a value than, say, meaningful social connection” and “the rugged individualism of the West is part of eastern Oregon’s make up.”

Individualism/Autonomy vs. social connection

I think he is on to something here. For example, the social connection vs. autonomy shows up in how we provide healthcare. In the U.S. we do not provide universal healthcare, Canada does. There is no for-profit health insurance industry in Canada, yet everyone has access to healthcare. The U.S. system is built upon a for-profit system that leaves 8.6% (28 million) of our fellow citizens without health insurance. How we provide healthcare is just the most glaring example of how we value individual choices over the common good. Also, the social safety net is very weak for the poorest among us in the U.S. — as we witnessed in the pandemic.

I got curious about where in the world people are the happiest. Turns out, Canada (#15) and the U.S. (#16) show up next to each other in a recent ranking of the happiest countries. The top countries are in northern Europe.

From the Gallup World Poll report, “[Finland] and its neighbors Denmark, Norway, Sweden and Iceland all score very well on the measures the report uses to explain its findings: healthy life expectancy, GDP per capita, social support in times of trouble, low corruption and high social trust, generosity in a community where people look after each other and freedom to make key life decisions.”

Critics would say that’s true, they may be happier, but they pay very high taxes. The countries highest on the “Happiest” list are often labeled as “socialist” by those same critics. That’s a discussion for another time and place. The point here is that the autonomy cherished by U.S. citizens shows up in less “social support.”

The myth of the cowboy

Photo by Taylor Brandon on Unsplash

Tim’s other point, about “rugged individualism,” caught my eye because of another nerdy side of me — I read books about the American South and how we got the way we are down here. Currently, I am into How the South Won the Civil War: Oligarchy, Democracy, and the Continuing Fight for the Soul of America by Heather Cox Richardson.

Richardson is a historian with 1.6 million followers on Facebook. She writes on that platform often and produces long videos discussing various history-related topics. In this current book she explains the growth of the “myth of the cowboy,” the ultimate “rugged individual.” According to her, since the late 19^th century, Americans have bought into this idea that anybody can attain whatever they want, that this country was built by autonomous “rugged individualists.” This is a myth because wealth actually went to a few elites from the days of the Founders to today.

Our founding documents lay out this contradiction in spades. The same property-owning White men who wrote, “All men are created equal,” enslaved Black people and did not give women or poor Whites a vote. We, as a nation, have been struggling with this contradiction ever since. Although Canadians do not have the history of slavery we do, we both share shameful treatment of indigenous peoples. Also, a discussion for another time and place. The point here is lionizing the “rugged individual” can show up as valuing autonomy at the expense of social connection.

Pastoral care at the end of life and autonomy

The phone exchange with the patient was typical of many we had over the months I was his chaplain. He ALWAYS chose another time. As a chaplain for those at the end of their lives I am always looking for ways to enhance autonomy, because I know it is so important to most of us. I gladly changed my plans. I figured this was my little way of affirming his autonomy.

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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

Posted September 1, 2022 by [email protected]

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.

Archive for the ‘Spirituality’ Category

“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

“Grace” found in the wilderness

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

God or no God, grace abounds

“Amazing Grace” sung by all

The Denial of Death

Psychology Today and the deathbed conversation

Denial can cut off meaningful conversations

Denial is normal

Can we “know” what God wants?

What does God want in a VERY serious illness?

Is God ONLY for saving a life?

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

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

Other hopes besides “not dying”

Ordained June 3, 1973

“Success” in the ministry

Less is more

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

For 25 years this list has been part of my lectures

Seeking autonomy and avoiding suffering

Setting the stage for disaster

Disaster strikes

Some things went right…

It’s “No problem”

A real miracle

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

One number jumped out

Individualism/Autonomy vs. social connection

The myth of the cowboy

Pastoral care at the end of life and autonomy

Volume Discounts for Branded Book Orders

Black

Color

Volume Discounts for Unbranded Book Orders

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