A year ago I shared the story Courage and Grace, featuring an inspiring patient named Elyse.  She’d landed back in the hospital with shortness of breath after a four-year remission from breast cancer, and we visited and prayed together as she awaited the results of diagnostic exams. 

During that visit, Elyse told me that her cancer diagnosis was the best thing that ever happened to her, because “the moment I got my diagnosis, I felt this powerful presence within me and outside of me, letting me know that, whatever happened, I was not alone and I’d be safe … and that comforting presence has never left me.” 

Elyse’s story did not end there—I had several more opportunities to visit with Elyse and her family.

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Elyse’s husband Keith asked me to join a goals of care conference.  Elyse’s shortness of breath had been caused by a large mass in her chest, and her cancer had metastasized to other places in her body.  As Elyse was still in her 50s, she and her family pursued treatments to extend her life, but none had borne fruit.  Elyse had now drifted out of consciousness, but she’d previously made clear to her family that she was ready to go if it was her time.

We gather and listen as Elyse’s doctors summarize the cascading problems causing her decline, how attempting to treat one will likely make another worse, and the lack of any clear path forward.  She is being kept alive through medications that keep her blood pressure up, and will likely die within minutes if they are withdrawn.  Keith lifts his head and speaks:  “Time to let her move on to her eternal reward.”  

Keith then turns to me and asks, “Pastor, would you join us in Elyse’s room and offer prayer as we say our goodbyes?  I know your presence would be a comfort to her—and to us all.”

As we enter Elyse’s ICU room, her favorite Pentecostal praise singer is streaming loudly from an iPhone near her bed.  Keith, their two daughters, their husbands, and Keith’s brother surround her bed.  They take turns expressing their love for her and praising God for the gift of her life and for His everlasting love.  At their request, I read the 23^rd Psalm and offer my own prayers in a manner aligned with their faith and concerns.

The music and prayers continue, mixed with tears and sobbing, as we watch Elyse’s blood pressure and heart rate fall to zero.  There are hugs all around, accompanied by expressions of joy that she is now in God’s arms, and how wonderful it will be to join her one day.

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One’s beliefs need not align with those of Elyse and her family, or hold any religious beliefs at all, to recognize this as a “good death”:  accompanied through life’s final passage by the people most important to you, who respect and honor your wishes for end-of-life care, and stand by you to the end.

The 23^rd Psalm is one of the most commonly recited texts in Judeo-Christian traditions, for good reason.  For me, the heart of the psalm is verse 4:

Even though I walk through the valley of the shadow of death,
I will fear no evil, for you are with me.

The “you” the psalmist refers to is “The Lord [who] is my shepherd”; for many, including Elyse, this image of divine protection is powerful, but for others it feels remote or meaningless.  To my mind, though, each of us has the ability to bring comfort and safety when someone we know has entered their “walk through the valley of the shadow of death.”  In my experience, accompanying those we love through this valley is a powerful antidote to the fear and anxiousness surrounding the mystery of death.

Many, though, find this accompaniment difficult.  Some friends of my father declined to visit him in his nursing home, saying “I’d rather remember Jack as he was,” and I have spoken with patients many times about loved ones who keep putting off visits.  On one level I find this understandable—seeing someone who was once vibrant but is now frail can be a painful reminder of our own vulnerability and mortality.  But it is also tragic—the one who is dying is denied the comfort that loved ones can bring, and the loved ones who keep a distance deny themselves of one of life’s most meaningful experiences.

This isn’t “chaplain work”—it’s for everyone, at every stage in life.  I recently shared time with a 10-year-old boy and his father as they visited the boy’s grandmother in the ICU, and I marveled at how natural the interactions among the three of them were despite the setting and circumstances.  The boy brought joyous smiles to her face, and he was absorbing valuable lessons about aging and dying.

Even with repeat experience, though, it never stops being hard.  Accompanying Elyse and her family was definitely hard, and it’s harder yet with the people who mean the most to us.  Still, I always feel a bit more completely human every time I show up for someone—and a bit more prepared for my own inevitable passage through the valley of the shadow of death.