In death, spirituality can deepen meaning of life
By Martha Rutland-Wallis and Hugh Maddry
Gina Pavone knows her time on earth is running short. Without a cure for the ovarian cancer that has spread to her liver, doctors said she has one, two, maybe three years left to live.
She's scared, but she is also ready because of a spiritual belief system that assures her life doesn't end at death.
"It's very hard to face death when you're really not sure what's out there," she said. "And, while I think you have to look at it, you can't dwell on it."
It took every religious lesson she's ever learned and every spiritual occurrence she's ever heard about, read about or experienced to get to this point.
"For the first six months after I was diagnosed, I just laid on the couch with my dog," said Pavone, 54, of Troy, Mich. "When I wasn't sleeping, I was reading spiritual books. I think I was looking for a way to get closer to God. I was looking to believe that (God) was going to take care of me."
Raised Catholic, Pavone said she strayed from the church after childhood, but is still grounded by some of its teachings. She also calls upon all her spiritual senses for strength.
"I really needed to know why I was here," she said. "I think we all ask that question."
That question is answered in many different ways because spirituality has many different faces. It is at the core of all religions, and, in one form or another, it's the comfort most people turn to when they realize they are about to enter an unknown place.
"We are coming to realize that spirituality is of the utmost importance at the end of life," said Rev. Kevin Calloway, who works with St. Paul African Methodist Episcopal Church in Olathe, Kan. "It is that which ultimately concerns us. When someone knows they are dying, life is put in perspective."
Spirituality may be found in the connections, relationships and meanings that give life passion, commitment and hope - a poetry writing group, a 12-step program, love of nature, meditation. It can come through a personal relationship with a higher power, but it can also be tapped via contemplation, art or music.
John Rudd, spiritual care coordinator at Hospice of Bluegrass in Lexington, Ky., oversees a training program that teaches chaplains to better understand how spirituality, as opposed to religion, relate to death and dying. Rudd said it's important for the religious community to respect the differences in people's spirituality.
"It's interesting to see how many people are not associated with any church or group but do have a deep spiritual connection and awareness and strive for a relationship with their higher existence," he said.
Some find deep reservoirs of faith they never even suspected were there. Karen Boland, associate pastor of the Unity Church of Today in Warren, Mich., has seen this happen frequently. An end-of-life diagnosis, she says, can send people into "a mad-dash search" that leads them into a realization that there are deeper truths. And the realization, though sudden, is profound.
"Sometimes it's those people who can jump deeper in an instant than those who have been searching for years," said Boland.
Where they land can be in any direction, including back to a faith they thought they had long ago given up.
"A deep religious faith and being involved in a faith community makes a difference for those with serious or terminal illness," said Dr. Harold G. Koenig, author of "The Healing Power of Faith" and a professor at Duke University. "Research shows that such involvement is related to less depression and anxiety, greater well being and higher quality of life. It may also be linked with stronger immune functioning, lower blood pressures and longer survival."
Despite that, confronting death, much less delving into its meaning, is not encouraged in America.
"We live in a death-denying culture," Rudd said. "We know in the back of our minds that it's going to happen but we don't practice it too often. It's a one-time life event and our culture teaches us that it's way down the road."
Truth be known, said Boland, "Everyone of us is standing in the exit line. And we don't know where in the line we are. ... Children die before parents, parents die before grandparents. . . . It's that randomness that adds to the fear."
For some, this is the time of fist-shaking at God, overwhelming fear of physical pain and worry about loved ones who will be left behind. When that initial shock wears off, people really want to talk about what they've accomplished in life and all that has been left undone.
Pavone said during the "crying" period, she had a lot of questions as well, questions such as, "Why me?"
In Rich Lech's case, it was, "Why not me?" according to his wife, Kathy Lech.
For 41-year-old Kathy, strong religious beliefs have provided the most strength during her husband's long-term illness with brain cancer. But her husband is an atheist.
"When people used to say he should thank God that doctors found his cancer early, he said, 'I don't thank God. I thank Aristotle, because he's the one who invented the scientific method that will help save my life.'"
But, said Kathy Lech, "I know the Holy Spirit has come down for us both. Rich is getting special help whether he knows it or not."
Lech said she has been secretly hoping that her husband, who is now receiving hospice care, would change his thinking.
No matter, she said. "Someday, I will go up to him (in heaven) and say, 'I told you so.'"
While some are secure in their one faith, some find searching and blending to be the answer.
That was the case for Rose Thomason. A writer from Palm Coast, Fla., who had followed a diverse spiritual path, she found all of them comforting when, at age 60, she was diagnosed with advanced breast cancer.
She found nourishment in a variety of spiritual traditions, including the Christianity she had grown up with. She was drawn to the contemplative traditions of both East and West. She practiced kum nye, a Buddhist form of body prayer, similar to yoga. She meditated regularly.
Above all, she delved into her own soul through her writing. When she was diagnosed, she kept a journal that was later published as a book, "Shoring Up My Soul: A Year with Cancer." In it, she described the connection between spirituality and dying: "Facing death focuses the viewer," she wrote, "clarifying the soul, and rendering the membranes thin between spirit and matter."
Toward the end of her life, her son, Mark, recalls the family sitting quietly at Rose's bedside. Each was praying silently. A Jamaican woman from Rose's church circle came, bringing her whole family. She asked Mark to offer a prayer for healing. Mark agreed, and was startled when the Jamaican family gathered round the bed, touching Rose and praying loudly. Quickly, he felt the power of this ceremony, a traditional laying on of hands. "I didn't understand it all," he explained, "but it felt good."
While spiritual leaders agree that dying could very well be a profoundly positive experience, they understand human fears about it. The notion of death takes away control, often leaving behind struggles with hopelessness and helplessness.
"We start asking, 'What's the use?'" Boland said, "and that's typically when the search for meaning in their life begins."
While Pavone is convinced that "there is more after the life on earth," she is not ready to leave her body just yet.
Now on her third set of chemotherapy drugs, her tumors are shrinking, offering hope for a longer life. But in the end, she said, "You have to get over the numbers and start concentrating on living."
Pavone is doing just that by moving to New York to be closer to her family. She and her boyfriend just purchased a house on Lake Champlain in Vermont, where they plan to spend time.
"I don't know what God's got in store for me," she said. "And I'm certainly not pushing any buttons. I just go through the routine, get my chemotherapy and all the blood tests."
When her mind wanders to scary places, "I think, I sit and I talk to God. There is nothing in between us."
Copyright © 2005 National Hospice and Palliative Care Organization
All rights reserved. Reprinted with permission.
Reviewed by athealth on February 7, 2014.