I love reading memoirs. I don’t know if it’s because I’m a youngest child, but I have always loved hearing what those who’ve gone before me have learned. Now that I’m older, it’s not so much for the purpose of avoiding pitfalls that others have experienced. It’s more like, savoring the humanness in others has taught me how to savor the humanness in myself. There is something so precious about how much we mess up, how hard we try, and how often things just don’t go the way we hoped. Life is so incredibly hard. And I have come to understand that achieving the goal that so many of us say we want, living to a very, very old age, is not what young people think it is. I think our highest rate of suicidal ideation is probably in those that are near or over 100 years old. Not because they haven’t lived a good life, but that all the good in life is behind them. They can’t taste or see or hear or walk or breathe deeply…all that brings joy is hard to access and everything is just so damn hard. I didn’t realize that until I started spending time with the uber elderly.
I realized the other day, that my job is like listening to a memoir in real time. People spend time doing life review at the end of their lives. Often in hospice, people are medically past the point where they are able to engage in this developmental practice, but not always. We take an inventory of what our life has been, catalog our regrets, review for what we are most grateful, and savor the beauty we’ve experienced. This is normal in old age and especially supportive of anticipatory grief work when facing death. Sometimes there are things that must be said or done. Most of the time, it’s simply held.
I was with a patient recently who has a historical relationship with meth. Her life reflects this – subsidized housing, no support system, estranged family, a friend who identified as a “caregiver” and then stole her hospice meds, lives alone…you get it. The other day, I was sitting on her couch that is nowhere near clean and I simply don’t care. I am petting her cat wondering if I will be bringing anything home to my cat from this one, but he’s so darn cute and soft. I breathe the stagnant air while she smokes and vapes (I’m supposed to tell her not to but I don’t). We openly talk about death and she said she’s planning on going to purgatory and then becoming a ghost. I said, “oh, I didn’t realize you were Catholic.” (these are the things I’m supposed to know). And she said, “oh, not like that purgatory. I’m going to pay some people back for all the wrong they’ve done me.” Ah. Slightly different interpretation. How delightful. She has been wronged many times, for sure. So we talked about our human need for justice, to have our harm be acknowledged, and how often that simply does not happen in this life. We laughed about the absurdity of knowing death is coming and not being able to do anything about it. It is kind of wild that we’re animals but we know so much more than all the other ones do. Awareness is not always a gift. Existential crisis, indeed.
I put her groceries away, handed her some M&Ms I found, updated her social worker, and wished her well, knowing that she’ll probably have to die in the hospital because there will be nowhere for her to go once she can’t get up on her own. That’s not really our preference in hospice, but what can we do? There isn’t a place for her. But there will always be a place for her, and for so many others, within me. Because the chaplain gets to be the keeper of the stories, the witness, the secret holder. And I cherish this so.
Sometimes people cry or say the truth to me in ways that are not socially acceptable. They apologize or say “oops I didn’t mean to say that out loud” like it’s an unusual thing. But of course, it’s not. We all need places to put the truths we feel we cannot acknowledge or should not say out loud. But what better place to put them than within the soul of another. We speak of relief when someone dies or disappointment when they don’t and this process just goes on and on. We feel judgement for our loved ones that simply won’t let go. And we feel the burdens, but we’re not supposed to ever say that caregiving is a burden. But can a burden be heavy and still be willingly carried? Yes. I think it can.
We live in a culture that so desperately wants to be independent, autonomous, self-determining. And yet, that doesn’t really work for us. Certainly not when we’re dying. For some of us, needing care is the worst possible outcome. It is so deeply painful to feel overwhelming need, even when the need is so lovingly addressed. Sometimes especially so. The role reversal of a child caring for a parent is sometimes too much for both sides of the situation. It feels undignified, or like it’s a life without quality. And yet, I can’t help but see that we come into this world totally dependent and if we’re lucky enough to not die tragically, we probably will leave this world totally dependent as well. So what is our relationship to our own needs? And can we be kind to ourselves when they are so very big? (I’m speaking to myself, by the way).
There are so many gifts I receive from spending my days with the dying. But one of them that strikes me so often is that my work is to help others be kind to themselves as they wither away. The slipping of power, will, ability that just moves without consent. Sometimes the slipping is rapid, in one fell swoop and other times, it is gradually further and further away every day. Some people are so relieved. They just set it down and walk away. And others are just desperate for every moment. And of course, many things in between. None of us really know what happens after we die. For some, that’s okay or even feels like an adventure (I once had a patient eat a hearty meal before taking his Medical Aid in Dying medications, “to fortify for the trip” to whatever comes next. I found that to be so tender and cool.) Others, especially those raised in fundamentalist religions, find this quite terrifying. And once again, everything in between.
Perhaps the greatest gift is that I live my life every day in light of the fact that it is temporary, that the present moment is all we have, and that living in integrity and kindness is the way I want to be no matter what. And to have that clarity and the courage these past few years to walk that out, in the middle of my life instead of at the end, is a gift the dying give me every single day.
We’re living in harrowing times. We don’t really know how bad things are going to get. How will you be in relationship with others? Will you be kind to yourself? Will you live your values no matter what?
By the way, I’m officially a reverend! Seemed like a funny time to finally tie that bow (two days before inauguration), but I wouldn’t change the timing for anything. I am so grateful for the years that led me to that moment and for the brevity of the moment itself.
