(c) Doug Slagle, Minister to the Gathering at Northern Hills, All Rights Reserved
Most of you know that I’ve spent the past few weeks with my family in California as we watched my father slowly, and often in pain, slip away. My dad suffered a stroke that we were told was not only survivable but one from which he could recover most of his abilities. Unrelated complications to his treatment, however, began to occur. After he was l placed on a ventilator and began having seizures, my siblings and I made the emotionally difficult decision to end life support and his suffering. Very quickly he crossed the line separating living from dying.
A Palliative care team with a doctor, nurse and social worker surrounded him and us. Everything possible was done to minimize evidence of medical intervention.
After the ventilator was removed, his breathing quickly changed. We gathered around him, held his hand and poured out our love and assurance that he would soon be comfortable. We told him we were ok, that he’d been a good dad, and that we would take care of our mom. Within an hour of our decision, he breathed his last. He went quickly and peacefully.
Since he passed, the time he was in the hospital, and his death, seem unreal to me and like a bad dream. I haven’t felt myself and still don’t. Did I really witness him go through that? Is he really gone?
These past few weeks I’ve spent lots of time thinking about death and, more importantly, about living. I’ve concluded that at the end, it’s vitally important that one is fully at peace – physically and mentally. Indeed, I realize even more than I did before that dying should emerge from the shadows in which our culture often keeps it. We do our best not to think about death even though it is as fundamental to life as is birth and growing up. We fight mightily against death – devising expensive and often painful procedures to hold it off – even though such interventions often prevent or delay its gentle and natural occurrence.
Much like birth is a joyous introduction, death should be a gentle conclusion. The dying of a loved one ought to end for us much like we finish a good book. Yes, there are no more pages to turn. Yes, we put the book up on a bookshelf. But the lessons, the memories, the joy, the entertainment, the values, the inspiration we gained from someone’s life – they all continue. We don’t fear a book’s finale, nor are we depressed when it arrives. For every beginning, for every story, there must always be an end. Unfortunately, that’s not how we often think about death.
Another lesson I’ve learned from time at the edge of my dad’s life is that how we die is determined by how we live. Leonardo da Vinci once said that as happy sleep comes at the end of a fulfilling day, a happy death comes at the end of a meaning filled life.
My dad’s final days, however, were not very happy. Doctors fought hard to save him and he went through a lot of pain and suffering as a result. In retrospect, it all seems so needless. Much of that is because my dad avoided the topic of dying when he was well. As a doctor, he was strangely quiet when faced with a terminal patient. He was otherwise an outwardly confident and boisterous man. But death frightened him, and so he did not talk about it. When death suddenly loomed for him, we did not know what he wanted – to fight hard against the dying of the light, or to go gently into the good night.
Fortunately, however, my dad must have evolved his thoughts about dying within the last few months. This last March he told me that he could not make the decision to end my mom’s life when she becomes terminal. After 59 years with her, that decision would be too hard for him, he said. Such a statement revealed how much he loved her – something which he rarely revealed. But the important thing for me was that dad finally talked about death. He was thinking about it.
Two days after his stroke my dad told my brother that when a person’s time is up, it is simply up. That matter of fact assertion is further proof to me that dad had evolved. No longer were thoughts of dying to be avoided.
Later still, only hours before he was placed on a ventilator, he looked intently at me and said, “Let’s end this. I don’t want to be a burden to my family.” While my siblings and I later debated those words and if he was able to understand what he said, they were added evidence my dad stood at the edge of life and thought not of himself or his fears, but of my mom, me and my siblings. Dying would not only be a relief to him, but he wanted us to be relieved as well. His words helped us later understand that he was was at peace about dying. When we reluctantly realized he’d had enough, we were able to lovingly give him his last wish.
What I’ve learned, though, is that we need to make our wishes about dying clearly known before we reach that edge. I’ve also learned that in order to die well, we need to evolve throughout life to reconcile relationships and be at peace with others. Fortunately, my dad did that.
He and I had a complicated relationship. I know I am not the son my dad would have preferred. I’m not macho, a so-called jock, a man’s man. I’m introspective and often quiet. My dad was the exact opposite – often speaking with a loud, boisterous voice. He usually filled a room with his presence. He liked the rough and tumble sports of football and basketball – and he was good at them. As a doctor, he was the epitome of a surgeon – self-confident and a bit arrogant. I once playfully teased him with a joke – “What’s the difference between God and a surgeon? ……God knows he’s not a surgeon.”
When I came out as gay eleven years ago, dad was clearly disappointed. I had confirmed his lifelong fears about me. He had often made fun of gay men – affecting a limp wrist or telling vulgar stories about them. Those hurt me and their memories can still sting.
I think in many ways his attitudes toward me led me to deny who I am when I was younger. I wanted to be the kind of man my dad could admire. My inability to accept that I was gay, however, was not all his fault. At some point in life we must take responsibility for ourselves and not blame others.
Even so, I used to be angry with my dad. At one point many years ago, I broke off my relationship with him and told him he could not see my daughters. If he thought it amusing to regularly make fun of me, then he could not enjoy his granddaughters. That was a cruel and immature response on my part. I regret it a lot. But it led my dad to appear at my door three months later. He came in, fumbled for words, and apologized. I immediately accepted his apology and offered my own. Just before departing, he turned to me and with a catch in his voice, told me for the only time in my life, that he loved me. I value that memory a lot.
My dad showed other evidence of evolving several years ago. He began to listen to my thoughts and opinions. He showed me new respect. Perhaps my courage to come out impressed him. Still later, he was kind and welcoming toward Keith. Last September when Keith and I visited my parents in California. I was impressed at how open and communicative my dad was with Keith. He fully accepted him as a part of our family and thereby, I think, he fully accepted me.
As my dad evolved, I evolved too. One thing I’ve learned is to let go of past hurts and forgive those who have hurt me – especially family members. I mentally made my own peace about dad several years ago. I’ve always loved him but I evolved to be able to also like him simply for who he was.
It’s a truth that has stood the test of time – when all is said and done and one nears the end of life, it’s family whom we want nearby. Forgiveness, empathy and old fashioned love triumphing over hurt and past wounds are what helps insure that at the most sensitive time in life, families are united.
As I said earlier, in order to die well, one must be explicit in telling others what your wishes are for when you are seriously ill or near death. Some want to fight their illness no matter what. Others value quality of life versus quantity of life. If quality of life will be severely compromised, some people often want all treatment to stop.
Living Wills are helpful but they are limited in scope and written for when a person is clearly beyond hope of recovery. Experts indicate one should consider preparing instead a statement of five end of life wishes. I’ve listed those on the back of your programs along with the website. Who do you want to make health care decisions for you when you can’t? What kinds of medical treatments do you want, or not want, if you are severely ill? How comfortable do you want to be when you are very sick? Medications are used to keep people comfortable but they can compromise treatments. How do you want people to treat you near the end of life? What do you want your loved ones to know when you are near death?
These are questions I wish my father had answered when he was well. They would have made the decisions my sibling nags and I made easier.
One of the seven Unitarian Universalist principles states that every person should be treated with dignity. For me, that must include dignity at the end of life. Medical science has many tools available to keep people alive, and the first instinct of most health professionals is to do exactly that. Their mindset is guided by our culture which insists that death should be avoided at all costs. But a compassionate approach to life should also include a compassionate approach to death. I believe most people value quality of life over quantity of life. We must insure that each person has a reasonable quality of life – and when quality is greatly reduced or cannot be recovered, natural death ought to be encouraged.
Approximately ten years ago the World Health Organization endorsed what is called Palliative Care for the very sick and dying. It is, “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering.” This is done by addressing the physical, emotional and spiritual needs of a patient during the end of life process.
Fortunately, such a Palliative Care team works at the hospital in which my father was treated. They were simply wonderful.
The most important lesson that was reinforced for me, however, is what I said earlier. How we die will almost entirely be determined by how we have lived. Make your end of life wishes very clear, write them down and communicate them to whomever you’ve asked to represent you. Find in your heart the ability to make peace with yourself and all family members and friends. Forgiveness is a gift not to an offender, but to yourself. We should each exit life full of love for everyone – whether or not they have hurt us in the past.
Our sense of well-being when we die will also be determined by a sense that death is not our true end. No matter what one believes, or doesn’t believe about a literal afterlife, we live onward in the things we do now. How much love have we put into the world? How have the lives of others – and of future generations – been improved because we lived? What are the legacies of service and generosity we leave behind that will echo long into the future?
My dad volunteered with Operation Smile, an organization that sends surgeons to repair cleft lips and palates in children free of charge. I accompanied him on one of those trips about fifteen years ago and I helped facilitate my dad’s surgery on one 11 year old boy. He was very shy, very reserved and timid. His father told me other kids teased him about his different appearance. My dad’s surgery on the boy was successful and when I returned to Belize a year later, the boy had markedly changed in personality. He was happy, more talkative and clearly more confident.
I thought of that boy in the past few weeks – a boy who is now a man, perhaps married and raising children of his own. My dad impacted that boy’s life in a significant way but he also indirectly affected the lives of that boy’s future wife, or husband, and his children. Echoes of my dad’s generosity and compassion thus extend outward in many ways. Those affected will never know my dad’s name but he nevertheless lives onward. That’s one of his resurrections. That is one of his after-lifes.
I deeply pray that each of us, when our time comes, will go gently into that good night – knowing we move into eternity at peace with our life legacy, at peace with death and how we die, and most importantly at peace and in love with everyone.
