Monday, May 17, 2010

Death and Dying: Incomplete Answers

This is a very difficult time. So much is making me question my Church and my allegiances within it.

From the Arizona Republic (5/15/2010): A Catholic nun and longtime administrator of St. Joseph's Hospital and Medical Center in Phoenix was demoted and reassigned in the wake of a decision to allow a pregnancy to be ended at 11 weeks gestation in order to save the life of a critically ill patient. The decision also drew a sharp rebuke from Bishop Thomas J. Olmsted, head of the Phoenix Diocese, who indicated that the nun was "automatically excommunicated" because of the action. The patient had pulmonary hypertension, a condition that limits the ability of the heart and lungs to function and is made worse, possibly even fatal, by pregnancy. Sr. McBride participated in the hospital ethics committee's decision to recommend termination of the pregnancy so that only one life (the fetus) would be lost rather than two. The pregnancy was terminated at the hospital which is run by Catholic Healthcare West. Both St. Joseph's and Bishop Olmsted issued statements regarding the case. Tell me, Your Excellency, would you have ruled this way if it had been your sister's life at stake? Would you be willing to explain to the family why the Catholic Church prefers a scenario that would almost certainly guarantee the death of both the mother and the unborn child? This is the first example of what we get when bioethical policy is made by celibate, childless men.

And I am watching my mother (photo above) slowly die from end-stage dementia. She almost never speaks anymore -- certainly not in complete coherent sentences, she is incontinent, cannot walk, can barely sit up, cannot feed herself, let alone bathe or dress herself. Her understanding of her surroundings is elusive and uncertain. Mostly she is very weak and sleeps a lot. Fortunately she is a Quaker and signed a firm living will forbidding all extraordinary forms of intervention. I know that she understood this to include all forms of artificial feeding such as IVs or feeding tubes. I, a Catholic, have durable medical power of attorney for her. I know what the Church teaches about end of life choices but I am legally and, in my personal opinion, morally obligated to uphold her choices even if they conflict with my Church's ethical teachings. This is helped by the fact that in cases like my mother's where there is no realistic hope of coming back to anything ressembling a meaningful life, I agree with my mother's choices, not the Catholic Church. So no IVs, no feeding tubes and when she can no longer swallow food and water, she will die. The Catholic Church's insistence that we must inflict artificial feeding and hydration on the terminally ill is the second example of what we get when bioethical policy is made by celibate, childless men.

Both denying abortion to mothers whose lives are endangered by carrying a pregnancy to term and not allowing dying people to refuse artificial feeding and hydration strike me as idolatry -- of the fetus in the first case, and of the physical body in the second. The men who make these policies are for the most part freed by their vocations from having to deal with the real life situations that confront husbands, fathers, and caretakers of elderly parents. Their dying parents are usually cared for by their married siblings somewhere else. Of course they grieve when their parents are terminally ill but they are spared the heartbreak of actually having to watch and deal with the day to day physical deterioration of their loved ones.

And it also makes me question the Church's teaching on euthanasia as I watch my mother's body go on long after her personality and ability to participate in her surroundings have vanished. If I had a pet in her condition, I would put the animal out of its misery quickly and painlessly as we did when our 20-year old cat became too weak to do anything but look forlornly at us. I know the reason this option is not available to humans is because we are not sufficiently spiritually mature as a species to use it wisely and compassionately.

The experience of my mother's dying is opening my eyes to where I find -- and don't find -- consolation within the Church. Nobody in my charismatic prayer group has called to ask why I wasn't at the retreat this weekend or how my mother is doing. Responses to previous reports on my mother's declining health from members of the group have ranged from "your mother isn't talking because she is resentful that she has to live in a nursing home" to "so? we all have problems" to attempts to cheer me up with unrealistic assertions that God will work a miracle in my mother if I pray hard enough. Meanwhile the unwritten expectation is that if I were really committed to the charismatic movement, I would put on my black and white uniform and a happy face and go to work as if nothing were happening. "Let the dead bury their dead" trumps "Honor thy father and thy mother".

But, as Fr. Michael Pfleger urged in his sermon last Sunday, I have not given up on prayer or on the Church. I continue to pray privately even though it often takes the form of saying a Rosary with tears streaming down my face while asking God why He is allowing my mother to continue to live in this condition (so far God hasn't provided any satisfactory answers). I go to my new parish where I am free to just be, without a whole lot of performance expectations, where I can sit in Mass and just be sad when I'm sad. I am not called upon to participate in some big media show and I can leave immediately and go to my mother's bedside, no questions asked. Seeing our pastor and knowing that he buried his mother last year after a long illness is helpful because even though we haven't spoken about it, his presence tells me that the pain I feel right now is survivable.

I miss the Renovacion somewhat but it is not what gives me comfort now. I don't know when, how or if I will return to it. So, Padre Hoyos, this is my answer, incomplete though it is.


  1. R.G. First and most important at all, let me say that I have a lot of respect for what you area going through and I commend you in your sincerity and openness in sharing all theses experiences with the readers. I can almost physically touch your pain, while reading your emotional outpour that you share with us and that also, I believe, is of help to you, because no matter how much we pray in loneliness, in reality the only tangible thing that we have and we can feel and count on here and now, is each other.

    For those that criticize you about the nursing home, let me tell them. They are wrong. In many cases, when a person is elderly and in need of 24/7 care, specially when there aren’t enough family members around to care for her at home, a decent, well managed facility with trained medical staff, is the best thing, plus of course, the love and frequent visits by the family, so they know that they are loved and they don’t feel neglected or abandoned. And I know that you have your heart at peace in that part.

    For those that say that God may make a miracle in this case. I tell them: You don’t want a miracle of that sort in situations like this and probably God will not oblige, because She/He knows better. You want the loved one to suffer the least and not to linger for long in a state like this.
    Last December I was fortunate enough for an emigrant, to be able to spend my father’s last week of his life, next to him and my mother. During that week, I spend four sleepless nights next to his hospital bed, watching him coming in and out from consciousness, due to the heavy morphine sedation that he had, to help him no to be in pain due to the sudden widespread cancer metastasis that he suffered. During those nights I was praying, not for a healing miracle, but for him not to suffer and to linger in that state for long, even thou, my mother and I, cling to his presence and few moments of dialogue we could have, like true moments of infinite value.
    Miracles may happen but not always of the kind that we wish for. And in my case they did, and three of them. Here they are:
    First, my father was able to wait for my arrival, even when his diagnosis was known they said: “He can go anytime”. Second: The challenge of the emigrant in cases like this is to try to balance time and resources, obligations here (work, vacation time, bills to pay, etc) and the desire to be there. When he passed away, I had enough time later to be able to spend weeks with my mother and help her do the unpleasant paperwork, etc, that these situations bring. And third and most impressive of the three miracles: He passed away in an afternoon, two hours after I have left to rest home after spending the last night with him and when my mother was just right there next to him and holding his hand. He waited for the right time and moment, to say good bye to life, next to the woman with whom he was married for 56 years and knew for more than 70.

    I don’t want to make this long comment about me, because is about you R.G. I just relay my own experience to illustrate and to share. Because I want to tell you that your heart knows what to do and where to be in a situation like this. Don’t let anyone’s comments or lack off, bother you. Moments like this are unrepeatable and they are of a life transforming value. Give yourself the guild free freedom to live them as your heart dictates you.
    Your mother’s eternal soul, knows what to do, even if we just see the body weakening away. If you have time in between of your prayers and rosaries, to read one of two books, from the famous doctor Elisabeth Kübler-Ross, I think that may help you bear this situation, as it did to my mother after my father’s passing.
    Perhaps from now on, the main message of the Retiros Espirituales and/or the Encuentros Católicos , should emphasize less the miracles and more the sudden message: “ You are your brother’s keeper” and too teach us how to analize missed opportunities. Because we should: “Work as if everything depends on us. Pray as if everything depends on God.

  2. I want to thank you for this blog. I want to thank you for your honesty and care and concern and love. I want to thank you for the good work you are doing. Your love and common sense and committment to your mother and the People of God is beautiful. May you stay steadfast in your prophetic voice rather than to the mere continuation of an institution. You are grace to me in this actual moment. Thank you.