An Essay on Care for the dying

"Where are the other nine?" Jesus asks.

The question was asked by Jesus in a different Gospel context, one involving which lepers came to give thanks and which did not.  But the question applies in a heartrending way on Calvary.  And the answer was not then and is not now forthcoming. Then, as now, the question continues. 

And it encompasses much more than a carelessly forgotten thank you.

The unspoken refrain, “Where are the other nine?” echoes through the most sentinel event of the gospels—the most sentinel event for Christian communities and families everywhere. It echoes through life and the end of life—from Calvary to the Beyond. 

The core of our faith—Christ bloodied but not bowed, arms wide open in redemption, wounded for love, dying on a darkened hill amid the jeers of strangers and the sobs of friends…These images—images of Jesus dying on the cross, accompanied only by his mother, Mary Magdalene, and his friend John are imprinted indelibly into our conscious—silk-screened into our very souls. 

From earliest childhood we see dying—dying as central to the beliefs we hold—to the lives we live. In our faith life, we Catholics do not divorce the body of Christ from the cross on which he dies. The image of the dying Christ is found on our pocket rosaries and on the review mirrors of our ‘autos’. The dying Christ hangs in the center of our churches and in the living rooms of our homes. We are surrounded by death—by redemption in suffering—by the resurrection and grace.

And yet. 

Somehow, in some strange fashion, we in the modern world have managed to separate the triumph of the cross from the act of dying—to sever meaning from suffering—and in the process, incidentally, to ostracize the sufferer from the community of care. 

Which is strange, considering what we believe. 

Famous artwork throughout the centuries has depicted the wider view—the view of those accompanying the dying Christ, those vigiling with him through the suffering of his final time on earth. Looking at that picture—we wonder—where are the rest of his followers? The other apostles? His faithful friends. 

Where can they have gone? 

Judas, sadly, we know about. Betrayal, hopelessness, despair, and a prideful unwillingness to ask for or accept forgiveness doomed him to be eternally absent from the sentinel event. What of Peter, the rock? Peter, too, has gone missing, bitter regret and remorse at his denials having kept him from vigiling with the Lord in his time of need. In time the fisherman would return, seeking and receiving life-saving forgiveness. Still, when it counted, he fled.

But what of the other nine? 

What of the rest of the apostles, who only hours before vowed to stay with Jesus until death do us part. What of James and James, Matthew and Philip, Andrew, Bartholomew, Simon the Zealot, Thaddaeus, and Thomas? 

One wonders…where were they when Jesus was dying?

Were they afraid? Or distracted? Paralyzed with fear at the ugly specter of death, or somewhere else, keeping busy with the important tasks of everyday life? Did they hide from that unpleasant sight—from death in all it’s unglory? Or did they, as we, seek information as a way of anesthetizing and smothering the instinct to ‘be with’? 

Could it be that instead of vigiling with the dying—instead of accompanying Jesus on his final journey—the apostles instead attended a lecture on the horrors of execution or the oppression of the Roman occupation? Or went to a bioethicists conference, where the discourse on the ethical perspectives of crucifixion was vetted before an audience of interested academics? 

One hopes not. Because obviously, such discourse might be good in theory, even important generally, but if all that talk serves only to distance us from those who need our care, then it is not good at all. 

Balance is needed in the modern discussion of end of life issues. And the balance missing from far too many of these forums is the balance of two planks of wood hanging in a darkened sky. 

Which is to say that all the talk in the world—even all the well-intended talk of do-gooders trying to do good with words rather than actions—all that talk is shallow indeed if it does not lead to the betterment of care for those who need our help. It is especially shallow, even callow, if it purports to help without providing the motivation, means, or opportunity to do so. 

Talk of burden and obligation, scarce resources, and people as vegetables has never yet led to particular and compassionate care being extended to dying persons. And that is the problem. We distract ourselves with meaningless wordage, sounding all the while like the soundtrack of Charlie Browns teacher; “Whah, Whah, Whah, Whah, Whah.” And we pat ourselves on the back, pleased, at a job well done. 

Many of us are, in truth, actually trying to help those who need health care and cannot afford it. That’s commendable. Yet the bitter debate in the public square and in congress over universal health care, Obama Care and Medicare for All or similar programs has been going on for decades. Addressing equal access to health care is essential, even imperative, but it cannot occur in lieu of addressing the needs of dying persons and their families. 

Hospice care and hospice programs can be, and usually are, helpful, at the end of life. But the hospice nurse, social worker, chaplain, and home health aide have, at most, a few hours a week each to spare in care of the dying. A spouse, child, family member or friend is providing hands-on, round-the-clock-care. While we argue vociferously about the politics of health care, someone down the street or around the block may be desperate for our help.   

Tragically, on the hill that is every man or woman’s death, far too many are alone and unaccompanied. And those family members or friends who do sit by the bedside of their dying loved ones, often call out for help which never arrives. Help that will arrive not from words, not ever, but from lived love in action, from friends and neighbors, hospice nurses and devoted doctors, fellow church members and strangers. 

But not from escapees from reality ensconced in ivory towers and hardened hearts. Not ever from there. Certainly not from advocates of parlor eugenics like Peter Singer or others who advocate killing disguised as caring and who fancy themselves merciful proponents of so-called death with dignity. 

More likely, help in the intellectual community comes from those like the Benedictine Sebastian More, whose book ‘The Crucified Jesus is no Stranger’ calls us to attend to those in our midst who suffer. Or the Jesuit philosopher, theologian, and economist Bernard Lonergan whose deep and lifelong commitment to Christ and to the Splendor of Truthcould not help but better the world with vivid intellect and lived empathy. 

Spoken words, written words, any words at all are worthless—when unaccompanied by action. Talk is cheap. Walk on the other hand, is not. 

The Via Delorosa—the Way of the Cross of chronic illness and unaccompanied caregiving is long and arduous. And the Simons who offer to help bear the weight of that cross are few. Families who care for beloved elders are often forced by job and livelihood to witness the Calvary of loved ones from hundreds of miles away. Doctors appointments, meal preparation, medication administration, personal care—all these things and more compose the way of the caregiving cross—all these things and more are balanced on the backs of families unsupported by a community of care. 

In this day and age, the ‘Tre Ore’ is often far longer than three hours. It is not unusual for the dying process to take months or years—fatigue and exhaustion not infrequently cause further stress, even illness in those who hold vigil. The anticipatory grief of seeing our loved ones die slowly is seen in a thousand slow motion replays of impaired memory or a hundred still frames of declining function. 

And the best of health care and hospice can only go so far. At some point, those stumbling on the road of caregiving will need more than a ten-minute slot with a rushed but compassionate physician. They need more than home care and more than pharmacology. They need more than hospice, even if well-provided. 

What is needed is sustenance for the journey—the sustenance provided by an intact community of care, by caregivers of the heart, even within the walls of institutions like hospitals or extended care facilitates. What is needed is not to understand, or worse yet, explore vacuous theory, but to seek and understand the needs of our neighbors and friends—to reach out as one, and touch the widow and the orphan, to accompany them with tenderness and kindness, competent medical care and a long term commitment to ‘be with’ them in time of sorrow.

What is needed is help, concrete, actual, hands-on help like that recently offered to my cousin Dan’s wife Nancy while her husband was dying. 

A sudden terminal diagnosis left the family in turmoil. A precipitous discharge from a local hospital with no help, no medications and no hospice referral for this dying 60-year-old was devastating. Barely able to walk and hardly able to eat, Dan was abandoned by a bumbling medical establishment. 

The word went out: Dan and Nancy and their boys needed help. 

And that help arrived, quickly, profusely, accompanied by great love. Cousins, brothers and sisters, a brother in law, and close friends arrived, pitching in day and night, holding Dan’s hand, watching over him at night so Nancy could sleep. Hospice came and went, and surely their help counted, but the biggest difference was made by those who walked the talk, the family and friends who cooked and cared, wept and walked with Dan and Nancy.

It was a privilege to attend to Dan and Nancy, an honor to help. And it made all the difference in the world. Instead of being shipped back to a hospital for his final breaths, Dan was ensconced in a bed in his own home, his boys by his side, his beloved Nancy and her faithful brother at the foot of the bed. 

Dan hadn’t talked or opened his eyes in a half a day, but they spoke tenderly and lovingly to him they watched the “still small breaths” at the end of his life. Fifty seconds went by with no breath. They watched, waiting, wondering if he had passed... Then, inexplicably, Dan opened his eyes widely, smiled a huge, delighted, and loving smile at Nancy. Then looking beyond her, he smiling again at someone or someone’s she could not see. And breathed his last. 

Did he see his Dad, my Unlce Mike, coming to welcome him? His Irish grandmother Agnes who serenaded him as an infant to the song Danny Boy? Was it the communion of Saints, the Good Lord himself? Or all of the above? We do not know. But we have faith in the grand welcome and warm embrace of his eternal homecoming. 

The other nine (and many more than nine) came and lived and helped Dan and Nancy with grace and courage. They were present at the foot of Dan’s cross. They accompanied Nancy on her Via Delerosea. They even, like Vernonica, helped wipe Dan's face with a cool, clean cloth, before, during, and after his death. And their presence and love incarnate made all the difference in the world.   

Where were the other nine in the Gospel?

Most likely, the missing apostles were hidden in their homes, weeping, hearts broken with grief and misery, fear and hopelessness. Most likely they did not know how to help—they felt overwhelmed and alone, isolated and abandoned. Most likely, like us, they just needed courage—courage and forbearance. And leadership. Mary the mother of Jesus and John, the Beloved disciple, could have helped with all of that, as could Mary Magdalene, but they were busy—busy at the foot of the cross. 

Would that that ‘the missing’ could have remembered life-saving words of Jesus: 

“Come to me all you who are heavy burdened and I will give you rest.”

“I am the way the truth and the life, he who believes in me shall live forever. And the bread I shall give is my flesh for the life of the word.”

But they did not remember the saving sustenance. They did not remember the Word made flesh, living, though dying, among us. 

For them, it was dark inside and out. Crouched in a forgotten corner of an ancient city, the‘missing apostles covered their eyes from the tragedy, averting their hearts lest they see their Lord and their God, their Savior and Friend, die ignominiously on a hill, forlorn and forgotten. 

Within, they could not remember---the words of Eternal Life—and Light.

As for the rest of the story? 

The Other Nine did remember the Word. Eventually. With the grace of God. And the help of the Holy Spirit.

The ‘missing’ returned to courage and to faith, to walking in, and with, the Light of Life. And they learned that what seems to be dark is only light, waiting to become manifest. They discovered  the awful finality of death is instead a glorious Resurrection-in-the-Making, one that we are privileged to assist with if given the chance. 

This chance is no burden but a privilege—much as Simon of Cyrene himself discovered eventually. He was after all, not ready to help Jesus carry his cross at first, not wanting to walk the Via Delarosa with a beaten and bloodied stranger. And Simon was no Veronica, waiting to soothe the face of the Savior with the cool cloth of love. No. No doubt, if given the chance, Simon himself would have gone missing, overwhelmed by the brutality of the scene and by a passion not his own. But he did not go missing, to his eternal credit. He walked the way of the cross with the Man-God, and in the process showed each of us the how of the way-of-accompaniment. 

The other nine were not present that day at Golgotha and they were not present—as far as we know—on the Way of the Cross. But they were present later, on their own way and at their own Calvary. And the Calvary and the Delarosa of others, in the Coliseum and elsewhere. 

The other nine lived to see Pentecost—the day when people of the world came to revere the sign of contradiction—that Balance-on-the-Hill we call the Triumph of the Cross.

And, praise be to God, they learned in their own lives to be present on the way and beneath the cross, loving and learning, comforting and grieving, praying and consoling—living the life of love in the shadow of death. 

And fearing no evil.

“The Lord is my shepherd; I shall not want. 

In verdant pastures he gives me repose. 

Beside restful waters he leadeth me. 

He refresheth my soul. 

He guides me in right paths for his name’s sake. 

Even though I walk in the valley of darkness 

I fear no evil; for you are at my side. 

With your rod and your staff that give me courage…

Only goodness and kindness shall follow me all the days of my life; 

And I shall dwell in the house of the Lord for years to come. 

Where are the other nine? 

They are here, in the house of the Lord, with the Shepherd, examples of courage in our valley of darkness. They are here in our hearts, exhorting us to walk the Via Delarosa amid our cities, to vigil at the foot of everyman’s cross, to live in love so that goodness and kindness shall follow us all the days of our lives. 

And so that we may dwell in the house of the Lord for years to come. 

And give thanks. 

St. James, son of Zebedee, pray for us. 

St. Andrew, pray for us.  

St. Philip, pray for us. 

St. Bartholomew, pray for us. 

St. Thomas, pray for us. 

St. James, son of Alphaeus, pray for us. 

St. Thaddaeus, pray for us. 

St. Simon the Zealot, pray for us. 

St. Matthew, pray for us. 

Daniel Dennehy, pray for us.