Guest Post: A Cantor’s Thoughts on End of Life Conversations

When I was hired to be the Cantor and sole clergy at Congregation Beth Shalom in Arlington, Texas, I officiated at more funerals during my first year than I had even been to in my life. I realized I needed some Pastoral Care training, and after finishing a unit of Clinical Pastoral Education at Texas Health Harris Methodist Hospital in Ft. Worth, TX, I was hired to be a PRN (“as needed”) chaplain there.   A part-time job with Vitas Healthcare to be the hospice chaplain for their Jewish patients followed.   I had never even thought about Advance Care Planning until my work at these institutions allowed me to witness what happened when a plan wasn’t in place, which was, and still is, often.

It’s hard for people to talk about end of life issues, and what they would want if their health began to fail.   This is the most important conversation that no one wants to have. We don’t want to acknowledge our own mortality. We can’t imagine a world in which we, or our loved ones, don’t exist. It’s simply impossible to wrap our heads around it.  But our tradition requires it because it can help us to live better.

We prepare so much for welcoming new life. There are supplies to buy, parenting classes to take, and college funds to set up. I even know some people who have put their unborn children on waiting lists for nursery school! We strive to learn everything we can about how to take care of this addition to the family.   Preparing for death……..not so much. And that can have detrimental consequences for the loved ones left behind.

I was recently involved in two cases involving spouses on life support that ended very differently. In the first, the husband had been in a serious motorcycle accident, but almost as if he had a premonition, he had spoken to his wife the week before and told her that if he was ever severely injured, and ended up in an irreversible condition, he would never want to continue living that way.

As upset and distraught as the wife was, she was able to discontinue life support when it became clear that that would indeed be his fate. She didn’t have to agonize over her decision because he had made it for her.

In the second, the husband’s heart was failing and he was also on life support. No matter what the medical team tried, nothing was helping. I sat with his wife outside his room for 3 hours as doctors and nurses rushed in and out with grim expressions. She was finally told that they had done everything possible, but there wasn’t any hope of recovery. But she wasn’t ready to let go. The next morning, things had further deteriorated. He had coded (stopped breathing) several times, and for hours the team continued a cycle of CPR and meds. I kept wondering, “Was this what he would’ve wanted? What was the point?” It was excruciating for her to watch, and yet, she didn’t want to be the one to decide when to end his life, even though I suspect it had ended hours before. It was only when the nurse came up to her and gently said, “You might not be ready for him to go but I believe that he is and his body has already begun that transition,” that she finally told them to stop their efforts.

The time to make life and death decisions is not when we are in the midst of crisis. So much pain and suffering could be avoided if only we sat down and talked about it all in advance. Just as talking about pregnancy doesn’t make one pregnant, talking about end of life issues doesn’t hasten death. In fact, it can actually help us focus on defining what quality of life really means to us. It forces us to ask questions: “What really gives my life meaning? What challenges would I be willing to endure in order to continue living if it came right down to it? What could I let go of? What could I not live without? And, if given the choice, how do I want to live out the end of my days?”

When we are able to answer those questions, it can help us to live each day with intention and gratitude. And if we are able to discuss it openly and communicate our desires to our families and our doctors, we begin to demystify it a bit, allowing us to even begin letting go of some of the fear.

Realizing the need to explore these issues in our community, I took my concerns to the Jewish Federation and we, together with our four area congregations, created the Advance Care Planning Committee of Ft. Worth and Tarrant County. We have worked tirelessly over the last year on our upcoming symposium, which will take place on November 15 entitled, “A Time to Talk: A Jewish Conversation about Advance Care Planning.” The goal is to help others navigate through all of the various issues surrounding end of life, including: how to begin “the conversation,” preplanning, creating Advance Directives, making medical and ethical decisions, how to live in the face of death, mourning rituals, Jewish views of the afterlife, and post-death family support. We are also creating an online go-to resource list with everything that they will need to help them through that process.

There is a poem, whose author is anonymous, which begins, “Birth is a beginning and death is a destination and life is a journey.” It is only when we are able to accept and plan for the reality of death that we can have a meaningful journey through life.  I hope that that our symposium will help to make that happen.

Cantor Sheri Allen is beginning her seventh year leading Congregation Beth Shalom in Arlington, and is currently serving a three year term on the Cantors Assembly Executive Council.

Cantor Allen is the Jewish Community Chaplain for VITAS Healthcare in Ft. Worth, where she provides pastoral care to Jewish patients and conducts seminars on Jewish end-of-life care for hospitals in the Dallas/Ft. Worth area. She also works as a PRN (on-call) Chaplain at Texas Health Harris Methodist Hospital in Ft. Worth. She has studied Clinical Pastoral Education at the Jewish Theological Seminary in New York and is also on the Executive Committee of the Attending Clergy Association. She has helped create the upcoming symposium,“A Time to Talk: A Jewish Community Conversation about Advance Care Planning” for the Ft. Worth & Tarrant County.

Cantor Allen lives in Ft. Worth with her husband Richard, who is a Professor in the Film, Television and Digital Media Department at TCU. They have three amazing grown children: Jeremy, Emily, and Rebekah.