Faith and Religion at the End of Life
BY ROGER C. BONE, MD Reprinted with permission.
In Reflections: A Guide to End of Life Issues for You and Your Family, distributed by the National Kidney Cancer Association, a chapter called "Afraid! Of whom am I afraid? Not Death — for who is He?" discusses the importance of a spiritual, religious perspective when one approaches death, especially if that death is likely to be sooner rather than later.
The personal spiritual statement on page two is a good example of how, as the author notes, "by turning to a holy book . . . one can find the strength to face this ultimate personal challenge."
The cold and calculating reality of dealing with personal finances is in sharp contrast to the warmth and peace achieved by coming to terms with a spiritual presence. The rules and regulations one must follow in order to adhere to legal and/or business obligations give way to a growing sense of personal understanding with God.
As the terminally ill person approaches dying, understanding God may be easy or very difficult. There are numerous facts that come into play; many of which may have been suppressed or repressed for years. Whereas, financial matters tend to focus on where you are in the world at this precise moment, spiritual considerations tend to encompass your entire existence. It is common in conversation with the terminally ill to have them reflect on how religion has affected their lives. Individuals will remember their parent's religious attitude along with their own significant childhood moments, such as baptisms, bar mitzvahs, first communions, weddings, or funerals. Some may recall spiritual revelations, epiphanies, or personal miracles.
One of the first great works of English literature, Pilgrim's Progress, by the late seventeenth-century writer John Bunyan, recounted the metaphorical trek of a man in search of spiritual guidance and fulfillment. Pilgrimages are a common theme in almost all religions. Jesus, Mohammed, and Buddha, for example, spent a significant part of their earthly existence searching for a greater understanding of the human condition or closeness with a higher being. Jesus spent forty days and forty nights in the desert, Mohammed traveled to Mecca, and Buddha wandered the land as an ascetic. Mankind's own spiritual quests have translated into epic proportions, such as Moses' parting of the Red Sea, the medieval Crusades to the Holy Land, or Joseph Smith's and Brigham Young's trip across the United States to establish Mormonism in Utah.
A terminally ill person usually does not have the stamina to participate in a long pilgrimage. Nevertheless, you can visit a childhood church, temple, or mosque. In addition, you can visit holy shrines or other significant monuments in your chosen religion that are closer to home. In this way, the dying patient is able to make his or her own symbolic spiritual trek.
You may be able to identify easily the religious guideposts of your life, but the journey may be arduous. There is no guarantee you will find what you are looking for. Still, you have no choice but to reconcile yourself with God or your chosen religion in some manner. To that end, allow me to suggest a few tips for the spiritual traveler.
Quality of Life
Facing the possibility of premature death often forces us to take a look at where we have been and where we are currently in our lives. Some people come to the conclusion they have not accomplished enough, loved enough, or contributed enough to the world. Others feel fulfilled and satisfied with what they have done and view death as a natural progression. Nevertheless, it is important to consider the "quality of life" you wish to pursue now.
Making this determination often requires an introspective look at what is important to you, what makes you feel complete. Is there something you always wanted to do but never tried? Is there an individual you had a disagreement with in the past and you now want to make amends? What activity brings you true joy and satisfaction? In my case, it is important for me to continue my professional work, write about my experience with cancer, and spend time with my family.
How you choose to live the rest of your life is a private and personal matter. It is something, however, that should not be disregarded. A positive state of mind can influence your body's reaction to treatment and can make a difference. It will also allow you to experience a more enjoyable quality of life.
A Religious Guide
It is important to speak to someone who is a representative of your religious persuasion, whether it is a minister, priest, rabbi, or other cleric. This person may not be well-known to you or you may have known him or her for many years. Any member of your religious community can serve this role, it does not have to be "the leader" of your particular place of worship. In any case, the topic of dying in a spiritual sense will most likely be new for you.
Your religious guide is in charge of meeting your "spiritual needs." The term "spiritual needs" is commonly overused and has an almost commercial ring to it. The terminally ill person, in this instance, does not need a guide to settle practical issues such as donations or funeral arrangements. Your religious guide will be able to do much more for you.
First of all, he or she can put your impending death in a broader religious context and neutralize some of your anger and isolation. Religious phrases and passages that you did not listen to very closely before will be interpreted by your guide with new meaning. You may suddenly see that theology provides great comfort in its breadth and understanding of personal tragedy. There is consolation in the fact that so many have gone before you and thought long and hard about the consequences of death. If you pause and reflect on their teachings, you realize they have paved the way.
Secondly, a religious guide offers personal solace and compassion. An experienced grief counselor is adept at answering questions and putting some of your fears to rest. True, you receive sympathy from friends, family, and, occasionally, your physician. Yet, the understanding provided by your spiritual guide is special and unique.
Thirdly, your guide discusses in detail your religion's view of the afterlife. This topic is particularly difficult-especially in contemporary secular society. Nevertheless, it is now an issue that interests us deeply and weighs heavily on our minds. You may feel embarrassed about asking your spouse or physician about the "afterlife." Your religious guide can address this question freely and in an uncomplicated manner.
Finally, a religious guide restores, renews, and invigorates your faith. He or she can define "faith" or "belief" and show how it spiritually drives and propels our spiritual pilgrimage. Facing death, naturally, severely tests one's convictions. You may ask yourself, "Why would God do this to me?" The preservation, or in some cases restoration, of one's faith allows you to overcome this question and understand that God has not singled you out but that you are progressing through the natural process of life.
Family Member
The possibility should not be overlooked that someone in your family is meaningful to you in a spiritual and religious way. Often, this role is assumed by a spouse. Many couples often read their holy book or pray together each night. However, it is just as likely that a surviving parent, a son or daughter, or even a distant relative responds spiritually to your needs and can be your religious guide. Since religion is such a private and personal consideration, this individual may not step forward and volunteer his or her assistance. You must openly communicate this prospect because that person may be waiting for some indication from you. Anyone can help you enormously, if you simply ask.
The Holy Book
All religions have a holy book, such as the Bible, the Torah, or the Koran, that encompasses their myth, history and teachings. For myself, as for many of us, the Bible has represented the word of God. It is a written spiritual guide that brings great peace to its followers.
After I discovered I was terminally ill, I composed a spiritual statement. I want to share it with you as an example of how developing a relationship with a higher being can be fulfilling. It is not meant to convert the reader. Instead, I want to show that by turning to a holy book, in my case the Bible, one can find the strength to face this ultimate personal challenge. Everything in this statement is based directly on my interpretation of scripture.
Death is the opposite of life; the normal end of life which comes with the departure of the spirit from the body. This is when eternity of the soul begins. Eternity refers to an endless span of time, whether before the Creation or after the end of the present age. Eternal life is mentioned many times in the New Testament referring to the kind of life believers in Christ receive — for their enjoyment in this life and their reward for the life to come. Immortality is the concept of eternal life of the whole person, sprit and body.
At death, the nonmaterial part of a man goes either to paradise or to a place which is described as one where the inhabitant is in agony in flame. The material part of the body goes to the grave. According to the Bible, there is to be a resurrection in which the body comes out of the grave, is reinhabited by the soul, and commences the eternal form of its existence with either life in heaven or condemnation in hell. Eternal life for the believer is not an inactive endless existence, but rather freedom from all of the evils of this present world and active services of worshipping God in fellowship with his Son their Savior.
So, what is this idea of soul or spirit? It is something you can't see, the immaterial part of man, similar to spirit. The Greek word for soul is translated as "mind. " Soul can refer to life, self, the person, and a pronoun (I, me, you, yourself, himself, anyone, everyone). Also, soul can be the seat of the heart, mind, emotions, desire, or will. It can be used to show the whole life or totality of life. Soul is used synonymously with "spirit. " The spirit sometimes refers to a higher level of human nature than does soul. The spirit of man is separated from the body at death. Between death and glorification, humans are referred to as spirits, but the final state of mind is spirit united with a glorified body. And, I believe, this is the definition of "life eternal."
Prayer
As a physician who has spent the majority of his life as a scientist, I was very interested in an article in the Wall Street Journal that was published about two months after I was diagnosed with metastasis of renal cancer. The headline read "The Healing Power of Prayer is Tested by Science." Writing on the power of prayer as a form of "remote healing," the journalist reviewed research projects at a number of universities, including the University of California at San Francisco, Temple University, and the University of New Mexico. Their hypothesis, stated here in general terms, is that the body emits an energy that can be affected in invisible ways by positive energy from another source-a kind of interactive energy exchange.
Deeply religious people will surely applaud this recognition of what they have for centuries called the "power of prayer." Praying is a fundamental activity in most religions; the very cornerstone of faith and hope. For some of us, it is something we see in every aspect of our daily lives. We teach little children to pray at meals and at bedtime. Students promise God they will study more in the future if they pass an important exam today. Sports fans pray their favorite team will win the "big game." We hope we get what we want for Christmas. But, of course, prayer is so much more important.
Prayer is important because it is a personal and private communication between oneself and a greater being. It is also the acceptance of the unknown in terms of trust and hope. The English poet John Dryden wrote long ago: "Death in itself is nothing; but fear/To be we know not what; we know not where." The act of prayer allows us to bridge that gap between the present and the unknown future without fear. It allows us comfort in knowing that this world of pain and suffering, for the healthy and the ill, will dissipate after death into peace and understanding.
In the Intensive Care Units where I worked for several years, I often observed family members and friends praying for a critically ill or injured patient. In the context of the hospital setting, the act seemed a useless gesture compared to the jumble of high tech machinery surrounding the patient. Yet, I also saw that prayer brought solace and peace not only to the person praying but somehow, indescribably, to the patient as well.
Church and Cemetery
As it becomes more difficult to travel anywhere except to medical appointments and treatments, it may be worthwhile for as long as possible to attend your church, synagogue, or other place of worship on a regular basis. Looking forward to church and its fellowship is extremely rewarding. It is also comforting to know that your friends and family have your interests at heart. For someone who has not been a church member for most of his or her life, it can also be a potent experience.
In the same vein, visiting the cemetery where you will be buried, if burial is the choice that you have made for your remains after you die, is not the morbid experience you may think it is at first. Again, returning to a theme that I have reiterated throughout the book, it is better to be comfortable with the atmosphere and trappings of death than to treat them with fear and needless horror. Most cemeteries are located in naturalistic and peaceful settings, and visiting your final resting place will ease your mind and even provide you with some sense of the afterlife.
Private Meditation
It is important to note that the terminally ill patient may not accept God or belong to any organized religion. Yet, it is my experience that most people believe in something. A person may believe, for example, in the healing power of nature and its cycle. He or she may find peace in the fact that death is a natural process and a return to the greater whole. Others may believe in meditation, which is the power to think through a situation and arrive at a suitable resolution. Whatever one's beliefs are, it is important to find a way to come to terms with the idea of death.
"Afraid! Of whom am I afraid? Not Death — for who is He?"
These lines from a poem by Emily Dickinson speak to the core of what religious belief can do to remedy one's normal fear of the unknown. Faith overcomes death and turns it into just another phase in the natural transition of life. The recognition of death as a transition stage to a higher understanding is common among most religions. It is, if I may use Christian terms, a doorway to a state of grace.
Yet, if religion allows us to look forward, it also allows us to look back. Dr. Patrick Francis Sheehy in his book on On Dying With Dignity writes in his conclusion: "For the dying patient, religion is important when it makes life dignified and worthwhile." Religion allows us to reflect on our good deeds, our selfless acts, and the best moments of our existence. It is part of our personal history and our broader community. It also permits reconciliation and forgiveness for the mistakes we may have made. Finally, if we let it, religion will bring us comfort at the most trying time of our life.
©1997, National Kidney Cancer Association |
