Drafting the “White Book for Global Palliative Care Advocacy” in 2019, the Pontifical Academy for Life laid out its commitment to a holistic approach to caring for every sick or dying person based not on some theory, but on the real needs of patients and their families seen by Catholic doctors, nurses and chaplains in their daily exercise of care.
Recently, a 50-year-old nurse, who was working in the pediatric ward of a large cancer center where I also serve as chaplain, was diagnosed with stomach cancer. She describes herself as a nonbeliever and says she doesn’t even believe in the help of psychology.
Surgical and medical interventions, including chemo and radiation, did not stop the progression of the disease. This woman, an only child, never got married, her mother died a few years ago, her father is still youngish despite being over 80 years old.
She built positive relationships with her colleagues in the ward, with doctors and friends outside the hospital. “All these people are my family,” she repeated over and over again.
As the disease progressed, she had a growing awareness of the precariousness of her health and the resulting physical problems. She said, “I have to get help because my dad alone can’t handle my situation too.”
This is what led her to overcome her resistance and contact a psychiatrist, whom she has known for years, and ask for help. She still says, “If it were up to me, I would make a different choice; I would let myself die, but I can’t for my dad.”
At the invitation of the psychiatrist, who realizes she needs hope and someone to listen, I began meeting Mary regularly, knowing that she had no personal hostility toward me, even if I am a chaplain. We talked about spiritual matters related to the meaning of life.
At Christmastime, she confided in me for the first time, “From what I have learned from my patients, I know very well that I’ll be gone by next Christmas.” She added, “I’m not so worried about myself, but about my dad who will be left alone.”
Then she raised the question of what the afterlife would be like.
I told her, “When we are healthy, we live without stopping to reflect on this question. Based on the possible answer, certain choices may or may not be made.” I asked her, “What do you think there is after death?”
She replied, “I don’t know exactly; I remember the catechism a little; but I don’t know exactly; I don’t go to Mass anymore; I just don’t know.”
I responded by quoting the last judgment in Matthew 25: “Whatever you did for one of these least brothers of mine, you did for me.” I then asked her, “How many little patients did you accompany together with their parents in all these years?”
“So many,” she replied.
I added, “That is the reason why, at the end of your earthly existence, in the evangelical perspective, you will be welcomed by the many patients, children, boys and girls, teenagers, you helped when they were in the ward. We will be judged on charity, with the certainty that God’s mercy is greater than our frailties, limitations, sins. This is what the Gospel tells us.”
My answer doesn’t end the discussion but leaves the question open. That’s why she feels welcomed, not in search of pre-established answers but in search of an open dialogue (and an inner dialogue) in the face of the great questions of existence.
This woman approaches death, lovingly helped and supported by her friends. Palliative care underlines this constant attention to the patient. However, how many health systems guarantee this kind of support? Can the logic of profit alone be the main criteria of care models?
Father Tullio Proserpio is chaplain at National Cancer Institute in Milan and the Pontifical Academy for Life.