November 18, 2017

Another Look: The IM Interview with Chaplain Mike (2)

Note from CM: Before I started writing for Internet Monk, Michael Spencer asked me to do an interview about Evangelicals and Pastoral Care for the Dying. I’m working on some upcoming posts about using the Bible in ministry and pastoral care, and in preparation I thought it might be good to revisit this seminal discussion. Today, part two.

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Old Man in Sorrow (On the Threshold of Eternity), Van Gogh

THE INTERVIEW (part 2)

4. At what point is it appropriate for a minister to talk about death when a family may be refusing to speak about it?

The subject usually comes up naturally if folks have access to the kind of support I just talked about — a calm, reasonable, caring human friend to sit with them, who is available to listen and support them. Occasionally, a compassionate minister or friend may need to help someone face reality and speak the truth plainly when it is being denied. But most of the time, it is clear that people know what’s going on, and they just need time until they can talk about it.

We have all kinds of people who come into hospice care, and they come from a variety of faith and non-faith backgrounds. Some are on-board and realistic from the beginning. Others say “Don’t mention death or use the word hospice. Hide your badge so mom won’t know you are from hospice.” Some refuse to sign “Do Not Resuscitate” orders because they can’t imagine not trying to bring dad back if possible. They put off making funeral arrangements or getting necessary documents together. Some don’t want the chaplain to visit. A friend of mine said he once had a patient who called the chaplain, “the sky-pilot,” the person you only see when you’re ready to be launched into the afterlife! Other folks struggle when grandma doesn’t want to eat anymore, and so they keep trying to force food into her. Many people refuse to give or take pain medications, especially morphine, because they view that as crossing the line and forsaking life.

So, in hospice we have to be gentle with people and respect their journey. We pretty much don’t force anything but emphasize giving good information and the kind of supportive presence that will give people permission to talk about things they’d rather not face. I’d recommend ministers and friends do the same. Again, it’s not efficient. It takes time. But it is loving, and the “small miracles” we see every day of people being helped and supported through some of the toughest experiences of their lives are worth as much as seeing Lazarus come forth.

5. You deal with many people with little or no faith resources for approaching death. What is your pastoral care strategy in that situation?

First, let me make a foundational statement about what a chaplain is and is not.

Because I am not a pastor in a local church but work for a healthcare organization, I must approach things differently than a minister would. A church pastor has a covenant relationship with his people and serves them with a whole system of theological understandings and expectations in place. A chaplain, on the other hand, must honor the spiritual and religious commitments of patients (even those that he might deem wrong), and serve them according to their own faith traditions. So, if I get a Buddhist patient, unless she wants to talk about the Christian view of God and salvation, it is not my job to force that on her. I will ask if she wants support from someone in her own religious community. Only if she asks me, or I get her permission, will I share my faith with her.

Secondly, let me lay a theological foundation for the way I approach everyone.

The doctrines that have guided me from the beginning in this work are the Bible’s teachings on creation and common grace. God created each human being in his image, and by his grace and providence he sustains us all. I meet and deal with people first based on our common humanity under God. Every person is my neighbor, and I am called, simply, to love my neighbor. Being a chaplain means involves specific ways of doing that. It’s more of a “love your neighbor” ministry than a “win the lost’ ministry (though I’m not always sure about the dichotomy).

Furthermore, because I believe in common grace, I do not understand my job as bringing God to people. He is already with them, and he is already working, no matter who they are. To reference Eugene Peterson again, my duty is (1) to recognize that God has gone before me in every encounter, (2) to discover some of what God is doing in that person’s world, and (3) to figure out how to best cooperate with God in what he is trying to accomplish.

So, when I have a new patient and family without a faith background, I meet them on their turf as neighbor and friend. I do not have an agenda, other than to listen and learn how I might be of assistance. I tell them I am available as a spiritual and pastoral resource, if that is what they want and need, but my main job is simply to be there with them for support. I always offer to pray for them (and ask their permission to do so), and I try to make my prayers personal, filled with Biblical language, and focused on God’s love for people and his promises to be with us in Christ.

I find that this kind of approach often leads to more discussion about “spiritual things” than if I would try to force the matter. One joyful consequence is that I have been asked to do many funerals for un-churched folks, and at the funerals I always try to clearly present the story of Jesus, his salvation, and the hope of eternal life.

I’m not sure evangelicals in general think in these terms. We are often weak on creation and common grace. Instead we see God mainly at work within the community that is separated from the world. We also identify his work primarily with specific “spiritual” matters that we focus on. We sometimes don’t do well simply as human beings living among fellow human beings who are our neighbors, all walking together through the common experiences of life. We are often too “spiritual” for our own good, and for the good of others.

6. What sorts of things make the process of grief difficult for evangelicals?

In my first grief support group, I learned something as I listened to folks talk: It is hard to go to church after losing a loved one. I’ve heard that particularly from those who’ve lost spouses.

  • First of all, nobody knows how to relate to Joe anymore now that it’s no longer “Joe and Mary.”
  • Second, few know what to say, and this leads to many awkward and some hurtful encounters.
  • Third, you (the bereaved) don’t know what to say either, especially when the song leader keeps telling you to smile and be happy in Jesus, and all your brothers and sisters keep saying over and over again, “Remember, she’s in a better place.”
  • Fourth, you have to sit through something alone that you had always done together; and if your spouse ever sang in the choir or did something up front regularly, then it’s hard to be there and watch others take her place.
  • Fifth, the church revolves around fellowship and activism. But you would rather be alone, and you don’t have the strength to teach middle-schoolers right now. You don’t fit any longer.
  • Sixth, since the church is “focused on the family,” you feel like a fifth wheel all the time when you are around other adults.
  • Seventh, you have to sit and listen to the “7-Day Sex Challenge” sermon series and other such silly talks from the pulpit.

I have heard some incredible stories. A woman I know lost her young son in a tragic accident. Not long afterward, she went to church and stayed in the sanctuary after the service, crying there in the pew. The pastor came by and said, “Now, now, let’s not forget our testimony.” That may be the cruelest sentence I have ever heard pass between one human being and another.

Other cliches or stupid remarks well-meaning Christians use include,

  • “She’s in a better place.” That’s right. By faith we trust that our believing loved ones are being comforted in God’s presence. But what about the bereaved? Is he in a better place?
  • “God never gives us anything more than we can bear.” Really? Then why does Paul exhort us to “bear one another’s burdens”? Some things must be too heavy for one person to carry alone. Don’t throw it off on God. He may be asking you to lend a hand.
  • “I know exactly how you feel.” No you don’t. Not even close. If you did, you wouldn’t say that, you’d probably just join the crying and give the bereaved a hug.
  • “I remember when so and so died” — Guess what? No one wants to hear your story right now. This is not about you, or someone else. This is about someone drowning in loss.
  • “Just call if I can be of any help.” Let me clue you in on something. This person does not have strength to pick up the phone and ask for help. This is time for others to take the initiative. Help or don’t help. But be quiet about it.

I tell grieving people all the time just to expect that people will say stupid things and not to take it too personally. Most of us are downright pitiful when it comes to knowing what to say at times like this. Add to that our discomfort with the whole death and dying thing, and the fact that it doesn’t fit into our paradigm of church activities, and the result is usually not a pretty picture.

The overriding issue is that we have lost all sense of the time and energy involved in the process of grief, and we have not allowed space in our lives to let people grieve the way they need to. There is usually a big rush of caring and expressions of sympathy in the first week or two after someone experiences a loss, but then, since we have to get back to our lives, we expect that the bereaved will somehow just magically “get over it” and get back to his.

Other faith communities have learned to do it better. For example, Orthodox Jews have an entire 12-month process of tradition and liturgy for the grieving, which is lived out by the bereaved and faith community alike. However, in evangelicalism the issue again becomes, “How does allowing someone the time and space to grieve fit into our paradigm of fellowship and activism?”

7. If death has come in tragedy, how can evangelical ministers acknowledge that kind of loss while also upholding hope?

As a hospice chaplain, I don’t deal with a lot of sudden deaths, accidents, and the like. I have as a pastor. In the moment, helping people in these circumstances likewise involves finding a way to serve with true human compassion. By God’s grace, I want to be that reasonable, levelheaded, quiet and supportive presence, who can walk faithfully with those going through the tragedy.

A woman in our church had a grandson who died in an automobile accident. She asked me to come to the home where all the relatives, friends, and church members were arriving to be with the family. This was a very expressive bunch, temperamentally and theologically, and the room was filled with wailing and crying and people letting out their emotions in unrestrained ways. What did I do? For most of the evening, I stood with my back to a wall, off to the side and was simply present. Every once in awhile I quietly greeted someone with a hug or pat on the shoulder, but that was about it. I literally did nothing. Yet, if you would ask that woman today what she remembers most about me being her pastor for more than 9 years, she would tell you it was all the help I gave her that night.

After a tragedy, it is important that the pastor and folks in the church realize that the bereaved who are left behind will need support that may require extraordinary attention in the short-term and consistent loving care for the long haul. Hope doesn’t come through words alone, but through a solid and reliable support group that sticks with the hurting.

Having said that, words are also important. Regular participation in the liturgy, which rehearses the fundamental truths of the Gospel over and over again, week after week, and which enables people to feed on God’s saving and sustaining presence through Word and Sacrament, can provide genuine help in reorienting those whose lives have become radically disoriented by tragedy.

8. How does the Gospel inform your work as a hospice chaplain?

The Gospel is the announcement that, in Jesus, God’s new creation has broken into this fallen, dying creation. Through Jesus Christ, the promised new day of God’s rule has dawned, and because of Christ’s life, death, resurrection, ascension, and sending of the Spirit, he has dealt the decisive blow to sin, evil, and death, and is creating a new people who will be with him forever in a new heavens and new earth. Until that new creation is revealed in its fullness, those made new by Jesus are called to live in this fallen world as God’s representatives. It is through his new people that God fulfills his mission of taking this Gospel to all the hidden corners of the world, announcing and creating newness everywhere.

That is a grand plan and vocation, but its outworking could not be more down-to-earth. Jesus said the Kingdom unfolds in small, hidden, subversive, often undetectable ways. A primary way it spreads is when one person made new humbles himself to serve another person in need. The Gospel doesn’t set us above other people, it sends us to kneel before them so that we might wash their feet. It doesn’t make us less human, but more fully human; doesn’t separate us from the world around us, but sends us into every part of that world to love and serve our neighbors.

And that’s why I love what I do so much. As a hospice chaplain, it is my privilege to go into places where people are hurting, crying, dying. By God’s grace, I pray that I may announce and create a bit of newness each day for those bound by sin and death. That is Gospel ministry to me.

I wish I knew better how to translate this into counsel for every church, pastor, and Christian. In my view we need to abandon the misguided missions that intoxicate us, and come back to Gospel basics. Forget “building a great church.” Share the good news. Visit the sick. Give relief to the suffering. Sit with the dying. Comfort the bereaved. Be generous to those in need. Be hospitable. Love your neighbor. Live in fully human ways among your fellow human beings under God.

This is not a new “law,” but the Gospel lived out, the “Jesus-shaped” way that the Spirit constrains us to pursue.

Comments

  1. Richard says:

    Thanks, so much, for sharing these thoughts. When my own life imploded (divorce in my case, not death), there seemed to be nothing for me in the community I was part of. A few words from the minister about it being like a death, but nothing about how to grieve, what to expect. What is love, if not the willingness to hear difficult truths from each other?

    • What is love if not that? I dunno; forgiveness, affection, mutual service, pleasure, joy?

      • Rick Ro. says:

        I’m guessing Richard wasn’t limiting his definition to just “the willingness to hear difficult truths.” Yours are good, too. 🙂

        • Christiane says:

          just listening helps people . . . . . even if you don’t know what to say . . . . . maybe it’s even better just to let them talk and be heard

  2. Heather Angus says:

    Chaplain Mike, your interviews of yesterday and today are truly so supportive and helpful to me. I’m “only” 74, but as a cancer survivor I have no illusions about living till I’m 90. Maybe 80 if luck is with me. I’ve been reading a very good book by Dr. Atul Gawande called Being Mortal. It has the same kind of compassion and concern for the dying as you have so often shown in your writings. Thank you so much for these ministries of yours, both with the dying and with us here at IM.

  3. Rick Ro. says:

    Some interesting items in here, CM.

    –> “Many people refuse to give or take pain medications, especially morphine, because they view that as crossing the line and forsaking life.”

    So sad. I’d say the human race has come a long way in end-of-life-care, but there are still those who live in the 1800s.

    –> “Secondly, let me lay a theological foundation for the way I approach everyone.”

    The five paragraphs that follow that are gold. Thanks for your perspective.

    –> “6. What sorts of things make the process of grief difficult for evangelicals?”

    Your several-paragraph answer would be funny if it weren’t true. If there’s one thing I’ve learned since being a regular at the Internet Monk, it’s how to respond to people who’ve lost loved ones. I’m sure that in the distant past I would’ve pulled out some of these lines, but now I just go up and hug grieving people and tell them I’m sorry for their loss.

    A few years ago a friend lost her three-year-old granddaughter to a medical condition. Before the girl’s service, this woman approached me and I just wrapped my arms around her and let her cry.

    –> “For most of the evening, I stood with my back to a wall, off to the side and was simply present. Every once in awhile I quietly greeted someone with a hug or pat on the shoulder, but that was about it. I literally did nothing. Yet, if you would ask that woman today what she remembers most about me being her pastor for more than 9 years, she would tell you it was all the help I gave her that night.”

    You mean you didn’t trot out the ol’ “God has a plan” line? 😉

  4. Thank you CM. I’ve gone back to these archived articles often to help keep me grounded and focused on what’s important while walking with people through the hard times.

  5. Ronald Avra says:

    I’ve been busy for a couple of days, just sticking my head in to check on what is going on. Good to see these two posts; very helpful to be reminded of what counts. Thanks very much.

    • So true. There is a good reason Jesus emphasizes the positive side of the poor and dejected states – it is there that we see life and remember the plight of others. The fat cat lives in shadows that obscure the full nature of things. For the record, I include myself in that fat category generally. I live comfortably and need every reminder of my poverty. Jesus was “acquainted with suffering”. Richard Rohr talks about living at the bottom and on the edges. It counts there.