By Anne Millington
“No one can serve two masters, for either he will hate the one and love the other; or else he will be devoted to one and despise the other. You cannot serve both God and mammon.” (Matthew 6:24)
Kathy¹ sat in the ICU, tears filling her eyes. Her father, John, was dying, and the time had come for comfort measures only. Kathy knew it, her siblings knew it, her father’s girlfriend, Donna, knew it. As her father’s healthcare proxy, Kathy had expected to sign the paperwork. But to her shock, the nurse announced, “Donna’s the healthcare proxy. We’ll need Donna’s signature.” The story rapidly emerged. Donna and John had secretly married the prior week, and Donna had been quickly named not only his healthcare proxy but also the sole beneficiary of his entire estate. Apparently, John had been very hurt by Kathy and her siblings’ lack of attention to him in his declining years, and in vengeance chose to “surprise them” by leaving everything to Donna.
Death is a major event, physically, emotionally and, yes, financially. Whether the person dying has vast assets or vast debts, in death that person permanently leaves everything to heirs. While pretty much everyone knows in their bones that “you can’t take it with you,” Jesus’ words in Matthew’s Gospel nevertheless acknowledge the power of mammon to be a master that we serve. In a perfect world, assets transition peacefully and fairly, honoring loving relationships, honoring a life well lived. The world is not perfect, though, and Kathy and her siblings had just found this out, experiencing hurt and betrayal that has scarred them to this day. When wealth masters us, we give in to our baser instincts of greed or miserliness. When wealth masters us, we give up on human relationships, on our efforts to foster, deepen and heal our loving connection to others. When wealth masters us, we wield it as a weapon to punish, to avenge, to wound.
As chaplains in end-of-life situations, we are naturally called to support people in choosing God as their master, prioritizing loving God and loving each other. Our spiritual health, after all, depends on the love in our lives, on the quality of our relationships. Ideally, wealth should reflect and testify to that person’s loving relationships. Wealth bequeathed should honor those relationships fully and fairly, filling all its recipients with feelings of being cared for and loved. But … is wealth instead the mouthpiece for unresolved conflict? Are hard feelings about money the elephant in the room? Is there any evidence of sibling rivalry? Once we have a sense of wealth’s current role in a particular situation, we can try to nurse it into a healthier role, where it supports rather than devastates the spiritual health of all involved.
Helen was an ICU patient whose oxygen needs had reached such a high level that she would require ICU care for the rest of her life. She was tired and ready to let go, and the medical team believed continued life support was only forestalling the inevitable. It was time to reconsider Helen’s “full code” status, to consider making her CMO. Nevertheless, Suzanna, Helen’s daughter and healthcare proxy, would not sign the paperwork. “She’s scared,” Suzanna claimed. “She is not ready to give up, not just yet. She could improve. I’m praying for a miracle.” But as the days dragged on, we learned that Suzanna lived in Helen’s house largely because she had no income and nowhere else to go, and there were such large liens on the house that once Helen died it would be lost to creditors. Was Suzanna prolonging Helen’s dying in order to have a place to live? We cannot have known without asking — and even asking might not have resulted in a clear or honest response. Nevertheless, a question like “How will you cope financially after Mom dies?” might have at least given space to the voices of any unspoken motives and particularly to any shame Suzanna’s self-serving behavior might be causing. Although spiritual distress was thick in the air, the situation resolved when Helen suddenly passed away, while still on oxygen, and the immediate need to probe Suzanna’s motives disappeared.
While shame may have a stake in end-of-life money matters, guilt may abound as well. Julia appeared very sad now that her great-aunt Vivian had been placed in hospice care. She opened a photo album to show me Vivian’s pictures from her years as a professional dancer and actress. Tears streaming down her face, Julia proudly recounted how Vivian had been famous in her day and had accumulated significant accolades and wealth. “I know she can hear me,” Julia whispered tearfully, gesturing towards Vivian, who was lying sedated in bed, “I keep telling her it’s OK to die now, but I know she’ll just keep living as long as she can to spite me.”
Her words struck me as odd. But she explained that Vivian had been a difficult and demanding personality, quite a diva even. She had never married or had children, and she had been estranged for years from most of her blood relatives. And yet Julia was her next of kin, Julia was her sole heir. Julia, who had been poor all her life, would now be wealthy. Julia felt guilty for being in line for this windfall, and Vivian had deepened that sense of guilt, claiming that all Julia cared about was money, and that she did not deserve to inherit it at all.
“How do you feel about becoming wealthy?” I asked Julia. Her face instantly exploded in glee, despite her intention to hold everything in with her tears, “I am so excited!” she responded. And then her face quickly turned crestfallen. “But I promise to put it all to good use, to spend the rest of my life giving back, doing for others.” Well aware now of Julia’s guilt, I looked at her and said, “Julia, it is not your fault that you are Vivian’s heir.” Relief swept over her face. She had done nothing wrong, and I only wish Vivian had been able to join in Julia’s joy over her upcoming wealth, honoring their connection as blood relatives, maybe even making up for lost time together, maybe even learning to love and be loved by one another. I was glad at least that I had given her at least a moment to express her joy, a brief pause from the guilt she carried.
Fortunately, there are times where hurt, shame and guilt can be nipped completely in the bud. I recall a visit I had with Dottie and her husband Richard. Richard was in the hospital yet again. He had dementia, along with a number of cardiac issues, and the daily stress of caring for Richard was truly taking its toll on Dottie. Although she had two daughters who lived nearby, neither of them had been very involved in Richard’s care. “I have written both girls out of our wills, even though they don’t know it,” Dottie declared to me bitterly, “because they have not offered enough help. And I have written a letter to the girls expressing this, and I have told my lawyer to read it to them once Richard and I have both died.” Jolting straight up in my chair, I blurted, “Don’t do it! Talk to your daughters now!”
Later that day, I apologized for trying to tell her what to do, and yet I could see that my words had resonated. Soon after, Dottie sat down with her daughters and expressed all of her disappointment in them, all of her anger, all of her sadness. And her daughters not only heard her, they also responded. They apologized for their unintentional negligence, and from that day forward played a much more active role in Dottie and Richard’s lives. While caring for Richard is still draining, these days Dottie looks more peaceful, more content. Her daughters are now there for her, she has reinstated them into her will, and the bitter deathbed letter has been torn up.
As patients and their families approach death, we chaplains encourage the dying to place God’s love on its proper and fitting throne, relegating their wealth directly into love’s service. This is not always easy, especially because shame, guilt and other strong emotions often shush talk of wealth. And yet love, truly, is stronger than death. Love lives on, long after our bodies have crumbled and our assets have dispersed. By encouraging people to serve God’s love rather than mammon’s tug, we lead others to see God in all things, to see Christ in all things, even and perhaps especially in the sorrow that still comes with dying and death.
Anne Millington is a chaplain at Beth Israel Deaconess Hospital in Milton, MA.
¹ Names and circumstances altered to maintain confidentiality.