Spiritual Always

Rev. Chris Jimmerson
March 18, 2018
First UU Church of Austin
4700 Grover Ave., Austin, TX 78756
austinuu.org

Spirituality may be even more important to us if we are facing challenges to our quality of life, or even our own mortality. How do we face difficult decisions in ways that maximize our agency, quality of life, and our ability to maintain our spirituality?

Call to Worship

We enter, now, into this place of renewal.

We join together, now, in this community that sustains and upholds.

We imagine, now, a world with more compassion, more justice, more love.

We worship, now, that which is greater than us, and that holds our aspirations, our fortitude, our faith, our hope.

Now, we enter into this shared spirit of gratitude and community.

Now, we worship, together.

Reading

CHRISTMAS AT MIDLIFE
-Mary Anne Perrone

I am no longer waiting for a special occasion; I burn the best candles on ordinary days.

I am no longer waiting for the house to be clean; I fill it with people who understand that even dust is Sacred.

I am no longer waiting for everyone to understand me; It’s just not their task

I am no longer waiting for the perfect children; my children have their own names that burn as brightly as any star.

I am no longer waiting for the other shoe to drop; It already did, and I survived.

I am no longer waiting for the time to be right; the time is always now.

I am no longer waiting for the mate who will complete me; I am grateful to be so warmly, tenderly held.

I am no longer waiting for a quiet moment; my heart can be stilled whenever it is called.

I am no longer waiting for the world to be at peace; I unclench my grasp and breathe peace in and out.

I am no longer waiting to do something great; being awake to carry my grain of sand is enough.

I am no longer waiting to be recognized; I know that I dance in a holy circle.

I am no longer waiting for Forgiveness. I believe, I Believe.

Sermon

When we first got the call, we did not realize how serious things were. Our niece, Paige, had gone in for an adjustment to her pacemaker but suffered cardiac arrest during the procedure.

Paige was more like a sister to my spouse, Wayne, and for that matter to me. Her mother, and Wayne’s oldest sister, had been a lot older than Wayne. So much so, in fact, that Paige was much closer in age to us. She was almost exactly the same age as me.

Wayne made immediate plans to fly to where Paige was in the hospital. Not knowing quite how serious things really were, we agreed that I would stay behind.

The next day, Wayne called me. He let me know that Paige had died and been revived more than once after she had gone into cardiac arrest.

Her higher cognitive functioning was gone. Her kidneys were failing. Only the machines they had attached to her were keeping her body alive.

Wayne and Paige’s younger brother and one of Wayne’s other sisters (Paige’s aunt) were there. Her younger brother was faced with making the agonizing decision of whether or not to turn off the machines.

The family talked. He told the doctors to turn the machines off – to let her go.

Wayne called me later that same day to let me know she had died.

This is a scene that plays out all too often in hospitals across the country. We have the technology to keep people physically alive long after the person, the spirit, the mind is no longer. And even when consciousness is still there, we can far too easily trade away quality of life for vague hopes of extended life that too often go unfulfilled.

In Paige’s case, she had left a real spiritual gift to herself and to those of us who loved her. Perhaps because she had developed congestive heart failure at a relatively early age, she had put into place the documents that detailed her wishes should various medical circumstances develop. She had created a will that specified how she wished her values to continue to be expressed in the world after her death.

As importantly, she had discussed these wishes with key members of her family.

So when the time came, her family, her younger brother already knew what she would want them to do. I can only imagine how much harder it might have been had they not known.

Paige left our world having known that she had empowered the people she loved to enact her wishes in circumstances where she could not express them herself. There is an agency to this that too that to me has a spiritual element to it.

I share this story partially because too often aging, death, disability are topics we avoid.

And yet who here this morning is immortal?

And I have more bad news. We are all only temporarily abled. Like all complex systems, wear and tear, illness and accidents will eventually begin to break us down.

I think Paige’s story is a great example of someone who did not avoid these inevitabilities – of preparing ahead of time so that her own agency reached beyond even her physical longevity.

In his book, “Being Mortal: Medicine and What Matters in the End”, Dr. Atul Gawande addresses how the medical model for handling aging and disability that we have adopted can take away that agency – can rob of us of the spiritual development that might otherwise be possible as we age, face fatal illness and/or disabilities.

He talks about alternatives that would prioritize quality of life over absolute safety and squeezing out a few more days of life.

Now before I go on, I want to acknowledge that there are likely people who are confronted with one or more of these challenges here today or whom have loved ones who are. Know that I know one of the reasons we avoid these topics is because they are difficult. They are emotional. Please know that I am available to you to talk further later on if need be.

My fellow Unitarian Universalist Minister, Jennifer L. Brower, outlines a number of spiritual tasks and opportunities for spiritual growth that we encounter as we age, many of which we also face if confronted with a fatal illness or the loss of one or more of our physical abilities. She defines spiritual in a way that I really love, so rather than paraphrase, I want to read you her actual words:

“If we understand the ‘spirit’ to mean the animating or vital force within each person — ‘spirit'” derived from the Latin spiritus, meaning ‘soul, courage, vigor, breath’ — then the spirit is our vital center or our core. And the ‘spiritual’ are those things which support that center; those things which enliven us and give us a sense of courage, or heart, for our living. Spiritual experiences are those events in life and moments in relationships which attune us to that vital or animating force within and which give greater meaning and depth to our day-to-day living.”

As we face aging, end of life issues, disability or some combination of these, we often need these spiritual experiences even more so. They can help us make sense of what is happening to us, find meaning and agency even within our new circumstances and maintain the relationships that sustain and comfort us.

As I mentioned earlier though, the problem, Dr. Gawande addresses in his book is that our “medicalized” model for handling disability, fatal illness and caring for the aged can and often does take away our very ability to engage our vital center, our spirit.

He tells heartbreaking stories of people in nursing homes in a room with someone they do not know and placed on a schedule that prioritizes the nursing home’s need for safety and efficiency over the residents’ agency and quality of life. Understandably, family members also often prioritize the safety of their loved ones without being aware of how extreme safety measures can so restrict quality of life.

Likewise, he tells wrenching stories of people with a fatal illness being given treatments and medical procedures with a false hope of extended life, at the cost of such treatments themselves causing misery and robbing them of quality of life. Too often, he asserts, healthcare providers find it difficult to describe the true direness of the situation and end up offering additional medical treatment instead.

Dr. Gawande points out that it does not have to be this way. He describes true assisted living facilities. One where each person has their own apartment where they can lock their door if they wish. They can establish their own priorities regarding their safety versus their agency. If they want to risk having a cocktail at night and end up falling down because of it, it is their decision. Regardless, the assistance will be there is they need it.

He describes other facilities that feature individual bedrooms and bathrooms arranged around a homelike central living and kitchen area. Again, agency is prioritized over safety. The residents make their own decisions and schedules to the extent that they are able. Pets and other life are allowed within the facilities.

Similarly, Dr. Gawande describes the hospice movement that has arisen in the U.S. and tells of how it has given people facing death the chance for a greater quality of life and has reduced their suffering. Hospice staff can also greatly help family members through the decline and loss of their loved one.

One study even found that people who went into hospice care actually survived longer on average than people in similar circumstances who were put on aggressive therapies.

My stepfather, Ty, was in my life for over 40 years. In many ways, he was more my father than my actual dad. He too developed congestive heart failure. For Ty it was in late 60s and early 70s. I am so thankful that the last trip he was able to make was to be here at this church for my ordination just over three years ago.

Ty’s condition quickly deteriorated after that though, to the point to where his heart was no longer pumping sufficiently. He had trouble breathing. His feet swelled with fluids.

He and my mom went to Houston and spoke with a specialist who talked with Ty about having an artificial heart transplant.

I am also so thankful that upon his return back to the Beaumont area where they lived, Ty spoke with his regular cardiologist, who had the courage to tell Ty about how low the chances that the transplant would be successful. He told about the many ways that the transplant procedure itself could go wrong with a person in Ty’s condition and could lead to even greater misery.

Eventually, Ty decided not to have the procedure – to live out whatever time he might have left with as much quality of life as could be made possible with palliative treatment only.

Those were difficult conversation he and my mom and the family had, but they were necessary conversations. They let Ty have agency and enjoy what he could even in his waning days.

I remember my mom calling me one time – I can tell you this because she and I have talked about it – she called me worried that she was making Ty mad by pestering him about his continued cigarette smoking. He had been a lifelong smoker and continued it even after deciding he would seek no further treatment for his heart other than hospice care.

I was like, “Mom, leave him alone. He enjoys it. What harm’s it gonna do now?”

She let it go.

I remember visiting mom and Ty near the end of his life. Ty was in his favorite reclining chair in their living room. Home hospice care had him on a pretty high dose of morphine because he was having a lot of trouble breathing and it helped keep him from suffering because of it. He could not talk much.

Still, he greeted me with that famous smile of his that could still light up the room, and after exchanging pleasantries, I sat down in the chair next to him.

We just sat for a while together, not saying much and even in our silent being together saying everything that mattered.

It was for me a spiritual experience, and I hope and think it was for Ty too.

Again, I share Paige and Ty’s stories with you because I think that they both demonstrate one of life’s important spiritual practices.

They put their wishes in writing. They had the difficult conversations with loved ones before it was late.

And this is something we all can do that will give us agency later on when we might not otherwise be able to exercise it and, as it was with Paige, can also be a great gift to those we love.

Getting our wills together that express how we would like our values to be expressed beyond our time here one earth, creating our health care directives and power of attorney documents and perhaps most importantly having these discussions with our loved ones now, so that this is already all in place when need it is actually a spiritual endeavor.

While there are absolute guarantees, having those difficult discussions with loved ones about what types medical procedures and life support we would want i under what conditions makes it much more likely our wishes will be fulfilled and that our loved ones can do so with far less anguish.

Letting our loved ones know what types of assisted living facility we would want and again under what circumstances can ease the decision making process later and give us the best chance for a higher quality of life as we reach the end stages of life. Would you prefer agency over safety? Have you purchased a long-term care policy for in home care? If so, do your loved ones know all of this?

Here are the additional spiritual challenges and growth possibilities we may go through as we age or face physical decline as outlined by Rev. Brower:

Bereavement – learning to cope with the loss of significant persons in our lives and those who had been with us during earlier, life-shaping events and yet remaining able to form new, close, intimate relationships.
Redefining our sense of purpose in life – what do we do to find meaning after we retire – after raising a family is no longer part of our purpose in life?
Reconciling our sense of self with a body and mind that may begin failing us in some way.
Reviewing our life – are there things we have left undone, unsaid, unresolved that we might like to address?
Resolving our questions about the nature of God, or what is ultimate or the nature of human existence, as well as resolving anxieties about death and the process of dying.
Our relationship to religion and our religious community. For older and disabled folks, just getting to church on Sunday, even if given a ride, can be a difficult if not almost impossible chore.

Yet the desire for religious community often remains strong. I am so glad that Rev. Ellis at this church goes to the Westminster assisted living facility and provides a worship service once per month for several of our members who reside there.

Spirituality and agency remain basic to our human needs throughout life, even as we face our own physical limitations and our own mortality.

By working to advocate for a society that treats these as human needs and not simply a medical problem, we can give ourselves and others the best chance to be able to meet those needs.

By knowing what spiritual challenges may lie ahead for us, by doing our best to prepare for them, by having the difficult but holy conversations around them with our loved ones, by making our wishes known, we may best be able to turn those challenges into lifelong spiritual growth.

Thank you, Paige. Thank you, Ty, for helping me learn this.

Amen.

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