I walked into a patient’s room today who was unaware of my existence. She lay in a bed, staring at the wall with drool around her mouth. As a hospice chaplain, my job is to provide spiritual and emotional counseling. But in situations like these, I feel useless. Sitting bedside, I twiddled my thumbs, wondering what I was going to eat for lunch. After five minutes, I got up and left. After all, what does it matter?
One of the most difficult interactions occurs with patients who lack the cognitive function to interact in a meaningful way. Often, I’ll sit bedside and play music, or I’ll read poems, or just hold their hand in silence. All the while, the patient just lays there staring into space. It’s these times where I often say to myself, “why am I even here; what good is this?”
I value the interactions where there is a meaningful dialogue. I see my role as a counselor as someone who meets with people in crises and creates a safe environment to process and work through the pressing issues one is facing. It’s the imagery of journeying with the patient through the depths of existential angst that makes me proud to be in hospice. It’s a profound empathic connection that I am skilled and trained to embark on. After all, death and the process of death can be a frightening experience! So, you can see my dilemma when I walk into a room and see a patient who is living with an advance form of, say, Alzheimer’s, and is cognitively alert to almost nothing.
As I left the nursing facility and got into my car, I wondered if I was making a mistake with my abrupt departure. After all, if I felt as if my presence didn’t matter, perhaps the patient didn’t matter either. This didn’t sit right with me, and I felt compelled to delve deeper into my dilemma. For the next thirty-minutes inside my car while my mind ruminated with the question does it matter?
Before I knew it, I was hit with the conviction to test something out. What if I lived the next four hours as if everything mattered? Four hours may not seem like a lot, but given the mental fortitude needed for such a task, four hours seems like it would give me the insight I need. I mean, would I realize that futile interactions are meaningless? Or would my world be illuminated with beauty when I live as if everything matters? I drove off and was ready for my four-hour test.
I went to lunch, and while eating a woman in a wheel chair entered. At one point she began looking around looking confused. Given that the room was filled with so many people, I would normally keep to myself and assume that someone else will attend to her. Not this time. I stood up and approached her cleared a path so that she could get through. She looked so appreciative and even stopped to chat with me for a bit. Turns out that she has cerebral palsy and often feels that when she is in public, she feels that she does not matter much to others. For the rest of my lunch I sat with no earbuds in my ears while being mindfully aware of all that was around me. Often, I sit with my head down while listening intently on some podcast; but today my lunch was much more meaningful.
I then went in to work and was greeted by our receptionist at the front desk. Normally, I simply walk by her with a quick “hello” and get to business. Not this time. I asked her a litany of questions – that seemed most appropriate for office small talk – and she happily answered. She ended the conversation by saying, “thank you for listening.” What an interesting twist when I slow down to see who matters.
After work I went to Starbucks, which is my typical routine. As I approached the barista, I realized that the same barista has been serving me for 2 years, and I know absolutely nothing about her. Realizing that she matters, I made some small talk with her and learned that she is going back to school to study criminal justice and she works two jobs to support her and her daughter. There was also the usual homeless guy sitting in the corner that always waves at me. I usually divert my gaze because he seems really unstable. Not this time. I asked if I could buy him a coffee and he gladly accepted. For the first time, the barista and the homeless gentleman ceased to be simply background objects – they actually matter to me.
I arrived home that evening to greet my wife and 1-year-old son with a wide-open heart. Entering my house, I truly felt as if my ego had dissolved. Oddly, it was an effortless feeling. The obligatory duties that I sometimes begrudgingly do felt like tiny gifts of opportunity to experience life with a little more richness. Taking the time to attend to my family’s needs felt much easier and enjoyable. My inner selfish voice that is so ‘I’ focused was subdued, and so much more around me really mattered.
At the start of the four-test, however, I must admit that I felt like I had to muster up some effort to see what matters. However, hours into it, I felt light and ready for whatever the world wanted to present me. Of course, the next day came, and I quickly feel right back into the ego-driven nature that has been my norm. I’m a work in progress so no need for me to feel like a failure. Enlightenment is a process, not a destination.
When I look back at those four-hours, there are several nuggets of wisdom that stood out. When I lived as if everything matters, I noticed how quickly people ceased to be just objects of my periphery. Rather, I was able to see people as walking stories who harbor a treasure trove of joy, pain, meaning, wisdom, etc. After all, we’re more than flesh and bone who will one day be food for worms. Just as I crave meaning, significance and purpose, so does the barista who serves me coffee. Unfortunately, the preoccupation to protect our fragile persona often stifles our ability to see other humans with significant depth. Fear of exposing our secret shadows and vulnerabilities often propels us to view those outside our inner circle as a means-to-an-end or as background props within our scope of vision.
In contemplating my test, I became disrupted by the question: if I have intrinsic value and see myself as one possessing dignity, should I not bestow the same value and dignity to others? What makes me so special that I can be so discriminatory to those around me? For most, the tendency is to see the value of ourselves and those whom are exclusively within our inner circle, whom we have a relationship with. Thus, we gladly acknowledge the value of ourselves, relatives, friends and those whom we feel a kindred connection with. We soon become, however, amnesic to the intrinsic value of others as they stand outside our inner circle.
What does this mean when I’m with a cognitively impaired patient? Well, it means they are more than flesh on a bed. They are ambassadors of life. They are a living testimony of perseverance and gumption. Though I may deny or repress it, I am looking into my reflection. This very well may be me some day, lying in a bed unable to do anything for myself. This reflection inextricably connects me to the patient in front of me. I recognize that the patient matters just as much as me. Just has I have intrinsic value, so does the patient.
Intrinsic value is not limited, and ought not be limited to only those who can communicate or reason. My hospice patients are a living embodiment of a lifelong effort to strive and fight to make sense of this complicated universe. Even if they cannot articulate their effort, they are nevertheless entwined within the thread that weaves all of humanity together. The universal thread encompasses the truth that all of us are thrown into the universe without consent and doomed to piecemeal our existence into some type of meaningful narrative. The patient represents this truth, and this matters.
They matter to their loved ones and friends. Even if they lived as an isolated recluse, their life serves as a symbolic representation of the sacredness of being human. As they lie in bed staring into space, they are an image of you and me. Every wrinkle, nonsensical babble and repugnant odor reveals the fragility of life. Moreover, it shows the irony of life: we helplessly soil ourselves as babies and then again at the end of life – that is, if life doesn’t take us out in one quick swoop. This, however, need not serve as a depressing picture. This is life. Hardly depressing, life is a vigorous unfolding of meaningful experiences that takes us through the depths of darkness and the peaks of joy. The innumerable unfolding of meaningful experiences is what creates value for the individual. As a helpless patient lays in bed, they are the sacred representation of the intrinsic value of humanity. Thus, they matter.
During those four-hours, I also noticed how easier it was to be present. Being present is a common term that has recently gained momentum in Western thought. Being present means that we are grounded in the now, not being emotionally pulled into the past or having a mind possessed by the future. When guided by the presupposition that everything matters, being present is easier because you are more consciously aware of the world around you – in that moment. You’re aware of that specific flower in front of you, that person in the corner, that face that looks distressed, and that laughter in the background. The more present we are with the world around us, the more meaningful it is. While I’m accustomed to living on auto pilot, I must admit that life seems to be bolder, colorful, and meaningful when I slow down to allow myself to be aware of all that’s around me.
Being present clears one’s vision to see what matters. I want to be the kind chaplain who walks into a patient’s room and is keenly present to the needs and concerns as they arise. I want to sit at the bedside and accept all that emanates – without any pretense or judgment. When I live out the phrase everything matters, I’m able to calm my urges that are possessed by own self-serving perspective. When I’m present and everything matters, humility rises to the top of the ladder of virtues. What a rich experience it is to step outside the mask that protects the ego and allow life to unfold.
I can’t help but think what would I want if I was alone in a nursing home without the ability to communicate in a coherent way? I hope that a chaplain will sit at my bedside and realize the sacredness of my final chapter closing. I hope they will be able to hold a space of calm reverence and holy recognition of my pursuit of meaning and significance in life. Though some may call it a vegetative state, I hope they will be able to transcend clinical language and see that I am a powerful metaphor. I am the leaf on a tree that has gone through the dynamic and vibrant seasons; and now Winter is here. I am the drop of water in the vast ocean, part of the beautiful sea of humanity, and now the wave is taking me to shore. I am an actor on the stage of my own Shakespearean play, and will be exiting the stage quite soon. When these metaphors crescendo, they reveal that the hospital bed is in fact on holy ground. Indeed, the ground supports the hallowed phenomenon of a person’s very last breath. For any visitor that enters during my final moments, I hope they create a compassionate space to tenderly sit with me as my hundred-millionth breath comes to an end.
Perhaps when you see a patient or loved one who is about to fade to black, it will hit you that your exit is also inevitable. Rather than depress you, perhaps this will inspire you to re-evaluate your values and pursuits. Death need not be a nasty shadow that you suppress to the farthest reaches of your subconscious. Though death destroys us physically, the idea of death can save us. It’s precisely because that there is a finality that life can be experienced with an intensified preciousness. The infinitesimal wisdom found in experiencing life is why everything matters. We would all be blessed to live everyday as if everything matters.
To be fair, I realize people may disagree and argue that stress can arise when one feels the weight that everything matters. If everything matters, then you may feel that you must always do something or rise to the occasion to give every experience it’s proper due. What a chore! I think this is where the idea of being present may provide the antidote to the pressure of everything mattering. Living as if everything matters is more about the way we posture ourselves when we confront the world rather than a burden that we carry. Thus, the more we cultivate the mindset that everything matters, the more our initial reactions are subdued and less reactive. It’s as if we our creating space in our psyche for a peaceful and compassionate reaction to what is happening to us in the now. Far be it from being a philosophy that weighs us down, rather it’s a way of looking at life that make the present moment significant and beautiful.
With this approach to the world, the next day I went back to the patient that I so abruptly left the day before. I entered her room with fresh eyes and a renewed understanding. I saw an 85-year-old woman who matters. I knew I was on holy ground in front of a woman with intrinsic value. I called her daughter who lives out of state and inquired as to what here favorite songs are. We listened to Frank Sinatra during the visit, and not once did she speak or make eye contact with me. It’s okay though. This sacred moment matters because it highlights the preciousness of life.