The Good Death
A hospice chaplain reflects on the similarities between dying well and living well.
By Kristina Robb-Dover
On the day before Lois died, I arrived to find all 70 pounds of her emaciated frame contorted in a final, desperate protest against death. Her trembling hands were clutching the rails of her hospital bed, bracing for a struggle, her frail, matchstick legs thrashing against an invisible foe; and, while, by this point in her decline, Lois could not talk, she frantically peered out at me from between a pair of sunken cheeks. All of the cues suggested that Lois was about to die, but not without a fight. Over the last few weeks, Lois had stopped eating and begun to recoil into her own little world, and with each visit, I had found her progressively more pale and feeble, a gaunt shadow of her former self.
That day I held Lois’ hand, spoke words of comfort, and prayed for her. After all, that was my job. I am a hospice chaplain: my clientele are those who have been told by a doctor that they have one to six months to live because of some incurable terminal illness or, in the case of old age, sheer “failure to thrive.” In short, I help these persons to die.
In this line of work, I have learned a simple but profound truth. I have learned that there is such a thing as a “good” death, that a “good” death is as real as a “good” life, and that the two are intimately connected. Both, it seems, require finding meaning in the face of the inescapable reality that we are born, grow up, work, play, fall in love, have children, grow old, and then, finally, exit the world we know. Albert Camus called this pattern to human existence “the absurd.” Karl Barth preferred the term, “non-sense,” or “meaninglessness.” The apostle Paul likened death to a “sting”—a last, loud retort to human beings’ highest aspirations, noblest achievements, and most self-inflated of plans.
The “absurdity,” “nonsense” and “sting” of death all describe my own experience holding the hands of someone at death’s door. There, I come face to face with the seemingly senseless fact that they—and, ultimately, I—will stop breathing and thinking and loving and being.
What, then, constitutes a “good” death? I suggest that the beginning of an answer to that question lies in the courage to share with another human being one’s own unique story about what it really means to die. What is one letting go of? What does one most fear leaving behind? Where does one think she is going? What are one’s greatest joys? Proudest achievements? Deepest regrets? Darkest secrets? Unfulfilled dreams?
Aristotle located the essence of humanity in our ability to “speak”—to communicate our thoughts and feelings through words in such a way that we can elicit empathy from another. Centuries later, the claim still holds true. Homo sapiens are the only creatures on earth that can assign meaning to their experience through language. Precisely because it is so essentially “human,” language, whether verbal (in the form of written or spoken words) or non-verbal (such as touch), enjoys enormous power. It can hurt and heal; it can comfort and console; and while it may never domesticate death, language can put death in its place—that is, at the conclusion of a story that is unique and special in its own right and impossible to duplicate.
For me, the act of sharing one’s own death with others derives its healing value from another source, too: “On the night before he was to die, Christ took bread and broke it, saying, ‘This is my body, broken for you…’” When, as a Christian, I profess that Jesus Christ is the incarnate “Word” of God (John 1:1), I proclaim that the life, death, and resurrection of Jesus Christ are the unadulterated speech of God for and with me. And I profess that in life Jesus spoke words of hope and healing to the sick and the suffering; in death, words of empathy, demonstrating solidarity with human beings in their brokenness; and in resurrected life, assurance that death would not have the last word.
In this framework, communication between human beings at death attains far stronger resonance. What is said and what is not said, what is shared and what is withheld, can mean the difference between a good and a not-so-good death.
At 87 years of age, Lois was ready to die. Instead, she had painfully and reluctantly lingered on for three years in hospice care, long outliving the physicians’ prognosis of one to six months to live (an eligibility requirement for hospice). During that time, Lois’ doting daughter, Norma, had visited her regularly at tng nursing home, often leaving a bouquet of freshly cut flowers as a reminder of her love, and it was clear that that the two enjoyed a close mother-daughter relationship. Many things, no doubt, had been said—about how Norma wanted her mother to get better and come home, and about how hard it was for her to see her mother’s condition deteriorate. But many things had also remained unsaid, and these were perhaps the very things that needed utterance in order for Lois to die peacefully.
That day, Norma met me at Lois’ bedside, where, in between tears, she shared fond recollections of her mother. Then, softly and tentatively, she said, “I just want my mother to rest. She has been fighting so long.”
I asked Norma if she had ever given her mother “permission” to die. She broke into sobs again. “No,” she answered. I gently asked her if giving that permission was something she might be able to do. Norma again burst into tears, but this time she was nodding silently and in agreement.
Norma and Lois were Christians, so at this point I offered to say a prayer. “Heavenly Father,” I prayed, “Thank you for the life of Lois. Thank you for the way in which she has been such a good mother to Norma, and thank you for Norma’s devotion to Lois. Thank you for their love for one another. It has been such a long road for Lois, and she has fought so hard to stay alive for the sake of her daughter, but Lois is tired now, and Norma wants her to rest. I know that in your heavenly kingdom, where there will be no more pain and no more tears, Lois will find that rest, and, that when you call Lois home it will be only a temporary farewell, because Lois and her daughter will be reunited again. So please receive Lois into your kingdom and give her that rest. In Jesus’ name, Amen.”
After our prayer, I left the room to allow Norma some time alone with her mother. A few minutes later, Lois died, with her daughter at her side, having heard what needed to be said. In the end, perhaps that is what she had needed most: the truth, spoken directly, and to the point, embodied in loving human community. No run-on sentences, no poetic euphemisms—death has little patience for superfluities—but truth as Reality given voice and a space in which to breathe…one last time. Yes, good dying, like good living, I have learned, requires grace, honesty, acceptance, and the courage to let go when the time is right.
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Kristina Robb-Dover is a chaplain at Emory University Hospital and is preparing for ordination in the Presbyterian Church. Her last article for SoMA was Preaching the Bad News.
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