It occurred to me yesterday morning that I have been fearful of the role of full-time hospice chaplaincy for two main reasons.
The first is that I thought I might get burnt out ministering mostly to folks who are actively dying and their families, that the nature of unavoidable death without the affirmation of life might not be there. That without the balance, I would eventually tip over and absorb too much of the grief and not enough of the life.
If you are on my hospice list then you are most likely dying. Some folks get better with hospice care and no longer qualify for it, but mostly, folks die.
Here is the other point. Frankly I didn’t have confidence that my spunky little self was cut out for the solemnness of the gig. I met a ton of ministers and others who felt called to hospice while I was in seminary and CPE, and they tended to be very peaceful, calming, and reverent. I am mostly irreverent and have a quirky sense of humor. I am also naturally charismatic and sometimes find it difficult to tamper that gift down. I don’t mean to say that I am all that and a bag of chips, but I have that funny personality that is highly interested in others, connects easily to strangers and for the most part, is authentic. What you see is what you get.
I didn’t think that my calling was to hospice. I figured it was to helping people with addictions, and homelessness, and hospital type stuff. I love hospital chaplaincy and did well in training with the cases where it was messy. Messy with bells and whistles going off. Messy with theological issues. Messy with emotional responses.
This is what I discovered.
In the hospital, death is there and is often sudden. Unexpected. As chaplain you need to have your spiritual tanks filled because you respond to some deep stuff. People are plugged into machines, the heart is monitored, beeps and alarms go off. People rush in and rush out trying to save the patient. The main purpose of the medical team is curative, everybody jumps in at the code to save the life and the chaplain holds the sacred space.
A 17-year-old wraps their car around a tree and the family comes to the bedside, faced with issues of taking him off life support or organ donation. The baby’s heart isn’t working and he has to be medevaced to Children’s hospital. You are called to take someone to see their loved one in the morgue after death from an overdose and you lead them to a cold room, generally far away from the rest of the hospital, and generally underground. Shock is the response to sudden and unexpected death. It is surreal at times.
Death comes unexpectedly and on the emotional intensity scale of 1-10, 10 being full on, you give spiritual care and support, holding the sacred space for the family and the patients. It is a fast inhale, like when you are being startled and you quickly hold your breath for dear life, hoping death will not take it. And sometimes you go from emergency to emergency and you have to be there, one patient emergency after another. All of you, present and with The Divine because you are the symbol of the sacred in the moment. It is exhausting, but I was good it. I can hold my breath for a very long time.
In hospice, it is like a long and cleaning exhale. Death is not unexpected, it is unavoidable, for the most part. There are folks who struggle with accepting death, their own or the death their loved one. Hospice is provided only if there is a medical indication that curative medicine will no longer help. To be on hospice you have to have a terminal diagnosis with death imminent, generally less than 6 months. Hospice is when death has knocked the door has opened.
And with the exhale, it seems that the tension of intensity , the holding your breath against sudden illness and unexpected death, is released. The emotions are still there, but not as tense. The grieving process has begun. The emotion has moved from the shock of not accepting that death has come, to sometimes welcoming the relief from suffering that death sometimes brings.
In this place, with patients and their families, my true self can be present without filtering. Not to say that I was fake in my other work. I was authentic, but I feared that I could not be authentic in hospice full-time.
Well I seem to be wrong. This calling fits like a glove.
I can hold the space sometimes and relieve the tension by bringing life back into the room of the dying. “Tell me a little bit about your loved one” I say. I can get the story telling started because I am genuinely interested in the life of the patient. Family members get that. They can feel it and respond by sharing the life that their loved one lived. Granted I am still new at this type of gig. But if I can be my true self right from the get go, then I am pretty optimistic about it. All things will sugar out with time. I am hopeful this calling will get sweeter.