5 of 5 in series by Sarah Moon

In a more obscure novel, Death Comes for the Archbishop, renowned American novelist and Pulitzer Prize winner, Willa Cather, tells the tale of historical figures Jean-Baptiste Lamy and Joseph Machebeuf. These figures were missionaries in the New Mexico Territory in the late 1800s. Bishop Latour, the fictionalized name of Jean-Baptiste Lamy, travels through the territory ministering to all he encounters, whatever their circumstances. The novel spans his entire career and ends with his death. One passage captivated my heart and mind upon first and subsequent readings of the novel:

During those last weeks of the bishop’s life, he thought very little about death; it was the Past he was leaving. The future would take care of itself. But he had an intellectual curiosity about dying; about the changes that took place in a man’s beliefs and scale of values. More and more life seemed to him an experience of the Ego, in no sense the Ego itself. This conviction, he believed, was something apart from his religious life; it was an enlightenment that came to him as a man, a human creature. And he noticed that he judged conduct differently now; his own and that of others. The mistakes of his life seemed unimportant.[1]

Throughout this blog series, I have tried to keep readers in a contemplative mindset as they approach the physician-assisted suicide/Medical Aid in Dying (MAID) debate. To allow Cather’s words to soak in, read that passage one more time.

“The future would take care of itself.” Bishop Latour is a man who knew his identity as a beloved son of God. A son that would meet his Father once he died. So, he fixed his gaze on life and creation. Through this contemplation, the bishop was able to have more mercy for others and grew in empathy as he suffered.

Death is the moment our souls meet the Lord; whereas dying is the experience one has in the moments leading up to death.[2] These moments could be mere seconds to what seems to be excruciatingly long days.

The healthcare industry throws endless options for hospice, pain relief, and mode of death. The shortcoming with all of these options is that they all revolve around bodily suffering and healing. The healthcare industry has greatly neglected the need for spiritual healing while dying. This isn’t to say it isn’t ever mentioned, but rather the spiritual needs seem to be the last thing mentioned. The item in a list that is just placed there to make the list seem long and comprehensive.

But why such a disconnect with the meaning of death and how to best prepare for it? The Catechism of the Catholic Church is explicitly clear when it says, “The Christian meaning of death is revealed in the light of the Paschal mystery of the death and resurrection of Christ whom resides our only hope”.[3] The short answer is if palliative care specialists and policymakers do not start with an understanding of Christ’s passion, it is difficult if not near impossible to make any substantive headway in palliative care improvements.

There is a medieval Christian text called Ars moriendi (Latin for “The Art of Dying”) that was given out during bubonic plague outbreaks to help people prepare for death if priests were in short supply.[4] This text had nothing to do with medicine or pain relief in the way Americans would understand it, but rather it was focused on preparing the soul for the moment of death—the moment a soul meets the Lord. What if, in today’s world, we took a page out of the Ars moriendi and flipped the list to start with the spiritual needs of the dying rather than the bodily needs? What if the first call for someone in their last hours in the hospital was to a priest for Confession instead of more morphine? What if the nourishment of the soul was prioritized over the nourishment of the body? To shift palliative care to prioritize the soul’s preparation for death and then address the body’s needs requires a major cultural shift in how society views our own bodies, and it isn’t going to come from political speeches or doctor’s orders. Now, I’m not suggesting we neglect physical needs, but rather I am suggesting that we reframe our first principles so that our second principles are ordered and appropriate in caring for the dying. It is going to come from the conversion of individual hearts. It is going to come from experiencing the dying of others and preparing yourself for your own death. I see three realities come to life during the intimate and tender last moments of someone’s life– the spiritual battle that occurs while dying, the encounter of grace during those final moments, and the communal nature of the dying process.

Spiritual Battle

St. Augustine laments in his Confessions, “Thou hast made us for thyself, O Lord, and our heart is restless until it finds its rest in thee.”[5] Augustine understood that this earthly life was a steppingstone rather than a final home. This is an important ordering needed to fully embrace the questions surrounding dying. If a person understands the telos (Greek for “end”) of their life in this manner, they can better see the purpose of suffering and the process of dying. They will also have clarity on the spiritual attacks to expect in these final moments. If death is the moment the soul meets the Lord, then it is a realistic assumption that the Devil would be present, making a last-ditch effort, to steal souls.[6]

Encounter of Grace

With any battle, there must be opposing forces. With a spiritual battle, there is the Devil and there is God fighting for your soul. The act of dying it’s not simply reduced to a desolate war zone but also a place to encounter God’s grace. An encounter of grace is the intervention of God in this world. There are moments of grace throughout most novels, but I would argue that they are most obviously present around times of death. If dying is the Devil’s last-ditch effort, it is also God’s. It’s an opportunity for people to have their hearts converted. The thing about encounters of grace is that one must accept the invitation of grace. God will never force himself upon people, and if there is much suffering and pain present in the dying person, these encounters of grace can be easily missed or ignored.

Communal Nature

This brings me to my final reality of dying which is that it is a communal event. Life on earth is communal, so why wouldn’t the final moments of said life, the moments of dying, be communal? Humans learn from each other and being with dying people helps others learn about the experience they will face someday. Albeit the details of their death may vary, the preparations for the soul to meet the Lord should be similar. However, humans only learn how to prepare for death by experiencing it in some tangible way. Do we see and encounter dying people though? More and more Americans are dying in hospice care or the hospital with doctors and nurses around instead of family. As affluence increases so does the amount of elderly in care facilities. Many of today’s elderly are not being taken care of by their families in the home with their children and grandchildren. I assume good will with this decision. Most people do wish to take care of their parents and the elderly. There are circumstances where external and specialized care like hospice is necessary. However, the decision to outsource care has become the rule instead of the exception. One of the unintended consequences of this is that less people are seeing the dying process. They are not taking part in this intimate moment in a person’s life.

Death is not something to fear, but rather it is something to embrace by preparing properly. For Christians, this means putting on our armor as we enter our final spiritual battle right before we meet our Lord because death is not the end—rather the beginning. Scott Hahn explains it well when he says, “The mortality rate for each of us is 100 percent, the immortality rate for each of us is also 100 percent.”[7] This ordering and understanding of life and death is a major blind spot in palliative care along with many Americans facing death today. Too many people see death as an end. And to see it as an end makes it easy to miss the realities of dying. It is easy to not gear up for the spiritual battle of your soul. It is easy to miss God’s grace being offered. And it is easy to isolate oneself, to not burden others, in one’s suffering cutting off the reality that dying is a communal event. We must reorder how we approach death and dying to help us see the disorder that is present in the growing physician-assisted suicide/Medical Aid in Dying practice.

In previous articles, I have proposed ways to oppose physician-assisted suicide at a macro level through policy, but that leaves the micro level untouched. This is where the Church and its members can be of help. With a long history in healthcare, the Catholic Church is losing grounding in that sector, but the Church’s presence there is needed now more than ever. Hospital chaplains and prayer groups for the dying are of utmost priority if our society is ever going to reorder the dying experience. In the Twin Cities, there is an apostolate called Curatio, that consists of a group of Catholic physicians that pray for each other’s patients.

People outside the healthcare field play a role in converting hearts as well. At the end of each Sunday Mass at my parish, the whole congregation prays a Hail Mary for the next parishioner that will pass away. Through this continual practice, I have found myself more aware of the realities of dying. This is a way we, as a parish community, can partake in the communal aspect of dying by preparing said person for their final spiritual battle. At the hour of their death, Mother Mary will be with them, praying without ceasing.

In our own homes and families, I suggest having conversations about death and dying. Talk with your parents or children about taking care of older generations. For children of aging parents, if the conversation slips into desolation by your parents mentioning how they may be a burden on you, stop them right there. Affirm their unconditional human dignity. Then continue with the conversation by asking questions about why they think that. The culture has subtly conditioned people to think of themselves, especially in healthcare, as a very expensive bill. This hasn’t stripped someone of their dignity, but it sure has made it cloudy to see the truth. Have conversations about how you can help in those final years, months, or days of your parents’ lives. And finally, prayerfully consider the option of intergenerational living. Invite them into your home, if possible, to allow them to die in a community surrounded by their loved ones.

For parents, be honest about your desires and concerns with dying. To promote a culture of life instead of culture of death, Christians must talk about these issues and fears surrounding dying. Set expectations of being cared for by your children at a young age, so that it becomes normalized. If you have the opportunity, be an example to your children by opening your own home. Americans value freedom and the ability to do whatever they want without interfering in others’ lives a great deal, and it is going to take a major cultural shift to unravel that ideology. But we must start somewhere. Prayer and conversations with loved ones is the place to start.

[1] Cather, Willa. Death Comes For the Archbishop. Pg. 287-288. Alfred A. Knopf, Inc., 1927.

[2] Augustine, Saint, and Marcus Dods. The City of God. New York: Modern Library, 1950. Print.

[3] Catholic Church. Catechism of the Catholic Church. 2nd ed. Vatican: Libreria Editrice Vaticana, 2012. Print.

[4] Thomas, Columbia. “Improving Spiritual Care at the End of Life by Reclaiming the Ars Moriendi.” The National Catholic Bioethics Quarterly, vol. 20, no. 4, 2020, pp. 647–862.

[5] Augustine, Saint, and Maria Boulding. The Confessions. Vintage Books, 1998.

[6] Thomas, Ibid. 733

[7] Hahn, Scott, and Emily Stimpson Chapman. Hope to Die: the Christian Meaning of Death and the Resurrection of the Body. Emmaus Road Publishing, 2020.

 

Sarah Moon, MPH studied public health administration and policy at the University of Minnesota and currently is studying Catholic Studies at the University of St. Thomas. She works as a middle school science and math teacher at a classical Catholic school in the Twin Cities area.