By Norris Burkes March 7, 2021

I stood before my brother’s grave this week, holding my mother while my wife held me.

“I should have given him more time,” I whispered to my wife.

“Pardon,” she said, unable to understand my quivering words.

I cleared my throat to rephrase. 

“I should have asked for more time when the palliative-care nurse suggested we discontinue his life support.”

“No,” she said, “He had COVID. You did all you could do.” 

The flash of doubt from her chaplain/husband surely surprised her. After all, she knew that I’d helped to redirect the same uncertainty in scores of families I’d met in my role on the hospital palliative-care team.

Our team consisted of a chaplain, nurse, social worker and doctor who followed the Mayo Clinic guidelines to “… offer pain and symptom management and emotional and spiritual support [in the] face of a chronic, debilitating or life-threatening illness.”

Before COVID, our team typically met in a conference room where the family often asked us to do “everything.” 

The doctor would explain what “everything” meant. “If your loved one’s heart stops, we will do chest compressions and electric shock. If he stops breathing, we will put a tube down his throat to help him breathe.”

The hard part was hearing her add, “And if need be, we’ll make an incision in his windpipe to insert a more permanent tube. Later we might add a feeding tube through his stomach.”

After a long meaningful silence, the doctor would ask, “But for what purpose? To make him better?” 

Another pause. “He won’t get better.”

The doctor’s questions voiced the two requirements that must be met for us to do “everything.”  First, the patient has to want it. Second, it must be helpful. For many patients, including my brother, neither was true.

The doctor finally got to the part where she suggested a better option than “everything.” 

“How about we do nothing? What might happen if we disconnect the mechanical assistance and let the natural process occur with dignity and without pain?”

I can’t count how many families studied their laps as they insisted they couldn’t possibly make that decision. “Please,” they would say, “just keep doing everything. We are leaving this in God’s hands.”

I knew that feeling. I wanted to beg that they keep doing everything for my brother.

But instead, I remembered the countless occasions where the team doctor turned her attention in my direction to answer this very issue. 

She’d clear her throat and, like a soccer player directing the ball to another player for the goal, signal my turn to talk.

I’d reserve a moment of stillness, considering how I might warn the family. “Leaving it up to God,” in this context, was often an expression of procrastination rather than faith. 

The saying seems to convey more of a fear that God can’t answer the tough questions. At that point, it quickly becomes a religious coin toss between denial and faith.

But worst of all, it highlights a contradiction: If we’re really “leaving it up to God,” why do we need these machines to keep the ball in play? If we truly left it up to God, we wouldn’t be playing tug of war with the patient’s soul.

It was this second point that my wife was trying to make this week. “Might God’s will have been expressed in your brother’s dignified death just as it was in his honorable life?”

I did not ask the palliative care nurse to give my brother more time. On day 15, I truly turned it over to God. I consented to remove his so called “life-support,” and my brother was welcomed into God’s hands. 

“Well done, good and faithful servant.”  Matthew 25:23

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