Saturday, May 16, 2020

From the Palliative/Spiritual Care Bookshelf

Most people familiar with The Wild Reed would know that I work as a spiritual health provider (or interfaith chaplain) at a hospital in the Twin Cities' north metro. I'm the hospital's palliative care chaplain, which means I'm part of the palliative care team, one which also includes a physician, five nurse practitioners, and a social worker.

Palliative care is a specialized field of care that involves symptom management of chronic and/or terminal illnesses and end-of-life support and care. In my work as chaplain in this field, I endeavor to be for patients and their families a grounded, compassionate, and listening presence. In this way I accompany them on a journey of meaning-making (religious or otherwise) within the context of the incredibly challenging and often frightening situations that they're dealing with.

Tonight I thought I'd start a new series, one that draws from the contents of the many books on palliative and/or spiritual care that I have on my shelf at work. It seems appropriate to commence such a series with an excerpt from an anthology that's considered a classic in the field: Dying Well: Peace and Possibilities at the End of Life, edited by palliative care physician Ira Byock. Byock also serves as the chief medical officer of the Institute for Human Caring, and some of his other books include The Best Care Possible and The Four Things That Matter Most: A Book About Living.


Many of us have come to realize that death and dying are no mere abstractions. We have taken care of a grandparent or a parent who was dying. Some of us have helped care for a dying sibling, others of us have lain beside a dying spouse. Some of us have even cradled children as they died. And some will be reading this while facing, as we all will, death itself.

Through my years as a hospice doctor, I have learned that dying does not have to be agonizing. Physical suffering can always be alleviated. People need not die alone; many times the calm, caring presence of another can soothe a dying person’s anguish. I think it is realistic to hope for a future in which nobody has to die alone and nobody has to die with their pain untreated. But comfort and companionship are not all there is. I have learned from my patients and their families a surprising truth about dying: this stage of life holds remarkable possibilities. Despite the arduous nature of the experience, when people are relatively comfortable and know that they are not going to be abandoned, they frequently find ways to strengthen bonds with people they love and to create moments of profound meaning in their final passage.

As a [palliative/hospice care provider], being present as someone is dying tears the boundaries between the personal and professional realms of my being. The experience of a patient dying challenges me to accept a more intimate, and yet more deeply respectful, relationship with that person. I do not know how it could be otherwise. While I may bring clinical skills and years of experience to the task, ultimately I am simply present, offering to help and wanting to learn.

Over the years I have learned that the actual range of human experience of dying is broad. I have seen tremendous suffering, but I have also witnessed people who in their dying experienced a sense of wellness and peace that can only be called blissful. . . . [Sharing these types of stories is] the only satisfying way I know of exploring the paradox that people can become stronger and more whole as physical weakness becomes overwhelming and life itself wanes. . . . We can grow stronger within ourselves and closer to those we love as we confront the challenges of dying with honesty, caring, and commitment.

– Ira Byock, MD
Excerpted from Dying Well: Peace and Possibilities at the End of Life
pp. xiii-xiv


See also the previous Wild Reed posts:
Chaplaincy: A Ministry of Welcome
Interfaith Chaplaincy: Meeting People Where They're At
Spirituality and the Healthcare Setting
World Hospice and Palliative Care Day
Resilience and Hope
The Calm Before the Storm
George Yancy on the “Unspoken Reality of Death”
Arthur Kleinman on the “Soul of Care”

Related Off-site Links:
In Pandemic, Health Care Chaplains Address an “Existential and Spiritual Crisis” – Alejandra Molina (Religion News Service, March 20, 2020).
Hospital Chaplains Bring Hope and Solace to COVID-19 Patients and Staff – Lulu Garcia-Navarro (NPR News, March 29, 2020).
It's Time to Get Serious About End-of-Life Care for High-Risk Coronavirus Patients – Jessica Gold and Shoshana Ungerleider (TIME, March 30, 2020).
Learning to Cope With the Pandemic From Palliative Care Patients – Rob A. Ruff (, May 8, 2020).
Our Crash Course in Being Mortal – Ira Byock (Goop, May 2020).

Images: Michael J. Bayly.

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