March 20, 2007 - A Good Death

Today I receive an emergency call, to come to the critical-care unit of Jersey Shore University Medical Center. It’s Bill, one of the elders of our church. He’s dying.

Bill has been in “the Unit” for some weeks, being treated for complications of CLL, Chronic Lymphocytic Leukemia. He’s been in and out of hospitals for the past couple of years, but this time it’s pneumonia, and it’s not going away. His leukemia has flared up, his immune system is depressed, and it’s hard for his body to fight off the invaders. On Saturday, they put him on a ventilator, but the downward spiral continued. Earlier today, the doctor told Bill and his family there’s nothing more that medical science can do for him. He had a grim choice: stay on the ventilator and live a little longer, or remove it and let nature take its course.

Bill, who’s quite conscious and lucid, made the decision himself (thus, sparing his family a hard choice). Taking a pad of paper, he wrote, “Let’s get started.” Soon after I get there and say a prayer with Bill and a dozen or so family members, all of us holding hands around his bed, the nurse asks us to step out into the hallway for a few moments, while she and a technician remove the tubes. We return a few moments later and begin the vigil.

I’ve been in hospital rooms with dying people numerous times, but I think this is the first time the patient has ever been completely lucid as the ventilator was removed. To me, this makes the moment all the more powerful. I feel in awe of this man, who’s able to face his own death with such calm determination. Will it be so for me, when my moment comes?

The nurse increases the morphine drip, then turns off the computer monitor displaying his vital signs. She’ll keep track of the numbers from her monitor out in the nurses’ station, but here in the room the screen is blackened, except for the word, “Privacy.”

Time stands still, as it often does in such situations. The morphine beckons Bill into a merciful sleep, as his life slowly ebbs away. There’s no single moment when we can all say to each other, “There, it’s over.” Death (at least, this kind of death) is more of a process than a single pinpoint in time. It’s not as it so often is in the movies, when a too-healthy-looking actor says something profound, then falls back into the pillows. Yet, there does come a time, after the breathing has stopped, when the family members raise their heads, look up at one another and confirm, with a glance and a sigh, “Yes, he’s gone.”

We say another prayer. Hugs. Tears. First discussions about funeral plans. This is a close and loving family. They hate to be here, but at the same time there’s no other place in the world where any of them would rather be. They’re here for him. Joy and sorrow intermingle, in a sadly beautiful way. I feel it, too, because Bill was my friend. Then, the family goes off to get some well-earned rest, and I drive over to the church to conduct the monthly meeting of the Session, our governing board. It’s another one of those abrupt transitions, that are part and parcel of this peculiar job. From death to Robert’s Rules of Order in less than one hour.

It’s a somber meeting. Not so many years ago, Bill was one of the elders actively serving on the Session, and sat at this very table. He was well-known and well-loved in our church. We go through our essential business, but there’s not much joy in it.

Cancer has claimed another victim. Bill was 73, but he could otherwise have expected to live much longer. He was in excellent physical shape, having run several New York City Marathons as a younger man. He loved his wife, Jean, his children and his grandchildren. He had a lot to live for.

But, it was not to be. “Death is a mystery,” says the Church of Scotland liturgy I often use at funerals. A mystery, indeed. We can only trust that someday, in some other place very far from this one, it will seem less so.

"Listen, I will tell you a mystery! We will not all die, but we will all be changed..." (1 Corinthians 15:51)