Gently Lord. Oh gently lead us. Thro’ this lonely vale of tears,Lord, Oh Lord, in mercy give us thy rich grace in all our fears. In the hour of pain and anguish, in the hour when death draws near, Suffer not our hearts to languish, Suffer not our souls to fear. When this mortal life is ended, Bid us in they arms to rest, Till by angel bands attended, We awake among the best. Anonymous Hymn, Circa 1850
The family patriarch recently died. He passed an eventful 93 years: born on the cusp of the First World War to German expatriots in Japan, growing up Weimar Germany which provided memories of the hyperinflation that caused him to wheelbarrel piles of nearly worthless deutschmark to the store for a loaf of bread, trying out for the Olympic team as a Jew in Hitler’s Germany the year that Jesse Owen’s prowess made a lie of the Fuhrer’s claim of Aryan superiority, fleeing to America only to soon return to Europe and Germany itself as a sergeant in the US Army, and afterward living the ‘American dream’ as a businessman in the newly minted suburbs of New York with wife and two children, and then raising his deceased sister’s children, becoming widowed, remarrying and ending up with four more stepchildren. And that was only the first 50 plus years…
It was difficult to witness the physical decline of this active, energetic man. Through the years there were so many episodes we thought he would not survive - from the time nearly every bone on one side of his body was crushed by a car flattened him as he walked to the train station one early morning to the innumerable crises of breathlessness and fluid retention that occurred with increasing frequency in his last years. But survive he did. Quite literally, the man knew not how to quit.
The will to live is such a powerful force. When he lay mangled on the road, a priest was called along with the EMTs because the no one knew which would be more useful (nor did they know his religion). The orthopedic surgeon who put him back together suggested he get used to the idea of not being able to walk again, but he was hiking and back on the tennis court within a year. Although he needed a lift in one shoe that caused his gate to be a bit gimpy and his shoulder blade protruded out at an odd angle, he inexplicably manifested little evidence of any other damage and went on to thrive for nearly another four decades.
But while his will to live carried so forcefully through life even as the body inevitably began to diminish, it served him less well in the final months when his heart was so compromised and every breath was a struggle. Instinctively, he knew how to go forth in life, but less so how to retreat from it. And he had precious few resources to draw on in making this transition.
It seemed most of his time and energy were occupied with medical specialists and medical tests and medical procedures galore – most of which his insurance subsidized at what have been an enormous cost. But I wonder if, in all that whirlwind of activity, there was any counsel or assistance in the process of dying.
It is not an original observation that the emphasis on youthfulness and longevity has created a cultural deficiency when it comes to dealing with death in many modern societies. The process of dying is most often not handled as an inexorable passage but as a failure at prolongation. We mostly die after heroic interventions – unconsciously, amidst strangers with tubes in our nose, monitors beeping and drugs in our veins.
One of the silver linings of the so-called ‘healthcare crisis’ is that it is forcing something of a re-evaluation of resources expended on end of life care and hopefully it will also cause us to re-evaluate this end of life scenario in general.
What is the job of a physician? No one put it more succinctly than the founder of homeopathy, Samuel Hahnemann, who open his most fundamental treatise with, “The physician’s highest and only calling is to make the sick healthy, to cure, as it is called.”1 and that, “the highest ideal of cure is the rapid, gentle and permanent restoration of health…”2
But when cure is no longer possible and the physical life of an individual is playing itself out, the physician’s role necessarily changes dramatically. Clearly, one of his or her chief functions is to administer comfort. This can extend far beyond prescription of analgesics such as morphine and attending to other bodily needs.
Recently I witnessed, for instance, how in the last days of his life the 93 year old patriarch of my family drew the greatest comfort from the mere presence of his long term family physician. This doctor, himself quite advanced in years, performed only an ancillary role in his care which had for the most part been dispersed to cardiologists and urologists and oncologists and other specialists as the various parts of his body began to break down.
For this dying man, someone who had long eschewed any belief in religion, spirit and the hereafter, it was the presence of an old GP which gave him the greatest sense that he was being looked after by a person who knew him, who cared for him and this brought him great solace.
I recently read something that spoke to this – and spoke to me – quite directly. To paraphrase: The greatest purpose of a physician is to facilitate Well-being in a person; that is, to make it possible for that person to accept and experience Well-being. This may take place while he or she is still firmly rooted in the physical body or as the form of the body is being released. While for some it is possible to sense this wellness in physical health, for others this is no longer, or never was, possible, and it is only as the body is being relinquished that it can take place. It is in the moment that Well-being is truly accepted that illness departs.
The bedside ministrations of priests, rabbis, lamas, shamans or the agents of any spiritual tradition, in a way, also address this same purpose: to facilitate comfort, tranquility and Well-being as life comes to an end.
If given an opportunity, a homeopath too can often play a role in this most critical juncture in a person’s life. Unfortunately, this choice is recognized relatively rarely in a domain dominated by a different school of medicine. But nonetheless, a correctly chosen and appropriately administered homeopathic remedy can bring about Well-being to various degrees in the dying.
One of the most gratifying cases in my practice entailed working with an elderly woman in the terminal stages of breast cancer who had decided to forgo all heroic life extending medical measures. It was her intent to die in her own home fully conscious, not in a hospital nor in an opiate haze. She was chiefly cared for by her daughter, a hospice nurse and, indirectly over the phone, myself.
The remedy Arsenicum album performed wonderfully for her. This homeopathic dilution of the white oxide of arsenic has long been known to relieve the burning pains resulting from cancerous ulcers and tumors. Moreover, it has a great effect on quelling the restless anxiety and existential desperation that arises in many people as they face death.
Some weeks after her passing, the daughter called to relate how her mother had died without pain and in peace. She mentioned that the hospice nurse had remarked that it was an unusual death – graceful, tranquil and unadorned.
1 & 2: Hahnemann, Samuel. The Organon of Medicine of the Medical Art, Aphorisms 1 and 2, edited by Wendy O’Reilly