Everyone is an Expert

expertWhen first admitted into hospice care, one of the patients mentioned they looked forward to the chaplain’s visit. In recent years, before and especially during his illness, this person told the admitting nurse about reading (and re-reading) the Bible cover-to-cover.

“There’s nothing the chaplain can say that I don’t already know about the Bible.”

Really?

Did humility, humor, or hubris influence our new patient’s claim? Were the words a boast . . . or a clever way to avoid deeper, and more difficult emotions?

Many of the people every hospice serves have faith traditions with a unique book. The Hindu reveres the Bhagavad-Gita. Jews claim the Torah. Christians embrace the New Testament. Muslims honor the Koran. Some patients may know little about the sacred text at the center of their religion, while others may possess a scholar’s awareness. A life-threatening disease can cause one person to explore—for the first time, or with renewed energy—the words of their faith, hoping to uncover answers or encouragement. The next person might abandon her or his religion’s familiar statements and stories because their illness proves God doesn’t care or never existed.

A hospice chaplain enters into a person’s life, often for hours or days. The chaplain has no interest in arguing or interpreting or defending or condemning any scripture. Instead, what is important to the chaplain is what is important to the patient. Often, and even more essential, what are the real hurts and hopes in the shadows behind a patient’s knowledge or ignorance or abandonment of their faith?

All hospice staff have met and will meet family members claiming to be experts. There’s nothing the home health aide or nurse or social worker or doctor can say that the patient or caregivers doesn’t already know. After all, this is the information age! In every article I’ve posted for this hospice blog, I’ve scanned the web to clarify or seek data. With a slick mouse click or an easy finger swipe, I can find out “exactly” what is wrong with me. And what is wrong with you! What caused that cancer? What is the best treatment for COPD? Is it harmful to take morphine? What are the adverse side effects of Ativan? On we search, often acting as if we’ve become experts. Whether we read the Bible from Genesis to Revelation or memorize the Mayo Clinic’s insider information about our particular disease, we are full of information.

Well, we are full of something . . .

Often, we are more full of fear. Or doubt. Or shattered dreams. Or loneliness. Or anger.

A few years ago I was anticipating hand surgery because of carpal tunnel syndrome. I’d first gone to doctor, uncertain of why my wrist ached and fingers were numb. Efforts were made to treat the problem with physical therapy. I was told to do or not do certain activities. I had an odd test that recorded how fast (or slow) my nerves conveyed electrical signals up and down my arm. Eventually I faced surgery. These were my hands. I needed them to type on a keyboard, for hugging and handshakes, to hoist a wine glass, take my dog for walks, and for holding hands with my wife. I scoured the Internet, wanting to become an “expert” on the procedure and its aftermath. Much of what I found was the worst! Botched surgeries! Raging infections! Physical therapy scams! The web overflows with awful exclamation points!!!!!!

These days, a hospice nurse can be told she’s wrong about suggested medications for a patient because Dr. Oz reported or WebMD warned or a Google search discovered or the cousin who is a pharmacist recommended . . . well, whatever was said or found, it contradicted the nurse. And so patients or caregivers debate the nurse standing in your room, with your chart in his hands, and who is a phone call away from consulting your physician.

Will the patient argue with or listen to the nurse?

Will the caregiver quote random “experts” or learn from the nurse?

In the time of dying, no one is an expert. Truly, I’m glad sacred texts like the Bible or the Bhagavad-Gita provide comfort for certain believers. I’m glad for the user-friendly knowledge on reputable websites. I’m glad for family members that are medical professionals who bring their knowledge into caring for a spouse or parent or second cousin. I’m glad people can answer a confident “Yes” when a social worker asks if they’ve completed a POLST or DNR form.

But whether a drug regime, theology, or a Medicare form, I hope patients and caregivers, along with hospice professionals, can admit all forms of expertise are limited when we enter the sacred, scary landscape of dying.

When a person responds to the joys and sorrows of others as if they were his own, he has attained the highest state of spiritual union. – from the Bhagavad-Gita

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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