14339473020_f52d762211_z“Hands” by Marjan Lazarevski via Flickr

Rev. Elizabeth Zarelli Turner, who is the Rector of St. Mark’s Episcopal Church in Austin, Texas, has been at the bedsides of the dying for 29 years. 

To speak of a death as a “good death” would seem to be a contradiction in terms. For most of us, our idea of a “good death” is to die suddenly and without pain, after having lived a long, full, and healthy life. But that is only a “good death” for the one who has died—it is devastating for the loved ones who have not had an opportunity to say goodbye, to make amends as needed, to say “I love you” one last time. The Episcopal Church’s Book of Common Prayer includes The Great Litany. In one of the petitions we pray, “. . . from dying suddenly and unprepared, Good Lord, deliver us.” That petition intended to have as its focus dying without being “right” with God, but over the course of my ordained ministry I have come to realize how painful it is for loved ones to be unprepared for a sudden death.

So—sudden death aside—what might constitute a “good death?”

In the first instance a “good death” is a death with good palliative care; a death with pain managed and under control. I am so thankful when hospice is involved in the care of someone who is dying, because hospice team members are expert at controlling pain, in so far as it can be controlled. Pain management is also critical to enabling a person near death, and his/her loved ones, to attend to the emotional, psychological, and spiritual needs of the one who is dying. What are those needs?

One need is the need to say goodbye to those who are most loved. This first became clear to me when a dear friend of ours died fairly suddenly. We had dinner with her one evening, and the next afternoon I was called to the hospital because she had suffered a massive cerebral aneurysm just hours before. This friend had homes in London and in New York City, and her sisters and friends had homes elsewhere as well. But on this day, most of her nearest and dearest were in New York and able to say their goodbyes.

One of her dear friends was my husband, who had been in Connecticut all day and had no idea that our friend was near death. As soon as he returned to the city, we went to the hospital, and she was still alive. He touched her, but said nothing. I told him that he had to let her know he was there. He did so, said a prayer, and in that instant she took her last breath. He was the last of the friends she needed to say goodbye to before her death.

This same friend died without knowing just how special she was, how well loved by her numerous friends. Her funeral was attended by more than 500 people who dearly loved her, and my prayer was that she was in the near presence of God, seeing that great gathering of people whose lives she had touched. Most of us will have much more modest funerals, with far fewer people, but prior to our deaths we will need to know that we are loved and that our life has made some difference in the lives of others. This particular friend had a gift for being a friend–she always knew the appropriate gift for the appropriate occasion. Sadly, she died without knowing how profoundly she was loved, and that her life and generosity had made a huge difference in the lives of her friends.

Those who are dying also need to know that those they leave behind will be okay. In November of 2011, National Public Radio host Terry Gross interviewed Joan Didion about the deaths of her husband and their daughter. Ms. Gross asked Ms. Didion if she was afraid to die, to which Ms. Didion responded, “No, because what we fear about death is what happens to those we leave behind, and I now have no one.” I often have to tell loved ones of those who are dying to assure their dying loved one that they will be fine. I have been astonished by the human capacity to delay death until the assurances have been spoken.

Those who are dying also need forgiveness from, and reconciliation with, those whom they have wronged (or who have wronged them). Several months ago, one of my parishioners died at the age of 90. She had three children—the oldest of whom moved in with her and cared for her; the middle of whom was in the same city but largely absent; and the youngest, who now lives on the East Coast, but was wounded by her parents’ divorce and other painful circumstances. My parishioner really wanted to be dead about ten years ago, but once she was about to die of Parkinson’s she clung to life . . . waiting for forgiveness and reconciliation. The daughter called and said the “right” things—enough to allow her mother to let go and die.

Those who are dying also need to walk a tightrope between hope and inevitability. They need to hold on to the hope that there might be for them healing and a cure, while at the same time acknowledging that death is looming. I see this most often in cases of people dying of cancer. Oncologists have a hard time giving up and acknowledging that they have done all that can be done–there is no more that can be done.

I write this only days after we said goodbye to a dear friend. Three years ago, Heather was diagnosed with Stage IV metastatic cancer. It was breast cancer that never presented itself with a tumor; it was only evident because of the pain in her hip. Once diagnosed, she was not expected to live longer than a few months, but she survived three years. What she needed during the past three years was the best possible medical care (MD Anderson Cancer Center); she needed a loving circle of family and friends to tend to simple things like knitting caps for her bald head and a husband who would read to her every day; she needed to know that her children were getting on with their lives, but in the last few weeks she needed them to be present with her; she needed to know that despite the pain of her death, her loved ones would be okay; she needed to know that her life had made a difference; and she needed to let go.

This is what she wrote about the end of her life: “In recent months I’ve found that the power of Love is as startling as the force of nature. When I found that my life was as fragile as a nestling’s egg, disintegrating as I tried to pick up its shattered pieces, something appeared, an unexpected padding, to help me into a new life. The realities of death and illness, grief and anger—the possibility that this new home will fall—never stop looming. But over time the steady swooping kindnesses have built an improbable nest in which I have been, for now (and what else is there?), protected.”

 

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  • cheryl November 7, 2014 at 8:31 am

    Thank you for bringing God, love and saying good bye to our loved ones before they go. So very important. I was raised using the Book of Common Prayer and so glad you mentioned it, as it has so much to offer us in our daily lives. Beautiful prose, of which I will will share with many. Thank you for your very insightful letter to WVFC. – Cheryl

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