Author: Greg Morgan

Telling Our Life Stories

On By Greg Morgan3 Comments

It was a lighter day at the hospital, so I reviewed charts on the oncology unit to identify patients who might welcome a visit. Sue, in her 70s, had lived with metastatic breast cancer for a few years; she’d been admitted for intractable nausea, which was starting to settle down. After ruling out other causes, her doctors had concluded it was the spread of her cancer itself that had caused the nausea.

I knock and introduce myself, and Sue welcomes me in.

“It’s nice of you to stop by. I was raised Catholic but haven’t really followed any religion as an adult.”

“That’s true of a lot of patients here. We chaplains are here to discuss matters of faith for those who want that, but mostly we’re here just to offer company and to listen to whatever is on your heart.”

Sue thinks quietly for a minute, then speaks. “I was hoping my nausea was something else, but they tell me it’s my cancer moving to a new phase …” She begins to tear up.

“I’m sorry, Sue, that’s hard news to hear.”

“I’ve been through surgery, chemo, and radiation, but those aren’t options now. There’s an immune therapy treatment I could try; it might make a difference, but even if it doesn’t, it could give me more time with my wife and our children and grandchildren. I think I want to try it.”

“I can understand why you might. What would you like me to know about this family you love so much?”

“Well, my wife and I both have children from previous marriages who are about the same age, and they have all become close, especially as they had their own children.”

“That’s wonderful!”

“I should back up a minute. I grew up in a family that was loving but very conservative … I’m sorry, you don’t really want to hear all this, do you?”

“Oh yes I do. This is what we do. I love hearing all about the interesting lives people have lived.”

“OK, then …” and Sue is off and running with a beautiful tale of how she and the family who loves her today came to be.

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More and more each day, as a chaplain and as a human being, I appreciate the power and beauty of what we call “life review”: one person sharing with another a story of their journey through life that brought them to the place they find themselves today.

Engaging in life review is by no means limited to the later stages in life. It is precisely what people in the budding stages of romantic relationships share with each other, whether as teens or starting anew in their fifties. Most of us remember the thrill of this well. Regardless of the hard parts along the way—or perhaps especially because of them—it is immensely meaningful to tell one’s life story to another person who demonstrates genuine interest. We are wired for this, as storytellers and as listeners.

That said, I think life review takes on greater significance as we age, yet often the need for it goes unmet. “Yes, dad, we know that story about the time your car burned up on the turnpike” is a classic. I know I’m as guilty as anyone of repeating my stories, yet I’m always grateful for new ears to tell my stories to. I’ve come to believe that telling our life stories—and having them validated by listeners—is one of our principal means of reassuring ourselves of the significance of the lives we’ve lived.

Sadly, we often wait too long to make time for engaging with our elders in life review. My favorite memorial services feature people telling stories about the departed, but often many in attendance—even close family members—say to themselves, “I had no idea.” Years later we might ask, “I wonder what Mom felt when she first saw Dad after he came back from three years at war,” but the opportunity for that conversation is gone.

These thoughts have whetted my appetite for seeking out and listening to the life stories of people of any age, and I try to encourage others to do the same. It is gratifying to know that, in doing so, we are helping them feel the benefits of having their stories heard. Just as important, though, is what we can gain from it. In a recent column Anne Lamott said, “When my friend Pammy was dying at the age of 37, her doctor told me, ‘Watch her now, because she’s teaching us how to live.’”

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Three days later I’m back on the oncology unit and I pop in to greet Sue again before she discharges home. She appears momentarily confused, asks me to repeat my name, then smiles.

“You’ll have to forgive me, these meds make my brain a bit foggy. I do remember you visiting me.”

“No problem at all, the meds can do that. I really loved our conversation, and I wanted to see how you are doing today.”

“I’m definitely feeling better. My nausea is gone, though I’m still pretty weak. I’ll start immune therapy treatments on Monday, and I’m hopeful they will do some good. But I’m sad that I won’t be able to return to my work—it’s just too demanding.”

“When we spoke last time you didn’t mention your work. It sounds like it’s been an important part of your life. Would you be willing to tell me about it?”

“I’d love to. I’ve done a lot of things, always having something to do with photography. It all goes back to when I was in high school. I was always good in art, but then I had this teacher … I’m sorry, you don’t really want to hear all this, do you?”

I smile and say, “Of course I do.”

Sue smiles back. “That’s right, of course you do. As I was saying …”

Here for Each Other

On By Greg Morgan3 Comments

It is late 2021. I listen in stunned silence as my urologist goes over my prostate biopsy results. After years of monitoring my PSA levels had begun climbing, and now I know why: “Grade Group 3 = Gleason 4+3=7” is as cryptic as it gets, but its interpretation—“Intermediate Unfavorable”—is not.

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This is a story of how friends can show up for one another—and, in particular, how friends showed up for me at this moment. It begins fifteen years earlier, and the community from which it arises goes back yet further. These memories are filtered through my own lens of experience. I have shared what follows with each friend and I have incorporated their memories—filtered through their own lenses—to land closer to the truth. The story is ultimately mine, but each friend agreed to include their story for any benefit it might bring to others.

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It is 2006. Rosalie, a physician in my Quaker meeting, is bringing a prepared message to our worship, wearing a brightly colored scarf wrapped around her head. She thanks our community for the support she’s received since her breast cancer diagnosis and subsequent mastectomy and chemotherapy.

Then Rosalie unwraps the scarf, revealing her gleaming bald head. Many in worship gasp, and she continues. “I’m the same Rosalie I ever was, but I have now joined an elite group that includes Mitch [a bald member of our meeting] and Yul Brynner.” She continues in a light-hearted tone, and we all breathe more easily, knowing she is back.

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One of the first things I noted when I began participating in Quaker community 30+ years ago was the openness with which others shared the truly hard parts of their lives—and requested and received support from the community. What struck me as Rosalie spoke that day was her transparency, as if to say, “I share this with you because you are my friends, and I want you to know me as I am today, with no mystery and no embarrassment.” I decided then that this was someone I wanted to know better.

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It is 2009. Caryl, the first friend I made among Quakers, asks me, Rosalie, and a couple of others to support her during a difficult period at work. We do so, expecting to gather for only a year or two, but Caryl’s work remains volatile. Meanwhile, life goes on and we journey through it together. In 2011 Caryl, widowed twenty years earlier, marries Jeff, a more recent widower, and we celebrate a joy that neither anticipated ever experiencing again.

Two years later Caryl shares the hard news that she’s been diagnosed with Parkinson’s disease, about which it is often said “the only thing predictable is unpredictability.” Over the years, as Caryl’s Parkinson’s advances, Jeff begins participating actively. Today, several friends continue to share intimate gatherings in support of Caryl—and Jeff.

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“Anchor committee” is one of several flavors of spiritual care committees, a practice common among (but not limited to) Quakers. The goal of a spiritual care committee “is to provide sustained support, guidance, and accountability throughout the duration of the need.”1—exactly what Caryl requested.

I love the image of an anchor committee—friends gathered to offer a friend stability and centeredness during a stormy period in life. The document in the footnote provides helpful guidance for how to support effectively as a group, but such groups need not be grounded in religious faith or communities.

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It is 2011. Fred, a long-term member of our Quaker meeting, has been diagnosed with frontal lobe dementia and ALS, which are closely related. Many of us don Fred’s favorite striped shirts for a Walk for ALS along the Portland waterfront, joined by students from Fred’s teaching years. We all watch as, week by week, these diseases break Fred’s body, challenge his spirit, and tear a hole in the heart of his wife, our beloved Peg, a spiritual director. It becomes clear that an upcoming birthday will be his last, and Fred asks for a community birthday party so he can celebrate it with us.

Our friend Mike helps organize the gathering, and asks Fred what he would like. Everyone dressed in striped shirts, and lots of music, especially Beatles. Mike presses Fred for specific songs, and Fred—by now struggling to breathe—sucks in all the wind he can summon and answers, “Why Don’t We Do It In The Road.” And so it comes to pass that a hundred of us gather in striped shirts for an evening of musical celebration of Fred, including a raucous rendition of Fred’s requested song.

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Fred’s birthday party is one of my defining images of what it means to be a caring community of friends. It is tremendously sad to watch a beloved friend become wasted by disease, and many find it difficult to spend time with such a person on the cusp of death, saying a real and final good-bye. But death comes to all of us and it is far worse, I believe, to walk through this alone. When it’s my time, I hope to go like Fred, surrounded by friends like these with whom I have truly shared life’s journey.

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I share my cancer diagnosis with my family and with my Quaker community. I get a call from Rosalie. “Greg, it seems you might want a care committee. I’m happy to convene one for you. Who would you like me to invite?” I agree, and my answer includes Caryl, Jeff, and Peg. All agree to serve. My wife Diane is offered the option of joining and she accepts. It’s her journey, too, of course.

I am more accustomed to offering care, and it is humbling to share as vulnerably as these friends have shared with me–but my trust in them is complete. In our first meeting Rosalie, no stranger to cancer, asks “Have you given your tumor a name yet?” I pause and reply, “The Beast.” She counters, “That seems like a name you’d share publicly. How do you address it directly?” I wince at being called out—remember that word “accountability”?—but I center and let my emotions rise. “YOU MOTHERFUCKER!!” I bellow. Rosalie smiles and continues, “Now that sounds more authentic. Do others have questions?” We are off and running.

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To live in this world you must be able to do three things
to love what is mortal
to hold it against your bones knowing your own life depends on it
and, when the time comes to let it go, to let it go.

Mary Oliver, from “In Blackwater Woods”

As friends in an intentional community, we have made the commitment to love each other despite our mortality, and to hold each other close, especially when our lives depend on it. While our Quaker meeting is a religious community, religion is not essential—my wife’s long-running cooking club has moved increasingly in this direction as its members confront the ravages of aging. What matters most is a group commitment to show up for and love each other, come what may.

It’s never too early to ask, “Who are these people for me?”

  1. A Care Committee: A Ministry of Prayer and Learning Devoted to the School of the Spirit is under the care of the committee on Worship and Care of Philadelphia Yearly Meeting of the Religious Society of Friends. ↩︎

Peace

On By Greg MorganLeave a comment

Betty was in her early 80s, admitted for a bleeding mass in her esophagus that seemed likely to prove malignant and inoperable. She’d requested a chaplain visit overnight, so I made her my first priority that morning.

“Greetings, Betty, I’m Chaplain Greg. Thanks for inviting me to be with you.”

“I’m so happy to see you. I’m doing well this morning. I have been blessed to know Jesus Christ as my Lord and savior since I was a little girl.”

“What a joy that is! I’m happy for you!”

Betty proceeds unprompted with “life review,” sharing about her 60-year marriage to her husband, a retired pastor with several chronic medical conditions, and their children and grandchildren, who continue to play an active, supportive role in their lives.

“Now it seems my time may be coming … I’m excited to finally meet Jesus face-to-face, though I worry a bit about my husband. We’ve always talked that he’d be the first to go, given his health, but now it looks like I may be. Still, I trust God to care for him as He always has, and our children will be there for him, too. And it won’t be much longer until we are together in heaven.”

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My friend John asked me at dinner recently, “What percentage of the people you see nearing end of life are at peace with their situation? What factors seem to make the difference?” I am under no illusion that I have definitive answers to these questions, but I’ve seen enough to offer a few thoughts.

My answer to John’s first question was, “Maybe 60%, maybe more.” Betty is just one example among several since our dinner. I will continue to keep this question in mind over the coming months as I go about my rounds, but it feels right, at least for the population I see in the hospital where I work. John’s second question—“What factors seem to make the difference?”—is harder.

Religious faith is an important source of peace for many facing death, but it’s no guarantee—for some, their faith can elicit a sense of having fallen short of what was expected of them in life, and fear of the consequences. And I’ve seen plenty of patients with no active religion, or even explicit atheism, who seem fully at peace with their imminent deaths (Clark, The Science Teacher, is one example).

One factor uniting Christian Betty with atheist Clark is a sense of wonderment about the source of their existence and the universe we inhabit, as well as deep gratitude for the life that this source provided. Gratitude is a theme that runs through so many of the patients I see who are at peace, even (or perhaps especially) in those whose lives have been remarkably difficult (for example, Dean in From The Ashes).

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Lucy, in her 50s, was a new admission to the oncology unit but no stranger to cancer. Her lung cancer, diagnosed 10 years earlier, had been managed with surgery and chemotherapy, but after recent headaches and dizziness she was re-evaluated and found to have tumors throughout her brain. She made a request for a chaplain visit the night she was admitted.

Lucy greets me warmly as I arrive, guessing correctly from my attire that I’m the chaplain she’d requested. She gets right down to business.

“It looks like this is it,” she begins. “I’ve had a good run and gotten a lot of extra years, but I’ve always known this day would come and now it’s here.”

“I’m sorry, Lucy—that’s difficult news, even if you are prepared for it. How’s that sitting with you this morning?”

“I’m mostly OK. I’ve got my affairs in order, and I’ve discussed this possibility with my kids for years, so they’re as prepared as they can be.” Her voice trails off but her eyes remain engaged. I wait for more.

“What I really wanted to talk to you about is my sister, who I haven’t spoken to in years. We got along well enough growing up, but as an adult she became really mean and cruel to me.” Lucy relates an escalating series of events, culminating in an act of betrayal that led Lucy to cut off communications between them.

“That’s heartbreaking, Lucy,” I reply, “but I can understand why you felt you needed to set that boundary in order to protect yourself.”

“I don’t regret it, but I realize I’m still angry about the way she treated me. I don’t want to die angry. I wanted to talk with you about how I can forgive her—I think I need to find a way to do that in order to die in peace.”

So we talk about how forgiving another person is something one can do on one’s own. It doesn’t require anything of the person being forgiven, no matter how much one might wish for an apology or just an acknowledgement of hurt. It doesn’t even need to be communicated to the other person. Forgiveness is something one can offer for the sole purpose of putting one’s own heart at rest.

“I never thought about it that way at all, but now that you say it, it makes perfect sense. I think I’m ready to start writing down what I want to say. I’ll figure out later if I actually want to send it to her.”

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Every time we chart a spiritual care encounter, we are prompted to assess the patient/family regarding “Forgiveness/Peace.” At one end of the scale, 1 = “Sense of reconciliation” and 2 = “Still have some things to reconcile.” In this context, reconciliation means “Is the patient/family reconciled with and at peace with their situation?” It doesn’t necessarily mean “Have they reconciled with the important people in their lives?” but it certainly can. In fact, the other end of the scale is 4 = “Distanced from others” and 5 = “Alienated from others,” reflecting the importance of relationships in finding peace.

Betty and Clark are good examples of “1” but I’d say the “2” I gave Lucy is more common, especially in the early days of a hospitalization. Most of us have some Unfinished Business (to cite yet another post) that we need to take care of, and a medical crisis can prompt us to take steps to heal relationships that we may have long been putting off. One of the most important things we can do as chaplains is to serve as a sounding board to help others identify the unfinished business in their lives so they can begin to move forward toward peace.

That night at dinner, I told John I thought one of the biggest factors impacting a patient’s sense of peace is having enough time to prepare for end of life. I would now frame that differently: it’s having very little unfinished business—especially unreconciled relationships that need to be set right in order to be at peace. It’s a helpful reminder that it’s never too soon to begin that work …

Duncan Turns 70

On By Greg Morgan3 Comments

I rise to do my morning yoga, and I realize it is Duncan’s birthday, his 70th. My mind is immediately flooded with memories of our lives together, which grow in meaning for me with passage of time. The mark of a true lifelong friend.

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I am 11, and my parents have moved me from the overcrowded parochial school that is all I’ve known to a small private boys school. I know almost no one there, and it feels like the others have been together for years. I have no clue how to fit in to the culture and can’t wait for each day to end. Before long, though, a goofy-looking red-haired kid, who seems well liked by everyone, invites me to spend the night at his home. I have more fun than I can ever remember, and when I return the favor it is even better. In short order I am “one of Duncan’s friends,” and school life is suddenly easier.

That summer, much to my delight, my parents move our family to a house two blocks from Duncan’s. As we enter 7th grade, we begin walking to and from school every day, a practice we keep up through high school graduation. We spend afternoons and weekends together, too, listening to the Beatles and the Grateful Dead, sharing a love of the Colorado mountains, getting in good trouble (and bad) together, and always having each other’s backs.

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I watched Duncan exercise his superpower of radical hospitality many times over these years. If a kid seemed lost—or, even worse, ostracized—Duncan would reach out, bring him into our ever-expanding circle, and simply say, “Jeff’s cool”—and it became so. Though I’ve tried, I’ve never been able to do this as intentionally and seamlessly as Duncan. There are many who, like me, revere Duncan for the quality of his friendship. My bond with him somehow feels unique, but others feel the same way about theirs.

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There is a shadow underneath Duncan’s sunny disposition, though, and I understand why. He is the youngest brother in a patriarchal family led by his maternal grandfather; many mornings his grandfather and older brothers are gathered over business at the breakfast table when I arrive for Duncan. I sit on the steps nearby and can’t help overhearing them berate Duncan as a loser who won’t amount to much. They may think they are challenging him to raise his game, but I can watch him slowly internalize their messaging.

We are juniors, and our math teacher is called out of the classroom for a moment. We seize the opportunity to look through the grade book sitting on his desk. Everyone’s grades are pretty much as we expect, but we note an unmarked column of numbers that we determine are IQ test scores. We are stunned to see that Duncan has the highest score of all, even though his school performance is below average. We declare him the most underperforming student in the school, in the spirit of rebellious admiration, but I can watch Duncan internalize this label, too.

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As I reflect on the depth of our friendship during these years, I recognize we are kindred spirits in more ways than I could see at the time. I, too, had older siblings that I felt I couldn’t measure up to, and a home I longed to escape from. I, too, had been startled to learn that my IQ score was quite high, only slightly lower than Duncan’s; for me, though, this news gave me confidence that if I cared more I could do better, and I began to respond accordingly.

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I head off to college and Duncan follows me out to Portland, though to a different college due to his lower grades. He never returns for a second semester, instead taking an entry level job in the family business. I try to connect with him during trips back to Kansas City, but with little success. I see his lovely mother the day before our 20th high school reunion and she tells me Duncan is excited to see me there, but he ghosts all events he has signed up for. Years later he serves as an intern on a geology field project led by one of my sisters; she says he seems great, and would love to see me.

It is 2007, and my father has died. At my sister’s urging, Duncan shows up at a post-memorial gathering at another sister’s home. Duncan’s red hair has turned white, but it is as if nothing else has changed. We hug tightly, cry copiously, and spend several hours filling in the blanks of the years gone by. Duncan has bounced around in his work and his relationships, but drugs and alcohol have been steady companions. Duncan tells me he has no liver left and is on borrowed time. It is a shock but not a surprise when we learn later that year that he’s been found dead, slumped over his guitar—52 years old.

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Duncan lives on in the lives of those he touched. Several of us exchange emails whenever stirred by memories of Duncan, most recently when Phil Lesh of the Dead died. We do so again today, on his 70th birthday. We all miss him dearly. I was blessed to have him in my life when I did, and I am blessed to have a community of friends and family with whom I can share his memory today.

I’ve never succeeded in conveying Duncan’s profound spirit to anyone who didn’t experience it directly. On one level he was simply someone who never amounted to much—as the men in his family predicted—a slacker who squandered the benefits of a privileged upbringing. But, as I’ve experienced often, such a surface can obscure a rich, complex, and spirit-filled human within, and that person’s spirit can create a ripple deeper and more powerful than anything one might easily observe.

Duncan helped me believe in my own self-worth in ways that no one else had before, and he taught me that even the most unlikely people are worthy of friendship and respect. Duncan’s spirit continues to inspire and inform my work in chaplaincy today.

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More stories of Duncan are contained in the beautiful New Yorker article Scars, written by David Owen, another member of my class touched deeply by Duncan. I am “Henry” in this article, a moniker I carried throughout these years. The photo of Duncan accompanying this post was taken by David in the San Juan mountains of southwestern Colorado, a place we all thought of as heaven on earth.

We’re All Human

On By Greg Morgan1 Comment

During my clinical internships, a patient request came in to the chaplain’s office, where several of us were gathered.

“It’s for Willy,” one of the chaplains announces to the room. The others nod.

“Hey, Greg, this would be a good one for you,” she continues. “Willy’s in and out of the hospital a lot, we all know him. He’s a nice guy and loves chaplain visits, but he can be demanding so we try to share the load. Your turn today.”

I review Willy’s chart, which reveals a history of IV drug use and homelessness, though he is now clean, sober, and housed. He has several chronic medical conditions, including a heart condition I’m not familiar with: endocarditis. I mention this to one of the chaplains.

“Ah, yes, we see a lot of that, especially with patients like Willy. You’ll want to read up on it at some point. But you don’t need to know anything about it for your visit.”

So I head off, and Willy is just as advertised: Grumpy to see yet another new chaplain, but softening slowly as we engage. Grateful for company, happy to share about his religious upbringing and the twists and turns of his life, and appreciative of prayer. While difficult to disengage from, he leaves me hoping I will see him again—which I do. A beautiful, complicated human.

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Endocarditis is an inflammation of the lining of the heart, characterized by lesions, called vegetations, that are as strange as anything I’ve seen in medicine. Visualized via echocardiogram, they remind me of strands of kelp floating in a sea bed. Needless to say, that’s not a good thing for one’s heart valves or overall health, and it can be difficult to treat.

Endocarditis is usually caused by bacterial or fungal infections, and there are many risk factors that make people susceptible to it. The most prevalent, at least in the population served by my hospital, is IV drug use. That’s one of the reasons my chaplain colleague thought a visit with Willy would be a valuable part of my training experience.

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A year later I am called to a “rapid response” for Vivian, a patient on the floor where I’d visited Willy. This term means there has been an unexplained change in a patient’s condition. While often not serious, chaplains always respond in case visitors are present who may be distressed by the change in the patient or by the flurry of responders. This time there are no visitors, but it’s clear Vivian’s situation is not good. I stand aside as she is whisked down the hall on a gurney to the ICU. I check with her bedside nurse and learn that Vivian is visited daily by her husband as well as other family and friends.

I return to the chaplain’s office to scan Vivian’s chart, where I learn that, in addition to cancer, she’d been receiving treatment for endocarditis, possibly caused by an infection in her chemo port. I then head to the ICU, where providers of all kinds are rushing in and out of her room. The charge nurse spots me quickly and says, “We need you to take point with the husband, who’s on his way.” She paused to get an update from another nurse, then turns back to me. “He just arrived in the waiting room.”

What follows is some of the most difficult work I’ve done as a chaplain: Conveying the gravity of Vivian’s condition without prematurely extinguishing hope. Accompanying her husband through shock and grief while helping him spread the news of Vivian’s situation to loved ones. Welcoming family members to the ICU waiting room and gathering them for updates from doctors working to save Vivian’s life. Steadying them through new waves of grief as they receive the news that nothing more can be done. Keeping vigil with them in the waiting room as the staff prepare Vivian’s room for all to gather to say their good-byes, then accompanying them back to see her. Through it all, we share many tears and prayers.

In the agonizing waits between updates, I ask her loved ones what they would like me to know about Vivian. I learn that she is a committed life partner, a hard worker, a person of bedrock faith, a loyal friend, the life of a good party. All I can say in response is that she sounds like someone I would like to know. Yes, they say, everyone loves Vivian.

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I step outside of Vivian’s room to speak with Dr. Weiss, who’s been leading the charge to save Vivian’s life. He is busily charting the care that had been provided to Vivian.

“This might take me a while,” he says tersely, without looking up.

“I understand, I will wait,” I reply as calmly as I can manage.

After 30 seconds or so he stops typing, hangs his head for a moment, then turns toward me. “I’m sorry. What’s your question?”

“I’m trying to prepare the family for the next step, which I suspect is you explaining the process of disconnecting life support.”

He nods. “I need a few minutes, but I don’t want to wait too long, either. What do you think?”

“Five minutes is probably about right. Give me a couple of minutes, then come in whenever you feel ready.”

He nods again, then pauses. “You know, when I saw she had endocarditis, I just assumed she was a drug user, though I realize now that she’s not. I’m sitting here feeling like a complete asshole that this thought even crossed my mind, because it shouldn’t—and didn’t—change the care we gave her. Still, I feel terrible that I thought it anyway.”

“Well, if it’s any consolation to you … I went through the same thought process. I don’t think that makes us assholes, I think it just means we’re human.”

We share a brief nod and smile, then resume our duties.

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The Trappist spiritual leader Thomas Merton urges us “to resolutely put away our attachment to natural appearance and our habit of judging according to the outward face of things … Our job is to love others without stopping to inquire whether or not they are worthy.”1

Like many spiritual teachings, I hold this as an ideal to which I fervently aspire, but most days I fall short. I’m only human, and this habit of judging has usually run its course before I even recognize it happening. Dr. Weiss is only human, too. Same for Willy, for that matter. I know we’ll all keep trying, but we’ll also keep failing. We’re all human, and that’s the best we humans can do.

I’m just grateful we have each other to look to for support when we do fail, and a Creator with infinite compassion for our limitations.

  1. For the full context of this quote please see: Thomas Merton on Loving Others ↩︎

Toxic Theology

On By Greg Morgan3 Comments

I was paged to a “Rapid Response” on my hospital’s inpatient rehab unit, as Carla, a patient engaged in physical therapy, had suddenly become unresponsive. As usual, I sought out family and was quickly introduced to Carla’s husband, Randy, and his brother. They seemed unusually calm.

“It’s probably just a medication imbalance,” Randy began. “This has happened before. But thank you for coming, Chaplain. We’re Christians and we believe in the power of prayer—Carla’s got an army of prayer warriors pulling for her.” Randy’s brother nodded.

“Can you tell me what brought Carla to our rehab unit?” I asked.

“She was shot two months ago in a robbery at a grocery store in the small town where we live. The bullets did a lot of damage, and after the wounds healed they sent her up here to Portland to regain as much function as she can. She’s been doing well, though there have been setbacks … like this.”

“Oh, I’m so sorry. That’s just terrible.”

“The hardest thing …” Randy said, “is that we saw the whole thing on film from the security cameras. I guess she didn’t get down fast enough for the robber. He shot her once and then, when she was lying on the ground, he shot her two more times for no reason at all. I just can’t understand evil like that.”

Just then Randy needed to provide information to the medical team treating Carla, so I told him we’d keep them all in our prayers, then departed.

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The problem of evil has challenged thoughtful people from the beginning of time. We humans have an instinctive impulse to try to understand cause and effect, to find meaning or make sense out of our experiences. When a person dies unexpectedly or has a life-shattering experience, we can’t help but ask why. Often, there are no answers available.

The problem of evil has an extra dimension for people who believe in a god with the power to influence human affairs. This problem has its own term, theodicy, used by philosophers and theologians who wrestle with it. No one gets through seminary without studying different schools of thought on this topic, and no one graduates without having to develop a personal point of view on it.

I was forced to reckon with the flimsiness of my own fledgling theology more than 25 years ago, when the spouse of a work colleague was brutally murdered. I wrote about this experience during my first year of seminary (God Not Feeling Omnipotent), and I have continued to test and refine the point of view expressed in that post ever since.

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A few days later Carla was on a medical unit I was covering, and I looked in on her. During previous visits she’d been surrounded by family and appeared confused, but this evening she was alone and alert.

“Oh, hi, Chaplain. Thank you for coming to see me.”

“Greetings, Carla. It looks like the fog of the past few days has cleared. I’m glad to have a chance to meet you properly.”

“Yes, it was the meds, but they adjusted them and now I can think again. Do you have a few minutes?”

“Absolutely, that’s why I’m here.”

“I’ve been sitting here thinking about why this happened to me. I’m grateful that lots of people are praying for me, but they keep saying things like ‘Everything happens for a reason’ and ‘This must be part of God’s plan.’ Those sayings don’t make any sense to me right now.”

“Can you say a little more?”

“Well, if this is God’s punishment for something I did, I can’t figure out what I did to deserve this. I know I haven’t lived a perfect life, but I’ve tried to follow God’s commandments. I probably won’t ever walk again. How is that fair?”

“I agree, it really doesn’t seem fair.”

“And how is this supposed to be part of God’s plan? Would God purposely do this to me so that I might learn some lesson, or so that other people might benefit from my example?”

I pause, then reply. “The God I believe in doesn’t act that way.”

“The God I thought I believed in wouldn’t act that way, either, which is why this is so confusing.” Carla’s eyes fill with tears, and her voice quivers. “Why did God do this to me? What do you think, Chaplain? Tell me.”

I offer my hand and Carla takes it. We share silence together as I let my own feelings rush in, and then I try to gather my thoughts.

“Carla, I’ve had to change my understanding of God over time in order to make sense of situations like yours. The only God I can believe in is always on the side of love, always working to heal our brokenness. That God would never say ‘Let’s put a couple of bullets in Carla to teach her some humility.’”

Carla laughs through her tears. “Thank you for saying that. I can’t imagine God being that way, either.”

“On the contrary, I believe God was doing everything in their power to stop the robber from shooting you. But I’ve had to conclude that God doesn’t have the power to stop something like that. I’ve had to let go of the idea that God is all powerful in order to hold onto the idea that God is all loving.”

“That’s a lot to take in …” Carla responds uncertainly. “But I do believe that God is all loving.”

“And I believe that God has been with you throughout this ordeal, including tonight, working to heal your body and, especially, your spirit.”

We close with a time of prayer, giving thanks to a God who loves us through our pain and doubts.

◊

Toxic theology is all around us. It may wear the cloak of religion (“It’s all part of God’s plan”) or it may simply be part of the cultural air we breathe (“Everything happens for a reason”). It often arises as we try to make sense of things that make no sense, as we try to assert control over events or emotions that feel out of control, as we seek safety when we feel vulnerable. While it may at first be benign, we often give it power over domains where it can be destructive without ever realizing what we have done.

Any theology, whether religious or secular, can become toxic when we seek to apply it to other people. Carla’s prayer warriors were no doubt well meaning, but they assumed their theology applied equally to Carla without having any experience of Carla’s suffering. I always have trepidation when a patient asks me about my own theology, especially from a place of vulnerability, as I don’t have their life experience and don’t know what conflicts it may create for them. I can only speak from my own experience and hope they find something of value in my words.

We live in a time when, as much as ever, people are seeking to impose their world view on others without first seeking to understand the experiences of others that shaped their different world view. I am grateful for every opportunity I get to listen deeply to the life experiences of others. I always come away convinced of the power of love to bridge our differences.

Safe Passage

On By Greg Morgan2 Comments

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 23rd 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.

◊

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 23rd 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.

Leaving Home

On By Greg Morgan7 Comments

I knocked on the door and was welcomed in by Mike, a man in his 70s who’d been hospitalized with a lung infection.  I’d had a good previous visit with him, and I’d noticed in his chart that he was making sufficient progress that he would soon be discharged to his home.

“Greetings, Mike,” I begin.

“Greetings, Chaplain,” he replies.  “I’m glad you stopped by—they won’t be keeping me here much longer.”

“So I hear … you look great, much stronger than when I last saw you.  I’m sure it will be nice to be home with your wife, and to sleep in your own bed.”

“Yes, it will …”  Mike’s voice trails off as he turns his gaze toward the window.  His face flushes a bit and his eyelids quiver almost imperceptibly.  I quietly take a seat by his bedside and wait.

“An hour ago I signed off on the sale of our home.  We’ve lived there for 50 years.  It’s where we raised our family, and it’s the only home our children have known.  I know it’s the right step for us, but I’m sitting here feeling the weight of it—that this is finally happening, and there’s no turning back.”

“That’s a huge milestone in life, Mike.  I can understand why your emotions would feel so strong.”

Mike launches into “life review,” sharing stories about he and his wife buying the house, raising their children, and special events they celebrated there.  He also remarks how their house has become too much for them, and how much easier life will feel in their new home in a retirement community.

“With all this, it seems ridiculous for me to get so emotional—we’ve been so fortunate compared to so many others, and we’ll do fine in our new place.”

“Those things can all be true and it can still feel like a big loss,” I offer.

“I suppose more than anything it’s a reminder that most of my life is behind me now. There’s no denying we’re getting older.”

“Also true, hard stuff.  It’s good that you can name it like that.”

At Mike’s request, we close with a time of prayer, celebrating all he had been granted in life thus far, and seeking blessings for all that was yet to come.

◊

When Mike and I spoke many months ago, I had no idea I was about to embark on a similar journey.  My wife and I had spoken from time to time about how we couldn’t stay forever in our beloved house of 41 years, but the timeframe for moving kept shifting.  After all, age 70 seems safely distant at age 60, much less so at age 69.

This spring we agreed we should begin getting familiar with options that might fit with our family priorities and finances.  Quite serendipitously, the first house we looked at—just to get a sense of the neighborhood, we said—we fell in love with and agreed we could imagine our future there.  Just as serendipitously, an unsolicited letter arrived in our mailbox from what turned out to be a perfect buyer.  Before we knew it, we were sprinting to make the purchase and sale happen, and uprooting our lives to a new home 15 miles away. 

Only now is the enormity of what we have done settling in … and the story of Mike has bubbled to the surface.  Many of the feelings and memories Mike experienced that day now stir within me.  I find myself trying to listen to that chaplain’s voice.  It’s one thing to speak such words when playing the disinterested third party, quite something else when it’s first person singular.  I can’t deny the weight of the transition, nor should I try (says the chaplain again).  Getting through this move, and the process of absorbing its meaning, is the reason behind Elder Chaplain’s three month hiatus.

An acquaintance whose work I admire uses the phrase “befriending mortality” to capture the heart of her practice.  This resonates strongly for me, as it captures one of my deepest hopes for my work as a chaplain, and for my writing in Elder Chaplain.  Mortality is like an uninvited guest in one’s house, one that may at first reside unobtrusively but over time becomes increasingly disruptive, and eviction is not an option.  The great Sufi mystic Rumi teaches us to befriend such guests:

Welcome and entertain them all!
Even if they’re a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.[1]

We have now swept our former house empty of its furniture, and we are preparing our new house in hopeful anticipation of new delights.  Mortality made the move to the new house right along with us, and will undoubtedly be a disruptive guest in the future, as it has been in the past.  I’m not ready to say we’re friends, but we are learning each other’s ways and accepting that we’re in it together for the long haul.

[1] The Guest House, by Rumi.

You Are Safe With Me

On By Greg Morgan1 Comment

A couple of years ago, during Pride Month, someone at our hospital offered the button pictured above to anyone who wanted one.  I have worn mine on my badge every day since, as “You are safe with me” is an appropriate message in any situation.  Two recent patient encounters drove this home for me.

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Evan was a 32-year-old living on the streets, using fentanyl daily.  A wound on his hand became infected; without care that infection grew into an abscess heading up his arm.  Unable to bear the pain any longer, he came to our ER and was admitted for antibiotic treatment and surgery.  When his nurse asked him if he would like to see a chaplain, he said he would.

I entered Evan’s room and found him in a fetal tuck, the sheets pulled over his head.  When I announced myself, he peeled the covers back just enough to eye me, revealing close-cropped rainbow-colored hair.  He motioned for me to sit on the foot of his bed, so I did.  I told Evan I’d be happy to listen to anything he wanted to say, or just sit with him in silence.  He responded, “Silence,” so I closed my eyes and sat silently.  From time to time I looked over to him; often his eyes were closed; sometimes he was observing me, and I tried to offer an affirming smile.

After a few minutes I said, “I am also happy to offer a hand to hold, if that is something you’d like, but it’s completely up to you.”  Quickly a hand slipped out from the covers, still stained from the grime of the street despite a hospital cleansing.  I placed his hand in mine.  His grip was initially limp, but soon he began squeezing gently, and I squeezed in response.

Then Evan spoke.  “I just want to be healed from my addictions.  Will you pray for me?”  I asked, “Is there a religious tradition that is important to you?” and he replied, “Methodist.”  I asked, “Were you raised in that church?” and he nodded yes; I asked, “Was that a good place for you?” and he nodded again; I asked, “Is that someplace you would like to move back toward?” and he nodded a third time.  So I offered prayers using Christian language, giving voice to his pain and longings.

◊

As I shared in my previous post, Not That Kind of Chaplain, one of the central elements of creating a safe space is giving the other person maximum agency to set the terms of the encounter.  For Ingrid, the patient at the center of that story, this was easy.  But patients like Evan generally bring to the encounter a history of trauma, and life on the streets means having no safe spaces.  Any attempt to move the encounter forward more quickly than the other person is comfortable with is likely to backfire.

Maslow’s hierarchy of needs places safety second only to our physiological needs, and under duress it can jump to the top.  Most of us, when meeting a person for the first time, hold our cards close to our chests, opening up only to the degree we perceive the other person to be safe.  My own needs for safety were much on my mind when I entered Evan’s room, and approaching him the way I did served my needs as well as his. I’m grateful that we each found the other to be sufficiently safe for such a meaningful encounter.

◊

Angela, a mother of three and survivor of a suicide attempt a month earlier, was admitted for a terrifying constriction in her windpipe.  After surgical treatment she was healing well.  During my first two visits other family members were present.  Angela projected an upbeat vibe, but always urged me to return. 

On my third visit Angela was alone.  She opened our conversation by saying, “I really like your button.  I noticed it before and wanted to say something.” 

I replied, “I like it too.  One of the most important parts of my job is to make people feel safe to share what’s really on their hearts.”

With that opening, Angela proceeded to speak honestly about her suicide attempt and all that led up to it:  a lifelong struggle with depression, the end of a long-term relationship, losing her home and moving into a trailer, troubles with her kids, a sense of hopelessness, and a bottle of pills too readily available.  But like George Bailey in the movie It’s A Wonderful Life, the people who showed up and cared for Angela through this crisis gave her a renewed appreciation for the value of her life and her importance to so many people.

Then she said, “I feel like I’ve grown distant from God.  I used to go to a Bible church that I liked a lot, but then a new pastor came in saying all kinds of hateful things about people who didn’t believe the same way he did.  That didn’t seem at all like what Jesus was teaching, so I left.  But now I don’t think about the good things Jesus taught any more.  Could you pray for me?”  And so we prayed together.

◊

“You are safe with me” has become an important personal mantra, concisely encapsulating the type of person I want to be in all my relationships.  I still have to tend to my own personal boundaries, of course, and not every person is someone I can feel safe with.  Pursuing this goal has been a journey of personal growth, one that began years ago in my personal and professional life, even if I couldn’t previously name it this way.  Now that I can, it’s something I want to consciously keep getting better at.

Not That Kind of Chaplain

On By Greg Morgan7 Comments

A spiritual care consult order came in from a unit I was covering.  Annie, a nurse on the unit, noted that Ingrid, an elderly woman in her care, seemed lonely and anxious; Annie thought she might benefit from someone to talk to.  Annie is delighted when I arrive and takes me in to see Ingrid.

“Hello, Ingrid!” she announces brightly.  “The chaplain is here to see you.”

“I didn’t ask to see a chaplain,” protests Ingrid.  “Why would I want to see a chaplain?”

“When we talked this morning,” Annie replies, “you agreed it might be helpful to have someone to talk with.  That’s why Chaplain Greg is here.”

“Yes, I did say that, but I didn’t say I wanted to talk to a chaplain.”

“Oh, don’t worry, Ingrid,” Annie smiles.  “He’s not THAT kind of chaplain.  Trust me, you want to talk to our chaplains—they’re the best!”

“If you say so …” Ingrid relents feebly.  Annie executes a quick about-face and heads out the door.

“Greetings, Ingrid,” I begin.  “Annie’s right, I don’t have any agenda, I’m just here to offer you company.  You don’t have to talk to me at all if you don’t want to, it won’t hurt my feelings.  It’s entirely up to you.”

“OK … but I don’t even know where to begin.”

“Well, you’ve clearly lived a long life, and I’m sure you’ve got stories to tell.  What would you like me to know about you?”

“I was born 94 years ago in a small town in Norway, north of the Arctic Circle,” Ingrid begins, and she is off and running with what we call “life review”—including positive memories of her Lutheran upbringing, a faith that fell by the wayside when she married and moved to the U.S.  It was amazing and heartwarming.  Acknowledging that her life is now nearing its end, she accepts this with equanimity and gratitude.

“I realize I’ve talked your ear off,” Ingrid concludes as she begins to fade, “but I do feel much better now.  So this is what you do, listen to people like me?”

“We do many things,” I reply, “but listening is the most important.  If people have religious or spiritual concerns, we are certainly there for that.  Often, though, people just need to talk to someone who really wants to listen.  It can be healing for them, and in return we get to meet wonderful people like you.”

“So now I know.  If that’s what chaplains do, you can come by any time.”

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Ingrid’s reluctance to visit with a chaplain was not at all unusual.  I once had a man shout “OUT!” the moment the word “chaplain” left my lips.  More often, people smile nervously and say, “No, thanks, I’m fine” when they sense religion might be on the agenda.  It’s unfortunate, but I can’t say I blame them.

Our children were born almost 40 years ago in a Catholic hospital, with a crucifix displayed prominently in each room.  The care we received was wonderful, but each time before discharge a nun, calling herself a chaplain, came by to perform a blessing on our babies.  She didn’t ask about our beliefs, and her agenda, not the desires of the newly expanded family, was the focus of the encounter.  We told her, “No, thanks, we’re fine.”

I know of many chaplains who struggle in workplaces where the other chaplains celebrate the number of souls they save for Jesus, despite training that emphasizes the need for respecting the faith traditions—including no tradition—of those they serve.  Even worse, a movement has recently emerged to place “volunteer chaplains” with no formal training in schools and other public institutions, with an explicit goal of proselytizing.[1]  No wonder the word “chaplain” sparks trepidation in many who hear it.

I’m happy to say I’m not that kind of chaplain, and neither are my colleagues.  We seek to put the patient (and/or family) and their needs at the center, and let them guide us toward the type of care that will be healing for them.  That begins with helping them feel safe to speak from their heart, without fear of judgment, much less a religious pitch.

Patients who want prayer or other religious care are usually direct about it, and we are always delighted to inquire about their faith and practices and offer care aligned with their preferences.  More often than not, though, the patient’s needs and wants are less obvious, so we try to approach in a way that is open and inviting.  Often, as with Ingrid, a patient may have no issue with religion, it’s just not what they need or want at that time. 

But many patients have a difficult relationship with religion, whether from being judged or abused in the past, or from feelings of shame regarding things they have done.  In such cases an explicit religious association can shut down a conversation before it ever gets started.  Once a patient feels safe, though, it’s not unusual for them to steer the conversation toward religion or spirituality, and to take a step or two toward healing their own religious trauma.

If one searches online for “chaplain images,” the vast majority of what pops up is explicitly religious and overwhelmingly Christian; while I am very much a Christian, I’m just not that kind of chaplain.  I selected the photo that opens this post because it represents the kind of chaplain that I seek to be:  down in the mess of life with my patients and my fellow care providers, meeting people where they are and offering them a distinctive kind of care they just might really need, even if they didn’t know it.

[1] “Some state lawmakers want school chaplains as part of a ‘rescue mission’ for public education,” AP News, March 29, 2024