A Still, Small Voice

He is well known to all of us at the hospital, but today he looks different. It has only been a few weeks since we saw him last. His face is fallen, his usual smile stifled by the pain and breathlessness resulting from the massive amount of fluid pushing up against his diaphragm. His eyes are a pale yellow, the sign of an overworked and failing liver unable to clear the icteric substance from his body. His lungs are tired, prompting frequent rests to catch his breath as he walks supporting his body with one hand against the wall. His stomach protrudes, the tension of the fluid against his skin notable from his shirt which is no longer large enough to cover his entire abdomen. His legs are swollen and heavy, each step forward a pace backward for his heart which struggles to keep up with the unyielding demands of his body. His blood pressure is lower than usual, a sign that his kidneys, too, are losing control in a whirlwind of irreversible hormone imbalances. A violent bodily storm signals this man’s earthly life is coming to its end.

“Then a violent wind came that ripped through the mountain, 

shattering everything in its wake. After that came an earthquake. Then a fire.”

The past year brought with it a windstorm of outpatient visits for weight checks, changes in medication dosing, extensive counseling, and regular blood tests. It was accompanied by innumerable emergency room visits to remove about five liters of fluid from his abdomen when the fluid built up too much to breathe or walk. There were also the frequent hospitalizations for the occasional aftershocks- delicate blood pressures after removing fluid, the need for careful adjustments of his diuretics, and suspected abdominal infections. With the severity of his illness and the lack of available treatment options, each visit was a reminder that we were one step closer to this inevitable moment, the extinguishing of a slowly burning fire.

“The Lord was not in the windstorm. Or the earthquake. 

And he was not in the fire.”

It is a calm Sunday and I am walking back from the hospital kitchen after eating lunch. Though I usually walk up to the house after lunch, I hear a still, small Voice tell me to go check on him. We recently decided to pursue palliative care measures after quickly realizing his body would not rebound from this final insult. We hope to alleviate his suffering as he nears death. As I slowly and quietly approach his hospital bed I am taken aback by the emptiness of his surroundings. It was habitual to see him walk, fight, recover, and rest alone along this journey of suffering, never a family member or friend at his bedside. It never occurred to me, however, that he would die alone as well. I wonder if he ever felt abandoned by the One who was never apparently present in the windstorm, in the earthquake, or in the fire.

“But after the fire…there came a still, small Voice, a tiny whispering sound.”

As he breathes his last breaths his eyes lock with mine and his arm reaches out to grab my shoulder. In his silent, wordless gestures I hear a still, small Voice say, “thank you.” And in an instant that seems to last much longer, I realize that all of this time he was never truly alone. His “thank you” brings to light all of the people who accompanied him and sustained him through this arduous journey: the nursing technicians who administered his medicines and helped him to the restroom, the cooks who prepared and served his three daily meals, the custodial staff who routinely changed his sheets and swept the floor near his bed, the lab technicians who regularly drew and analyzed his blood, the maintenance staff who handled and disposed of the large amounts of fluid we drained from his abdomen, and the priest and sisters who ensured his receipt of the Sacraments as spiritual nourishment. We all knew him by name though One larger than himself lay hidden behind the skin and bones of his tangible human body. And while accompanying him in the final moments of his life I saw the gentle face and heard the still, small voice of the One who had always been truly present within him.

“Out of these fires, we need to listen for that still small Voice. God is calling to us now, even if it sounds like only a whisper. In times like this we realize life is precious, but life is also fragile. What we have, we could lose in an instant. So, we should live for God, enjoy every moment, and never take anyone or anything in our lives for granted.”

~ Quoted inserts from: Archbishop José Gomez