Rev. Dr. Arul Dhas. T
Reader, Chaplaincy, CMC-Vellore

‘Palliative care resonates with the healing ministry that affirms the sanctity and dignity of human life from the moment of conception to natural death’. Dr. Arul Dhas, in this article, explains to us the complex concepts of pain, suffering and spirituality in the simplest language possible.

Life has different components. Some have exciting lives and others have dull and boring lives. There is lot of unpredictability in life. There is joy and there is pain. Some of us are care-givers and others care-receivers. It is useful to know and understand different components of life so that we can help one another and be a source of hope to each other. Our goal could be bringing meaning and purpose in us and in others.
Pain is a basic bodily sensation caused by harmful stimulus, received by naked nerve endings, characterized by physical discomfort. When there is pain without meaning or purpose that can be referred to as suffering. This may be called spiritual suffering. Spiritual suffering deals with meaning, connectedness, forgiveness and hope. Spirituality deals with all these four dimensions. Awareness and sensitivity are acutely needed to experience spirituality. If someone is not able to feel pain or joy, that state is called numbness where we experience lack of life.
Meaning pertains to making sense of what one is going through. When a mother goes through pain of labour, she is aware of the implications of it and thus bears it graciously. When someone suffers pain or inconvenience vicariously (= for someone else’s sake), he/she too goes through it with courage and firmness. However, when we do not know why we are going through a particular pain, it becomes unbearable and suffering. Some people feel that all kinds of pain have to be removed. This is neither possible nor good. Any pain has to be taken on individual basis and considered separately.
Connectedness is another dimension of spirituality. We refer to connectedness with God, with others, with nature and with self. Each dimension of this connectedness is worth noting and we need to pay attention. In connectedness there is a mystic experience. Connectedness also is relatedness. Our joy and pain are closely linked with this relation. If there is brokenness, that gives pain. Oneness and unity brings joy and happiness. Again, if oneness is with ethically sound one, it brings joy and if oneness is with the evil one, that leads to unhappiness.
Forgiveness is rectifying the brokenness. It is bringing the oneness back into life. There are many who experience brokenness in their relationships. Particularly when someone is in the last stage of his/her life, the thought of broken relationships can bring a lot of pain. Therefore, a caregiver should take every effort to bring the back the unity in the life of a dying patient. Someone receiving palliative care should be willing to go through this process even if it may evoke certain painful moments temporarily.
Forgiveness is letting go of someone or something. One can achieve this by undergoing a ‘life review’. A life review may include listing out the names of all whom one has hurt during his/her lifetime. Another step in this process is listing out the names of people whom they have hurt during the their lifetime. Of course, the ability to remember and memory of events will play a major role. If there is no memory of such events, then probably healing has already occurred.
Another dimension of a healed life is gratitude. In the last part of one’s life, if he/she is able to recollect different people and situations for which he/she is grateful, that is a great blessing. Resentfulness brings pain; gratefulness brings joy. The one who undergoes life review also could be encouraged to offer a prayer of healing. Healing is part of peace and, peace is part of healing.
Hope is another dimension of spirituality. Hope is the ability to look forward with some expectation. Often, it is connected to having a glimpse of the end. End may be vague and unclear. However, some religious faiths are useful in this area. When pain is immense and without much meaning one may not be able to experience hope in life. Often religious beliefs help to have hope. Many hope in the divine being and provision of divine presence in the future.
Life needs to be lived abundantly and to its fullest. Whether we are educated or not, wealthy or not, good or not, we need to live our lives with meaning, connections, forgiveness and hope. This is what many normally refer as spiritual life which is relevant in end-of-life care as well.

 

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