It was early in my shift at the hospital where I work as a chaplain and I’d been paged to the intensive care unit. As I walked out of the elevator and made my way down the hallway to the nurses station I heard a man’s anguished voice cry out:
“Let me die!” “I know where I’m going and I know how to get there!”
It was Howard, a patient I’d been seeing for a couple of weeks, ever since he’d been admitted after being flown down from Alaska with his wife Sally on a medical transport plane. Howard was in his mid-sixties and had been dealing with a number of life-threatening and debilitating conditions for more than five years. His body was weakened from the dozens of procedures and surgeries he’d had and finally his organs weren’t functioning well enough to keep him going.
He was on artificial support to keep his heart pumping and his blood pressure stable. A couple of days before this, when I had last sat with him and Sally, they had just been informed by the medical team that they’re wasn’t anything more to do. That morning the palliative care doctor had met with them and talked about what it means to be put on comfort care.
In the weeks I had known Howard he had told me about his career as a commercial pilot flying people and supplies between the far-flung villages and cities in Alaska. He shared stories of ice build-up on his planes’ wings, poorly plowed runways, and having to land and take-off in near darkness.
As he lay flat on his back in the intensive care unit surrounded by pumps and monitors with lines inserted into his arms and drains coming out of his abdomen, unable to move except to raise his hands an inch or two, it was hard to imagine that this man had once been robust and active; had enjoyed canoeing and climbing mountains.
One time when Sally was out of the room Howard confided that perhaps he hadn’t been the best husband to his wife, having been gone so much of the time and always putting his work first. They’d never had children of their own, which is one reason Howard said, he’d been a Sunday School teacher for over thirty years. When asked about his religious beliefs, Howard demurred a bit before saying, “It’s not flashy, really, more of a quiet faith.” “I know God and I know my place in his world.”
Whenever I’m providing care to someone who is near the end of life, I try to move them to a place where they feel comfortable sharing with me their ideas about not only the meaning of life, but what death is and whether there is life after death. Howard’s “quiet faith” provided him with the assurance he would go on to a heavenly place and even though he wasn’t quite sure what that was, he knew it would be a wonderful place free from the suffering he had endured these past years.
Sally, on the other hand, was not ready to let go of her husband. It wasn’t that they had unfinished business, she just didn’t want to be left alone and on her own. We had explored these feelings a bit, but never got very far because she didn’t want to give up hope, as she called it. As she said, “We’ve been through rough patches before and always come out of them.”
Howard knew that this time things were different–that they’d reached the end of the line–but Sally just couldn’t accept that, even after their discussion with the doctor about stopping curative treatment and just doing what was necessary to keep Howard comfortable until the end came.
Their differing desires that evening is what prompted Howard to yell “Let me die!” “I know where I’m going and I know how to get there!” He was tired of fighting. He was worn out from years of medical interventions. He wanted peace.
It’s been my experience in my work as a minister, either as a chaplain or a pastor, that people put off trying to figure out what happens after death. It’s a lot to tangle with, especially if one doesn’t subscribe to religious doctrines about salvation and life after death. And even people who state they are believers aren’t always sure of what will happen to them.
Many people have told me that when they die everything will go dark and that’ll be the end of it. Often that is a solid conviction, but other times it’s a hope. There are those, too, who have rejected the fundamental Christian faith of their upbringing, often one in which the concept of sin and eternal damnation is used as means of control, but which still was an unpleasant possibility even though they hadn’t subscribed to such a belief since they were young.
But Howard knew where he was going. He also knew that his God was a merciful God and that regardless of what he had done in his life, he was cherished and loved by God, and would be provided a life after this one.
Howard also knew how to get there. Would there be angels come to escort him over to the other side? Did he know that he would have to disengage from the physical reality around him in order to let go enough to begin the journey? I wish I could have talked with him about this, but there wasn’t time. He was ready to go and letting everyone know it.
Since Howard was still conscious and able to make his own healthcare decisions, he directed the medical team to remove the artificial support so that he could die. Sally wasn’t happy about this, but she respected his wishes.
After the nurses had finished removing the lines and had given him some anti-anxiety and pain meds Howard started to relax. You could see it in his face and in his countenance. He didn’t die right away. It would take a number of hours during which he finally became unconscious.
At one point as I stood over him, I couldn’t help but thinking to myself, “Where is he going?” and “How is is getting there?”
Someday….someday, I, too, will know….as will all of us.
***Howard and Sally are pseudonyms***