Every so often in hospice you get asked a baffling question, one that you don’t have a ready answer for. Sometimes it’s because the answer is simply beyond fathoming or beyond a simple explanation: “why is this happening to me?” or “why does God allow so much evil in the world?” Other times I’m baffled because the answer seems so obvious that I’m trying to understand why it’s asked at all. Such was the question I had posed to me a while back:

“Why does God have to take my mom? She never did anything wrong!”

The unspeakable answers were the simplest ones. First off, she was near 80. Second, she had advanced dementia, was aspirating frequently and had already lived beyond the 6 months we typically regard as being “appropriate for hospice”. Third, the Calvinist in me wanted to mention the “never did anything wrong” part, but it knew better than to raise that conversation. The mourning don’t need lectures on total depravity.

I did try to talk as gently as possible about how her mother had reached the end of a very long and good life, and how hard it was to say goodbye. I listened a lot. I tried to look at the questions behind the questions, and even the questions behind those. But as illogical as it sounded, the main thought that kept coming up was “mom shouldn’t die because she was good.”

This was not the first time I’d heard this sentiment, although it was the first time I heard it put forth so plainly. Thinking back on the conversation I had with her, I was puzzled and even felt a bit angry. I wondered who taught her that death was somehow avoidable, or that good people don’t die, or that death itself was a punishment for something. Theologically that last thought made a bit more sense to me, as we’re often taught that “the wages of sin is death” and so on, but that we are saved from eternal death by Christ. Could it be that some hold the idea of Christ saves us from literally dying, and that death is a failure on someone’s part – either on the person or on Jesus himself? That really didn’t make any sense to me.

As I continued to puzzle over the situation, I talked with some others about this daughter, her family and her mom. She had never been accepting of the decline, and while she wanted hospice there for her mom we had to constantly reinforce that her mom wanted to be a DNR. We had done a lot of education about the dying process, but I had not been allowed in the home because they had their own Catholic priest (the “front” reason), but also it reminded them that mom was going to die (the unspoken, “back” reason). The mom had lived with the daughter pretty much her entire life. It was clear that the life of one was the life of the other. They were so enmeshed that they even slept in the same bed. The rest of the family didn’t get along and offered little help. It seemed like a system that ran on anxiety and the fear of loss. The loss of mom meant the loss of self. And that’s when it hit me that the question was as much about mom as it was about her.

She was saying, in effect, “Why do I have to die? I never did anything wrong? Why is God punishing me?”

After she died I called and tried to listen and address some of these “back” issues, but it was like rowing up Niagara Falls. Needless to say, we considered this to be a “high risk” bereavement case and will follow the daughter and anyone else in the family, and provide some referral support as well as materials to help cope with the loss. But dealing with the loss of meaning is a difficult task for anyone, especially one who is ill-equipped emotionally, spiritually, psychologically and socially to do so. I feel that I can help, but only help so far along the road.

The picture our patient in her obituary showed her not as her 80 year old self, but was taken probably back in her 50’s. One one hand it showed a woman happy and much more vibrant than she had been. On the other it showed someone trapped in time. In the obituary it also noted that our patient had known that the true meaning of life had been to be surrounded by family.