By Norris Burkes Aug 13 2023

The author of Ecclesiastes says there is “a time to every purpose under the heavens; a time to be born, and a time to die.”

During my career as a health-care chaplain, I’ve seen both of these times.

In the 2000s, I comforted the parents of premature babies born in our Neonatal Intensive Care Unit, NICU at Sutter Memorial Hospital in Sacramento. In recent years, I’ve seen the other end of life’s journey with hospice patients, most of whom are elderly and struggling for a few more weeks of time.

When I compare my former role in NICU with my years working in hospice, I’m struck by a bit of whiplash as I consider the opposite poles of each.

In the NICU, I met patients like little Johnny. He lived in a world of wires, IV bottles, and back-lit beds. Doctors, nurses and respiratory therapists constantly squeezed through tangled tubes to deliver highly specialized health care to him and others, the tiniest people you’d ever see.

Most hospice patients remain in their homes, under homemade quilts crafted by volunteers. Our staff attended them in simple ways with smiles, encouraging words and shared tears. Not much tech, unless you count the laptop carried for charting.

In hospice, I visited Miss Joni who, like little Johnny, marked each breath as a victory. There was a drastic age difference between the two, but they shared many similarities.

Both enjoyed the gift of life. In the NICU, one could peek at the gift long before you were supposed to peek. In hospice, you had to look carefully to find the gift that was nearly faded beyond recognition.

Both patients were in a race. For Johnny, getting a head start didn’t mean he would finish the race early — it meant his race was longer and full of obstacles. For Miss Joni, it meant she would see the finish line sooner than she wanted.

Both patients struggled to live just one more day. Little Johnny’s parents hoped that another day suggested the possibility of a healthy life. For Miss Joni, one more day held out the tease of another.

Prayers went up for both patients. Prayers for Johnny were offered with fervency and purpose. Miss Joni prayed with less certainty, not knowing if she should ask for another day or for a more peaceful departure.

Nurses attended both patients, but Johnny shared his nurse with only one other baby, while Miss Joni shared a nurse and a few aides with 30 other patients.

Machines were a part of both lives. Machines sustained the hopes of parents while Miss Joni signed papers that declared she refused to let machines rob her of dignity.

Cost was a concern for both patients. Medical ethicists debated spending so much of the health care dollar to save Johnny. Miss Joni turned to hospice when the bills became unbearable.

Both cried. Johnny couldn’t tell us why he cried and Miss Joni couldn’t stop telling us why she cried.

Both had family who thought medical staff should have done more. Both were attended by staff members who thought family should have visited more.

Both required their diapers changed — one by nurses with loving coos and the other by underpaid aides with grimacing faces.

Both were rich — Johnny with potential and Miss Joni with history.

Both faced the possibility of death every day. If it came for Johnny, it would inspire the grief that naturally follows the loss of such potential.

When it came for Miss Joni, it would likely come with a mixture of grief and relief.

Life would cease for both patients eventually — one at the beginning and one at the end.

All of which serves to remind us that, also from Ecclesiastes, “the race is neither to the swift nor the battle to the strong … but time and chance happens to them all.”


Earlier this year, I trained Gregory Ingram to replace me at Hospice of the Foothills so I could assume the role of pastor at Community Church, (Formerly, First Baptist). Gregory will be our guest speaker Sunday at 10:30 a.m., 300 Main St. NC.

Topic: Listening to patients: reflections of a hospice chaplain. 1 Corinthians 15:31


Contact me by email at or by snail mail 10566 Combie Road, Suite 6643, Auburn, Calif., 95602 or voicemail 843-608-9715. Visit my website at where you can read past columns or purchase my books.