Hospice: The Gentle Goodbye A Post by Phyllis

Angel Wings 2
Pair of angel wings on heavenly blue background

Just after dawn on December 11, 2007, my mother went to God. There was a beautiful peacefulness that fell over that bright, winter morning that seemed perfect. Mom had battled several chronic, debilitating diseases that slowly robbed her of her energy and physical function. Her mind was always clear and her determination to live to see her grandchildren grow and to be with her husband of 59 years was intact. Unfortunately, her body had betraying her. Mom and I were very different. Our life’s journey together could best be described as rocky but the journeys end was her last gift to me.

It began one Thursday evening when I went to visit my parents. Mom had just come home from yet another unavoidable hospitalization. She was out of immediate danger but the likelihood of a relapse and perhaps a challenging surgery was weighing heavy on her mind. She looked tired, frail and was having difficulty speaking. I could sense she was in pain although she characteristically denied it. As I sat down next to her, she looked me right in the eye and in a clear voice said, “I’m too weak to live and too strong to die. I want to go to God.” She went on to explain that she was done taking her medications, had seen her last doctor, and had been to the hospital for the last time. If those declarations weren’t enough she asked me, “What are you going to do?” I knew immediately what she meant. She wanted me to take control of this out-of-control situation. She was entrusting me to help her live her last days in comfort and dignity. She wanted me to ensure that her transition from this life would be as gentle on her husband, children, grandchildren, and family as possible. The best solution was to arrange for hospice services.

I was the nurse in the family and I tried my best to collaborate with mom’s private doctor. We spoke so often that we were on a first name basis for many years. Dr. Bob had grown very fond of my parents and their relation. Our common goal was to keep mom comfortable and out of the hospital. Once my mom’s wishes were clear, my role was then to ensure that those wishes were carried out. First, I helped my dad understand and accept her decision. Next, I call Dr. Bob and explained her request. He was very supportive. We both knew that the only treatment he could offer her was palliative. Clearly, in his medical opinion, mom had less than six months to live. He made all the arrangements from his office. Finally, it was now time to call my sister.  The inevitability of losing our mom to death was here. Thankfully, as in all things pertaining to our parents, we would do this together.

The next twelve days were exceptional. Mom was peaceful with her decision. She enjoyed her days with dad, her visits with her grandchildren, and her messages from family and friends. Although she refused to take any more medication, she did allow the hospice nurse to obtain an order for pain meds so she could be truly comfortable. The hospice team arranged for a priest to come to the house. She received the sacraments of Holy Communion and the Anointing of the Sick. Mom prayed her rosary daily and in a few days slipped into a coma.

For twelve days the angels from hospice supported my family through the process of letting go. They immediately responded to phone calls and answered endless questions. Nurses came daily with supplies, understanding, and support. Their presence and professionalism allowed me the opportunity to be a daughter and not a nurse. On the day that mom died, it was the hospice nurse that we called first. She came right away, pronounced her and walked us through the next step.

The Value of Choice

I have been a nurse for 30 years now. For the majority of my career I practiced in critical care and emergency trauma units. I fought death constantly with knowledge, skill, medications, and technology. I had limited success. During the last 10 years however, my focus has shifted from the length of one’s life to a profound appreciation for the quality of one’s life. High tech healthcare has its place when lives need to be saved. However, death does come to us all.

Hospice services allow for the care of loved ones to take place in safe, familiar surroundings with those they love close by. It empowers the patient through their last days, offers them the respect of honoring their choices and the dignity of privacy. Hospice care assists the family during horrific moments of anger, regret, and grief that under less supportive circumstances could seriously challenge the family’s unity.

It’s important to understand that hospice is a philosophy of care rather than a specific place. It is an option for people whose life expectancy is six months or less. Treatment outcomes are based on pain and symptom relief rather than pursuing curative measures. This approach enables the person to live his/her last days with dignity, grace and support. Hospice affirms life and does not hasten or postpone death. Hospice care focuses on all aspects of physical, social, emotional, and spiritual well-being. There is no age restriction. Anyone in the last stages of life is eligible.

Hospice Care Services

  1. The Interdisciplinary Team: Team members include doctors, nurses, social workers, counselors, home health aides, clergy, therapists, and trained volunteers who offer support based on their areas of specialty. The team provides a comprehensive palliative plan of care aimed at relieving symptoms and giving social, emotional, and spiritual support.
  2. Pain Management and Control of Symptoms: The goal of these services is to help the patient to achieve comfort while allowing them to remain alert enough to make important decisions and remain in control.
  3. Spiritual Care: Since people differ in their spiritual needs and religious beliefs, spiritual care is individualized and never forced.
  4. Home Care and In-patient Care: Hospice care is typically centered in the home. However, it may be necessary to admit the patient to a hospital, extended-care facility, or a hospice in-patient facility. The hospice team can then facilitate this transfer and stay involved in the patient’s treatment. The team can also facilitate resuming in-home care when appropriate.
  5. Family Conferences: These conferences are facilitated by the hospice nurse or social worker. They serve to help family members stay informed about the patient’s condition and what to expect. Family conferences also provide an opportunity and safe forum to share fears, feelings, talk about expectations, and learn about the process of dying.
  6. Bereavement Care: Bereavement is the time of mourning following a loss. The hospice team works with surviving family members to help them through the grieving process. The team can refer family members and friends to other professional services if necessary. Bereavement follow-up services are provided for at least a year after the loved one’s death.

Hospice Care Settings

Approximately 80 to 90 percent of hospice services are provided in the home. But, it is important to know that if the patient’s lives in a nursing home, hospice services can be offered there as well. Hospitals that treat seriously ill patients often have a hospice program too. Some hospitals have a dedicated hospice unit, while others have hospice teams who visit patients in any unit. Lastly, many communities have independently owned hospice centers that feature in-patient care as well as home care hospice services. Independent hospice center can benefit individuals who do not have family caregivers.

Who is eligible for Hospice Care?

  1. You are eligible for hospice care if your doctor has certified your prognosis as not longer than six months. This applies to anyone of any age. Should you be blessed with improved health and no longer need hospice care, you will remain eligible to reapply for hospice care if it is necessary in the future.
  2. While the majority of hospice referrals are cancer related, hospice is not exclusively for cancer patients. People with terminal neuromuscular diseases or any end stage disease can also benefit greatly from the services. It is not uncommon for people with Alzheimer’s to be referred to hospice when they are in the final stages of the illness.

Are Hospice Services Expensive?

Hospice care customarily costs less than conventional care in a hospital or nursing home. This is because with home hospice, you pay only for the specific care that you need. In addition, volunteers may often provide many services at little or no cost, such as telephone support, meal preparation and running errands. Most private insurance plans, Medicare and Medicaid cover the services.

While patients usually pay out-of-pocket for any services not covered by insurance, hospice services can be provided without charge if you have limited funds. If you are unable to pay, most hospices will try to provide care using funds raised from community donations and charitable foundations.

Closing Thoughts

Hospice care truly provides for the gentlest of goodbyes. It allowed me the space and time to be able to cherish my last moments with my mom. I look back on those days in peace not pain and I will always be grateful for the last gift my mom gave me, her trust.

References

National Hospice & Palliative Care Organization

http://www.nhpco.org/custom/directory/main.cfm

Center for Medicare & Medicaid Services

http://www.cms.hhs.gov/center/hospice.asp

National Association for Home Care & Hospice

http://www.nahc.org/

4 Top Strategies for Finding Your Dream Job by Phyllis

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Originally Publish Date: March 16, 2017 https://www.aorn.org/aorn-org/surgicalexpo/conference-blog/find-your-periop-dream-job

 

I want to share some career coaching guidance with you:

1. Build a Strong Resume that Reflects Your Worth

Ensure your full name with credentials appears at the top in the header along with your contact information. The correct formatting is, name (middle initial optional), highest academic credential, RN, certification. For example, Mary A. Smith, MSN, RN, CNOR. A summary or statement of intent is no longer advised.

Your first section should be Academic Education. Start with your highest degree. If you’re still in school, it’s acceptable to note the date you started and an anticipated date of graduation. Next list your Professional Experience, Certifications & Memberships and Continuing Education & Computer Skills. End with Honors/Awards & Achievements.

If you find a job posting on the AORN Career Center site or other site, read it carefully and make sure that important phrases contained in that job posting language are also contained somewhere in your resume. This will increase the likelihood that the computer will recognize the language and select your resume, over others, for the recruiter to read.

2. Develop an Elevator Pitch

Once your resume is pulled, it is likely that you’ll get a screening call from a recruiter. This could be a make or break conversation. A successful screening conversation is the gateway to an actual interview. When the recruiter asks, “why did you apply for this position?” or “tell me about yourself?” you must be ready to share a ninety-second clear, passionate, and compelling answer that communicates you’re a serious candidate.

Take your time to form the exact four to five sentences that make your point. It may take an hour’s worth of revisions to get this just right but the return on your investment could be huge. You want to sound prepared but not rehearsed in your delivery. You may use your elevator pitch more frequently than expected. It’s always professional and polished to have it ready when networking and speaking with colleagues or vendors.

3. Invest in Your Own Resilience

Nurses downplay the need to take care of themselves so they can take care of others. Caring comes so naturally that we often forget that we cannot render quality, safe care when we’re physically tired or energetically depleted. Ensuring that we take good care of ourselves is actually quite generous. Building resilience allows us to stay fresh and available so we can deliver a consistent caring product every day.

Here are two suggestions for keeping your resilience well full. Incorporate some silent, still time into your life. Nurses are professional doers and always on the go. That may mean you take a walk and just experience the outdoors. It could mean that you discover meditation or yoga. There’s peace in stillness and we can all use a break from the endless noise of our thoughts.

Allow yourself to be cared for by others. Nurses are always giving and the only way to balance that is to allow yourself to receive. Lose the need for control and perfection by finding a way to delegate more at work and at home. Resist the urge to host every holiday and enjoy being a guest. Both of these practices will be hard at first but stick with it and notice the change in your energy level and yourself.

It’s been my honor to be the career coach for AORN since 2012. Each year at the conference, I have the opportunity to meet some AORN members for the first time and reconnect with members from past events. The most common question I’ve been asked over the years is, “so what is coaching all about?” This brings me to my final piece of career advice – career and personal coaching.

4. Consider Career and Personal Coaching

Career coaching is a great way to get individualized guidance and assistance with establishing your professional goals, making career choices, creating an academic roadmap, polishing interview techniques, and becoming skilled in marketing yourself. It often involves reviewing and revising resumes and learning how to increase your chances of getting your resume into the right hands once it’s uploaded to an organization’s career page. Sharpening your social media skills on sites such as LinkedIn is often useful as well.

Personal coaching is the process of supporting personal growth in a nonjudgmental manner. It can be challenging to remain clear and authentic about your goals and yourself as you try to navigate your life. Responsibilities, set-backs, and the demands of an adult life can overshadow your understanding of the present and cloud your vision for the future. Our human nature creates blind spots to options and solutions. Coaching provides vital support as one explores behaviors and attitudes that can short-circuit success in life and career.

THANK YOU SeeSee. Florence “SeeSee” Rigney, RN is the oldest working nurse…!

 

Florence “SeeSee” Rigney is the oldest working nurse in the United States. Last May, a video of her 90th birthday celebration went viral. The recording captures her in blue scrubs and a bedazzled “happy birthday” tiara holding back tears among her cheering colleagues. For 70 years she’s worked on and off as an operating room nurse at Tacoma General Hospital. When she first started, she got paid $115 a month. These days, she gets a ton of attention for being a high-energy compassionate nurse who still moves down the halls of the surgical unit faster than women a third her age. In 2015, Rigney was on The Dr. Oz Show and nominated for a March of Dimes Nurse of the Year award. Her birthday video was shared by The Huffington Post, The Today Show and BuzzFeed. She admits she feels a bit like a local celebrity even though she’s bashful about all the publicity. “I feel very honored to think that all of this has happened to me just because I turned 90, and I’m still here!”

HerVoiceIsMyVoice: Celebrate the Women Who Inspire Us Every Day

The strength of individual women empowers us all. This International Women’s Day, we’re turning up the volume on female voices and honoring the impact they have on all of us. #HerVoiceIsMyVoice is a moment to celebrate and share the voices of inspirational women from around the world.

Show your support on social by sharing the voice of a woman who has inspired you using #HerVoiceIsMyVoice.

It Is My Pleasure To Introduce You To: Daughters Unite

 

 

Daughters Unite was created for caring daughters by caring daughters who face the challenges of being sandwiched between their spouses, kids and/or careers and the disabled and aging adults in their lives.

Share your story and help a fellow daughter reduce the chaos and craziness in her life! Send a quick “I’m interested” email to Tell My Story. We’ll get back to you within 24 hours with all the details about how to submit.

We love introducing our friends to one another. Daughters Unite meet Daughterhood. Founder, Anne Tumlinson has spent the last two decades working on improving how America cares for its frailest, most vulnerable older adults. Check out – www.daughterhood.org.

THINK ABOUT IT.

What if there was one trusted place where you were heard, where you were understood, where you were validated, where you were supported and where you could immediately get answers to the never ending questions that come up  when caring for an aging parent or other disabled adult loved one?

 

Direct Message Us on FB, Twitter & Instagram

Email us @ info@daughtersunite.com

Twitter: @DaughtersUnite

Commencement Remarks to the Touro College School of Health Science 2016 Graduates offered by Phyllis on September 13, 2016.

Graduates in Cap and Gown
Graduates in Cap and Gown — Image by © Royalty-Free/Corbis

 

Dean Primavera, distinguished faculty, honored guests, proud parents and family and my newly graduated colleagues…

I want to begin my guidance to you this afternoon by reminding all of you of just how unique and wonderful you all are. You see many people care capable to feel empathy for someone given the right circumstances. It is the rare few that cannot feel something when the news is filled with stories of the survivors of an earthquake or a picture of a five year old stunned by the events of war.

But it is the rare soul that can mobilize their empathy and compassionate nature into the action we call caregiving; and even fewer that take it on as their life’s work. Serving your fellow man, woman or child is the highest form of generosity I know and you have all chosen this Path.

So I would like to offer you three steps to take to ensure that you stay connected to the beautiful mission that you have accepted:

First: Create a place for stillness in your daily life.

                Professional caregivers are perpetual doers. The only way to balance continuous doing is to stop and be still. The goal of stillness is to free you from the endless loop of thoughts in your head and encourage you to be more in your body. Simple exercises such as mindful-breathing can offer you an opportunity to pause and rest in a peaceful place. The answer to many of the questions that you will be asking yourself over the next twenty-five years lie in that wonderful silent, still place. Find the simple things in life that can offer you a momentary rest from the noise in your head.

Second: Allow others to care for you.

                Suggesting to a professional caregiver that they may need to be cared for is often offensive to them. Caregivers see themselves as strong, indispensable and indestructible. When I suggest that someone may need caring for, it is often thought that I am suggesting that they are weak or even damaged. Self-care is an act of generosity not selfishness. Self-care allows you to stay available to serve. Taking good care of yourself keeps you connected to your compassionate nature longer and in a more authentic manner.

I often hear professional caregivers explain to me how they take care of themselves and indeed, that is the issue and my point. Taking care of yourself does not let you receive care. Allowing yourself to receive is vital. It is in the receiving of care from another, either through friendship, love, massage, reiki, or delegation of responsibility, that our spirits are renewed, reconnected and refreshed.

Finally: Develop you emotional intelligence.

We are at a time in our industry and professions where knowledge and skills are not enough. Gone are the days of accepting that someone is great at what they do but no one can stand to work with them. The days condoning of ego-dominated behaviors are numbered.

Emotional intelligence has not been stressed in healthcare largely due to the fact that we have been trying to figure out a way to survive.  We have been trying to find a model of care and understand how we are going to pay for that model since 1984 with the break from the fee-for-service structure. We are now fairly clear on a model of care and how it will be financed. It is time to turn our attention to mastering the four skills of emotional intelligence: self-awareness, self-management, social-awareness and relationship-management. We need to master these behavioral expectations in the same manner that our non-healthcare professional colleagues are held accountable to do.

Solid emotional intelligence skills are tools for reducing the risk of compassion fatigue and reducing the prevalence of bullying and incivility in our professions. If we do not redirect our attention to these essential “soft-skills”, we will have no chance of creating a true, interdisciplinary model of care that is patient-centered and humane. We will continue to lose the best of us to venues of practice other than the bedside where we need the best most.

In closing, may you never forget that the Universe only asked a very few of us to devote our lives to the service of others…and you said yes. Blessings and congratulations Class of 2016.

 

An Interview with Phyllis

Originally featured in Women of Distinction Magazine: September 8, 2016

http://go.epublish4me.com/ebook/ebook?id=10090395#/0

High Resonance Healing Words
Healer’s outstretched open hand surrounded by random wise healing words on a rustic stone effect background

Q&A

Q: A good deal of your coaching practice is centered on working with family caregivers. What are some of the challenges facing family caregivers today?

A: Their biggest challenge is to have a life of their own while caring full time for their loved one and not self-destruct in the process. I think it is so important to remember that in most cases, family caregivers never saw this responsibility coming. They didn’t go to school to learn how to be caregivers. They did not make a conscious decision to make a career in caregiving. They responded to a life-changing event, which usually involved a spouse, parent or child. They made the significant changes necessary to be fully present and care for that person. That is not only love and loyalty in action; it is the highest form of generosity. By in large, family caregivers go it alone. What community resources were available are now all but gone since the economic downturn of 2007. So my work with these clients is centered on finding ways to meet their self-care needs and in identifying ways to seek assistance. I am a huge proponent of the care model put forth by The Share the Care Organization. This not-for-profit organization conducts training programs to teach professional and family caregivers how to set up care circles. We usually have a group of friends and neighbors who would like to help but are not capable of rendering physical care. This care model focuses on what people can do. Perhaps you can help with marketing, lawn care, driving to doctor appointments, etc. Creating care circles allow others to help you and your loved one so that the responsibilities of your life do not become overwhelming.

Q: What is your approach to coaching?

A: My approach to coaching is to view my client as whole, competent and capable. I understand how challenging it can be to remain clear and authentic about ones goals and one self as you try to navigate your life. Responsibilities, setbacks and the demands of an adult life can overshadow a person’s understanding of the present and cloud his or her vision for the future. Our very human nature creates blind spots to options and solutions. My goal is to empower my client to access their own innate knowing and personal wisdom. I can support them as they explore where they are now, guide them in clarifying where they want to be, assist them in setting up a timeline, and support them efforts to attain their goals in a nonjudgmental manner.

Q: What is compassion fatigue?

A: It is a condition characterized by a gradual lessening of your ability to render empathic care over time. Those at risk for the development of compassion fatigue include: nurses, social workers, first responders, special education teachers, and the family caregivers of those with chronic illnesses. Symptoms include but are not limited to, a decrease in experiences of pleasure practicing a profession you once loved, a sense of relentless stress, anxiety over the thought of going to work, and a pervasive negative attitude that creeps into all areas of your life. Long term, this can have devastating effects on your work performance and relationships and life.

Q: How can you start a person along the process of recovery from compassion fatigue?

A: Caregivers have a difficult time with the idea of receiving care therefore, acknowledging that you may be experiencing compassion fatigue and seeking help is a healthy first step. Everyone’s journey to the development of the syndrome is unique so there is no such thing as one approach fits all. However, the biggest hurdle to get over is to embrace the fact that you must take just as good care of yourself as you do others. It is vital to approach caregiving from a place of fullness and not try to render care when you are fueling yourself from the fumes of your compassionate nature. The airline industry really gives the best advice. Put your own oxygen on first, and then help the other person. A big part of recovery is to incorporate an adequate rest and self-care regimen into your life. This adaptation should be seen as a treatment for compassion fatigue and as a vaccination against developing the syndrome again.

Q: Why do you recommend a regular mindful practice for caregivers?

A: People who are drawn to human services are perpetual doers. They start doing from the minute they wake up and don’t stop until they fall asleep. They only way to add a sense of balance to that approach to life is to incorporate regularly scheduled times when we are just still and breathing. Doers are always in their head thinking about what they need to do and whom they need to do it for. So taking time to just sit and breathe, so that you are more aware of being in your body rather than stuck in the endless loop of thinking, can offer a much needed break from perpetual doing.

Q: What inspired you to write your book; Rediscover the Joy of Being a Nurse?

A: As I was crisscrossing the country speaking and coaching at various nursing events, I was deeply saddened by the degree of personal pain these nurses were struggling with every day. I felt the need to try to offer some guidance to those who felt so disconnected from something that meant so much to them. The insight the book offers is not centered on anything that we learned in nursing school. Rather, it is focused on the development of three vital life skills: the ability to adapt, the ability to make and sustain relationships and the ability to be resilient. I believe that cultivating these three life skills can help nurses refocus their attention on themselves and what they need to have a content professional and personal life for the long term.

Q: What has been the most successful marketing strategy for you?

A: Developing my relationship within the social networks on LinkedIn. I have found LinkedIn to be the most professional and powerful networking medium. Everyone using this platform is serious and looking to connect with other serious individuals. Engaging on LinkedIn is a commitment of time and effort but the return on my investment has been worth it. Many of my most important opportunities have been offered to me through LinkedIn.

Teresa of Calcutta: A Life of Caring and Service

Mother Teresa Documentary

 

Life as a Young Sister

Captivated by stories of missionaries, Agnes left her family home in Skopje in 1928 at the age of 18 to join the Sisters of Loreto. “Be so kind to hear my sincere desire,” she humbly wrote to the Loreto Mother Superior. “I want to join your Society, so that one day I may become a missionary sister, and work for Jesus who died for us all.”

Needing to learn English first, the young postulant spent six weeks in Loreto Abbey in Dublin, Ireland. She set sail for India on December 1, 1928, to give her life to service.

Call within a Call

For years, Mother Teresa refused to talk about this seminal moment in her life. But worldwide interest in her “call within a call” would not diminish. Reluctantly, she spoke about it. “God was calling me to give up all and to surrender myself to him in the service of the poorest of the poor in the slums.”

The call happened on September 10, 1946, as she traveled by train from Calcutta to Darjeeling. Suddenly, a new mission presented itself. “To fail would have been to break the faith,” she said.

Relief for Calcutta’s Suffering

Mother Teresa opened wide the doors of mercy and charity for the poorest of the poor in Calcutta. It was her life’s calling—what she considered to be an order from God. Mother Teresa directed her Missionaries of Charity to serve “the hungry, the naked, the homeless, the crippled, the blind, the lepers, all those people who feel unwanted, unloved, uncared for throughout society, people who have become a burden to the society and are shunned by everyone.”

One of Mother Teresa’s deepest fears after she founded the Missionaries of Charity was that she or one of her sisters and brothers would do or say something to cause scandal or detract from the Order’s mission. In all likelihood this explains, at least in part, her reluctance to speak publicly of the interior locutions she had experienced for seven or eight months after the call within a call came on the train to Darjeeling.

Yet Teresa did cause scandal, although only after she’d been dead for a decade, and then only for a short time. In 2007, Come Be My Light, a book that collected many of her most personal and private correspondence, was published. It immediately caused sorrow and confusion in her admirers and a glee that bordered on what the Germans call schadenfreude, taking pleasure in another’s misfortune, in her detractors.

Her letters revealed that, except for one short period, Teresa had been afflicted with a deep sense of God’s absence for the last half-century of her life. Such was her unflagging dedication to the work she’d undertaken for God that most of the world was completely unsuspecting of her spiritual darkness.

On hearing the news, many Christians were confused. What did Teresa’s long stay in the spiritual wilderness mean? Was she a victim of depression? Had she lost faith in God? What gave her the inner strength to carry on even when she anguished over what she felt to be God’s abandonment of her?

Even Teresa’s closest companions in the Missionaries of Charity were bewildered. Never had she made any reference to the darkness except for an oblique reference that would’ve meant nothing to anyone but her confessors with whom she shared what she was going through. Four years before she died, she warned her sisters that “the Devil” is continuously on the prowl in order to “make you feel it is impossible that Jesus really loves you, is really cleaving to you. This is a danger for all of us.” None of them could have guessed that the remark was autobiographical.

For their part, Teresa’s detractors pointed to the revelations in Come Be My Light as evidence that Teresa was a faux-saint whose public displays of piety were hypocritical. Longtime critic Christopher Hitchens declared that the letters revealed Teresa to be a “confused old lady” who had “ceased to believe,” and whose service to others was nothing more than “part of an effort to still the misery within.” He also argued that the Catholic Church’s interpretation of Teresa’s time in the desert as a dark night of the soul was a perverse piece of marketing that sought to spin despair as faith.
A Soul in Anguish

There’s no sense in denying that Mother Teresa’s sojourn in the wilderness is disconcerting. If God can seem absent to a saint like her, what chance do the rest of us have to connect with God? It’s also quite probably true, given the nature of her work among the poorest of the poor, that at times Teresa felt psychologically depressed or burnt out. What normal person wouldn’t? But to conclude that the darkness was the result of depression, much less loss of faith, is to overlook its spiritual significance.

Psychological depression is me-centered; the depressive’s gaze is always directed inward. Teresa’s, on the other hand, was directed outward, to the God whose absence she so keenly felt. Depression renders a sufferer listless; Mother Teresa was always on the go, doing the work to which she felt God had called her. Moreover, dark periods don’t necessarily suggest a loss of faith. Instead, they are recognized in the Christian tradition as periods of great spiritual development.

Many Christian saints have recounted their own experiences of darkness in their relationships with God, but it was the sixteenth-century St. John of the Cross who wrote what’s still considered to be the best analysis of them. Not surprisingly, Mother Teresa knew his writings, and once remarked that even though John’s words made her “hunger for God,” they also expressed what for her was “the terrible feeling of being ‘unwanted’ by Him.”

For John of the Cross, the noche oscura or “dark night of the soul” is a forlorn feeling of being abandoned by God. “Both the sense and the spirit,” he writes, “as though under an immense and dark load, undergo such agony and pain that the soul would consider death a relief.” The soul suffers most from the conviction that “God has rejected it, and with abhorrence cast it into darkness.” 

But what feels like abandonment is far from it. The painful sense of being rejected by God is actually a purgation of the senses and spirit that prepares the way for an “inflow of God into the soul.” There is no set time limit for a dark night of the soul, although most do not last as long as Mother Teresa’s did. Nor does the dark night mean that the sufferer has ceased to believe in God, although intense doubts can arise.

In one of her letters, Mother Teresa writes, “In my soul I feel just that terrible pain of loss—of God not wanting me—of God not being God—of God not really existing.”8 But the occasional dreadful thought that God may be a fiction wasn’t her primary torment.

Even if Teresa had never read John of the Cross’s description of the noche oscura, she would’ve had some idea of it from her namesake, St. Thérèse de Lisieux, the Little Flower, who likewise suffered from a sense of abandonment toward the end of her short life. Thérèse wrote that “God hides, is wrapped in darkness,” and she accounted for this by arguing that the love of Christ is so overwhelming that its fullness has to be withheld from mortals, a withdrawal that naturally causes suffering.

Mother Teresa’s suffering when God hid from her was intense. From first to last, her private correspondence to her confessors attests to that. Just a few passages, representative of the whole, convey something of the loneliness into which her sense of God’s absence drove her.

The longing for God is terribly painful and yet the darkness is becoming greater.        What contradiction there is in my soul.

          —The pain within is so great…Please ask Our Lady to be my Mother in this darkness.

          The place of God in my soul is blank—There is no God in me.

          In the darkness…Lord, my God, who am I that You should forsake me?…

          The one You have thrown away as unwanted—unloved.

          I call, I cling,

          I want—and there is no One to answer—no One on

          Whom I can clin—no, No One. Alone. The darkness is so dark—and I am alone.

          Before I used to get such help & consolation from spiritual direction—from the time the work has started— nothing.

“The work” Teresa mentions in the last quotation refers, of course, to the ministry to which she was called on that providential train trip to Darjeeling. What especially bewildered and saddened her was that the darkness had descended in 1949, right when she believed she was doing precisely the work God had created her to do. Her loss of the presence of God coincided with the granting of the long-sought permission to found the order that became the Missionaries of Charity. Surely the Vatican’s approval was a sign from God that he loved her and wanted her to succeed. But it was just at that point that she felt the door slam shut. God disappeared.

There was to be but one time the door opened in her many years of darkness. Pius XII was the pontiff who gave permission to found her Order. When he died in October 1958, Archbishop Périer celebrated a requiem Mass in the Calcutta cathedral. Teresa attended, and on that same day received a respite from her forlornness. As she wrote Périer, “I prayed to [Pius] for a proof that God is pleased with the Society. There & then disappeared that long darkness, that pain of loss—of loneliness—of that strange suffering of ten years. Today my soul is filled with love.”

But in just a short time, God “thought it better for me to be in the tunnel—so He is gone again.” Teresa would endure the tunnel for the next four decades.
‘Yes to God’

As the years of darkness came and went, Mother Teresa slowly began to see them as something different from the dark night of the soul described by John of the Cross and experienced by Thérèse de Lisieux. It was, she concluded, an essential part of her vocation as a Missionary of Charity.

Even as a teenager back in Skobje, Teresa had longed to serve the poor. When she became a missionary nun, she spent her Sundays roaming the slums around the Loreto compound bringing relief to the poor. When she received the call within a call, she dedicated the rest of her life to giving the poor, the sick, the lonely, and the dying the love that the world had denied them. Moreover, she voluntarily took on their poverty as her own.

Teresa dedicated her life to this work because she believed that Christ demanded it of her. As she so often said, when she succored the poor and the sick, she ministered to Christ in his distressing disguise, the Christ who thirsted. So it was perhaps inevitable, given that she shared in the suffering of the people she served, that Teresa would eventually discern her own inner poverty as a share in the suffering of Christ himself. She remembered the oath she’d made back in 1942 never to deny God anything asked of her, and she realized that loyalty to the oath meant embracing God’s withdrawal.

“We must know exactly when we say yes to God what is in that yes. Yes means ‘I surrender,’ totally, fully, without any counting the cost.” It meant accepting whatever God gave, and giving whatever God chose to take away. And for Teresa, it meant accepting the burden of Christ’s Passion.

When she was allowed that insight into the nature of her darkness, she recognized it as an inevitable aspect of the call within a call, and would go so far as to say that she actually loved the darkness because it was “a part, a very, very small part of Jesus’ darkness & pain on earth.”


Lost and Found

Teresa’s final years were ones in which poor health and physical suffering became her daily burden. Just a few months before her death, suffering from heart failure and pneumonia, she lay in a hospital bed, unable to speak because of the bronchial tube that had been inserted to help her breathe. She tried to communicate with her caretakers by writing on slips of paper, but was too weak to do so. Finally, mustering all her strength, she was able to scrawl, “I want Jesus.” Mass was celebrated in her hospital room and she was able to take a small amount of the consecrated wine.

Those who were with her at the time believed that her request for Jesus meant that she desired the Eucharist, and that’s surely a part of what she meant to communicate. But given her decades of living without a sense of Christ’s presence, it’s not too much to conclude that she also meant she wanted the darkness of God’s withdrawal to end. She’d spent over fifty years reliving Christ’s Passion. If it was God’s will that she suffer, so be it. But she longed for it to end.

In 1962, in the second decade of her sense of abandonment, Teresa wrote something that anticipated her later understanding of her vocation to suffer the Passion of Christ, “If I ever become a saint—I will surely be one of ‘darkness.’ I will continually be absent from heaven—to light the light of those in darkness on earth.”

This is an extraordinary thing to say, because it suggests that Mother Teresa was willing to relinquish the joy of heaven for the sake of those of us who also lie awake in the night wondering where God has gone. No one would deny that the diminutive nun who served Christ in his distressing disguise for over fifty years deserved some rest. But Teresa thought otherwise. Her lifelong dedication to serving God in his people was, so far as she was concerned, only an apprenticeship for her real work after she died.

This is an excerpt from the book St. Teresa of Calcutta: Missionary, Mother, Mystic, published by Franciscan Media.