The Wicos Problem

A quick observation from When Breath Becomes Air, Paul Kalanithi.  

During lucid moments, I was acutely aware that with this many voices, cacophony results. In medicine, this is known as the WICOS problem: Wh Is the Captain Of the Ship?   p189

The WICOS Problem. When the doctors get together to decide what to do for you and decide who is in charge. 

 

Music for life

Martin Luther wrote, "next to theology, I accord music the highest honor." Or words to that effect.  Wiki Luther Music

Music is a language that needs no study, only enjoyment. Study it if you wish, many do. Just remember, you don't need to make music to be musical. Valuing the music and it's effects upon your mood, attitude, and overall health is my promotion for the moment.

In Musicophilia, Sacks wrote,

Music can take you to places you have never been before, wish to go to, wish to avoid, and help you navigate all of them. It is rhythmical geography for the soul. When it comes to the end of a cherished life, it is a memory restorer/curator, sort of like a musical picture album for the mind.

I played music this week for dozens of people. It is almost always affirmed by a smile, a nod of recognition, joining in and singing with the tune, a reminder of other songs, a piece of history that seems long lost. Music resurrects the life or a slice of it long assumed dead. It can bring back joy and courage and resilience, even healing when it is properly used.

A while back, I entered a room of a client and began to play hymns softly on my harmonica. I routinely do this and my charges are not surprised or bothered by it. They just know that pastor Marty has his harmonica in his left hand and he will likely play me a tune or two. As I played This is My Father's World, my client began to sing the words of the light and airy hymn. Her mood improved and her day was brighter. The nurse and others in the room were somewhat surprised because they had not seen this side of the client, the memories of a hymn that came flowing from her mouth so easily. I think it was a bit of a shock actually. It was assumed that there was not much left of her mind, nothing reserved for lucid speech anyhow. It even surprised me a little bit.

It has pushed me to research more and play more music. To be able to see family members smile as their loved one sings along when they thought all that has been lost, is a magical moment. A restorative moment. A healing moment. A hopeful moment. A musical moment.

On occasion, I have played music and within seconds of conclusion, the loved one goes to sleep for the last time. When family is present, this is often the most peaceful memory they could wish for. It stuns me how this happens, but then I remember the power that music has to bring one close to God and thankful for life on earth and prepared for life hereafter.

A lot of communication goes on when music is involved.

Laughter

Death is no laughing matter. To make fun of anything at or near the time of death is risky. My advice is don't do it. I have done it and regretted it and done it and thought it good. It is still risky. You need to have a good reason and good delivery and good timing, or it will be remembered as the foolish attempt to make things better.

So when is humor appropriate? And how do you use it? I recently officiated at a funeral where the deceased left me clear instructions to be funny at his funeral. None of this moping stuff. He was a stoical, hardworking, accomplished man and he had little time for tears. Needless to say, there were plenty of tears at his funeral, but I did my best to be funny. Of course, I told everyone that if they laughed at anything I said, it was his fault because he told me to be funny. We used to trade jokes when I visited him. He had some good ones, some I could use and some I couldn't, and some bad ones, some I could use and some I had to lose. But humor was a part of our journey together before he died.

I really got to know this man and his family. I was a part of them for a while. That is why I hardly every use humor with someone I have just met or right at the start of our relationship. That kind of humor says more about my fears or insecurities at that first meeting than it does about how I might minister to the patient. No, humor is too valuable to waste it like that. 

Green lights for humor. When they are funny first. When they smile easily or laugh at something you say. When they give you permission to tell a joke. When they are sad and you ask them if they would like to hear a joke or a funny story. Get permission first, at least the first few times.

When people ask me what I can do for them, I have a short list, Pray and stay, smile a while, play some music on my harmonica, share Scripture, and I often tell them, I can tell bad jokes. Jokes and music are almost always welcome, even in the most devoted and religious patients.

Some jokes are without strategic purpose, except to lighten the mood and get someone to laugh. There is medicine there, right? But I use funny stories to get a conversation going.  

A woman arrived at the Gates of Heaven. While she was waiting for Saint Peter to greet her, she peeked through the gates.

She saw a beautiful banquet table. Sitting all around were her parents and all the other people she had loved and who had died before her. They saw her and began calling greetings to her "Hello - How are you! We've been waiting for you! Good to see you."

When Saint Peter came by, the woman said to him, "This is such a wonderful place! How do I get in?" "You have to spell a word," Saint Peter told her.

"Which word?" the woman asked.

"Love."

The woman correctly spelled "Love" and Saint Peter welcomed her into Heaven.

About a year later, Saint Peter came to the woman and asked her to watch the Gates of Heaven for him that day.

While the woman was guarding the Gates of Heaven, her husband arrived. "I'm surprised to see you," the woman said. "How have you been?"

"Oh, I've been doing pretty well since you died," her husband told her. "I married the beautiful young nurse who took care of you while you were ill. And then I won the multi-state lottery. I sold the little house you and I lived in and bought a huge mansion. And my wife and I traveled all around the world. We were on vacation in Cancun and I went water skiing today. I fell and hit my head, and here I am. What a bummer! How do I get in?"

"You have to spell a word," the woman told him.

"Which word?" her husband asked.

"Czechoslovakia."

Now that is funny. More importantly, it's useful as a lead into questions about heaven, who's going, how do you get there, who decides whether you get in and more. That story allows me to share the good news of God's plan for a Forever Friendship with God. I like to share Psalm 100 after I tell that story. Here is the Message version.

Psalm 100The Message (MSG)

A Thanksgiving Psalm
100 1-2 On your feet now—applaud God!
    Bring a gift of laughter,
    sing yourselves into his presence.
3 Know this: God is God, and God, God.
    He made us; we didn’t make him.
    We’re his people, his well-tended sheep.
4 Enter with the password: “Thank you!”
    Make yourselves at home, talking praise.
    Thank him. Worship him.
5 For God is sheer beauty,
    all-generous in love,
    loyal always and ever.
Sing yourselves into His presence. So God must love music. I'm glad for that, being a musician. And he must love to laugh, because it says bring a gift of laughter as well. Hallelujah, God likes to laugh. And it almost looks like He requires it to get into heaven. The third requirement in this Psalm is Gratitude. Knowing where your blessings come from and offering thanks and praise to God for them. Gratitude, or as Peterson puts it in the Message, the password to heaven is "Thank You."
So sing and get funny and thank God for all of it. 
Humor: purposefully employed can open up a world of conversations and gently open closed doors to what is often a difficult and painful subject, Death. Presented well, a funny story can help one show up at the gates, all so well prepared for that face to face meeting with an enchanting and accepting God who loves to laugh and sing and fellowship with His children. Master humor and God will teach you how to make a difference with your funnies.
What do you call a Rabbit with Fleas. Bugs Bunny. That's all folks.

Conversational Aids to Talk About Death

Death is, for most people, the last thing in life that they want to talk about. And for many people it will indeed be the last thing they talk about. We’re simply not very good at talking about it and it shows. I waver back and forth on this idea. You are free to stay silent about your death or anyone's death for as long as you please. I meet more than a few folks who do just that. I will support your right to do that. But I don't agree with it.

It's been my experience that talking about death is the best preparation for enjoying the rest of your life, including the last few months. Facing death, talking about it, empowers one to review their life and renew and remember how meaningful life has been. And the last weeks of that life are filled with more joy and gratitude for the blessings they've received.

So how do we talk about death? Here are some ways to talk about it.

I offer a quick outline, each of which will have a separate blog post coming up.

  • Humor
  • Music
  • Stories, Native Cultures, Close To the Earth
  • Questions
  • Scriptures or Sacred writings
  • Poetry
  • Directly
  • Indirectly
  • Intimacy
  • Tears
  • Movies

Peace Be With You.

 

The Conversations

There are two important conversations in our lives. You can ignore or avoid them altogether but you will face them nonetheless.

I never got the Birds and Bees conversation, did you? I would have been spared some serious embarassment if I had. I got what little I could on the subject from the Brady Bunch. As you can imagine, I knew very little about the Birds and the Bees.

The other conversation was about death. I did get that one, from my father. He said that "when he died, to throw him in a Pine box and bury it." Simple and clear. Way to go dad. You could have expounded some, but hey, at least I knew what you thought about dying.

The conversation about End Of Life is important and can clear the way for a death with meaning and dignity for everyone involved. Avoiding the conversation leads to more anxiety and suffering than most of us realize. Most of us see little need to talk about our death and it's manner. This is sad and unfortunate.

I work among the dying and have this conversation everyday. It does get easier. And there are a number of ways to have the conversation. Stay tuned and we'll converse some more.

 

Communicating with the Living

We have been losing our ability to communicate verbally and in writing for many years now. I have a collection of letters/correspondence from Civil War soldiers and officers that is so creative and thoughtful that it makes our modern emails look like they are written by amoebas. And our spoken conversations are almost as embarrassing. 

We find ourselves increasingly at a loss for words in our daily routines and it is hurting our relationships and more. Listening to Headlee will remind us of the basics of what a conversation is all about. You've heard most of this before, some might be new. Good refresher or original ideas, either way, good words for those who converse daily. 

Pass Me Not

I read somewhere that every second, two people in the world die. Now it's up to four and by the time I finish this sentence, it will be 16, if the math works out. Talk about counting what really counts. Who likes counting deaths? Somebody must do it, I just don't imagine that they like it.

I drive by a lot of houses most days. And some nursing homes too. I used to drive by with little or no thought as to the occupants. Now, I seem to know a great deal about many of them. And I know more than I ever imagined about who is near death in town. My mind works geographically, positional writing in other words. I anchor the stories with the place. And there are many stories from all over town that are in my brain box. I will drive by a house and faces come to my mind. And stories; and I'm amazed all over again. Various places in town are so much richer now. Many of those stories are incredibly amazing. And I would not have known them if it were not for my work of going into those homes instead of passing them by.

There is an old hymn, Pass Me Not Oh Gentle Saviour.

  1. Pass me not, O gentle Savior,
    Hear my humble cry;
    While on others Thou art calling,
    Do not pass me by.
    • Refrain:
      Savior, Savior,
      Hear my humble cry,
      While on others Thou art calling,
      Do not pass me by.
  2. Let me at Thy throne of mercy
    Find a sweet relief;
    Kneeling there in deep contrition,
    Help my unbelief.
  3. Trusting only in Thy merit,
    Would I seek Thy face;
    Heal my wounded, broken spirit,
    Save me by Thy grace.
  4. Thou the spring of all my comfort,
    More than life to me,
    Whom have I on earth beside Thee,
    Whom in Heav’n but Thee.

I like Saviour instead of Savior. Just sounds more substantial.

The Lord does not pass us by as Fanny Crosby reminds us in this hymn. He is with us when we are born and through every chapter of our lives and right on through our death and beyond. He is our God and we are His children and He will not pass us by.

You too can join in this Sabbatical work of stopping and resting with someone, not passing them by. So many of us go looking for life in its excited glory by running into the world, leaving behind all the ones who have gone before us. They are old, they are not important anymore, they aren't able to do much. What do we tell ourselves about them, maybe not in words but in vague thoughts?

The truth is, they are fascinating, rich, wise, capable, full of zip and treasures to behold. Do not pass them by. Visit this week, by phone, or internet, or in person. I'll see you out there.

Harbor Master or Wave Wrangler

A ship in harbor is safe but that is not what ships are built for.

John A Shedd 

Sailor and Theologian

Pastors navigate their crew through all waters in every season. They take respite in harbor, and prepare for the next voyage. But they are secretly plagued by Harbor fever, always ready to enlarge their horizons.


Pastor Pastor Who Art Thou?

 

It is difficult to get a man to understand something if his livelihood depends upon his not understanding it.” 

– Upton Sinclair 

The word “pastor” is not in the New Testament very often. The word pastor simply means “shepherd”.  What does the Bible mean when it uses the word pastor? Although the word pastor is in the Bible a few times…

The modern role and function of a pastor is found nowhere in scripture.

If you had lived during the first century and then read the word “pastor” in a letter written to the church, you would have a much different idea come to mind.

So what does a pastor do to be a real pastor and who decides what a real pastor does? Stay tuned.

 

The Called Pastor

To be Called is to hear the Voice of God. Mysterious? Yes. Simple? Yes. Easy? Rarely. Probably never. 

The greatest danger to the Called is failure to follow the Caller. The ONE who calls. In the world of the Called, this failure is more common than it is evident.

The Called must follow the Caller, not the Calling. That's the only way to live the Calling. Easy? I don't think so. But life changing. In fact, it's the only way to change the world.

What is a Funeral?

I don't count funerals anymore than I count haircuts, and I've had my share of both of them. For me, they are a natural part of my life and work. Each funeral counts of course, it matters deeply to family and friends what you say or share at the service. In fact, the things said at a funeral may well be the last memories of someone and family and friends will carry those memories to their own grave.

I'm not sure that we are having more funerals today, although it feels like it. I just had 6 in three weeks and another one coming up in two days and another one in July. I'm slowing down this weekend so that I can process all the atmosphere that funerals bring, both joy and sadness. These emotions find their way into my heart as I pastor the loved ones who remain alive and grieve. My main joy is to help them return to a thriving life again. This doesn't always happen. Some never do recover from the loss of their loved one. But most do. My part is to help them regain their spirit, their purpose, their goals for living.

Most funerals are not traditional anymore. In a church setting they might be. But from my office, they have come to be a mix of memories, hopes, fears, words of remembrance, words of hope, and to a lesser extent than I am used to, words of Scripture. That last part I find challenging. I'm pretty sure I will always have words of Scripture to share. It's not that people are against sharing a word from God, they just are not familiar with it as much today. Which also means, they are not used to traditional funerals either. Today we call them Memorial services, conducted in a funeral home, or church, or some other facility or the last nursing residence lived in. These are often beautiful and tribute filled services.

The only thing missing is a sure and certain word from the Lord. When we die, we can offer little surety or certainty to the gathered congregation. Our death is proof of that. It is the life well lived in the grace of a loving God that inspires us to look for God's word at a funeral or memorial service. Most funeral services still include some Scripture, the 23rd Psalm for sure, the Lord's Prayer and others. Yet, the meaning of those Scriptures is growing less important. You can leave many services today and not even know why a Scripture was included. This allows hopelessness to creep into our memorial services, uninvited and unawares.

No, our hope is built on an enduring and everlasting friendship with God. A Forever Friendship. And for that, we need to hear what He has to say on the subject. That's where all hope comes from!

Rain

To step outside tonight was to take a shower, be refreshed. Accompanied by the lightening, the rain got our attention. Throw in some marble size hail and you begin to hunker down. Tornado's in the region made it even more intense.

Now it's quiet. Thankfully. Till next time. I'm grateful for the rain, especially since so many are dry.

Rain may be the quickest reminder to show gratitude. The dryer it has been, the more gratitude we may find. Trick is, to be grateful when their is plenty of rain.

That is the trick. Isn't it? To be grateful in our prime, when things are coming up roses. When everything looks good, that is the time to offer gratitude. It will make us more grateful when the roses fade and the rain does not fall.

Spirituality

I've been searching for definitions of Spirituality. About as many definitions as pennies in my piggy bank, and just as pennyfull. The idea of Spirituality is varied, from what gets you up in the morning to what makes you tick to a spark of divinity within to no such thing as spirituality. It's like trying to sew a button on a poached egg. Messy. 

I'm supposed to be able to assess a persons spirituality. I take a peek into their minds and hearts and come away with a qualitative, quantitative opinion of their spirit. Needless to say, I think Jesus is better at it than I am.

I've turned toward the idea of a Forever Friendship with God. I often ask about the status of someone's friendship with God. Do they want to be friends with Him forever? Likely as not, I'll read a passage from the Bible that explains how much God loves us and is doing everything to secure our friendship. 

I ask unusual questions. By that, I mean, not the usual ones about your insurance provider, or if you've had any serious surgeries, or who is your next of kin, or do you want extra life measures to extend your life? No, I ask questions about stuff deep inside you where no X-ray has gone before, a new frontier for many.

And usually it's ok, sometimes it hits a nerve, and sometimes it opens a faucet of faith and friendship for eternity. It's a delicate thing to ask and assess spirituality in others. Imagine a dentist setting a jackhammer next to your chair and donning a gasmask before he says this is going to hurt you more than me. In fact, it doesn't hurt him at all, he seems to enjoy it.

No, spirituality is whispered to the surface, teased out of its nooks, easy to be observed if we know what to watch for. It's love in action. Watch for the acts and you may witness the spirit. Some of my patients bless the whole day with one smile. One sentence and I'm encouraged immeasurably.  

There are days when my spirituality is assessed by them and they know just how to enlarge it. I leave them thinking that they did more for me than I did for them. And I'm good with that. 

Vets

I meet a lot of vets in my work as a Hospice Chaplain. I've been told that over 900 WW11 vets are dying each day and by 2032 they will all have passed on. I believe the last WW1 vet died in 2011. And Vietnam vets are passing at some 500 a day.

Many of these vets are talking more about their combat experiences. Many do not have the words. These men and women who wore a uniform have all sacrificed something of their lives for their country. Even those of us who never saw combat have made substantial sacrifices.

Most do not care to be called a hero, but they are grateful when they are recognized for their service. Personally, anyone who puts on a uniform in order to serve others already has one foot in hero territory, even if we choose not to make a big deal out of it.

The stories of these vets, at least the ones they will share with us are worth hearing. They are stories of devotion, sacrifice, values, courage and faith. We should be listening for these valuable stories, we may not have much longer before they can be heard.