miscellaneous browsings

I’ve not been around here much; I’ve been busy trying to finish up some summer reading projects before classes begin.  Anyway, here are some of the things I’ve been reading and thinking about of late:

1) Some weeks ago, Rod Dreher (at his new, and very engaging, blog) linked to a New Yorker piece by Atul Gawande, titled “Letting Go,” about care for the dying.  Excerpt:

Dying used to be accompanied by a prescribed set of customs. Guides to ars moriendi, the art of dying, were extraordinarily popular; a 1415 medieval Latin text was reprinted in more than a hundred editions across Europe. Reaffirming one’s faith, repenting one’s sins, and letting go of one’s worldly possessions and desires were crucial, and the guides provided families with prayers and questions for the dying in order to put them in the right frame of mind during their final hours. Last words came to hold a particular place of reverence.

These days, swift catastrophic illness is the exception; for most people, death comes only after long medical struggle with an incurable condition—advanced cancer, progressive organ failure (usually the heart, kidney, or liver), or the multiple debilities of very old age. In all such cases, death is certain, but the timing isn’t. So everyone struggles with this uncertainty—with how, and when, to accept that the battle is lost. As for last words, they hardly seem to exist anymore. Technology sustains our organs until we are well past the point of awareness and coherence. Besides, how do you attend to the thoughts and concerns of the dying when medicine has made it almost impossible to be sure who the dying even are? Is someone with terminal cancer, dementia, incurable congestive heart failure dying, exactly?

I once cared for a woman in her sixties who had severe chest and abdominal pain from a bowel obstruction that had ruptured her colon, caused her to have a heart attack, and put her into septic shock and renal failure. I performed an emergency operation to remove the damaged length of colon and give her a colostomy. A cardiologist stented her coronary arteries. We put her on dialysis, a ventilator, and intravenous feeding, and stabilized her. After a couple of weeks, though, it was clear that she was not going to get much better. The septic shock had left her with heart and respiratory failure as well as dry gangrene of her foot, which would have to be amputated. She had a large, open abdominal wound with leaking bowel contents, which would require twice-a-day cleaning and dressing for weeks in order to heal. She would not be able to eat. She would need a tracheotomy. Her kidneys were gone, and she would have to spend three days a week on a dialysis machine for the rest of her life.

She was unmarried and without children. So I sat with her sisters in the I.C.U. family room to talk about whether we should proceed with the amputation and the tracheotomy. “Is she dying?” one of the sisters asked me. I didn’t know how to answer the question. I wasn’t even sure what the word “dying” meant anymore. In the past few decades, medical science has rendered obsolete centuries of experience, tradition, and language about our mortality, and created a new difficulty for mankind: how to die.

This led me to reflect more upon how we die in America, how truncated our funeral customs have become — even in the South, where traditional funeral practices (open caskets, wakes, cars stopping for funeral processions) still obtain.  To that end, I’ve been reading Rob Moll’s new book The Art of Dying and Tom Long’s Accompany Them with Singing: The Christian Funeral.  Both have helped me begin to think through what it means to “die well.”

2) Two pieces from the New York Times in recent days:

What Is It About Twenty-Somethings? A lengthy, but well-done, analysis of one of the biggest problems among people my age and younger: the seeming inability to transition from adolescence into adulthood.

Taking a Break from the Lord’s Work. My own observations regarding this subject attest to how much of a problem this is in conservative churches of Christ.  How many congregations out there make provisions for this kind of rest for their preacher?

3)  An excerpt from William Robinson’s Completing the Reformation (1955).  Robinson — if you’re not familiar with him — was perhaps the premier writer and thinker among the British Churches of Christ in the first half of the 20th century.  The link will take you to a discussion of the sacraments of baptism and the Lord’s Supper that is well worth considering.

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One response to “miscellaneous browsings

  1. Hey Chris, have you had an opportunity to read Hauerwas’ thoughts on death and dying. I think it’s brilliant stuff. The forward to this book is a good introduction if you’re unfamiliar.

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