I didn’t think he would remember me, but he embraced my presence. I didn’t think he would cry to me, but he sobbed. I didn’t think the prognosis would be as grim, but it was. I didn’t expect to hear what he said, but I did. I didn’t think it would impact me so greatly, but I reflected on the encounter for many days thereafter.
I had received a referral from the palliative care team to see Carol Weiss, a Jewish, unaffiliated, 67-year-old woman with ovarian cancer. Unfortunately, I was not given more information. Upon entering her room, Room 306, I introduced myself. I was greeted by her husband, Michael, who then introduced me to the six other family members in the room. As I realized that it was not the most opportune time for my visit, I told Carol and her husband that I would return later that day or later in the week (we knew that she would be in the hospital for the next few days).
Two days later, Carol would be my first visit of the day. As I walked down the hospital corridor, I recognized Michael standing alone, outside Room 306, leaning up against the wall. He looked worn out and disheveled. Michael recognized me, thanked me for returning and informed me that the nurses were washing his wife, hence the reason he was standing outside.
I had barely opened my mouth to say a word, when Michael broke down sobbing. “I need to be strong, I need to be strong,” he said in between uncontrollable sobs. “Carol can not see me like this.”
For 15 minutes I listened as Michael described his loving wife of 40 years who was given only days left to live. He described their special marriage and their family. He described what he had been feeling for the past few weeks during his wife’s medical decline. He described his heartbreak and anger toward God. Michael expressed hope for him and his family to receive some quality time with Carol, as she would be receiving hospice care at home.
My heart was broken watching and hearing his pain. After Michael calmed down, we stood together, face to face, for several seconds, in silence.
“I know I am lucky to have these days with Carol,” he continued. “She can’t leave yet. We still have things to discuss.” I briefly imagined all that one would potentially want to share with a spouse in those final days. Things about the children, finances, legacy and so much more. “Carol told me that after she is cremated she wants her ashes sprinkled over the ocean. She always loved the water…” Michael took my hand and began to cry again, while I felt the color drain from my face.
Jewish law mandates that human remains be buried after death. Cremation is absolutely prohibited. Period.
I was thrown off guard, not expecting to hear what I just did. I knew I had to speak up to Michael immediately. Though these predicaments have occurred before, the timing on this one was far from ideal. Michael’s face was still wet from tears and I was going to bring up the topic of cremation? Needing to think quickly and refocus myself immediately, I realized it was now or never….it had to be now. I also knew that speaking and acting with the utmost sensitivity was absolutely crucial.
I wished for God to help put the right words in my mouth.
“Michael, has Carol considered burial?” Carol did in fact consider burial, but cremation was firmly what she wanted. I asked Michael if he and the rest of the family approved of the decision. He replied they all did. I explained to him very directly but softly about the importance of the human body in Jewish belief as belonging to God, the sanctity of the body and the importance of it being ‘returned’ in its entirety as it was given. I explained to him directly but softly how we bury things that we treasure, not burn them.
Michael was staring at me the entire time. He seemed to hear the words I spoke. I was unsure how he would react to what I had said.
“Thank you so much,” he said kindly, “I understand what you are saying, but cremation is really what Carol wants.”
At that moment, the door opened and the nurse said that Carol was ready for visitors.
I have one more chance, I thought. Maybe, just maybe, I could engage Carol directly, somehow, in opening up this discussion. If I could skillfully do this, perhaps she would reconsider her decision. I felt re-inspired.
However, upon entering the room, I saw a woman on the bed who looked like she had aged 20 years from only two days before. She looked so frail. Pale. Weak. She looked depleted and exhausted. I re-introduced myself to Carol and mentioned that I had been speaking to Michael in the hallway. Carol could barely utter a few words without taking a breath of air and without her eyelids falling.
I wanted so badly to enter the conversation with her.
I looked at this woman and saw a Jewish soul...soon to be burned to ashes. My heart was screaming inside. Yet, to engage Carol at that moment seemed highly inappropriate.
I could not do it.
“Maybe Michael will share with you part of our conversation” were the only words that I could muster. She nodded her head, as I gently touched her hand. She thanked me for my presence. Michael thanked me for my time with him, as he gave me a wink with his eye. We had an understood kind of bond together that I knew he was appreciative for. I gave Michael my card in case he decided to call me, I said a quick prayer and left Michael and Carol to be alone.
I left the room with a heavy heart, a deep sadness and strong pain, knowing that this Jewish woman would most likely be cremated and I could not prevent it.
And then the back and forth conversations began in my head: “Should I have said more? Done more? Been more firm? Should I have tried harder?” “No,” I said to myself, as I slowly left the room. “Carol has no strength to have this discussion right now. Michael heard me clearly; he has my card if he wants to reach me. I did what I could.” But my mind continued to race: “Maybe I should try again. How can I just walk away?”
I found myself at a halt, frozen, standing by the hallway elevators, contemplating what to do.
Right then, my phone buzzed with a text to go immediately to the ICU for a patient.
Perhaps that was my answer. Perhaps God was telling me: Yes. Time to walk away.
Contrary to what you think, this story has no ending. I do not know what happened to Carol.
This article was written not for the purpose of discussing cremation, though it is something that unfortunately occurs quite often. It was also not written for the purpose of discussing how we are often caught in various religious and ethical dilemmas that interfere with our professional roles.
Rather, it was written as a reminder to do the very best in the moment and then leave the rest up to God. We are each conduits of God, executing His will. As Rabbi Tarfon says in Ethics of Our Fathers (2:16), “It is not your duty to finish the work, but neither are you at liberty to neglect it.”
God knows I tried.
By Debby Pfeiffer
Debby Pfeiffer is a board-certified chaplain working at Morristown Medical Center through its affiliation with the Jewish Federation of Greater Metrowest, NJ. She resides in Bergenfield, NJ, with her husband and children. She can be reached at [email protected]