He was a big man, both tall and broad. The left half of his body filled the chair; the right half seemed to be melting away. The skin on the right side of his face drooped inches down his cheek into a long flapping jowl, lips more downturned than seemed possible, and his eyelid draped across the socket. The left side of his face was set like stone—eye squinted, lip a firm, smoldering line. Anger radiated out of one side, exhaustion out of the other.
He’d recently been discharged from the hospital to this nursing home, a lovely, private, and expensive place. He was dying of something else, but the stroke was what people noticed. It left him aphasic, or no longer able to speak, and no longer able to use the right side of his body. His left side, though much less damaged, was stiff and spastic.
I talked to the nurse to try to get a sense of who he was, since he wouldn’t be able to speak to me. She didn’t know him because he’d come to the nursing home for rehab after the stroke, after he lost his ability to talk. She said they didn’t know how much brain damage there was. He didn’t smile, make eye contact, or interact with the staff except to fight them when they tried to touch him. He was prone to rages in which he would lash out with his left arm and leg. She suspected the brain damage might be extensive.
“I wouldn’t go in there,” she said. “He doesn’t like visitors, and I don’t know what he would do.”
“Okay. I’ll just call his wife to give her my contact info, in case she ever needs anything from me.”
These introductory phone calls can be tricky. There’s a real art to them, especially when the patient is in a nursing home and the family is at home. You have to get your name and title in there fast, and then try to explain the role of the chaplain and why you’re calling before they say they already have a pastor and hang up.
Sometimes spouses are wary. Sometimes they willingly share insights about their husbands’ or wives’ likes, dislikes, history, and faith, or want to set up a time to meet in person. Sometimes they say they don’t want to talk to the chaplain. Sometimes they say they don’t want to talk to the chaplain and then go on to talk for an hour and ask me to call back the next week, when they reiterate that they don’t want to talk to the chaplain, talk for an hour, and ask me to call back again in a week. There are people out there with whom I have talked for hours, and I would never know them if they walked in and sat down right in front of me. Sometimes they open up right away, not because of anything I’ve said or done, but because they need to talk to someone, and the title “chaplain” means I am someone to talk to. One patient’s husband cut me off just as I launched into my introductory spiel. “I know what a chaplain is,” he said, “because I was in the service. The chaplain’s the person you can tell your secrets to.”
As I pulled out my phone to call this new patient’s wife, the nurse stopped pouring pills into little cups and looked up at me.
“She’s a nice lady, but very emotional. Kinda hysterical and in denial. She could use you, actually.”
The nurse was right about the emotional part. The wife began to cry as soon as I introduced myself. She told me all about her beloved husband. His kindness, his humor, his strength. He’d played piano and had his own law practice for more than forty years. He was a good father. She said she knew that he was lashing out, but she didn’t believe there was significant brain damage. She thought he was afraid, and that the nurses had jumped to conclusions. She said she knew they didn’t like her and considered her husband a bully. She thought a visit from me was a great idea. She told me he loved the Bible. She thought it might be nice if I read to him. “He’s so alone. Please go see him and read him a bit of Scripture,” she said. “Please see him.”
I told the nurse I was going in just to say hello.
“Suit yourself. Just make sure you sit far enough away so he can’t grab or hit you. Take your lanyard off so he can’t choke you,” she said, nodding toward the ID around my neck. “Let me know when you’re done in there so I don’t worry.”
Nursing home nurses usually ignore me, look vaguely bothered when I grab a patient chart to put in paperwork, and never, never, never ask me to check back in with them after a visit, so this made me a little nervous.
I knocked on the patient’s door, walked in, and introduced myself. He glanced at me and then looked straight ahead. I told him his wife had asked that I visit and read to him. He made no sign of disagreeing, so I opened up to the book of Psalms. It’s my go-to Bible book. Almost everyone who likes the Bible likes the psalms. I read it slowly, lingering over the poetry and watching him from the corner of my eye. He seemed to ignore me, but once I finished, he motioned with his good hand, like he was reaching out for the book.
“Do you want to hold the Bible?” I asked. He didn’t nod, but he kept his shaking hand outstretched, kept his eyes fixed on the book, and grunted. I placed it open in his lap. “Maybe you could find your favorite passage, and I’ll read it aloud.”
The Bible was small, small enough to fit in my work bag along with giant files of folders and a laptop computer. The print was tiny and the paper like wisps. I could barely read it myself if the light was low. He began to use his left hand, the fingers stiff and splayed, to try to turn the pages. He couldn’t really manipulate them, though, with his hand so clumsy. He slowly but too forcefully swiped at them, pushing swaths of paper back and forth, going forward and back in the book. The tissue-thin pages crumpled. He ripped some of them, grunting. Back and forth he went, slowly swiping bunches of pages. Tissue paper began drifting to the ground as pages tore away from the binding. He never lifted his eyes from his activity.
I perched on the edge of my seat and watched this. I couldn’t tell if he was meaninglessly turning the pages or angrily trying to destroy the book.
“Do you have a favorite verse?” I asked tentatively. I reached out to take the damaged book from him. He roughly swatted my hand, and then continued to turn the pages. His concentration was absolute, almost palpable.
I didn’t know how to end this. Even if he was looking for a particular passage, I couldn’t see how he would ever find it. I didn’t know how to get the Bible back from him, and I didn’t know how to bring a graceful end to a process that had been going on for at least five minutes now, a very long five minutes. I considered getting the nurse, but worried that doing so would destroy whatever chance I had of making a connection with him. I was afraid of getting near enough to him to get the book back. I didn’t know what to do and was embarrassed by my own uncertainty. I wanted to get out of there.
Then he stopped, grunted loudly at me, and held the book out to me in his violently trembling hand.
I took it gingerly and looked down. The Bible, what was left of it, was open to a page in Jeremiah.
Most of the book of Jeremiah is a tough read. Jeremiah was a Hebrew prophet whose scathing critique of his people gave rise to the word “jeremiad,” a long, bitter list of society’s faults and predictions of its collapse. A jeremiad is not comforting.
The biblical prophets, despite what all too many people think, were not fortune-tellers. They did not predict events far in the future, and while early Christians (and some still today) liked to look for places where Jesus was foretold centuries earlier in the writings, that’s not what the prophets themselves were trying to do.
The prophets were trying to tell hard truths to people who didn’t want to hear it, right then and right there.
Jeremiah didn’t pull any punches with his hard truths. He lived during a turbulent and devastating time for the Hebrew people. In the forty-some-odd years that he dictated his book to his scribe Baruch, he also went out and preached in public about all the sins and shortcomings of the Hebrews and the terrible things that would befall them if they continued, wrote scathing letters to the priests and elders, and did things to draw attention to his warnings (fun things like roaming the streets with a massive wooden yoke around his neck). During this span, the kingdom of Judah was invaded and collapsed, the Temple in Jerusalem was utterly destroyed, and the Babylonian Exile began, sending the Hebrew people away from the land God had promised them and into Babylon. They lost their homeland and Jewish life as they knew it. It seemed God had abandoned them and broken all His promises to them.
Jeremiah had been warning his people that disaster was imminent for years—decades—and he placed the blame squarely on their shoulders. He told the Hebrew people that they deserved all the hardships they faced. He said that the Lord had told him to say all these things.
So when my patient landed in Jeremiah, forcefully handed me the open Bible, grunted, and nodded, I had a flash of panic. Should I read it aloud, no matter what it said? What if he had landed in, say, Jeremiah, chapter 17:
Through your own fault you will lose
the inheritance I gave you.
I will enslave you to your enemies
in a land you do not know,
for you have kindled my anger,
and it will burn forever.
Or Jeremiah, chapter 4:
What are you doing, you devastated one?
Why dress yourself in scarlet
and put on jewels of gold?
Why highlight your eyes with makeup?
You adorn yourself in vain.
Your lovers despise you;
they want to kill you.
Should I flip to another page? Should I pretend to not understand? There was no way, I thought, that he could have meant to land in Jeremiah.
“Do you want me to read this to you?” I asked. For the first time he looked at me. I thought I saw the barest nod.
I looked down at the torn and mangled Bible now in my lap. I quickly scanned the two lines at the top of the page.
I looked over at the man. “Is this your favorite?” I asked, stupidly. He looked away, so that his drooping side faced me.
I read the lines out loud.
I have loved you with an everlasting love;
I have drawn you with unfailing kindness.
Tears began to roll down his cheek, but he was quiet. I was relieved. The verse he’d landed on wasn’t a blistering one. He was calm. I had the remainder of my Bible back.
And then, because I was afraid, and because my fear stopped me from being curious, I stopped reading.
“Okay!” I said, with false brightness. “Time for me to go!”
I picked up my bag and walked out.
“What in the world was going on in there?” the nurse asked.
“Oh, it was fine,” I said. “I just read a little bit to him.”
It was only when I got home that I read the rest of the chapter.
The LORD appeared to us in the past, saying:
“I have loved you with an everlasting love;
I have drawn you with unfailing kindness.
I will build you up again,
and you, Virgin Israel, will be rebuilt.
Again you will take up your timbrels
and go out to dance with the joyful.
Again you will plant vineyards
on the hills of Samaria;
the farmers will plant them
and enjoy their fruit.
There will be a day when watchmen cry out
on the hills of Ephraim,
‘Come, let us go up to Zion,
to the LORD our God.’”
This is what the LORD says:
“Sing with joy for Jacob;
shout for the foremost of the nations.
Make your praises heard, and say,
‘LORD, save your people, the remnant of Israel.’
See, I will bring them from the land of the north
and gather them from the ends of the earth.
Among them will be the blind and the lame,
expectant mothers and women in labor;
a great throng will return. . . .
“They will come and shout for joy on the heights of Zion;
they will rejoice in the bounty of the LORD—
the grain, the new wine and the olive oil,
the young of the flocks and herds.
They will be like a well-watered garden,
and they will sorrow no more.
Then young women will dance and be glad,
young men and old as well.
I will turn their mourning into gladness;
I will give them comfort and joy instead of sorrow.”
Can you think of any words more comforting for a man who had lost so much? The words of God, as Jeremiah reported them, promising that in the midst of such loss, there not only could be, but would be, joy again? That there would be dancing and singing? That even old men would dance and be glad again?
These were the words he handed to me. He had spent ten minutes and untold effort to find the words he wanted to hear, and I did not read them to him.
So why? Why, even after I read the lovely verse at the top of the page?
Already on edge from the nurse’s warnings, and more so as he’d destroyed the Bible, I’d seen JEREMIAH at the top of the page and assumed the worst. I’d forgotten that even though God had decried the behavior of the people of Judah, he had also promised that their suffering would not last forever. Through Jeremiah, the Lord had promised the people that they would return home, that they would survive. And they did. In fact, some scholars argue that it was during the Babylonian Exile that the Jewish people really became Jewish. That was when Judaism developed its revolutionary and defining belief in monotheism. Unable to perform animal sacrifices, which could only be done in the Temple in Jerusalem, the Jews began to study the Torah in earnest, and the rabbinic tradition was born. Worship in newly formed local synagogues began and included singing, prayers, and readings from the Torah, which are the hallmarks of Jewish worship today. In these ways and more, the Babylonian Exile made the Jewish people more deeply who they were. I had focused only on the suffering, forgetting that something wonderful was born of it. I’d forgotten that even in the midst of Jeremiah’s screeds, God promised His people comfort. He promised that although they might suffer, they would never be destroyed. He promised that even if they turned away from him, he would never stop loving them.
I had been on edge, yes. But I had also already made up my mind about this man about whom I knew almost nothing. I had assumed that he did not know what he was doing and that the page he landed on was a mistake or a coincidence. I had judged him incompetent based on a few grunts, some spastic movements, and the nurse’s report. I didn’t see the kind husband, the successful lawyer, the doting grandfather. A man who very well might have a biblical passage so dear to him that he would destroy a Bible to find it.
His wife had not asked me to comfort him. She had asked me to see him. In that, I failed. I’d visited him, but I had not actually seen him. I hadn’t been able to see past his stroke-damaged body.
The desire to be seen and known and accepted for who one really is comes up time and again with my families and patients. It must be hard when other people’s perception of your body does not match up with who you know yourself to be, and when people judge you based only on that body. It must be hard when those around you refuse to accept you as you identify yourself, finding you frightening, or something to pity.
“This might sound crazy to you,” another patient said very slowly as she carefully rearranged some flowers in a vase. Sally had worked for decades as a florist, had been happily married, raised four children, played bridge on Tuesdays and Bunko on Thursdays at the library, liked nothing better than a cruise in the Caribbean in the middle of the harsh, wet Rhode Island winter. “I’m actually Joan of Arc. Reincarnated.”
“Ahh,” I said.
“Do you think I’m crazy?” She stopped fiddling with the flowers and looked directly at me.
“No.”
“Why not?”
“Half the world believes in reincarnation. Who am I to say it isn’t true?”
She sighed deeply. “That’s a relief.” She sighed again. “I can’t even begin to tell you how much of a relief that is. Thank you.”
Her son was concerned. “Mom told me that she told you about her Joan of Arc thing?” he said one day.
“She did,” I answered.
“Thanks for going along with it. She’s not really crazy, you know. We have no idea where this comes from. She’s been saying it for years. God, maybe decades. Long before she got sick. It meant a lot to her, that you didn’t think she was crazy.”
One of the benefits of having actually gone crazy myself is that “crazy” doesn’t bother me. That experience changed my definition and understanding of crazy completely.
The bigger benefit, though, is that I’m not so quick to reject ideas of what might be possible. I suppose that’s why people take dissociative drugs like ketamine recreationally in the first place—to expand their minds. I guess in that sense it worked for me. Despite all the trauma and pain it brought me, it also left me willing to entertain just about any idea people throw my way. Not that I don’t have my own set of beliefs and principles, but I can usually see someone else’s point and the logic behind their beliefs, no matter how unusual, and not be concerned or threatened by it.
“I don’t know why she holds on to that idea,” Sally’s son said, perplexed. “Why in the world would she say such a thing?”
Because maybe she really is the reincarnation of Joan of Arc, I thought but didn’t say.
Now, I didn’t necessarily believe that Sally was Joan. Of course, there was no definitive proof she wasn’t, either. How could you prove it? It would be like trying to prove there are no green aliens. You can’t prove a negative.
A much more interesting question to ask would have been “What does it mean to be the reincarnation of Joan of Arc? How does that affect your life?”
I never got to ask that, though. Sally never again brought up reincarnation, or her identity, although there were plenty of chances to. It seemed that it was just important to her that I know and accept that she was who she believed herself to be.
• • •
WHO DO YOU believe yourself to be? It’s a strange question, right? But trying to answer it honestly tells a person so much about themselves.
When I was sick, back in the days of flip phones, I put a banner message on my home screen so that I saw it every time I opened the phone.
It said, YOU ARE CAPABLE.
At the time, I was not capable. I was not capable of holding down a job. I was not capable of taking care of a baby. I was not even capable of taking care of myself.
But I needed to believe, despite all outward appearances and the circumstances in which I found myself, that I was capable at my very core, even if I was not capable right then. I needed to be reminded of it, all day long.
But I also needed to keep it a secret. I didn’t write it on a note to pin above the kitchen sink or on the bathroom mirror, as I often do with things I need to remember.
I didn’t want anyone to see that message for two reasons. First, I didn’t want anyone to know that I needed to be reminded of it; I didn’t want pity. Second, I was afraid that someone would tell me it wasn’t actually true. I didn’t want someone to say, in the slow, soothing, insulting voice people often adopted when speaking to me then, that I had once been a capable person, but that it was no longer the case, and that I was now officially and forevermore an incapable person. I was afraid that the ketamine and the psychosis might have changed the very deepest part of me, that my basic identity had been destroyed. That I suddenly, at the age of thirty-one, had become no one at all.
Are we created by our experiences? Can our deepest self be destroyed by what happens in this life? Or do we have some sort of unchanging, essential soul?
• • •
WHEN I WALKED IN, John put down the book he was reading. It was a history of the very earliest years of the colony of Massachusetts. Many of the events it described had taken place in the area where we were sitting, on Buzzards Bay.
“Glad I wasn’t a Pilgrim on a day like today,” he said.
I knew what he meant. Winter along the southern coast of Massachusetts is brutal. It’s gray every single day, depressing by two thirty in the afternoon and dark at four. It is wet. So wet. The mist off the ocean freezes into little salty ice balls that the wind drives into your skin. The frozen mist coats everything—the windows, the trees, your face and eyes—with sticky gray salt. Some days you never warm up, even inside with central heat and wool socks.
“Can you imagine landing here four hundred years ago?” I said. “And there’s nothing? Nowhere to get inside, nowhere to warm up, nowhere to buy food?”
“Would have been awful. Just the beach and that boat you’d been stuck on for months already. Couldn’t get out of the wet.” He nodded gravely.
“Those Pilgrims were tough people. I would have turned around and gone back. They were much tougher than me.”
He cocked his head to the side and looked at me carefully. “You talk about being tough as though it’s a good thing,” he said finally.
I had to think for a second. “Yeah. I guess I do think it’s a good thing. I guess I wish I was tougher.”
“No you don’t.” He looked away and waved his hand.
“I don’t?” I asked.
“No. Toughness makes people mean. You’re lucky you don’t have to be tough.” His face was weathered and lined; his hands were thick, meaty paws; his dark brown eyes searched my face from under deeply hooded brows.
“But toughness makes you strong. That’s what I wish. That I was strong.”
“You’re so wrong. They’re not the same at all, being tough and being strong.”
“No?”
“Nope. They’re opposites.”
“How so?”
“You have to be tough because you’re not strong. That’s how it works. I was tough. Didn’t have a choice. But it wasn’t something I wanted. I’ll tell you the truth: You’re lucky if you don’t have to become tough. You can stay who you really are. Nobody’s born tough. Something makes you that way. Being tough makes you mean. It’s better if you can stay kind. Nobody should want to be tough.”
“What made you tough?”
He looked at me for a long time. “Life.”
He’d gone off to war in the Pacific as a newly married man. While there, his wife had their first child, a little girl. He met his daughter for the first time on leave, when she was a toddler.
“Then I went back,” he said. “I thought about that baby every day, and my wife every day. I would close my eyes and I could feel myself back there. I could hear them and see them and feel them. It’s what got me through it. Just remembering them.
“She used to write to me almost every day, but then the letters started to come less and less. I thought she was busy with the baby, or that it was getting harder to get the letters to us. I never suspected anything.
“So when that letter came, I just snapped. She didn’t love me anymore. She’d met someone else, and she was leaving me.
“She included a picture of me holding my little girl.
“You know you hear about ‘Dear John’ letters? It was literally a Dear John letter. I read it squatting there in the dirt. I threw it on the ground. Then I stood up and walked into the jungle. I wanted to kill someone. My officer called after me but he didn’t stop me. He knew he couldn’t. I walked out to where I knew there were some Japs hiding. And I killed them.”
We sat in silence.
“I didn’t see my daughter again for a long time. By then she was a big girl. She didn’t know me, and she didn’t love me. But why would she? I was a stranger to her. Hell, I was a stranger to myself. That’s what being tough does. It makes you a stranger.”
When I first started working in hospice, someone told me this: In most of life, you can be weak inside and get through by putting on a tough outer shell. But if you work in hospice, you have to stay soft on the outside. So in order to stand up straight, you have to have a spine of steel. Two ways to go through the world, two ways to deal with the loss that is an inevitable experience in life—with a hard shell or with a rock-solid backbone.
When I was still a hospital chaplain, a nurse called me one afternoon to the neonatal intensive care unit. A baby was dying.
She’d been born premature and very, very small, and it had seemed at first that she would survive. But then, in a galloping cascade of crises, she’d gone from surprisingly hardy to barely surviving in just an hour. It can happen like that.
While the doctors and nurses worked on the baby, I sat with the mother in one of the little windowless rooms filled with couches and boxes of tissues that most patients and visitors don’t even know hospitals have. This was the mother’s first pregnancy that had gone beyond the first trimester. She told me she’d had twins, and the boy had already died. She’d had preeclampsia. She was forty-three. She didn’t think there would be any more children.
When there was nothing else the medical team could do, a nurse came and got us.
Back on the unit, the baby had been wrapped in a warm blanket. The doctor handed her to the mother. For the first time, she got to see her daughter’s face without tubes in the mouth and nose, without an IV in her scalp.
The woman said nothing for a long time, did not cry or ask questions. “Thank you,” she said to the tiny baby in her arms. “Thank you for making me your mommy.”
The three of us sat together for a long time in the corner of the neonatal intensive care unit—the baby, her mother, and me.
“I always wanted to be a mother,” the woman said suddenly. “I became a mother when they were born.”
“Yes,” I said.
“I’m still a mother, even though they’re gone. I’ll always be a mother, no matter what else happens. They gave me that.”
The things you lose do shape who you become. There’s no getting around that. But the losses don’t obliterate what came before. The loss of that mother’s two babies did not negate the fact that she had become a mother and that she would remain a mother after their deaths. My stroke patient’s loss of language did not negate his years as a father, husband, lawyer, piano player.
Sometimes the pain of loss is so great that an outer shell seems like the only way to protect our souls, a shell so tough we no longer recognize ourselves. But we are still there. Everything we were is still there. It’s just hidden from sight. Sometimes it’s even hidden from ourselves.
When I was sick, and for many, many years afterward, I desperately wanted to go back in time. I wanted to go back to being the person I was before I got sick. I missed that woman, I missed who I was—her mind, her body, her spiritual life, her beliefs about herself and the world. I wanted her back. I wanted to be her again. I thought she was gone forever. Obliterated.
But it doesn’t work that way. I couldn’t go back to being who I was then. But the person I’d been then wasn’t gone, either.
Nature doesn’t work that way. A tree puts out new, tender growth every spring. Those leaves inevitably die, but the rings of the tree’s trunk are always there, deep inside, from its very first spring. Some rings are thick, when life is easy and rain plentiful. Some are so narrow they can barely be seen, when the tree is struggling to stay alive. But all the rings are still there.
A barnacle grows by accretion, its shell getting thicker and thicker with every passing day, protecting the tiny fleshy body that first attached itself to something hard. That you can no longer see that body doesn’t mean that the barnacle isn’t alive inside its shell.
Living things continue to develop until the moment they die, whether or not anyone else recognizes it. There’s no losing who you once were, but there’s no going back, either. There is only becoming.
Do we have an essential soul, or is our identity at the mercy of what happens to us? The answer seems to be both at the same time. We are becoming who we already are up until the moment we die.
Even after terrible things happen to us, we are still becoming who we are. Like the Hebrews of Jeremiah’s time, who were still becoming Jews despite their enormous suffering and loss.
Tree or barnacle: There are two ways to grow, to respond to the inevitable losses and traumas of life. Two ways to become who you always were.