Chaplain's Corner

On a beautiful, warm, sunny day, it is easy to forget the troubles all around us, unless of course the troubles are happening to us. I enjoy summer time; I enjoy the freedom from the cold, from the biting winds, the need to bundle up to go outside. I enjoy the green trees and grass as opposed to the naked trees and barrenness of a snow covered landscape. I’m not a winter person.

But there are events in life that make the environment in which we live almost irrelevant. Dying is one of those events. Mercifully, some die suddenly, sadly others die slowly and some die so slowly that it seems nothing less than some cruel punishment.

Recently, I officiated at the funeral of a woman that I knew and cared for back in the late 1990’s when I was still pastoring a church in Transcona. She was afflicted with Multiple Sclerosis. She was fine until she had children. I am told that this happens at times that a woman with MS experiences a worsening of the disease after a pregnancy. In 1999 still a young woman, she was admitted to a personal care home where she spent the last 14 years of her not too long life, slowing deteriorating, moving predictably, but slowing towards death. One morning, after getting up and getting dressed by the staff, she chose not to go out to breakfast. 10 minutes later, the staff came back in and she was gone.

This dying business, we all know it is inevitable, we all know that short of committing suicide we have no control over how or when we will die. Most of us live, for the most part, quite indifferent to death, except for those times when the death of a close loved one or friend stops us for a time. However,  it doesn’t take long that the routines of living engulf us again and our thoughts of death slip back into the semi-consciousness of our minds. This of course is as it should be. Can you imagine the state of the world if every person lived in dread of their own death? What a morose and forlorn place this world would be.

But then there are those people who come face to face with death as a normal part of their lives: Funeral directors, doctors, nurses, health care aids, housekeepers who clean rooms and beds, all too often because the last occupant of the bed has died. My work brings me close to death often as does the work of folks like coroners and police officers, and EMS personnel, just to name a few.

How do these folks cope with living in the presence of death so much of the time? Well, there are a variety of ways, some of them adaptive and some of them maladaptive, all of them attempts to remain in the presences of dying without being overwhelmed by it. It might be helpful to explore some of the ways health care workers cope with death.

One way that health care workers deal with death that is rather disturbing to those who don’t work in the field is through a morbid sense of humor. Most of the time this sense of humor is not expressed when patients or their families are around, but occasionally it is over heard or someone new to the system hears it and is quite taken back. This kind of humor is inappropriate and offensive to those who do not deal with death on a regular basis, but it is one of the ways that stress is relieved by those who work with death all too often.

Another way that health care workers deal with their repeated exposure to death is losing empathy for those who suffer. Many of us have been taken back by a nurse or doctor or health care aid that doesn’t seem to care at all for you as a person. Some working in heath care stop caring emotionally to deal with the overload of what caring would require of them. Instead of breaking beneath the burden of empathy, they focus their care clinically.

Some health care workers personalize their repeated exposures to death. The death that they deal with at work provides the context to re-experience a personal loss they experienced. Depending on the circumstances of the death, those who personalize often struggle most when the death has some resemblance to a death they experienced in their personal life. These health care workers may cope very well when they deal with the death of an elderly patient, but may struggle to even stay engaged in care when the person who dies is a 16 year old, because they have had that experience in their own life and it is just too close.

Others internalize their emotions related to the deaths they deal with in their work. These people are consummate professionals. They have a personal code that does not allow the feelings their work may illicit to interfere in anyway with the work that needs to be done. Internalizers “stuff” their emotional responses to the deaths they deal with in their work. This coping mechanism has its hazards because our internal capacity for stuffed emotions is only so big and when we are “full” generally the result is some kind of explosion or spillage of emotion often in inappropriate ways or with the wrong people. Occasionally these internalizers, these consummate professionals will have an explosion or melt-down at work and leave every one shocked because “this is so unlike him or her.”

Others chose to numb out there feelings related to the all too often experience of death that is part of their work. These folks are a bit different from those who have lost empathy for many times they turn to some kind of addictive behavior to numb out the overload of feelings that their regular exposure to death brings into their live. Most addictive behaviors are mechanism, not health ones but mechanisms none-the-less that deal with the pain by helping the person escape for a bit.

So, how do I deal the repeated exposures to death that are part of my work? Well, like others I experience a number of different ways of dealing with death in my work. When a couple experiences the death of an infant, I still find that I personalize and find myself feeling the losses that my wife and I experienced years ago. I don’t know if this will ever change? When the death is that of an elderly person who had lived a life of faith, I experience a bit of sorrow wrapped in a lot of joy, for the Christian faith sees such deaths, not as tragic, but as throwing off the shackles of this life for the glory of a heavenly existence.

But then there are deaths, tragic death, young people and adults in their prime; accidents, suicides, and sometimes murders. These deaths are harder to deal with. Personally, I tend to detach myself from the tragedy and focus on how I might be helpful to those who survive. I tend to lose my response to the death in caring for the living, focusing all of my energy on what I might be able to do to help those closest to the death to cope with the horrible, unexpected loss. I keep reminding myself, “This is not about me, it is about these folks who are suddenly thrust into the most unwanted and unexpected thing they could imagine”.

I wonder how you deal with death. I know one person who never goes to a funeral. That’s one way. I know another that goes to almost every funeral, even if the acquaintance with the deceased was very minimal. That’s another way. Most of us probably fall in the middle somewhere. It might not hurt to stop and ask the question, “What do I do with the losses I experience in life? Am I a personalizer, an internalizer, do I use humor to deal with the tension that death delivers or maybe I turn to something to just numb out the feelings? It’s worth thinking about.