Metropolitan Anthony of Sourozh


The Oxford Conference Address. Guilde of St. Barnabas
Theme: Suffering and pain, Death, Medical ethics   Place: Medical institutions   Period: 1966-1970   Genre: Talk

When someone is ill, obviously it is not the moment to come and say, “H’m! You are ill. You do realise that life is precarious, ephemeral . . . and that you will stand before the Judgment Seat of God? . . .” yet I have seen it done to a degree that gave me a lesson for ever. It was in the first year of war. . . .

I was in a surgical hospital where we did heavy surgery behind the front lines, and we had a Chaplain of a given denomination. His point of view was that every patient who was dangerously ill should be made to receive Communion. So whenever a patient had been operated upon or was brought in badly wounded awaiting operation, the Chaplain came in. He was a solid, sturdy little man, who stood at the foot of the bed, looked at the chart and said, “H’m,” until the patient said: “Well, Father, I’m not so bad to-day?” “Yes,” replied the Chaplain, “I suppose that’s what your nurse said?” “No, the doctor said so, he has given me injections, he said they would do me a lot of good!” “Yes,” said the Chaplain, “That’s what they always say.” And so he went on until the man knew that he was dying, and that there was only one chance for him, in addition to dying, not to go to Hell. It was to receive Communion. Then the poor creature received Communion, after which he rang the bell and said to the Sister: “Please make sure that that man never comes near me again.” But the Chaplain never would have come near him — there was no point any more. He had been convinced to receive Communion, he was safe in the hands of God, whether he died or not was a secondary point, because if he lived he would go back to the fighting, if not, he would be buried with the Sacraments of the Church.

Well, you see, that is a caricature of things, and a real one, because I have seen that happen over nine months during which we had constantly about 900 patients in hospital. If that is exactly what one should not do to the sufferer, what should one do for a man who is facing illness and suffering, physical and moral?

First, one can say something on these lines — “You have been agitating yourself a good deal — you couldn’t stop! How lucky you are! God gives you a chance to stay in bed and worry about nothing except your condition, to fight for health and to fight for yourself.” And if you stop there, long before the man feels that life is running short, he can face a great deal, and you can talk. But, of course, you must talk and if you have only time to come for ten minutes, you had better leave him in peace altogether — he will manage better without you than with just a prick from time to time.

But if you can settle, and help him face the fact that he is now at rest, he can now live within the eternal values, by which I mean not the values of the life of heaven, but the real values which are eternal to him. He loves his wife, he loves his children, his friends, his life, so many things. You can bring him to an understanding that there are a number of things which prevent him from being deeply and solidly established in these very eternal and real things — resentment, jealousy, irritation, hatred and all those things which you find if you begin to talk to him, which prevent him from loving with his whole heart, from being free to love, free to face life, free in all possible respects. And if you are attentive, if you do, attentively, meaningfully, your job, a year, months, before he begins to think of death in terms of decay, he will have reached the point where he thinks of eternity in terms of: “Now I am in it; I am expanding; I am exhilarated by what it contains”; and you can also in the process help him to face physical and moral pain on a variety of levels. But this is possible only if the man is taught and helped to face up to moral and physical things, because the more you begin to destroy in him pain and struggle the less he is capable of facing either the great eternal realities already within himself, or what he is capable of becoming.

We underrate almost constantly the greatness of man, the greatness of the human mind, the human heart, and human courage. So often, someone of whom we expect practically nothing, whom we expect to collapse at the first word we say, is the man who becomes great in stature when face to face with tragic circumstances. I have seen it in the war, when moral courage suddenly prevails, but I have also seen it in the most ordinary homes, when someone who groans, is exacting, mean and tiresome as long as he or she thinks that the illness is passing, and too slowly at that, suddenly comes face to face with the truth, and is able to stand, with real greatness.

I should like to add something about this question of telling people about death, the coming death, the possible death. There is a great deal of suffering in this problem of one’s own death. One cannot, I think, give a sweeping, clear-cut answer as to whether or not one should tell a person that he is dying, partly because people are so different, but partly — and much more — because the circumstances in which you must tell a person vary a great deal. You cannot tell a person that he (or she) is dying — and go! When a doctor settles down on the bed and says, “Well, you are aware of the seriousness of your illness and, of course, medical science has made immense progress so far, but … er …” and goes on like that, leading the person to know that death is near, and then says, “Well, I’ll come and see you to-morrow,” and walks out. What has he done? He may then go to the husband (or a daughter) and say, “You go in now, we have had a sort of little-bit-shattering talk, but a cup of tea will help!” But that is no solution at all. I am sorry, it may seem absolutely ridiculous, but it is as ridiculous as life. It is exactly what happens. When a clergyman comes and is in collusion with the doctor and the family, and then in a sort of parsonic, nasal way, begins to speak of “eternal life,” and of the happiness of this and that, and “how nice it will be for ‘you’ to be ‘there’,” well, really, this is no help at all.

So I would put as a first, absolute condition that the person who is going to speak to the dying must be prepared to stay with him for as long as is necessary, for hours, or days. If it is a friend, it must be the closest, if a relative, the kind of relative who is capable of doing this, and not simply a relative according to the Table of Kindred and Affinity. It must not be a functional thing — the priest — the doctor — the nurse, as such, but someone chosen because this person is prepared to do it, and it can be done. I know that from my own experience…

Published: GUILDE OF ST. BARNABAS. GUILDE NEWS. 1966, november [p.16-18]


… the person who is going to speak to the dying man must be prepared to stay with him as long as necessary, for hours, or days … It must not be a functional thing — the priest — the doctor— the nurse, as such, but someone chosen because this person is prepared to do it, and it can be done. I know this from my own experience…. simply being with the dying — hours together — saying nothing. This is an ability which I dare say clergy should develop more than they possess it, the ability to sit with someone, saying or doing nothing. Not just sitting looking vaguely and vacantly about, just knowing that “if I sit for half an hour I will have done my job” — and not sitting with a sort of pious look — “I am praying next to my patient”; and not talking in a pious (nor impious) way, because there are “pious” ways which are so close to blasphemy that one would do better not to use them. You see, I speak quite frankly. I am a priest, you are, too, in the majority. (The Oxford Conference was mainly attended by Hospital Chaplains). If you do not recognise yourself, you have a picture of me, at least.

This ability just to sit and go deep, so deep in sympathy, in compassion, is showing to the patient that you do not need these discourses, that your presence speaks; that if there is a need, you can put a hand on the person and it will mean more than whatever you can say. Well then, this ability to sit and be silent is the first thing, and later you may discover that Death can do something quite incredible to relationships . . . when death comes into a house and establishes itself at our hearth, something happens which is treasured, and not only by the dying. Everything acquires a dimension of eternity and immensity, every gesture, every word, could be the last gesture, the last word, and it has to be a summing-up of all that each has meant for the other. There can be no shallowness, because there might not be a “tomorrow” when things could be put right. It does not make the situation tense, it simply makes it deep; it makes it completely serene, because there is nothing but the present moment, and this present moment is to be the summing-up of all that is true and precious and beautiful in a common past.

One of the tragic things I find in the West more than amongst our Russians — because our Russian people are much more outspoken in these things and break through barriers more than you do — is the gradual loneliness in which a dying person is secluded. The person knows, in body and in soul, that death is coming, but the husband smiles, the daughter smiles, the nurse smiles, the doctor smiles, and everyone smiles in such a way that the patient knows it is a lie because — goodness — because people have a heart and are sensitive to one another. And the result is that if there is distress, it is to be faced in a lonely way, if there is fear, if there is hope, if there is despair, if there is need for the help of a priest even at that point the help will snap, because the priest is part of the conspiracy. But if the things of eternal value have been spoken of, as we said earlier, then there are so many things which you do not need to say in this deep time of silent being together, and the patient knows that here is a person to help him who is prepared to go all the way, and not just “hit and run.”

I think that there is a whole field of education that we must undertake with regard to families, and to clergy and to doctors and nurses, because it cannot be a functional thing, but an offering by and because one is “such-and-such” a person in relation to the other. If this is done, a great deal can be achieved.

All this you may call “help out of suffering.” It is, in a way, but in the right way, because this does not take away from the person the real problem. It takes away from the role, from the situation, those shocking and monstrous circumstances that make it impossible for this person to face a situation which is great, and not only frightening. Which is greater than it is frightening!

I think we must come to the point — WE MUST LEARN. It may take us all our life, until we can one day have done the right thing to one person, but that does not matter. We must come to the point of realising that suffering, whether physical or moral, leads somewhere, if it is faced, if it is lived through; and that our role is not to take it away, but by sympathy, by compassion, by — well, shall I use Charles William’s word — by “co-inherence,” by this mutual interpenetration of lives, interwovenness of lives to make it possible for the person to face it, to walk along until the moment comes when there is no longer any point in the mere facing and struggling on. This is the moment when the patient can say, “Now I can accept the drug because all that was to be done is done,” or this is the point when with humanity, with understanding, we can say, “You must now have less suffering in order to go farther in your experience.”

But we are not there to make it impossible for people to go through a physical experience that has moral content, or through a spiritual experience that is the very process of growth into eternity. They are going, and we are there to help them to go, not into the void of which people are afraid, but into the fulness of Life which makes it possible for people not to see any void, and to be fulfilled.

(This concludes the address as such, but there are many passages in the answers to questions which followed that are well worth quoting. These will, I am afraid, have to wait until next time. — Editor).

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