Sunday, 7 June 2009

Is there life before death? On aged care and anxiety

A guest-post by Scott Stephens (an abridged version of this post was published in Eureka Street)

Sigmund Freud once wrote that the only feeling that doesn’t lie is anxiety. This is a hard thing for us to hear, because few feelings terrify us more than anxiety. Anxiety disrupts our carefully constructed and managed zones of comfort, and acts as a stubborn reminder of the world without. Anxiety, in other words, is the way are affected by the reality of the things we can’t change, the things that just won’t go away. Perhaps that’s why we try so hard to suppress it. We convince ourselves that, if we ignore it, if we sedate it, if we pretend it isn’t there, if we close our eyes, it will just go away. To be sure, one of the great luxuries of modern life is that we have so many ways of avoiding the things that make us feel anxious.

If we don’t like the traumatic images we are seeing on SBS World News, we change the channel and watch The Biggest Loser instead. If we don’t like what we are hearing on Radio National, there’s plenty of vulgar banality waiting on Triple M. If you don’t like all that talk you hear in church about sin, repentance and following Jesus, you can always stay home and watch Hillsong and feel much better about yourself. And that’s not even to mention our contemporary panoply of narcotics – from alcohol and prozac to retail therapy and comfort food.

But deep down, the anxiety never goes away. It’s always there, lurking just beneath the surface. As Freud explained, anxiety is immutable because, ultimately, it is the chill of death’s own inevitability. So what happens when we try to do to death what we do to our other, more contingent sources of anxiety, and just ‘change the channel’? How, in other words, do we try to forget our own mortality? The answer is devastatingly simple: nursing homes.

While there are, no doubt, some wonderful examples of aged care facilities that provide both community and dignity for those who have entered their twilight years and are in need of additional care, this is certainly not the experience of the majority of our elderly. For, increasingly, the elderly have become the ritual sacrifices that we as a society offer to the most implacable of our modern gods: what Hervé Juvin has described (in his mordant masterpiece, L’avènement du corps) as a kind of provisional immortality, a deathless existence realized in unlimited consumption.

Precisely because they are painful reminders of our mortality and fragility, and thus disrupt our sacrosanct comfort, so many of our elderly are consigned to sub-standard, and often degrading, care as a way of classifying them as not really alive, but ‘not yet dead’. The cold reality of aged care is that institutionalization has become a mechanism of our desire to forget death and our wish to go on living unperturbed in our capitalist nirvana.

But it is now imperative that we recognize that our collective failure to care for – and indeed to honour – the lives of our elderly degrades us all. Further, the systemic forgetting of the elderly is one of the great causes of the weakness and moral impoverishment in our culture. Lives tempered by age and shaped by hard-earned virtue are gifts of God, and it is to our detriment that we ignore them.

Perhaps it is time to revive the long Christian tradition that regarded old age as a theatre of virtue and courage. Aging was imagined as a kind of final transaction, whereby the elderly show what the good life looks like, having finally reached the point where they can drop all pretense and start telling the story of their lives honestly – or, to put it in a more Augustinian fashion, to tell the story of their lives as an unbroken confession of sin enabled by God’s grace.

But the elderly, in this perspective, also bear witness to what the good death looks like, how to face the completion of one’s life with courage and faith. Aquinas, for instance, regarded the martyr as the archetype for Christian courage in the face of death. All the while, those gathered round in loving community express their humble gratitude for these lives well lived, and urge them not to waver in their faith as they sprint toward their final prize.

There is a rather surprising fictional counterpart to this Christian tradition in the final volume of Philip Pullman’s His Dark Materials trilogy. The children, Lyra and Will, have made their perilous journey to the world of the dead on the pretense that Lyra must apologise to a friend she inadvertently betrayed, and for whose death she was responsible. Once there, it becomes clear that their destiny is much grander than that: their destiny is to defeat death itself by, quite literally, cutting a hole in the other side of this cavernous Sheol and thereby allowing the atoms of the ghosts of the dead to disperse into the benign indifference of the universe.

When one of the harpies – whose role is to torment the dead by hissing and spitting their venomous reminders of the dead’s failed lives – objects that releasing the dead would negate their very reason for being, one of the children’s traveling companions makes a remarkable suggestion:

‘Then’, said Tialys, ‘let’s make a bargain with you. Instead of seeing only the wickedness and cruelty and greed of the ghosts that come down here, from now on you will have the right to ask every ghost to tell you the story of their lives, and they will have to tell the truth about what they’ve seen and touched and heard and loved and known in the world. Every one of these ghosts has a story; every single one that comes down in the future will have true things to tell you about the world. And you’ll have the right to hear them, and they will have to tell you.’

Could not this rather purgatorial vocation be a model of the community’s care of the elderly? To listen with humble gratitude to lives that have finally learned to tell the truth about themselves, that have stripped themselves of every last shred of pretense, and that now simply need a loving community to hear.

However much our death-defined culture may wish to deny it, there is life before death. It may be weak and frail, but so are the other gifts that God has given us in order to demonstrate his grace, and confound our supposed strength. As the apostle Paul put it, ‘the weakness of God is stronger than human strength’.

20 Comments:

Bobby Grow said...

Good post!

Your sentiment reminds me of Arthur McGill's in his book: Death and Life: An American Theology.

Daniel said...

Having Christian parents in their 90s who live with me, I have become very aware of their life-just-before-death state of being. I've also become more aware of older people I meet in other walks of life as well. Because of the close exposure to my parents' aging (and the constant reminder of my own aging that results), I have come to realize that the last precious moments of my parents' lives are precious opportunities for me to celebrate life as well. I'm daily reminded of the John Prine chorus to the song, "Hello in There," that was somewhat popular many years ago:

"So if you're walking down the street some time ... Spot some hollow ancient eyes ... Please don't pass 'em by and stare
like you didn't care... say, Hello in there ... Say, hello."

Anonymous said...

I read Tillich's "The Courage to Be" (Which, of course, deals a lot in this subject) while going through my own battle with depression and anxiety. Two passages stand out, however:

“The courage to be is the courage to accept oneself as accepted in spite of being unacceptable”


and

"The courage to be is rooted in the God who appears when God has disappeared in the anxiety of doubt"

Craig said...

Thanks for this post. Why is it that we do not see the elderly (and the mentally handicapped, for that matter) as they truly are, an indispensable part of the body of Christ, as Paul writes? Some parts indeed are weak, but that makes them all the more necessary for the rest of the body. Oh, how we have vivisected the body of Christ!

Anonymous said...

I cant help but wonder if many of the elderly people I know have actually "stripped themselves of every last shred of pretense" and have finally "learned to tell the truth about themselves." For whatever reason, I doubt it.

But I suppose that is one of the points of this post - to confront such a suspicious, cynical attitude. Perhaps I'm revealing my "introspective western conscience" in attempting to apply this post too personally. But service to the elderly has always been the first thing that comes to mind when I consider how one might follow Jesus in doing acts of mercy and display the values of the kingdom in suburbia. Perhaps a good place to start would be asking the elderly people I know (those I know personally and those I meet in visiting nursing homes) the question, "Is there anything you have learned over the course of your life you think I need to know?"

Thanks for the thought provoking post,

Brian

Anonymous said...

when my mom died in a british no hope hospital her last words were "stupid, stupid, stupid." when i asked what was stupid she said life and then croaked. no dignity no anything really just a back full of scars from a violent father and a life full of tears from a useless husband, no fucking anything just meaningless shit and then death and if Scott old boy if you want us to care then undo the last century. You're reminding me of an english teacher that came to my 'all twats together' secondary school, lots of ideals, unless they meant his own personal sacrifice. Then of course sorry but! God I fucking hate hate hate the bullshit classes, live off the taxpayer and pontificate like a paedophile priest. wankers

roger flyer said...

Wow!...to the previous anonymous poster. I can't let your comment go by without a moment of silence and some honest tears.

And a prayer for your mom and you.

roger flyer said...

Scott-

This is a powerful post full of hard to face truths--and kudos to Ben for finding you!

I had hoped to serve God (and secretly to find glory) working with the fittest and the brightest, and God (in his love for me and His creation) set me to work with children and infirm aged.

Young theologians-
Be careful what you pray for.

Ben Myers said...

Anon: thanks for your brutally honest comment. The description of your mother's death is one of the saddest things I've heard. I think a story like this illustrates exactly why Scott's questions are so pertinent and so important.

Anonymous said...

but ben
sadly, as a "believer" and medical doctor, struggling but hoping, i can only tell you, this is rather the rule than the exception
yours sincerely
kurt usar md graz austria

kim fabricius said...

By way of thanks, Scott, here is a poem by Elizabeth Jennings entitled "Old People's Nursing Home".

The men have ceased to be men, the women, women.
Or so it appears at first.
Here are children dressed for a meal, napkins in collars,
Here are meals from the nursery, here is the nurse.
So it appears to one who is half
Within this house and half outside.
“It will be calm,” someone suggested.

And so it seemed at first - tidy and calm
With the weather outside tidy and calm,
The carpets, pressed to the walls, forbidding noise,
No smell of a hospital, no smell at all,
And that is what I longed for first, the scent
Of a hyacinth bypassing sickness and pungent with growth,
Perfume thrust on the wrist and rising in clouds
In circles of foreign summers.

But there was no smell, not even the deathly sick
Odour of death. And then I realized:
Death is shut from this house, the language of death,
The accoutrements of dying.
A ghost would be lively. Ghosts are not allowed here
And neither is talk of birth.

The faces differentiate themselves,
The men half-women, the women half-men
And each entirely children
Except in anger, except in ignorance.
These wrinkled faces know too much, these gnarled
Hands have touched the pulse of love, have known
The family increase and birth’s harvesting.

But that was the past and this house has shut out the past
And it dare not face the future:
So it lives in a perilous present that could be cracked
By a broken cup or a laugh.
Cups are unbreakable here,
Jokes are in print too small
And the noisy future, the passionate past are dammed
Partly by deafness, partly
By doctors’ decisions and nurses’
Hiding the stuff of life and death away -
Tear-heavy handkerchiefs, the whiff of pain.

And I who carry compassion find it useless,
I who am very young here feel part-guilty,
Part-helpless. Most, out of place.
For my past and future spread throughout my present,
Time is a scheme of light and dark,
“What is time?” an old woman whispers.
Nobody answers and I,
With a load of compassion to scatter, refuse to tell her
For to do so would set the rainbow over this house,
Of movements and mornings which lead to death, and death
Is an outcast here for a night, for an hour, for how long?

Tom said...

Anonymous' comment certainly do illustrate the importance of Scot's statements, but also illustrate more. And among the realities they point toward is the uncomfortable one that some die in a self-will God forsakenness that belies the empty compassion of claims to universal grace and salvation. The Jesus of the Christian gospels and gospel certainly was not guilty of this empty compassion, and it is worth recalling, for example, that one of the thieves crucified with our Lord joined the mockers even in the extremity of his deadly peri and to a more deadly peril.

Of course, none of us knows what the spiritual condition of Anonymous' mother might be. But the sum of hard bitten responses to hard bitten situations in our lives is a way of damnation. And while our hearts yearn for no one to go down that path, the reality of the two human destinies, witnessed to be the one faithful Christians identify as Lord of all, ought not to be silenced in our empty compassion and unreality.

Thankfully, I will not be the judge of these matters in any particular case, nor will any of the contributors to this blog. So part of real care for the elderly and dieing is to commend them into the hand of their Maker in our prayers and alert them to this awesome One in our witness. And, as Scot affirms eloquently, that requires our connection to them.

roger flyer said...

Tom-With our mustered mercy and grace. Kyrie Eleison.

keree said...

A month ago I started working in an Aged Care Facility. My initial comment was “I would rather be a forensic jail Chaplain!! But I am grateful for the work and will do it willingly (if not enthusiastically).” Throughout my whole ministry I have never seen myself as having any special giftedness with older people. I have now been working in Aged Care for a month. I came home the other night and realised it was the first time in five years I had enjoyed myself at “work”. What a wonderful surprise!! It is not anything that I am doing but rather what the residents are giving to me. All I do is listen.

Aged Care facilities (like the post notes) fall into the good care and appalling categories. Self-determination is a big issue for ACAT (Aged Care Assessment Team) workers. The reality is sadly that there are those who are able to remain independent, who can look after themselves with or without family support and those who can’t. What has surprised me is the extent of family dysfunction and isolation experienced by many of the people I have spent time with. Yes, they may have contributed to their situation, but they still have that experience. Some (not all) of that isolation is relieved through their being in the Aged Care facility.

The best quote I have ever heard about being elderly is “old age is not for cowards”!

So thanks again for the post.

evaberlinerin said...

What a good Blog!! I have finaly found one interesting and reflexive blog about theology!Thank you!

Eva from Hauptstadtreisen

Alex said...

Tom,

Someone, Anonymous, is deeply angry about the indignity of his or her mother's death and from their description, rightly so. And your response is to enquire, in a round about way, about whether his mother is saved or not? Surely I am not the only one who feels a lurch of sickness seeing the total lack of compassion in what you have written and the odd tangent you have taken. It is totally inappropriate and only serves to compound his or her opinion of Scott and people reading this blog as soulless idealists happy to prattle on at a theological register, utterly divorced from the realities of human sufferings.

Anonymous said...

alex

it is absolutely possible to master lifes difficulties and the harshest ones with "dignity"
but if someone begins wondering whether outrage and despair
endanger salvation- the mocking of crucified thief is an absurd analogy- he, i.e.tom,or I for that matter,has seriously misunderstood for exmple the book of job
blessings and thanks
kurt usar md

Alex said...

Kurt,

Your response is spot on.

Oppshom said...

Thanks so much to Scott, Ben, Kim, and all others. This post and the Jenning's poem have come at a wonderful time for me. I am currently debating with family members to keep a loved one out of a nursing home. Post, poem, and responses were all written so well. Thanks.

Aged Care Christchurch said...

With my dad, I saw him getting weaker by the day. It made me realize that what we have right now could all be gone tomorrow. We should treasure each moments.

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