By Reverend Barbara Moulton
The call came to me unexpectedly from the hospital switchboard after I had left work one day. I was told that a palliative patient desired to be married, and they hoped I could officiate.
I had not had any interaction with this patient, prior to the request. So it was important that I clarify the circumstances. I assured them that I would be happy to do the ceremony, as long as certain conditions were filled. I mentioned the need for a marriage license and confirmed that this would be a religious ceremony as my ordination is with a denomination that would not allow me to perform a civil ceremony. With the agreement in place, I said I would see the patient the next day.
When I arrived at the hospital the next morning, I was told that the marriage license had been obtained, and they were hoping for the wedding to take place that day. This was a little sooner than I had anticipated, so I headed to the palliative room immediately. While I was happy to conduct the wedding in principle, I knew that I had an ethical responsibility to confirm that both participants were willing and able to fully understand and consent to the commitments of the marriage vows.
The meeting was brief but put my concerns completely to rest. The patient was the groom-to-be, Michael, who clearly expressed that it was his desire to marry Aileen. They had been together for 25 years and, while his death was not imminent, the news of the past few days had not been good. They recognized that the medication required to control his pain would soon make it difficult, if not impossible, to meaningfully participate in the marriage vows.
I agreed to perform the marriage, and told them I would go home to change and prepare the wedding ceremony, which we agreed would take place at noon.
As I was driving home, it occurred to me that Aileen might not have a bouquet. As soon as I got home I phoned the florist we had used for both weddings of my daughters and asked if they could put together a hand-tied bouquet for me to pick up. I asked that it be charged to my church account, knowing that my faith community would be happy to participate in this compassionate act. Without breaking confidence, I provided the reason why it was needed quickly and they volunteered to deliver it to the hospital in time for the ceremony. They delivered it to the front desk in my name.
When I arrived back at the hospital, the bouquet was waiting, along with two stands of silk flowers for the room. The florist provided these without rental charge. I later realized that they had no desire to charge me for the bouquet either. They never billed my church.
The witnesses were the sister of the bride and one of our volunteers. Aileen had changed into a simple outfit; Mike into a shirt and bowtie. The colors of the bouquet and floral stands blended well and we proceeded with the short ceremony. They both spoke their vows with strength and purpose.
So many times I have heard couples promise to love each other until the parting of death. But on this day those familiar words were so poignant. Everyone in the room was deeply moved. As Michael placed the ring on Aileen’s finger I said a prayer of thanksgiving within my heart, reflecting the gratitude I felt for being part of the day.
At the end of the ceremony, I blessed the couple and left them to privately take some photos. It had been an emotional day for me but, as I drove home, I knew in my heart that it had been a good thing.
Close to his death, Mike was back in our hospital. I visited with him and he thanked me for conducting the ceremony that day. He knew that he was now nearing the end and as I spent time with him I was happy that I had been able to journey with him and Aileen those few months before.
Mike moved to a local residential hospice shortly after that visit and died in the presence of his wife. I was honored to be asked to conduct his funeral and as we celebrated his life together, it felt right that I was there.
As I have reflected on the part I played in Mike and Aileen’s wedding, I have realized that it demonstrated the patient-centered care that we hope to provide. Patient weddings are not part of my job description as coordinator of spiritual care, but the willingness to facilitate a wedding certainly falls within its scope. I took part by virtue of my ordination but if I had not been able to perform the marriage according to the requirements of my faith tradition, I would have found someone who could.
Palliative care is both compassionate and affirmative. We focus most often on compassion, responding to physical, emotional and spiritual distress. We do our best to alleviate pain and provide comfort.
But it is not enough to provide comfort measures. Approaching the end of life will often cause patients and their families to listen to an inner voice of spiritualty and seek spiritual renewal. Spiritual care affirms this process.
For Mike and Aileen, the knowledge of what lay ahead brought to the forefront a desire to be married.
For Mike and Aileen, the knowledge of what lay ahead brought to the forefront a desire to be married. As I met with them, I did not have any sense that their life together had been lacking without this ceremony. Their love and commitment to each other was evident to anyone who met them. The evidence of that love informed my decision.
As the end of life approaches, we will often focus on what is most important to us. We seek to affirm these things and, in so doing, find a blessing. Marrying the person he had loved for more than a quarter of a century did not make the love real for Mike. But as he affirmed that love and the woman who had devoted herself to him, he participated in an act of spiritual grace. My role, as a provider of spiritual care, was to support him in this.
In spiritual care, we differentiate between religious needs and spiritual needs. Religious needs can be very specific to a faith tradition. Ceremonies and rituals bring comfort and the onus is upon all caregivers to ensure that religious needs are met.
But although Mike and Aileen were agreeable to a religious ceremony, the wedding was far more spiritual than religious. It was a way to acknowledge the meaning that each of them brought to the other. It was a way to celebrate their love. It gave words to the promises that they were already keeping.
It is not something that will happen often in the hospital setting. However, if we take patient-centered care seriously, our response to any kind of request for specific spiritual and religious care must be “yes, if at all possible” rather than “we don’t think that is possible.”
Staff members who were present on the wing that day told me what it meant to them to see our hospital respond to a request in this way. As I carried the bouquet down to the patient room, it seemed to me I was walking a path of grace and blessing.
I can’t help but feel that our hospital community was at its best that day as we responded to a patient’s need.
Reverend Barbara Moulton is the coordinator of spiritual care at Headwaters Health Care Centre, Orangeville, Ontario, Canada. She can be reached at firstname.lastname@example.org