Thursday, November 12, 2015

Our Children

They say a parent can only be as happy as their most miserable child. I doubt this is true all the time, but I can see what they mean. In this time of hay fever, colds, and flu, with Christmas approaching, we find not just our children but all of those who we build our lives around no longer distant.  Our parents and friends, our siblings and spouses, each makes their way through work and life, through distance and distraction to find their places again in the center of our lives. How they are doing, how their lives are going affects us deeply and vice versa.
                Though it is a hassle to have so much of who we are bound up in so much of who the other is, there is beauty in that as well. A rough honesty that reminds us of that most basic truth that our borders remain largely imaginary, that what separates us and them, you from me, is thin and porous and easily broken through. Our child’s misery may make us miserable, and their joy may make us joyous because on final inspection, where us and them begins and ends is foggy. Their misery is our misery their joy is our joy.
                Imagine this connection extended to the world: the bonded emotions not just to those closest to us but to everyone. Imagine a world in which all of us realized the truth that we are bound to everyone across time and space, near and far. Imagine a world in which we were all as miserable as the most miserable person alive and all as joyous as the most joyous person alive. How would we treat one another? I have seen you treat your patients as if this were true, as if their happiness, their comfort, their peace, was your own peace. I have seen it, and it has been an inspiration, and it has been beautiful, and it is the great gift you offer to the other, to each of us, and to yourself because in reaching out a healing hand to one, we reach out to all.

Friday, October 30, 2015


My dog ate a blanket this week, which was abnormal. Not that abnormal as the mutt will take a bite out of anything he can find when he has a stomach ache; some ancient animal instinct, built in by millions of years of evolution, designed to help him get up whatever it is that is making him sick. The problem is: evolution is a blunt instrument which lives and dies by mistakes. Eating a crocheted blanket was a mistake that nearly cost my dog his life.
                The poor creature woke me up at midnight, hacking and vomiting. When I got in the living room, I found a house full of vile substances pulled from the dog’s guts. The rest of the night was spent with the pooch, trying to ease his pain, to provide some relief for the poor creature. At one point, I looked into his big dark eyes. There I saw the sweetness he had as a puppy, the loyalty he has shown as the dog. In those eyes, I saw a value and a meaning that dwells in the old pooch and is the old pooch, and I felt a profound sense of regret.
                I felt regret that for years until that moment in which our eyes caught, the dog had largely slipped out of my consciousness. Not that he was forgotten, he had been fed and walked, watered and generally cared for, but since the birth of my son, the dog has largely become furniture in my life. Something I move from point a to point b, something that is in my life but always in the periphery of my vision, only brought to the center when something goes wrong with it.
                The sick and the dying often find themselves on the periphery of our vision. We see them out of the corner of our eyes, but they too are furniture. Items that appear and disappear from our lives. Only during episodes of pain, or relapses, declines or infections do they come to the center of our vision, only when they are broken, and that is a shame.
                The dog’s okay. I have a second chance to give him and the life he owns its proper attention, but it took pain to give him this chance again. With the people we encounter, each time we are pilgrims in their homes, we are given this chance. This is a chance to allow them to move to the center of our attention for a while, to find a moment in which they are not on the outside but inside. And in allowing them to drift to the center, perhaps we will be blessed to see the beauty that lives in them, the meaning and the value they are and contain, and in that way see the wonders that so many of us have for so long been missing out on.

Tuesday, October 20, 2015


I cut my middle finger on my left hand last week making dinner. I cut it deep, and it was made worse because on the tip of my middle finger is a skin graft, placed after an accident years ago. The foreign tissue doesn’t have the same nerves as normal finger tips, and as such I didn’t feel any pain until the blade had bitten deep. Once I felt the cut, I immediately dropped the knife and walked to the sink, waiting for the blood to come. And it did, but it took a long time getting there.  So long that I wondered if it would bleed at all, that perhaps the patch itself was some dead thing attached to the living me, desperately trying to hang on to the life which had long since left it.
                Many things occupy this liminal space between life and death, pain and numbness. As we enter the fall, nature itself seems to find a transitional home in this thin space. Trees are some place between alive and dead, animals settle in for slumber, the vibrant verdant world begins to dull.
                And I suppose all of us have inhabited this space as well. This space where you wonder: if you cut yourself, will you bleed? This space where we are numb and dull, clinging to anything alive.
                These times, often around pain or loss, times of confusion or worry, are usually brief and can have a beauty and a meaning all their own, like the fall.  Those we serve on the other hand, may find themselves forced into this numb, thin space by illness and the world around them. A world that holds their value at null and that often sees them as only a burden, a dead thing clinging to our lives.
                The world may see them this way, but we know better. We know that if they are cut, they bleed. We know they are not numbed by the callousness of the world, but feel as we do. We can see them for the life they have, we can know their value and with that their pain. In this new season of death, may we look for the life that has always been there.

Friday, October 16, 2015


My daughter was baptized last week. As always, the faithful gathered around the ancient font with her to witness and participate in the ritual. Should you take seriously the words and the rites, the practice of the faith, then something very interesting happened there at that little bird bath when the water was poured over her head. There in that dingy old church with the chipped plaster and worn carpets, God claimed her little life for the greater life of the faith. Not only that, but the people gathered with my daughter claimed her as their own, as part of their family, as their responsibility and she too responsible for them. Among the odd and usually disheveled ranks of our church membership is a young woman who struggles with many demons and them severe delusions. After the baptism, when it was time for prayers, this young woman prayed that her daughter be blessed and cared for, her daughter who had just been baptized that day. The daughter she was talking about was my sweet girl twisted and changed into her child through the sick alchemy of mental illness. It was sad, and a little scary, but there is no doubt that this young woman, confused as she was, had love in her voice as she prayed. Setting aside the fear and the strangeness of the situation, there may be something deep and even beautiful in this woman claiming my child as her own, and it begs a question: whose are we? Is my daughter really “mine?” Is my wife “mine?” Am I hers? Yes and no. While we must not claim ownership of each other, we are bound to one another. We are tied with cords visible and invisible, we affect the lives spiritually, emotionally, materially of all those we encounter in our time on this world and our existence ripples forward and backwards, affecting things past and thing to come. In that way, when we go about our tasks, when we stagger out onto the world to meet our clients, even for the first time, we do not meet them as strangers. In that bed is a brother or sister, a cousin, a friend, an enemy, a mother, and father. We meet one we are responsible for and one responsible for us. So as we go about our tasks, may we care for those who come into our lives, as though we are caring for our own children, because in many hidden, strange and beautiful ways, we already are.

Tuesday, September 15, 2015

A Gift in a Storm

Last Thursday morning I attended a funeral, last Wednesday evening I sat with a family in the hospital as they came to see the body of a young man before it was taken into the coroner’s care. Ostensibly, these two events were nearly the same. In each case loved ones came from all around to be together, and to be in the presence of the material left behind after the death of their loved one. In each case they cried, they laughed, they prayed, and they mourned, and yet these two events could not have been more different. A funeral is order tinged with the chaotic. It follows a course, moves in channels well-worn and cut by the endless streams of black clad mourners who have darkened church doors and funeral parlor lounges. The words and prayers have a cadence recognized by all, and in that routine the magic of familiarity and order gives scaffolding on which to hang powerful emotions. The hospital room, the dying chamber is often devoid of these predicable comforts. In those moments just after a death, where the flesh still contains a dim ember of the life that had burned out, where the blood is still damp and the bed is the one on which the act of dying had taken place; those comforts of the ordinary are no comforts at all. The hospital room is all chaos; order simply lingers on the margins, providing only borders. When we are there in those chaotic times, in those final moments of a life and those first moments of death we can be an anchor. Something for the families and loved ones to hold fast to as the world tosses and turns wildly around them. We are the skilled, the trained, and the experienced. We are those whose very presence tell the bereaved that they are not alone, that they stand in the company of millions who have known that same pain, and that they, like all those before them will find a new life on the other side of chaos. In that way, your very presence is a gift and a comfort. The greatest of honors, humbling and powerful.
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Wednesday, August 19, 2015

A Temple and a Wailing Wall

Google image search My ten week old can smile and that’s about it. She can’t walk, or dance or sing. She has yet to eat solid food or mow the lawn. She hasn’t worked a day in her life so of course, no pay checks. She can only smile, but what’s a smile anyway? When you consider the universe, the vast empty space of it all, punctuated only here and there by the light of stars, a few mounds of matter, when you think about how even in those small pockets of something instead of nothing, even there life has only been seen on this planet, and most of that life is unmoving and unthinking outside of pure instinct; a smile may be more than it would first appear. When you consider it in the grand scheme of it all, a smile, a sign of happiness, an outward representation of an inward state given for its own sake, is truly a rare and remarkable thing. While compared to an active adult, my child’s abilities in the world are greatly limited. When held up next to all else that exists, her simple smile becomes nothing short of astounding. Our patients also are often limited. What abilities they had, what powers were at their disposal, ripped away by illness and time. Who they were: diminished, what they could do: stolen, but that doesn’t mean they don’t have value, that doesn’t mean they aren’t remarkable. From the mumbled prayer of the comatose to the song of the demented, even taking that last breath, that last filling of the lungs with the spirit is an act of such rare beauty as to be almost unheard of in this universe. May we honor all life for what it is: the home for the divine, and pay homage to every death as a Wailing Wall, the remnant, the echo of where the Holy had dwelt within the profane.

Wednesday, August 12, 2015

Between the Dark and the Flame

On the weekends, if it is nice outside, I like to have a fire after dark. No great shakes, just a few sticks, a couple logs wreathed in flames in my tiny fire pit. It usually doesn’t take long to get the fire going, and once the wood is caught and burning on its own, I’ll plop down in my lawn chair, kick my feet up on an over turned 5 gallon bucket like the class act I am, grab a cold beverage and take a sip. It never fails that before I can take a second pull, the flames have begun to die out, the fire grown too hot, the wind turned kicking a column of smoke in my eyes, or the logs need to be shifted else those ever fragile flames may burn out.
                The entire night will go this way. I’ll get the fire just how I like it, have enough time to sit back and enjoy the warmth for a moment before something changes and I need to move again. A constant recalibration, a dancing with the chaotic flames, all of which done just to maintain that sweet spot, that elusive place of the burning flames and the cold night meeting to produce comfort and warmth.
                google image search Sometimes I think that is what we do: we help people find the sweet spot around the death bed. The place where a family member can show their care and love for the dying, but with enough help and support that they don’t get burnt by the pain. We help the dying find where they can be with the ones they love, the place they can occupy at the end of life so that they don’t get left out in the cold. It is a moving target, ebbing and flowing with the fluidity of love and memory. The art of our craft is to help find that spot between the dark and the flame, where families and patients can live and move and love and die in the warmth and comfort of each other’s care.

Thursday, July 23, 2015

Prayer Cards

The other day I was cleaning out my office. In the midst of shredding documents and tossing detritus, I came upon a stack of funeral prayer cards. Those laminated three-by-five inch pieces of paper often with a sweet picture of the deceased on it, the date of birth and death, funeral information and the 23rd Psalm, the Lord’s Prayer, or some quasi-religious, but always heartfelt poem. I couldn’t bring myself to toss them. They say if left to fend for itself, after about one millennia, all the material we humans have made will either have broken up and returned to the earth, or be so worn as to be unrecognizable. Libraries will be nothing but heaps of petrified wood, buildings fallow fields, cities forest and plains. The only material which will not give into time and the elements, the only stuff of our existence which will survive to near infinitude, is plastic. There, thousands of years from now, once we are all dead and gone, in a buried layer of existence interspersed between soda bottles and Barbie dolls, will be those laminated prayer cards, eternally reminding the universe of the individuals who have faded out of existence. Our lives, as with the world, hold on to very little. The people we encounter tend to be brushed out of our memories by time and distance; their memories worn down to nothing. But there are those people we choose to let in, those people we affect and allow to affect us in deep, authentic, and profound ways. They are stamped on our hearts, laminated into our souls. When our lives are through, when our times have come, they will be the last to go: enduring pieces of the other that have made a home in us, and in turn gave us meaning. Meeting and caring for these people is the true blessing of our task, and a great gift of this work.

Monday, July 20, 2015

Small Resurrections

I, like all of you, am often asked if this work makes me sad. Does spending day after day steeped in that facet of life so hidden in plain sight, so pervasive and yet taboo as death wear upon a soul? My answer is for the most part “no.” I, like all of you, have found a way to live with and to understand death so that watching it, living in its wake, is no longer much of a struggle. But when I answer “no” like any conclusive statement, I am only telling a half truth. Leaving out kids and tragedy, the thing that tears me up about this job is often the good stuff, the things we would call “wins.” The mock wedding that takes place months before the real thing so grandma can watch her first grandchild tie the knot, the last trip to the casino, the few bites of a treasured recipe, a few pulls of a final smoke or tugs off a bottle of beer. These last events that few and lucky people choose to experience before their time on this earth ends. These things have always made me sad. To me they seem too small to cap lives, too forced to be authentic, too pathetic to mark the end of a person’s time on this earth, oh but
do I know. There seems to be more going on in these last hurrahs than meets the eye. They seem to be less about the experience itself and more about the life that has been lived. Less about the taste of the particular meal and more about all the dinners shared with loved ones over the years. Less about a few hours pouring coins into a shiny box and more about the jackpots won, the adventures lived. These last experiences are slivers of beauty past, small resurrections before the death. These last things breathe a bit of life back into dying bones and ensure that nothing is wasted, they truly become occasions for great joy.
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Thursday, July 9, 2015

Death Bed Wisdom

They say that wisdom can be found in the most unexpected of places that she does not always dwell in dusty old books, well worn sayings, and that smoky myth of “common sense.” Perhaps the start of knowing wisdom is to see that there is no place where she is not. Elisabeth was 70, she lived in one room above and abandoned furniture store in the part of town the good folks avoid after dark. It was a home for women in recovery, recovery from drugs and alcohol, recovery from abuse and violence, recovery from lives misspent and lives mistreated. When I met Elisabeth cancer had already torn its way through her body, her blood tainted by AIDS, Her liver blackened by cirrhosis, and her lungs ceased by COPD. The life forced upon her was killing her and Elisabeth knew it. She faced that death heroically, beautifully, with her eyes wide open. In the end she welcomed the pale specter as an old friend. Elisabeth did what she could to mitigate the pain, she did not hesitate to take her meds or call the nurse for help. She did so not out of fear, but out of a desire to get the distractions of pain and uncomforted behind her so that she could get on with the business of living truly and dying well. She reconnected with a brother she had not spoken with in years. She told those she loved about that love, she made good on her debts, and forgave her debtors. She set up her own cremation and memorial services. Elisabeth offered final words of wisdom to those around her. She blessed her friends by letting them care for her. And when death arrived Elisabeth was able to say, “I have nothing left to do in this life but to die.” Something few can say, and even fewer can mean. Elisabeth was a 70 year old dying drug addict with aids and she had more to teach the world and myself about death and about life than any book, or class, or sermon ever could. In our patients are endless stores of wisdom. Fonts overflowing with lessons learned through struggle, and fires of life passed through. Many were burnt by life’s flames along the way, and many were left more beautiful for it. May we always be open to the wisdom and courage we are confronted with in death bed after death bed, and perhaps a piece, just a touch of who they were will become a part of us.
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Thursday, July 2, 2015

Nothing to Offer

If you have ever had a newborn, you know what I am about to say is true, but you’re probably smart enough to have kept it to yourself. Newborn babies are good for nothing. They demand and demand and offer nothing in return. They give no sweet smile, they are months from a real hug, a year or so from saying “I love you.” It seems a mistake of evolution that at the point when a human can offer the least in return is the very moment when they demand the most. Yet humans keep having babies, and by and large, those babies are cared for. Why? I think it’s because we don’t actually care for the babies, but for the potential they harbor. The worlds they will inhabit and create, the love they will show, the things they will produce, the things that they will change and the things that will change them. To care for a baby is to honor the filled manger and the potential life it represents. The dying too are needy with nothing to offer. Life follow its circuit and the end resembles the beginning. By and large the dying are cared for also, but why? In caring for the dying we do not honor life in its potential, but the potential that has been realized. We honor the love that has been given, the plans fulfilled, the material created, the experiences that have been shared. In caring for the dying we show that that life and the one who lived it has mattered, that their days have had value. Even if we don’t know the entire story of a life, we have faith that that life is worth serving, and that faith is a virtue. To care for the dying to care for those who have created the worlds in which we have been blessed to live.

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Wednesday, July 1, 2015

In Our Place

There is a couple who live across the street from me, a husband and wife. He’s 91, she’s 90. She’s a talker, he hardly says a word. They’re Polish immigrants who fled horrors at home to make a home in this country. A few weeks ago, as my dear wife was waddling her way down the street and through the end of her third trimester carrying our daughter, the wife in the couple across the way called out in her thick Polish accent: “When is the baby due?” “Anytime now,” my wife replied. Quietly, almost under his breath, the husband who was sitting next to his wife on the porch leaned in and said: “Our replacement.” Meaning, I believe, that as his time on this earth draws to an end, our little girl will fill the spot he had occupied. She will take up the vacant space left behind when he sheds his mortal coil. Most people will never see their life in this vein; most people will never understand their death as making space for new life, the end of their possibility opening up avenues for others. Most people will never think about the gift and blessing it is for one life to give way to the other, but it is a gift and blessing nonetheless. The beautiful thing about our world, its endless hope, is that the hole left behind after a death will be filled again, that every death makes way for new and expansive life. In helping people die, in easing the pain of their transition and allowing their final moments to be peaceful, we honor that last noble act. We provide blessing for the final selflessness, we allow one world to fade away gentle as new universes burst into existence.
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Thursday, June 18, 2015

Whale Fall

When a whale dies, after the great beast’s mammoth frame has slipped beneath the waves and settled on the ocean floor, from its lifeless frame a universe of organisms are born and nurtured. The decaying form gifts new life to scores of creatures, to wandering scavengers, to the ocean floor on which it lands. Dozens of species have been discovered which exist only on these whale falls settled on the bottom of the world, some living off one body for ninety years. Something as distasteful as the decaying corpse of a whale, means life to thousands of God’s creatures. Sometimes what seems worthless can be the greatest blessing. It was a pill; a collection of various chemicals crushed up and stirred together. The component parts of the pill have little value on their own, elements and compounds found all around us in the air and the soil, plastic and paper. But together in the correct amounts and forms they can ease pain, cure illness, save lives. Just a little pill made from the ordinary things of our world can change a life for the better. Sometimes what seems the tiniest of things can be the greatest blessing. What will matter, what will change the way things are does not come with a sign. What will touch a life, what will build up the broken, heal the wounds, can be hard to see before its work is done. Tonight the food we serve may just be food, or it may be hope. The kind word we offer may just be conversation, or it could make all the difference. We cannot know ahead of time what will matter and what will simply pass away, but what we can do is offer what we have and who we are. At times it may not feel like much, in the face of death and illness, but it can matter. If the decaying corpse of a whale can provide life for millions of organism for a century, surely if a few chemicals crushed up and encapsulated together can ease pain, surely we have something to offer. Sometimes what seems so humble, so inadequate, can be the greatest blessing.
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Thursday, June 11, 2015


I have to rush to the keyboard before if fades away. Type furiously before the last traces drift off into the ether and travel to a new place, settle in another home. Only a hint remains still clinging to the fibers of a dirty shirt, a few strands of hair. The scent of birth has flooded my world as it has flooded all others, but the tide will inevitably go out again. There is a smell to birth, not the new baby smell of Hallmark cards and nostalgic parents’ tears, but something more visceral, more complicated, more profound. The first time each of our virgin lungs sucked in the air with all the sweet and poison scents it is laced with, we smelled it. At the birth of our children it once again fills our lungs. It is the first incense filling the temple. The scent of birth carries to the divine throne room visceral prayers of hope and a dirge for pain yet unfelt; beautiful and terrible all at once. The smell of new birth is pain. A mother’s sweat and labor, a father’s worry, an infant’s fear. It is pain yet unfelt, failure and loss, heartaches and illness, eventually death. Inevitable. It is joy unbound, all things new, pure potential. An olfactory unending, perfectly recognizable and infinitely strange. It is the aroma of a full manger and an empty tomb; different from all other scents and yet containing the cosmos. In the scent of life, pain, and hurt, love and joy twist together rising into the atmosphere. It is all things, but different from each. On final examination it is, perhaps the only unequivocally good thing in the world. I may never smell the scent of birth again, and if I don’t, well I have had enough, and that is fine. Thank you God, and love, that I smelled it today.

Wednesday, May 27, 2015

I Was Thirsty

Does a patient or their family every offer you a bottle of water, or a cup of coffee when you show up for a visit? Do you ever think about why? What does someone who can’t be sure of their next breath care if you’re a little parched or in need of a shot caffeine? Shouldn’t they worry about their own issues before they get involved with yours? Maybe, maybe not. Questions like these fail to take into account the essential fact that as people we are more than our basic needs. That caring for something, be it a person, or a dog, or a garden, work of art, or anything else, is at the center of our humanity. I visited a bereaved man last week; a man who since the loss of his wife has struggled to meet even his own basic needs. I went to care for him, but before I would offer active listening or talk about coping mechanisms, he offered me something to drink. This man, who had struggled for weeks to get out of bed, had made a special trip to the store just to pick something up, to have something to offer. This small act was a great kindness, a good deed. Where are such acts of kindness created? What led this man and the thousands of others before and after him to reach out even when they were in need of a hand? These acts of care come from the same place that pushes people to throw baby showers for co-workers and to spend their days and their nights caring for the dying. What brings about these good works, these acts of care, is born in the very deepest part of us: the soul of our souls, our secret heart. The place where the divine resides in each of us and where the love and care are breathed into existence. The very center of our being is the source of love for the other. The greatest thing we can do for another is to recognize that secret heart, that temple to the holy in each of them. To know the infinite love that has chosen to make a home in their soul, and allow them to see that love in each of us.
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Tuesday, May 19, 2015

A thirtieth of a second

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Mary looked at a picture of herself at a party, a candid shot with her at the center. It was taken a month after her husband, her love, her partner, her friend, had died. The image was of a graduation party for a nephew of hers. In the picture, people were smiling, dancing, drinking, eating, living. Mary was smiling too, but a year later as she examined the photo, a thirtieth of second - a sliver of time, Mary saw in that moment a difference between herself and the other partygoers; something that separated them. From her husband’s diagnosis until sometime after his death, Mary had lived in a fog. Her mind, dulled by fear and then grief, a thick haze stood as a veil between her and the world. In the image, she was among her friends and family, but separate from them; in this world but touching nothing. Even as she could see this about herself in the picture, she noticed a difference in the eyes of those around her. A few sets of eye were planted squarely on Mary; friends and family looking on, their gazes thick with a sympathy that bordered on sorrow. They saw her as a ragged thing, once beautiful now forever scared and broken. Most just looked way, as if to cast your vision on someone who so recently had been acquainted with death would be to invite the shadow into their lives. We can see with different eyes; we who know the unceasing and pervasive presence of death and dying in the world; we for whom the final breath is not exotic but common. We can see those losing and those who have lost with eyes of care, of empathy not sympathy, of love and not fear. We can see them not as suffering but as people who suffer, not as the grieving but as people living with grief. We can cast a gaze that sees the person before the pain, the life before the loss and perhaps in the reflection of our eyes, those who loved and lost can find a glimmer of hope for the future.

Monday, May 11, 2015

Mother’s Day

I don’t know what it is like to be a mother. I can’t image carrying new life in my guts, or the process of pushing that life out into the world, but I do know the commitment it takes just to keep a child alive. They say that human gestation is nine months in the womb and two to three years outside of it, longer than any other creature walking God’s green earth. We are born broken, we are born weak, unable to sustain our own existence for more than a matter of hours. It’s only through the strength of our mothers that we survive. To be a mother is to continue to care for your child. To care for them when they are good and cute, sweet and clean, and to care for them when they are vicious and mean, selfish and dirty. To be a mother is care for a child when you would rather not, when you cannot, when it hurts. To be a mother is to care for a child because if you don’t, if the child is left to their own devices, that child will not live. Just to see a child live until adulthood is a task beyond comprehension, motivated by a thick, rich, love beyond explanation or end dates. Motherhood is to give all of yourself so that the other may live. By virtue of the simple fact they are alive, we can be sure that those who have entered our care, at least for a time, have been on the receiving end of this love. Our patient’s very life proves that for a moment they were at the center of another’s universe. They were the complete focus and total recipient of another’s love and care. May each of us take a lesson from the billions of sainted mothers who have lived and loved in this world. May those in our charge find a home at the center of our worlds, if only for a moment. May they be the focus of our care as if their very lives depended on it, because in many ways they do. May we be as mothers to those we serve, giving deeply of ourselves, so that the other may know life and once again feel maternal love.
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Thursday, May 7, 2015

Unafraid in the Land of the Dying

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On Wednesdays, my kid and I go to the cemetery. If it’s nice outside and we have the time, we out among the tombs and graves, and he plays. Bouncing from headstone to headstone and digging in the dirt, the boy loves the graveyard. For a child the land of the dead holds no terror, the bodies beneath his feet no fright. When it’s time to leave, the child pitches a holy fit same as when it’s time to leave Grandma’s or the park. He’s sad to go home because he has so much fun with the dead. We go to the Lutheran cemetery, which sits directly north of the Jewish cemetery and south of the Bohemian graveyard, just east of First Ave. These cemeteries are located here because this is the spot where the train line used to end nearly a century ago. It was the last stop for Chicago public transportation. In other words, the cemeteries were formed as far from the city and the living as possible without being out of reach. You can judge a society by how they treat their animals and their dead. We aren’t bad to our pets, but we want as little to do with our dead as possible. We like them just on the edge of our vision, the land of the dead a blurry haze deep in our periphery. Often the same goes for the dying, tucked away in hospitals or facilities removed from the land of the living even before they draw their last breath. Like the cemeteries, the dying are pushed just to the limits of our reach. You who care for the dying serve as a foil to this. Part of your duty is to open the gates to the land of the dead and dying and let a little life in. It is through your kindness, your bravery, and your love that people can become a little more like my child who walks unafraid in the land of the dying. Then they, like my son, can find a measure of comfort among the tombs. In helping others come to the dying, in helping them to stand by the bed side, we allow those leaving this world to finish their days well and loved, surrounded by those they care for in the land of the living.

Wednesday, April 29, 2015

As Large as Our Vision

Five years ago, give or take one in either direction, I read “The Book of Disquiet” by the Portuguese philosophical novelist Pessoa. I only remember one line and I probably understand it wrong. Still that being said, after all these years the phrase that still bounces around my mind is: “We are as large as our vision.” Or something like that. For the past week or so I have been dealing with a sty on my sinister eye. Besides the slight mar on the Mona Lisa-like beauty of my face, it has been among the smallest of tragedies at home or abroad. While it is only a minor annoyance, a slight pain, the sty has decreased my field of vision, forcing me to rely heavily on my right eye, which can see about as well as a near-sighted mole. For the past week my world has become fuzzy, thin, and small. In turn I have found myself cranky and short, irritable and small. To see small is to see with damaged vision, too tight to take it all in, too fuzzy for focus, and as our vision shrinks we diminish along with it. Depending on our gaze, the world is either a tiny place or else a cosmos endlessly complicated, interwoven, and huge. A small world is one of problems; a large world is full of potential. A small world is a world of weakness, a large world one of strength. Small worlds contain only pain, large worlds make space for relief, small worlds only know suffering, large worlds know meaning within and beyond the suffering. May we always see large and in turn may we grow to meet our vision. Grow to trust in the strength of others, to hope for wholeness beyond the brokenness, and to see our patients and their families as massive as they truly are. May we be large enough to bear another’s burden just long enough to help them see their ability to carry it themselves.
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Tuesday, April 21, 2015

The Beat of Life and Death

I used to think of my car as an island of good tunes in a sea of pop-y nonsense. The car used to be home to Dylan and the Dead, the Stones and the Talking Heads. Since my child got old enough to have an opinion, I would pay to hear Lloyd Price and sitting through a Smokey Robinson tune would be a miracle. Nowadays Hugh cries if he can’t listen to the ubiquitous songs, the Katy Perry and Taylor Swift anthems which are spread thin across every platform from radio to TV commercials. The top forty garbage that lays like a blanket over the media world, the songs we are subject to hear a hundred times a day. It’s a shame but no surprise Hugh likes this stuff. Humans are designed to be drawn to the familiar. The average heart beats between 60 and 120 beats per minute. This is the cadence of the quickening rhythm of life. I have been told that nearly every popular piece of music, every tune that resonates with large swaths of the population, matches this magic rhythm of 60 to 120 beats per minute. Something happens to us when we hear music with this beat, a familiarity as the outside matches the inside; the harmony of the heart and human experience, the beat and the body, overlap. Music that lands in that mystic 60 to 120 beats per minute, is the anthem of life, and that draws us to it. A dying person’s heartbeat can become erratic and chaotic, prone to sudden changes and shifts, the rhythm out of sync with that song of life. The heartbeat of the dying is dissonant, less the polished notes of a symphony and more the harsh wail of a car alarm. While the sweet spot of 60 to 120 beats is accessible to all, the heartbeat of the dying is in not nearly as familiar, not nearly as pleasing. The heartbeat of the dying is not a top 40 pop song, it’s Miles Davis not Britney Spears. We are drawn to the comfortable, fall easily into the simple and familiar, but we can find a strange beauty in the eerie, erratic rhythm at the end of a life. The song of death can carry a meaning and power all its own. Our task is to smooth out the shrill notes, to make sense of the noise. When we do our jobs right, when things go as we wish them to go, our patients and families can find meaning in the end of a life. We can help people move confidently along the rhythm of death. It is our blessing and our charge to help our patients and their families to find beauty in the final heartbeats, and music in our last moments.
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Tuesday, April 14, 2015

Cracks in the Plaster

Google Image Search (I think this picture is from Dr. Who)
Two year olds make interesting theologians. Sometime before we moved in to our home, probably in a springtime downpour, water had crept its way into the corner of my boy’s bedroom and left its mark on the ceiling. A small spider web of cracks in the plaster reaches out in every direction. Just a little imperfection in the paint, a crack in the plaster. Every so often he will look up at this small crack, point and say: “Jesus coming.” Meaning in two year old speak that Jesus is going to, or has already entered his room through this crack in the ceiling. It’s hard to know where he picked this theological tid bit up. It might have been that somewhere along the way, as so many kids do, Hugh got Santa confused with Christ and as many fewer kids do, the chimney confused with a crack in his ceiling. That could be, but like so many fathers, I’m sure my child is a prodigy and perhaps there is more to this observation than is immediately apparent. While our home is older, for the most part it’s in very good shape. There are a few spots of chipped paint, maybe a window or two that could use a good cleaning, or even replacing. The furnace is ancient, but still works. Yet for the most part the house is in good shape. So what draws my son’s eye to this one, small imperfection, and what makes him associate it with how he understands the divine? Why would his new mind place the transcendent in the broken? Perhaps because that is the place where goodness, where what binds all of us together and makes us better than ourselves alone, is made most apparent. We miss the beauty in the smooth, the blessing in the unbroken, the joy in the working. When things function as they should, when traffic flows, when our bodies are strong, our work productive, there is a holiness to that harmony, but one which remains in the background, hidden from site. It has slipped through our fingers. If we want to really see the holy, touch the sacred, we must go to the broken. We must sit in the hospital room, hold the hand of the dying, wipe the tears of the bereaved. It is there in the brokenness that the best of who we are and who we can be together becomes palpable. It is in our care for each other through the pain that the transcendent is made tangible. It is in the broken places, through the cracks in everything, that the light gets in.

Wednesday, April 8, 2015

A Bullet in the Back of God

This one is political feel free to skip it if you want The murder of Walter L. Scott was a crime on us all. The system, the system by which we survive, by which society is allowed to grow and thrive, is a good system, and the most important part of it is the police. The police allow us to put aside the eye for eyes, to beat our swords into plowshares, to live by love, trusting that when things go wrong a dispassionate third party exists to sort things out. This has allowed violence to drop to its lowest point in the entire course of human history. We truly live in a beautiful time, and police, courts, elected officials, and every other part of our system allows for that. The system works by working for all, and if it doesn’t, becomes useless for all. The man who murdered Walter L. Scott took eight shots not just at the man but at the system, and in turn all of us. One shot rang out, it tore through Walter L. Scott’s back, and it ripped through our lies. Another shot rang out, the bullet puncturing Walter’s side, and it put a tear through our trust. A third shot rang out, it whizzed over Walter’s head putting at risk everyone in the neighborhood and everyone in the country. The murderer’s gun sang a fourth time. This bullet entered Walter’s arm, exited his hands. He would never hold his children again. We lost grip on our children’s future. A fifth shot missed again, digging itself in the wall of a nearby building as it dug itself into the foundations of our laws. The gun was fired again and Walter fell to the ground no place left to run. Hopefully we can no longer evade the truth. A seventh shot again in the back, tracing old lines from years of beatings and abuse, the racism that is part of all of our skin no matter how much we deny it. The eighth brutal shot flew from the murderer’s gun. It silenced his heart and made all of ours scream, and left a bullet hole in the back of God. Walter was murdered that day. Along with his death, our system and our society was wounded. Death’s grasp on the individual is strong, but we are stronger together. As a society we can heal the wound, we can become whole again, though the scars must remain to remind us. We can emerge stronger and better, but Walter is still dead and his family will still grieve, and that is a horror and a tragedy.

Tuesday, April 7, 2015

Grace before the Garden

*Google image search
Imagine the Last Supper: friends are gathered, food and drink are served. If everything went right, and I suppose it did, that night the upper room rang with laughter and arguments, tears and sighs, the sounds any gathering of true friends and true family. As with any good gathering, there is that point, that golden moment, where you wish it would never end. I imagine it was at that moment, at that time, where all Jesus wanted to do was have one more glass of wine, one more laugh, one more embrace with his friends. It was at that moment he had to go to the garden. From that point on everything would be different, and I imagine he relished those final moments in that upper room with those he loved. Our lives are full of these final moments, most much more mundane than the Last Supper. The last drink at a party, the last day of a vacation, the last dance at a wedding. These final moments of joy are bittersweet; we savor the instant knowing that it is fleeting and hoping it or something like it will come again. There are final moments of gravity also: the last moment before a child gets on the school bus for the first time, the last class in an education, the last day of a long and meaningful career. These moments shake and form our lives, and among them is the last breath of a loved one’s life. Final moments come to us all. We may keep them at bay for as long as possible, but the night has to end, the career will see itself through, our lives cannot be lived for eternity. When we do our jobs right, when all things work together for the benefit of those in our care, we allow others to live these last moments. To suck the marrow from final moments, to see them in brilliant color, and hold those last instances forever. In that way, final moments can exist in beautiful stillness, forever.

Tuesday, March 31, 2015

Pastel beyond the Pale

Saturday, my neighborhood had its annual Easter Egg Hunt; an event that seems to have less to do with the Christian holiday than it does with festivities in the Roman Coliseum. With the scream of the starting whistle, hundreds of children barreled toward the candy colored plastic eggs strewn haphazardly around an open field. Elbows flew, teeth were bared, hearts broken, hopes and fingers stomped. Within thirty seconds, a torrent of tears were streaming down children’s faces; a battle field of skinned knees, stolen treasures. What did they have to show for their efforts? Sugary candy and toys that posed choking hazards to children under three, all the kids were under three. As Easter Egg Hunts go it was a rousing success, and none of the pastel clad children seemed to mind that it was a balmy 31 degrees out and overcast. If you strip away the kids, and the toys, and the laughter, and the tears, you are left with eggs and bunnies; universal symbols of fertility and new life. The thing of it is, February sets records for its cold temperatures and March has continued this frosty trend. While the symbols spoke of new life, the world remained dead. No flowers have bloomed, grass is still brown and brittle, trees have yet to bud. This Easter Holiday confronted us with new life in a world still frozen in wintery gloom. But the kids didn’t mind. They knew spring is just around the corner. We who are caring for the dying spend our working days and nights in the winter; in the times where lives become barren. Each day we encounter and care for those whose potential on this earth is all but spent. For the loving, for the caring, which each of you are, this can be brutal. The winter of death can chill us to the bone. But there is a lesson in those children bounding over frozen ground after those eggs. With winter all around, they looked to the spring just out of view, the pastel beyond the pale, the feast that will mark the end of the famine. May we who stand by the bedside always live in the hope that even as death comes, it never comes alone. Just beyond the horizon, just coming into view is its constant traveling companion. The trees will bud again, the flowers will bloom again, because wherever death goes, new life is never far behind, and there is comfort in that. For more check out
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Friday, March 27, 2015

Whispering to Ghosts

Sometimes early in the morning, my boy will wake up calm. He usually is far from calm, screaming and raddling his crib like a caged animal. But every so often he gently pulls his consciousness from sleeping to awake. During these rare occurrences, instead of crying out, he will start the day talking to himself. At eighteen months old, what he chooses to say is very interesting. Alone in his crib, he will list off a litany of the names of people he has met: Mommy, Daddy, Baba, Nana, Grandma, Grandpa, Shannon, Zack, Angela, Hope, Abbie, Max, Elmo, Ernie. Each day this list grows, and as every new person is added the list just gets longer. So far, nobody has dropped off. Lying in bed, while part of me just wishes he would just shut up so I could grab another minute or two of rest, I wonder why he does it. Why would a child, to whom the entire world is new and exciting, spend his time thinking about second cousins once removed who he met for a couple of minutes at a Bar-Be-Que? Some people will tell you children are born innocent. They are not, or at least my son wasn’t. But he is unsullied and uninfected with the cares and desires of this world. He has yet to be confined by societal pressures, or the dreams and cares of others. What he thinks about is his own, and what he chooses to think about is the people in his life. With the entire world stripped away, what matters most to the boy when he first wakes up, is the people in his life. In naming them, he somehow calls them back to himself. His tiny little bedroom is filled with memories of all his buddies. I might not say their names, but I have found myself doing the same thing with people who have long since went to the grave, people who made an impression in my heart and stamped themselves upon my soul through the alchemy of connection. I might not call out a litany of names like the boy, but even whispers in the spirit call them back. I miss them some times, Mary’s whit, Joe’s heart, Fran’s wisdom. Once and awhile I think we need to bring them back, to give the dead a place before our minds once more, to breathe life into the dry bones, and from that draw the strength continue to care for those still alive.
*Goggle Image Search

Tuesday, March 24, 2015

Working Their Way Out of the Dark

*Google image search When was the last time you watched the stars burn at night? Stood far out past the immaterial canopy of head lights, LEDS, and 60 watt bulbs? Out past the glow of the universe we have built for ourselves and held your gaze deep into the blackened world beyond that veil? The world where eternal points still burn. I rarely get the chance to see the stars, but when I do I watch them with the zeal of a convert. It is amazing how the longer a person looks at the sky allowing their eyes to adjust to the infinity of space, the more the brilliant points of light slither their way through the inky void and into perception. It is as if they know you’re looking. Ancient universes of indescribable power and beauty find a new home in the watching eye, given new birth in the gaze of the beholder, working their way out of the dark. In these moments, the night sky opens its gates and its treasures spill out. Truly looking at the life of another is not unlike gazing at the stars. Seeing past the clouds of ourselves and our hang ups, looking past the dark night of our prejudice and pain, our distractions and diversions to see the bits of beauty and light in another life poking through. What does it mean to be the last to see the simmering beauty of another life? The last to perceive the points of light that pierce the night sky of the dying’s existence. It is there in the revealed glow of another we meet the divine. In the light of the other, we touch that which is beyond ourselves. When we spend our time truly looking at the other, allowing the light of their life to tear the veil that separates us, when they enter our hearts, it is there we gaze on the very face of God, and our task becomes our blessing.

Monday, March 23, 2015

Moments and Monuments

Two men sat together as they often do, chatting. One had a lost a loved one but time had passed. Raw wounds had become jagged scars, searing pain had become a dull longing ache, an ache the man now knew would never leave him. This bereaved friend turned to the other, “I want to thank you,” he said. “For what?” his friend replied. “On the day she died, when I called you said: ‘I’ll be right there.’ It wasn’t so much that you came that mattered, it was words. At a time of complete confusion, you gave me something to count on.” The friend looked up, tears building in the rim of his eyes. “How do you remember what I said?” he asked. “Everything from that day is painted on my heart,” the bereaved replied. For the most part, human memory is a series of fading impressions and lingering senses. A nebulous cloud of information we draw on to pull the scattered past back together. Most memory is fraught with discrepancies and mistakes, more a haphazardly put together reproduction of hazy events than picture of true history. That is, except for those most painful parts of our lives. True trauma and tragedy is often marked by a perfect recall of the event, such that sentences spoken in haste can be recalled word for word years later. Talk to someone about the last breaths of their mother, spouse, child, not a second of that time will have slipped their mind, not an instant disappeared back into the ether. Though these captured instants happen at times of great strain and difficulty, they are often accented by words and deeds of astounding beauty and heroic care. These memories are etched forever on the walls of time. These moments become monuments; canvases stained forever with the pigments of pain, comfort, and of release, preserved for the ages. As we walk in these timeless lands, may we always be guided by love instead of fear, with bravery and with mercy. And in so doing, those instants will hang forever on the walls of the minds of those we have served, framed by pain and loss, but masterpieces of love and compassion nonetheless.

Thursday, March 19, 2015

Order of Service

On Sunday, as we always do, our remnant of the faithful gathered in a worn and old church. Faded glory and ancient wisdom hung thick in the air as the musicians played the meditation before service. Just as the music quieted and the preacher drew his breath to begin, the crash of two cars colliding outside the church rang through the sacred hall. Nobody was seriously injured in the accident, though the people involved were far from happy, and within a moment or two the police were on the scene. The church service had to continue, and so the hymns were sung accompanied by sirens as well as piano, red and blue flashes added to the flicker of candles and the jeweled rays of sunlight passed through stained glass. The chaos of the world slipped right into the order of the service. This could have been distracting, the holy spell of the temple broken by the profane world nudging through the door, but it wasn’t. The shrill screams of the sirens made the beauty in the melodies more pronounced. The chaos of flashing lights and raised voices made the peace and order of the service appear more fragile and more precious than it had before. Order added balance to the chaos outside and chaos added body and depth to the order of the service. A dying person is in the street, out at the accident, amongst the brokenness, the noise, and the fear. We show up among the dying with more than meds, more than strength, and more than skill. We bring expertise in the face the unknown, calm in the face of calamity, hope to confront disappear. We walk the dying from the chaos of illness into the sanctuary of care. It is there in that place where order and chaos, life and death bleed together. It is there that miracles happen. That is the place we are blessed to do our work.

Tuesday, March 17, 2015

The Smiling God

Can’t remember when, probably at some dusty market, I picked up an Icon of Jesus. It now hangs on the basement wall. In the painting, as in many icons, the Christian deity is kind-eyed and sourpussed. The serious face gazes out from the ten by five inch block of wood the image was painted on. I have been told the faithful of the Christian Orthodox church see icons as sacramental, as imbued with the spirit of God. That in some real way the painting on the wall is more than pigment and wood, but the very essence of Jesus. In some way, Jesus lives within the artwork. Bowing to her children’s demands, a woman who had lost her husband donated every stitch of clothing he owned within a week of his death, save one undershirt. It was tucked away in the corner of a drawer, neither the woman nor her children noticed it during their cleanse of the home. Worn threadbare, the shirt had been a point of gentle contention between the two. She told him to throw it away, she knew he never would. Today she sleeps in that shirt, because it is a close as she can get to lying next to him. We do not die whole. We leave pieces of ourselves scattered through worlds we have inhabited. Slivers of our souls have leached into old T-shirts, drops of our spirit left in ripped and worn copies of our favorite books, flashes of our very lives imprinted on old photographs. But the biggest portions of ourselves we leave in those we have known. Each of you who has cared for another now harbors pieces of them inside of you. We are homes for wandering souls. When I heard this woman’s story, I went home and took a look at that icon of Jesus. That sternfaced deity. I relaxed on the couch, turned on the music I like and once comfortable called back to mind the pieces of all those I have cared for and have left this world. They drew breath once more, if only in my mind. We sat together, and after some time I glanced up at the face on the icon and though it was impossible, and it only lasted a moment, the stern-faced God seemed to smile back. *Google image search

Friday, March 13, 2015

Lake Michigan Frozen

*Google image search
Walking by the banks of the great inland sea, away from the ramblings of lives in motion. To the right birch trees stand white and bear the bones of the earth jetting out in endless reaching. To the left the frozen waves, the stilled motion of the breakers held perpetually in a moment, clawing against the chaos. In the suspended instant, the world dances, spinning and struggling in since time immortal. A husband and wife, after sixty years of marriage, begin a new ritual of holding each other’s hands through the dark. They hope the grasp will keep the specter of death at bay during the night. A son throws himself on the body of his mother as life slips from her, holding her against the ceaseless pull of the inevitable. A mother returns to the hospital in the middle of the night hoping to hold the child who only took a single breath in this world. She holds the child, feeling for what life may be left in the tiny frame. Each holding on to a moment, each clawing against the chaos. To be human is to light and tend a candle in the ceaseless storm, to hold on to smoke, to make a moment stretch on forever. There is beauty uncomprehended in that hope and love without end. So if in the course of today or tomorrow you should come upon the dying or those tending to them and should you have the time, hold their hands, remain by their sides as they claw against the chaos. In doing so, you will be privy to true humanity and a precious frozen beauty.

Thursday, March 12, 2015


My kid had pneumonia. It made breath the first and last friend, the constant companion, that which quickened the dirt in the garden, a struggle to take in. It hurt him, it killed me. After the doctor’s visit, my dear wife took the kid home, and I went to the pharmacy to fill the prescriptions. I handed over the scripts and the pharmacist said it would be twenty minutes. Up until that point the day had been nothing but fear and rushing. Appointments were set up, schedules were adjusted, a child was watched with an unblinking eye. But then for twenty minutes I had nothing to do but wander around the brightly-lit store. I looked at items I would never buy, and thought thoughts that weren’t about life or death. It was beautiful. In that wandering there was comfort. When the order was finished the pharmacist handed me the medications in a brown paper bag. Taking it in my hand, I felt its material. I heard the crunch of the paper, and I was immediately transported to childhood, carried back to days of taking my lunch to school, it contents not albuterol and antibiotics, but peanut butter and hostess cupcakes. For an instant my senses brought me to a time without worries and fears. In that escape there was comfort. Eventually, my mind wandered to the contents of the bag. Medications, little tablets and vials of solutions, each proves the existence of illness and the pain that comes with it. Each pointing to the hope that the pain can be healed, that the horror can be kept at bay. In that hope there was comfort. My fears were largely unwarranted, the concerns of a newish dad thinking the worst. They were fears none-the-less, and that twenty minutes to wander, that brown paper bag, and those medications were comforts. Those in fear for the health and the life of their loved ones, caught up in the midst of a crisis do not experience the worry as a momentary thing. They are awash in it, buried under the swells of terrible thoughts half thought and the heaviest of worries. For them any reprieve from the pain is no small thing, it is the greatest of gift. Today give that gift. Allow all those who are worn out to wander from the bedside and realize that the world is larger than the sick room. Give them an instant to escape their fears. Take over the worry, and they can breathe again. Give them a hope for peace and an end to suffering. In doing so, you will add some comfort to this world. That is precious and a beautiful thing.

Wednesday, March 11, 2015

Mourner’s Song

Some cultures demand it, others shudder to hear it. Some see it as a measure of the love lost, others as weakness. I can’t recall the first time I heard it. I don’t remember the dead, don’t remember the family, the place, or the time of day. It must have been in the hospital, outside of some room where the specter of death had just passed. I do remember the sound, the first hearing of a song sung a million times, always heard different and always absolutely the same the mourner’s song, the cry of someone who has lost another. The gut wrenching call of those who have had a piece of themselves ripped from their being and from this world. For some it is a loud guttural response loud enough to be heard through closed doors and around corners. For others the mourning song is something more internal, a soft cry, or perhaps relieved laughter. Whether it is screamed out for all to hear, or a dirge played for an audience of one in the theater of the heart, the mourner always sings. Mourning is nothing more than a love song without a melody, the arraignment of a life lost played in one cacophonous instant. The love that has lost its object demands a body, and it takes it shape in the sounds of mourning. Just like all of death, the mourner’s song can be something ugly, something hard to hear and frightening. It can be difficult to dwell in that place with the mourner, even harder to do it day in and day out. But there is more to the mourner’s cry than the ugly. Beauty can be found there. The mourner’s song is built on notes of laughter as much as tears, on love as much as loss, on joy as much as pain. Any song worth singing, any tune worth playing is buried somewhere in the mourner’s call, and in that way the song of the mourner can be the most beautiful of music.

One in a billion

One in a billion As I understand it, and I understand it poorly, we, this, all that is and all that ever will be, is the result of imperfection. Matter is born of heat and light. All matter was born with a twin. For every drop, every ounce of matter, a drop and an ounce of antimatter was created. And since the dawn of time there was sibling rivalry such that matter and antimatter when they touch they destroy each other. If the laws of physics were perfect, if the universe were symmetrical and uniform, then as quick as the universe could give birth to matter it would mourn its death. Nothing would be left, but as it turns out for every billion pieces of antimatter created there is a billion and one pieces of matter created. In other words the universe is imperfect and because of that we exist. Each of us is one in a billion. We are the left over, the aggregate result of the imperfect laws of physics. Bob was imperfect, the son of a patient. Bob was not a strong man or a smart man. By many standards his life had been a failure; a string of jobs begun and lost, a grown man living at home with his mom, he had few friends and little to show for himself. Bob cared for his dying mother, a task which had seemed beyond his capacities. She was older but not small, she suffered from pain and respiratory distress. She needed help with bathing and toileting. Even for those with training and strength, the task of caring for a dying person is a struggle. It seemed Bob didn’t have it in him, that he was too imperfect for the task. Nancy was an RN assigned to the case, and her vision was bigger than most. Where others would have seen only the imperfections, she saw unique strengths, where others would see only the failure, she saw the potential. Nancy saw in Bob’s strength and imperfections the building blocks of a caregiver. With thought and patience, Nancy built Bob up. Bob’s mother died peacefully in her home, with the best of care given by her own son. After the grief and the time, Bob was a different man. He had pride in the care he had given; he found meaning in the love that he showed. From that day on Bob was stronger, more confident. Through Nancy’s help and the care he gave, Bob found his worth even in his imperfection. From then on Bob recognized that he is like the rest of us one in a billion, and new life was born out of death. That too is a miracle. *All names have been changed.

Tuesday, March 10, 2015


This weekend my wife and I moved our kid form his crib to a big boy bed. The move was not well received. To the little guy, the bars of the crib were a comfort, something he could rely on to hold him up, to keep him safe as he slumbered, something he could depend on. Taking away his crib, while necessary, cut into his comfort, pared back his safety, removed a sliver of his trust in this world. Perhaps a first step on a road that can and often does lead to distrust and cynicism. We are born dependent. Reliant on our caregivers for all things. It’s a good thing babies don’t know anything of the world they enter. It’s a good thing that my son was ignorant to the fact his crib was some cheap off brand contraption, put together in haste by his father who is about as handy as a gold fish. More than the bed, it’s a good thing my son was born with no inkling of how petty I can be, how lazy and selfish. If he knew, how could he depend on me? If babies were born with a working knowledge of human weakness, childhood would be a terror of dependence without comfort, need without trust. It’s a good thing children are ignorant of human frailty, our patients are not. It is an audacious thing we ask of them. These newly dependent people, from whom freedom and strength has been stolen. We ask them, not innocent children, but seasoned adults, often adults who have faced down the horrors of a normal life and the pain of a terminal illness to depend on us, people who they have never met before, and what’s more amazing is they do. We are welcomed as honored guests into strangers’ homes. The world, with all its problems, gives us little reason to trust the other, and so there is a touch of the divine and a hint of miracle in the way our patients and families receive us. Today, may we walk in reverence as pilgrims on holy ground, as servants at the temple of the bedside, and know the honor of being entrusted with another’s life and with another’s death.

Friday, March 6, 2015

The Loud Speaker Dirge

The overhead speaker at a hospital sings. Its song is of life and death. It can rush staff to a stopped heart when calling out its codes, and it can warm hearts still beating when it plays that little nursery rhyme jingle at every birth. The speaker reminds us that within slivers of time and moments of space lives begin and lives end. I had a patient named John. He was the kind of guy you either loved or hated, most hated. He was gruff and sarcastic, hilarious and often mean. Years of disease wrapped a barbed wire around his tender heart. He struggled with illness for what seemed like ages, and for ages John drove everyone around him nuts. That is, until his grandson was born. The birth of the child did not extend John’s life. No, the 52-year old died three months later. The birth of this child did, however, allow John to die peacefully. This child, this squirming little ball of neediness and love, let John know, in unbroken flesh, that there was more to life than his death. After the birth, John’s anger gave way to gratitude, cruelty to kindness. John was a man without any faith, but the birth of this child gave his last days meaning. The new life that entered this world allowed John to leave it. Life itself opened the door for John to die well. If we leave out the great by and by, set aside notions of what comes after this world, all we are left with is the hospital speakers. The call to attend the dying and the encouragement to rejoice at new birth. For John and perhaps for all of us, that is enough. So when our task grows hard, when it seems the only song that plays is the funeral dirge, may we remember that somewhere hospital speakers are playing their happy little jingle. There is always new life.