It was like one of those political rallies. You know, when one person yells “What do we want?” followed by an uncoordinated chant that should probably be narrowed down to one key idea. What works is when the crowd responds with something like “Peace!” When it really breaks down is when that key idea is something like “Affordable Healthcare!”
Anyway, that’s how I felt when I spoke with the nurse who was trying to care for my grandmother as best as she knew how. She said “Well, death is the enemy. We’re going to fight this.” It’s as if she were chanting by herself, and she wanted me to chant along with her:
“What do we want?”
“For patients not to die, ever!”
“When do we want it?”
Perhaps she was hoping I would chant along with her curative philosophy and agree that the preeminent value in life… is life. In the moment, I didn’t say anything, but perhaps my silence disappointed her.
Meanwhile, my grandmother, a week or so shy of 93, is bleeding uncontrollably and actively dying. The hospital staff took heroic measures to “bring her back” from the edge of death, including unending amounts of blood that frankly might have been put to better use on someone who had a chance. I’m not saying I wanted my grandmother to bleed to death, but I am saying we already knew the end was here for my dear Granny. There was no need to inject her and ventilate her and feed her medicine that would make her vomit. That is no way to die. Here, death is not the enemy, but this torture is. I believe in dying a good death, and this was not how I would chose to die if I were blessed enough to have a choice in the matter.
Great strides have been taken in medicine to take into account the dignity of patients who are in pain or nearing death. An entirely new medical specialty called “palliative care” has been established to help people who are in pain feel better. Another philosophy called “hospice,” which often makes use of palliative care principles, helps people who are dying become comfortable and safe. Sometimes this means withdrawing medications so the patient can talk to family members again and feel as normal as possible. Sometimes, this means giving pain medication. And sometimes it means providing comfort and pastoral care to family members while the patients decline. To that end, chaplaincy now offers a “palliative care specialty certificate,” which provides training beyond board certification as a chaplain. The medical specialty for MDs and chaplaincy certification for MDivs together provide that patients like my grandmother will feel comfortable and safe in their final days of life. Additionally, the chaplain certificate will help ministers and seminarians become more competent pastoral caregivers.
The enemy is not death, and the goal should not always be life. Dying a good death can also be a goal—particularly when death is immanent. Regardless of whether my grandmother received palliative care at the end of her life, she was still going to die of her condition. MDs and MDivs now have language and tools to help them better care for their patients—patients like my grandmother—and to help them die with dignity, as well as providing better pastoral care to their families.
For more information on the chaplaincy Palliative Care Specialty Certificate, see http://www.healthcarechaplaincy.org/palliative-care-chaplaincy.html.
Photo courtesy of M.D. Anderson Cancer Center of the University of Texas.