A sermon by a guest preacher, March 21, 2010
Psalms 23
[Our guest preacher is the Rev. Larry Greer, Pastoral Coordinator and Chaplain at Hospice of Southern Maine]
Thank you for inviting me today to speak and be present with you. I do have the honor and privilege to serve as the Pastoral Care Coordinator and Chaplain for HSM. We are in the midst of Lent and what a better time to think about death because Lent is a time to go within to soul search, reflect and take stock of our lives. Some of our sister traditions use Lent as a time to give up something and I think today as we speak about the uncomfortable topic of dying we also look to the message from David in the 23rd Psalm. When we feel alone, that God is not with us–when our heart is filled with dread about life or about death–we can take to our heart the message of the 23rd Psalm, “The Lord is my Shepherd.” God is love. God casts out all fear.
Today I would to try and take us through a very short sort of a hospice 101 and then invite you to bring your questions and thoughts to a gathering after worship today.
Hospice is a special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments. Whew! What does that mean? Well lets look at what happens when one gets a prognosis that you are dying. If I were told today that I three months to live… well today is March 21st April 21st May 21st and June 21st. It means that even if I live longer than my appointed 3 months last Christmas was my last one and I didn’t even know it. It means that I will not go to the 4th of July parade or family cookout. It means that the seeds I have saved from last summers garden and the new seed I have purchased in anticipation of that garden will not be planted, tended or harvested by me. It means that what I had planned to do is gone. Right in the middle of my life I hit, what one of my professors, Dr. Kathleen Rushnak, coined as the brick wall. We hear words like malignant, metastases, no longer respond to treatment, referral to hospice and our world stops. This brick wall stands right in front of us like an insurmountable obstacle.
Hospice provides patient-centered palliative care for individuals who are terminally ill and combines emotional, spiritual, and social support with expert medical and nursing care. Hospice neither prolongs life nor hastens death. The goal of hospice care is to improve the quality of a patient’s last days by offering comfort and dignity. Every Wednesday morning the Interdisciplinary Team meets to discuss our patients and families. This Team is made of the R.N. case manager, Home Health Aide, Social workers, Chaplains, Clinical manager and supervisors and the medical director. Hospice addresses all symptoms of a disease, with a special emphasis on controlling a patient’s pain and discomfort. In our team approach we recognize that pain is not always physical and we help with the emotional, social and spiritual impact of the disease on the patient and the patient’s family and friends. Dying is hard work. It is hard emotionally because as we say good bye to our loved one our loved one is saying good bye to all of us. It is hard physically as there will be pain and suffering. It is hard spiritually as the very meaning of our lives is called into question.
Hospice offers a variety of bereavement and counseling services to families before and after a patient’s death. Hospice of Southern Maine has over 140 trained professional volunteer who are an integral part of our patient care.
My chief responsibility at HSM is to serve as a spiritual companion and counselor to our patients, their families and also to support our staff.
It has been my experience that the best pastoral care for the dying is based on presence, the ability to “be” in the moment without agenda or judgment. I like to think of the hospice chaplains as the jazz musician; one who hears the beat and does not try to change the beat but joins in and takes the beat to a deeper level.
Even though I know I have educated myself very well on the topic of death and dying, much of what I have learned about being with the dying is through the actual practice of ministry at the end-of-life. I draw my strength from the many great “teachers” who have allowed me the opportunity to “be” with them in their final days.
Often when I arrive there can be many misconceptions about who this chaplain is and what kind of agenda will he appear with. There is a very funny story that sometimes happens. When I arrive I am greeted by the family who whisper they want to talk in the drive way. We move like the cartoon all in a mass to the driveway. They whisper, “Dad is in his room, he‘s dying. He doesn‘t know and we don‘t want him to know.” We then we will move again in mass to the bedroom where we have a grand ole time telling stories and laughing and dad will say, “I want to talk with Larry.” The family leaves and dad says, “I’m dying, they don’t know and I don’t want them to know.” It is a amusing story but we miss so much when we hide and are not open with our feeling and relationships especially at end of life.
Many will begin our conversation with the statement, “Well, I am not very religious.” To which I reply; “Well, I’m not either.” There is a beautiful poem by Hafiz a thirteenth century Sufi master that I will often quote to begin our time exploring who and where is this Divine Being we sometimes call God. the poem is titled:
The God Who Only Knows Four Words.
Every child knows God
Not the God of names,
Not the God of Don’t,
Not the God who ever does anything weird.
But the God who only knows four words
And keeps repeating them,
“Come Dance with me.”
“Come Dance with me.”
Sometimes folks dance with God in their religious faith. Sometimes they dance with God in nature. Sometimes they dance with God with family. I work hard to remain open to however the Divine may manifest for this family because hitting that wall causes a shift to take place in reality. It separates life before diagnoses from life after.
20th Century German philosopher, Martin Heidegger says that events like death–knowing we are going to die– causes a shift within us from the “forgetfulness of being” to the “mindfulness of being.” You know there are two worlds I work in; the world of the living and the world of the dying. Whether it is politically correct to refer to the worlds in this way it is the truth. We as the living do not know that world of the dying. We do not think of our own deaths; too often we can get caught up in the forgetfulness of being. Our culture lulls us into that forgetfulness state of being. We think that what ever more we can have will bring us happiness. If I can just get a boat, if I just had a canopy for my boat, if I just had a bigger boat.
The dying know who we are because they use to be us. They know what we are doing at 5 p.m. while they are laying in their beds. We are living our lives, making dinner, planning, making our lists of “to do” for today, tomorrow, and next year. The “forgetfulness of being” is the routine we live in. When a person learns they are dying a shift takes place in their being. They move from the forgetfulness of being to the mindfulness of being. This is a spiritual shift. It is spiritual because the questions and thoughts are now existential in nature. Who am I? What was my purpose? What did I do with the time I was given on the earth? How did I use the talents God gave me? Did I love? Was I loved? Will I be remembered?
When a person finds out they are dying they find the future they had filled with colorful plans, dreams, and goals is an empty slate. The dying have small futures. It may be ten days, two weeks, or several months, but theirs is a future qualitatively different and extremely more intense than the future of people in the world of the living. The impending loss of one’s own life, the loss of one’s deepest expectations about life, its meaning, its purpose, how it works, how it should be, is the spiritual conversation that ensues, whether it be within one’s own self or with others. The act of dying is the most powerful spiritual opportunity of a lifetime! This is the moment when the 23rd Psalm can for me become most meaningful and comforting. The Lord is my shepherd. I shall not want. The Lord is my shepherd. I have everything I need. A shepherd is a protector, a provider of food, shelter, and care that all his flock stay close and are not lost. He is everything to the sheep and is usually the only individual that they see for long periods of time. A relationship forms between shepherd and sheep. They come to depend on him for everything and he provides it for them because he cares what happens to them. He leads the sheep into places where they can rest and feed, and where they can drink.
Our western culture teaches more is better. You have seen the bumper sticker “the one with the most toys wins.” We live in a world in which many, if not most, people are engulfed with fear and anxiety. Some fear the future; they’re anxious about what’s going to happen. Others fear the past and they’re anxious about what has happened. And still others fear even the present, anxiety has gripped their souls and they cannot imagine how they can cope with the ugliness of present circumstances in their lives. Thousands of people each day wake up with untold burdens to bear and anxiety with which they must deal. The message of the Twenty-Third Psalm is that we are never alone. The point of the Psalm is God’s faithfulness to us.
I don’t know how much you know about sheep, but my father-in-law was in the sheep business and over the past 30+ years I have learned more about sheep that I would ever need or want to know. I did learn that sheep are not too smart and actually have to be lead to water and still waters; they will not drink from a fast moving stream and they need to be moved to greener pastures. We are a lot like those sheep. We need direction. We need the key to the golden handcuffs of our material possessions to remember that God is our shepherd and we have everything within us to succeed. To remember that God will be with us both in our living and in our dying.
I invite you to just breath with me for just a minute and as you breath in breath the words, “The Lord is my shepherd.” And as you breath out breath out the words “I have everything I need.” I invite you to use this breath meditation as you walk through the rest of Lent and through the rest of our lives so that at the end of our lives we will know that God is just a breath away. We will know that we are not alone… Together we kneel. Together we walk, holding one another’s hand, holding one another up. Together we do love’s work and God will be there as the ground of our very being.