Life and Death

By Dan Valenti

Life and death. Birth and eternity.

At the fourth annual professionals for Divine Mercy Conference at Holy Cross College in Worcester, Mass., there was enough drama for a dozen theatrical scenarios. The 135 attendees might not have gone in looking for it, but the pathos was there nonetheless as speakers dealt with what are perhaps the two most spiritual themes of all time: mortality and the hereafter.

The two-day conference, which began Tuesday, is sponsored by Healthcare Professionals for Divine Mercy, an Apostolate of the Marians of the Immaculate Conception.

Dr. John Clark, MD, clinical director for the Center for Head and Neck Cancers at Massachusetts General Hospital in Boston, Mass., gave his audience a unique perspective on the treatment and care of the Very Rev. Fr. Mark Garrow, MIC, former Provincial of the Marians' U.S. Province based in Stockbridge, Mass., who died of cancer in Oct. 19, 2007, at the age of 52. Doctor Clark used his clinical experience with Fr. Mark to make a larger point about the dual needs of patient and provider. It was so typical of Fr. Mark, still teaching us about God.

One Hope, One Wish
"[Father Mark] ended up caring for us as much as we cared for him," Dr. Clark said, "maybe more so, because we reached a point where we could do no more for him. Yet the store of strength to face his situation seemed bottomless. For eight months, we didn't hear him express any personal fears. We asked him about it, and he had none. He did, however, express one hope and one wish."

Father Mark's hope was that his care providers would be honest with him and let him know when further treatment would no longer be beneficial. That they did. His one wish, Dr. Clark said, was that he would be able to say the Mass in Latin after treatment, an intervention that eventually took 90 percent of Fr. Mark's tongue and robbed this noted homilist of his ability to speak. The hope spoke to the patient's pragmatic approach in facing his illness. The wish exemplified Fr. Mark's determination, while one breath was still his to breath, to continue his spiritual journey.

In treating terminal illness, needs of both the patient and the provider must be considered, Dr. Clark shared. Care providers should ask if the patient is prepared for an outcome that might not be the one they want to hear. This leads to an assessment of a patient's spiritual needs. Most cancer patients don't possess the spiritual resolve of a Fr. Mark Garrow. Moreover, someone with a benign skin cancer being treated by a dermatologist will have different spiritual needs than a patient with an inoperable, terminal condition.

Spiritual Dimension Needed
"Cancers with a high morbidity require ... a spiritual dimension [to treatment]," Dr. Clark said. Healthcare providers should take into account a patient's life status, life experiences, degree of trust in the medical system, and "faith status" (how strongly a patient relies on spirituality). He said there is a greater emphasis in medical school today on the spiritual factors of care and treatment, a more holistic approach that reverses a prior trend to marginalize matters of faith and ignore the spiritual dimension.

Physicians and nurses should treat the person with cancer, as opposed to treating the cancer itself, Dr. Clark said. He cited a recent study by the Dana-Farber Cancer Institute suggesting that patients typically feel their spiritual needs are not being met either by their religious community (a pastor, parish, or congregation, for example) or by the medical system.

"The emotional and spiritual support [of cancer patients] is quite poor," Dr. Clark admitted. Healthcare professionals working to bring spirituality into their clinical experiences are scarce. "There are not enough of us to go around." He was preaching to the choir, but he urged healthcare professionals to share their faith experiences with colleagues. Later, in the panel discussion, Dr. Clark shared how difficult that can be. "I am one of the few physicians who does use the word 'God' in my profession. I know what to say, but the question is finding the courage to say it."

Complicating matters is the disabling fear patients often feel in dealing with terminal illness, Dr. Clark said. Even though cancer rates are falling and "cancer is a highly curable disease these days," getting a cancer diagnosis is a "life threatening, life altering prognosis." Doctors and nurses must always keep in mind what the patient is going through. Trends and statistics may be positive, but a person with cancer takes no comfort from numbers on a spreadsheet. He or she is experiencing that journey in a way that is almost crushing in its intense subjectivity, where the risk is feeling alienated and alone.

Science and Faith
A key challenge for healthcare providers is whether spirituality and medicine are compatible. Doctor Clark briefly outlined the historical development of science and rationalism and mentioned the split between objective approaches and faith. Are the two reconcilable? "Yes," he answered. "I believe that medical science can bring spirituality into care and still work with a scientific view of the world that includes evolution."

Doctor Clark defined an "optimal oncologist" as a doctor that wears three hats: he or she is part chemist, part physician, and part priest.

"The human condition has all kinds of dimensions," said Fr. Kazimierz Chwalek, MIC, Marians' director of evangelization and development, who later spoke at the conference on the efficacy of mercy in pastoral care. "We have physical, emotional, and spiritual aspects" that each must be attended, or treatment will not be balanced. Father Kaz thanked the attendees, "all of you here today who do so much for those who are sick, in despair, and broken."

'Medical Burnout'
Dr. Bryan Thatcher, MD, international director of Doctors for Divine Mercy and founder of Eucharistic Apostles of The Divine Mercy (EADM), opened the plenary sessions following morning Mass celebrated by the Most Rev. Robert McManus, Bishop of Worcester. People in the healthcare profession need to recognize the tremendous pressures that can build up, which can lead to what he called "medical burnout."

Stress factors include "excessive burdens, increasing paperwork and regulation, outcomes that are not what you hoped, seeing people lose their loved ones, watching your patients die, and not being able to keep up with the demands of the profession balanced by the needs of your personal life."

Dr. Thatcher pointed out the risk of frustration that can lead to discouragement and even despair. "The only antidote is hope, trust in God, and having a sacramental life."

Other speakers included:

* Elene Viscosi, NP, an oncology specialist as Massachusetts General Hospital, Boston, who addressed spiritual concerns in end-of-life situations
• Registered nurse Marie Romagnano, founder and director of Healthcare Professionals for Divine Mercy, who gave a moving clinical history in her role of caring for Fr. Mark Garrow during his fatal illness
• Mark Tuttle, a victim of a horrific farm accident, who recounted the role faith played in his recovery after a tractor fell on him and buried him a foot into the ground at his family's farm
• Fr. Germain Kopaczynski, a Catholic bioethicist and former director of education of the National Catholic Bioethics Center, who gave the Catholic Church's moral guidelines for the thorny decisions doctors, nurses, patients, and families often confront in end-of-life illnesses
• Fr. Seraphim Michalenko, MIC, director of the Association of Marian Helpers, who shared a history of the Image of The Divine Mercy and its role in healing, and
• Fr. Kaz, who talked about "Spirituality and Sacraments of Mercy in Pastoral Care."

The annual gathering is co-sponsored by the University of Massachusetts Medical School of Continuing Education. The conference concludes today with a day-long session, again at Holy Cross. Plenary sessions are being conducted in Hogan Hall on campus.

Dan Valenti writes for numerous publications of the Marians of the Immaculate Conception, both in print and online. He is the author of "Dan Valenti's Journal" on

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