End of Life Care

Dame Cicely Saunders is one of the great spiritual benefactors of the modern era. At least that is how I rate the white-haired, kindly looking British physician who, in 1967, began the hospice approach to helping people at the time of their dying.

This quietly dynamic Londoner, now 85, thought it important to move the place where people prepared for death away from hospitals to a home-like setting. She also placed emphasis upon making people comfortable rather than trying to cure them when that was no longer possible.

Thus she brought to the care of the dying not only physicians and nurses but also chaplains and others who could provide for their spiritual needs. She recognized that the soul needed support as much as did the body.

Dr. Saunders has taught people to express five sentiments as they approach death:

  1. I forgive you
  2. Please forgive me
  3. Thank you
  4. I love you
  5. Good-bye

She herself is a person of great spiritual stature. She once told an interviewer that, rather than dying suddenly, she would prefer to die of cancer. Dying a slow death would give her time to make the statements noted above.

Dr. Saunders draws inspiration from writers both ancient and modern. She finds hope expressed by Julian (or Juliana) of Norwich, a 14th century English mystic who, living at the time of the black plague that ravaged Europe, nevertheless wrote the famous words “all shall be well.”

She also takes inspiration from J. R. R. Tolkien, author of “Lord of the Rings” with its promise of overcoming evil, and from J.K. Rowling who has written the wildly successful Harry Potter series.

Dr. Saunders has brought about a revolution in end-of-life care. Many Americans have found in hospice care crucial support in their time of passage. However 50 percent of those who die each year do so in hospitals despite the desire of the overwhelming majority to be in their own homes when they die.

If all American hospitals offered hospice or palliative care services, then the situation would not be so bad. But, despite the advances in such care, fewer than 60 percent of our hospitals do offer such.

Emily Chandler, a Boston-area resident who is both a nurse and an ordained minister, explains the benefits of the hospice approach as follows: “Experience with hospice has taught us that rather than being a fearful, dreadful experience, dying can be healing, peaceful, even spiritually fulfilling for patients and their loved ones.”

As to what caregivers can do, she writes: “Attuned to the possibilities of sensory spirituality, we can enhance a peaceful, even joyful participation in the encounter with mystery that dying entails. In the process, we can learn something of our own spiritual journeys ourselves.”

The reference to “sensory spirituality” refers to Emily Chandler’s confidence in experiences that engage more than one sense at the same time. As an example, she says that combining sights and sounds or sounds and aromas can be effective in supporting healing memories.

Rev. Chandler also thinks that the great need of people when they come to die is to remember hope. It is a time for them to look back on their lives, if possible, and recall the images they have had of the transcendent, of what goes beyond the seen.

It can help them spiritually to think back to the familiar symbols that put them in touch with God, the beyond, the mystery of life. This is also the time when well-loved stories can be retold with the help of family members, friends, or others in attendance. These tales can stir the heart as they bring back the people and the events that figured large in the person’s life.

In this way, hope remembered can provide comfort and perhaps inspiration at this time of such crucial importance. Dying can thus become an event that summarizes life’s value, making it a supreme human experience.

The approaches to end-of-life care indicated here give expression to a strong movement toward favoring care over cure when the latter is no longer feasible. More and more people in later life want their time of dying to be one in which their bodies are made as comfortable as possible and their souls receive the attention they need.

Richard Griffin

Child Growing; Elder Growing

A small personal encounter in my 75th year has brought into sharp relief the fact that we all, young and old, are silently changing, growing older physically and being transformed internally. Even in an anxious time when the world is preparing for war, and people feel unsettled by catastrophe, incidents like this one call for attention and reflection.

On a recent evening I arrived at the home of dear friends and was greeted at the door by their 11-year-old daughter, whom I will here call Alison. She is a delightful young girl, sprightly in body and lively in mind, whom I have known from almost the beginning of her life.

Arriving at her house for dinner, I was warmly greeted at the door by my young friend. On this occasion, Alison made conversation with me more easily than usual, among other things telling me about her dog Euterpe who was running around the area near the front door, excited by the approach of us visitors.

I did not notice anything else unusual in my contact with Alison on this occasion. While we conversed, she maintained eye contact and was attentive as I took off my coat. Assuming the role of hostess while her parents were busy in the kitchen, she made me feel comfortable in her home.

Later in the evening, however, when Alison was out of earshot, her mother, whom I will here call Wendy, told me of questions Alison had asked her about me. “What has happened to Richard’s arm? Did he injure it?” Alison wanted to know.

Wendy was astonished to hear her daughter’s questions and replied: “Why nothing has happened to Richard. His arm was always like that, since it was damaged during his birth.”

Like Wendy, I also was surprised at Alison asking about my arm since, throughout her life, she had seen me dozens of times previously and had had many opportunities to notice the signs of this injury. Never before had she given any indication of recognizing my impairment.

In reflecting later on the girl’s discovery, I attributed it to Alison’s arrival at a new stage of development. Previously, I surmised, she was not able to notice my disability, despite numerous opportunities to do so. She had not matured enough to take note of this kind of defect in an adult. It required more internal growth for her to see me as I really am.

Some adults, it is true, have occasionally failed to notice that my left arm is shorter and smaller than my right. Looking at me from certain angles, they could have missed this fact. But they would not have taken years to discover the bodily defect caused by birth injury.

Incidentally, I do not claim this disability counts as major, comparable to what many other people face. But, like all bodily differences, it has loomed large in my psyche, especially when I was young, and has had an important role in my own personal development.

Thus, aside from the growth in consciousness that I assume this discovery on Alison’s part may reveal, I paid attention to my own response to Wendy’s telling me about the incident. Though she related it to me in the presence of several other friends, I did not recoil in shame and embarrassment as I would have done earlier in my life. Instead, I listened to her anecdote with intense interest, but with most of my attention focused on what was going on in Alison’s adolescent psyche.

I confess, however, to some lurking feelings of defensiveness, but they were lodged in the far background of my psyche rather than in the front of my mind. Not yet am I entirely free of emotional response to remarks about my body image.

Reflecting further on this event, I take this apparently minor incident as an important sign of change in myself. It serves as evidence of my progress in self- acceptance, to my mind the most fundamental of later life’s tasks.

I had come far from the time when I used to stand before three-way mirrors in department stores, trying on new sports coats, and cringing at my own image. Now, after the passage of decades, I can at last accept myself with some equanimity as I actually am rather than as I wish myself to have been.

However, God has not finished with me yet, my life is still not at an end and I still have a distance to travel before that self-acceptance becomes more definitive.

This apparently trivial incident has signaled for me the way younger and older are all in the daily activity of growing interiorly as well as visibly. What we are able to see and how we come to feel about ourselves and our body image form part of the human adventure.

Richard Griffin

Benedictine Spirituality

Does a man who was born somewhere around the year 480 have anything to say to modern-day Americans? If that man is Saint Benedict, the answer is yes.

The spirituality taught by this patron saint of Europe speaks to many people nowadays and not all of them are monks. One such person is Lynn Huber, a resident of Colorado, who draws daily nourishment from Benedictine teaching., After growing up in a different religious tradition, this middle-aged woman discovered Christianity and, in recent years, has become an Episcopal priest.

In a talk given a week ago in Chicago, Ms. Huber laid out the major elements of this spirituality, showing how they can enrich the lives of people living in the world.

The small book of rules that Benedict left for his followers provides a framework for a vibrant spiritual life. Chief among his requirements are vows of obedience, stability, and conversion of life, three ways of finding God.

For Lynn Huber and others like her who choose to become affiliated with a monastery without actually becoming a  monk or nun, the spirit behind the vows has meaning. Obedience implies an effort to see yourself as you really are in the sight of God. It means listening to God in the effort to discover a simplicity of life.

For monks, stability means living one’s whole life in the same monastery. Recognizing both the challenges and the blessings of living with the same people for years, Benedict described this setting as “the place of our wounding and the place of our healing.”  

For those living with a spouse or with other people in the world, this changes the basic question from “Am I going to stay” to “How are we going to make it together?”  In other words, one expects to stay with life partners and one concentrates on making it work.

By contrast with those who commit themselves to stability, we Americans tend to be restless and, on average, move every five years. There is not necessarily anything wrong with frequent moves, but it may make personal relationships more difficult.

St. Benedict called the third vow “conversio morum” or a radical change of behavior. In practice this involves the determination to “seek and serve the Lord in all things.”  For lay people outside the monastery that would mean, among other things, the habit of seeing Christ in every person.

The Benedictine way of life is marked by equal attention to work, prayer, study, and leisure. In the current era when so many people seem to have no time for anything but work, this ideal can serve to remind us of the importance of balance in our life. Sometimes, if we want to give God a greater place in our days, we must learn to slow down.

An effective way of approaching this rhythm of life is to take up the practice of another Benedictine spiritual device called “lectio divina”  or sacred reading. Currently many seekers, among them Lynn Huber,  hold this practice in high regard and use it every day.

You do it by taking four steps:

  1. Lectio, by which you read out loud and slowly a passage from the Bible or other appropriate text
  2. Meditatio, or thinking about it, whereby you let your mind play with whatever strikes you in the reading and pay attention to your feelings about it.
  3. Oratio, or praying about it. You talk with God, sharing with God your thoughts, feelings, desires, hopes, and what ever else moves you.
  4. Contemplation, or sitting with it. This involves listening to God and waiting on God with your eyes closed, your body still, your mind and heart open.

At her talk last week, Lynn Huber led those present in a lectio divina, using Psalm 23, “The Lord Is My Shepherd.”

Many people who have adopted Lectio Divina do it for 20 minutes, twice a day. But this form of prayer is flexible, ready to be adapted to whatever time you have.

These few features of practices handed down by Saint Benedict may suggest the value of his tradition. The beauty of Benedictine spirituality is its simplicity, its way of making the approach to God attractive and adaptable to use by many different kinds of people.

No wonder that Saint Benedict has long been recognized as one of the great masters of the spiritual life.

Richard Griffin

Mr. Rogers

Mr. Rogers was easy to make fun of. Even a person like me, without a talent for mimicry, could have parodied his words and actions. “Won’t you be my neighbor?” could be made to sound mawkish. And his ritual taking off his jacket and outdoor shoes, then putting on a sweater and sneakers, might have been held up to ridicule.

In fact, comedians on television did sometimes parody Mr. Rogers. However, he was obviously too genuine a person for them to do so with  any ill feeling.

After his recent death, the best thing said of him was that he was just as fine a person off screen as he appeared to be on his program. Apparently, his private personality was identical with the TV persona that reached milllions.

In these times, when public image seems far more powerful than private character, the authenticity of Fred Rogers comes as a morale booster. Unless the nation has been terribly taken in, this man was the real thing.

His spirituality goes far to explain why he was able to maintain his personal qualities throughout a television career that lasted almost 50 years. His custom was to rise before five in the morning and then devote two hours to prayer and spiritual reading. In an interview with Kim Shippey, a Christian Science writer, in 2000, he offered more detail: “I read a chapter from the Old Testament and one from the New Testament, and inspirational works by many other writers.”

But Fred Rogers did not conclude his devotions after his morning session. “All day long I offer prayers of gratitude to God for God’s goodness,” he told Ms. Shippey. “I’ll be driving along and I’ll see something and I’ll just say, ‘Thank you, thank you, thank you.’”

Of course this Presbyterian minister was well schooled in the Bible. In his seminary courses he had received training about the sacred scriptures of the Jewish and Christian faiths. But not everybody who studies scripture makes it an integral part of his or her lifestyle. Fred Rogers internalized it so that the Bible fed his soul each day.  

What always impressed me about Mr. Rogers was the love he manifested toward each child who appeared on his program and each child in his television audience. Making the kid feel good about who he or she was went far beyond mere self-esteem therapy. For Mr. Rogers it was a recognition of the human being as God’s handiwork.

Subtly Fred Rogers was doing his own form of ministry. In the television age he had discovered a new way to extend the Lord’s good news to the children of America. No wonder that the day after he died, the student newspaper at our local  university reported that students were mourning his loss.  

When they were growing up, most of them at least, this television personality had been one of their most familiar teachers and they now missed him. It’s true that most children would outgrow him. At a certain point in their development some would become embarrassed if caught still watching him. But later on they might  recognize the unique contribution he had made to their lives.

That contribution rests on the skillful way he taught them the most important things about life. He was an educator in the classic sense of someone who was committed to inculcating values, rather than just facts. What a contrast he made with the Saturday morning cartoons that were typical television fare for so many children!

One of the values most prominent in his programs was human diversity. By treating everyone with respect, no matter their color or origins, this man taught children and other viewers, whatever their age, that each human being deserves to be treated with respect and love.

Yes, many older people watched “Mr. Roger’s Neighborhood.” Of them, he told his interviewer: “There are those who have said to me, ‘I watched your program on such-and-such a day, and you said exactly what I needed to hear.” And I look back at the videotapes and find that wasn’t what I said at all. I think people hear what they are spiritually ready to hear.”

Others may wish to quarrel with me but I believe Fred Rogers to have been a saint for our times.

Richard Griffin

Dona Nobis Pacem

Never had the familiar words struck me with such force as they did at a concert last week. Those Latin words “dona nobis pacem” (grant us peace) come at the end of Beethoven’s Missa Solemnis and express a request for a gift needed at every stage of history.

This prayer rang out even more eloquently than usual at this time when war once again so menacingly looms before us.

This petition  for peace had a special impact on me because it was sung by a combined chorus of some 200 college students. Massed on the stage of Sanders Theater behind a professional orchestra, the youthful singers gave eloquent expression to my own desire for peace and that of many other people around this country and, indeed, the world.

In my 75th year, there is nothing I hope for more ardently for my own daughter and others in the rising generations than for them to live in peace.

Beethoven himself lived in a time of armed conflicts that roiled the countries of Europe. When his Solemn Mass was first performed in 1824, listeners would have been reminded of Napoleon’s recent invasions of Vienna where the composer lived.

At the beginning of the words “Dona nobis pacem” in the score, he inscribed German words translated as “Prayer for inner and outer peace.”  This heading showed his understanding of the spiritual meaning of peace as well as its external manifestations.

This winter has brought us all a turbulence that strikes me as different in character from any I have experienced in a lifetime of ups and downs. Andrew Delbanco, a Columbia University professor of literature, in a recent talk, referred to these months as “a time of great darkness and pessimism.”  That is what I hear from many people encountered on my daily rounds.

This period perhaps could also be called a “phony war,” evoking the October 1939-April 1940 waiting period before World War II heated up. We feel ourselves on the edge of a crevice, ready to leap over or disastrously fall in.

Many people, now senior, grew up believing in the adage “there is nothing new under the sun.”  By now, we know better. The current time of tension stretched out over many weeks is unique in our experience. Some 250,000  warriors ready to spring on Iraq, intense diplomatic struggles at the United Nations, continued erosion of personal savings, and much more, mark this as a period that tests the inner resources of just about everyone.

I also bemoan our decline in representative government. How, for instance,  can the president promise some 30 billion dollars to Turkey without any debate in the Congress that has the responsibility to appropriate major expenditures?

Is not the veteran senator, Robert Byrd of West Virginia, right to bemoan the silence of the senate at a time of such crisis? “There is no debate,” he lamented, “ no discussion, no attempt to lay out for the nation the pros and cons of this particular war. There is nothing.”

The thunderous silence on the floor of the senate in the face of decisions that may affect our national well-being and will determine our nation’s place in the world troubles me. Our representatives ought to be debating the wisdom of alternative courses of action.

I find the conduct of our federal government profoundly disturbing in other ways as well. Though it is delicate to question personal religious practice, the strong reliance of the president on religious motivation, something he himself talks about, especially bothers me. As a person to whom religion has loomed large over a lifetime and continues to do so now, I have learned how hazardous it can be to interpret a particular course of action as willed by God.

To justify the use of massive force against Iraq, the president puts faith in “regime change” and the creation of democratic rule. A  new government in Baghdad will supposedly serve as a model inducing other Arab nations to change their ruling structure. What a utopian plan built on wishful thinking!

But, in case you don’t like that scheme,  he comes up with alternative rationales as occasion requires. No one of them justifies an assault on Iraq without the backing of the UN. That is the conviction of most spiritual leaders of the world, including those of my own tradition.

I have chosen to write about the threat of war this week because of feeling torn by it. In doing so, I assume that many other people of my generation feel the same way. Even those of us blessed with long life have never previously experienced quite this set of circumstances. We have survived many other crises but this combination is different.

“Grant us peace” remains my prayer, along with the hope that our nation will find paths leading  to the well-being of our own people and peaceful  solidarity with the other nations of the world.

Richard Griffin

Sarceaux Father

One morning last month, if you had been in the village of Sarceaux in northwestern France, you might have seen a man named Olivier, 33 years of age, placing in the mailboxes of townspeople a sheet of paper with a shocking message that he had composed on his computer.

The message angrily told what it was like to grow up the unacknowledged son of a Roman Catholic priest. For his whole life almost up to that point, everyone had considered him fatherless. On his school identification papers he had always written “Father’s name: X,” as was customary for children of  unknown paternity.

In 1989 he had discovered his father’s identity.  However, he did not feel free to discuss the matter until this past January when his mother went on television and talked openly about her 40-year relationship with a priest whose name she did not disclose. Several times previously, she had talked about it on television, but anonymously.

Now, with the backing of his mother Françoise, Olivier had decided to reveal his father’s name to the residents of Sarceaux.

His father, it turns out, is Jean Mabille, now 80 years old and the parish priest of Sarceaux. In addition to his son, he also fathered two other children by Françoise, sisters younger than Olivier. Since the end of last year, the priest has also been a grandfather.

When they first came together, Françoise was only 16 years old and the priest was 25 years her senior. When Olivier was born, he says, he could not have acknowledged his paternity but he promised his bishop not to see Françoise again. He managed to keep this promise for 13 years but the couple ultimately came together again.

After keeping her lover’s identity secret for so many years, Françoise finally decided to expose the father of her children. The Paris newspaper Le Monde, which recently reported the story, quotes her as saying: “I would be remiss to wait till he was dead before witnessing” to what the priest had done.

Now that the news is out, the local church has had to take action. The bishop of Sées, with the backing of his diocesan council, has told Jean Mabille to acknowledge his children. Through the years, the priest has been giving some money to Françoise for the children’s support, but this new requirement goes further in requiring him to go public.

In general, Francoise does not feel bitter against her quasi-husband. However, she has one complaint, namely that “he shares the joys and sorrows of other people but not ours.” She was baptized as a Catholic but now is an agnostic.

People in Sarceaux appreciate their pastor, one recalling how he comforted her when her father died. There also seems to be widespread feeling that priests should be allowed to marry. “A pastor is not a stick of wood,” says one man. Listeners to a call-in radio program said, in essence: “It’s better for a priest to produce children than to be a pedophile.”

His son feels thankful at not having to appear a half-orphan any longer. Were he still a schoolboy, he would not now have to mark his father’s identity with those humiliating X’s. Olivier has been in touch with the bishop by both  telephone and email. The prelate admits that there’s a basic underlying question connected with the story–the celibacy of priests.

How the daughters feel, Le Monde does not tell us. It would not be surprising to find them identifying with their mother and what she has been through in this longtime affair.

The advance of age can bring surprises, some of which can be quite unsettling. The situations of Jean and Françoise, she only 56, he 80, surely differ between them. And having unfolded in such a small community, this crisis has an especially dramatic edge.

I wonder how the pastor feels about having been exposed at his advanced age. Perhaps he has been fearing the revelation just now made by his clandestine sexual partner. Or maybe he had confidence that, after so many years, the secret would never be revealed.

As a psychiatrist friend has suggested to me, this crisis in Jean’s life can be seen as a rich opportunity for a spiritual breakthrough. Confronted with the public knowing about his illicit liaison of years past, he can now accept the consequences of what he did and reach out to his children and their mother with love and sympathy.  Whether he feels in inclined to do so, however, seems doubtful, at least if the newspaper reports are accurate.  

The best index of his current feelings may be his reported failure to telephone Françoise since the time when she went public. The bishop wants him to acknowledge his wife and children, but he apparently shows himself more distant from her than formerly.

Further details about the story are available online in French editions of both Le Monde and Figaro.

Richard Griffin

Soul’s Week

Following my usual practice, I have reviewed the events of the past week for spiritual meaning. As I survey my calendar, the last few days of February turn out to have been rich in happenings relevant to the life of the spirit.

The full meaning of these events would probably have escaped my notice, however, unless I had taken pains to sift them for what they say to my soul. Like elusive fish, their meanings would have escaped my soul’s net if I had not cast it more widely and deeply.

The first of these events was the funeral of a man whom I did not know well. However, I felt personally connected with him because he was the father of an old friend. When she recounted for me the circumstances of her father’s dying, I felt all the more tied to him.

Bill shared many of my values, including a love of opera. And he did not die that Saturday afternoon until the radio broadcast of the Metropolitan Opera’s production of Don Giovanni, to which he had been listening, had concluded. For a rabid opera fan of many years, what a way to go!

More seriously, he also did not die until the arrival of his other daughter, who had come home from France and reached the hospital only a few minutes before her father’s departure from this world. That was a dramatic arrival, perhaps made possible by Bill’s managing to delay his own death. In any case, it served as a consolation to all the members of his family gathered around.

Seeing the box of his ashes before us gathered at his funeral, I felt touched, as always, by the mystery of it all. Never having lost a childlike wonder at the way people pass from this life, I continue to feel stirred to ask questions. How can the rich complexity of a person’s physical and psychic life be reduced to this small material scope? Despite what lies before us, I believe that ultimately it cannot, but that life will be restored in a new way, difficult to imagine.

The second event that I continue to ponder is an informed account of President Bush’s religious faith. Evan Thomas, a distinguished editor and writer  at Newsweek, told how the president reads the Bible every day. And he prays to God with steady fervor. In fact, Mr. Bush “has a pretty close relationship with his maker,” the editor reported.

The religious component looms large in the president’s hard line against Saddam Hussein. President Bush apparently believes himself called by God to the mission of toppling the Iraqi dictator. He takes it as a duty sanctioned by the Supreme Being to bring down the enemy.

I find this approach of our country’s leader to be deeply problematic and personally troubling. Leaders in my spiritual tradition, from the pope to many other bishops in this country and around the world, constantly brand the proposed war as unjustified. They believe it does not satisfy the basic requirements for a war to be morally valid and warn of its consequences to the people of the world.

A third event of his past week for me was seeing the film “The Pianist.” Marvelously well made by Roman Polanski, this movie presents an agonizing account of the German army’s murderous assault against Polish Jews in World War II. I often found it difficult to watch the brutality of soldiers against the civilian population, one of the many mass atrocities of the 20th century.

This imaginative experience raised for me again the mystery of evil. How can it be that we human beings treat other members of the human family outrageously, simply because of racial, religious, or ethnic differences? And for Christians to mistreat people who share the Jewish heritage of Jesus makes no sense whatsoever.

These three events, all of them raising difficult issues, brought me up close to mystery. The death of one person, the religion-supported decision to wage war, and the horrific portrayal of human degradation and slaughter, has confronted me with the reality of our human situation.

These issues provide much to reflect upon and to pray over. They challenge hopeful attitudes toward the world but can also be seen to underline the value of a deeper spirituality.

Richard Griffin