Last week my friend Cynthia died. An internal medicine physician who diagnosed her own ALS, Cynthia spent an entire career caring for underserved and overlooked individuals and families. A doctor of exceptional clinical skills, she owned another gift – a capacity to heal as well as cure.
Cynthia’s passing reminded me of a group of medical residents, rotating through our hospital several years ago.
Unprepared for the onslaught of critically ill children, this group of young doctors approached me (a hospital chaplain) with questions about how to engage a family whose child showed no signs of getting well. The eight-year-old girl had come to the hospital a month earlier with a multitude of problems including unmanageable seizures, a complex surgery, and a long slow process of waking up. Persistent infections suggested that she might never fully awaken, or even go home from the hospital.
Each day the residents expressed more anxiety about their lack of experience with such a heartbreak. They felt awkward having so little clinical medicine to offer. They also expressed their discomfort and even fear of walking into a room full of anguished family members.
So, we decided to have a conversation about this. Guided by their own observations and intuition, the residents shaped a plan. The first thing they would do upon entering the child’s room would be to take a deep breath and sit down. Once they quelled the urge to jump up and rush to the next task, they would share with the family how hard it was to watch them struggle with their child’s health crisis. They also wanted to acknowledge the family’s courage and anxiety they must have felt not knowing what the future held.
The residents agreed that, once they grew more confident, they would ask the parents to talk about their little girl. What made her laugh? Did she have a beloved pet? A favorite teacher? What did they enjoy doing together? Next they would ask the family if they could bring photos, favorite books, and personal items to help hospital staff get to know the youngster in their care. Perhaps most important, the residents wanted to learn how to calmly sit in silence or listen to another’s distress without attempting to fix it. How could they bring themselves to simply be present?
Eventually, through their own intention and growing awareness, the young doctors figured out how to relate to a dying child and her family.
Days passed, and I eventually saw each of them sitting comfortably with the family. The mother later told me that she had never seen so many conscientious young physicians who displayed such a genuine interest in her child. A seemingly hopeless medical situation became a source of healing for everyone. It was an early and priceless lesson for the residents.
On the other hand, Cynthia and I met under quite different circumstances. I came to her clinic as a theology graduate student completing a practicum in spirituality and healing in medicine. She, a bright, no-nonsense internist was in pursuit of science-based evidence, accurate scans, and positive clinical outcomes. Spirituality was a hard sell in 1987. She might have viewed the medical residents’ plan of “presence” practiced without action as inadequate, or simply a waste of time. But not today.
Through the years, a thriving medical practice, and a life ending illness, Cynthia grew into more than a clinical star. It was her unhurried presence, her capacity to listen without judgment, and her genuine attention to others and the life around her that captured all of us. And now, as she walked with purpose through the last chapter, she embraced each day with profound gratitude.
By their nature, serious illness and death invite us to become reflective.
They nudge us to put down our masks and busyness and begin an inward journey in search of what is ultimately worthy and good about life. Have our hearts opened or closed through the years? Who are we and where do we stand with our relationships and commitments? How do we give life to one another? Where do we find God’s creative presence?
Ironically, when the time came to say goodbye to Cynthia, it was not a quiet and reflective time. Nobody stayed away wringing their hands, fearful of intruding. Instead, they all showed up. Her home filled with family and friends carrying photo albums and coffee cake. Unable to speak, and tethered to a ventilator and feeding tube, Cynthia held court for several days greeting and high-fiving new arrivals. She laughed at old stories, and joyfully wrote notes and greetings on her Boogie Board. Music wafted through the house. Food went in the oven. Families with infants made themselves comfortable on the floor.
Cynthia occasionally dozed off and then awoke, eager to get back into the conversation. She listened to every story and question with rapt attention. Her focused presence became palpable. Nieces and nephews wiggled onto the sofa to sit next to her. I offered a simple healing service, and everyone took part. Each person who came through the door must have felt fully seen and heard by their friend and doctor. At the end of the party, Cynthia raised her hands high in a gesture of thanks for a beautiful life and so many friendships. It was a celebration of the highest order.
Surely listening lies at the very heart of medicine. Yet a listening presence also lies at the heart of justice, love, and a healing peace. Cynthia provided a teaching moment of this, and we were transformed.