To Everything There is a Season

"To everything there is a season and a time for every matter under heaven…A time to be born and a time to die…” Ecclesiastes

 

In the course of my life as a minister I have spent much time in the presence of the dying and the bereaved. The names of those I have accompanied through these stages are written in my journals and their stories inspire my life and ministry. I believe that to walk with someone through the final stages of life is one of the most sacred experiences we can have.

From a spiritual perspective, "palliative", or "end-of-life", care is very much a service of “accompaniment”. The word accompaniment really names it well when you look at the Latin roots com-panis, "with bread". To accompany is to “break bread with”. It is to walk the journey with another as a companion for a particular and significant stage of life. When I remember those who have accompanied me in the difficult stages of my journey, I think of the following qualities that I value in them:

• availability and commitment;
• an ability to be a “non-anxious" presence;
• honesty, humility, and compassion;
• a capacity to both listen and reflect;
• a comfort level with silence;
• a sense of humor; and
• a certain wisdom that comes from experience.

It is also important to me to have a person who shares somewhat of my spiritual orientation. In that way we can use a common language of symbol, story and prayer.

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A particular challenge for the person living in the advanced stages of cancer is, “knowing when to let go”.  It seems to me that in the cancer journey there is a time to fight the "dragon" with all of the weapons we can muster. I've also seen that there can come a time when it's helpful to "let go", so that the final stage can be one of peace and dignity and not one of prolonged pain and suffering.

"Letting go" is not giving up. Death is not defeat or failure. It’s not about winning or losing, but rather about accepting the very imminent reality of our mortality. My experience has been that when the terminally ill reach the place of "letting go" a deep peace follows for the individual, their family, and their friends. Discerning the time of this transition is deeply personal and needs to be respected by caregivers and family alike.

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End-of-life care belongs to the family. It is another area of medicine which is being reclaimed through patient and family empowerment and education. Many hospitals and communities now have progressive Palliative Care programs that help our loved ones through the final stages of life with dignity and respect.

In Canada, Dr. David Kuhl has written an insightful book on palliative care. “What Dying People Want: Practical Wisdom for the End of Life” is an excellent account of David’s 15 year experience of palliative care in Vancouver. In it he addresses such issues as: Time and Anxiety; Bad News; Physical Pain; Life Review; Speaking the Truth; Self-Realization; and Transcendence.

In the US, Dr. Ira Byock has written and advocated extensively on end-of-life care. His website, http://www.dyingwell.org/, has numerous helpful resources and an excellent synopsis of the “Developmental Landmarks and Taskwork for the End of Life”. It is helpful reading if you, or a loved one, are facing end-of-life issues.

In peace... Rob; in Vancouver

"I wanted a perfect ending. Now I've learned, the hard way, that some poems don't rhyme, and some stories don't have a clear beginning, middle, and end. Life is about not knowing, having to change, taking the moment and making the best of it, without knowing what's going to happen next. Delicious Ambiguity". Gilda Radner

originally posted in July 2007