After a full day of reminding people that they are dust, mortal, and needing to repent, I’m ever more aware of how many times my colleagues and I try to help people make decisions about their loved ones’ care. Most often, the realities of today’s words about our mortality are seldom integrated into family conversations about mortality, and how to decide when “enough is enough” with regard to treatment and interventions that prolong life (and likely, suffering).
Here’s a reflection I wrote earlier this year about reconciling our mortality and limits in the context of health care:
I stood outside of a patient’s room on one of our intensive care units, talking with the nurse, as we both waited for more of the patient’s family to arrive. The family had asked that a chaplain pray with them before the staff withdraws life support. We expected that the patient would die soon.
The nurse said to me, “if something devastating happens to me. I’d want to quit. I am not a fighter.” I think she’s describing “surrender” more than quit, I said to her. We both have heard many times how family members describe patients as “fighters.”
Most of us who work in the intensive care unit see how families agonize over decision-making. When devastating injury or a terrible prognosis is given to patients or family members, very few people would not choose “full speed ahead” for the course of treatment.
We understand that family members are in shock. They want what they had: a vibrant, dear person who had plans for tomorrow and next week. They want continued hopes and a future.
Those of us who work in intensive care units wish we could protect families from future pain of prolonged illness or deficits. We want to warn against what fighting might mean. We wish the general public had a better grasp of how very difficult (not to mention costly) it can be to “do everything.” It is not a matter of wanting to change minds, but we hold an aching desire for them to know some of what lies ahead.
Fighting, or continuing to “do everything” seems to be the valiant course, whereas surrendering may seem like giving up, or quitting. Sometimes, of course, it’s a matter of quickly doing something to save a life. I wonder if we viewed these actions as a process, rather than as opposite choices.
When 2 Corinthians uses a phrase that refers to God “reconciling the world to himself,” I think of coming to terms with an awful diagnosis, or a devastating injury, as a process of reconciliation. How do we make sense of difficult, devastating news and also respond quite immediately to options of treatment, plans of care, and other courses of action. The process is very compressed when news is given to people in shock. No wonder it seems “either, or,” as in, “fight,” or “quit.”
In this particular case that the nurse and I faced the other day, the patient had experienced significant, long-term illness. The family was clearly ready to let go. I don’t know what they were like at the beginning of this illness. We do know—we could see—-that they were weary, and were ready to let go.
When God is reconciling the world to himself, it sounds sacred and holy. Our efforts to come to terms with grief, or limitations, are messy, profane, painful, gut-wrenching, and awful. How do we know how much to fight or surrender, especially on behalf of someone else?
We have occasions to come to terms with our limits throughout life; we might not want to accommodate our worsening hearing, or honestly evaluate our abilities. We don’t want not to treat a cancer that threatens our health. Then, something happens to remind us to adjust, yet again. Is there grace in accepting such changes?
Can faith that God bestows on us hold us so securely that we don’t have to be the ones holding on for dear life? I hope we can rest in the faith God gives. I hope we see it is not about fighting, but rather, discerning, somehow integrating truth and hope, faith and love, again, and again. Facing terrible news, or even difficult realities, means coming to terms with ourselves. Can we reconcile the bad news of illness or limits with new ways to hope that God will carry us through, in life and in death? We belong to God, the catechism says. We are not our own, but belong, body and soul, in life and in death, to our faithful Savior—the same savior who makes possible the reconciling process that God is enacting.