According to Hilaire Belloc, the non-Jewish world in the B.C. era held a lower view of the value of human life than what we currently understand. He backed up his assertion by describing the ease and broadness of killing in these kingdoms. They applied their understanding of human value when they tortured insubordinate slaves, and slaughtered rival nations’ soldiers and families.
There is probably some truth to Belloc’s claim. We in America don’t condone brutality (at least officially), even if done to our enemies. Consider that we treated the body of our number one enemy, Osama bin Laden, with respect, giving him a funeral according to the Islam tradition. And although we support our military service personnel, we don’t allow them to disrespect our enemy and go unpunished. I’m thinking of the Abu Ghraib Prison event.
There have been moments in America’s history when we applauded a man who was willing to kill another. In “Roughing It,” Mark Twain talks about his seven years in the Nevada territory. The era modeled the “Old West.” Mining towns prospered and died, and the Pony Express ran wild. In one Nevada town, Twain wrote, a man wasn’t a man until he had notched his first kill. The town’s most powerful person was typically the bartender who kept and used a pistol, and was also the mayor and chief banker. At that point in our history, we had elevated notoriety, power, and fame over human life.
In the past 2 months I’ve adjusted how I talk to prospective hospice patients and families about the decision to enter hospice care. Although I have continued to describe our basic services, and our commitment to praying for our patients, I’ve spent more time, and even added more emphasis on the magnitude of choosing hospice care. I hope it has helped folks begin the transition from curative to palliative care. I know that the shift has helped me better see how difficult the hospice decision is.
Let me say now what all hospice care providers (I presume) know, and that families who have already entered hospice will testify: Most wish they had started hospice sooner. The journey is richer with a trained palliative team informing, directing, and comforting.
The wonderful service and ministry of hospice does not remove the significance of the patient’s or family’s decision. Selecting hospice means resignation to curative treatment. It is an acknowledgement that a person’s time to die is near. I don’t know how I will respond when my time comes, but I know that I have seen people embrace their impending physical death as a friend, others shirk from it as from a vile enemy. Some welcome it because their battle with disease has been arduous, and entering hospice means they don’t have to the difficult and painful work of fighting anymore. Others, on the other end of the spectrum, resist letting go of the small hope of cure. They must become physically and psychologically defeated before stepping over. Obviously, the latter situations are much more difficult to observe and assist.
My wife asked me this morning why people suffering from end-stage cancer can be doing fairly well, then pass within a few hours or a day. I replied that cancer is like a snowball. The bigger it gets, the more snow it collects. A large cancer typically grows logarithmically faster than a small one. Once it reaches a certain biomass, the human physical body seems to succumb quickly. Those of us who resist our impending deaths sometimes become broken just hours or a day before we pass.
So when I meet with a family or a patient, I try to discuss how hospice is designed to help those who have 6 months or less to live. I attempt to word it in a way that fits their circumstance, that is respectful of their difficult situation. It is poignant when a family hears the hospice professional’s spoken words, that their loved one will soon leave the land of the dying.
Our lead chaplain feels that bereavement begins when someone signs up for hospice. He calls it pre-bereavement. You see, entering hospice allows the family to go ahead and begin grieving their impending loss. For some families, particularly when dementia has robbed a loved one of their mentation and personality, their loss is already in place and mostly complete even before death. The mother who raised them is long-gone, even though her body is living.
Yes, it is a big deal, a momentous time in our lives when we humans approach our inevitable deaths. As we continue to approach families and patients with compassion, we should take care not to divorce hospice care from the notion and reality of our dying.