Hospice Patients Alliance: Patient Advocates


The Captain and the Lighthouse Keeper



by Ron Panzer

November 16, 2011



When you live on the coast, your life intersects with water, one way or another, at one time or another, one day to the next. And that means boats, ships, swimming and knowing the difference between a flounder, a striped bass, or a shark.

You can't travel across large bodies of water without a boat or ship, and there is a beauty that is unique to the waters. Whether stream, river, bay or ocean, there is nothing like sailing along from one point to the next. But as every captain of the boat knows, there is an ever-present sense of danger, no matter how peaceful it may all appear. From having life-vests on hand, anchors, ship-to-shore radios, to staying tuned to weather reports for what is coming even days ahead ... you do it, because you know what may come today, not tomorrow, or ever.

And out on the water, the most peaceful glass-like sea can become a roaring world of chaos and danger. Just ask the sailors (if you could) on the 729 foot Great Lakes freighter, the "Edmund Fitzgerald," that sank in a treacherous storm on Lake Superior as recently as 1975. There's nothing like seeing the bow of your ship cutting through whitewater-filled waves towering over you, wondering if you're going to make it to the other side when the bow cuts under such huge waves. You hope to live another day. You hope the bow doesn't remain under water leading you and the ship to a very, very quick end.

Harbors have their safety, but they must also, by definition, have dangers ... shallow areas that threaten to beach the craft or break it apart on a hidden sandbar or in some areas, a reef. Landlubbers have no idea how alert sailors must be, because a captain sails from safe haven to safe haven, harbor to harbor, island of life to island of life. That really is all there is, with three-quarters of the Earth covered in water.

Danger is all around, threatening one's life and the lives of all who entrust their lives to your hands. It may seem like just a quick recreation, but it could change in a moment. Lifesaving skills, CPR, first-aid kits and flares are all necessary, ready at a moment's notice.

The captains study the maps, know the safe paths, the best harbors, how to avoid danger and what to do when danger approaches in spite of his best efforts. Lighthouse keepers are the sentinels upon whom the captains rely when darkness covers all. Though they live a lonely life, their service has saved unknowable numbers of lives. Yes, it is unknowable how many lives have been saved ..., but that doesn't mean they are insignificant numbers. The lighthouses are one of the pillars of safety in the dangerous world that exists between island of life and island of life. Islands, peninsulas, even continents, they're all islands of life, and we are simply temporary inhabitants on this Earth.

Going through life we tend to live in a fanciful, utopian vision of what life is supposed to be, until reality knocks us flat and jars us into the realization that we've just come close to smashing into a reef or going down for good. Those who have thought about these things and provided us with the maps and the lighthouses for our lives have shared their wisdom with us. Whether we call it philosophy or religion, a foundation for how to live in harmony with the Creator and flourish in peace while journeying through this world is what it's about. "Love of wisdom" or "tying together again" man with the reality that is God, we find a starting point to begin our journey over the waters of our lives. We find an ethical code for behavior that benefits us all as individuals and society as a whole.

Yet, who thinks about the lighthouse keepers? Have you? Imagine you're watching from the lighthouse and a ship ignores the light and crashes on a reef a short distance from shore. Such anguish and pain you feel! How much you suffer knowing that you tried to save them, but there was nothing you could do. What a lonely, difficult position to be in! But each time a ship sails by and nothing happens at all? You look out and smile and know that all the years of your lonely existence are justified, even if it is just one ship with only one passenger on board.

You know the saying, "that whoever saves even one life, to him is given credit for saving the entire world." (Talmud Sanhedrin 37a) For what is the world? And what is all humanity? One person, and another, and another. All of humanity is made of just one person, and you, and me, and just one more and one more.

There are those of us who sail from island of life to island of life, ferrying others along in this world, in health care, even at the end-of-life care setting. And there are those who simply shine a light of hope and caution, guiding us all to safe harbor. What a terrific responsibility it is to hold someone's life in your hand, yet we do it every day, one person at a time. One patient at a time. The patient is the person, never "just a patient."

Dianne Irving, PhD 1 has written about the foundations for ethical action in the health care, scientific and experimental setting. A lighthouse keeper among men and women who has given and given without asking anything at all in return. We would do well to heed the caution of the lighthouse keepers of our time, because in between these islands of life, there is the threat of death, disease and harm. Sometimes, that threat is intended by those who have gone astray. There are pirates and islands of death. We don't seek those dark places out, but some do. They take pleasure in journeying to the islands of death.

Captains know that if your path is even 1 degree off course, over many miles, you will, without doubt, end up far from your desired destination. That is why the captain checks the maps, the buoys, the landmarks, lighthouses and guidance; he checks the sun, the moon and the stars, and then rechecks his position over and over constantly. It's not being "obsessive" or perfectionistic. It's the reality. It's necessary for a safe voyage. It's the standard. The way of doing things.

When it comes to health care, the philosophic and religious positions of those who make decisions matter, and logical, clear reasoning is essential. A materialist who does not value the lives of the disabled or elderly is going to come to a different conclusion than someone who, like Albert Schweitzer, has reverence for life. Without reverence for life, even those who defend the vulnerable will eventually go astray.

It is interesting to see that today, almost nobody speaks about such a great person as Albert Schweitzer. 1952 Nobel prize winner, physician, theologian, musician and so many other things, reverence for life was central to everything he did. He truly was a great captain on the seas of this life, for a time, when he was with us, serving the poor and needy. He was appreciated in his time (1875 to 1965), but why is it that today he is virtually forgotten? The answer lies within the character of our society and how much we value or devalue life.

We often forget that we have only a short time here before we, like old captains before us, get too old and must retire and surrender the wheel to other, younger captains who have taken on the challenges of the sea. We only have a short time with our patients, however long that may be. We only have a short time with other persons, however long our lives may be. How we choose to honor the lives of our patients matters.

That we care and give and never stifle the voice of our patients matters. That we allow life to be lived till life ends naturally matters. Dame Cicely Saunders said that the patient's life matters to the very end, and we are here to help them live their lives fully till the end comes of its own accord, naturally. We cannot rob our patients and their families and loved ones of those moments that number fewer and fewer as the end approaches. Like a golden treasure or fine wine that one would never even think to waste, these moments of life are precious, intimate, unforgettable.

It is our responsibility to steer the ship from island of life to island of life, and though one patient's days may end, it is never our right to throw them overboard at any time. To do so is a terrible betrayal of the mission, a disgrace to everything we stand for, a crime.

So, to those who seek to impose death through euthanasia, assisted-suicide or terminal sedation and dehydration, I say, "heed the cautions of the lighthouse keepers," sail safely through the darkness of our time, and bring your passengers to a safe haven where love and professional care runs through everything you do. Sailing along while ignoring the maps and the lighthouse keepers can only bring ruin to everything we are about. Ignoring the warnings of those who have come before is filled with peril, and the victimization of the vulnerable elderly, disabled and chronically-ill is certainly the end result.

We may rescue some patients who unknowingly have stumbled into the hands of health care pirates who would plunder them, imprison them, and leave them abandoned on islands of death. But it is a dangerous world, and we need to be prepared to act at a moment's notice. We need to advocate for those in need. And we need to stay strong so that we can serve those who are in a weaker position. We should never forget that as we sail the seas of this life, carrying our passengers to their destination.

"The Lord by wisdom founded the earth; by understanding He established the heavens."

                  (Proverbs 3:19)

We see the infinitely complex and wonderfully-ordered Creation before us, even in each human being we serve, in every cell, tissue, organ and system. How can we not wonder at the miracle in each life that we see before us? How can we not recognize our own humanity in the one across from us? How can we forget all that is involved in, and part of, each patient we serve? We must, with humility and reverence for life, understand the wisdom of those who have given us guidance and respect those entrusted into our care. They deserve no less and their trust must be rewarded with our supportive care.



____________________________



1 See: Archives of the writings of Dianne Irving, PhD
http://www.lifeissues.net/writer.php?ID=irv
and "What is Bioethics?"
http://www.lifeissues.net/writers/irv/irv_36whatisbioethics01.html





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