Confirming Erik: The gift of hospice care

May 2, 2006

There was nothing particularly unusual or newsworthy about my father-in-law’s death at age 84. Even so, it was unsettling, given that until his diagnosis of stage four cancer on March 1, he had been living alone in his home and was seemingly healthy—and that despite his doctor’s prognosis of having several months to live, he died after only three more weeks.

This brief time offered some wonderful gifts. First and not least was an opportunity for final visits with children, grandchildren and great-grandchildren. He never lost his sense of humor, and he conveyed a sense of peace and contentment that was striking to all of us.

On the day that my wife and I left for what turned out to be our final visit with Bill, I received a gift in the mail: a copy of Mrs. Hunter’s Happy Death: Lessons on Living from People Preparing to Die, by John Fanestil. It proved to be not only a poignant reflection that fit our mood as we were driving, but also an instructive witness to the Christian tradition’s wisdom about good, graceful and even “happy” practices of dying.

Fanestil draws on the stories of “happy deaths” that were popular in religious magazines in both the United States and England during the 18th and 19th centuries. He writes: “Happy dying was a ritualized way of dying practiced widely for generations—and in fact for centuries across the history of the Christian church. Rooted in the paradoxically good news of Christ’s death on the cross, this ritual encouraged those who practiced it to seek an experience of God’s grace—what today we would call a ‘spiritual high’—enabling them to transcend the pain and suffering and grief that come with death.”

In the second section of the book, Fanestil draws out ten lessons on living from people preparing to die. These lessons are shaped by practices such as prayer, making the Bible’s story your own, bearing testimony, taking up the cross, “drinking from the celestial stream” and remembering the saints. By cultivating these practices while we are living, we cultivate habits that will enable us to die well.

Mrs. Hunter and her happy death became a valued companion during my father-in-law’s dying days. They were not easy times. The process of saying goodbye was difficult, and we were acutely aware of unresolved pain and estrangement that persisted in the broader family even unto death. Even so, our final afternoon with Bill was marked by practices such as prayer and testimony—especially as we remembered saints who had gone before us. And Bill, faithful Baptist that he was, reflected with anticipation about his readiness to be with God and to be reunited with loved ones who had gone before him.

We were able to share such wonderful family time because of another gift we received—the gift of hospice care. Physicians, nurses, social workers and chaplains formed a wonderful team that supported and cared for Bill in beautiful ways. His room was well equipped to allow family members to gather, and we never felt as if we were intruders. The caretakers made Bill comfortable while carefully avoiding the hypermedical intervention that often makes the dying process awful rather than graceful.

We had already been appreciating and supporting hospice from a distance, and had advocated for hospice in a variety of contexts. But it is one thing to understand the significance of hospice intellectually and to advocate for it, and quite another thing to experience its ministries personally. The hospice setting was indispensable to our ability to receive the gift of storytelling among the family, and to pay attention to the practices of a “happy death.”

Fanestil notes that with the advent of hospice care, “the work of dying is being wrested from medical professionals, and being returned to its rightful place in the institutions of family and home and religious community. This is for the good. Dying is not at its root a medical process. It is a process with profound and obvious physical dimensions, but that is only a part of it. Like other natural processes—birth, giving birth, love, making love—dying is a natural process infused with profound emotional and spiritual dimensions.”

In recent days, I have reflected on the importance of creating, cultivating and renewing institutions that enable faithful practices such as dying well. A half-century ago, hospice was largely nonexistent in the United States. Indeed, we seemed to be heading toward an inevitable medicalization of death and dying.

Thanks to the efforts of pioneering leaders who cared about the deep connections between how people die and how they live, countless dying patients and their families are being cared for in settings that both embody and enable faithful practices of care.

As we give thanks for Bill’s living and his dying, we give thanks for the gift of time and family that ease our sense of loss. We also remember the gifts that others offer at a much greater distance—the gifts of Christian practices passed on from generation to generation, of books that tell poignant and inspiring stories, of people who dedicate their lives to caring for the dying, and of institutions that embody the wisdom of dying well. They are gifts we have known in varying degrees over the years, yet never have we appreciated them as we did, unexpectedly, during a few intense weeks in March.