Working through a hard death

Caregivers and health care professionals can and often do greatly to assist those who are suffering and dying. Even with careful pain management and comfort measures, however, the dying process can still be agonizing and difficult. Each death has a unique and particular trajectory, but even the most difficult and unpleasant deaths often have powerful graces and remarkable opportunities for growth mysteriously interwoven into them.

Some time ago, I corresponded with a registered nurse about her mother's final battle with lung cancer. She described the unexpected shifts in her mother's condition that had taken place over a period of eight days: "...passing through a day of Cheyne-Stokes respirations [a pattern of deep breathing, followed by stoppage of breathing, followed by repetition of the cycle], days of such shallow breathing that death seemed literally one breath away, days of calm coma, two days where the smell of imminent death was detectable, signs of diminished extremity perfusions coming and then going, coming and then going, day after day, no urine output, then urine output, then no urine, then urine again, emerge from this state and embark upon three hours of increasingly severe respiratory distress culminating in a violent respiratory arrest."

No stranger to death and dying, this nurse had assisted countless other patients with pain, air and hunger management. During her mom's final hours, she had significantly increased morphine doses per hospice protocols, but with little or no apparent relief. Her mother's death ended up being very hard. Reflecting on it afterwards, she realized that if she had not been both a healthcare professional and a person who trusted deeply in God, she would have been, to use her own words, "out of my mind with horror."

Why certain deaths are so much harder than others is no easier to explain than why certain lives are so much harder than others. It gives us pause, though, to ask whether suffering doesn't have some hidden but important meaning, however it enters our lives. As we seek to use the tools of medicine to alleviate the suffering of those who are dying, we realize how delicate a balancing act it can be, fraught with difficult decisions about dosages and interventions, and not always guaranteed to work. When pain and suffering cannot be alleviated, patients ought to be helped to appreciate the Christian understanding of redemptive suffering.

The nurse described how she and her mother had experienced this Christian understanding themselves: "My Mom and I prayed hard and much over this past year. She was expected to die a year ago. As we began to understand that she was actually improving and that she (and I) had been given this gift of time, we became increasingly devoted to the Divine Mercy of Jesus. I am of the opinion that God gave Mom an opportunity to be on the cross with Him."

Real suffering engages a lot of complex emotions. We may worry that our crosses will be more than we can bear. We may not see how our sufferings could really have any value or meaning. In the end, suffering can make us bitter or it can make us better, depending upon how we respond to it and use it to enter into deeper union with the Lord who suffered and died a hard death for us.

I'm reminded of a story I once heard about a priest in Poland who taught at the seminary. Each year, there had been fewer candidates entering the seminary, rarely more than 8 or 9, and it was becoming a serious concern for the seminary and the diocese. One day, this priest learned he had a terminal illness, with only a few months to live. Shortly afterwards, he turned to God and said: "Lord Jesus, I will do my best to offer up the sufferings that lie ahead of me, whatever they may be, but I would ask that you send us 18 new candidates for next year's incoming class." The good priest faced an excruciating death, but a few months later when the candidates started showing up at the seminary, there were exactly 18 new students in the class.

His story speaks of how suffering has meaning whenever we unite it to the redemptive sufferings of Christ. Our sufferings and struggles are an important, albeit temporary, part of our journey. They are a harbinger of a greater destiny and a promise of our transformation. Pope John Paul II once described it this way: "The cross of Christ throws salvific light, in a most penetrating way, on man's life... the cross reaches man together with the resurrection." Our experience of suffering and death, even a very hard death, offers us mysterious and dramatic graces, with the reassurance that God himself is ever near to those who carry their cross.

Father Tadeusz Pacholczyk, Ph.D. earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River, MA, and serves as the Director of Education at The National Catholic Bioethics Center in Philadelphia. See