Learning to cope with the pandemic from palliative care patients 

By | May 9, 2020

I’m a palliative care chaplain who provides spiritual support to patients with serious, life-changing, and for some, life-threatening, illnesses. A common story they tell is an illness, like a storm, blew them off their life’s map.  They find themselves lost in the unfamiliar territory of sickness. The future, once certain and promising, is now uncertain and ominous. Plans they’d made are on hold, possibly canceled. The specter of death looms on the horizon.

I’ve realized the current pandemic has landed us all in a spot similar to the palliative care patients I meet. The coronavirus storm blew us off the map we’d been using, leaving us needing new routines and new practices to guide us. Many feel disoriented in this new, unfamiliar territory. The future is uncertain, temporarily and maybe longer. Plans are on hold; we don’t know when life will return to normal.  Many are pondering their mortality as death tolls grow.

I’ve learned from palliative care patients ways to constructively cope with the uncertainties of serious illness. Here are a few of them, offered in the hope they help us deal with the pandemic.

You’ll experience grief. Serious illness and a crisis like this pandemic create losses, of health, life being normal, regular routines, the future being predictable.  Losses produce grief, which needs attention to be resolved. So during this time of change, name your losses.  Feel the emotions of your grief—sadness, anger, loneliness, or fear—without judgment.  Notice what is yet possible. And remember, grief is a normal response to loss and change.

Try to stay in the present.  Life happens in the present.  The past is gone, and the future is yet to be.  Yet in the face of illness or crisis, we often live in the past, wishing we’d made better choices; or in the future, worrying about what’s ahead.  When we ruminate on the past or fret about the future, it’s helpful to return to the present.  A way to do so is by focusing on your breath.  Breathing happens in and connects us to the present.  Take a few deep breaths.  Remind yourself, “I’m here now.”

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Everything is impermanent. Peace activist Thich Nhat Hanh says we suffer in wanting things to be permanent when they are not. Life’s impermanence can be painful—we want enjoyable aspects of life to continue and struggle when illness, crisis, or death impose limits.  Yet, recognizing and embracing that the future is always uncertain can liberate us from the temptation to deny that truth, freeing up energy we can use in other ways. This is why some religious traditions add, “God willing” when making future plans.

Connect with others.  Robert Fulghum’s essay, “All I Really Need to Know I Learned in Kindergarten,” includes this lesson: “When you go out into the world, watch out for traffic, hold hands, and stick together.” I’ve learned a sure way to endure the challenges of illness is to “hold hands” with loved ones and “stick together.”  So amidst the physical distancing needed now, hold hands with your dear ones (while staying six feet apart!), stick together (even in virtual ways), and remember you’re not alone.

Intentionally seek beauty. Poet John O’Donohue said, “… if you can keep (a) … little contour (of beauty) … you can glimpse at sideways now, and again, you can endure great bleakness.” Beauty — like a song, poem, work of art, bouquet of flowers, or sunset — can help us endure a serious illness or serious pandemic.  Keep a bit of beauty nearby these bleak days to glance at now and again.

Look for meaningful moments. Psychiatrist Viktor Frankl said, “Life is never made unbearable by circumstances but only by lack of meaning.” Making constructive meaning of an illness or pandemic helps make it bearable.  There may be nothing meaningful in the illness or pandemic itself, but meaning can be discovered in acts of kindness we see, in support from loved ones, or in springtime blooms emerging.  Look for meaningful moments during these uncertain days.

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Be prepared. Author William Saroyan humorously said, “Everybody has to die, but I always believed an exception would be made in my case.” Amidst a difficult illness or COVID-19, it can be tempting to seriously believe we will be spared from death.  But denying death will inevitably come for us, puts us at risk of being caught unaware and unprepared. Thinking ahead to our death can help us prepare — practically, emotionally, and spiritually. Take a few moments to ponder your mortality.  Consider what you want and need to do before you die. Thinking about death can help us live more fully.

You may grow spiritually. Author Richard Rohr teaches that spiritual growth is produced by great suffering and great love.  This is why serious illness creates for some a deepened spirituality, drawing them closer to themselves, others, nature, and the sacred.  Be open to the possibility of inspiration and spiritual growth these days.  It happened for a New York doctor, who, though overwhelmed by a deluge of COVID-19 patients, facilitated a phone call between a grieving son and his dying Jewish mother.  The doctor wrote, “… I stopped what I was doing out of respect for this 100-year old woman and put the cell on speakerphone and told (her son) to talk. He was crying for his mother and praying… and it woke up some emotion in me that I had forgotten about. Time slowed down and I felt restored to myself. When he was done, he thanked me and blessed me, and I said thank you to him.”

Give thanks. Writer Anne Lamott said, “The two best prayers I know are ‘Help me, help me.’ and ‘Thank you, thank you.’” Serious illness and a global pandemic cause us to cry for help—from God or the universe,  healthcare providers, or loved ones.  And as we do, gratitude – giving thanks for blessings in our lives – provides a counterbalance to fear and worry. So notice the blessings in your life (even the mundane like toilet paper!), and be grateful.

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Rob A. Ruff is a hospital chaplain.

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