Margaret Blevins
Margaret Blevins 87T


 

Guiding Through Grief
Experiences of a Hospice Chaplain


I grew up the daughter of the owner of a funeral home in a small town in Virginia. It was in an environment where I heard a lot about people dying every day, and so death seemed natural to me, not something to fear. When I was a little girl, I watched my father provide comfort and compassion to the families of those who had died.

As a young girl, I often went into the chapel at the funeral home to visit with the people who were lying in state, and (when no one was present) I played my piano recital pieces on the small organ for them. I guess this was my first experience of ministry. Next door to my father’s funeral home stood the church where I was baptized and the church I attended until I went away to college. My grandfather was the pastor of that church. He was also ministering to those who suffered spiritually and emotionally. I am sure that both of these factors played a role in my calling to this ministry for those who are dying.

As a graduate of Candler School of Theology in 1987, I did not have a clear idea about my ministry until years later. I worked in the Emory University Division of Campus Life with students for many years and felt that perhaps this was where God wanted me to be. Later, when I became a chaplain in the Emory Clinical Pastoral Education program, I discovered my true calling. In one of our discussions, we used a genogram—a kind of family tree—to look at our family backgrounds and how this had shaped our lives. I thought about this one day and realized that there are no coincidences in this life.

Today, I work as a chaplain in a hospice inpatient unit. Hospice gives me an opportunity to provide support to people in times of their deepest spiritual need, and to do this in even very small ways that are personally meaningful to them. My ministry may include sharing stories and family pictures, playing a CD of favorite music, reading a passage of scripture, offering a prayer, or simply holding a hand.

Sharing the lives of people who are living through a sacred time is an honor and a privilege. There can be pain, both physical and emotional, and the support of the chaplain is important in helping someone to move from despair to hope. Hospice care can be a time of transformation, not only for the patient but for all the family members and friends who care for them.

While my husband and I were living in Americus, Georgia, for a few years, I served as minister of a small Christian church. It was during this time that I first became involved in hospice care. Each day, I would be asked to visit patients in their homes. Sometimes it was a stately old home, or a farm in the country, or a trailer park. This taught me that death does not discriminate; that death comes to each of us in ways that may be a blessing after suffering a long illness.

Hospice offered a time for me to get to know the people in the community, and the patient and family in ways that would never have been possible at any other time. I am sometimes asked to preach at the funeral of a patient and to join the family for a meal. I have been enfolded into this time of sharing—grief and sorrow have drawn me into an amazing understanding of how the greater community can respond with gentle, loving, and healing gestures to a family. As the flowers and casseroles are delivered to the home, the familiar scriptures and hymns provide a structure for living in this time of loss. This experience has taken on a new level of meaning for me—an understanding of how we can all survive these moments with grace and dignity. In small town life in the rural South, these rituals are deeply embedded and become a way of life that promotes care and reaching out to one another in a close-knit community. Stories are shared of the good memories of the deceased, and laughter and tears make a time of loss more bearable. These were special moments that taught me, in ways I couldn’t have imagined, what I had learned at the Candler School of Theology about the incarnate presence of God.

Here in Atlanta, we have a great number of people from many different cultures and religions. In hospice, we support each in their particular faith. Many patients will receive support from their own pastors and religious community leaders and friends. Others may not be active in a religious institution, and as their chaplain, I provide them with support in ways that are appropriate for them. If their faith is different from mine, at their request, I will try to locate a religious leader of their faith. If they do not speak English, I will try to find an interpreter to assist. If there are special burial concerns, I will coordinate these with the funeral homes. I always seek to support the patient by honoring his or her faith or spiritual life. Above all else, I am certain that this is not the time to try to persuade them to change their minds about what they believe. No matter how much I may personally disagree with them, this is not the time or place for theological debates.

Grief support for patients and families is a part of hospice care, both before and after the death of the patient. Hospice follows the bereaved family members for a year after the death, to make sure they are moving through the various stages of grief. Counseling is available as needed from the chaplains or bereavement counselors.

Sometimes families may not agree on what should be done for a patient, and there is tension between various members. It’s not necessary for me to try to fix this; rather, just being with someone who is hurting can be sufficient. Words are not always necessary, and as the chaplain, I can provide comfort simply by “showing up” and being available to help with practical matters. It is who and what I may represent to them that matter at times like this.

Each person I encounter helps me to become a better chaplain. Today, I am walking the path of a hospice chaplain, and at the same time, I am accompanying my husband on his journey as a survivor of a serious illness.

Last fall, John was diagnosed with his terminal diagnosis of a stage-four malignant brain tumor. He is responding well to treatment, and we are hopeful that his life has been extended far beyond the average survival time. We have been overwhelmed by the generosity and loving support of friends. I have gained a new perspective from this experience of being both the recipient of care and support while continuing in my role as a hospice chaplain in caring for others. With God’s help, John and I continue to live our lives to the fullest, one day at a time.

Margaret Blevins 87T is a hospice chaplain with Odyssey HealthCare, and the wife of John Shippee, featured below.


Living With Dying The power of a terminal diagnosis

The five-inch scar on his scalp is unobscured by hair or hat, a battle scar he never expected signaling a vulnerability that has opened John Shippee’s heart.

A malignant tumor the size of a small orange was removed from his brain in October 2006, and any remaining traces were blasted by chemotherapy and radiation.

“My particular cancer has a pretty uncompromising terminal prognosis,” he says. “But that doesn’t mean I can’t live fully. It’s one of the paradoxes of my illness: I know I have a disease—there are subtle reminders all the time. But I don’t feel at all like I’m dying.”

Shippee, a consultant for nonprofit agencies who studied graduate-level theology at Emory, knows that the tumor could come back at any time. He quotes the statistics: most people with stage four glioblastoma can expect to die within a year of diagnosis; just a quarter live for two years. Shippee was diagnosed late last year at age sixty-two.

The first symptoms occurred just after he returned from Baden, Switzerland, with his mother, who is in her eighties, where they had celebrated their cousin’s hundredth birthday. The irony is not lost on Shippee. “We’re a long-lived family,” he says wryly.

After returning home to Atlanta, Shippee, a methodical man who takes pride in his attention to detail, immersed himself in preparing a grant proposal. He sent it to colleagues rife with spelling and grammatical errors. “I just don’t make those kinds of mistakes,” he said. “It mystified all of us.”

One evening at dinner, he carefully ate half of what was on his plate—he couldn’t see the other half of his food. His optometrist performed a vision test, and found that his right peripheral vision was gone. When he walked out of her office into the parking lot, Shippee realized he had no idea where he had parked. None. He walked up and down each row until he recognized his 2003 silver Subaru Forester.

He was sent to specialists. By this point, he was having difficulty walking, couldn’t sign his name, and couldn’t remember his mother’s phone number.

The tumor, six centimeters by five centimeters, was “like a bulbous Chinese radish with long, leafy tendrils,” says Shippee. It was in the left occipital lobe of his brain, sapping away skills and knowledge as it grew.

Shippee had immediate support from his wife, Margaret Blevins 87T, a hospice chaplain who worked at Emory for nearly thirty years (see page 28), and his stepson, Stephen Blevins Thomas 91C. They rallied around him as he developed a plan. “It came down to, what was I going to do with my time? Whether I have two seconds or twenty years—neither is likely, but neither is impossible either—how was I going to respond to this news?”

First, he took a Commedia dell’arte mask he had purchased in Italy to hang over his IV pole in the hospital “to show that I was more than an anonymous brain tumor in an equally anonymous—and embarrassing—hospital gown,” and to get a smile from the doctors and nurses. Truth be told, the mask was a bit of a rebellious act.

“Throughout my life, I’ve been a social activist. I continue to maintain these concerns despite the fact that I might be dying. I’m not just John the cancer patient or John the survivor,” he says. “I’m the sum of all my previous life experiences.”

Shippee wanted to bring these experiences to bear in a meaningful way, so he began speaking—at Emory, at his church, in his community—about what it is like to have a terminal illness and to be treated solely as “a patient, which automatically makes you the least respected and most objectified person in the medical hierarchy.”

He spoke at an Emory conference about improving the dying process. He began writing a book with the help of Assistant Clinical Professor Gary Gunderson and his daughter, playwright Lauren Gunderson 04C. He started videotaping his thoughts for future generations. He spoke with medical students as a guest lecturer. And he had conversations with others who were inhabiting this strange new borderland of living in direct confrontation with dying.

On NPR’s “My Cancer” blog, hosted by journalist Leroy Sievers, Shippee submitted an entry that reads:

“Since October my identity has been unconditionally tied up with my cancer and my status as one whose diagnosis is probably terminal. In some ways, this has been an advantage. I have been listened to as never before and had deeper conversations with friends and colleagues than I have ever had. . . . I have begun to have a bit of success in getting the medical and other caregiving communities to listen to our voices and at least start to respond in like manner, rather than as distanced professionals.”

Most of the time, Shippee deals with his illness in a logical, analytical fashion. “I’m kind of emotionally challenged. I’ve not cried yet,” he says. “The only time I came close was when I was watching my grandnephews play, and thinking that I might never again see them or my grandchildren.”

He does, however, feel a certain urgency about the time he has left.

“I’m graced with having this period of my life in which to make sense of it all,” he says, “To mend and strengthen my relationships. To affirm others. To tell my story. I am living my life fully, integrating my impending death rather than allowing it to dominate.”—M.J.L.

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© 2007 Emory University