Hospice Chaplain Reflects On Life, Death And The 'Strength Of The Human Soul'

As a hospice chaplain, it's Kerry Egan's job to help dying people accept their own mortality. Sometimes that means sitting with them as they express their regrets and fears. Other times, she listens as they recount their life stories and reflect on the experiences that brought them joy.

"There's no time to preach or teach," Egan tells Fresh Air's Terry Gross. "You have to use whatever tools that person already has in their spiritual toolbox to help them come to meaning in their lives."

Every patient is unique. Some find meaning in religion. For others, it comes from family, friends and relationships or in art and literature and music. "If you think about how different every single person who's living ... is, well, people are just as different in the dying process," says Egan, who lives in Columbia, S.C.

In her new memoir, On Living, Egan describes her hospice work and the impact it has had on her own life. She says that despite the sadness and loss that are implicit in her work, there is also great joy.

"I'm constantly reminded of the strength of the human soul," she says. "I'm constantly reminded of ... how much love people have for each other, and the love that's all around us that we just don't necessarily take a moment to see."

Interview Highlights

On what a hospice chaplain does

A chaplain should never go in and preach to someone; that's not our role. Our role isn't to tell you what to believe. Our role is to say, "What is it you believe and how does that help you — or not help you — in this process, this process of dying, this process of letting go of the life you've loved (or maybe have not loved) and coming to some peaceful place?" ...

Ideally you have months to do this. You have months to sit down with someone once a week or twice a month and talk with them about their beliefs, religious and otherwise, to make meaning of their lives. But a lot of times, you just don't have that time.

On helping people get to a calmer place

One of the big things a chaplain does is to model it, and that sounds so simple ... but when you start to learn how to work as a chaplain, you hear people talk all the time about presence. You have to have pastoral presence, or sometimes I call it spiritual presence, and I remember thinking, What does that even mean? I don't know what in God's earth that means.

What it really means is to model a sense of — in the midst of this storm of emotion — you can stay calm. Right, it does not have to overtake you. You would be surprised how powerful that is for someone else, just to be with someone who is maintaining a sense of presence, of not being in the past, of not being in the future, of literally being present, you know? ... That has a way of calming people down.

Also, as human beings we're such social creatures, it's easier to do this with someone. It's easier to sort of face the hard things in your life when you're not alone, and that's a big part of what a chaplain does, is she stays with you. ... That's the key point of the job is you need to keep it together so that the other person can sort of fall apart and then you're modeling for them what it looks like to come back to a place of peace where you can start to say, "OK, what does that all mean?"

On how many people in hospice feel about death

People who die in hospice hopefully have had a little more time to reflect on their lives, to talk about what they think comes next, and ideally for me, and maybe this is a little selfish, I don't know ... I would hope that my patients aren't afraid anymore. I think people would be really surprised to know that a lot of hospice patients aren't nearly as afraid of dying as you think they are. I think some of us who are healthy in the middle of life have a real fear and horror of death, and I think a lot of hospice patients don't. They don't anymore. Some of them are downright curious.

On people often having visions of their mothers before they die

Anybody who works in hospice will tell you, anybody, that it's really common for people who are dying to see their mothers. It's not a necessary step, everybody doesn't experience it, but it happens a lot. ... They come to them, they wave at them, sometimes they talk to them, and it's really, really comforting to people.

Is that real? Not real? You know, I've come to this place where I don't know and I'm OK with that. I'm really OK not fully understanding. I wasn't like that before. I think there are going to be a lot of things in life, whether you've experienced them yet or not, that we cannot fully understand, that we can't fully make meaning of, we can try, and that at some point, you have to be OK saying, "I don't know that I really know what that means, but it's part of my experience and I need to accept it."

On needing to stay "soft" in her work, but with a "spine of steel"

I think it's just the nature of living, that there's a lot that's so beautiful and so wonderful and so joyful and so fun, but there's also so much loss and pain. Everybody dies, I mean it's just the nature of life, and so you're going to have to deal with those losses and that sadness.

There's two ways to do it, and in hospice you're really going to deal with a lot of loss, because all of your patients die and you do come to love them and their families. You can put on this hard outer shell and not let it affect you, just be like, I don't feel it, I don't feel you, I don't love you, I have no connection to you. That's one way — unfortunately, sometimes a really common way — that people deal with the barrage of loss.

But to be effective as a chaplain, to create that peaceful place, that presence that I talked about, you have to be very open to them. You have to be willing to enter into their world, to engage with them, to walk with them in that journey of meaning-making.

If you're not willing to be soft on the outside, you're not going to get any work done. And if you have to be soft on the outside to be an effective chaplain, well then something's got to hold you up, and the only thing that can hold you up is sort of an interior strength. That's it.

On why being a hospice chaplain makes her a happier person

I'm a happier person when I'm working as a chaplain. ... Death is really sad. When someone dies, it's really sad, but there's also enormous joy to be had and funny times and happy times and everything. It's life, right? Dying is part of living, so everything you have in the course of a life you have in the course of dying. ...

I think when people are dying they can't necessarily do a lot physically, and so they're in their minds a lot, they remember a lot, they remember their lives. They talk about what they did in their lives, and they find so much happiness and joy in the memory — but oftentimes they'll say, "You know, I was so happy and I didn't appreciate it then."

So that's a constant reminder for me to stop and say, "Wow, I've got some really good stuff going on in my life right now. I'm really happy." I think a lot of people go around happy and they don't even know they're happy. It's such a joy to be aware of it.