you have been saved, through faith—and this not from yourselves, it is the gift of God—not by works, so that no one can boast. Ephesians 2:8-9 NIV

WISDOM OF THE AGED
By Sharon Quick, MD, FCP, FAAP
Washington State Coordinator, American Academy of Medical Ethics

Spring 2004...The sun is beginning to sink toward the horizon, turning the clouds a pale orange-pink, as I watch an elderly man slowly struggle up a short set of stairs leading to an old restored mansion, now home to a restaurant. His once 6 foot 4-inch large-boned frame is shortened and bent with age. His pale skin is covered with age spots and sags over prominent bones. With the help of his son on one side and a cane on the other, step-by-step he shuffles to a back room where he sinks into a chair to celebrate his 44th wedding anniversary with his family. It is his first outing in the months after he had broken his hip. Though his body bears the marks of age and disease and his chest heaves with effort, his eyes have a gleam and a broad smile lights up his face with a youthful joy that belies his age and poor health.

It does not seem long ago that he was quite active with his children: shooting baskets, pitching softballs, reading books, and jumping off the high dive to an audience of young admiring faces. Now, he seems a stranger until his smile and familiar sparkle in his eyes touch my heartstrings with the knowledge that my father’s core essence that loves his family and God beyond measure is the same, and even vibrantly growing, allowing him to find joy and contentment under oppressive circumstances. It is just his external wrapping that is changing.

There’s a game in which players take turns removing blocks one-by-one from a tower until it finally collapses. Over the years, various diseases have irreversibly plucked block after block from Dad’s once sturdy towering frame. It sometimes seems inconceivable that the remaining fragile structure still stands.

Dad has a thick medical chart with a list of complicated disorders that would make the brightest medical student shudder. If the hospital gave “frequent flyer” awards, my father would have a platinum card. A fraction of his heart function remains, leaving him with severely limited energy and endurance; a walk up the driveway exhausts him. Lymphoma has distended his abdomen with excess fluid. His brilliant mind has slowly become mired with tangled neuronal connections characteristic of Alzheimer’s dementia. This man who once excelled in detailed mathematical calculations can no longer add numbers, remember recent events, or drive. His tremendous knowledge of Scripture has been reduced to a few verses; his favorite is Ephesians 2:8-9, which he finds applicable to nearly every Bible study he attends. His pleasant countenance is now sometimes marred by frowns of frustration, misunderstanding, and/or discontent with his limitations.

As the external vestiges of my father are chipped away, the essence of his being remains—a core devoted to Christ and continuing to bear fruit. His lack of complaining, repetitive showers of appreciation for my mother, frequent praise of God for His blessings, thankfulness that he still remembers the Gospel, and smiling positive attitude constitute an incredible witness to those around him. For example, Dad is never pleased to be in the hospital, yet he doesn’t dwell on his problems. When asked about himself, he replies briefly, and then goes on to praise the nurses and count his blessings. He puts me to shame. He is humble enough not to recognize he is “doing” a mighty work just by “being,” for human worth and dignity reside in the latter, and are not dependent on the former.

Although Dad has lost his ability to be “useful,” in a worldly sense, he is teaching me as much now as when he had a sound mind. After thirteen years of post-graduate training, I can think of no greater teacher than my dad. His instruction surpasses multitudes of facts and figures and stems from his deep loving reverence for His Lord. With such true wisdom he has demonstrated how to grow in character through response to trials, spiritual discipline, and commitment to family. He is slowly teaching me a final lesson--how to confront infirmity unto death with joy and grace.

How has my dad managed to see the good in every situation, even when it takes a microscope to find it? Why has he not become bitter in the face of trials? Years of spiritual discipline with meditation on Scripture, teaching Bible classes, and prayer centered on God’s will being done culminate in molding a heart that embodies the character of Christ. Not perfectly, of course, but trials are faced and relationships forged with fruit born out of a heart that puts the Lord first. The life-giving Source of that positive attitude is the sinewy thread holding his fragmented body together.

One cannot discuss my father without mention of my mother; the two have truly become one. My mother has unshakable loyalty and devotion to my father, even as he has slowly become very different from the man she married. My mother vowed to honor her husband until “death do us part;” never could she have anticipated Dad’s slow degeneration by multiple depletions. Mom serves God and my father by substituting her own time and talents to fill in some of those “blocks” missing in my Dad. When Dad cannot remember vital information, Mom becomes the nerve connections that think for him. Dad’s physical degeneration has left him with little energy to even chew. Mom finds ingenious ways of getting nutritious food into his body. She knows his body functions so well that she rectifies the slightest malfunction before it gets out of hand. She has become his legs and energy; she goes where and when he cannot. Medical textbooks suggest that Dad should have died about ten years ago. But, the books don’t account for the love of a devoted wife and God’s unfinished earthly plans for a man who has learned peaceful contentment in deplorable circumstances.

Spring 2005...My family is singing some favorite hymns while celebrating my parents’ 45th anniversary. After the first verse of Amazing Grace, Dad continued alone with a second verse—a love song to my mother made up on the spot. The man who has trouble recognizing his own children and had to be prompted to write his name in the anniversary card to his wife was spontaneously composing poetry. Through teary eyes we witnessed a miracle: God’s grace allowing my father to present a gift to my mother in the form of a cherished encounter with a temporarily more clear-minded husband.

August 31, 2005....It is after midnight at my parents’ home. My dad is under hospice care and can no longer speak, focus his eyes, or respond. Hours earlier he seemed to understand some of what was said to him. His pastor had joined the family at Dad’s bedside, prayed, and recited some Bible verses. When he finished Ephesians 2:8-9, Dad sat forward in bed and let out a loud “ARRGGHH.” This was his biggest response in the last two days--acknowledging his Savior’s grace with his last remnant of physical strength. We were able to catch a glimpse of a soul, vibrant with life, and excited to be going home.

I am singing Dad’s favorite hymns as I sit as his bedside and watch a scene that is quite familiar to me, as a physician: breathing slows, color turns an ashen grey, coldness spreads from hands and feet up the extremities, and finally, the heart stops. Yet I am seeing anew in this process of death. Sunset years signify the last years, yet some of the most beautiful. We pause in our activities and turn to gaze at the orange-red hues of sunset. I find myself being drawn toward my father, reflecting on his increasing beauty of character with each passing year, confident that He who began a good work in him is carrying it on to completion (Phil 1:6), even now. I am privileged to have been able to gaze into my dad’s eyes, and catch a glimpse of my Father in heaven. Now, on this night of his death, the oranges have turned to red, and darkened, casting shadows that have dulled his eyes and shrouded the vitality of his body. As I close his eyelids, I know I will someday see those glorious eyes alive with love again--the dawn I wake in heaven.

See also Will to Live Form, and End of Life resources