One of the
great privileges and challenges of ministry is that from time to time you get
to, or have to, talk about things that make people uncomfortable. There are the
main roles you play in the life of your congregation: pastor, preacher,
teacher, priest and prophet. In
seminary, they teach you that when you are preaching about uncomfortable
things, you are speaking with a prophetic voice.
This doesn’t
mean some sort of super-natural prophecy, like that of the poor Cassandra of
Greek Myth; doomed to know the future and cursed to have everyone ignore you
and think that you are crazy. But in this story lies some of the tension of
speaking from the place of the prophetic voice.
It is with
that voice that I come to you this morning.
In this
season of Autumn where leaves have begun to fall, and final harvests from our
home gardens have been reaped, where pumpkins stand guard on front porches, the
seasons of life naturally come to mind.
Soon the
Earth will turn cold and nothing will grow outside. The animals that can, will
hibernate, the rest struggle to find withered, dry cold grass to eat. Some animals will migrate south for the
winter to warmer climates, and some of us will put on warm coats with hats and
gloves and tough it out in the kind of luxury our ancestors could scarcely
imagine.
The reading
that Karl shared with us a moment ago is from a children’s book about
dying. The leaf does not want to die.
This however, is the fate of all who begin a life.
Death is merely
one more season in a natural life.
Death comes
to us in many forms.
One of the
many ways that life doesn’t end in a thirteen note scale, or a major chord is
when we are not ready to die. We are not ready to die because we don’t have a
sense of completion.
I’d like to
share with you some words of Stan Goldberg, author of the book “Lessons for the
Living”
My life is
tethered to a number few people have ever heard of—a Gleason score of 7. It’s a
measure of prostate cancer severity that ranges from a forgettable number 1 to
a terminal 9. My lucky 7 pleased me on the cusp of living and dying. Not a
particularly comfortable neighborhood to take up residence, but one in which
I’m forced to life. During the operation to remove the prostate, my surgeon
found that the cancer spread beyond the prostate gland and also into one of the
lymph nodes. Three weeks after the operation we jointly decided what to do
about it.
“You have two
choices,” he said.
“To live or
die?” I responded with gallows humor. I only became alarmed when he didn’t
smile.
“The first is
waiting until the PSA number rises A rising PSA indicates the cancer cells are
growing. When it happens we’ll start female hormone therapy. The hormones will
reduce your level of testosterone, which feeds the cancer cells.”
“And the
second?” I asked.
“To start
immediately.”
“Which has the
best chance of killing the cancer?”
He replied
“Neither.”
Neither?
Although he kept talking, it was as if he was speaking an unintelligible
foreign language. Eventually, I heard
English again.[1]
Though his
words are uniquely his own, the experience of Mr. Goldberg is fairly universal.
In my own work as a hospital chaplain, I have been witness to experiences like
Mr. Goldberg. In my own work as a parish minister, I have had people for whom I
care deeply come to me with a story very much like this.
The average
life expectancy for a male in the United States is 76.2 years. For women that
expectancy is 81.1 years.[2]
There are of course some variations to all of this, but to get into all of that
will not serve this morning’s purpose.
First, those
numbers are a lot smaller than I thought they’d be, and secondly, I think most
of us think of ourselves as above average in general, and probably hope that
we’ll be well above average in this one aspect.
I also think
that like when a car promises us 35 miles to the gallon, we think “oh, that’s
for most people, I’m sure I’ll do better than that.”
But like the
gas mileage, in our own lives, we are not in complete and solo control over all
the variables involved.
Today there
are 53,364 Americans who’ve reached the age of 100, out of a population of 361
million people.[3] The
odds are not impossible that you could also reach 100, but you have less than a
0.02% chance of it.
At some
point, most of us will have to recognize that we have encountered a diminished
capacity in our functioning as a person. This may come in the form of disease
or even just plain ol’ old age.
Even though
I am not an old man in any sense of the words, unless you’re a ten year old, I
have already seen some of this change in myself. When I first heard the words
of Bonnie Raitt’s song “Nick of Time”
I see my folks are getting on
And I watch their bodies change
I know they see the same in me
And it makes us both feel strange
No matter how you tell yourself
It's what we all go through
Those lines are pretty hard to take
When they're staring back at you
Scared you'll run out of time.[4]
The words
didn’t have too much of a meaning to me. They were nice and poetic, but I was
twenty-one then, and my parents bodies hadn’t started to change, let alone my
own. Twenty-five years have passed since I first heard this song, and I can
tell you that my body has changed, and so have those of my parents.
I’m now
older than my Dad was when this song came out.
Again, I
say, I’m not old. I have no illusions about that. But I can tell you that about
5 years ago I realized that I had stopped perching on chairs, and really began
to sit in them. And I always used to hear this phrase “the blossom of youth,”
and I never saw it around me, until I lost it, and then finally I understood
what the phrase meant.
It’s in the
spirit of recognizing the changing phases of life that causes me to explore
this topic of Hospice, and it’s place in our lives.
In the
hospital, when a doctor would recommend hospice care to the family of a
patient, the family universally became very worried. Hospice, it would seem
from the reaction of people means death, and not just death, but a death that
will come quickly.
Hospice care
does not equal death. In fact hospice care in fact focuses on care, choices
comfort and dignity.
Death comes
to us all, sometimes suddenly, without warning. Sometimes it comes by our own
hand. Sometimes it is a gentle winding down.
The quote
from Mr. Goldberg I used earlier is not about immediate death, though at first
it is all he can hear, and who could blame him?
One’s
mortality is always theoretical, something that will probably happen at some
far off date. And then something like a
visit to the doctor’s office seems to change all that.
Of course,
it’s not really changed. It isn’t as though Mr. Goldberg, or any of us, assumed
that we would never die.
It’s just
that a visit like the one that Mr. Goldberg had with his doctor brings the fact
of his own mortality into a sharper focus.
One response
that Stan Goldberg had to learning of his own, possibly greatly shortened
lifespan, is that he became a hospice volunteer at a the Zen Project’s Guest
House, George Mark’s Children’s House and three other Bay Area hospice care
facilities.
Part of his
response to his own suffering was to attend to those who were in even graver
danger than he was. His work changed and deepened his life.
Part of why
he began to volunteer in hospice work was to diminish his own fear of the unknown.
It was not always a smooth and easy path, he reports, but he has spent over a
decade as a hospice volunteer to date.
I hope that
our own discussion, abbreviated as it may be this morning, will serve to open
up this topic so that we, too, can ease our fear of the unknown.
This is
something that is somewhat unknown to me, too.
Though I worked alongside nurses trained in hospice care, though my own
beloved worked as a hospice chaplain, I have not yet needed it myself.
I do,
however, have one personal experience with hospice care.
When my
elderly friend Wallace Palmer Rusterholtz was dying, we had hospice care. I saw
we, because until we reached a certain point, Wallace had a health care worker,
and I was the relief person for that worker. So I spent sometimes 4 or 5 nights
a week with Wallace to relieve the home health care worker. Sometimes I spent entire weekends with
Wallace.
I loved
Wallace, but I was utterly untrained in caring for the very elderly. I did what
I knew how to do, like cooking and cleaning, and reading and entertaining him.
I did his shopping, helped him manage his books, etc. There were things that I
learned along the way that were part of caring for him that I will not tell you
about because to do so would, I feel, violate his dignity.
And then at
some point, I don’t remember know when, we turned a corner and we engaged in
hospice care. We got a case worker, a team of nurses and a lot of support.
Engaging
with a hospice system allowed me to care for my adopted grandfather and mentor.
I no longer had to be concerned about a long list of things, I was freer to
focus on our relationship and our connection.
I had the
comfort of knowing that under proper Medical Care that as Wallace was
declining, he never felt a moment of discomfort.
Wallace
chose hospice care, at the recommendation I believe of our minister, and he,
and I, were grateful.
Rev. Denis will
tell you that most people are only in hospice care for 3 hours or less, and as
a former hospice chaplain, this drives him crazy. He worries that those who
wait until the last minute miss so many benefits of hospice care…care that is
focused on comfort and dignity.
What hospice
did for Wallace and me was it allowed us the space and time to work toward a
death that was not dissonant, but rather resolved.
Wallace
chose. He could’ve easily chosen not to, as well.
He had a
choice.
As many of
us do, about a great many things.
I—for
one—hope that when choices come upon you, that you choose the most
life-affirming option.
I also hope
that I, too will make those life affirming choices more often then not.
When you
feel boxed into a corner, into a place of unpleasantness, I hope that you will
live anyway; to bravely face what must be faced and make choices that are
consistent with your highest values.
Do this at
age 20 or age 98.
And at every
age in between.
In spite of
the hardships of life, the knocking about, the tripping and falling, the
disappointments, among all those things… live anyway.
Bless you on
this, our shared journey.
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