By the Rev. Karen F. Siegfriedt; Trinity Episcopal Church, Sutter Creek, CA 6/28/15
“Three men stood by the ocean, looking at the same sunset. One man saw the immense physical beauty and enjoyed the event in itself. This man was the “sensate” type, who like 80 percent of the world, deals with what he can see, feel, touch, move, and fix. This was enough reality for him for he had little interest in larger ideas, intuitions, or the grand scheme of things. He saw with his first eye, which was good. A second man saw the sunset. He enjoyed all the beauty that the first man did. Like all lovers of coherent thought, technology, and science he also enjoyed his power to make sense of the universe and explain what he discovered. He thought about the cyclical rotation of the planets and stars. Through imagination, intuition, and reason, he saw with his second eye, which was even better. The third man saw the sunset, knowing and enjoying all that the first and the second men did. But in his ability to progress from seeing to explaining to tasting, he also remained in awe before an underlying mystery, coherence, and spaciousness that connected him with everything else. He used his third eye, which is the full goal of all seeing and all knowing. This was the best.” (The Naked Now by R. Rohr)
Today, I would like to talk about making conscious medical decisions. In order to do this with integrity, we need to take an informed look at the state of our health, our expectations of life, the likelihood of suffering, and our fear of death. Like the second man looking at the sunset, it is important for us to look beyond our physical symptoms and use our reason and knowledge to make good and conscious decisions. But even more so, we need to go beyond our reason and connect with the underlying mystery of life, the Divine Presence, to truly discover our purpose here on earth.
Today’s gospel reading contains two stories of healing, two different females, and two encounters with Jesus. One woman has been hemorrhaging for 12 years and the other appears to have died at the age of 12 years old. Both are in need of healing, both have received an incredible gift of grace, and both are given another chance to live a full life. But this is where the similarities end. The bleeding woman is without social, religious, or economic status. She is unnamed, deemed impure, and ostracized because of her discharge of blood. The 12-year old child has everything the bleeding woman doesn’t: a man to advocate for her, wealth, status, and position. And yet somehow, in their encounters with Jesus, both are healed.
What stands out for me in the story about the unnamed women who had bled for 12 years and who exhausted all of her resources on medical care for a chronic condition, is that she really wanted to live. She wanted to be an integral part of society, not just pushed to the sidelines as being an “impure” person because of her discharged. She wanted to embrace the fullness of her personhood. She seemed to be highly motivated, possessing great courage and determination. As a result, she took a chance and pushed through the crowd in spite of all the Jewish laws that prohibited her from coming in contact with others. She reached out to Jesus and touched his garment and immediately, her bleeding stopped. Chances are she had heard about his gifts of healing and felt that this was her last chance to become well. Perhaps she was spiritually enlightened, being able to perceive divine healing in his very being. Or perhaps she was simply broke and decided to try alternative medicine. Whatever the motivation was, however strong her faith might have been, she received a grace and “was healed of her disease.”
I think most of us can relate to this story, especially those of us who are aging. Many of us spend an enormous amount of time and resources responding to a chronic medical condition. Much of the time, we are not cured but only maintained at a lesser level. This story tends to raise questions like: Will I be healed? or Why are some people of faith healed and others are not? While faith is an integral part of our healing process it does not guarantee a long life but does guarantee an abundant life. There is a season and time for every matter under heaven. “A time to be born and a time to die.” (Ecclesiastes 3)
So how do you make medical decisions about your own life? Is faith an integral part of your decision making process? Do you tend to be an impulsive decision maker, opting for the first treatment that is offered? Or are you the type that thinks about things for a long time, does extensive research, lists the pros and cons, and then consciously makes an informed decision? Maybe you are the type that simply lets nature take its course and go with the flow? Or maybe you are fearful of death and make decisions based on quantity and not quality. I would like relay three stories about three different people and how they made their medical decisions. See if you can relate to any of these.
The first story is about a man who was nearly 80 years old. I met him in the emergency room in Yuma AZ, after his wife experienced a heart attack and was dead on arrival. As the student chaplain, it was my job to minister to him. While he was deeply grieved over the loss of his wife, he seemed to accept it and was fairly calm. I asked him if there was anyone to go home to. He said, no. I then asked him if he were taking any medicines. He said he was taking a pill for his heart but decided that he was going to stop the medicine. I asked him why. He said: “I have had a wonderful life. I am approaching my 80th year and my beloved wife has died. I am ready to go too. But don’t worry about me. I am not going to go home and kill myself. I am simply accepting what is and have chosen to go naturally without any medical intervention.” This was a man who valued quality over quantity.
The second story is about a man named Art who was diagnosed with mesothelioma, a cancer of the lung caused by asbestos inhalation, probably some 50 years earlier. This kind of cancer has an extremely poor prognosis. Once you have it, there is little you can do. Art was in his early to mid 70’s and he loved life. He embraced every minute with joy. He came and told me that he would do anything to extend his life even if he had to go to Australia and eat apricot pits. He finally convinced a doctor to do radical surgery as “a research subject.” The operation was extremely painful but Art was determined to live. The surgery was unsuccessful and Art died in pain but he never complained.
The third story was written by Katy Butler in her book, Knocking on Heaven’s Gate. Katy laid out the multitude of personal and medical issues as her parents entered their 80s. After her father suffered a stroke, he developed a hernia. While Medicare would not pay for a truss, they would pay for surgery and so the family felt pressured to pursue this option. But right before the surgery, the doctor decided that the father would need a pacemaker to survive the surgery. So the family felt obligated to have a pacemaker inserted in order to complete the hernia operation. But then with all of his medical problems mounting, he developed blood clots and had a brain hemorrhage. This resulted in dementia. The pace maker kept his heart going and his wife became his round-the-clock caregiver. Katy Butler explains how our current medical system more often than not intentionally draws out the process of dying. Medication, surgical interventions, technology - all of these things led to the shell of the man she knew as her father, simultaneously saving him but dooming him in the end.
A few months ago, the Trinity Health Ministry Board discussed a controversial article by Dr. Ezekiel Emmanuel. Dr. Emanuel is an eminent oncologist and outspoken defender of the Affordable Care Act. He is a healthy, active, 57 year old respected physician who hopes to die at the age of 75. If he lives past that age, he will refuse all medical intervention. He doesn’t intend to end his life at 75 but he will refuse to accept any medical procedures, treatments, surgeries and antibiotics after that age. He wants to die naturally and does not want to endure the problems associated with artificially extending one’s life. We began to discuss Ezekiel’s position as well as our own preferences. One member said that if her heart stopped, she did not want to be brought back. Another said that 75 years old was way too young to stop medical intervention. Some said that they would have chemo but did not want to be on a ventilator. I said that I plan to make different medical decisions after I reach the age of 78.
As you can imagine, our discussion became very lively and so we decided to have this discussion on a parish level. So here we are today, reflecting on our own health, desires, goals, and fears. Perhaps you relate to the woman who was healed in today’s gospel or the man who wanted to go naturally or Art who loved life so much that he would try almost anything to extend his time on earth. I would like to hear your ideas and thoughts about making conscious medical decisions and where you fall on the spectrum. After the silence, please come to the microphone to share your insights, questions, and concerns. I believe that this is an important conversation for us to have and your contribution will greatly enhance our own thinking about this very important topic.