The Pain – Emotional and Spiritual – of Terminal Illness

Part of living is coming to grips with death – our own and those around us.  I am in the unique, privileged position of walking beside those who are dying, along with their family and friends.  Sometimes I do not become involved until receiving a call from a family member or close friend asking for help in planning a funeral.  However, there are many times I am indeed privileged to walk with the patient and their loved ones through the dying process.  I have recently spent time with a very courageous couple who are daily facing her impending death, and doing so with grace, dignity, pain, suffering, humor, faith, and hope.  I watch him care for her with tenderness, and I’m sure behind-the-scenes grief and frustration.  I watch her exhibit the grace to receive in the midst of her failing health.   

I am reminded of the passage in II Corinthians that describes them so well:

“Therefore we do not lose heart.  Though outwardly we are wasting away, yet inwardly we are being renewed day by day.  For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all.  So we fix our eyes not on what is seen, but on what is unseen.  For what is seen is temporary, but what is unseen is eternal.”  Part of the pain of dying is the wasting away of our bodies, and this passage reminds us of the hope of Heaven, the promise of renewal and the confidence of eternity.

Often we shy away from discussing the practical, ‘nitty gritty’ pieces of the dying process.

Here are a few ‘special problems’ the family and patient may have to deal with:

>  Progressive physical decline - and the emotions that are integral.

>  Numerous remissions and relapses and the psychological reactions that arise with

    each.

>  Long periods of uncertainty and fear and pain.

>  Dilemmas about treatment choices.

>  Intensive treatment regimens and their side effects.

>  Pre and post-treatment anxiety.  (What next?  Or...knowing what to expect and

    dreading it!)

>  Lengthened periods of anticipatory grief (the continual ups and downs - the emotional

    roller-coaster ride for patient and family.)

>  Increased financial, spiritual, social, physical, and emotional pressures.

>  Choices surrounding hospice care.

>  Loneliness, for both the patient facing this final journey and for the family anticipating 

    separation.

>  The need to be able to talk and to be assured that someone will listen to your story,

    whether you are the patient or the family or friends.

>  End-of-life issues, such as family discussions about discontinuance of life support. 

    Special note:  If a family has never openly discussed these issues, their trauma will be

    multiplied and amplified.

We can only imagine what awaits us.  May God grant us the privilege of ‘imagining with others’ what lies ahead and being used by Him during this final journey.

*For more on ministering during the final journey, I invite you to look at blog posts - August 30, 2010 - and August 23, 2010.

New Beginnings

“God is a God of new beginnings…” you’ve heard me say that before.  I have not written a blog for way too long – in fact, when I looked at the date of my last writing, I couldn’t believe it had been that long. To say that time has gotten away from me is a true statement and yet, I feel like the timing is good for me to begin again.

New year; new beginning.  Right?  There are many things that begin anew in a new year – new taxes, new calendar, new semester in school, new weight loss program, new resolutions, new classes, opportunity for a fresh start.  It’s the time of year we begin thinking of cleaning house – out with the old; in with the new.  In fact, I am a proponent of “When in doubt, throw it out!” 

Though pre-holiday time is one when many struggle with loneliness and depression (thinking they will yet again go through a very lonely holiday season), post-holiday time can also be one of struggle, particularly as we head into spring.  The New Year and promise of spring is supposed to be a time of newness and possibilities – new growth, birds singing, bulbs sprouting.  BUT … what if everything appears the same in your life –

• You are STILL out of work
• Singleness is STILL an issue you struggle with
• Your husband told you during the holidays that he did not want to be married to you anymore
• You and your wife made it through another holiday, barely holding it together without fighting in front of the kids
• You are STILL holding on to the anger you felt before the turn of the calendar year
• Your teenage son is STILL rebellious
• Your hearing is STILL diminishing
• The hip replacement surgery is STILL looming
• You STILL have to help your aging parent see that they need to move out of their home
• You are STILL struggling with infertility
• Finances are STILL tight – in fact, the situation is worse because you charged Christmas gifts to your credit card

It is into this life that Jesus came - for you and for me.  He came to make all things new … not to take us out of our difficulties and joblessness and pain and suffering … but in the midst of those things that are STILL happening in our lives, to give us a new beginning WHILE in the midst of it all.  Right here, right now!

He wants to give us fresh eyes, an alternative perspective in our recognition that He is with us; that He will never leave us nor forsake us; that “In this world you WILL have suffering; but be of good cheer, for I have overcome the world.”  He wants us to understand that He is a redeeming God and can bring wholeness and newness out of broken pieces.  I definitely don’t have it all figured out.  I struggle, too.  I deal with disappointments as well.  I definitely don’t always understand God’s ways.  I hurt like you, but I am confident of this -- “The steadfast love of the Lord never ceases; His mercies are new every morning, Great is His faithfulness.”  God is a God of new beginnings!



Barb's "Top Ten!"

As I was giving a couple of workshops last week, it occurred to me that a helpful blog post might be the following: 

My “TOP TEN!” in ministering to those who are hurting.

> First of all, I have learned that being in someone’s pain with them involves ‘being all there.’  God uses theory and practice, but God uses ME and God uses YOU!  God wants me to listen to Him on the spot – to be available, to be used, and to be ministered TO all at the same time.  I can do nothing on my own without His using me; however, “I can do ALL things through Him who strengthens me.” (Philippians 4:13)

> I have learned that I need to respect the dignity of those who come through my doors or over my phone line for help, even those who may be difficult or may ‘push my buttons’.  I need to have a spirit of discernment – “wise as a serpent; gentle as a dove,” and to be non-judgmental.  I may not agree, but they are still in pain and in need of a ‘listener.’

> I have learned the importance of having a view from another’s eyes.  While a baby baptism may for those involved be a joyous occasion, there may be those in attendance for whom it is extremely painful…those struggling with their singleness or their infertility…those who would love to be, but never will be, parents or grandparents.

> I have learned that as much as I might wish it, I cannot take away another’s pain, nor can I fix the problem, but I CAN help to bear the burdens of that one.  This is what I am called to do – “Bear one another’s burdens and thus fulfill the law of Christ.” (Galatians 6:2)

> I have learned to listen and that my example or my story which may at the time seem relevant to me, may actually be a deterrent.  What really matters is THEIR story and their need to tell it and to have someone really listen so they can tell it often.

> I have come to appreciate that silence is precious; words need to be guarded carefully.  Sometimes incessant talking and inappropriate humor can be an irritant.  Whose needs am I meeting – mine or the one for whom I am caring?

> I have learned that sometimes I need to be bold in giving care.  I need to have the freedom to ask the delicate, ‘uncomfortable’ questions.  Perhaps God will use me to ask, “Are you afraid?”  “Are you struggling?”  “Was it hurtful?”

> I have learned that I don’t know everything, and therefore, I strongly believe in the value and beauty of team and corporate wisdom.  I don’t always have to have an answer or give my opinion.  Sometimes the greatest care I can give is to find out what wisdom someone else might have to share in this particular situation.

> I have learned the beauty of “weeping with those who weep”, and “laughing (or rejoicing) with those who laugh,” and that God uses the comfort I have received to comfort another.

> I have learned that grief takes as long as it takes, is a process rather than a destination, and I dare not put another on my time table for healing – and that the ‘death bed is a very holy place’ for the believer but for the one who doesn’t have the assurance of going to be with Jesus, it may be terrifying for the dying person or their family.

DO NOT EVER FORGET – GOD USES PROGRAMS, TRAINING AND EXPERIENCE – BUT MORE IMPORTANTLY, GOD USES YOU in caring for another…your servant heart, your uniqueness, guided by His Spirit…God uses YOU!  As He chooses to use us, He also equips us as ‘grace-givers.’  It is a privilege to be making decisions based upon what is best for the other  Philippians 2:3-4…”Do nothing out of selfish ambition or vain conceit, but in humility consider others better than yourselves.  Each of you should look not only to his own interests, but also to the interests of others.”

Contentment

Are you content?  What a loaded question.  If you are like me, your answer might be something like …”sometimes, with certain things, at certain times, most of the time, not right now, I was last month…” all over the board!  Recently while on a wonderful, beautiful, restful vacation I spent some time looking out upon a lovely setting, pondering the subject of ‘contentment.’  It was easy to be content in my ‘setting,’ but even in that idyllic moment, I found myself struggling with a couple of things.  Go figure!

I realize that Jesus calls us to be content – in fact, here are some phrases from the Bible that talk about the issue of contentment:  “…for I have learned the secret of being content in any and every situation;  --- but if we have food and clothing, we will be content with that; ---  be content with what you have because God has said, never, ever will I leave you, never will I forsake you.”

How do I learn the ‘secret of being content?’  Sometimes in trying to get to the heart of a matter, it helps to discover what it is NOT!  The key to contentment is definitely NOT found in having an abundance – ‘if I have enough, then I’ll be content.’  What is enough after all?  My measuring stick of enough is very likely different from yours – whether in things or in relationships.    The secret rather has to do with our focus or preoccupation.  Contentment is a necessary, learned act of obedience.  To learn to be content can help us through many life difficulties … whether our struggle is financial or relational, emotional or spiritual.  Contentment is a growth journey, one that I cannot do on my own.  God has promised to strengthen me, empower me, help me learn to appreciate what I have.

For some, the issue of struggle involves not having what someone else has (and wishing you did) – the right kind of vacation, the right kind of car, the right kind of house, the money to shop whenever, wherever, the right kind of retirement, better health, the right kind of college for your children.  For others, the issue involves relationships – wishing that you had the kind of relationship with your spouse, your daughter, your mother or your friend that someone else has with their spouse, or daughter or relative or friend – or the issues may concern our health or our career, our education, or our mental prowess.

So – how do we ‘get there from here?’  When we struggle, when we are discontent, what does it take to ‘get it’ – to really learn the secret?  Some have a more difficult journey than others and take two steps forward and three back.  Perhaps all of us have a more difficult time in some areas than others.  Take some time to think through your weaker areas.

In trying to develop a heart that is content, does it sound too simplistic to practice the act of thankfulness?  “Lord, I may not have what she has, but thank you for what you have given to me.  Because you know me better than I know myself, you know what I need, you know what I have and you really, really love me.  That is enough!  You are enough!”

I’m not there yet – but I’m on the journey – learning to be content - maybe that is enough for now!

KEEPING YOUR PROMISE

You have a marriage story to tell.  Some of it is good, some of it not so much.  Some of it is Christ-honoring; some of it other-honoring, perhaps self serving, perhaps you both are caught up in the busyness of life or your own wants, preferences or needs.  You and I both know that Christian marriages are in trouble just as those in the world.  Don’t you imagine that Christian couples who are divorcing thought at one time, “It may be happening to them, but it will never happen to us?”  But it did – and is – and will.  How does this happen?  Why does this happen?  In the beginning, you may have been deluded into thinking that since you loved each other, and wanted to be Christ-centered, your marriage would more easily survive the fierce storms that have devastated other marriages.  Or … you may think since you are the exception; your situation is different; you have a ‘right’ to be happy; your issues are more difficult to deal with than others’ and God is ‘okay’ with your separating because of your unique circumstances. 

A marriage crisis can either tear a marriage apart or bring a couple closer together. The Chinese symbol for crisis means danger or opportunity.  When a crisis hits, big or small, you have the option of going down one path or another – choosing that path that leads further apart (the path that leads to danger); or taking that opportunity road that brings you closer together, regardless how bumpy and painful the working through part may be.

A marriage crisis forces two people to face themselves honestly and consider their own character flaws and selfishness – their own sin! There is nothing like living with someone year in and year out to show one's ‘true colors,’ to have one’s own sin exposed.

A preoccupation with looking for what is wrong in a spouse can obscure what is right.  Scripture gives us the antidote for that kind of critical thinking:  Philippians 4:8 … “Whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable…think about these things.”  I don’t know about you, but I tend more quickly to spot the impure or unlovely things!  There may be 5 things that are good, helpful, kind in my husband and 1 that ‘makes me crazy.’  Guess what?  Left to my own devices, I concentrate on the crazy-making one!  God wants me to ‘take those thoughts captive,’ to look first at the log in my own eye before I look for the little splinter in his.

Marriage is the closest bond that is possible between two human beings.  There is nothing like the experience of being humbled by another person, and by the same person day in and day out.  It can be exhausting unnerving, and infuriating.  There is no suffering like the suffering involved in being close to another person and being wounded by that person.  Sometimes in our woundedness we are deceived into thinking that we are the exception to God’s plan. 

A successful marriage is so much more than ‘toughing it out’ – enduring – keeping from the divorce court!  One couple changed their vows from “as long as you both shall live” to “as long as you both shall love.”  Their friends, present at the wedding, not only did NOT object – but praised them for getting away from the old fashioned wording.  That’s like saying I will love her as long as I want to, and if I ever don’t want to, I’ll move on.

For the Christian – what is WRONG with this picture?  God views marriage as a covenant relationship – a covenant with the One who thought of marriage in the first place.  The covenant relationship trumps personal preferences, feelings, and needs.  We have a choice – to be a covenant breaker or a covenant keeper!