Been Busy

Sorry you haven't heard from me in a while. I've been busy on some of my other websites. Here are some of the things I've been writing:

Mary Speaks to All of Us

What I Learned About Marriage From Two Nursing Home Residents

I re-posted my last reflection on Lumen Fidei.

Saint of the Day: Saints Fausta and Evilasius

Some memes I've made:

Confirmation Classes are starting again. Technically, I'm going to be teaching two classes at once which is unheard of in my parish. One of my classes will be ending in November, so it shouldn't be too bad. 

There have been a number of things in the news lately about pro-life and women's issues that I would like to comment on and I'll get to work on that. I just wanted to let you know I haven't disappeared. 

I gotta use this cartoon every excuse I get. Although I'm done with the shameless plugging.

Lumen Fidei #22: Why Does God Allow Suffering?

From #57: To those who suffer, God does not provide arguments which explain everything; rather, his response is that of an accompanying presence, a history of goodness which touches every story of suffering and opens up a ray of light.

In my time as a nursing assistant and later as a chaplain intern, I was asked many times why is there suffering. It came up in many of my classes. I even had one class that dedicated a semester completely do that question in college.

The best I can say is that no one answer is going to work for every person in every situation. If someone who is suffering asks you "Why?" there is no answer you can give that will help them. The best you can do is, if appropriate, help them find an answer themselves and listen to them.

One thing I appreciate about Christianity is that it offers something more than an answer. It offers a God who knows all about suffering and who cares about each and every one of us deeply. Jesus Christ died abandoned by his friends in one of the most horrifying ways imaginable (likely asphyxiation). During his life, he suffered all the pains we do. Friends of his died, notably Lazarus. He lived far from home as he traveled preaching. He felt hunger, he felt thirst, and I'm sure he felt all the other aches and pains that we do.

So when we come to him in our suffering, he understands us intimately. He's been there. He might not be able to tell us why we are suffering, but he can be present to us in our suffering.

This is the last installment in a series of posts reflecting on quotes from Pope Francis' first encyclical. It's been fun and given my background, I think it's very appropriate that we ended with a post about the meaning of suffering. If you want to read more, visit here.

Keeping an Alzheimer's Patient Alive?

In Canada right now there is a court case in which a family is suing a nursing home for spoon-feeding their loved one.

Her advanced directives say that she does not want to be fed if she becomes incapacitated. She worked as a nurse and she's seen people die from Alzheimer's. She was abundantly clear with her loved ones that she did not want to die like that.

But the feeding isn't being forced upon her. She's opening her own mouth and swallowing the food. Although her family argues that it's just a reflex, I say that's irrelevant. The important thing is she is doing it, so on some level she's feeling hunger and she's eating.

They say she's in a so-called "vegetative" state. She has to be transferred using a lift. She spends her day in bed or in her wheelchair. Eating is likely one of the only things she can do anymore. And again, that is also irrelevant. Euthanasia is always wrong.

I think my opinion in the case is pretty clear, but this is where it gets murky. The nursing home has threatened to call the police if her family tries to take her out. They have refused to transfer her to a hospice. I think the nursing home is overstepping it's bounds in those respects.

Source

No, she should not be denied food that she is eating on her own, but that does need to be balanced with the family's rights. The family is wrong in insisting that she starve to death. The nursing home is wrong in not letting the family move her. Yes, she needs to be protected from abuse. But, it's still her family.

I've seen people die from Alzheimer's as well. It is not a pretty way to go, but no way is pretty. As Dr. House said (Edited for language):

"Our bodies break down, sometimes when we're 90, sometimes before we're even born, but it always happens and there's never any dignity in it. I don't care if you can walk, see, wipe your own [butt]. It's always ugly. Always. You can live with dignity, we can't die with it."

This case in part shows how advanced directives can be tricky. No one can account for every possible circumstance. Who knows, she might have been only referring to getting a feeding tube or hydration through an IV. Spoon-feeding is not unreasonable, especially if it's not forced. As one person noted on Free Republic, if spoon-feeding becomes optional, what next?

Also, how can we judge her quality of life? We don't know what it's like until/if we get into her shoes. Quality of life arguments have always bugged me. Only the person living the life can judge it's quality and, again, I question the relevancy of the question.

So, if quality of life, how conscious she is of eating and her disabilities are all irrelevant, what is relevant? She's a human being, for starters. Even from a secular perspective, the value of human life has always been seen as an absolute good that can only be taken away for an important, grave reason.

From my religious perspective, life is a mysterious gift that is not ours to take away. God formed us in our mothers' wombs (Psalm 139:13), and only God can take us Home. It's like that Bill Cosby quote, "You know, I brought you in this world, and I can take you out." Only God can do that.

No, no she can't.

The most important thing in this case is that this woman is a child of God. Everything else is secondary. Primarily, she needs to be protected. Secondarily, her family has rights as her legal guardians and I'm not sure if this nursing home has not overstepped their bounds a little bit in this case. I'll be awaiting the outcome of this case. It will be an important decision setting precedence for or against euthanasia in Canada.

I've Graduated!!!!

In January 2008, I went straight to grad school after graduating college. Due to numerous financial and personal issues, I dropped out, moved back home and worked full-time for two years.

I went back in September 2010. I went to school full-time while working part-time, volunteering for three different organizations, and sorta, kinda "planning" a wedding (my roommate actually did a lot of that job for me).

Got married in July 2011, moved half-way across the country, and had an unexpected baby. Thanks to the patience of the staff at Aquinas Institute and Rev. Terry Culbertson at Upstate University Hospital, I was able to complete the 5 remaining courses to finish my degree.

I technically graduated in December 2012, but I got to walk this past Friday. It is the end of a very long journey. As a woman I met Saturday said, "You really wanted this."

Unrealistic Views about Death

I read an interesting op-ed from the Washington Post yesterday. It was written by a doctor talking about our unrealistic view of death.

In part, she bought into Elizabeth Kubler-Ross' myth that there once was a day when we weren't afraid of death, a day that never existed. But overall, I think that her words are well worth noting:

For all its technological sophistication and hefty price tag, modern medicine may be doing more to complicate the end of life than to prolong or improve it.

Amen.

Sequestering our elderly keeps most of us from knowing what it’s like to grow old.

This physical and emotional distance becomes obvious as we make decisions that accompany life’s end. Suffering is like a fire: Those who sit closest feel the most heat; a picture of a fire gives off no warmth. That’s why it’s typically the son or daughter who has been physically closest to an elderly parent’s pain who is the most willing to let go.

I have long noted how we seem to move our dying out into the nursing homes on the edge of town. I like her analogy, that "suffering is like a flame." Looking back at my years working in the nursing homes, I see how the family who had visited the resident every week are more willing to let go than the family that is flying in to make the final decisions. We cannot let our own fear of death cloud our judgment in caring for our dying loved ones. Even the Church says there is a time when people can be let go.

Directive 57 of the Ethical Directives for Catholic Health Care states:

A person may forgo extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient's judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community.

And you cannot make blanket statements in regards to what constitutes extraordinary treatment. An example used in my ethics class once: A dying woman is ballooning up and her skin is cracked and weeping because her body no longer processes fluids correctly. In a case like that, it is not unreasonable to forego IV fluids.

Death is inevitable. Doctors can do a lot to postpone it, but they cannot prevent it. Sometimes it's just time to let someone go.

  

Lessons from Death: A Palm Sunday Reflection

Thinking about this week's entry, I had no idea where to start. The readings this week really don't leave much to talk about. Facing Jesus' pending death (liturgically speaking), I have no idea what to say. For several years I worked with the elderly in nursing homes. Every day, I was faced with the prospect of one of my residents' dying. So, you could say, I know quite a bit about death. In light of Jesus' crucifixion, I would like to share two of those death stories with you.

Illustration from Ars Moriendi.

One of the earliest deaths I encountered was of a fairly young man. He was in his 50s, maybe? He was suffering from a lifetime of smoking and being extremely obese. His family blamed him for his health problems. They simply dropped him off in the nursing home and didn't come to see him again until after he was dead.

He was a fascinating person. I always wished I had talked to him about his life story. He had experienced life on both sides of care-giving. He worked caring for the severely handicapped and then he ended his life being cared for at the nursing home. I wonder what insights he would have had. He and I were the only liberals at the nursing home and this was shortly before Obama was elected the first time. We'd talk about politics all the time, grateful to have someone in this small town who agreed with us. He died only a couple days before the election and I made sure I voted in honor of him (and I've regretted my vote ever since, but that's another post for another time.)

He is the only resident I've ever had who I'm genuinely concerned about. He died very, very angry at everyone and everything. I could imagine him getting to the pearly gates and saying, "F-you, God! You treated me so horribly during life, I don't want to have anything to do with you in death! Where were you when my family and friends deserted me? Why did you let me fall apart and die before the age of 60?" I pray for his soul anytime that he comes to my mind.

I've seen crowds at the nursing home that would put the crowd at JPII's funeral to shame. 

But, now that I've shared an ugly death, let me share a better one. At another home I worked at, I had a resident that I knew for a whopping 3 hours. I came on to my shift and as the day-shift person walked me through my assignment, she pointed out a new resident to me. She was in her 70's but she didn't look past 40. She was a beautiful woman with bright eyes and flawless chocolate brown skin. The only interactions I had with her was her bath and her postmortem care.

Her room was full of family the whole afternoon. We didn't expect her to die, it's as if her family knew something we didn't. It came as a complete surprise when the nurse came and got me to prepare her for the funeral home. It wasn't even quite dinner time yet. The funeral home wasn't able to take her right away, though. It seemed as if half of St. Louis came to pay their respects. Family and friends were lined up down the hall. Small children were running around and playing all over my wing of the building. The other residents enjoyed seeing so many cute little kids. I found out later that while this woman never had kids, she had dozens of nieces and nephews and their children who she was very close to. Regardless of the inconvenience of working around these people for the rest of my shift, I was happy to see so many. It was the first and the last time I ever saw such a crowd while I worked in St. Louis. At other homes I worked at, this was the normal occurrence.

I don't know what it says about me that I associate "surrounded by people" with "a happy death." That'll have to be explored later. For right now, I have a few closing thoughts:

• Don't get me wrong. There is no such thing as a pretty death and don't let any pro-euthanasia activist tell you otherwise. Death is the great equalizer. It doesn't matter if you're homeless, you're rich, you're the President of the United States or you're the Pope. Everyone dies and in the very end, it all happens in much the same way. I'll spare you the grizzly details, but it's enough to know that it sucks and it sucks for everyone.
• What matters is how we live. St. Benedict often advised his followers to keep death always on their mind. I think this is very good advice. I think the world would be a better place if we all thought about death a little more. Not to be morbid, but death puts everything in life in perspective. All those petty little things that we occupy our time with, will they matter in the end? If it won't matter in the end, don't worry about it! We will all be spending a lot more time dead than we will be spending alive.
• We spend a lot of time, energy, and money running from old age and death. It is a race we will all eventually lose. Old age is not ugly. It is not something to run from. Even if we lose our abilities and wind up in a home, I can tell you right now that my residents have all changed my life for the better. I think we should have mandatory CNA service. Like young Israelis are required to work in the military for a couple years, I think we all should be required to be a CNA for a couple years. That way we'll have plenty of people to help the elderly. I know my work with the elderly changed me profoundly, I think everyone would benefit from the humbling task of helping another person with their daily activities.  

St. Benedict, pray for us!

Not 100% appropriate but it is one of my favorite songs of all time and I couldn't get it out of my head while writing this: "Don't Fear the Reaper" by Blue Oyster Cult

...and the Impact of the Dying

The title of the article is quite melodramatic, but this article from the CNA last week reminds me of another topic near and dear to my heart.

Let me start us off with a true story:

I have been a nursing assistant for 6 years. As a nursing assistant, my job can and does include caring for the basic needs of people who are dying. One particular death I’d like to share with you.

This is one of the more recent deaths I've seen. This lady, we’ll call her Joan, was somewhere in her eighties. I’m not sure of all of the details of her condition. Between her and her family it had been decided that she would not get a feeding tube. As of this night, that I will never forget, she had been living off of lemonade for over a month. She refused all other forms of nourishment (except for sometimes she’d let her daughter give her some root beer).

She was skin and bones. As soon as you entered the room where she was, you could hear her struggling to breathe, but we couldn’t suck out the gunk out of her lungs because it would have done more harm than good. Every time an aide had to do something for her, clean her up, change her clothes, anything like that, she would look at us, completely terrified. She was paranoid about falling out of bed when we rolled her. Kind of crazy given that she had been a small woman to begin with and she was just getting smaller.

That last night, I was the aide that gave her her last drink of lemonade 20 minutes before she died. She took the drink willingly, it was through a straw, and I had the head of her bed all the way up, but she coughed every other sip like the liquid was going into her lungs not her stomach. And she looked at me with eyes I will never forget: She was hurting, she was scared, and she just wanted me to do something, anything, to take it all away. To this day, when I think of desperation, when I think of despair, all I have to do is think of those eyes. Thank God, she died 20 minutes after that moment. As I told everyone at the nursing home, “She arrived just in time for a huge dinner with Jesus.”

I think that the handicapped have much to offer us. The dying have even more. Terry Pratchett is one of my favorite authors and I respect him. But if the time comes and he does commit assisted suicide, he is robbing the world of an immense gift of caring for him and standing witness. He would only be contributing to a mindset that "People are only worth what they can physically contribute to society."

My work with the dying has taught me a lot about living. It has taught me to appreciate the time I have on this earth. It has taught me to look at everything through the eyes of eternity, not through the eyes of the here and now. It has taught me the importance of love and relationships, as those are really the only things that we can "take with us." Love and relationships are really the only things that matter in the end. All 25 of the deaths I have witnessed have left their mark on my soul and I wouldn't trade them for the world.

The Dignity of the Handicapped...

It was a bad day in my Mythology class. The teacher made a scene in front of everyone, pointing out that I shouldn't be in that class. He said I was too dumb and I had apparently not read the readings. I went home after class. I had some time between class and going to work. I didn't want to go to work, I was so humiliated, depressed, and angry. I tried to call in, but my charge nurse that evening wouldn't accept it. So I reluctantly got dressed and made my way to work.

When I got there, I was greeted by a sight I will never forget. We had a resident there who had the most beautiful green eyes and red hair. His body was so badly deformed, he had to use a lying-down wheelchair. His body was permanently in the fetal position. He could not move anything on his own except for a few of his face muscles. The only time we heard his voice was when he was having a seizure when he would sometimes scream. As a walked in the door that evening, he was there, lying in his wheelchair, right in front of the front doors with a ceiling light right over him like a spot-light.

Like Someone in the Great Somewhere wanted to make sure I saw him. Like Someone wanted me to know I was blessed, at least I could go to school. Like Someone wanted me to know I was needed, I had a job to do. My residents at my first job working with the severely handicapped taught me many things. Here are just a few:

1) How to appreciate the small things in life: Like laughing at a silly face or throwing around a soft ball. (Or throwing around silverware and food when some of them got particularly feisty)

2)How to accept differences: My dozen residents had differing levels of ability in many different areas. One was only moderately MR (Mentally Retarded) and blind. She could pretty much do for herself with constant instruction and supervision. Others were wheelchair-bound and non-verbal but you could tell by their facial expressions that they knew exactly what was going on. A few could not walk, but could surely throw things across the room if they wanted to. Working with them, one has to work with and recognize their strengths as well as their weaknesses. Helping them to use their strengths is really the only way that a small staff can care for so many residents.

3)There are many ways of communicating: One does not need to speak to get one's point across. The eyes can tell stories. Your facial expression and gestures can articulate pretty much everything that words can.

4)There are many ways of knowing: Even if you don't know all of the words someone is saying, you can understand exactly what they mean. My residents were very much in tune with subtleties of tone and expression. They knew when people were angry, hurt, or sick. They knew when one of my co-workers were pregnant. They might not have understood that she was going to have a baby, but they knew to be gentle and kind to her.

This is just the beginning of the list. My residents taught me many more things. They made me who I am today. It pains me when I hear statistics like 90% of babies diagnosed with Down's Syndrome prenatally are aborted. A Down's Syndrome diagnosis isn't a death sentence, it isn't even an indicator that the child will have a diminished "quality of life" (there are people who live perfectly normal lives with Down's). And even if the child has a diminished "quality of life" there is still much that the child can give the world. I know my residents gave me an abundance.

And stories like this warm my heart.