Madge Used 5 Words

Still alive?

“Why am I still alive?”

Madge repeated those five words, again and again.

Back then, as a twenty-something clergy and newly appointed associate pastor, visiting Madge and nearly everything else I did was a new experience. I fumbled through communion. I over-prepared for sermons. I felt like the youth group kids knew more than I did, and definitely outnumbered me.

The senior pastor, with decades of church work behind him, was a kind man and excellent mentor. He took me on visits, introduced me to the congregation. I entered homes, apartments, emergency rooms, hospitals, job sites, lunched at restaurants with church members, and . . . went to convalescent facilities.

The last was the worst. Well, maybe I should say toughest. No, both. The foul smells clashing with the stark odor of disinfectants, the rattle of wheelchairs and gurneys, the bored looks of underpaid, overworked staff, and the endless hallways paved with shiny linoleum.

And there was Madge. (Not her real name.)

But it’s a real memory. If Madge’s sterile room, with a thin curtain on ceiling runners separating the two beds, wasn’t my introduction to a SNF—skilled nursing facility—she is my earliest recollection. I was merely a witness, for it was the senior pastor who took the lead. He held Madge’s hand, talked to her about her family, asked how she was doing (she never replied), read snippets of scripture, and then bowed in prayer near the visit’s conclusion.

Madge did only two things during the minutes (which seemed hours) in her room. She was silent or she muttered that question.

“Why am I still alive?”

Elderly and feeble, most of her friends had died. Her family rarely came by. She likely had dementia. Once, the senior pastor told me, Madge was a quiet, dedicated church member. In the past, she could be counted on for bringing dishes to potlucks and eagerly joining Bible study groups.

Now, there only seemed that question.

“Why does she ask that?” I asked.

I don’t recall his specific answer, because maybe all answers felt inadequate. If her question was meaningless repetition, influenced by isolation or illness, it was also wrenching for any in hearing range. The senior pastor visited her several times a month. She always asked just that question. I occasionally visited, and heard—again—the question I could not answer.

Because it represented one of my initial frustrating visits in a convalescent facility, I recall Madge. But I also remember because others have echoed her question.

It is certainly whispered or shouted in hospice care.

Some who’ve asked did have dementia. Indeed, Madge’s question fulfills one of the current requirements for a late stage (and hospice appropriate) Alzheimer’s diagnosis: the “ability to speak is limited to approximately 6 intelligible words or fewer in an average day…”

Madge used five words.

I have overheard some answers to why someone is “still” alive:

  • It’s God’s will . . . and, of course, God acts in mysterious ways.
  • There’s a predetermined date for death, and it’s not her time to die yet.
  • He or she has unfinished business.
  • Though the mind is “weak,” the body remains strong.

What answer would you give? What answers have you heard?

I have sometimes wondered: does a person remain alive—even when they want to die or it seems there’s no apparent reason to continue living—because it’s important for the people in their life to care for them? Sometimes I feel okay about that “wondering,” and sometimes not.

There are similarities between birth and death. In both, we are helpless and need others. And those others who care for us have the potential to change and grow and become better persons because they are tending to another’s needs. That seems more “obvious” when parents nurture a baby. And though less obvious when a frazzled adult child tries to care for a dying parent, there is still the reality of vulnerability as death approaches for the hospice patient.

Why am I still alive? is thus answered by saying: Will the family or friends caring for the patient have an opportunity to serve, to grow, to sacrifice, to give back, to be reminded about their own mortality, to reaffirm what’s important in life?

It makes sense, right? I’ve seen examples of the busy, one-day-blurs-into-another adult children being “forced” to care for aging parents. Eventually they realized it was transformational to be a part of a beloved’s final days. Best-selling memoirs have been published, glowingly describing a journey from a “thorny” experience to stopping and smelling the proverbial roses by caring for a dying parent.

But I remember Madge. No one in her family stepped forward to eventually have Ah-ha! moments by helping her. And I’ve witnessed, in the church members I’ve visited and in the hospice patients I’ve met, many asking this question and there simply was no answer.

I am sorry I have no one-size-fits-all answer about this question.

But I did visit Madge again. The senior pastor continued—until she died—to regularly pray for her by her bedside. And since then, though with many failures, I have tried to support people when they were hurting, when they asked questions that couldn’t be answered.

Truthfully, I don’t have much of an answer for most of the best and worst questions. But I continue to believe if someone like Madge keeps repeating the questions, I can keep repeating my action of returning to her room, or making a phone call, or sending a text, or grasping a hand. I can repeat the heartfelt, heart-aching gesture of letting another know I am with them.

If I can’t do that, then: why am I still alive?

(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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  1. As a transplant recipient I had often surmised, “Why am I still alive?” Once in discussion with a group of nursing students I was asked if I knew why I was still alive when others had succumbed to their disease. The only answer I had at the time was that there was a difference between giving up and letting go. The will to live was strong in me and I never did give up but I did let go and then for some reason I didn’t die. Since that time many years ago I have come to the realization that I had work to do on myself and more work to do for others. It wasn’t time to go yet because there was still some purpose in my being alive just like Madge. My 90 plus grandmother said this just before she died, “I am ready now!”

  2. I’ve had patients ask that and I would tell them I didnt have the answer but there was some reason for them to be here still. There must be some person they’re meant to see or speak with, something they may still need to accomplish, or just that their time hasn’t arrived yet.
    I had one who had reacted terribly to every form of treatment they tried for her cancer and she hurt horribly from all the sores in her mouth and throat. She vowed no more treatment, went home and had about six months of life and love before she passed.

    • Betty:

      It’s heartening to read your line: “She . . . went home and about six months of life and love before she passed.”


  3. Well, Larry, you found the answer to why you’re still alive and it is wrapped in the ordinary life of a pastor. Somewhere along the line the pastor always there, emerged into a wonderful mature caregiver with a sense of pastoral care not all pastors possess.

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