Something happened that has never happened to me before. I witnessed a small miracle. I’m a relatively new hospice chaplain. Hospice of course is an approach to caring for individuals who are suffering from terminal illnesses and are expected to live for six months or less. It’s my job to help patients connect to their spiritual needs, and feel hope.
Now that’s a tall order. How do you guide a dying patient to embrace hope? As a Reform Jew I have come to terms with the reality that hope can’t be God performing a miracle and your cancer, your dementia or your heart disease will suddenly disappear.
And, yes, I do understand that some traditional Jews believe that there is always hope that that miracle will happen. Some believe that it should be God who brings closure to a person’s life. But, as the 20th-century American Orthodox authority Rabbi Moshe Feinstein said, “those individuals whom the physicians recognize cannot be cured . . . but could receive medications to extend their lives, in which they would suffer, should not be given such medications.” In other words he agrees that the cure should not be worse than the disease.
The hope that I try to instill in the mind of a dying patient is that their passing will be free of as much pain and suffering as possible. After all as a hospice nurse once told me, “We take such good care of people when they enter this world. Why shouldn’t we make then comfortable when they exit this world?”
I encourage patients to talk about what they think will happen to them after they die. Do they have a relationship with God? Do they believe in an afterlife?
This is all well and good with patients who are lucid and awake and willing to talk. What about patients who have dementia and either can’t follow a conversation or they’re not able to communicate at all?
This is what I experienced with a recent patient I was seeing.
How could I ask questions about anything?
How could I ask about family dynamics? What is her relationship with her family? Was there anyone she wished to see or talk to or apologize to before she passes? Is she a member of a synagogue? Has the rabbi or cantor been contacted? Has she made any funeral plans? What would she like done at her funeral? What music, if any, would she like played at the service? And on, and on and on. Of course, I was able to get the information I needed from her family, but how could I connect with her now?
I knew that music can trigger memories from the past. Research suggests that listening to or singing songs can provide emotional and behavioral benefits for people with Alzheimer’s disease and other types of dementia. Musical memories are often preserved in Alzheimer’s disease because key brain areas linked to musical memory are relatively undamaged by the disease.
I had never tried to sing to someone who couldn’t communicate though. I decided to sing the first verse of Debbie Friedman’s Mi Shebeirach: “May the One who blessed our ancestors help us find the courage to make our lives a blessing, and let us say Amen.”
The patient bobbed her head to the rhythm of the tune; she even started to conduct me. That was unexpected. But then I realized that she doesn’t know this song. What other simple Hebrew melody could I sing?
I chose one of the simplest tunes sung in any synagogue, Solomon Sulzer’s setting of the Sh’ma. I started singing it, and that’s when she started smiling and mouthing the words. For me that was a small miracle. Music which had always been my way to connect a congregation to the Almighty, had allowed me to connect with her.
And, I thanked God for that connection.
Cantor Don Alan Croll is chaplain of Pathway Hospice, spiritual leader of Congregation Beth El Binah and cantor emeritus of Temple Shalom. He is a member of the Rabbinic Association of Greater Dallas.