Cancer Blog
By Brian Zimmerman
Begun on July 31, 2021
Email: dyingman1@yahoo.com
My Dying Words
Entry #3:
August 3, 2021
“My mother is a fish.”
“As I Lay Dying”, William Faulkner, Modern Library edition, p. 79 (Vardaman chapter; yes, that’s the ENTIRE chapter)
Little Experience of Death
Before my diagnosis of a terminal disease, I had had very limited experience of death and dying personally (except with my dad, who also died of cancer, though of a very different sort and in his 80’s). Most of my experience was from my clinical work in the hospitals where I practiced acute care PT, but more importantly, in my home health job. I entered literally hundreds of homes over 6 years seeing people sick, or suffering from injuries or recovering from surgeries, or dying, and observed the many forms of family dynamics in responding to those circumstances. Sickness and dying/death are not experienced in a vacuum. I gave the quote above from one of my favorite authors about the death of a mother. The quote is from a chapter narrated by her young son, Vardaman, as he tries to make sense of her death. The reason I bring this quote in is that Vardaman’s experience of his mother’s death is in a context of what he has experienced of death. And, I saw this phenomenon many times in home health.
The first time I realized how limited my cultural experience of sickness/suffering/dying was in a hospital setting. I received a referral to go see an elderly black woman who was recovering from surgery. When I arrived at her room, I had difficult entering because it was packed with her family: children, grandchildren, great-grandchildren were all in there. It sounded like a party or family holiday get together going on. I called her name –“Mrs. Smith?” and was told I was in the correct room and so pushed my way in with “Excuse me, excuse me” constantly to reach her. When we discussed her discharge plans, she assured me she would have plenty of help. I believed her.
Almost literally right next door was an elderly white woman who was also recovering. But, when I entered her room and called her name – “Mrs. Jones?”, it was like an echo in a cathedral. The room was empty except for her, and I saw no visitors any time I went to see her. When I asked about her discharge plans, she was very vague except to say she wanted to go home. “Do you have any children?” I asked. “Oh yes,” she responded, but one lived in Maryland, another in Tennessee, etc. Okay, what about local family? Well, there’s a sister, but they don’t have much to do with each other. Friends and neighbors? Well, she had a neighbor who would check in occasionally. In other words, she was going home without being able to care for herself and having no expectation of any assistance from anyone else. She assured me she would be fine. I didn’t believe her.
Death Care Requires More than One Generation
So, what I saw over the course of years was that many middle class white people live in multi-generation family situations for only a short time (for the length of their children’s childhood), and then were alone with a spouse for the rest of their lives. But, many black, Asian, and Hispanic families are multigenerational for many years. So, when grandma gets sick or injured or feeble, there’s always someone there to help her. Trying to replace that family assistance with paid help is extraordinarily difficult and expensive. Maybe the idea that the end of life is an individual’s problem and not anyone else’s needs to re-thought by those of us who grew up in a family that scattered as soon as the children could leave and live on their own.
I’ll close this entry by mentioning Paul’s discussion of familial responsibilities in 1 Timothy 5:
“3 Honor widows who are widows indeed; 4 but if any widow has children or grandchildren, they must first learn to practice piety in regard to their own family and to [a]make some return to their parents; for this is acceptable in the sight of God”.
Paul elsewhere makes clear the obvious responsibility that parents have for their children. But, here he reverses the responsibility, an application I believe of one of the 10 commandments: “Honor your father and mother.” Honor initially is about obedience when we are young children, but what constitutes honor changes when we become adult children. We were cared for when young by our parents, but as they age, now the roles should reverse and we honor them as we become the caregivers. And, those parents or children who resist that responsibility have the worst experience of sickness or suffering or dying in my observation. The parent who obstinately refuses to accept help from her children causes them no end of worry and trouble. The child who refuses to accept that mom can’t care for herself any longer just increases the mom’s worries and suffering and dangers.
But, of course, that’s only the problem situations I saw. I saw also many families in which they were willing to change and accept the situation: a parent who was willing to move in with a child or even move from out of state to be near a child, and children who built rooms or even mother-in-law suites onto the house, or simply opened up a bedroom to a parent who moved in with the family. It often meant the child had to alter their work life, such as working from home or taking early retirement, but usually involving a loss of income that they accepted because they were willing to provide care for their mom or dad, or sometimes both. I had a lot of respect for that kind of sacrifice as they had no way of knowing exactly what it would involve or how long it would continue.
What About the Church?
Of course, I can’t let the church off the hook here as Paul makes it clear that widows who have no family to care for them are to be cared for by the church. How many churches are set up for that responsibility?
“16 If any woman who is a believer has dependent widows, she must assist them and the church must not be burdened, so that it may assist those who are widows indeed.”
As boomers age and as our culture fractures our familial bonds, I think this problem will only continue to grow. There’s not enough caregivers, ALF’s (assisted living facilities), and nursing homes to care for all these elderly people. Our idea of family needs to be more accepting and intentional in accommodating multi-generational responsibilities.