Revelation 7:9-17 & 1 John 3:1-3

As many of you are aware, I am currently participating in a Clinical Pastoral Education chaplaincy program at St. Anthony’s North Hospital.  Clinical Pastoral Education, or CPE for short, is about educating and improving the quality of pastoral care offered by spiritual caregivers such as myself.  CPE began in 1925 as a form of theological education that takes place not exclusively in  classrooms, but also in clinical settings where ministry is being practiced. The main textbook of CPE is the so-called “living human document,” meaning it focuses on the people receiving care and the people giving care.   At its core, CPE is a study of humanity, from the beginnings of life at birth to the end of life at death—and everything in between.[1]

Often much of the work in a CPE program revolves around death. Death is after all the most inevitable fact of life; or as my mom likes to say, “the only two sure things in life are death and taxes.”  So a good portion of my training is around helping people come to terms with their own mortality and with families dealing with the death of a loved one.

In my limited experience, helping people come to terms with their own mortality or that of their loved one can often be the hardest task for a chaplain.  I think partly because “our society and mainstream American culture have never grappled with the fundamental fact of mortality.”[2]  We need not look hard to see our culture’s willful ignorance of our own impermanence.  Whether it be plastic surgery, anti-aging skin creams, or even the latest “super food” guaranteed to make us feel more vibrant and youthful, it’s pretty obvious “Americans are scared to death of dying.”  And in many cases that’s with good reason… “for we make dying a lot harder than it has to be.”[3] But it hasn’t always been this way.

Throughout history, homo sapiens have mostly died quickly. Primitives commonly died in childbirth or as infants. Children and adults died due to trauma and infections that today would be considered almost trivial, things like appendicitis or a fall that results in an open arm bone fracture that then gets infected. But our ancestors also died in short order from cancer, kidney failure, and heart failure, which people in the twenty-first century are either cured of or live with for many months or years.[4]

Modern advances in science and medicine have delayed the dying process quite dramatically. “Because so many treatments now work, many people survive longer with one, or several previously lethal conditions. Clinicians now talk about a patient’s ‘illness burden,’ a term for the accumulated aches, pains, and disabilities that come with diseases and the side effects of treatment.  As odd as it may sound, people are sicker before they die today than ever before.”[5] In many ways dying has become a lot harder… It is not easy to die well in modern times.[6]

While many of these advanced treatments have done much to improve the quantity of life, they have not done much to improve the quality of life.  A narrow focus on disease treatment and sustaining life no matter what “can leave someone who is living with an advanced disease feeling lost and confused, physically uncomfortable, not knowing how to get through each day or how to plan for the future.”[7] This is why modern medicine has sometimes been accused of treating the disease rather than the person.

When asked how people want to die, the near universal consensus is that people want to spend their final days at home, surrounded by the people they know and love and who love them.  But in actuality, only about 20% of Americans are at home when they die. Instead over 30% die in nursing homes, with the rest of deaths being in hospital.  And of those hospital deaths, nearly 40% of those patients spend their last days in the ICU “where they will likely be sedated or have their arms tied down so they will not pull out breathing tubes, intravenous lines, or catheters.  Dying is hard, but it does not have to be this hard.”[8]

The will to live in humans is powerful, sometimes even miraculous in the face of certain demise.  But love of life shouldn’t be just about avoiding death at all costs. It shouldn’t be about desperate, futile attempts to stretch quantity of life when there is no quality of life.  Loving life, affirming life means “one needs to affirm all of life—and that includes the part that we call ‘dying.’”[9]  Death is natural, death is inevitable, and death is the final chapter in life.  If the book of our life was stock full of chapters detailing the fullness and richness of our life, wouldn’t it make sense that our final chapter in life, our death, also be one of dignity and respect?

I think it is important to say that “there is no universally right way for a person to die.  What constitutes dying well for one person might be entirely wrong for another…Dying is the hardest, least desirable time in any of our lives.  But it is possible to feel well within oneself and right with the world even as one dies.  Therein lies hope for us all.”[10]  Being that this is “All Saints’ Day,” I feel that there is no better Sunday during the Christian year than this to talk openly and honestly about death.

Whether we like or not, the moment we take our first breath on earth, the time clock of our life starts ticking and only God knows when our time will run out, but accepting that reality—that we will all die some day is important, even healthy.  So rather than fearing death or avoiding it at all costs, we should embrace our mortality, be thankful for the amazing gift that life is, and embrace life to the fullest.  Life is, I believe, about quality, not just quantity.

So I believe it is essential for me, not only as someone receiving specialized training in this area, but also as your pastor, to implore you to treat your inevitable death with the same passion and purpose with which you live the rest of your life.  Not only so that your final chapter in life, your death, reflects the same dignity and value by which you lived your life, but also because as a Christian, death is not understood as an ending so much as a transition—from this life to the next.

Reading in the book of Revelation today, we read a text specifically chosen for All Saints Day, and it fits well.  Though this book of the Bible is often misunderstood and misinterpreted, it is at its core a call to faithfulness in times of trials and meant to be a source of hope in the face of uncertainty.  John sees in his vision a cast of innumerable humans, from every nation and tribe, all peoples and languages, worshipping God and crying out, “Salvation belongs to our God who is seated on the throne, and to the Lamb!”  These great multitudes of people have survived the tests and troubles of life on earth and are giving praise to God for deliverance.  They are at a place in which hunger and thirst are no more, where God will wipe every tear from their eye.

In our other reading for this Sunday, 1 John 3, we read of God’s love for humanity, of the destiny of believers, and of the forgiveness of sin. We are, John writes, children of God.  And as children of God we have the comfort and the hope that “there is something more to come…it fortifies us through a life of turmoil and temptation… As Christians, we live with hope, the hope that all things will be renewed, the hope that we will not remain the same but will become new.”[11] In 1 Thessalonians 4, a passage we will delve into more next week, the apostle Paul writes that Christians are not to grieve as those who have no hope.  Paul writes to comfort the believers at the church in Thessalonica that death is not the end; that there is hope beyond the grave.

“All Saint’s  Day is a time when as the family of faith, children of God and joint heirs with Christ, we not only bear each other’s burdens but also claim for those who have died the hope and confidence we have together in the risen Christ.  Through the credibility of the cross and the resurrection of Jesus Christ, we claim our legacy, which is grounded in the victory of Christ over the grave.”[12] Christians can therefore rejoice in a love that is stronger than death, a love that conquers all.

So today on All Souls Day, as we remember the loved ones we have lost over the past year, those apart of this church who are no longer with us, and the saints who have gone before us, I invite you to consider your own mortality, your impending death.  But not simply your death, but your life as a whole, for death is simply the final chapter of your life—and it should reflect the things you valued and treasured and defined the person you were.

Obviously we cannot predict how our lives will end; no one knows how much time we get on this earth.  We don’t know if circumstances will hasten our demise or the final events that will precede our last moments on earth.   But there are things we can do from a practical and spiritual perspective to prepare for that day.

First, we can prepare the necessary legal documents to ensure that our wishes are carried out at the end of our life and thereafter.  These include things like appointing a medical power of attorney, creating a living will, prescribing preferences in regards to artificial resuscitation and hydration, and choosing to be on the registered donor list or not—things we in the CPE world call Advance Directives.

Secondly, we can talk to our friends and family about what our wishes and values are.  The death of a family member can be challenging enough on families, so there is no need for additional stress over internal conflicts about end of life treatments, organ and tissue donation, and even methods of burial.  Talk about these things—about whether you prefer burial or cremation, about whether you would like to be kept alive on artificial life-support, about whether you want you organs and tissue to be donated.

Third, we can live as people who have hope—as those for whom death is not the end.  Yes, the loss of a loved one, especially tragically and unexpectedly, is painful and sorrowful and I strongly reject anyone who tries to instruct someone on how to grieve.  We all grieve in our own way, at our own pace.  But I encourage you to remember the testimony of the scriptures and of the Christians who have lived throughout the millennia—death is not the end!  In our grief, we can take heart in a love that is stronger than death and in a God who will wipe every tear from our eye!

And lastly, as medical doctor and author Ira Byock advises, both at our death and throughout all our life we can say —“Thank you. Please forgive me. I forgive you.  I love you.”

 

[1] http://www.acpe.edu/

[2] Byock, Ira. The Best Care Possible. (New York: Avery Publishing, 2012) 1.

[3] Byock, The Best Care Possible, 2.

[4] Byock, The Best Care Possible, 2.

[5] Byock, The Best Care Possible, 3.

[6] Byock, The Best Care Possible, 2.

[7] Byock, The Best Care Possible, 3.

[8] Byock, The Best Care Possible, 3.

[9] Byock, The Best Care Possible, 7.

[10] Byock, The Best Care Possible, 81.

[11] Ji-Sun Kim, Grace. “1 John 3:1-3: Theological Perspective,” 4:232.

[12] Jackson, William N. “1 John 3:1-3: Pastoral Perspective,” in Feasting on the Word, ed. David Bartlett and Barbara Brown Taylor, Year A (Louisville: Westminster John Knox, 2011), 4:230-232.

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