The First Vigil: The Birth of Music-Thanatology ™


Photo: Lynn Johnson
An environment of peace and support is created for patients and loved ones.

“…Solvitur ambulando – It is solved by walking…” – St. Augustine

Life as an Orderly: As an undergraduate student, I worked in a geriatric home and saw and met many experiences for which I was not formally prepared by education. Nevertheless, it seems that the future was placed in my lap all in a single day, at dusk. This is the time of day when the sun begins to set and the hermit thrush begins to sing. At work, I saw the elderly frequently in one of two extreme conditions. They were either sedated into a stupor or left by choice in unmitigated pain and almost always, in either situation, their deaths were characterized by the spiritual suffering that accompanies abandonment, isolation, disfigurement, depression, and overall loss of meaning. Many died accompanied only by the blare of television and the canned laughter of I Love Lucy re-runs. Most had outlived beloved companions, lovers, friends, spouses, and many had no remaining family. In the large for-profit residential home at which I was employed, the elderly were not visited by associated agency ministers, priests or rabbis, nor chaplains, social workers or psychologists who might help them deal with their cumulative disappointments or prepare them for their inevitable deaths. They appeared to die in their wheelchairs and beds as if satellites, torn asunder from a base ship, almost floating away. Looking back, one can only wince to imagine the content of their thoughts and feelings. Hopefully, some of them died to peace, but I know from experience that this was not always the case.

Death was Misplaced: Their deaths were acknowledged in the records as statistics or as events charged, at most, with economic significance. As orderlies, we were taught that an empty bed was a loss of revenue, and the issue was to repair the gap in generated income with the timely admission of a new resident. The death of a resident had nothing to do with the death of someone who, until recently, had been somebody’s son or daughter. We were taught hygienic procedures and protocols. When a resident died, we were taught to ring the buzzer, get the gurney, call the morgue, get the deceased into a body bag, and sanitize the room. A half-day turnaround was the maximum acceptable margin of lost time and lost revenue. Employees and residents observed furtive silence regarding each death, not because we were so instructed, but because we had no systemic tools and no processes available for anything except a literal, mechanical world view. When death occurred, it was, repeatedly, as if the human being who used to live in room 103 had simply never existed. I was baffled and confused, as well as inarticulate.

Destiny Unfolds: Even these conditions, of themselves, did not set the author on a “path” to “found” something. Music-thanatology takes inspiration from history, and renews one of the earliest commitments of the Benedictine Holy Rule, the monastic infirmary and the possibility of a blessed death. Yet prescriptive music is delivered today through the lives of commitment by substantive lay professionals – not monastics! – who are called to anew to vocation and profession.

Spiritual Formation: The work began for me almost thirty years ago in experiences with two dissimilar but essential figures: a priest and a patient. The priest was a brilliant thinker, and had a particular commitment to young adults, making himself available to grapple with the issues of the day. Yet also, he demanded much from everyone with whom he came into contact, because he was so alert and on fire. He sought continually to bring out the best and the most in others, even if the birthing process was a stretch. He taught thought-provoking courses and seminars in philosophy and epistemology at a local college and lived in a nearby town where he served as a pastor to am small congregation. I had been so ignorant at that time, I thought only Catholic ministers were called priests! In any event, I had been troubled by my experiences at the geriatric home. I was especially troubled when the bodies of recently deceased residents were treated in a less than dignified manner. As a newcomer to the clinical environment, I didn’t know what to do with my growing unease. To be able to discuss it with the priest was the gift of a lifetime. He was the kind of peripatetic teacher with whom one could walk and talk, and really grapple with material in an instructive and informative way. Actually, young people knew he was serious about one of us and was giving us his undivided attention if he asked us to walk, rather than meet him in the library or a study corner.

Genuine Commitment: And so it is that we spent an entire afternoon together, walking cobblestone streets; this became a cataclysmic event for the rest of my life. Essentially, he taught me a master-class in commitment. He listened and played back the scenario to me as I had presented it. I was a rookie; he on the other hand had life experience, a strong formation, vigilant purpose, and intelligence of the heart.

I saw a problem and he saw a spiritual opportunity. He said with rather burning focus and solemnity, “Don’t leave them. Protect them.”

Tough Love: He described the possibility of a protective zone of interiorized stillness and holiness, and asked me what would really happen if I entered a room, found a resident newly deceased, and did not immediately ring the buzzer as we had been taught. What would really happen if an employee took a moment to stand there quietly and say a prayer, giving the soul the possibility to leave the tabernacle of the body gradually? He also told me (among other things) that my understanding of the words “religious” and “spiritual” were narrow and undifferentiated, that I should deepen my own spirituality and religious commitment (both) and expand these dimensions in order to serve more freely and cleanly. He even suggested that I familiarize myself with the world’s sacred scriptures, not only the New Testament, and learn to love these other sources, to be able to pray them silently from memory, to be open to the diverse religious and spiritual differences and needs in human beings. His assignment was a tall order. He never reduced the critical distinctions between religions or even denominations, nor was he syncretic. Rather, he asked me to broaden my own dimensions and deepen them in a far richer and more conscious sacramental life. I was in my early twenties, and this counsel was nothing short of comprehensive.

Unique Particularity: He was probably already concerned with what would soon become obvious to religious teachers and ministers everywhere – the secular world had begun to espouse a new spirituality without religion. At that time, young people felt liberated. The banquet was available but we didn’t know that we’d begun the smorgasbord menu approach to spirituality that would become so prevalent in the next thirty years. The new was exotic and startling. It had been recently broadcast to rave reviews. People felt very free to explore, read about, tailor new ways and means, appreciate and in some ways assimilate fragments of other traditions. We were genuinely hungry for God, meaning, depth, and answers. But I was still finding my way into the earliest possible beginnings of what one might call an adult spirituality, and wanted to deepen, but didn’t really and truly know how to become closer to God in a living way. Many of my friends had gone to India, several times, and most had left their birth religions and were very moved by the new teachers, lived in ashrams in America, or new commune efforts, and in general looked to the East for answers. For me, intuitively, I knew only three things but I knew them with all my heart. First, I hadn’t even begun to fathom what my own tradition had to offer, so how could I legitimately leave it? Second, the Eucharist was a truly sacred mystery, and third, the Gospels could not be exhausted. Because of the three, I stayed very close to my own well. That didn’t mean, though, that I had access to a bucket. The priest on the other hand had the wisdom of experience. He felt and taught that in order to be of service, and in order to be real, or get real, a person needed to be rooted in a personally demanding religious practice without which one would fall into illusion and inflation. He was able to convince me of this truth just because of the way he lived. He walked his talk. Even so, we take each step as we can, and cannot of our own will hasten the spirit’s bloom before its time.

Authenticity: So, protect them. Don’t ring the buzzer right away. It was so simple and small. It was so big and bold. Ever since then, God has never left me off the hook regarding paradox. Its blaring presence is one of the ways that I know I’m veering towards authenticity instead of security. When I responded to his challenge by mumbling something lame about being worried that I could be fired, he reminded me of my own Irish Catholic heritage. (I’m a first generation American). He was German, with the timing of a master strategist, daredevil twinkling eyes, and an incorrigible appeal. “Don’t you know anything about the Irish?” he asked, ironically. “Don’t you know about the hedgerow liturgies?” He was referring to a time when many aspects of Irish culture had been suppressed, including religious expression, and when, during the destruction of Irish libraries in the 1600s, in acts of spiritual courage, musicians and poets committed them to memory. Like the Irish priests who would meet their parishioners secretly under the shelter of the hedgerows to celebrate Mass, the poets and singers of Irish culture would recite in the woods and under the shade of those same hedgerows. This commitment involves the lineage of risk.

In the days and weeks that followed, something shifted inwardly and it resulted in a gesture of readiness. The first infant steps toward service did not discourage me. Discouragement came much later.

The Man with Emphysema: Then I met a second person in this story: an elderly man in the geriatric home who was dying of emphysema. He was a combative resident, often verbally and physically abusive, so it was hard to love him. Whoever was daily assigned to his room to bathe and feed him or to pass the meds used to take a deep breath and grit their teeth. When I came on duty that particular day, I was informed that he was expected to die very soon, perhaps on our shift or the next, and I was assigned to his care. Every medical intervention had, in fact, been exhausted; his lungs were simply disintegrating. He was imminent.

Being Present: When I entered the room, the death rattle was very loud, and he was thrashing. In retrospect, I understand now that it was alarming for both of us, but in such different ways. There was an immediacy to the situation that is difficult to describe. Everything fell away and just two human beings were left in the same room, facing a moment that would become very large. The notions of revenue streams and sanitation protocols did not exist.

A Relationship of Trust: Acoustically, his death rattle filled the room, like a kind of sound ocean saying “anxiety – anguish,” and these affected my own heart instantaneously. I closed the door to give him privacy and hold his hand, calling his name. He was suffering, frightened, gasping and crying out. This is what the literature of monastic medicine calls an agonal death. To my surprise, unlike the year in which he avoided contact, as soon as he heard his name, he held on to me, and met my eyes through his spoke terror. Before I knew it, I had simply gotten into bed and propped myself up behind him in a midwifery position, the way a Lamaze partner will help a mother with a gravity position in an unmedicated labor. With my head and heart lined up behind his, and my legs folded near his waist, it was possible to bolster his diminished body. Before I had time to think, I found myself singing quietly to him, holding him. I made my way through the entire Mass of the Angels, the Adoro te devote of Thomas Aquinas, the Ubi Caritas, the Salve Regina, and the Mass of the Blessed Virgin Mary. These came out simply because they are beautiful, and were as much parts of me as are my hands and feet. I never learned the details of his life or his religious identity, if he had one. I only knew that he was dying, his lungs were filling up with liquid, and he was unable to breathe. That moment of combined song and prayer now seems crucial – the music was not a form of distraction therapy. This delicate, permeable event was a real vigil, and the music, sung prayer, inseparable from intention, had become a genuine medicine.

This narrative is continued in Healing and Curing: Musical-Sacramental Midwifery.

This text was excerpted from Transitus: A Blessed Death in the Modern World.

Last updated Tuesday, 25-Feb-2014