Tuesday, December 16, 2014

Silent Night, Holy Night: Sacred Dying is another reason to write condolence

My end-of-life work has expanded this year to vigiling at deathbeds.

As a volunteer with a local hospital's No One Dies Alone (NODA) program, I am asked to sit with a dying patient for a few hours. When a family accepts the offer of NODA services, round-the-clock (or specific windows of respite) coverage are scheduled.

Silent Night, Holy Night

During my orientation with Chaplain Diane, I was asked to indicate which 4-hour shifts (in a 24/7 grid) I could serve as a 'compassionate companion.' At first glance, the choices were baffling; my mind quickly shuttled through my commitments and habits and I found myself putting check marks on 4 a.m. to 8 a.m., two days per week. That impulse has been wonderfully rewarding. It is nighttime when most families take a break, go home to rest, give pets attention, and squeeze in other life responsibilities.

I am called out weekly into what is always a Silent Night, a Holy Night. There are very few vehicles on the roads and it is pure pleasure to descend the ramp to the rebuilt freeway and take my pick of 5 lanes' white concrete streaking by. I say a prayer that my presence be helpful.

It's almost 4 a.m. when I log in at the nurses station. The 4th floor is bright but hushed and I enter the patient room, knowing only his or her name, age, and status for 'universal precautions' (i.e. if communicable infection.) "Hello, Stanley," I say as I approach the bed, "my name is Deborah. I'm going to spend some time with you tonight."

"Doesn't Deborah think about anything else besides death?" Sure, I do. But like anyone else with a passion, responding to a 'calling' delivers unparalleled satisfaction. 

Are you familiar with the dynamic of synchronicity? 

Carl Jung, a 20th century pioneering psychoanalyst, believed in significant connections between thought and occurrence. What we focus on may manifest itself in coincidences that may provide insight, aid and opportunity. I have often expressed that just as we consider birth a momentous occasion, death [and dying] should be honored for its mystery and significance.

Thus I synchronistically found myself in the Dewey Decimal stacks of 291.38. 

Allow me to detour for a moment and explain that the Call Number 291 is Comparative Religions. I do not believe books on dying should be bogged down by religious proscription, shelved A to Z between Atheism and Zoroastrianism. I certainly wouldn't want to find books on dying in Call Number 616, Diseases. May I respectfully suggest a reclassification to 269, Spiritual Renewal or the crux Call Number 218, Humankind. Can I get a Comment from a librarian, please?

I felt at home when my eyes laid on the spine of 291.38A Sacred Dying, Creating rituals for embracing the end of life. This is Megory Anderson's attempt to provide both "testimonial and handbook" on how to "reclaim death and dying for the person going through it." She acknowledges that the hospice movement has returned the family to the farewell, but cautions that solicitous concerns about grieving divert loving attention away from the person actively dying.

Dr. Megory Anderson
A theologian, author, educator and liturgist, Dr. Megory Anderson is the founder and executive director of the Sacred Dying Foundation in San Francisco.

Readers will be inspired by Dr. Anderson's skill and experience in creating meaningful rituals. With her insights and passion for "honoring the final hours of a person's life," she has created a set of tools which family members and caregivers can employ, mindfully, to enhance the transition from physical life. The Sacred Dying Foundation also offers Vigil Training for individuals and institutions.

Sitting Vigil

Sitting vigil is the term for companioning a dying person. It may be a time with or without an exchange of words. In many cases, my patients are in advanced stages of dying, unconscious, in a pain-managed dream state, generally unresponsive. Rhonda Macchello, MD, adjunct faculty medical advisor to the Sacred Dying Foundation notes:
 "Fundamentally, dying is a spiritual process and not a biological one."
That tips over a lot of our assumptions. Whether a dying person is conscious or comatose, comfort measures for the body are secondary. However, it is crucial to create a structured focus on the person dying, and it is imperative to assume full  function of hearing:  auditory input--whether discordant or soothing, has an impact. When caregivers, family and friends surround the deathbed with their veil of sorrow, a good transition is impeded.

Take it outside

It's true:  with few exceptions, the sense of hearing remains to the end of life. Conversation and squabbles among bystanders about medical care and decisions, expenses, funeral, wills, property, estates, fears, resentments, tiredness, inconvenience--and even sorrowful crying--are burdens to the spirit of the dying person. Step out of the room and out of 'earshot'.

Gifts for the dying

Death is sacred because of its mysteries and profound emotion. Stay focused on that. Enhance the reverence with soothing touch, peaceful music, pleasing scents, soft glowing light...
Forgiveness, gratitude, love...

"Rituals transform one state of being into another."

 Dr. Anderson uses the examples of blowing out candles on a birthday cake and rites of passage such as a first driver's license to describe the ritual triggers for thought, insight, and transformation. She acknowledges that religious rituals and symbols can be a part of vigiling if they are meaningful to the dying person, but suggests that personalized rituals will often address deeper issues. A special memento, a favorite toy, a religious article or often, the creative repurposing of an everyday item can be used to exercise the psyche in resolving concerns. The desired outcome is always a readiness to let go of the body, to 'leave'.

I loved her story of taking a sheet from a hospital's linens shelf, and tying knots to represent the concerns of a dying person. As each topic is discussed and 'let go', a knot is untied. Finally, the sheet is liberated to become a huge sail, its four corners held by family members who joyfully loft it overhead. And though this ritual is for the dying, the symbolism of freeing their loved one's soul is deeply comforting to family.

The Music of the Night

On a Silent Night, Holy Night (a vigil), one of the first things I do is turn off the television. Though there is a channel with calm music programming set to nature scenes, the digital broadcast is unreliable. Our NODA program equips a Comfort Cart in each room with a CD player and case of discs. My current favorites are Angel Symphony, Memory Road, and Walk in the Woods.

The melodies take me to deep ponds of gratitude for the person's life:  their humanity, kindness, and courage. I assume the best. I consider them teachers. I forgive their shadows and encourage the true glory of their soul to burst forth from a tired shell.

On a Silent Night, Holy Night- everything is possible.

Sacred dying is another reason to write condolence because life is a spectacular thing. It is note-worthy.

Thank you for caring!

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