In the middle of November I called to see Megan for the first time. She was in one of the spacious single rooms of the hospice, with a view to the well-stocked garden with fields beyond. Today the curtains were closed and Megan was lying propped up on pillows apparently asleep. She was not expected to live much longer.
Megan's daughter Clare was sitting in an armchair by the window reading a book. As I entered she looked up at me, smiled and put her book down. I introduced myself to her and we talked a little. Clare said her mother had a private sort of faith and she herself was 'not religious'.
Before I left I said, "Usually I offer to say a prayer with people, but that's probably not appropriate now?" Clare and I were surprised to hear a voice from the bed. "A prayer would be nice," said Megan softly.
"What shall we pray for? How do you need God to come to you?" I asked Megan.
"I just want to keep going to Christmas," said Megan weakly. "I don't want to spoil their Christmas."
"OK we'll ask God to help you to do that. When I pray I like to have a picture in mind. It could be light shining on you to give you strength, or Jesus' hand on you, or even a can of spinach. That's famous for giving strength."
Megan quickly grasped what I was saying. "Light," she said, "light would be good."
We asked for God to shine light on Megan and then kept quiet for a moment. "How does it feel?" I asked her.
"It's so bright...! So bright… And I can see his face!" Megan had her eyes closed and she was smiling.
"Whose face can you see?"
"Jesus. It's so bright…"
After a little, Megan's picture faded. We thanked God for coming to her as we had asked and I left.
The following day I called again. Clare was eager to see me. "I arrived early today," she explained. "As soon as I arrived Mum said to me, 'I want to go, I want to go...' I just told her that it was all right to go. 'You and Dad have done a good job. We'll all be fine now. It's all right to go." That night Megan died peacefully.
Megan's story illustrates a number of features of my limited experience as a new hospice chaplain.
Wanting to live a bit longer
Nearly everyone is looking to live a little longer. You might think that the focus of a hospice is on helping people to 'die well' but it is much more about helping people to live well for the limited time they have. We do not talk of 'terminal illness' but of 'life-limiting illness.' Immense care and attention in devoted to ensuring that people have the best quality of life possible for as long as possible. This is great in that people can be made comfortable to enjoy life again for a while. But it does little to help people prepare for death when it comes. Most people don't want to think about that. They want to be here 'for Christmas' or just a while longer.
For most people also, their wanting to live a bit longer is simply that they are anxious about dying. Many people will say, 'I'm not afraid of death' by which I think they mean that they don't believe in Hell. Even these people will show symptoms of great anxiety. Some of this is anxiety about the process of dying, some of it is about going into the great unknown beyond death. 70% of hospice patients are given some medical treatment for anxiety and 25% display what is known as 'terminal agitation'. In this agitation a patient will toss and turn as though intensely uncomfortable during a hot night, sometimes sweating profusely, sometimes wanting to be out of bed and then wanting to go straight back to bed. Doctors are unsure to what extent this is a physical reaction to the process of dying, kidneys ceasing to function etc. and to what extent it is an expression of anxiety or distress. Usually it is treated with tranquilisers.
For me, 'terminal agitation,' which occurs in some patients not in others with similar physical symptoms, is more likely an expression of anxiety or fear of death. Even when anxiety is apparent in someone a few months away from death, it is very hard to address other than through drugs. This anxiety can spoil a person's life almost as much as their physical pain, and Christians believe that in Jesus we have the perfect antidote. But most people don't want to talk about their anxiety and what might be causing it, so most people only have drugs to dull their anxiety as drugs dull their physical pain, as they look to live that little bit longer.