Thanks Angela on Catholica for pointing me to the following reflection. It’s a cracker. At first I thought I’d post excerpts and point you to the link but, for my record if nothing else, I’m posting the lot.
The patient art of dying
By Scott Stephens
The draft report of the Productivity Commission’s call for urgent reform of aged-care is an extraordinary and long-overdue document that, if implemented, will go a long way toward rectifying the myriad injustices and forms of institutional and economic abuse to which our elderly are subjected in the final years of their lives.
And yet it would be mistake, I believe, simply to limit our focus to the institutional and economic dimensions of aged-care, thereby keeping this problem at arm’s length. There is an equally important moral or personal dimension to the ongoing catastrophe of aged-care in Australia that demands a reform of our moral imaginations as well.
But whereas budgetary constraints and sheer political will are the impediments to the implementation of the Productivity Commission’s draft report, our impediment is that we have grown far too adept at suppressing our obligations to the elderly.
Anyone who has had any experience of working or volunteering in aged-care facilities knows the conditions in which our elderly so often live: their clothes drenched with either excrement or the property-less mush served to them as food; cavernous hallways echoing with howls and plaintive cries for assistance; under-resourced, overworked and frequently untrained staff rushing frenetically from task to task; the ambient disdain for these frail, barely existing hominoids who are not treated as though they were alive, but simply “not yet dead”.
With some noble but all too rare exceptions, this is the ubiquitous experience of residential aged care in the West. But perhaps this is the way it has always been. Perhaps there is something unnatural about the outsourcing of the care of our elderly to a disinterested third party, as if it ruptured the proper order of things.
Just take Elizabeth Jennings’s haunting poem “Old People’s Nursing Home”, written in the middle of last century (with thanks to Kim Fabricius for the reference).
The faces differentiate themselves,
The men half-women, the women half-men
And each entirely children
Except in anger, except in ignorance.
These wrinkled faces know too much, these gnarled
Hands have touched the pulse of love, have known
The family increase and birth’s harvesting.
But that was the past and this house has shut out the past
And it dare not face the future:
So it lives in a perilous present that could be cracked
By a broken cup or a laugh.
Cups are unbreakable here,
Jokes are in print too small
And the noisy future, the passionate past are dammed
Partly by deafness, partly
By doctors’ decisions and nurses’
Hiding the stuff of life and death away –
Tear-heavy handkerchiefs, the whiff of pain.
Jennings captured the unreality – and indeed, the hellish immorality – of the nursing home as a place where past and future, memory and hope, are somehow eradicated and all that is left is the nightmare of an immutable, insipid present in which not even cups can break.
But how can it be otherwise when it is one’s family and immediate community that safeguards memory and embodies hope, and while the expressed purpose of residential aged care is to separate the elderly from their families and communities?
And although it is inevitable that residents would look to the staff to function as an ersatz family, the staff are themselves ill-equipped and incapable of meeting the residents most basic material needs, much less provide the kind of emotional succour so necessary in old age.
The tragedy of residential aged care is that there is no way of simply dividing the different actors into the victims and the perpetrators, the indigent and the sadistic. Instead, the staff and the residents are bound, as it were, back-to-back in an institution that makes human affection and mutuality well-nigh impossible, and that is cruel in its very indifference.
One of the more worrying aspects of the Productivity Commission’s draft report is the worsening of two trends identified in the Commission’s 2008 report.
The first is the continued increase in the number of large residential aged care facilities – that is, those with more than 100 beds – run both by not-for-profit and by private for-profit operators, such as the Moran Health Care Group, TriCare and Macquarie Capital Alliance Group.
The effect of this expansion on smaller not-for-profit facilities – those with 40 or fewer beds – has been devastating, forcing them to contract from over 50 per cent of the total number of residential aged care facilities in 1998 to less than 30 per cent in 2010.
But the second, more disturbing trend identified by the Productivity Commission is the sharp reduction in the willingness of family members and communities to care for their elderly. As David de Vaus observed (and is cited in both reports), “The more the obligation has a direct impact on people’s lives the more reluctant they are to accept responsibility”.
It is not hard to imagine the future that awaits our elderly as these trends continue to converge: ever increasing numbers of the frail and infirm herded into an ever-decreasing number of sterile profit-based mega-facilities, and there left to vanish in anonymous isolation.
To be sure, there are family members that agonise over having to leave their loved ones in such a degrading environment but simply cannot see any other option. But for far too many Australians, the ability to go on living in our consumerist nirvana is predicated on the capacity to forget our obligations to the elderly.
And here there is a rather distressing correlation between our failure to honour our obligations to the unborn and to the elderly. In this respect, what Peter Hitchens says about the “strange popularity of abortion” applies to our haste to consign the elderly to third-party care:
“I have often thought that the strange popularity of abortion among people who ought to know better has much to do with this sensation of lost control, of being pulled down into a world of servitude, into becoming our own parents. It is not the doomed baby that the unwilling parents hate … It is the life they might have to live if the baby is born.”
And so it seems that the elderly, like unwanted pregnancies, have become a kind of ritual sacrifice that we as a society offer to the most implacable of our modern idols: what Herve Juvin has described as a kind of lived immortality sustained by unlimited choice, a freedom from obligation to others, and the delusion that we can somehow indefinitely defer our deaths.
So what might be a moral response to this intolerable and mutually demeaning situation? Alongside any reform and increase in funding for the provision of supported accommodation and community-based care, there must necessarily also be a change in what can only be described as our cultural ailment, our moral amnesia.
Perhaps a first step might be to remember that morality itself is neither bound by convenience nor enacted from a distance, but rather, as Gilbert Meilaender nicely puts it, “consists in large part in learning to deal with the unwanted and unexpected interruptions to our plans” – which the demands of the elderly undoubtedly are.
But there is a second facet of such a reform of our moral imaginations that is far more demanding, and requires the strength of an entire community to sustain. It is the patience to help the elderly die.
Residential aged care, paradoxically, does not let its wards die, but rather consigns them to an interminably aseptic life. Again, Elizabeth Jennings captured this with grim accuracy.
But there was no smell, not even the deathly sick
Odour of death. And then I realised:
Death is shut from this house, the language of death,
The accoutrements of dying.
A ghost would be lively. Ghosts are not allowed here
And neither is talk of birth.
We forget that the ars moriendi or the “art of dying” – of which Langland’s Piers Plowman is perhaps the best literary example – was cultivated in the mediaeval Christian tradition as an indispensable part of living well. But it was never understood as an individual virtue. It was instead a communal effort, whereby the community gathers to listen with patient gratitude to lives that have finally learned to tell the truth about themselves.
Dying, in other words, was deemed the last theatre of virtue and courage, the manifestation of the bond between the living and the dead whereby what it might mean to die well is exemplified.
One of the more surprising advocates of the Christian tradition of the ars moriendi is also one of the most notorious modern atheists. In the final volume of the His Dark Materials trilogy, Philip Pullman tells the story of Lyra and Will, two children who have made a perilous journey to the world of the dead so that Lyra may apologise to a friend she inadvertently betrayed, and for whose death she was responsible.
But once there, it becomes clear that their destiny is to destroy death itself by, quite literally, cutting a hole in the other side, thereby permitting the ghosts of the dead to disperse into the benign indifference of the universe.
When one of the harpies – whose role it is to torment the dead by spitting venomous reminders of their failed lives – complains that releasing the dead would negate the very reason for the harpies’ existence, the children’s travelling companion makes a touching suggestion:
“‘Then’, said Tialys, ‘let’s make a bargain with you. Instead of seeing only the wickedness and cruelty and greed of the ghosts that come down here, from now on you will have the right to ask every ghost to tell you the story of their lives, and they will have to tell the truth about what they’ve seen and touched and heard and loved and known in the world. Every one of these ghosts has a story; every single one that comes down in the future will have true things to tell you about the world. And you’ll have the right to hear them, and they will have to tell you.'”
If we don’t recover this patient art of dying, whereby we learn to tell the truth about ourselves, and if we don’t allow our lives to be formed by our obligations, it is not simply our elderly that will continue to suffer. We will find ourselves, and our moral imaginations, immeasurably poorer.
Ah the perils of YouTube links!
But as you’ll see, if you go to those august blogs, the videos are blank because of a copyright dispute.
Have no fear though, Wryday is safe for now because the internet will provide (for now).
When the covert camera operator sorts out the focus, it’s quite a good clip:
The problem is these visits are an ‘occasion of temptation’; the temptation to break my self-imposed exile.
I failed recently. I posted in a string with typically moderate Padre headline: HEY COYNE BISHOPS ENCOURAGE ME COS I DEFEND CATHOLICCHURCH (NB the link will probably fall off the edge of cyberspace eventually).
I don’t know what came over me.
Anyhow, there were a number of exchanges including a few with Jules, who sometimes graces me with her presence here. In the final exchange I posted this classic image with no additional comment:
In a fit of pique Jules — who, you’ll no doubt remember, commented unhindered here many times — had a sudden attack of the axe and pulled the posts (including the ponderous one from ‘The Co-Admin’, aka herself).
How ‘not nice’ is that?
So far — and I may be tempting fate here — this ‘umble blog has allowed every legitimate comment to be published. The one exception was responding to a specific request. I mean, how could I refuse? He begged me on his ‘non paralysed knee’.
Back to self imposed exile for this mischief maker!
I’m placing this post of mine here for the record as I try to clarify my own thoughts on the whole Mary thang:
It seems to me that Mary is anything but real, anything but someone we can relate to and follow as a tangible example.
At one end — Paul’s ‘signs’ — she is a god. If you don’t find that plausible go to Lourdes as I did a year or so back. For me it was a confronting experience. I was at once genuinely moved by the expression of emotion (the ‘in-love-ness’ spoken about here recently) and sense of unity in faith, and deeply concerned at the way Mary was viewed. In the central parade ground there is a statue of her, about 3 times life size, that looks like white marble until it is lit (from inside) at night like so many of the luminous minitures made in China and crassly marketed at exorbidant prices on the perimeter.
I suspect that every person there would give the theologically correct response if you suggested they were worshiping Mary as a god, but that aside, the whole site, the whole experience, is an elevation of Mary to the divine. Jesus hardly gets a look in.
At the other end — Paul’s ‘wisdom’ — is the kind of cerebral exchange that has happened here. Mary is a ‘theological question’ or a ‘dogmatic conundrum’.
Both ends rob her of her humanity — Paul’s ‘crucified’ — they detach her from something we can genuinely identify with. Her birth, her giving birth, her life after giving birth and even her death become nothing we can relate to — even if we don’t take into account modern scientific knowlege.
She is the plaster saint in the middle of the parade ground: forever young, forever beautiful (a beauty that probably has very little to do with a girl from the Middle East!) , forever passive, forever pure OR she is a disembodied intellectual exercise that doesn’t touch us like a mother touches us (let alone a wife or a friend!).
Both do her (and us) a grave disservice in my view. Isn’t it time we grew up? Isn’t it time we got real? Isn’t it time we gave her a respect and love that is akin to the woman who gave us birth?
I also add a comment a bit further down from ‘Stephen K’:
David, I woke up this morning, vaguely disquieted. I realised that not a single comment on this post has so far been contributed by a woman. I fear we’re being put to shame by a higher feminine sensibility and intelligence. I think this could be saying something very eloquently about the approach often taken – by men – and their focus in religious matters. The tendency to dissect beliefs and ideas by men often comes across like wood-for-trees blindness or laboratory-like obsessiveness, which is often unattractive. The dividing line between significant intellectual endeavour and angelic pin-dancing is often blurry and over-stepped. Perhaps a re-think of how and what is discussed would be salutary.
Now that’s what I’m talkin’ about.
Returning to the blogsphere this week I thought this reflection, by Brett Rutledge in The Punch, captured what many of us feel looking on to a tragedy that has no ‘answers’ (Wryday can wait a week!).
Love in the time of tragedy
Jordan Rice was 13 years old when he died. His rescue was imminent but he refused the help, insisting his would-be rescuers take his 10-year-old brother, Blake, first.
When his rescuers returned Jordan was insisting they take his mother, Donna, first – but there was no more time.
The rope to which he and Donna desperately clung snapped and they were both swept away by the raging floodwater.
They found a tree and both held on for as long as they could. But the rescuers could not reach them and Jordan could not hang on. As he was swept away for a second time Donna let go of the tree and went to save her son.
They were both lost.
There will be those who will speak admirably of Jordan and his sacrifice, and call what he did an act of courage or heroism. There will be those who will say the same of Donna or the rescuers and countless others whose names we do not yet know.
What Jordan and Donna did can be explained much more simply as an act of love.
In his own mind, Jordan probably wasn’t being brave or courageous. He probably didn’t think he was sacrificing his own life for that of his brother – and I am sure he never saw the circumstances as an opportunity to be a hero. He loved his little brother and he loved his mum and that was enough.
When we look at the pictures on our TV screens and listen to the stories of the mass destruction in Queensland, it somehow doesn’t seem real. Even for those who are experiencing it firsthand, it doesn’t seem real.
It isn’t the pictures that affect us or compel us to donate our time or money – because they are beyond our comprehension. Instead, we respond to the thing we comprehend most readily – the bonds of love between one human being and another.
Family members cry out to take a brother first… or a sister, or a mother. Friends abandon their own homes so they might help their neighbour. Bystanders wade into the torrent and reach out a hand to a stranger.
Those of us many miles away read the stories of Jordan, Donna and many others and we shed a tear and feel the pain of love lost. We donate what we can and we try to compensate for their loss by sending them our love. Love is what defines us.
It defines us no matter who we are or what we believe in. It causes us to put aside our differences. It binds us together.
As we take toll of the disaster that has engulfed the people of Queensland there will be a natural tendency to try and find reason amongst the chaos and to seek sense amongst the senselessness.
It is the human condition to try and find answers to questions of human tragedy. We will ask why it happened. Why the loss of life? Why Jordan and Donna? Why not me? We find it difficult to accept that sometimes there are no answers. Sometimes things just happen. Sometimes ‘bad luck’ is the closest we can get to an adequate explanation.
We will probably try to assign blame – as some already are – but that is nothing more than an expression of anger at our inability to tame the forces of nature or to anticipate its wrath and protect ourselves from it. We will be frustrated that we couldn’t have done more and despairing of our limitations. Despite all our great advances humanity remains flawed and inadequate. We don’t like being reminded.
Such feelings will give way to expressions of pride in the response of rescuers and calls for their bravery to be recognised, and no doubt such honours will be bestowed. But the greatest recognition will already have been given. Ample thanks will have been received in the form of a shaken hand, a knowing nod, a heartfelt hug or, at length, a timid smile or laugh.
They will give way to expressions of pride in our unity and compassion and the unique ability of Australians to come together in the face of adversity and help their fellow man. But it isn’t unique to Australia.
It is the most obvious example of how love transcends the deepest grief and it is evident everywhere in the world. It is, in fact, a fundamental tenet of the human condition and the only thing that provides hope for the human race. It tells us that our similarities far exceed our differences but, sadly, it takes a great tragedy for it to manifest itself widely. Even then it will be temporary .But at least we know what we are capable of.
Just as it always does, resolve will replace grief and the business of rebuilding will begin. There will be renewal and we will once again set ourselves the task of proving our infallibility and our invincibility. At some point we will again be proven wrong and another Jordan will cry out “Take my brother first…” We will once again recognise the bonds of love, shed a tear and be compelled to help in whatever way we can.
Those that have been lost will be remembered, initially by all of us, but always by those that loved them most. The ones left behind will be comforted by the kindnesses received by strangers and an outpouring of love from a world that recognises their pain as its own. Ultimately the tragedy itself will fade from our collective memory and pass in to history.
Though we may struggle to remember the names of Jordan Rice and his mother Donna in the years to come, let’s hope that we remember their example. Let’s hope we remember the example set by the rescuers or anyone else that tried to help. Let’s hope we remember that love is both a feeling and an action and is distinguished by its inability to differentiate between the two.
To love and be loved is the sum total of our existence. To say, “I love you” as we leave this world and hear or see it said in return is the greatest epitaph anyone can hope for.
Take my brother first… take my mother first…
That is enough.