December 14, 2017

Chaplain Mike Mercer: Evangelicals And The Pastoral Care of the Dying: The IM Interview

mmChaplain Mike Mercer is one of the long-time faithful friends of this web site. Many of you will recognize him as a frequent commenter. Mike has gone the extra mile to befriend me and that has been a true gift.

I wanted to do this interview because Mike is now involved in pastoral care of the dying and their families as a full-time ministry. This is an area where evangelical ministers and younger pastors need encouragement and help. Because pastoral care is so closely bound up with the integrity of the Gospel as a Word from God for the dying, I think this is a very worthy subject.

This is a long interview. One of IM’s longest. I have decided to keep it intact as one interview, though if discussion is sufficient we may venture to a second post for more focused discussion.

One request: When you share how pastoral care is done in your tradition, please do so from what you know, not from what “the instructions” say should be done. And be constructive and helpful.

Tell us a little about yourself, your journey as a Christian and your current ministry.

I grew up in the Midwest, in a moral, Protestant home, attending United Methodist churches. During my senior year in high school, after a move across the country that shook my foundations, I had a spiritual awakening and responded to an altar call in a Southern Baptist church, where I was re-baptized. I went to Lancaster Bible College in Pennsylvania. There, I became convinced of a call to enter the pastoral ministry. My wife and I were married after graduation, and our first congregation met in one of those historic, quaint, white steepled churches in Vermont, and there the people taught me much more about how to be a pastor than I taught them about Jesus.

After five years, we moved back to Chicago to go to seminary at Trinity in Deerfield. I was studying under some of the finest teachers in the world, pastoring a small church, our children were being born, and we had many wonderful friends supporting and encouraging us. However, there came a point after I graduated that I felt I needed some mentoring and more experience on a church staff. We also were trying to determine where we would put down roots as a family. So, when the opportunity came, we packed up and moved to Indianapolis. Here I served in a non-denominational church as the associate pastor with an emphasis on worship and music, but I also did a lot of pastoral care, teaching, and leading mission trips. Then I became the senior pastor in a sister congregation. After a rather difficult experience there, God opened up the opportunity to serve as a chaplain in a hospice program. Soon it will be five years since that journey began.

God used many past experiences to prepare and equip me for this work. In Vermont, our small church was a parish church. Because we were the only congregation in the village, I visited the sick and did funerals for all kinds of people, including complete strangers who’d had vacation homes in the mountains and wanted to be laid to rest there. We also had a significant population of older folks and shut-ins that I learned to love visiting. That was also true in the other churches where I served — I just seemed to connect well with the senior citizens. Also, while in seminary, I took my first CPE (Clinical Pastoral Education) course, and was introduced to the inner workings of the hospital and how to serve patients. Since then, I have always appreciated the strong connection between medical and spiritual care.

I consider my grandmother to be one of my greatest examples for ministry. After my grandpa died rather early in life, she devoted much of her adult life to caring for her elderly neighbors, friends, and fellow parishioners. Her simple and faithful service showed me what it means to be the salt of the earth.

I have always believed that pastoral ministry is about prayer, proclamation, and people-work. As my favorite pastoral author, Eugene Peterson, says, it is not about “running a church.” Frankly, I am appalled at how these perspectives have gotten turned around in today’s church, and how little attention is given to foundational ministries like pastoral visitation. It is a forgotten art.

That is why I am glad to be in a position now where personal work can be my primary focus. Every day I visit individuals and families in their homes, in extended-care facilities, and in hospitals. My job is to enter their worlds, befriend them, show them kindness, listen to them, answer their questions when I can, and provide various kinds of spiritual support that may help them find peace at the end of life. I have often imagined that Jesus’ earthly ministry must have been like this, as he went from village to village and house to house, engaging people in their own settings, exhibiting compassion, providing healing, giving hope.

Another reason I love my job is that I work with a team of skilled and compassionate professionals who all do their parts to serve our patients and families with regard to their medical needs, psycho-social needs, personal care needs, and, after a death, needs associated with the grieving process. Hospice is a wholistic service, covering body, soul, and spirit, and respecting the processes involved in the final season of life and beyond.

1. I first thought of this interview when it occurred to me that evangelicals don’t seem to have anything close to the resources of other traditions when it comes to pastoral care of the dying? Am I right?

In my experience, most people and churches in the evangelical world have their focus on fellowship and activism. The kind of work I do doesn’t fit the model very well.

I can’t tell you how many times I have had an evangelical friend or pastor ask me, with a sour look on his face, “Do you really like doing that?” They recognize that caring for those who are seriously ill and suffering is a part of life, but it’s a part they would rather avoid and deal with only when absolutely necessary. Not a regular part of the mission, you might say.

They know how to put people on the prayer chain. They know how to make a meal and bring it to a family that is going through a hard time. If there is something active they can do, like get a list together of folks to help the family with errands or cleaning house, etc., they might be able to organize some practical assistance. These things can be quite helpful, and should not be looked down upon. However, beyond that, there’s not much in the paradigm, especially if you’re talking about pastoral visitation. And we haven’t even talked about ministering to dying people who are outside the church, which is not even on the radar of most pastors or congregations.

It certainly was not an emphasis in my education. We had few pastoral care courses in my evangelical Bible College and seminary. Nor is it emphasized in churches. I don’t know many evangelical churches that have programs like the Stephen Ministry for equipping believers in caring ministry. The more pervasive model seems to be that churches will support a parachurch ministry and expect the work to be done by them. It’s not really part of the church’s mission.

With regard to care for the dying, most pastors and people have not been taught that it is a good use of their time, that it is Christ-like and genuinely helpful, to simply sit with people, actively listen to their feelings, and not feel like you have to give “answers” or put the situation in an understandable theological framework so that folks might know the divine “reason” behind what is happening. Evangelicals don’t usually have a great deal of good language with which to pray for these folks, either, and it may be the rarest of things to find an evangelical worship service (or even funeral service) that contains rubrics for lament or recognition of grief and loss.

Don’t get me started on mega-church pastoral care. From what I’ve seen, it’s virtually non-existent.

Now, I don’t want to be too hard on evangelicals alone here. Other traditions have more experience and better tools for being pastorally present with people, but that doesn’t mean it always happens. Mainline pastors often drop the ball here too. I’ve seen many a Roman Catholic priest do a perfunctory anointing of the sick and never really connect personally with the family. One can read the most beautiful prayer from the Book of Common Prayer without feeling or expressing any empathy whatsoever. Nevertheless, I have found that pastors and parishioners in the older traditions at least understand that this is one of the things the church and her ministers should be doing.

Ultimately, in my view, this is another area where the church (at least in the white, suburban culture with which I am most familiar) has become conformed to the death-denying, suffering-averse, productivity-centered world we live in. How is sitting with the dying gonna help build my church?

2. Is a significant part of this deficit because of evangelicals’ lack of liturgical resources?

That lack certainly doesn’t help. When most of our prayers begin, “Lord, we just want to thank you for” – it signals that we might suffer from a lack of language to appropriately relate to life’s awesome mysteries. Purely spontaneous prayer doesn’t work because we simply don’t have words when we are in a situation that overwhelms us.

But why do we rely on that? After all, we claim to be Bible-believing people. No book on earth contains human expressions of sorrow, pain, anguish, grief, disappointment, anger, guilt, loneliness, or fear like the Bible. We just have to read it! But because we haven’t really internalized the Scriptures, we don’t know how to be human, we don’t know how to pray as real people dealing with real life before a real God.

Walter Brueggemann writes about “the formfulness of grief. One thing we learn from Scripture is that, in the chaos of suffering, we need a sense of clarity and direction in the midst of our disorientation. So, we lament. The lament form gives us a pattern by which we may express our grief, contemplate our faith, and make a way through the wilderness of suffering. We usually don’t have the words. We are too overcome. It hurts too much to talk. Appropriate liturgies give us profound words to speak when we can’t, words that in turn speak to us, give us perspective, and help us survive.

3. Do evangelicals have a model of a “good death” or does their theology move them in the direction of asking God for miracles?

Coming to grips with the terminality of a loved one is a process for everyone, not just evangelicals. The difficulty of the process also varies depending on the situation. Losing my 90 year-old grandmother is sad, but I probably would not suffer undue shock or dismay, especially if her death followed a normal course. I would be happy that she had lived a long life. I would rejoice in memories of what we shared in life together. I would be grateful that she was able to be comfortable and peaceful, with her pain and symptoms managed well at the time of her passing. Most of us would probably call that a “good death.” We would be concerned and sad, we would offer prayers for her and the family, but I doubt if we would be calling all-night prayer meetings asking God to intervene.

However, a young person, a woman in the prime of her life, a robust middle-aged man, a person who is not at peace with God or others — in such cases the diagnosis of a terminal condition throws us all out of whack. And it should. The question then becomes: What are our options at that point? I’m not sure there is a single “evangelical theology” that speaks to the situation.

Those whose tradition emphasizes miracles, divine intervention, and healing would likely view the situation as absolutely NOT God’s will and would marshal all their resources to fight the devil they blame for the person’s illness. Others would be more stoic and submissive. Some might emphasize trying to understand what is happening, looking for “reasons” to satisfy the Christian perspective. Most all people will bounce up and down on a roller-coaster process of anticipatory grief, needing someone to be with them for support and encouragement all along the way.

In my view, that is the bottom line. No matter where people are with regard to their specific reactions to end of life issues, no matter their theology or conditioned response to tragedy or loss, they need support. They need a calm, reasonable, caring human friend to sit with them, who is available to listen and support them. I have sat with families that have all kinds of reactions, and my approach has been fairly consistent — BE THERE. Period. Trust the process, rely on the active presence of God, and walk down the road with them.

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. Iâve 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. Michael, thanks for this interview. I found it touching, challenging, and motivating. I’m glad there are people like Mercer involved in end-of-life care.

    I know I’ve read a similar summation of Peterson’s thoughts before, but something about reading it this morning has really moved me. It’s comforting without encouraging complacency, and God-centered without being dogmatically rigid.

  2. Of the many reasons I decided to leave my megachurch, one that really stuck in my craw was that in 8 years of membership I had been to one funeral. Surely in a church of 5,000 more people had died in those years. But we never heard about it, unless it was in a retrospective testimony on the video boards from someone who was helped by their small group. In this case the goal was usually to get people to join small groups by appealing to the sense of community they may be able to find there. We were a community of 5,000 predominantly young people, and we didn’t want to deal with death and grief. That kind of gets in the way of our, you know, lives.
    There is great wisdom in Chaplain Mike’s words, I believe. I want to be there for those who are grieving, and I don’t want to be one of those who spouts off stupid, unhelpful words. It is a learned process I’m sure, and I thank God for people like Mike who have followed the call to plunge headlong into it.
    One question I would like to hear Mike’s answer to is whether this was a painful process for him and whether it continues to be. I know it’s ultimately fulfilling work, but was it very hard to get used to being surrounded by death, and does it get any easier? There’s a part of his story that has me wanting to call up a hospice and volunteer, but I also imagine it’s something you need to be prepared for and continue to have a support structure around you to help ease your burden.

    • In my experience, hospices provide excellent training and support for volunteers.

      At times, there is an emotional toll, but there is also such tremendous encouragement and inspiration. It takes me into situations that involve life and its issues at their most fundamental level. The intensity is at times exhilarating, at times exhausting. Being part of a team really helps, because no one team member has to do it all. Because we travel about, there is often a nice balance of intense ministry and quiet contemplation while I drive.

      Bottom-line also, is that I always try to remember who has the really hard place in this ministry, and that is the patient and family who are going through the experience. We are there to support them, not to make it about us. Perspective and boundaries are important.

      • I have the great privilege of working with Chaplain Mike. He is the one who inspired me to join his team as a nurse case manager. The gentle spirit and quiet nature that he presents speak loudly to those listening. Boundaries are definitely needed along with a good, if not quirky, sense of humor. It also helps to work with the best team of people around.

        Before joining the hospice team I became a Stephen Minister. This is a wonderful support ministry for those experiencing loss. They also have good resources in pamphlet material, presented in easy quick reads.

  3. Colin Pacey says:

    Excellent interview. A breath of fresh air that needs to blow through the Church.

  4. Anxious Anglican says:

    IM: Great posting! This sort of perspective is what keeps me coming back to this site (and, in a larger sense, the church). Thank you.

  5. Vicki in NC says:

    My 44-year-old husband died of an extremely aggressive cancer four years ago. Forty-nine days from diagnosis to death. He did not profess to be a believer. The hospice chaplain was wonderful and treated him with grace and respect and my husband was very receptive to her. Others, whom my husband dubbed “The God Squad”, sought only to “save his soul”, and were met with disdain.

    God bless you, Mike Mercer, you have it exactly right. Not only in dealing with the dying, but in treating the survivors.

    • Headless Unicorn Guy says:

      When my mother died back in ’75 (same day as Rod Serling), I was 19 going on 5; I wish I knew then what I knew now. Back then, I was a cage-phase Christian involved with an aberrant Uber-Evangelical group and the only Christian reaction I knew was “The God Squad” one. Bad news all around.

  6. Thanks for this today Michael. We just met with the hospice people yesterday for my dad. They offered chaplain services but we had initially turned them down as my parents are died in the wool conservative christian people who might object to, say-gasp (!), a Lutheran pastor. Just hearing this man made me realize that I could call and talk to the chaplain in our hospice and see if he has a heart like Mr. Mercer. I’m sure if he does that it would be a delight to my parents to have him visit no matter what his background.

  7. I just lost my mother a couple weeks ago due to a long illness. She chose to die at home, cared for by her husband and other family. I was there for a week and a half (I live around 250 miles away) just a week before the end and would sit with her, not doing much, get her water if she needed it, monitor her pain levels and see if she needed changing or meds. Occasionally she was lucid, in one of those periods, she looked at me and said, I’m dying. My response, right or wrong, was, Yes, I know. It sounded callous to me at the time I said it, and yet, better than the ridiculousness of telling a women who hadn’t eaten food in 3 weeks and hadn’t been out of bed in 2 months, no, no you’re just under the weather.

    But their pastor was wonderful. First of all, he is a long-time friend of the family and my mother’s husband is a deacon in the church. Also, this is a small town of 1200 folk, with most people knowing each other, so there is a real community there, having little to do with what religious establishment one attends, if at all. Another thing is the pastor lives just across the street from them. Anyway, he was there pretty much every day and would visit with my mother’s husband (who at this point in time, needed the counseling more than mother, although the pastor would usually pop in and pray.) To me, he would just talk about whatever. All in all, I found a lot of respect for this Baptist pastor who was clearly family to these suffering people.

  8. Michael,

    I hope you don’t mind. I put a link on my blog directing people to yours. Excellent interview with Mike Mercer.

  9. Thoroughly enjoyed the interview (if one can ‘enjoy’ an interview about death and dying). Those cliche statements and the subsequent reminder how meaningless they are in the face of death and dying was a very powerful reminder of the need for better language to express what we are thinking.

    More and more I find myself coming back to the issue of language in faith and it is interesting that in this interview Mike even talks about it in terms of prayers and I appreciated that as well.

    Thank you so much for the piece.

  10. Scott Eaton says:

    Michael, this is one of the best interviews you have had at InternetMonk. Chaplain Mike, thank you for sharing so many helpful, encouraging, and challenging insights.

    Chaplain Mike, could you tell the IM audience how one becomes a hospice chaplain? Is there a need? It is an open field? What personal qualities does a person need to enter and thrive in this field of service? I think this would be interesting and helpful too.

    • Thanks for the kind words, Scott.

      Requirements for hospice chaplains vary. Where I work, the only requirement is an MDiv degree and ordination credentials. Some organizations are looking for Board Certified Chaplains, which means that the person has completed several units of CPE (Clinical Pastoral Education) and has gone through the certification process of the main national organization that gives chaplain credentials. Regardless of the credentialing issue, I would recommend taking at least some CPE.

      I believe that hospice will be a growing field in the future, especially with the changes forthcoming in health care. Not only is hospice a wonderful ministry, it is also a very cost-effective way to care for people at the end of life, since most hospice patients are at home rather than in an expensive facility.

      As far as personal qualities, I hope what I said in the interview will cover most of that.

      • Headless Unicorn Guy says:

        I believe that hospice will be a growing field in the future, especially with the changes forthcoming in health care.

        The problem is, these days the phrase “changes forthcoming in health care” triggers all the Conspiracy Trip about Death Panels, Concerned & Compassionate Bureaucratic Neglect, and Dr Kevorkian. Especially with the phrase “cost-effective” in the same paragraph. There’s a LOT of paranoia and Grand Unified Conspiracy Theories out there, and they now have “changes forthcoming in health care” as a Bright Red Panic Button.

        • I understand what you are saying, HUG, and I’ve worried as I’ve heard some of the crazies talk about “death panels.” I can only speak for our hospice when I say that we have very strong convictions and policies that we will do nothing to hasten death.

  11. Thank you, Michael and Chaplain Mike. This is helpful.

  12. “They need a calm, reasonable, caring human friend to sit with them, who is available to listen and support them. I have sat with families that have all kinds of reactions, and my approach has been fairly consistent—BE THERE. Period. Trust the process, rely on the active presence of God, and walk down the road with them.”

    Beautiful, true, real. Thank you, Mike Mercer, for sitting with people in the shadows of death. Thank you, imonk, for posting this rich conversation. The ministry of presence is powerful but often overlooked. You brought it into the light again. Bless you!

  13. Chaplain Mike: You cannot know how much your words and wisdom have encouraged me. I am a staff chaplain at a hospital in Illinois, been here for 12 years and have done the CPE thing years ago as well. Reading this interview leaves me with the desire to somehow talk to you or have other conversations with you. Is that possible? If I wanted to get in touch with you personally how could I do that? God bless you bro, this was really good and something I will probably share with the other chaplains in our department.

  14. IM
    Had not checked in for awhile, but so glad I did today. Bless you for conducting the interview and bless Chaplain Mike for his work and minstry.

  15. Having just buried my mother in law, who was closer to me than any other person not my wife, this is a great interview.

  16. That was a wonderful interview. Chaplain Mike, I liked your “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.”

    If the family of the dying person asks for your recommendation of a book to read to help them to deal with death and dying as well as possible, what do you recommend? I know it must vary, depending upon whether they are “church go-ers,” non-believers in God or something else.

    I find it hard myself to just listen to people without offering advice, but it’ is often important to do. The “pragmatic” part of me says, “OK, here is the problem. Let’s work out the solution.” But often I think my silence would have helped more than my words. As long as the silence was a listening, loving, taking-you-in silence and not a I-don’t-understand-or-really-care silence!

    • Most people who are in the midst of an end of life situation are in no condition to read anything very complicated. We use a booklet called, “Gone from My Sight,” which explains the dying process from the physical, emotional, and spiritual perspectives in very simple and understandable language. You can find more information about it at http://www.gonefrommysight.com.

      Abbey Press also publishes a good series of Caring Notes that are written for specific circumstances. You can find them at: http://www.onecaringplace.com.

      To be honest, however, I don’t use a great deal of written material. What is needed most is personal presence.

      • “Gone From My Sight” was the book that we had for Mother. It had been given to us by the hospice group she had been involved with last year (she made an impressive 8 month recovery before relapsing and dying). It’s a good pamphlet, but I think it helped me more by drawing back into my memory Elisabeth Kubler-Ross “On Death and Dying,” which I read in high school back in the day. Although Kubler-Ross is good, and informative, I think it’s too ponderous for someone in the midst of losing/loss.

        • Headless Unicorn Guy says:

          Also, I think Kubler-Ross was writing from a quasi-Spiritualist perspective, so you have to keep that in mind. To Dr Kubler-Ross, death was Forever. At best a spirit afterlife, no Resurrection (a doctrine that has fallen by the wayside for a LOT of Christians, too).

      • Thank you for those links to booklets, Chaplain Mike. Reading some of the testimonials about their helpfulness was impressive. But I do agree with you that it is your personal presence that is most needed. I thank you for the work that you do on behalf of those facing death and on behalf of their grieving families.

  17. Peggy in Shenandoah Valley says:

    Amen and amen! I have copied this to share with a church friend who serves as a chaplain both in a fire department and local hospital, as well as others including a friend with chronic illness whose church attendance is too often limited to “First Bedside Baptist.” My mother died when I was 10- long before it was okay for anyone to talk openly about cancer or death. My stepmother died in 1994. The changes in the intervening period were remarkable- and very welcome. The three months I lived with her and served as primary caretaker gave me some of my richest memories. Not only for the recipients, but also for the givers: the ministry of presence is so much more important than the words that are used- but as in the examples in this interview, words do have power- for both good and ill. Spend your words wisely; mostly, just be there.

  18. Andrea Tian says:

    Mike Mercer (I still want to call you Pastor Mike!), if I ever need end-of-life pastoral care, I sure hope you’re around to offer it to me 🙂

  19. Thank you for this interview, Michael, and Chaplain Mike. As someone who has been in the midst and on the periphary of a fair amount of death and suffering lately among those close to me, I found it very helpful and insightful. My own instinct used to be to want to solve the “problem,” but I have learned more and more that simply being present and open is what people often need.

    The following bit really jumped out at me:

    With regard to care for the dying, most pastors and people have not been taught that it is a good use of their time, that it is Christ-like and genuinely helpful, to simply sit with people, actively listen to their feelings, and not feel like you have to give “answers” or put the situation in an understandable theological framework so that folks might know the divine “reason” behind what is happening.

    This is so true, and not just in the area of care for the dying, but also many cases in care for those who are suffering. Neither one has been a strong suit for evanglicals. May voices like Chaplain Mike’s be heard and heeded widely. We need this.

    • Headless Unicorn Guy says:

      I have not been around death very much; just enough to realize that at such times, ANYTHING you say is going to sound really stupid. Better to just BE there for them.

      Wish I had learned that before the deaths of my parents.

  20. Thanks chaplain Mike for your heart and your willingness to share on this crucial aspect of pastoral care. But…, do you think it is ok to talk about death and dying in America? What would happen to our collective (secular and relgious) denial on this subject if it really got out there?

  21. Thank you for this wonderful interview. I work in a palliative care setting and have seen death many times. One lady from our church who was dying of cancer prematurely wanted to put her personal affairs in order and talk to a pastor about her approaching death. I called the church office and no one would come as they felt ill equipped to do anything more than pray for her healing. I had to get a social worker from the community to visit and felt very badly that the church could not meet her needs. I know there are doctors who deal badly with dying patients and training is needed to be able to counsel wisely in the face of death. Our society no longer allows time proper grieving either. People who meet up with Chaplain Mike and others like him are fortunate indeed.

  22. > “It’s more of a ‘love your neighbor’ ministry than a “win the lost” ministry (though I’m not always sure about the dichotomy).”

    Right you are. I think if we get the first part straight the second will follow. It’s also true with the two great commandments: “Love the Lord your God with all your heart, soul and strength”, and “Love your neighbor as yourself.” If we really get the first one straight the second will follow (which leads into what you said). No dichotomy.

  23. Although it’s true that Judaism has a year long mourning period, it is neatly carved up into periods of intensity. The first week, or Shiva is the most intense. It is a time when you usually don’t even venture out into public, you just stay with family. After that, the next month is less intense than Shiva, but still serious mourning. After that is a year of less intense mourning and remembrance of loss. After that, some light a candle at the year anniversary of the death of a close family member or someone close to them. I think this is fairly consistent with a natural aspect of the way we mourn as humans.

    Judaism has a similar problem as per going back to services. In Judaism, one is forbidden to mourn on the Sabbath. The Sabbath is always a time of joy. However, that doesn’t mean the congregation has to put on a happy face, so that’s probably a big difference.

    My mother’s visitation was on a Friday, her funeral on the Sabbath (she was a Baptist). I don’t belong to a crazy strict branch of Judaism anyway so I had no qualms about either. Plus, I could justify it under Torah.

    I think Interfaith chaplaincy needs are going to grow as our population grows more diverse. My family may carry it to an extreme measure (2 parents, 1 Baptist, 1 Jewish–3 children, 1 agnostic, 1 Catholic, 1 Jew), but I think it will become more common over time.

  24. Don Yeager says:

    As I read the interview, I remembered being told by a pastoral colleague that Dr. Fred Gealy, who taught at Perkins School of Theology in Dallas (my alma mater) many years ago, was once asked by an upstart student, “Dr. Gealy, have you ever held the hand of a dying man?” He responded, “I’ve never held any other kind.”

  25. I am a tiny blog; when I grow up I want to be like you!

    Seriously, this is typical of why I return again and again to this blog. My context is different; rural north Yorkshire, England, but you speak a language that is mine.

    Thank you for this wonderful post: it has helped me to see better what I do and articulate stuff I have felt.

  26. Great interview Imonk, and thanks Chaplain MIke. My wife died of cancer at 42 and Hospice was just a tremendous support. I also had wonderful support from our small church–our pastor was with us when she died. Several years later I attended a multi-site theater church with a superstar pastor. I looked around the theater and asked my friend where they held funerals. She had no idea since in the 6 years she had attended, she couldn’t remember anyone dying. I’m know this church is doing lots of good things, but I can’t imagine walking the journey I did in such a setting.

  27. Thank you both for this.

    There is a dire need for that new/improved paradigm of ministering to the dying in our churches. You’re so right! The only thing I knew to do is coordinate meals and the other “action items” you mentioned. It never occurred to me that someone might want me to just be there and I most certainly would not have been comfortable with the idea!

    About a month ago, I saw a movie that dealt with (although in a very quirky way) death and grieving. It set me on a thinking path. I have mulled over the way these fictional friends and church family offered their simple presence to a grieving man, explaining to him he didn’t need to do anything and they were just there to sit with him, “because that’s what people do when tragedy strikes. They come over and sit.”

    I thought at the time, and several times since, that people really don’t… at least no one I know. But we need to.

    I’ve felt so uncomfortable during prayers for healing for someone who is so obviously prepared to die, but I couldn’t put my finger on the reason at the time. I’ve watched young ministers totally avoid visiting the old and infirmed, and never really understood why. Now it makes sense. I suppose they are as uncomfortable/busy/insert-excuse-here as I am. Shame on me.

    Now this. I am so thankful for this interview and the understanding it provided to me.

    • Christiane says:

      Sometimes when I hear about the ‘discomfort’ some Christians have with being around the dying, I wish that they could understand the comfort of the ‘sacrament of the sick’ (used to be called the ‘last rites’).
      You can’t explain in words what this means to the dying person’s family who witness it.
      You have to be there to understand.
      There are things we want to convey to others for which there are no words.

  28. Thank you, Michael, for conducting this interview, and thank you, Mike, for sharing your ministry and wisdom with us. We here at iMonk enjoy wrangling over theological and church-related issues, and I rarely fail to put in my two cents — but there’s something about the gospel being acted out in humility and love in the real world that stills my argumentative tendencies and inspires me to say simply: “Yes! That’s truth in action. That’s pure, undiluted Jesus at work in the world. Praise God!”
    Thank you again, Mike. May God bless and watch over you and your family as you serve as His comforting hand to those who mourn.

  29. I’m a hospital chaplaincy intern, and I just want to say “thank you” for this interview. What Chaplain Mike says really matches up with the things I’ve been experiencing lately and the lessons that I’ve been learning as a newcomer to this business, and as I consider whether chaplaincy might actually become a full-time vocation for me it really helped me to clarify what the nature of this ministry is, and how it can be Gospel-oriented without being preachy or judgmental.

    Thanks, iMonk and Chaplain Mike!

  30. I am thinking that it must be more difficult to minister to the pastoral needs of the family of a dying family member who was a difficult person…cruel, abusive, anti-Christian. Especially if the family members are ones who have a strong belief in hell and eternal punishment. I know you couldn’t go into great detail here, but would you have a few tips in how you may handle something like that?

  31. iMonk,
    Thank so very much for this Post. And God bless Chaplain Mike for his expounding, living and preaching the Gospel.

  32. I just got off the phone with a woman in our congregation who had just spoken with her husband’s oncologist about ending his treatment. What could I do but listen, encourage her not to rush into any decisions that she might regret later, and pray with her? I had a hard time not crying over the phone.

    It’s good to hear from Chaplain Mike that this is the best approach. But I’m surprised that he thinks it isn’t common among evangelicals – it’s common among those I know. I’m sure there are lots of problems, but maybe his circle of experience isn’t as broad as he assumes.

    Still, we all need to grow in this area, and I am thankful to you for posting this interview.

    Chaplain Mike, you should think about writing a book.

    • “What could I do but listen, encourage her not to rush into any decisions that she might regret later, and pray with her? I had a hard time not crying over the phone.”

      Well, yes, but yet … my experience is that this type of approach can be exactly the problem.

      (First, let me say that, Greg, you know this exact situation and person, and I don’t. If you think that my comment does not apply to your specific situation, you are probably right.)

      In my experience, approaching someone in your local congregation is very risky when

      -There are no options left except those that will be regretted or can never be proven right or wrong. (e.g. many situations involving treatments that are dangerous and can cause much suffering, or even death, in and of themselves.) Being encouraged to not do something you will regret kind of completely misses the need (the free fall of being forced into thinking about an unthinkable decision) and makes the person feel at risk of being judged no matter what they do.

      – You (the primary care taker or decision maker) have utterly no emotional resources left to deal with someone else, who you hoped might help, if you risk saying something, and the something causes distress, stress, or upset in the other person. There are tears of distress and tears of presence, and they are different. There are prayers … and then there is “I’ll pray for you” as code for “I’m feeling really uncomfortable and helpless, and praying lets me end this encounter and put some distance between us.”

      -The decision maker has been through so much for so long already, and is so wrung out emotionally and physically and mentally, that their experience is that there is nothing left of them except broken shards of glass strewn all over the ground. And still the situation goes on and on, with unthinkable decisions having to be thought about and unendurable situations having to be endured. And in that situation, you (the decision maker) start having thoughts that shock you and make you wonder if you are a monster.

      It is then that simple presence is life-giving: I am here, I am here, I am here, I will not leave, you can not shock me, you do not need to care for me, I will walk this path all the way to the end with you. When you feel the darkness consuming you, my hand, my human touch, will stay on your shoulder. If you need to say the same uninsightful, seemly minor thing over and over again, to extremely boring lengths, I will be here. I will not leave. If you confess your darkest thoughts, I will not be shocked, but will be able to convey that you are not a monster, just deeply human.

      Having said all that, let me admit I’ve never been the primary care giver in a hospice situation. I’ve been on the periphery. And I’ve had to walk through my own difficult situations of other sorts. So I may be off in my perspective of presence during end of life situations.

      However, I wonder if the kind of intense presence I described is really purely possible in even good church settings.

      The boredom factor: I know that in my situations, there were times where I needed to be really repetitiously boring for long stretches of time – and the fact that my “ministry of presence” was provided by a professional who was receiving pay gave me permission to do so. Even a local church pastor of a small church, although a professional, seems usually too busy for the boring, repetitious stuff. Never mind the average church acquaintance – life has to go on for other people, they are busy, and most people are ill equipped to deal with a situation that doesn’t show measurable progress on a regular basis.

      The safety factor: The fact that there were professional boundaries on the relationship made it feel much safer to bring up the “monster” thoughts – if things went badly, I never had to see the person again. Theoretically it is possible that someone in a local church could be a presence for the monster thoughts, but it is something that goes very badly often enough that it is a terrible, stressful thing to risk in a situation where you have no resources left to cope with things going badly.

      The shock factor: A specialist professional really had walked the same path with a lot of people and had seen enough that they had worked through their own discomfort and could convey lack of shock at anything I said. They could convey with the conviction of long experience that I wasn’t a monster, just normal and was experiencing something deeply human. In a local church, often the pastor (besides seeming so busy that you never develop the relationship enough to risk saying the monster stuff) seems usually a generalist, and it is a risk on whether they have walked your particular path enough to not be shocked. Same thing with other members of the church community … here may be someone who has walked your exact path and is greatly helpful, but it is hard finding them, especially in the midst of the storm.

      The gender factor: I kind of hate to throw this one in here, but my (limited) experience, as a woman, in churches where the pastors and leadership (elders, deacons) were men, is that with them there was always this unspoken stress and tension in the air that seemed to be about “There is a man and a woman in the same room talking about an intense situation which the woman has emotions about; this is dangerous and uncomfortable.” That atmosphere was completely absent with the outside professional.

      Of course, optimally it isn’t an either-or answer on whether “the local congregation should handle it” or “the professional should handle it.” Ideally, it is probably a combination of both. I just haven’t actually seen that work out well in practice, much. Maybe I lack perspective or imagination or something.

      • You make some good points, and I obviously would say there is a place for professional care, since that is what I do.

        However…let’s not make this too complicated, either. My main criticism of the church with regard to caring for the suffering is that we have bought into our culture of busyness, programmed approaches, and the ethos of productivity, and have forgotten how to be simply human with one another. Crassly put, if you are too busy to love your neighbor, you’re too busy. If we can’t rearrange our schedules to sit with someone who is dying, our schedules are too dear to us.

  33. I am in a retirement area and I have taken more than one person through hospice as a local church pastor rather than as a chaplain. I found your interview very helpful, Chaplain.

    I know what a relief there is for people when I take them through the rites of confession, or anointing of the sick, or even the prayers for those in their last moments (even if they end up surviving). To have someone there who is willing to acknowledge what they already know (or fear), someone who is willing to acknowledge that life does have an ending (whether now or at some time in the future) is more of a relief than dancing around the subject. Yes, I do believe in the resurrection, but, this life that we are now living does have an ending before the new beginning.

    My personal experience is that people who have made it to the point of hospice want to be able to talk and to have someone hear them. But, not simply to hear them, but also to speak back to them the words of the rites that say to them that even now they are not alone that what they are going through is what their fathers, their grandfathers, their great-grandfathers, their ancestors, all went through, and that Mother Church is there to accompany them to the end in this world and to meet them in the next.

  34. To the two Mikes, thank you for this interview.

    Earlier this month I lost my mother to suicide after watching her battle with depression for some time. I feel like I have heard every cliche on Mike’s list a dozen times over in the last few weeks.

    I grew up in an LCMS Lutheran Church but left it in college for more charismatic/seeker driven churches that at age 18 I found to be more exciting. I’m now 27 and over the last few years I began to notice increasing problems in these churches and my study of scripture began leading my back to my roots. I thank God this happened because I do not know how I would have dealt with my mother’s death if I had not come to a more clear understanding of the objective reality of the Gospel, that can even save a woman so overcome by depression that she would take her own life.

    I have to say that what you gentlemen said about having a clear liturgy for such occasions and having a pastor that empathizes and actively listens is so true. My mother’s pastor has been wonderful for my family. I am so glad that when he visited he didn’t speak too much and prayed prayers from his prayerbook that were saturated with scripture and delivered earnestly. I felt that for the first time in a long time I saw a pastor truly at work.

    Thanks again for speaking openly and honestly about this subject.

  35. Mike McConville says:

    Chaplain Mike,

    I’m also a “Chaplain Mike,” but with the Navy. I’ve often thought about where I’ll be post-Navy (in about 10 years). Hospitial ministry is very appealing to me, especially Hospice. I’m even more interested after reading your interview. Thank you!

    There doesn’t seem to be much as far job opening adverts. How are they advertised, typically?
    Thanks again!