What Not to Say: "They are not suffering anymore"

A.Hanson, Boulder, CO. 2009

This is one of the trite platitudes that I have mixed feelings about.  It is not factually incorrect, but it is still not one of the better things that you can say to a grieving family.  When someone dies, after a prolonged illness, it is indeed true, their suffering is over. But the suffering of those they leave behind continues and intensifies.

This saying in particular is well-intentioned and comes from a place of wanting to offer care, but it is still one of those "What not to say" phrases. Saying, "they are not suffering anymore" is an attempt to erase the very real (and raw) pain and suffering that precipitated this death.  Death is hard work.  We all hope for a peaceful death, but in reality, that is only one potential outcome among many possibilities. To say, "they are not suffering anymore" denies the intensity and the rawness of what just occurred.

Death does not occur in a vacuum.  When someone that we love dies, that has ripple effects on everyone around them. A family system is disrupted. A way of life is over. There is suddenly an absence instead of a presence. A whole life of stories and experiences is just gone. And the suffering for those who grieve is just beginning.

So please, don't say, "they are not suffering anymore" when you mean "I cannot imagine how painful these last weeks have been while you watched your loved one slip away."

Say instead….

"I see your pain."
"I am willing to listen."
"Tell me about what hurts."
"Do you want to talk about it?"

What Not to Say: "God needed another angel/heaven needed them more than we do/God called them home"

A.Hanson, Minnesota, 2014

Today's post in the series of "What Not to Say" looks at the phrase, "God needed another Angel" and many similar phrases including, "heaven needed them more than we do", "God called them home", "Jesus needed them."  This phrase is often used in the moments and days after a death, particularly a death that is unexpected or exceptionally tragic, like the death of a child or of a young adult.

In my work, I have found that parents who grieve the death of a child sometimes express comfort in thinking of their child nestled into the loving arms of a God in heaven. I support them in finding whatever means can bring them comfort in unimaginable moments of pain.

But linking the death of a beloved person to the activity of God by anyone else is problematic.  It places blame on on God for the death, and creates a god who takes people from their loved ones at will.  This particular platitude can absolutely ruin any sort of comfort that someone can find in their belief system in the arduous days, weeks and months to come. It opens a crack of disbelief in an already fragile grasp of meaning-making, and makes room for the intrusive thoughts of, "What is wrong with me that I don't belief God actually needed my child/sister/father?"

Saying, "God needed another angel" denies the very human needs of love, care, nurture, and relationship.  It implies that God's need for something (which to be brutally honest, we can never actually know, although God never NEEDS anything, that is why God is God) is greater than ours and that our needs should always be subservient to those of a temperamental deity off in the sky. This is crap theology.  Every single major world religion has precedent in their holy texts for arguing with their deities and for lamenting pain and suffering.

Finally this platitude ignores the experience of those who do not ascribe to theological systems that have a deity and an understanding of life after death. Or who are atheist or agnostic or have belief systems that are outside a very specific expression of Christianity.

Instead of saying, "Heaven needed them more than we do", say, "I can see how much you love them.  Tell me about your child/partner/parent."  Or share a story of why their life matters to you.

Or bring a damn casserole over and say, "bake at 350 degrees for 30 minutes."  That's infinitely more comforting than claiming God swooped in like some vulture and took someone's beloved.

What not to say: "Everything happens for a reason"

A.Hanson, Denver, 2011

I stumbled across this really excellent article the other day, ""Everything Doesn't Happen For a Reason" by Tim Lawrence. It articulates the philosophy behind my care in chaplaincy.  I spend nearly all of my work hours walking alongside people who are living the very worst days of their lives. There really are not words for these moments, so most of the time I just stand or sit quietly. My ministry is one of presence.

But there are things that well-meaning people say that cause more harm than good.  I should preface that my patients guide their own care.  If someone expresses the belief that their illness or suffering, or that of their loved ones, fits into a plan that is meaningful or provides hope, I would explore that system with them.  I would never dismantle structures of meaning for someone.  This series of posts, "what not to say" is directed towards those who wish to support those who are suffering.

Platitudes like "everything happens for a reason" are misguided attempts at support that are much more like self-soothing on the part of those who seek to assuage their own discomfort.

Placing suffering into some greater plan is an attempt to push back the deep paralyzing fear that a crisis could happen entirely randomly. If we admit that someone experienced an entirely undeserved and random event, the unspoken corollary is, "It could happen to me too."

The task of placing meaning onto a random event, to find some greater purpose in suffering, is ONLY for the person for whom the suffering belongs.

Let me repeat that, ONLY the person who is experiencing the rupture of the fibers of their world can place meaning for good onto their suffering. 

No clergy-person or well-meaning friend or family member can assign a greater purpose to suffering.  Suffering is never part of God's plan.  It is not about drawing someone closer to the divine or reminding them to trust in God or turn their lives over to a higher power.

Meaning can be found on the other side of suffering.  I know many families who have found purpose in advocating for organ donation or financial support for disease research or have indeed found that their experience of suffering encourages them to draw closer to the divine.

But I also know people and their families whose lives have been destroyed. Who never recover.  Who never find meaning in their suffering.

Not everything happens for a reason.  Sometimes shit just happens.   By saying, "Everything happens for a reason" we refuse to see the person who is suffering. We do not see the pain right in front of us, instead, we jump forward to some greater meaning at the expense of the very real person who is living that pain.

Instead of saying, "Everything happens for a reason," say, "I can't imagine what you must be feeling. Can I sit with you?" or "I see you."

Or better yet, don't say anything.  Just be.  That's what I do a lot of the time.

Stories from the ICU: I see your suffering and I am not repulsed by it

As I unwind from my CPE residency, I have decided to share some of the amazing stories from my time as an ICU chaplain.  These are my best attempts to capture some of the fleeting and complex moments of those sacred hours.

This story comes from a night shift and from a call to the Cardiac ICU. I arrived at work to utter chaos. A patient had come into the Emergency Department in cardiac arrest. He coded twice in the ED, and much of the day chaplain and social worker's work that afternoon had been to find his family. There was one daughter who was camping in the mountains and unreachable by phone. Upon my arrival, the patient's son and daughter in law had been located and were at the hospital, although not in the patient's room.  The patient coded again and the physician begged me to locate the family. The patient was dying in spite of our best resuscitation efforts and chest compressions and intubation were non-beneficial. We tried never to have a patient die with a tube in their throat, it was distressing and traumatic for the family and uncomfortable for the patient. I tore off running to the family waiting area. Then the cafeteria. Then the chapel. And the parking lot. The family was ultimately located in their car outside the ED by an emergency nurse. We jogged to the CICU to what had to have been a horrible scene. Sometime in the course of the code blue, the patient had started bleeding and blood surrounded him on the bed, on the sheets and pillow and the floor. To someone accustomed to such things, it simply means putting on PPE, including plastic booties, a gown and gloves. So I did so. But to a family who belonged to that patient in the bed, it was devastating. The family was unable to bring themselves to enter the room.

The physician spoke with them in the hall and indicated that the patient was dying. The physician requested to extubate the patient and stop all heroic measures, as they were non-beneficial. The family gave consent. I stood with them outside the room as the patient's RN and respiratory therapist removed the tube. I warned them of the disturbing sound of suction. I stood with them in their suffering.

The patient began agonal breathing almost immediately. He was alone in the room and I went to his bedside. The family was frozen in the doorway.

Holding the patient's hand, I turned to them, saying, "He is dying. I will stay here with him and hold his hand so he is not alone. You do not have to come in if you do not want to, I know this is not how you want to see your father.  But I will stay here."

After a few minutes, the patient's son came to the bedside. He still was not touching his father. I said, "The breathing pattern that you hear is common for someone who is dying. He is not in pain, it is reflexive. Eventually there will be longer and longer pauses between breaths and then there will be a point where he will not take another breath."

The patient's son said, "Is it okay if I touch him?"

I responded, "Absolutely."  We each held one of the patient's hands, looking at his face, watching his chest rise ever so slightly. Until he was not breathing anymore.

Chaplaincy is standing in suffering. It is seeing suffering and not being repulsed by it. It is seeing the love and connection between father and son. It is about marking sacred moments. It is about bearing witness to love. For the opportunity to stand in a blood-spattered room and hold an elderly man's hand as he passed from this world to the next. To bear witness to suffering and not walk away. This is chaplaincy.