He was young. In fact, he couldn’t have been much older than 60, even if his weathered skin gave him the appearance of more advanced age. The nursing staff had called me in to help address his depression, but his depression wasn’t without warrant. The doctors had said those dreaded words to him only a few hours earlier: “We should focus on making you comfortable.”
He had end-stage pancreatic cancer.
Optimistic estimates gave him a few months.
More dire estimates gave him a few weeks.
No wonder he was feeling depressed.

There in the hospital room, with the only light peeking in around the drawn window shade, I sat with him and did my best to learn about him. I asked questions to try and help him reflect on his life, but he responded with one-word answers again and again.

What brought you to Jacksonville?
“Work.”

Do you have family in the area?
“Yes.”

Who’s nearby who might be able to help right now?
“Niece.”

Finally, he looked over at me and said sternly but not unkindly, “Chaplain, I appreciate what you’re trying to do, but all I really want right now is a cigarette.” Caught off guard, I stammered through an explanation of the hospital’s no-smoking policies, but then a smile crossed his lips for the first time since I had entered the room.
“What’s it going to do? Give me cancer?”

He had a point.

I got the nurses’ and doctor’s permissions (though the latter took some arm-twisting). We put him in a wheelchair, got him a lighter, and took him outside to a gazebo where he could light up a cigarette. After all, he didn’t have long, and he had a right to spend his last weeks as he wanted. I sat with him in silence. He puffed thoughtfully and closed his eyes for a moment as the sunshine cradled his back, and then it was time to return to the room. There were no more words between us; he just gave a resigned smile and nodded his head as if to say: Thank you and goodbye.

Now, I’m not writing this to advocate smoking. (Lord knows I already get enough flack over the alcohol stuff, so I’m not even touching the topic of cigarettes.) Rather, this experience raised questions for me about how we treat people as they near death. In our sanitized world, we often try to contain death. We banish it to hospitals and nursing facilities and then to funeral homes. We’ve built an industry around it. We take away choices, and as we do so, we take away agency and humanity.

What if, instead, we listened to the people who were inching closer life’s finish line? What if we did our best to accommodate their wishes? What if we helped people spend their final days doing the things they wanted and helped them set goals beyond “live another day”?

How differently might we look at death?
And how differently might we look at life?

 

 

HIPPA Disclaimer: Due to patient privacy regulations, any stories I share from the hospital will involve changes to protect patients’ identities. Timeframes, diagnoses, and personal identifying information are intentionally changed or left vague.