Is It OK?

I received a request for consult one evening for Robert, a 90-year-old man with many health issues.  His wife, Rosemary, was coming to terms with the likelihood of his imminent death, and she was asking practical questions around what she would need to do in the aftermath.  For many reasons, providing guidance in these matters falls to the Spiritual Care team.

I meet Rosemary outside of Robert’s room.  To my surprise, she looks much younger than I’d expected, somewhere in her 60s.  She seems fairly composed and confirms my understanding of her situation, so I suggest a quiet place just outside the nursing unit where we can talk.

She pauses for a moment, then says, “Do you suppose you could do a prayer in the room with Robert?  He’s not really a prayer person and neither am I, but it just seems like a good thing to do.”  I agree.

We enter his room, taking places on opposite sides of his bed.  Robert appears to be in a deep sleep; he hasn’t moved or spoken all day.  Rosemary announces in a loud voice, “Robert, I’ve got the chaplain here.  I thought it would be nice if he said a prayer.”  We each take one of his hands, then I take Rosemary’s and offer prayers for peace and comfort.  We leave Robert’s room and take our seats outside the nursing unit.  Rosemary seems visibly moved.

“Did you notice how firmly Robert took your hand?  We’ve been married 25 years and I’ve never seen him hold a man’s hand like that.  He rarely even holds mine that way …  He was more responsive than I’ve seen him today—I think your prayer really touched him.  I could feel him relax as you prayed—he seems to be at peace.  Maybe prayer matters more to him than I thought.”

Just then Robert’s nurse and a palliative care doctor approach.  We have an impromptu “goals of care” conference, with the doctor stating that Robert appears to be moving into actively dying.  Rosemary gradually accepts their recommendation to move Robert to “comfort measures only.”  After addressing a few more details, they leave us to resume our conversation.

“Robert has been incredibly healthy until the past 18 months or so.  He’s had a few hospitalizations since then, but each time he’s fought hard and pulled out.  I guess I thought he’d pull out this time, too …”  We sit together quietly while her words hang in the air.

“I mean, with our age difference, we talked openly about the fact that he would surely go first, and I would still have a lot of life ahead of me.  So it looks like that’s where we have finally arrived …?”

“It just might be,” I reply.  Again, we sit quietly for a bit.

“I have to ask you this,” Rosemary resumes again.  “Is it OK that I’m feeling a sense of happiness?  I always thought I’d feel distraught when Robert died but I’m not feeling that at all.”

“I think it’s important to pay attention to whatever it is you are feeling.  Can you say more?”

“Well, Robert and I talked a lot about what end of life might look like for him—that he might get dementia, or a long, painful illness.  Instead, we’ve had a lot of healthy years together, and now a short time of illness.  If this is what the end looks like for him, it seems good compared to the scenarios we’d contemplated.  I’m happy for him, and happy for me.”

“That all feels healthy to me.  Given that never dying isn’t an option, what you’re experiencing seems good in the spectrum of things.  Navigating end of life is one of the most difficult tests we face, and it seems that, with your help, Robert is going to do it well.  I think that’s definitely something to celebrate.”

Robert died around 4:00 am the following morning.

As a chaplain, I pay special attention when someone begins a question with “Is it OK …”  I see it as a sign they are feeling strong but conflicting emotions.  Patients and family members often regard chaplains (among others) as possessing the power to tell them what is and isn’t OK to feel.  As in this story, they can usually answer their question for themselves once given a safe space to express their feelings.  The chaplain’s job is often just to create the safe space.

One root of the problem, I think, is that many of our cultural traditions and religious institutions claim a moral authority that weakens our trust in the validity of our own feelings.  This can lead us to think we “should” feel a certain way about a situation (like an imminent death), when we might not feel that way at all.  In these situations, we often downplay our emotions and look to authority figures (religious, family, friends) to tell us how we should feel.  But our feelings simply are what they are, and they resist being reshaped by what someone else tells us they should be.  Instead, we end up in internal conflict.

Our raw emotions often aren’t the best guide for how we should act, of course, but I think it’s essential to listen for what they might be telling us.  They provide important data!  (In Quakerism, we say, “listen for how the Spirit may be moving within you.”)  Conventional wisdom may hold that happiness at the time of a loved one’s death is a sign of a hardened heart, but once Rosemary explored her feelings she could see they stemmed from a deep love of Robert and a mature understanding of mortality.  It was not only OK, it was beautiful, and I think Robert would have smiled to see her arrive at this place.

Rosemary didn’t need me to tell her this (nor could I have), she seemed only to need permission to look inside and find that truth for herself.  To paraphrase the Wizard of Oz, she had the power within her all along.

3 thoughts on “Is It OK?

  1. Bruce Alber

    Another amazing story with a very different perspective on end of life acceptance. I really liked your comment that some religious institutions tell us how we should feel. Your approach of listening and asking more open ended questions is far better.

    Liked by 1 person

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