First Parish Unitarian Universalist"Being With the Dying"
Sermon by Carla M. Torres
First Parish Unitarian Universalist - Canton MA
March 25, 2001
Thank you all very much for having me here this morning. My friend Mary has told me a lot about this church over the past few years, and I know how important it is to her. It really is a privilege, therefore, for me to be here.
I'd like to make it clear, right from the beginning, that I do not consider myself to be an expert on death or dying. In my opinion, the only real experts are those who have experienced it. While we all may have experienced death in another lifetime, my guess is that none of us remember it, including me.
I have, however, made a very conscious decision to make working with the dying my life's work, so I'm very pleased to have this opportunity to share what I've learned so far.
My message this morning will be that, while dying may not be an easy process to experience or watch, dying is safe, and dying is natural.
But first, a word about grief. I think most of us know that grieving is a continuous process, one that changes over time, but does not end. Most of us here this morning have probably experienced the death of a loved one, or may be grieving other losses. There may be people here who are living with a terminal disease. I don't know. What I do know, is that our process of grieving can come up when we least expect it to, and that being here this morning would be a very likely time for grief to percolate up to the surface.
If anything I say this morning brings up feelings of grief for anyone here, please do what you need to, to take care of yourselves. It's ok. I'll ask that if I need to pause for a moment, you'll give me that moment as well.
I have been interested in death and dying since childhood. There was a time when I was young, when two members of my immediate family died within 24 hours of each other. I remember a period of time that seemed like an eternity, in which we were constantly going from wake to wake to funeral to funeral to family gatherings full of mourning people.
While this was a terribly difficult time for my family, it inspired in me a curiosity about death. I remember touching my brother's hair as he lay in the casket, understanding that he was no longer there, and wondering where he had gone. That curiosity has guided my belief that the more we expose ourselves to the things that frighten us, the less frightening those things become.
In my work as an educator and home health aid at Hospice and Palliative Care of Cape Cod, I am constantly learning about the courage, vulnerability, friendship and support that people show one another when someone is dying. I am humbled over and over by the experience of witnessing death. It is an exquisite lesson for me in ego loss, and has given me a deep perspective about what is and is not important to me in my life.
My first experience in caring for someone dying, was with my sister, several years ago. She had been living with cancer for about two years, when she began to decline. My husband and I moved in with her to take care of her, with no real idea of what we were in for.
A quick word about my sister—she was a brilliant woman, generous and strong-willed. Her spiritual work was her life's work—she was a practicing Hindu. She met her dying process with incredible grace, and amazingly, interest. She told me that the experience she was having was the most incredible adventure she had ever been on.
Caring for her was, and remains, one of the greatest gifts life has given me. I learned the deep, and simple, and beautiful truth of the importance of people caring for each other—for she cared for us, as well.
It is not my intention this morning to glorify the process of dying. Even for my sister, a person who had what would be considered a good death, it wasn't easy. Like birth, dying can be arduous work, and so painful to watch.
Interestingly, though I spent 5 weeks with her, watching in excruciating detail each change that took place, I never fully believed she would die. My brain understood it, but my heart never did. This is something I see frequently with the patients and families I work with. Perhaps it is that denial is the best or only tool we have, sometimes, to help us get through.
My sister did die, though, and after she died a hospice nurse helped me to bathe and dress her body. According to her wishes, and based on her spiritual beliefs, her body stayed in the house for 24 hours. She wanted her loved ones to have enough time to say goodbye, and she wanted to give her spirit enough time to make its transition, unhurried, unrushed.
For many hours after her death, I sensed her presence, her energy, in the room with me, and I was comforted.
Our connection over those 5 weeks had been so intense and so spiritual, that I fully expected it to continue after she had died. I am still surprised sometimes, that I don't hear her voice in my ear or see her sitting near me. But truly, our relationship has continued, just not in the way I had expected. I would not have chosen a career in hospice work if not for her, and I certainly wouldn't be here this morning sharing experiences that may alleviate some of the fear people have of death and dying. For the guidance I'm sure she gives to me, I am deeply grateful.
I love this work. The opportunity to help people feel safe and maintain their dignity at such a vulnerable time is tremendously meaningful to me on my spiritual path.
As anyone who has cared for a dying loved one knows, however, is it not easy. One of most challenging aspects for me, is when a dying person is experiencing their anger. It can be so painful to work so hard, on so many levels to care for a dying loved one. When that person responds with anger, it can feel devastating.
There was an incident with my sister that will sound absurd in the re-telling, but is a perfect example of what this anger can look like.
She asked me one night to make some beans for her dinner. This was about one week before she died, although I didn't know that at the time. I was physically and emotionally drained after the four weeks I had been caring for her. I made her dinner, brought it upstairs to her, and she asked me how I had prepared the beans. It seems, I had not prepared them correctly, and my sister became very angry at me, lashing out in a way I couldn't understand.
I went back downstairs and fell to the kitchen floor, sobbing, devastated that she could treat me this way when I was trying so hard to take care of her. I began to feel angry, then terribly guilty for being angry at my dying sister. It was quite a scene.
I didn't have the tools yet, to understand that her ability to lash out was one of the only things she had left in her control, and that her anger was not about me at all. She was angry about dying, at 41 years old..
When I am with a patient who is directing his or her anger toward me, I do my best to take me, and my ego out of the way. I lavish on that person as much compassion, loving kindness and, most importantly, non-judgement as I possibly can. I remind myself that the anger is not about me.
It's important to remember that we always have the gift of our calm presence and full attention to give to our loved ones, and that that is what conveys our caring and friendship. When I am en route to a patient's house, particularly if I have never met the person before, or I'm aware that he or she is in a difficult place in their dying process, or if I'm aware that there are difficult dynamics happening in the family, I spend 10 minutes or so on a breathing meditation. This helps me to remain focused and centered. I ask the universe to help me to be a calm presence and in doing so, I am supported and strong, able to do the best job I can for the person I am going to see.
Once a relationship of trust and non-judgement has been established, and a person feels safe, beautiful moments can happen. One of these is when a dying person will tell the story of his or her life, finding the meaning, the value, the parts of their experience of life that mattered the most. When a person near the end of life is able to tell their story, it seems to make it ok for that person to begin to let go.
When I am with a patient and I sense that she or he has a desire to talk, I'll ask that person to "tell me about" the photo of their family, or their career, or their childhood. Then I make sure to be quiet and listen, knowing that this sharing is a gift for both of us.
Also, as long as a person is alive, there is the possibility of humor! Though our loved ones may look and behave differently when they are getting closer to death, it's important to remember that they are still the same people we've always known and loved, and that when appropriate, sharing laughter can help remind them and us that we can still share in happy moments.
Several weeks ago I brought my two young children to visit a woman I had been caring for for several months. We had a lovely, short visit, and when it was time for us to leave, she said, "Thank you so much for bringing the children to visit. They are adorable...they look like hummels!"
I know what hummels are, but I'm not sure I've ever seen one, and her comment struck me as so funny, I began to laugh. Then my children began to laugh, and before we knew it, this elderly, dying woman, bald from radiation, with her oxygen tubing on her face, was laughing along with us. It was wonderful—joyful and spontaneous, and it reminded her that she still mattered and could participate in happy moments with other people. It was a beautiful connection for all of us.
Something that I try not to do too much of, is give advice. When people are very sick they get advice from every direction, and I've noticed that this can cause people to feel some pressure to change, or to do a "better" job with their dying process. It can be such a relief for someone so sick to just have a friend to listen, or even to sit in silence together.
Let's take the lead our loved ones set. Even if we think we have nothing to offer, our presence and our attention convey our caring far better than any words of wisdom or advice.
There is also, of course, the beautiful power of touch to convey our caring. So much of the touching people get when they are dying is technical or clinical, and sometimes, when very ill, people sense others' reluctance to touch them.
When appropriate, and when both parties are comfortable, a back rub, foot massage, or brushing a loved one's hair...these can be the loveliest moments in weeks for a person who hasn't had much loving touch.
As the dying process continues, and a person gets closer to death, there is a withdrawal that seems to happen. A person may sleep, very deeply, most of the time, sometimes falling into what seems to be a semi-coma.
It may not appear to us that our loved ones are aware of us at all. We are told, however, that the sense of hearing is the last sense to go, so even if we don't think our loved ones can hear us, it's important to remember to continue to speak lovingly and know that our words and presence are understood.
Interesting things can happen when a person is nearing death. Many who work with the dying will say that they've seen dying people talking to angels, or to loved ones who have already died. Many believe that these spiritual beings come to help the dying person make the transition.
While I, too, have seen this happen many times, I'm not quite sure what to make of it.
I was in a patient's room once, where she was deeply asleep, and had been for many hours. She felt warm, so I removed a heavy blanket from her bed, and casually tossed it onto a nearby chair. Imagine my surprise when she opened her eyes and sharply said to me, "Why did you throw that blanket on him? Can't you see him sitting there?"
I apologized, put the blanket on a different chair, and by then she had gone back to sleep. This was unsettling to me. There was no-one in the chair that I could see, but obviously this dying woman knew he was there.
I try, now, to maintain my awareness when I am with a person nearing death, that there may be other beings in the room with us. Though I sometimes feel nervous about this, I am also comforted to know that when people are dying, they often seem to have help from somewhere else. It gives me hope that when my time comes, there may be spiritual help for me, too.
There seems to be a transformation that occurs, minutes or hours before the moment of death, in which any struggle is over, and the dying person is able to relax into the letting go that is death. Many call this grace. I have observed this many, many times, and I am deeply comforted by it. It is a reassurance to me that dying is safe.
The moment of death is a moment of the deepest stillness. Each time I have been present at a person's death, I've been awed that the most sacred and powerful transformation has taken place before me.
Being present at a death feels like a blessing to me, and I am so grateful to those who allowed me to be in that sacred space with them.
For me, witnessing death is like witnessing birth- it's a reminder that the boundaries we construct between us are illusion. We exit the world the same way we enter it- vulnerable and holy. We all stand on the same shared ground of uncertainty. We are all dying.
At my sister's memorial service 7 years ago, I said that her death was an appropriate reward for a life fully and consciously lived. I would love for the same to be said for all of us.