Chaplain Mike Mercer is one of the long-time faithful friends of this web site. Many of you will recognize him as a frequent commenter. Mike has gone the extra mile to befriend me and that has been a true gift.
I wanted to do this interview because Mike is now involved in pastoral care of the dying and their families as a full-time ministry. This is an area where evangelical ministers and younger pastors need encouragement and help. Because pastoral care is so closely bound up with the integrity of the Gospel as a Word from God for the dying, I think this is a very worthy subject.
This is a long interview. One of IM’s longest. I have decided to keep it intact as one interview, though if discussion is sufficient we may venture to a second post for more focused discussion.
One request: When you share how pastoral care is done in your tradition, please do so from what you know, not from what “the instructions” say should be done. And be constructive and helpful.
Tell us a little about yourself, your journey as a Christian and your current ministry.
I grew up in the Midwest, in a moral, Protestant home, attending United Methodist churches. During my senior year in high school, after a move across the country that shook my foundations, I had a spiritual awakening and responded to an altar call in a Southern Baptist church, where I was re-baptized. I went to Lancaster Bible College in Pennsylvania. There, I became convinced of a call to enter the pastoral ministry. My wife and I were married after graduation, and our first congregation met in one of those historic, quaint, white steepled churches in Vermont, and there the people taught me much more about how to be a pastor than I taught them about Jesus.
After five years, we moved back to Chicago to go to seminary at Trinity in Deerfield. I was studying under some of the finest teachers in the world, pastoring a small church, our children were being born, and we had many wonderful friends supporting and encouraging us. However, there came a point after I graduated that I felt I needed some mentoring and more experience on a church staff. We also were trying to determine where we would put down roots as a family. So, when the opportunity came, we packed up and moved to Indianapolis. Here I served in a non-denominational church as the associate pastor with an emphasis on worship and music, but I also did a lot of pastoral care, teaching, and leading mission trips. Then I became the senior pastor in a sister congregation. After a rather difficult experience there, God opened up the opportunity to serve as a chaplain in a hospice program. Soon it will be five years since that journey began.
God used many past experiences to prepare and equip me for this work. In Vermont, our small church was a parish church. Because we were the only congregation in the village, I visited the sick and did funerals for all kinds of people, including complete strangers who’d had vacation homes in the mountains and wanted to be laid to rest there. We also had a significant population of older folks and shut-ins that I learned to love visiting. That was also true in the other churches where I served — I just seemed to connect well with the senior citizens. Also, while in seminary, I took my first CPE (Clinical Pastoral Education) course, and was introduced to the inner workings of the hospital and how to serve patients. Since then, I have always appreciated the strong connection between medical and spiritual care.
I consider my grandmother to be one of my greatest examples for ministry. After my grandpa died rather early in life, she devoted much of her adult life to caring for her elderly neighbors, friends, and fellow parishioners. Her simple and faithful service showed me what it means to be the salt of the earth.
I have always believed that pastoral ministry is about prayer, proclamation, and people-work. As my favorite pastoral author, Eugene Peterson, says, it is not about “running a church.” Frankly, I am appalled at how these perspectives have gotten turned around in today’s church, and how little attention is given to foundational ministries like pastoral visitation. It is a forgotten art.
That is why I am glad to be in a position now where personal work can be my primary focus. Every day I visit individuals and families in their homes, in extended-care facilities, and in hospitals. My job is to enter their worlds, befriend them, show them kindness, listen to them, answer their questions when I can, and provide various kinds of spiritual support that may help them find peace at the end of life. I have often imagined that Jesus’ earthly ministry must have been like this, as he went from village to village and house to house, engaging people in their own settings, exhibiting compassion, providing healing, giving hope.
Another reason I love my job is that I work with a team of skilled and compassionate professionals who all do their parts to serve our patients and families with regard to their medical needs, psycho-social needs, personal care needs, and, after a death, needs associated with the grieving process. Hospice is a wholistic service, covering body, soul, and spirit, and respecting the processes involved in the final season of life and beyond.
1. I first thought of this interview when it occurred to me that evangelicals don’t seem to have anything close to the resources of other traditions when it comes to pastoral care of the dying? Am I right?
In my experience, most people and churches in the evangelical world have their focus on fellowship and activism. The kind of work I do doesn’t fit the model very well.
I can’t tell you how many times I have had an evangelical friend or pastor ask me, with a sour look on his face, “Do you really like doing that?” They recognize that caring for those who are seriously ill and suffering is a part of life, but it’s a part they would rather avoid and deal with only when absolutely necessary. Not a regular part of the mission, you might say.
They know how to put people on the prayer chain. They know how to make a meal and bring it to a family that is going through a hard time. If there is something active they can do, like get a list together of folks to help the family with errands or cleaning house, etc., they might be able to organize some practical assistance. These things can be quite helpful, and should not be looked down upon. However, beyond that, there’s not much in the paradigm, especially if you’re talking about pastoral visitation. And we haven’t even talked about ministering to dying people who are outside the church, which is not even on the radar of most pastors or congregations.
It certainly was not an emphasis in my education. We had few pastoral care courses in my evangelical Bible College and seminary. Nor is it emphasized in churches. I don’t know many evangelical churches that have programs like the Stephen Ministry for equipping believers in caring ministry. The more pervasive model seems to be that churches will support a parachurch ministry and expect the work to be done by them. It’s not really part of the church’s mission.
With regard to care for the dying, most pastors and people have not been taught that it is a good use of their time, that it is Christ-like and genuinely helpful, to simply sit with people, actively listen to their feelings, and not feel like you have to give “answers” or put the situation in an understandable theological framework so that folks might know the divine “reason” behind what is happening. Evangelicals don’t usually have a great deal of good language with which to pray for these folks, either, and it may be the rarest of things to find an evangelical worship service (or even funeral service) that contains rubrics for lament or recognition of grief and loss.
Don’t get me started on mega-church pastoral care. From what I’ve seen, it’s virtually non-existent.
Now, I don’t want to be too hard on evangelicals alone here. Other traditions have more experience and better tools for being pastorally present with people, but that doesn’t mean it always happens. Mainline pastors often drop the ball here too. I’ve seen many a Roman Catholic priest do a perfunctory anointing of the sick and never really connect personally with the family. One can read the most beautiful prayer from the Book of Common Prayer without feeling or expressing any empathy whatsoever. Nevertheless, I have found that pastors and parishioners in the older traditions at least understand that this is one of the things the church and her ministers should be doing.
Ultimately, in my view, this is another area where the church (at least in the white, suburban culture with which I am most familiar) has become conformed to the death-denying, suffering-averse, productivity-centered world we live in. How is sitting with the dying gonna help build my church?
2. Is a significant part of this deficit because of evangelicals’ lack of liturgical resources?
That lack certainly doesn’t help. When most of our prayers begin, “Lord, we just want to thank you for” – it signals that we might suffer from a lack of language to appropriately relate to life’s awesome mysteries. Purely spontaneous prayer doesn’t work because we simply don’t have words when we are in a situation that overwhelms us.
But why do we rely on that? After all, we claim to be Bible-believing people. No book on earth contains human expressions of sorrow, pain, anguish, grief, disappointment, anger, guilt, loneliness, or fear like the Bible. We just have to read it! But because we haven’t really internalized the Scriptures, we don’t know how to be human, we don’t know how to pray as real people dealing with real life before a real God.
Walter Brueggemann writes about “the formfulness of grief.“ One thing we learn from Scripture is that, in the chaos of suffering, we need a sense of clarity and direction in the midst of our disorientation. So, we lament. The lament form gives us a pattern by which we may express our grief, contemplate our faith, and make a way through the wilderness of suffering. We usually don’t have the words. We are too overcome. It hurts too much to talk. Appropriate liturgies give us profound words to speak when we can’t, words that in turn speak to us, give us perspective, and help us survive.
3. Do evangelicals have a model of a “good death” or does their theology move them in the direction of asking God for miracles?
Coming to grips with the terminality of a loved one is a process for everyone, not just evangelicals. The difficulty of the process also varies depending on the situation. Losing my 90 year-old grandmother is sad, but I probably would not suffer undue shock or dismay, especially if her death followed a normal course. I would be happy that she had lived a long life. I would rejoice in memories of what we shared in life together. I would be grateful that she was able to be comfortable and peaceful, with her pain and symptoms managed well at the time of her passing. Most of us would probably call that a “good death.” We would be concerned and sad, we would offer prayers for her and the family, but I doubt if we would be calling all-night prayer meetings asking God to intervene.
However, a young person, a woman in the prime of her life, a robust middle-aged man, a person who is not at peace with God or others — in such cases the diagnosis of a terminal condition throws us all out of whack. And it should. The question then becomes: What are our options at that point? I’m not sure there is a single “evangelical theology” that speaks to the situation.
Those whose tradition emphasizes miracles, divine intervention, and healing would likely view the situation as absolutely NOT God’s will and would marshal all their resources to fight the devil they blame for the person’s illness. Others would be more stoic and submissive. Some might emphasize trying to understand what is happening, looking for “reasons” to satisfy the Christian perspective. Most all people will bounce up and down on a roller-coaster process of anticipatory grief, needing someone to be with them for support and encouragement all along the way.
In my view, that is the bottom line. No matter where people are with regard to their specific reactions to end of life issues, no matter their theology or conditioned response to tragedy or loss, they need support. They need a calm, reasonable, caring human friend to sit with them, who is available to listen and support them. I have sat with families that have all kinds of reactions, and my approach has been fairly consistent — BE THERE. Period. Trust the process, rely on the active presence of God, and walk down the road with them.
4. At what point is it appropriate for a minister to talk about death when a family may be refusing to speak about it?
The subject usually comes up naturally if folks have access to the kind of support I just talked about — a calm, reasonable, caring human friend to sit with them, who is available to listen and support them. Occasionally, a compassionate minister or friend may need to help someone face reality and speak the truth plainly when it is being denied. But most of the time, it is clear that people know what’s going on, and they just need time until they can talk about it.
We have all kinds of people who come into hospice care, and they come from a variety of faith and non-faith backgrounds. Some are on-board and realistic from the beginning. Others say “Don’t mention death or use the word hospice. Hide your badge so mom won’t know you are from hospice.” Some refuse to sign “Do Not Resuscitate” orders because they can’t imagine not trying to bring dad back if possible. They put off making funeral arrangements or getting necessary documents together. Some don’t want the chaplain to visit. A friend of mine said he once had a patient who called the chaplain, “the sky-pilot,” the person you only see when you’re ready to be launched into the afterlife! Other folks struggle when grandma doesn’t want to eat anymore, and so they keep trying to force food into her. Many people refuse to give or take pain medications, especially morphine, because they view that as crossing the line and forsaking life.
So, in hospice we have to be gentle with people and respect their journey. We pretty much don’t force anything but emphasize giving good information and the kind of supportive presence that will give people permission to talk about things they’d rather not face. I’d recommend ministers and friends do the same. Again, it’s not efficient. It takes time. But it is loving, and the “small miracles” we see every day of people being helped and supported through some of the toughest experiences of their lives are worth as much as seeing Lazarus come forth.
5. You deal with many people with little or no faith resources for approaching death. What is your pastoral care strategy in that situation?
First, let me make a foundational statement about what a chaplain is and is not.
Because I am not a pastor in a local church but work for a healthcare organization, I must approach things differently than a minister would. A church pastor has a covenant relationship with his people and serves them with a whole system of theological understandings and expectations in place. A chaplain, on the other hand, must honor the spiritual and religious commitments of patients (even those that he might deem wrong), and serve them according to their own faith traditions. So, if I get a Buddhist patient, unless she wants to talk about the Christian view of God and salvation, it is not my job to force that on her. I will ask if she wants support from someone in her own religious community. Only if she asks me, or I get her permission, will I share my faith with her.
Secondly, let me lay a theological foundation for the way I approach everyone.
The doctrines that have guided me from the beginning in this work are the Bible’s teachings on creation and common grace. God created each human being in his image, and by his grace and providence he sustains us all. I meet and deal with people first based on our common humanity under God. Every person is my neighbor, and I am called, simply, to love my neighbor. Being a chaplain means involves specific ways of doing that. It’s more of a “love your neighbor” ministry than a “win the lost’ ministry (though I’m not always sure about the dichotomy).
Furthermore, because I believe in common grace, I do not understand my job as bringing God to people. He is already with them, and he is already working, no matter who they are. To reference Eugene Peterson again, my duty is (1) to recognize that God has gone before me in every encounter, (2) to discover some of what God is doing in that person’s world, and (3) to figure out how to best cooperate with God in what he is trying to accomplish.
So, when I have a new patient and family without a faith background, I meet them on their turf as neighbor and friend. I do not have an agenda, other than to listen and learn how I might be of assistance. I tell them I am available as a spiritual and pastoral resource, if that is what they want and need, but my main job is simply to be there with them for support. I always offer to pray for them (and ask their permission to do so), and I try to make my prayers personal, filled with Biblical language, and focused on God’s love for people and his promises to be with us in Christ.
I find that this kind of approach often leads to more discussion about “spiritual things” than if I would try to force the matter. One joyful consequence is that I have been asked to do many funerals for un-churched folks, and at the funerals I always try to clearly present the story of Jesus, his salvation, and the hope of eternal life.
I’m not sure evangelicals in general think in these terms. We are often weak on creation and common grace. Instead we see God mainly at work within the community that is separated from the world. We also identify his work primarily with specific “spiritual” matters that we focus on. We sometimes don’t do well simply as human beings living among fellow human beings who are our neighbors, all walking together through the common experiences of life. We are often too “spiritual” for our own good, and for the good of others.
6. What sorts of things make the process of grief difficult for evangelicals?
In my first grief support group, I learned something as I listened to folks talk: It is hard to go to church after losing a loved one. Iâve heard that particularly from those who’ve lost spouses.
* First of all, nobody knows how to relate to Joe anymore now that it’s no longer “Joe and Mary.”
* Second, few know what to say, and this leads to many awkward and some hurtful encounters.
* Third, you (the bereaved) don’t know what to say either, especially when the song leader keeps telling you to smile and be happy in Jesus, and all your brothers and sisters keep saying over and over again, “Remember, she’s in a better place.”
* Fourth, you have to sit through something alone that you had always done together; and if your spouse ever sang in the choir or did something up front regularly, then it’s hard to be there and watch others take her place.
* Fifth, the church revolves around fellowship and activism. But you would rather be alone, and you don’t have the strength to teach middle-schoolers right now. You don’t fit any longer.
* Sixth, since the church is “focused on the family,” you feel like a fifth wheel all the time when you are around other adults.
* Seventh, you have to sit and listen to the “7-Day Sex Challenge” sermon series and other such silly talks from the pulpit.
I have heard some incredible stories. A woman I know lost her young son in a tragic accident. Not long afterward, she went to church and stayed in the sanctuary after the service, crying there in the pew. The pastor came by and said, “Now, now, let’s not forget our testimony.” That may be the cruelest sentence I have ever heard pass between one human being and another.
Other cliches or stupid remarks well-meaning Christians use include,
* “She’s in a better place.” That’s right. By faith we trust that our believing loved ones are being comforted in God’s presence. But what about the bereaved? Is he in a better place?
* “God never gives us anything more than we can bear.” Really? Then why does Paul exhort us to “bear one another’s burdens”? Some things must be too heavy for one person to carry alone. Don’t throw it off on God. He may be asking you to lend a hand.
* “I know exactly how you feel.” No you don’t. Not even close. If you did, you wouldn’t say that, you’d probably just join the crying and give the bereaved a hug.
* “I remember when so and so died” — Guess what? No one wants to hear your story right now. This is not about you, or someone else. This is about someone drowning in loss.
* “Just call if I can be of any help.” Let me clue you in on something. This person does not have strength to pick up the phone and ask for help. This is time for others to take the initiative. Help or don’t help. But be quiet about it.
I tell grieving people all the time just to expect that people will say stupid things and not to take it too personally. Most of us are downright pitiful when it comes to knowing what to say at times like this. Add to that our discomfort with the whole death and dying thing, and the fact that it doesn’t fit into our paradigm of church activities, and the result is usually not a pretty picture.
The overriding issue is that we have lost all sense of the time and energy involved in the process of grief, and we have not allowed space in our lives to let people grieve the way they need to. There is usually a big rush of caring and expressions of sympathy in the first week or two after someone experiences a loss, but then, since we have to get back to our lives, we expect that the bereaved will somehow just magically “get over it” and get back to his.
Other faith communities have learned to do it better. For example, Orthodox Jews have an entire 12-month process of tradition and liturgy for the grieving, which is lived out by the bereaved and faith community alike. However, in evangelicalism the issue again becomes, “How does allowing someone the time and space to grieve fit into our paradigm of fellowship and activism?”
7. If death has come in tragedy, how can evangelical ministers acknowledge that kind of loss while also upholding hope?
As a hospice chaplain, I don’t deal with a lot of sudden deaths, accidents, and the like. I have as a pastor. In the moment, helping people in these circumstances likewise involves finding a way to serve with true human compassion. By God’s grace, I want to be that reasonable, levelheaded, quiet and supportive presence, who can walk faithfully with those going through the tragedy.
A woman in our church had a grandson who died in an automobile accident. She asked me to come to the home where all the relatives, friends, and church members were arriving to be with the family. This was a very expressive bunch, temperamentally and theologically, and the room was filled with wailing and crying and people letting out their emotions in unrestrained ways. What did I do? For most of the evening, I stood with my back to a wall, off to the side and was simply present. Every once in awhile I quietly greeted someone with a hug or pat on the shoulder, but that was about it. I literally did nothing. Yet, if you would ask that woman today what she remembers most about me being her pastor for more than 9 years, she would tell you it was all the help I gave her that night.
After a tragedy, it is important that the pastor and folks in the church realize that the bereaved who are left behind will need support that may require extraordinary attention in the short-term and consistent loving care for the long haul. Hope doesn’t come through words alone, but through a solid and reliable support group that sticks with the hurting.
Having said that, words are also important. Regular participation in the liturgy, which rehearses the fundamental truths of the Gospel over and over again, week after week, and which enables people to feed on God’s saving and sustaining presence through Word and Sacrament, can provide genuine help in reorienting those whose lives have become radically disoriented by tragedy.
8. How does the Gospel inform your work as a hospice chaplain?
The Gospel is the announcement that, in Jesus, God’s new creation has broken into this fallen, dying creation. Through Jesus Christ, the promised new day of God’s rule has dawned, and because of Christ’s life, death, resurrection, ascension, and sending of the Spirit, he has dealt the decisive blow to sin, evil, and death, and is creating a new people who will be with him forever in a new heavens and new earth. Until that new creation is revealed in its fullness, those made new by Jesus are called to live in this fallen world as God’s representatives. It is through his new people that God fulfills his mission of taking this Gospel to all the hidden corners of the world, announcing and creating newness everywhere.
That is a grand plan and vocation, but its outworking could not be more down-to-earth. Jesus said the Kingdom unfolds in small, hidden, subversive, often undetectable ways. A primary way it spreads is when one person made new humbles himself to serve another person in need. The Gospel doesn’t set us above other people, it sends us to kneel before them so that we might wash their feet. It doesn’t make us less human, but more fully human; doesn’t separate us from the world around us, but sends us into every part of that world to love and serve our neighbors.
And that’s why I love what I do so much. As a hospice chaplain, it is my privilege to go into places where people are hurting, crying, dying. By God’s grace, I pray that I may announce and create a bit of newness each day for those bound by sin and death. That is Gospel ministry to me.
I wish I knew better how to translate this into counsel for every church, pastor, and Christian. In my view we need to abandon the misguided missions that intoxicate us, and come back to Gospel basics. Forget “building a great church.” Share the good news. Visit the sick. Give relief to the suffering. Sit with the dying. Comfort the bereaved. Be generous to those in need. Be hospitable. Love your neighbor. Live in fully human ways among your fellow human beings under God.
This is not a new “law,” but the Gospel lived out, the “Jesus-shaped” way that the Spirit constrains us to pursue.