Love and Service: Lessons at the End of Life

Newsletter Issue: 
November 2008

"Look forward to your transition.
It’s the first time you will experience unconditional love.
There will be all peace and love, and all the nightmares and the
    turmoil you went through in your life will be like nothing.

When you make your transition you are asked two things basically:
How much love you have been able to give and receive,
    and how much service you have rendered.
And you will know every consequence of every deed, every thought,
    and every word you have ever uttered.
And that is, symbolically speaking, going through hell
    when you see how many chances you have missed.
But you also see how a nice act of kindness
    has touched hundreds of lives that you’re totally unaware of.
So concentrate on love while you’re still around,
    and teach your children early unconditional love.
So remember, concentrate on love, and look forward to the transition.
It’s the most beautiful experience you can ever imagine.
Vayas con Dios!"
("Unconditional Love", Elisabeth Kubler-Ross, M.D.

These beautiful words were spoken by Dr. Elisabeth Kubler-Ross on the brilliant and moving CD, Graceful Passages: A Companion for Living and Dying, produced by Gary Malkin and Michael Stillwater.

Why listen to a message for the dying, when we are living, at least right at this moment? What do the dying themselves have to teach us? And what does death have to do with a life of service, and love? Well, everything!

A central part of my ministry now is hospice chaplaincy at Hospice by the Bay in Larkspur, California. I sit with people who are likely nearing the end of their life. I am also present for their families and caregivers. Although I trained in hospice chaplaincy at ChI (so I thought I knew what I was doing when I took my current job), I have discovered I how much more there is to know, and am now on a whole new learning curve!

My 'work', if you could call it that, is not really about what I do; it’s about who I am. I am someone who receives and gives love. That is the service I provide. And the two are inextricable, inseparable. There’s no clear distinction between being the giver and being the receiver. There’s this flow that happens. This occurs whether a patient is alert and clear-headed, or has dementia...whether she is awake or asleep, articulate or even completely non-responsive.

So, here’s the paradox: who is the patient and who is the chaplain? Who is giving service and who is receiving it? Who is the lover and who is the beloved?

These are ultimately, the questions we are invited to ask ourselves all the time, as people living a spiritual life. They all really ask the question that is answered in this New Testament scripture:

Jesus answered, “The first (commandment) is “Hear O Israel, the Lord our God, the Lord is one; you shall love the Lord your God with all your heart and with all your soul and with all your mind, and with all your strength. The second is this, “You shall love your neighbor as yourself.”  There is no other commandment greater than these.” (Mark 12:29-31)

That question is, how then shall we live? And the answer is, of course. to love. To love. To learn how to love our own imperfect, messy selves. To love everyone else the same way (even though they are also imperfect and messy).

This is also how we love God.  This is truly the “service” we are asked to make of our lives. The job, the career, the vocation—those are just the vehicles, the containers for our true calling: to love.

Elisabeth Kubler-Ross taught and worked with thousands of people when they were dying, and this is also what she learned from them. They taught her, as I am now being taught by patients and other hospice workers, to look at the love, and to practice it. Allow yourself to receive it, she says, and allow yourself to give it. Concentrate on love, and teach your children early unconditional love.

Let it in.  Let it out.  Let go of everything else. 

I had a wonderful patient, Agnes, who had reached her 102nd birthday by the time she died. She died peacefully at home, in the home of her beloved daughter, Sarah, who had invited her mother there 35 years ago! In the time I was privileged to visit Agnes, she used to hold tightly to both of my hands and draw me very close, then look deeply into my eyes, and ask me about myself. And whatever I told her, she was sure to bring up and ask about on my next visit!

I felt overwhelmed with joy at this kind of care and attention, yet worried that I was not getting her to talk about herself enough. I wanted to know about her life, her thoughts about what happens next, her spiritual life, and so on. She would answer those questions, when I was pushy enough to get my way about being the interview-ER rather than the interview-EE. In her answers, I saw that her love for her daughter was the central force in her mind and heart. However, usually Agnes had her way and took charge of our visits. (My boss, who leads the spiritual care department where I work, has been teaching me that hospice work is patient-centered and patient-directed. Agnes is the perfect example of this!) 

Later Sarah invited me to her mother’s memorial service at the tiny church they had attended. The pastor, after a short homily, invited everyone in the congregation to tell his or her own Agnes story.  When I listened to all these stories, from people who had known her for anywhere from 3 months to 70 years, I had the stunning realization that Agnes was simply being her normal everyday self with me—no different than she was with anyone else! Her way of living was to be genuinely interested in people. Her “practice,” you might call it, was to learn about them and care about the details of their lives.

I heard variations on this story again and again. One person, a friend of Sarah’s, had moved away for about 20 years, and had recently returned. When she visited, Agnes asked after her boys, whose names she still remembered. She said, “I guess Sam must be 23 now? And Jules 25?” The woman said she felt as loved as though she had never gone away. 

Agnes died the way she lived. With all her vast experience in the world over more than a century, the essence—that she loved and was loved—was what remained at the end. And that essence, the lovingkindness, now lives in the hearts of everyone whose life she touched. Her love was the service. Her service was the love. And now it lives on.
   
Viktor Frankl, who wrote one of the most significant books of the 20th century, Man’s Search for Meaning, said, “Man’s main concern is not to gain pleasure or avoid pain but rather to see a meaning in his life.” He believed that the search for meaning was a drive in all of us. It can be found or grown even in lives of the comfort and ease and material abundance that exists in our 21st-century lives today.

The desire for one’s life to have had meaning is perhaps more acute when one realizes one is near the end. And so, with this lovely message from Elisabeth Kubler-Ross, we can turn toward our own precious life’s meaning today, in this moment:

Who do I love?
How am I loved?
How am I of service?
How do I permit others to be of service to me?

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