Tuesday, January 22, 2008

Until the Kingdom Comes....

This has been a day for discussing mortality. Actually, it’s been a week for it – and it’s only Tuesday! But in two days I’ve had a week’s worth of such considerations.

I’m not really talking about death here: it hasn’t been that a number of patients have died. Rather, it’s been that a number of patients and family members have been thinking about dying, about that point where either medical science or human will or both reach the point where there is nothing more to do. Some are there, some can only see it in the foreseeable future; but for all it is a firm reality. There’s the patient who no longer seems to care, and the patient who’s announced that it’s time to have last conversations, to say goodbye and then “to sleep, perchance to dream.” There is the spouse who doesn’t want to let go, but who is realizing the beloved will never be quite the same, even if in some sense the body continues to function. There’s the patient newly diagnosed with the same disease that took the lives of all his siblings. All of them are seeing with particular clarity a truth they knew but, like most of us most of the time, shelved, somehow thinking there would always be “another day.”

That truth is that we die. Unless the Kingdom comes first, we can all expect to die. It has long been a soapbox issue for me to rail when I see a new medical study talking about “the mortality rate.” A new study comes out, proclaiming the great leap forward, the new chemical or the new technique that offer such progress. And such progress is often described this way: “with the new medicine the death rate (from x circumstance) was reduced by 15% (or 2% or 20% or whatever number is presented). Brothers and Sisters, the truth is this: the death rate is 100%. Until Christ changes things beyond all recognition, the death rate is 100%, and all of us will fall.

As a chaplain it’s often within in my purview – indeed, it’s sometimes my responsibility – to point out this truth. In general I have always wanted the bare fact to be stated by the physician, because often the bare fact requires illustration, illumination, with biology and chemistry and engineering that the physician is better able to provide, and better heard in providing. But once the bare fact is out there, the human reception, the emotional incorporation, falls under my professional sphere. Often enough it’s simply to hear and encourage the resulting grief. Sometimes it’s to ask the question that no one else can ask: “And what if your loved one is dying? What if this is the end?”

Understand that in general I’m not interested in stripping way denial. Denial as an initial reaction in grief is a buffer, a shock absorber (both literal and metaphorical). It can actually aid the grieving process, allowing the griever to absorb without being overcome. But sometimes there are decisions that must be made. Sometimes when medical science or human will or both reach their limit for the patient, those around the patient must be confronted with that which they’ve most feared, most avoided; for if they do not the patient suffers – suffers what some of them, and certainly some of us in the business, consider literally a fate worse than death.

As a priest it’s also part of my purview. Indeed, the Church instructs me to instruct you that someday you will die. There is this rubric in the Prayer Book:

The Minister of the Congregation is directed to instruct the people, from time to time, about the duty of Christian parents to make prudent provision for the well-being of their families, and of all persons to make wills, while they are in health, arranging for the disposal of their temporal goods, not neglecting, if they are able, to leave bequests for religious and charitable uses.

I cite it regularly, although I fear I may be one of the few priests who does. Many of my Sundays are spent supplying, filling in for colleagues who are traveling or ill. When we get to the announcements I announce my “second sermon.” When they laugh, I say, “You think I’m kidding.” I speak to the rubric, and then expand on it to discuss the importance of Health Care Treatment Directives and Durable Powers of Attorney for Health Care – to say, not only must we expect to die, but we can expect that we might well get sick, and make appropriate provision. (I will offer here, as I do in the congregations, a gold star to the person who knows just where in the 1979 Prayer Book to find this rubric. It is in a place that makes sense, but it’s not where I would have put it.)

So, as a priest and a chaplain it is part of my role, part of my practice, to bring home now and again that we are mortal. It is an important fact of life, for all that we do our best to ignore it or delay it or prevent it. It will confront each of us, and because of each of us those we love, sooner or later. Indeed, it is critical that we appreciate it (by which I do not mean to pursue it, suicidally or homicidally, or ascetically); for our faith is built on our mortality. We believe in Him who became mortal that we might become immortal – in him who died that we might live. We believe Christ took on all that is our human nature, including our mortality, so as to transform it. We participate in his resurrection because we participate in his death; but we participate in his death because he participated in ours. Until the Kingdom comes, we have no way to resurrection except through death.

And so until the Kingdom comes, we must discover and rediscover the truth: the death rate is 100%. And when some have difficulty with that, I will do my best to help them. I will do my best to be with them as they realize and recognize mortality. I’m a priest and a chaplain; it’s what I do.

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