“The Conversation,” a Yom Kippur Sermon by Rabbi Esther Adler

Editor’s Note: This Yom Kippur sermon was delivered by Rabbi Esther Adler at Mount Zion Temple in St. Paul, MN. She gave Jewish Sacred Aging permission to repost it here.

Before beginning college last month, University of Chicago freshmen received a welcome letter from the dean with a warning that the school does not support “trigger warnings.” I had never heard of this, but apparently trigger warnings have become fodder for folks on both the right and the left who believe they have gotten totally out of hand.

Rabbi Esther Adler, Mount ZIon Temple, Saint Paul, MN
Rabbi Esther Adler, Mount ZIon Temple, Saint Paul, MN

For those of you who, like me, are a little behind on popular culture, these are statements at the beginning of a course, reading, or media presentation, that the content that might offend or “trigger” a traumatic response in the consumer.

The University of Chicago said no more Trigger warnings, so students, be prepared…We are not at the University of Chicago, so I am going to go ahead and issue a “trigger warning:”  This sermon might be hard to hear.

I hope it will be a trigger ‐ not for a traumatic response, but for a thoughtful one. I am going to talk about something nobody wants to talk about, but that needs to be talked about.

Have you had “the talk?” No, not that talk.

That talk is easy compared to this talk.

Bear with me.   I’m going to ease us into this.

In her 2012 book “I hate everyone…starting with me”  Joan Rivers wrote:
When I die (and yes, Melissa, that day will come; and yes, Melissa, everything’s in your name), I want my funeral to be a huge showbiz affair with lights, cameras, actionI want paparazzi and I want publicists making a scene! I want it to be Hollywood all the way. I don’t want some rabbi rambling on; I want Meryl Streep crying, in five different accents. I want to look gorgeous, I want to be buried in a Valentino gown And I want a wind machine so that even in the casket my hair is blowing just like Beyoncé’s.”

Joan Rivers died suddenly in 2014. Well before that, in what turned out to be her last interview, Rivers added a serious note:

Melissa says, ‘I don’t want to hear about it, I don’t want to talk about it’, but I say it’s coming. It’s inevitable. It’s no longer an abstract thing. It’s like, God, I’m in my eighties,” she said. “Nobody, when I die, is going to say, ‘How young?’ They’re going to say, ‘She had a great ride.’”

“Melissa says ‘I don’t want to hear about it. I don’t want to talk about it.’”  Most of us, I suspect, are with Melissa. We don’t want to hear about it; we don’t want to talk about it. Who would want to talk about their loved ones dying?  And yet…

At least Melissa knew what to do when Joan died unexpectedly after minor surgery.  Well, maybe not exactly what to do ‐ The wind machine thing is a little over the top, but at least Melissa had an idea of what her mother wanted.

Joan Rivers was irreverent, of course, but also wise. She understood that it was important to talk about that one thing we all share‐ every single one of us ‐, the one thing that is for sure: Every one of us is going to die one day.  And so are the people we love.

Some 20 years ago there was a headline in the Onion, “World Death Rate Holding Steady At 100 Percent.” Trigger Warning ‐ I am going to talk about some hard stuff now.

In the Unetanneh tokef we say “On Rosh HaShanah it is written, and on Yom Kippur it is sealed…who shall live and who shall die…but Teshuva, Tefilah, and Tzedakkah ‐ repentance, prayer, and charity ‐ avert the severity of the decree.”

I daresay most of us do not take this prayer literally. We know that it doesn’t happen this way. Instead we take it to be a reminder that we never know what tomorrow will bring, and so we must choose to live our lives well.

Today, I want us to extend the metaphor, and consider not just how ill choose to live our lives,but how we will choose to die our deaths.

The Angel of Death visited the synagogue right before Yom Kippur. He told the Rabbi, the Cantor, and the President that they could each express one last wish before he took them. The Cantor said, “I want to sing Kol Nidre one last time.” The Rabbi said, “I want to give one last sermon.”  The President said, “Please, take me first.”

In truth, considering how we will die is a luxury afforded us by modern times. For most of human history, death came suddenly, or if not suddenly or at least relatively quickly: Whether afflicted by terminal illness or catastrophic accident, once death was imminent, it came quickly. People did not linger for weeks, months, or years as they do now.

George Washington developed a sore throat after being out in the rain and was dead by the next evening. That’s not how we die today. Most people today die after long medical battles with incurable conditions – cancer, heart or kidney or liver failure, Alzheimer’s disease, complications of stroke, the debilities of old age. As soon as these maladies are detected, modern medicine mobilizes. Sophisticated diagnostic technologies are deployed, surgical and medical strategies are launched. Pharmacological and nuclear medicine are advanced. Life goes to war against death.

Today, medicine can replicate most of the major organ functions: A heart pump can circulate your blood, a ventilator can breathe for you, a feeding tube can provide nutrition, dialysis replaces your kidney function.

But here’s the thing: Sometimes these helpful measures turn out to be more harmful. Fragile elderly ribs can be broken during CPR.  Chemotherapy can cause devastating side effects.

Feeding tubes can sustain a person with no brain function for years, Draining a family emotionally and financially.

And here’s the other thing: before the doctors can do any of these measures that can prolong life or slow impending death, somebody has to give them permission.

The question is, who will it be?

Consider this scenario ‐ or God forbid perhaps you have experienced it:

You are gathered with your family in the waiting room at the hospital; Your loved one is intensive care. The doctors need to know what you want them to do. Start on a ventilator? A feeding tube? Treat the infection? Re‐start the heart? They need to know right now.

Under that pressure, it is extraordinarily difficult to make wise decisions. You argue with one another. Sibling against sibling, spouse against children, the local family members who have been dealing with this for months or years, against the family members that have just flown in. What would mom have wanted? What’s right? Who gets to have the final word?

Whatever decision is made, the family will likely never again be whole. You will doubt yourselves, and worse, you may forever look at one another with suspicion and ask: How could you? Why didn’t you love her more?

These decisions are never black and white. There is always a degree of uncertainty. It’s a normal part of grieving to wonder whether we’ve done the right thing, done all we could do. But without knowing a loved one’s true wishes and values,the one who must finally decide

can be left forever haunted: Did I give up too soon? Did she suffer too long? Should I have done more?  Less? Was I thinking about him or about myself? What if…?

We Jews believe there might be an afterlife ‐ it is a mystery and we will probably never know for sure. But of this I am certain, there is an “after‐death.” After death we either leave a legacy of second‐guessing, guilt, and recrimination, or we leave a gift of gratitude, wholeness and peace.1

A story, from Mitch Albom: A man applies for a job as a hired hand on a farm. He gives his letter of recommendation to the farmer. It reads simply, ‘He sleeps in a storm.’ The owner is desperate for help, so he hires the man anyway. Several weeks pass, and suddenly, in the middle of the night, a powerful storm rips through the valley. Awakened by the swirling rain and howling wind, the owner leaps out of bed. He calls for his new hired hand, but the man is sound asleep. “Angry, the farmer dashes off to the barn. He sees, to his amazement, that the animals are secure with plenty of feed. He runs out to the field. He sees the bales of wheat have been bound and are wrapped in tarps. He races to the silo. The doors are latched, and the grain is dry. And then he understands. ‘He sleeps in a storm.’2

When a loved one is dying, and the storm of decisions descends, will you be prepared? Will you know what they wanted or will you lay awake wondering and trying to figure it out?

When you are dying, and your loved ones have to make those decisions, will they be able to sleep in the storm?

Pulitzer Prize winning journalist Ellen Goodman describes the time she was faced with this question and came to understand its importance.

“At the end of her life my mother could not even decide what she wanted for lunch, let alone what health care she wanted. So when I got a call from the nursing home doctor saying mom had another bout of pneumonia, and do I want her to have antibiotics, I thought, what is he asking me ­ do I want her to live or die? ­ I was blindsided.

Can I call ya back?

Can I have another minute?”

Goodman goes on to say that

Many months and many decisions later I realized how deeply I wished I had my mother’s voice, in my ear, telling me what she would have wanted.”3

It was too late for her own mother, so Ellen Goodman did something For the rest of us. She founded the Conversation Project. The mission of The Conversation Project is to be a “national public engagement campaign to ensure that each person’s wishes for end‐of‐life care are both expressed and respected.” The project has its roots in the growing understanding that too many people are dying in ways they would not choose and that too many loved ones are left feeling guilty and uncertain about whether they did the right thing.”

Rabbi Abraham Joshua Heschel has written: “In the presence of death there is only silence, and a sense of awe.” I think he is telling us how the experience can be, not how it necessarily is. If we are prepared, then we can spend the last moments with our loved ones sharing a sense of quiet and awe, rather than urgent decision making and confusion.

Congregation Beth Am in Palo Alto CA has invited congregants to share their experiences on their website.  A woman wrote:

Four years ago, my husband of 56 years was hospitalized briefly and found to be terminally ill. Although he suffered from dementia at the time, I knew exactly what he wanted because we had talked about it, and we had signed all the documents years before. He came home from the hospital, and we had in‐home hospice care. The children and grandchildren came to visit, and when the time came, we were together.4

Statistics reveal an alarming disconnect between what most people want at the end of life, and what actually happens. A study in California showed that 70% of people want to die at home surrounded by family, but that only 30% actually do. 80% of people say that if seriously ill, they would want to have a conversation  about end‐of‐life care with their doctor. 7% actually do.

90% of people say that talking with loved ones about end‐of‐life care is important. 27% have actually done so.

The reasons are not hard to discern. We don’t want to talk about death ‐ of our loved ones’ or our own. It is difficult. It is scary.  It is sad.  It is inconvenient. If we talk about death we’ll bring  it on sooner.  If we don’t talk about it, it won’t happen.

Ellen Goodman points out that it is always too soon to have the conversation until it is too late. But there is another way to look at it, and it is a Jewish way.

Goodman, who is Jewish, says that the Conversation Project “emphasizes having a conversation about values — what matters to you, not what‘s the matter with you.” When we start talking about what might matter most to us at the end of life, we are sharing more than our thoughts and concerns about medical treatments. We are sharing who we are, what we value about living, and what legacy we hope to leave our loved ones and our communities.6

Isn’t that why we are all here in this sanctuary today? To reflect on who we are, what we value about living, and what legacy we hope to leave our loved ones and our communities? It’s not so hard for us, because we are used to doing it on Yom Kippur.  Everyone is doing it.  We are doing it together.

But actually, we are supposed to do it every day. In the Mishna, Rabbi Eliezer teaches “Repent one day before your death,” the obvious implication being that every day is an opportunity for Teshuva: turning inward to find and become our best selves.

Similarly, then, any day can be an opportunity to turn outward to our loved ones, and talk about the values that guide the way we live, and that we hope will guide what happens when our time comes to die. These are conversations best had at the kitchen table, not the operating table. “We are all mortal,” writes Ellen Goodman, “yet as a society we have been painfully slow in recognizing how many of the people we love are not dying in the way they would choose: in comfort, among people who care about them, and engaged in what matters most for as long as possible.”

I am very fortunate that my father, now in his 97th year, and thank God still vibrant, has had the conversation with me. I know what he values, and what he wants when his time comes. But I confess on this Yom Kippur day, that I have not had the conversation with my family.                     I am in good health, and God willing I will be long‐lived like my father ‐ so NOW is the perfect time for the conversation.

Because while we might not take literally the image of God writing names in two columns in the Book of Life, the truth is that in the coming year some of us will die, perhaps by fire, perhaps by water, perhaps in ripe age, perhaps not. Such things are not in our control. But we can have a say in what will happen to us in our dying days, no matter whether they come tomorrow or after long years ‐‐‐  If we have the conversation.

The good news is that we don’t have to do it alone. In about a month, on November 18, we will be participating, along with synagogues and churches nationwide, in Conversation Sabbath,

an outreach campaign from the Conversation Project. You may have already read about it in our Temple Bulletin.  On that Shabbat we will have an opportunity to explore together the ideas

I have been talking about, and God willing, begin our own conversations. And then to continue the conversation as our lives and circumstances change.

We will learn about the resources and tool kit available from the conversation Project, and together perhaps we can muster the courage we will need to have the talk with our loved ones. The Conversation Project does not advocate any particular position about end‐of‐life care; its resources are designed specifically to help us think about, talk about, and then put in writing our ultimate goals and values.

Its “Starter Kit” suggests questions to consider such as: Where are you on the continuum from, From “I only want to know the basics” to “I want to know as much as I can?” From “I want my doctors to do what they think is best” to “I want to have a say in every decision.” From “I want to live as long as possible, no matter what” to “Quality of life is more important to me than quantity.”

People who have taken the risk and started these conversations have found that it is in fact life‐affirming. Talking together, cultivating a subtle day‐to‐day awareness of our mortality, is a deeply spiritual practice that nourishes a sense of awe, joy and gratitude for this one, unique,

amazing life we have been given.7    This gift of finitude—should we be willing to unpack it from

its wrapping of of avoidance and fear—the gift is more life right now. It is this awareness that lets us sing with the Psalmist: Zeh hayom asah Adonai… nagila v’nism’cha vo ‐ This is the day we have been given: let us rejoice and be glad in it. (Psalm 118)8

John Greenleaf Whittier, early American poet and abolitionist  wrote:

“Of all sad words of tongue or pen, the saddest are these, ‘It might have been.”

A modern day poet, who also was my mother, demurred:

The saddest words of tongue or pen Are said to be “it might have been.” Sadder still, “it could have been.” But saddest of all, the rueful sigh “It would have been, if only I…”

This is the day we have been given. Let us use it well, and begin the conversation. For more information and resources visit: theconversationproject.org

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