Tag: #Elder

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.

◊

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.’”

◊

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 …”

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.

◊

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.

Dying is Often the Easy Part

On By Greg Morgan5 Comments

Marge was in her late 80s, hospitalized for congestive heart failure.  When we first met, she was being attended to by her daughter, Karen, who welcomed me in.  “Mom’s doing better today.  She’s active in her church, she’ll be happy to see you.”  We settled in for a nice conversation about her family, her faith, and her friends, and Karen and I departed together.

When I returned two days later, Marge was in her bedside chair wearing a bright lilac print dress—a sure sign she was being discharged.  I commented that it looked like she was having a good day.

“Oh, yes!” she exclaimed.  “The doctor came by this morning and said there is nothing more they can do for me.  I’ll be going home very soon to Jesus, and to my parents, and to all who have gone before me.  It’s so exciting, I can hardly wait!  I’ve been on the phone telling all my friends.”

What can one say to that?  One might or might not share Marge’s theology, but her joy was infectious.  Wouldn’t we all hope to be so positive nearing end of life?  I joined in her celebratory prayer and wished her a good journey.

On the way back to my office I ran into Karen coming off the elevator.  “Have you seen my mother today?” she asked anxiously.  I told her I was just coming from her room, and that we’d had a good visit.

“Really?” she asked.  “Because she’s calling all her friends and telling them she’s going home to Jesus now.  They are freaking out, and I am, too.”

“I think you need to go talk to your mother” was all I could say.

◊

If there is one lesson chaplaincy teaches endlessly, it’s that we can control or change so little.  I might have once thought a chaplain’s job was to say something transformative, but it’s much more about presence and listening.  Rather than feeling the need to be a font of wisdom, we need to trust the patient (or loved one) to know what needs to be said, and to leave them feeling deeply listened to and validated.  With rare exception, a chaplain fixes nothing.

It’s a helpful lesson, especially when dealing with mortality—the “problem” that can’t be fixed.  Whether through instinct or culture, though, we keep trying.  When the topic is our own existence, we tend to ask for whatever treatment is most likely to prolong our life.  At some point, though, for most people, death’s inevitability becomes clear, and we become reconciled to our inability to change the outcome.

When the life on the line is that of a loved one, though, it can be much harder.  We don’t feel our loved one’s pain or exhaustion. We don’t go through their deeply personal evaluation of the struggle to keep living vs. the possibilities of what lies beyond death (even if simply nothingness).  We focus instead on our own dread of the loss we see coming—perhaps because we have never known such a loss, perhaps because it conjures up painful losses from our past.  It’s a brutal reminder that life brings suffering that we are powerless to prevent.  It cannot be fixed.

What we can do, as a chaplain or as a loved one, is accompany.  We can try to be present to the other’s reality, to give them space to tell us difficult things, to help them feel known the way they want to be known.  I understand why Marge’s daughter and friends didn’t want to hear what Marge had to say, but that was Marge’s reality at that time and she wanted company in her joy.  This, at least, I could offer her.

I’ve often wondered how the conversation went after I parted with Karen by the elevator.  I wasn’t invited to join that conversation, and it wasn’t my job to insert myself. I have to trust that they could lead each other to where they needed to be.  I have my hopes, but I will never know.  I rarely do.

Practicing Hope

On By Greg Morgan4 Comments

James was a middle-aged man whose metastatic cancer had caused paralysis below the waist.  When we met, he spoke of his leadership responsibility for his extended family, including children, grandchildren, and his younger siblings.  While acknowledging the possibility of dying soon, he felt his purpose in life was to heal and rehabilitate so he could resume his responsibilities.  To do anything less felt like failure.

James began treatments for the cancer causing his paralysis, but these made eating intolerably painful and he began wasting away.  He shared how deeply this scared him, but it didn’t weaken his resolve.  James reflected thoughtfully on how humbling his illness was, but also on the life lessons it was teaching him.  He wanted to capture them all to share with his loved ones during his remaining time on earth.

James was no stranger to hardship.  His family of origin was large and poor; his mother exuded love for God, but James fell into gang life.  James shared, in a matter-of-fact way, about being on the receiving end of bullets shot with the intent to kill, and about renewing his relationship with Jesus while in solitary confinement.  By his thirties he had earned his release and begun the life of a working family man.

The seeds of faith within James grew stronger as he confronted his illness.  He began speaking openly about his mortality, slowly building his trust in God to care for his loved ones when he could no longer do so.  At the same time his faith also intensified his will to push through pain toward recovery.  James began making steady progress, putting on weight, then walking a few steps, eventually climbing stairs.

As the prospect of discharge to home came into view, James wanted to explore “a new kind of prayer”—one that felt truly authentic, not formulaic.  Above all, he wanted to express gratitude for his life—not just the domestic life he looked forward to going home to, but every step of the journey that made him the person he is today.  He had come to embrace himself fully as a child of God.

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I adopted the tagline “Practicing Hope Amid Loss” for many reasons.  Hope, like gratitude, is a muscle that develops strength with practice.  Krista Tippett adds, “[Hope] is not wishful thinking, and it’s not idealism.  It’s an imaginative leap.”[1]  The challenge of our elder years, it seems to me, is finding that place where we can be fully present to and engaged with loss while, at the same time, not losing faith that light remains in the darkness.  Some days that feels like quite the imaginative leap.

My eight visits with James, spread over four weeks, gave me a master class in practicing hope.  Since the onset of COVID our family has endured one health crisis after another, and sometimes I have struggled to imagine positive outcomes.  After one of these crises hit, my supervisor commented that it would be entirely understandable if I needed to take some time away from chaplaincy.  But I was finding that chaplaincy work was helping me keep my situation in perspective, even inspiring me.  Shortly thereafter I met James, and for that I am forever grateful.  He turned out to be just what I needed.

My training taught me to keep my situation “out of the room,” to focus fully on James and get my own needs met elsewhere.  It wasn’t difficult—James’s life experiences were so far removed from mine, and his personality and needs were so intense, that there wasn’t room for me in that room anyway.  Later, reflecting quietly, I could see how he was raising and addressing many of the same questions and fears that had been filling my mind.  He not only challenged me to adopt a posture of hope, he showed me what it looked like to practice hope in the midst of loss.

In the end, James’s hope bore fruit:  he received what he had been seeking—more time with his family.  In the end, I have been blessed, too—our health crises have left their mark, but our spirits have been strengthened.  Many situations we confront as chaplains—and as humans—seem to have no possibility of a happy ending.  I believe it is good for us to build up our muscles of hope whenever we can so that they may become a source of strength when the loss that surrounds us becomes deeper.

[1] Krista Tippett Wants You to See All the Hope That’s Being Hidden, NY Times, July 10, 2022.