The Hospital
I have never liked hospitals. Hospitals can so often seem to be places where we attempt to sequester the pain and confusion and despair that are a part of so many lives—to keep them out of sight and out of mind. When we go to the hospital, we look in a mirror and we see ourselves in 5, 10, 20, 50 years—it doesn’t really matter how long. The question isn’t if but when we will take our place amongst all of these broken down worn out decaying bodies.
How do we live and move inside these places? How do we pretend to have normal conversations about weather and sports and church and children’s activities alongside a wild-eyed woman stumbling around with her dressing gown wide open, or a sad-faced old man who keeps wandering around blankly, pushing his walker into chairs? How do we visit when the woman next to us is sobbing confusedly as she coughs down her sixth pill of the morning? How can we speak of things like eternity and suffering and salvation over the din of mindless television programs blaring to occupy these fading treasures of glorious humanity, these flickering lights? How do we pray and talk and laugh and speak of life in these halls of death? What good could possibly come of our feeble attempts to wrest order out of all this chaos?
I get back into my car after my hospital visit and the man on the radio is interviewing a physicist from Oxford. They’re talking about quantum physics, relativity, and the “undeniable” existence of multiple universes parallel to our own. In another universe, right now, I am having completely different experiences than the “me” that I think is exclusively real is currently having. Maybe I’m riding a scooter or a horse. Maybe I’m skydiving or planting a garden. Maybe I’ve taken up smoking.
The conversation is lively and enthusiastic, full of impressive sounding facts and statistics and studies and recent developments. “But it all just seems so unbelievable,” says the program host to the Oxford physicist. The esteemed scientist replies, “well, the question is do you want to understand the world as it really is or not? This is the way progress is made.”
Progress. Maybe.
Maybe in another universe the dear person I visited this morning is not staring blankly at a wall, wondering if the doctors will be able to fix all the problems, and wring a few more years out of what has already been a full life. Maybe in a parallel universe there are no more tests to wait for, no more antiseptic smells and sterile utensils, no gross-looking half-eaten jello on the plate, no harried “recreation therapists” with no time to talk, no bedpans and vomiting, no wilting flowers and limp balloons, no visits that are always too short.
There may be other universes out there where better things are happening to other versions of ourselves. There may be a heaven, for that matter. Both can seem equally remote and irrelevant from “the world as it really is.” After a trip to the hospital, I am less interested in the question of how many universes it takes to explain the one I see than I am in whether the one I see has love and hope in its future.
I read these words from Romans 8 in the hospital today:
For I am convinced that neither death, nor life, nor angels, nor things present, nor things to come, nor powers, nor height, nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.
The love of God in Christ Jesus our Lord. Enough for multiple universes. Enough for the hospital room.
Rumblings 
So when did it change? When did hospitals go from places of healing to this? or am I assuming too much?
Ernie
My feelings also…
As one who works every day in Hospitals, I see things through a different lens than you do Ryan. There is despair but I also see hope in many (though clearly not all) people going through treatments, including those approaching End of Life.
You have picked up on the awfulness of hospitals…. While I deal with the same realities I am also privileged to see recovery and healing.
“How do we pray and talk and laugh and speak of life in these halls of death?” This particular sentence struck me because we pray and talk and laugh and speak of life in these halls because the patients live. The longer I work with dying patients (and I do every single day) the more I learn from them is that even though they know they are dying, they haven’t yet.
I don’t know that I can really express myself (I don’t have your gift of writing). What I can say is that one of the more fulfilling parts of my work is helping people in their dying process. As I say to the residents, there are good deaths and there are bad deaths. Despair contributes to a bad death; hope and prayer and laughter contribute to a good death.
Yes, it’s an admittedly bleak reflection upon a specific experience in what is probably one of the less hopeful parts of the hospital. I wrote it quite hastily after returning from the hospital today—kind of a stream of consciousness thing. Looking back on it now, I can certainly see that my words only reflect part of the story, and through my own very limited lens. I haven’t spent much time in hospitals (yet), so perhaps the sorts of sights and smells and experiences of this morning hit me harder than they would someone who is more accustomed to this environment, more skilled at seeing the goodness, hope, and life that is present, even in difficult situations. I appreciate the reminder from both of you that to whatever extent my words here describe certain aspects of the hospital, it is also (primarily) a place of healing.
Mike, I think you expressed yourself extremely well. I was particularly struck by this phrase: “even though they know they are dying, they haven’t yet.” So much truth and hope packed into those few words. I very much admire the work that you do in working for healing and recovery, and helping people to die (and live) well. Your patients are fortunate to have you. Thank you for your words here.
I think you may have retreated too far here.
An emergency room surgeon friend tells me that the motto of his profession is “to cut is to cure.” Personally, he knows that belief, and yet he does not believe it. Some people survive medical procedures, and others do not. Some would have lived longer and better lives had they never entered hospitals, others are helped by them and for others it makes no difference one way or the other. Other doctor friends have also confided the conflicts they feel about this. I will never forget an afternoon on the side of a mountain when a doctor friend told me how he had chosen to practice medicine rather than physics because he believed he could help people. After many years in practice he realizes that his ideals are not met with reality.
Death and suffering are the front line in ministry. No one is unaffected by it. No one who is healthy becomes desensitized. Those who spend time there need the support of others.
What you say is true, Ken—those who spend time with death and suffering need support. They also need reminders that hope and life exist alongside these things, and that these are to be celebrated and embraced. It was good for me to be reminded by Ernie and Mike of this.
The support I was thinking about, but did not say (responding from my ipod,) is counseling for the helper, the kind that therapists receive, for example. It is part of recovery from situations that naturally cause anxiety. Pastors generally lack that kind of support, but it is nice to have it if their pastoral care activities take them into situations like the one you described. Counselors come to recognize when things happen that overwhelm them, even if subtle, and, if they work in a clinic, they have this resource to help them recover.
Certainly, what Mike wrote about hope and life is true. And as one older friend once wisely said to me, “We are all dying.” She said that in the context of discussing a forestry project that attempted to identify and cut down trees that are living, but diseased and dying in the forester’s opinion. It seemed to her that cutting down living trees because a forester believed they would die anyway was presumptuous. Seven years ago a forester told me that one of my trees would be dead soon. Well, not yet. He missed another, I guess. It died last year. No matter how good or bad things look today, it is folly to be presumptuous about life and death.
Very true, Ken. Pastors can be among the most poorly equipped to recognize and address feelings of being overwhelmed, compassion fatigue, anxiety, etc—especially pastors with, say, theology degrees instead of pastoral/counseling degrees. To pick a random example :).
It is, indeed, a dangerous to speak presumptuously about life and death. Around such mysteries, we must tread carefully and with great compassion.
I think it was Marva Dawn who said something akin to “we given up care in place of a cure”. I’m trying to recall, but her comments were in the context of the Church at times acting like a fallen power. My sense is that our culture much prefers cure over care, yet healing involves so much more than physiological care, as those who spend their time in hospitals can attest. In many health regions across our country, funding of chaplaincy has been reduced dramatically or altogether. This might be an opportunity for the church-at-large to respond to a need that it once filled only a century ago, in providing health care. Instead of having church sponsored hospitals, there seems to be room for increased chaplaincy, visitation, and the like. The sick and dying in hospitals are forgotten ones of society. Life around continues to move along at its ever growing pace, but not for them. Hope is what we need.
Marva Dawn has much to teach us about the role that suffering can play in the life of faith. She is an excellent safeguard against an overly triumphalist church.
I had a coffee with the hospital chaplain yesterday and came away very encouraged. He is filling the role you speak of, and with great joy. It is great to see.
I feel depressed about the whole thing now. And I think it’s ok to feel sad about things that are difficult and sometimes miserable. I know a few adults above forty who have jokingly talked of plans to do drugs and drink themselves to death once they become senile. But quality of life is so poor at that age I understand the desire to end life before that happens. that’s great that you are visiting people. Have you talked about this in your church? Or brought these people to their attention? You should do a whole sermon on end of life and that subculture.
I certainly wasn’t trying to depress anyone! Mostly, I was just reflecting upon an experience. As you say, some things are just sad…
Re: euthanasia, I understand the desire too. We’ve not talked about it formally in church, nor do I have any sermons on this topic planned :). I have had the occasional conversation with people who wonder about this matter and for whom it is desperately relevant. It’s a very complicated issue and the conversations have been hard ones. Easy answers are elusive here.
Thanks for the very relevant song—love the Cold War Kids!
I spent the last few weeks at a hospital, and this week spent a good part of my time Wednesday/Thursday at a hospice. Then my dad died last night at the hospice at 11.30 pm. Ryan your hospital visit sounds like what I saw in the wing of the hospital waiting for Dad to be moved to the hospice. The hospice had a very mellow and pleasant vibe to it although people who go there are on a 1-way ticket to meet the grim reaper. Both hospital and hospice staff are special people doing the job/ministry that Mike C describes. I can’t imagine that work.
Today was spent with funeral details and learning that a brass plate mounted on granite for two burial plots cost something like 5000/6000.00 (that would pay for dad’s and prepare for mom’s). I balked at the cost saying that my father would protest spending 6000.00 to mark graves – much better to send the money via MCC to the starving children in Africa. I told the salesman that due to our faith and hope that our worldview meant that helping others was far more valued than metal grave markers (it seemed quite eloquent at the time, but I’m running of about 4-hours sleep). Then we learned that the only other option was to leave the grave completely unmarked (which seems a bit harsh) – so we tabled our decision and w/discuss this as a family. Dying is an expensive event.
Ryan you had interesting musing about alternative universes speculating that they may be much better than ours. When I read that portion of your post I wondered if the opposite may also be true; those universes could be so dark and bleak that ours look like paradise. I’m pinning my hope on the resurrection and New Creation.
I’m very sorry to hear about your father’s passing, Larry. I hope your last days with him were meaningful ones, and filled with hope.
I’m also sorry (though not surprised) to hear about your frustrations with those who profit from death. I recently sat with a woman who expressed similar bewildering frustration with the cost of giving her deceased husband a simple gravestone. Dying is expensive indeed….
Re: multiple universes, of course you’re right—if one is inclined to believe in such things, there is certainly no reason to imagine that human experience is better there than here. I suppose if there are an infinite number and variety of universes out there, it stands to reason that some would be blissful, some would be horrific, and many would be somewhere in between. If you’re inclined to believe in such things…
Personally, I don’t have that much faith. Like you, I’m pinning my hope on the resurrection and the New Creation.
Jenna wrote:
“I feel depressed about the whole thing now. And I think it’s ok to feel sad about things that are difficult and sometimes miserable. I know a few adults above forty who have jokingly talked of plans to do drugs and drink themselves to death once they become senile. But quality of life is so poor at that age I understand the desire to end life before that happens.”
Over the past few years watching my Dad and his “long goodbye” I have speculated that as baby-boomers age, aging baby boomer evangelicals like myself are going to negotiate / theologize a way to rationalize end of life suicide. It will take a bit of doing but we have emptied out hell; why not figure out a way to guarantee a peaceful passing.
Yes, this conversation is coming… I have had it, and I anticipate its continuing reappearance.
Thanks for the thoughts everyone. Here’s another interesting song on the topic of heaven and death. Give me some solace and hope. http://youtu.be/NqJ44J4m7Tk
What a great song! Hope he does this one on Friday…
Henri Nouwen’s books have some profound words to say about death and being a witness in our dying. My grandparents, who were once so full of life in their 80s, are now in their 90s and in home where their diapers must be changed and everyday seems the same as Ryan described. I have found the visits difficult. The miracles of health research do not always make for miraculous last days.
No, they certainly do not. I often think that when it comes to health care our technological reach has exceeded our ethical grasp. We can preserve and extend life far beyond what was possible in the past, but, as Larry notes above, this is leading to all kinds of disturbing questions and decisions. As you say, last days are often far from miraculous.
Writers like Nouwen are hugely important if only for what they can teach us about the suffering, the dying, the forgotten and neglected. I have long appreciated Nouwen’s work in communicating the dignity and value that are often where we would least expect to find it.
12 years ago my then father-in-law suffered from terminal bone cancer. It was and I imagine still is, a slow and excruciating way to die. The last several months were spent in a chronic care facility, on the 5th floor, cheerfully known as “death row”.
In the beginning it was a difficult place to visit, despondancy and tears everywhere…horrified faces, blank faces. People present to each other without smile or conversation. Sour antiseptic smells. It seemed as if impending death has an odor that no cleaning solution can completely eviscerate. If Purgatory has a waiting room, than this would be it.
But it got better. Nick really looked forward to my visits. When the weather permitted I took him outside in a wheelchair. While it seemed that almost every movement was painful for him and he often audibly moaned when I moved him, he was insistent that we go outside. He loved the fresh air and it allowed him to partake of his last remaining indulgence, cigarette smoking. I’d hold the butt, he’d suck in the smoke. As peculiar as it sounds I still think of this exchange as one of the most generous actions of my life.
While there was a great deal of sadness and pain for Nick, he was happy, smiling and reconcilled with his situation, more often than not, on our little excursions outside. Once I kidded him that he was probably reliving his school boy days when on class field trips he probably “buggered off” and went smoking. He laughed and said something like, “yeah, that would have been just like me.”
In the end when he was to sick to move we talked about forgiveness. He had been a chronic alcoholic and he and his family had suffered immeasurably as a result. We talked about redemptive suffering. We were both Catholic so we were free to examine our belief in purgatory. It really helped him to believe that his intense suffering was neither random or pure punishment but rather the love of Christ biginning the purifying process of healing and redemption within him. He liked me to read the 23rd psalm a lot..go figure 🙂 On his second last and last day he spoke of a beautiful lady in white, standing and smiling at the end of his bed. I asked him if he thought she was waiting for him, he said he thought so.
Later that evening, (I was at work) he died in the arms of his oldest daughter. She told him that she forgave him, she loved him and that he had suffered enough and it was time to let go. She believes he weakly smiled and then he simply stopped breathing…
So when I think of places like you describe in this poignant thread, I nod in assent but I remember that the relationships we choose to have, or tragically in some cases, choose not to have, trump any other pain or indignity we could otherwise experience.
It is my experience, that in the end, it isn’t that they are dying painful deaths that overwhelms the terminally ill, it is the fact that they might be dying them alone.
God bless you in your ministry.
Beautiful story, Paul. I couldn’t agree more with your assessment of the meaning and value in walking with those who are suffering through the valley of the shadow of death.
Thanks for sharing this.