Tag: Death

Atul Gawande’s ‘Being Mortal’ and the Need for Hope

Published on by nickcady2 Comments

Image result for being mortal atul

I recently finished Atul Gawande’s book Being Mortal. It was given to me by a friend from church who recommended I read it, and I’m glad I did.

The Author and his beliefs

Atul Gawande is an American medical doctor, the son of two doctors who immigrated to the U.S. from India. He was raised nominally Hindu, but by his own admission he is functionally secular and non-religious, and the focus of his book is not at all on giving hope beyond this life, only on dealing with the death from a clinical perspective.

However, I would argue that whatever you believe about the future invariably affects the way you interpret the meaning and purpose of life, as well as how you cope with mortality, and this does come through in some of his conclusions.

Content and Highlights

The book begins with a description of physical changes that happen as people age, beginning at age 35.

Dying Well

Next, Atul Gawande gives a brief history of nursing homes. I found this part very interesting. About 50% of Americans die in nursing homes. Some might say this is very sad, which in some ways it is – however, understanding the way that most people died in the past makes you see that this is actually a great improvement over 100 years ago, when many people died in state-funded “poor houses” which even at their best had awful conditions.

He then goes on to describe the development of “assisted living” facilities, and how many have now deviated from their original purpose and design. He also tells stories of people who have sought to improve these facilities through innovation, such as bringing living things, e.g. plants, animals and children into these homes to improve residents’ quality of life.

While the author does say that the older model of a multi-generational home in which elderly people are cared for at home until they die has some benefits, he also shows its limits and downsides, using his own grandfather as an example.

Palliative Care

Atul also describes the benefits of palliative care for elderly people, which is focused on improving a person’s quality of life rather than on invasive treatments which may reduce a dying person’s quality of life even though they have little to no chance of curing them or significantly prolonging their life.

Even though palliative care has been shown to help improve and often prolong a person’s life, one of the sad things Gawande points out is that many insurance providers have stopped paying for palliative care, but they continue paying for invasive treatments, even if they are unnecessary or unhelpful to patients. This perpetuates a cycle of doing everything possible for patients, even if those treatments are not likely to lengthen their life and will probably make their quality of life worse.

The Big Point

Atul Gawande’s main point is summed up in this statement:

“Over and over, we in medicine inflict deep gouges at the end of people’s lives and then stand oblivious to the harm done.”

He argues that as people live longer and more die of old age, we should be focused on helping people stay in control of their lives as long as possible, achieve their goals, and die with dignity.

A Reason for Living

It is impossible to talk about dying without some sort of existential discussion about what gives life meaning and purpose.

At one point, Atul Gawande references the Harvard philosopher Josiah Royce, who said that “simply existing – merely being housed and fed and safe and alive – seems empty and meaningless to us.” He goes on to explain that we all seek a cause beyond ourselves, and it is in ascribing value to the cause and seeing it as worth sacrificing for, that gives our lives meaning.

Royce said that this reason for living was the opposite of individualism. An individualist puts self-interest first, seeing his or her own pain, pleasure and existence as their greatest concern. For the individualist, self-sacrifice makes no sense, but since their own self is the highest cause for which they live, their life has no meaning other than to make themselves happy. Ironically, it is for this reason that happiness and satisfaction will always elude them. For the individualist death is meaningless and ultimately terrifying.

It is for this reason, Gawande explains, that we all need something beyond ourselves and outside of ourselves to live for, and this is why elderly people who have pets, for example, tend to live longer lives.

The problem with Gawande’s search for meaning

The problem with Gawande’s search for meaning, is that he has identified a real need, and yet he basically says in the end that since he doesn’t believe there is anything beyond this life, therefore it is better to give someone the illusion that their life has meaning and purpose and value beyond themselves, even though no such thing really exists.

He does mention that people want their lives to make a difference after they are gone, but what he fails to answer is: to what end?  Why should anyone care about what happens after they are gone, if life is actually meaningless, and after this light burns out there is only darkness? From this same logic, a totally selfish existentialism could also be argued for – such as that of the Epicureans: “Let us eat and drink, for tomorrow we die!” – in other words #YOLO – since we only live once, who cares what destruction we leave in our wake for others to deal with?! It’ll be their problem, not ours!

The solution which only the gospel gives

In this search for meaning and purpose, I would argue that it is only the gospel message of Jesus Christ which gives a satisfactory answer to humankind’s search for meaning and hope beyond this life.

It is only the gospel which gives us real hope beyond this life, and a real mission in this life which has more than just illusionary results. In the gospel we have hope for life beyond this one, and the effects of our mission are eternal in nature.

As CS Lewis put it at the end of the Chronicles of Narnia:

“For us, this is the end of all the stories…but for them it was only the beginning of the real story. All their life in this world and all their adventures in Narnia had only been the cover and the title page: now at last they were beginning Chapter One of the Great Story which no one on earth has read: which goes on for ever: in which every chapter is better than the one before.” – CS Lewis, The Last Battle

In order to truly “die well”, what we need is not just dignity, but HOPE. And this is found only and ultimately in the gospel message of Jesus Christ.

Should you read it?

I would recommend Atul Gawande’s Being Mortal. It was full of important thoughts about the process of dying in Western society today. However, I recommend reading the book with an eye to its one glaring shortcoming: it fails to address the need for and the source of HOPE both for this life and the one to come.

Was Paul Suicidal?

Published on by nickcady4 Comments

Recently at White Fields I have been teaching through Paul’s Letter to the Philippians in a study titled, The Pursuit of Happiness.

This past Sunday I taught on Paul’s famous saying: “For me to live is Christ and to die is gain” – and I explained how the gospel gives new meaning to our lives and it redefines what death means for us. Audio of that message can be found here.

In that sermon, I didn’t get to what Paul says after that famous phrase. Here’s the rest:

For to me to live is Christ, and to die is gain. If I am to live in the flesh, that means fruitful labor for me. Yet which I shall choose I cannot tell. I am hard pressed between the two. My desire is to depart and be with Christ, for that is far better. But to remain in the flesh is more necessary on your account. Convinced of this, I know that I will remain and continue with you all, for your progress and joy in the faith, so that in me you may have ample cause to glory in Christ Jesus, because of my coming to you again. (Philippians 1:21-26)

A reader of this blog sent me a message this week about this passage:

I have always wondered if Paul was experiencing a period of depression when he wrote this epistle. What he says in verse 1:22, “yet what I shall choose I cannot tell” even makes me consider that he was in some ways considering “suicide”. I know that sounds preposterous, and I’m not suggesting that he actually thought of killing himself but rather maybe purposely doing something that would result in his death. In todays world it might be called “suicide-by-cop”. It seems as he continues through the remainder of the chapter that he convinces himself that it is better to remain for the benefit of others. It could be that he was just experiencing a time when his death seemed imminent and he was preparing the readers for that eventuality, but I think that he was experiencing a great amount of stress during this time. As always, he was able, through the Spirit, to overcome his stress and turn it into a beautiful, encouraging letter. I believe it probable that all men of great faith experience times of doubt or fear brought on by the enemy.

That’s an interesting thought. Certainly Paul was facing dire circumstances, and I fully agree with the final sentence, but I wouldn’t go so far as to agree that Paul might have been having suicidal thoughts – even to the degree of doing something that might provoke someone else to kill him.

To me, the tone of the letter is one of triumph in the face of harsh circumstances, even death.

I believe that what’s going through Paul’s mind as he writes those words is that he wants to explain something important to the Philippians: That although as Christians, the ultimate hope of the Gospel is the hope of eternal life in paradise with God, that should never minimize the purpose that God has for our lives here on Earth.

This seems to have been a problem amongst some of the early Christians. 2 Thessalonians was written, in part, to let the Christians know that Jesus had not yet returned, that the Parausia, the Second Coming, was still to come – but that as we await Jesus’ imminent return, we should not be inactive;  we should still work hard. That’s why he says:

If anyone is not willing to work, let him not eat. For we hear that some among you walk in idleness, not busy at work, but busybodies. Now such persons we command and encourage in the Lord Jesus Christ to do their work quietly and to earn their own living. (2 Thessalonians 3:10-12)

The context of that, is that the Thessalonians were eagerly expecting the return of Jesus any day – as all early Christians did, and as it seems that Jesus intended all Christians to do, which is the reason for his vagueness about when his return will take place.

The point is this: We should not have a Christianity in which we encourage people to just believe in Jesus and then hang on and wait for death! I think Paul wanted to Philippians to understand that: that Christianity isn’t only about going to heaven when you die, it’s about living this life for Christ – as much as, and as long as possible.

It’s not only that because of the Gospel, DEATH IS GAIN – but also: because of the Gospel, TO LIVE IS CHRIST!

Another reason why I think Paul was not discouraged when he wrote to the Philippians is because he closes the letter by saying:

Greet every saint in Christ Jesus. The brothers who are with me greet you. All the saints greet you, especially those of Caesar’s household. (Philippians 4:21-22)

What this means is that members of Caesar’s household, including the Praetorian Guard (members of which were chained to Paul 24 hrs a day in 6 hr shifts), were becoming Christians through his being there in jail. I think Paul was feeling particularly encouraged after facing years of discouragement prior to this. Finally he was starting to see some fruit and the purpose for which God must have allowed this series of terrible difficulties and injustices happen to him. Many of us may never get to see that in our difficulties, but when we do it helps to encourage us that God is indeed in control and using all of the frayed strands to create a beautiful tapestry.

 

Advent Meditations: 4 – Set Free

Published on by nickcady1 Comment

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Since therefore the children share in flesh and blood, he himself likewise partook of the same things, that through death he might destroy the one who has the power of death, that is, the devil, and deliver all those who through fear of death were subject to lifelong slavery. – Hebrews 2:14-15

Last night I was at the hospital with the family and close friends of a woman who was passing on from this life. She was a wonderful wife, mother and friend, and she will be dearly missed.

But although she has passed from this life, she is not dead – she is alive and we will see her again.

That is the hope of the Gospel, and she and her husband believe and embrace the Gospel.

The verse above sums up the significance of Christmas more succinctly and clearly than almost any other passage in the Bible: because we, God’s children, are flesh and blood, HE took on flesh and blood, that through his death, he might destroy death and the devil and set us free from bondage to the fear of death.

The reason Jesus was born was so he could die. God became a man, because as God he could not die, but as a man he could. Therefore, he had to become human. Good Friday is the reason for Christmas.

Because of his death, we are set free from the power of death, and therefore we can be free of the fear of death. Our ultimate security has an immediate affect on our lives. The happy ending takes away the slavery to fear in the here and now.

When you no longer fear the last and greatest enemy: death, then you are truly free to live a bold, courageous life of pursuing things that really matter and giving of yourself radically in a way that makes a difference in the lives of others and the world, because you have nothing to lose.

Live in that freedom today.

“Always Go To The Funeral”

Published on by nickcady3 Comments

 

I ran across this article from NPR’s All Things Considered called “Always Go To The Funeral.” It’s worth listening to or reading.

As a pastor, I attend a fair number of funerals. Since our congregation is relatively young, these aren’t usually funerals for our church members, but funerals for their loved ones who pass away.

I think going to funerals is important. There are certain moments and events in life that are worth inconveniencing yourself for; honoring the life of a human being is one of them. 

A lot of people avoid funerals because death is something that we all feel is a foreign imposition on us – something that is inherently wrong. We are right to feel that way actually;  God’s Word makes it clear that we were made to live forever, and that sickness, pain and death are a curse – part of the very curse that Jesus Christ came to set us free from. However, it’s that very reason why it’s a healthy thing for us to attend funerals – to be faced with the ultimate realities that make the hope of the Gospel truly good news.

One thing I’ve realized over the years as a pastor, is that most people aren’t prepared for how to handle those who suffer or grieve. On a recent trip to Hungary I taught a seminar for the church there, whose pastor had recently lost a child, on how to understand grief and how to love and minister to grieving people. This instruction is so helpful, because most people (at least over there) default to either avoiding the situation or saying things which aren’t helpful. In reality, one of the best things you can do for someone who is grieving is not say anything, but just be around – present, available.
Yes, funerals are uncomfortable. Guess who else doesn’t enjoy being at that funeral: the person who lost a loved one. Bless them by being there beside them in their time of loss.