When I die, I would prefer to do so in company, not alone with machines. I especially want to have the company of those I love around me, to hear their prayers whispered in my ears, to feel their hands grasping my hands. Such prayer, such touch could ease my journey from this world to the world to come. But will the people I love be able to break through the sterile barricades so often erected between the dying and the living by the American health care system?
We have expurgated death from what we see. We are warned in the United States that television news images of death and violence may disturb some viewers or are unsuitable for children (except, alas, for the children who have to undergo such death and violence). The news media in the United States blurred out the face of the Syrian child, Aylan Kurdi, who drowned off the coast of Turkey in 2015. The message: Don’t disturb American viewers.
Allow me to share with you what it means for me as a Catholic Christian—a Jesuit for 62 years, a priest for 51—to face my death, as I have faced the deaths of others. During the past six decades I have spent 26 years in West Africa, the most vivid years of my life, and I still visit Africa annually, especially Nigeria and Ghana. I had a Muslim friend in Ghana whose death nearly 40 years ago remains painfully etched in my memory, precisely because—as was also the case with my mother’s death—I was not able to be with him, to accompany him on that final human journey. (Although I accompanied my sister, my only sibling, in the last weeks of her life three years ago, I was not actually with her at the moment of her death either.)
When I am dying, will the people I love be able to break through the sterile barricades so often erected between the dying and the living by the American health care system?
My friend was called Malam Baba. I use the nickname (“Papa Teacher”) by which he was best known in Accra, the capital and largest city of Ghana; his real name was Musa ibn Muhammad. Earlier in his life he had prayed professionally for politicians and business entrepreneurs; he was reputed to be mustajab al-du’a, to use a technical term from Sufism, or “one whose prayer is answered.” Such was the mundane success of his prayers that he lived in a modest house a bit more substantial than many others in Nima, the central section of Accra. As he aged and his sight deteriorated (a side effect of a brain tumor), Malam Baba became more interior, more concentrated on God. He finally spurned the idea of petitionary prayer made for financial reward.
When I first sought out Malam Baba, I wanted to learn from him the history of the Tijaniyya Muslim mystical confraternity in Accra. Malam Baba, although a devout Tijani, had no interest in discussing history. He wanted, instead, to talk with me about God, about Jesus, about Muhammad. And so we did, weekly for about a year. In all the time I knew Malam Baba, his radical entrusting of himself to God (what is called tawakkul in Arabic) moved me deeply. His only interest was God, and he wanted to know about my experience of God. I finally stopped taking any notes during our conversations; he was not to be the object of my scholarly curiosity.
About a year after I first started to visit Malam Baba, I went on sabbatical to the United States; before I left, fuel shortages and general chaos in Accra made it impossible for me to get to his house and bid him farewell, although he knew about my upcoming sabbatical. While I was away, some of Malam Baba’s disciples came by taxi to look for me at my house on the campus of the university where I worked, hoping that my sabbatical was over. Malam Baba’s brain tumor had worsened, and he was dying; he wanted to talk with me once again before the end. Alas, just as I was far away from the United States when my mother died 10 years later, so too I was far away from Ghana when Malam Baba died. I was unable to be with either of them at the end. When I heard of Malam Baba’s death on my return from sabbatical, I was dumbstruck. It is still difficult for me, even today, to deal with that loss.
I have learned much from both Christians and Muslims over the past five decades since I first lived in West Africa. I first read the Sura of the Cave (Surat al-kahf), the 18th Sura of the Quran, when I was a graduate student. In the years since, I have come to realize more poignantly the meaning of that Sura, and especially its narrative about the seven youthful sleepers who woke up from death. They also then went back to the sleep of death to await the day of resurrection, to which they bore eloquent witness. Along with its Christian parallels, such as the poem on the Sleepers of Ephesus by the sixth- and seventh-century Syrian Christian monk Mar Jacob of Serugh, the Sura of the Cave has enabled me to understand partly the common treasure we Muslims and Christians share in our fears and hopes when confronted with death. The People of the Cave, in both Christian and Muslim narratives, were youths who lived together in faith, who fell asleep together in hope, hidden away from the enemies of their faith and hope, and who rose together in love to bear witness to God and to the day when all of us will rise again.
What do the Quranic and Syriac Christian narratives about the People of the Cave have to say to us about the interstices of theology and biomedicine at the border of death? There are motifs of Mar Jacob’s poem and in the Quranic narrative that I wish to underline. Mar Jacob recounts the persecution of Christians during the short reign of the Roman emperor Decius (249-251). During a visit to Ephesus, Decius tries to impose sacrifice to the gods of imperial Rome on Christian Ephesians, including these boys who hide in a cave to avoid apostasy. There they sleep, thinking it is only for a night. Mar Jacob wrote that “the Lord saw the faith of the dear lambs and...took their spirits and raised them up above, to heaven, and left a watcher to be guarding their limbs.” By “a watcher” Mar Jacob apparently meant an angel who accompanied them in their death and who guarded their bodies in the cave while their souls went to heaven.
Centuries later, well into the history of the Eastern Christian Roman Empire, stones are removed from the entrance of the tomb. “Light entered in and awoke the children of light.” Thinking they had only slept one night, the boys send one of their number into Ephesus to buy food with ancient coins. Those coins startle the Christians of Ephesus and finally lead them to the mountain retreat where the boy and his companions have slept since the persecution of Decius.
The Christian emperor Theodosius is brought into the picture; he even tries to persuade the boys to relocate in downtown Ephesus, where the emperor promises he will “build a shrine over their bodies.” The boys prefer their mountain cave, declaring that “the shepherd who chose us is the one who bade us be here.” They envision their role to be witnesses: “For your sake has Christ the Lord awoken us, so that you might see and hold firm that the resurrection truly exists.” In a touching final detail, the emperor covers the boys with his cloak as they return to the sleep of death.
An African hospital ward seems to me more Christian, more Muslim, more human than the solitary confinement I glimpse through the windows of intensive care units in modern American hospitals.
The Quranic story of the Seven Sleepers lacks the Christian details in the version preserved by Mar Jacob. As is true with so many of the stories in the Quran, it presumes familiarity with the narrative already, not because Muhammad had read it (Muslims generally deny his literacy) but because the story of the Sleepers of Ephesus had entered into the oral tradition of Arabia through Christians living there. Muhammad may have known this story already as a youth on the Syrian caravan route, but the Prophet experienced the story precisely as revelation only when his Meccan compatriots challenged his teaching about the hour of judgment and the resurrection of the dead.
God’s voice in the Quran sums up the lesson of the dying and rising sleepers: “Thus did We bring them [the companions of the cave] to the attention [of the faithless] so that they might know God’s promise is true and that there is no doubt about the Hour” (Quran 18:21).In the Christian story of the Sleepers of Ephesus, God is said to have appointed an angelic “watcher” over the seven youths in their cave tomb. In the Quran God himself is said to have watched over the sleepers and even watched over their dog, with the tenderness of a mother: “We [God] turned them over, rocking them to the right and to the left, while their dog stretched out its legs” (Quran 18:17).
My intent in quoting just a few words from this passage from the Quran, and from the Syriac poem of Mar Jacob, is to make a simple point about how we care for the dying. In the hospitalization of the terminally ill in the United States, every effort seems to be made to ensure a sterile environment where the dying are plugged into respirators, monitors and other elaborate machinery to keep them breathing, responding to treatment and doing what the system thinks they should do. I would prefer to return to Africa before I become terminally ill, so that I can die surrounded by friends. It may not be that hygienic, but I would rather be spoken to, prayed with, turned over in bed, accompanied by friends as I set off on my final journey. An African hospital ward seems to me more Christian, more Muslim, more human than the solitary confinement I glimpse through the windows of intensive care units in modern American hospitals.
Al-baqa’ l’illahi, Muslims say in Arabic: Only God is everlasting. Inna l’illahi wa inna’ ilayhi raji’un: Truly we belong to God and to God alone we will return (Quran 2:156). In the Catholic Christian tradition, we pray, “May their souls and the souls of all the faithful departed through the mercy of God rest in peace. Amen.” I miss you, Malam Baba. I am so sorry I was not there with you at the end. I know we will meet again on the day of the resurrection. When we both arrive there—or, much better, then—I want to introduce you to my mother and my sister.
If you want to do something to humanize American healthcare, you could at least advocate for Catholic Healthcare to understand that the front line of Mission is their provision of Board Certified Chaplains to provide Spiritual Care throughout their facilities. They have either forgotten, or do not care.
You could also advocate for CMS to change their Hospice reimbursement to include BCCs as the standard of reimbursable Spiritual Care providers. Any person can call themselves a spiritual care provider or "chaplain". Only a BCC has 5+ years of education and training to provide spiritual care to all persons. And the sick and dying deserve our level of care.
Not entirely true. I have an MDiv and 5 quarters of CPE but am not a BCC. I currently work part time in a parish as a funeral coordinator, but before we had children I worked as a hospital chaplain, and now volunteer as a chaplain for our local hospice. One does not need to be board certified to be an effective chaplain, one just needs the education, training and experience.
Beautiful article. Reminds me I need to reread Ernest Becker’s THE DENIAL OF DEATH (1978 ?). Despite the omnipresent technology and seeming isolation, my experiences of hospitals the past few months has shown me that the medical professionals and support staff are very warm, caring, engaged, compassionately concerned, and deeply human. May we all find such people with us when we make that voyage into eternity.
- Rick Malloy, S.J.
imagine being this much of a dhimmi that you have to write a long article complaining about hospitals not being Christian enough to have large gatherings around your deathbed.
Thank you, Fr Ryan, for a beautiful, ecumenical, article. As someone near your age, I relate to the sadness of missing those who went before. Will you publish your translations/interpretations of Quran? They are excellent for English readers...
Is there no balance in Jesuit life?
Intensive care units (in the Anglosphere and Europe) deliver people on the point of death to a hospital ward and then home in a large number of instances.
They are life-affirming, not death-watch locales.
If no nearest and dearest are present at an expected death, that is down to themselves and their circumstances and seldom anything to do with a hospital or hospice.
West Africans are 100% humans whether or not they are Muslim and demonstrate human love, warmth and affection out of their natural humanity.
Islam has nothing to offer us. It is a post-Christian political religion on a par with Mormonism in being full of falsehood and misdirection. In particular, for followers of it, death has not lost its sting as any true familiarity with Qur'an, Hadith and Sira reveal, Allah is capricious and hell has a majority of women in it.