He maketh me to lie down in green pastures. He leadeth me beside still waters.

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In May, my mother-in-law, Joy Ellsworth, had had enough with a pain in her right side and finally agreed with our urging her to go to the hospital emergency room. Despite the fact that her primary care physician had been encouraging Joy for some time to do just that, Joy’s style was to call the provider’s office, schedule an appointment and make her complaints in person, apparently assuming that eventually blood and urine tests would sufficiently inform the doctor as to what might be source of her discomfort and pain.

Joy at age 81 was being treated for diabetes, was legally blind; possessed of vision only out of the corner of one eye and dealing with intestinal problems she might have assumed to be an irritable bowel syndrome or something else manageable with medication. An extremely stoic personality when it came to her health and privacy issues, Joy tended to long-suffering rather than open herself up to an assortment of medical tests and explorations. She seemed quite ready at the drop of a hat to pooh pooh the notion that she might be seriously in need of more dramatic medical attention and that her ability to endure discomfort had worked for her long enough to cause her to attempt to ignore her condition despite warning signs.

What the medical provider knew in terms of Joy’s complaints, was that appointments, blood and urine tests were not going to provide a solution so long as Joy could “manage” her discomfort and avoid learning anything catastrophic about her health.

We were in the hospital Emergency Room for more than 8 hours. During that time a sequence of medical tests and examinations were run including scans, an EKG and x-rays. None of the tests indicated a cause of the unremitting pain in her right side just below her rib cage  …. until the last exam, an ultrasound. The result of the ultra sound revealed a growth on her liver and a suspicion that required a biopsy.

Based on the tests, all signs pointed to liver cancer.

In June the results were in, the diagnosis was stage 4 cancer in the liver, bile ducts and lymph nodes. The only question was the origination point from which the cancer had metastasized. It had not begun in the liver and eventually the conclusion was reached that the start point was somewhere near the connection between the stomach and the large intestine.

Joy was referred to an oncologist. By this time, my wife’s siblings had been fully apprised of Joy’s condition and its implications.

My perception of Joy’s stoically heroic or heroically stoic (makes no difference) way of expressing herself about her life, her fears, her expectations, is that the stoicism was part of a larger self-presentation that tended in a narcissistic direction. For years Lietta and I had discussed the seemingly over-arching  concern Joy exhibited in terms of how she was perceived – by everyone – and not just immediate family. Particularly after she became a widow, her need to portray herself in a spot-lighted way became more pronounced.

Lietta and I had arguments about how we ought to manage our interactions with Joy in an open and honest manner, given Joy’s tendency to act as if she were constantly on stage and in front of an audience. On more than one occasion, I found myself caught in a three-way conversation with Lietta and Joy in which I was obviously the audience Joy was speaking to even though her interaction was with Lietta her daughter.


The rest of what I write is entirely my opinion and judgement based on my observance of events, behaviors and listening to dialogues between Joy and others.

Once having become aware of Joy’s “performance” and “audience-minded” way of speaking to individuals when other people were present, it became somewhat of a challenge to hold an honest conversation with a mother-in-law who treated everyone in the same self-interested way: she only told you what she wanted you to know … and nothing more.

Under the diagnosis of a terminal illness, Joy could no longer reveal to you only what she wanted you to know. We all knew what Joy knew and had confirmed with her medical providers: she was dying and her condition was not fixable.

Remaining heroically stoic, she rejected the idea of chemo or radiation therapy if such could not hold out a promise of more than six months assuming therapeutic success. Remarkably poised about not wanting unnecessary physical distress and adamant in seeking to preserve her dignity in dying, Joy signed documentation requesting non-heroic measures in treating her condition and agreed to accept hospice care when the time came.

She wanted to die at home, planned to do so and hoped to do it by falling asleep and not waking up.

At the outset, stunned family members flocked to her home almost en masse – which was great for raising her spirits but also harmful in draining her strength and energy.

Lietta and I – next door to Joy’s home – experienced a sense of being somewhat suddenly pushed aside as her children and grandchildren arrived to see mother and grandmother one more time; to “be there” for Mom or Grandmother, and what appeared to be an attempt to one more time act out a previous time when Joy had hosted and presided over a Thanksgiving or Christmas celebration.

Only this time, Joy was in a recliner, breathing through a tube connected to an oxygen machine via a 25 foot rubber tube and doing her best to be the hostess with the mostess.
The visits simultaneously raised her spirits and drained her strength, requiring that she frequently retire to her bed to sleep while the celebration continued. That’s the way she wanted it to be.

For Lietta and I, the two years of Joy’s life in Spokane, during which time we had witnessed the onset of her declining health which was kind of offset by a greater frequency of intimate interactions in private meals, movies, long drives, a seemingly endless array of rummage and craft sales during the autumn months of both years, shopping (including dropping her off at a store and leaving her to leisurely push a cart through an entire Fred Meyer’s, Target, Shopko, Burlington stores. There were church visits,  shared meals at home, Red Hats meetings and visits to several senior centers, church services at the Episcopal cathedral, the Methodist, Lutheran and U.U. churches.

All that came to an abrupt end as Joy became temporarily lost in all the family affection that surrounded her.

The decline in her health was surprisingly rapid. The arrival and departure of family members eventually trickled down to her four adult children. Then a time came when they needed to return home to take care of their own affairs – all the time promising and intending to return for the final scene.

On Sunday, August 13th, Lietta and I inherited the care and keeping of Joy who by that time was almost entirely sleeping her way through each day. On Monday we helped her walk to the living room to her chair after she awoke. After a few hours, she was ready to return to her bed, but her strength had failed her and she was unable to stand or walk. Lietta called hospice and ordered a wheel chair which was delivered that afternoon. We managed to return Joy to her bed. She did not leave that bed again.

By Wednesday, after emotional episodes with Joy who was in and out of coherency,  Lietta and I had concluded that Joy was more than likely not going to be able to pass in her home in her sleep. We contacted the hospice folks who were of the same mind.

She was taken to a hospice facility in North Spokane where adequate care was given and skilled nursing immediately available on a constant basis. Lietta’s brother flew in from Arizona to be with his mother at the end.

Friday morning, we gathered around Joy’s bed, Lietta tearful and bearing up with a courage I cannot measure. Joy was lying on her side, seemly asleep or unconscious, her death rattle already sounding. The hospice chaplain was miles away and not scheduled to visit until the afternoon.

Never taking her eyes off her mother, Lietta asked me to read scripture. I read The Lord’s Prayer verse by verse with Lietta repeating after me and speaking to Joy. When we were finished I started into the 23rd Psalm (the Lord is My Shepherd).

“He maketh me to lie down in green pastures. He leadeth me beside still waters.”

At some point, when Lietta was repeating a phrase I had just read, Joy opened her eyes, looked directly into Lietta’s face for a few last fleeting moments and then closed her eyes again.

I did not see her breathe again. Lietta called for the nurse who confirmed Joy’s passing.

The last mortal vision Joy saw was that of her oldest daughter attending her until the final moment.


I have no idea how long it will be until Lietta is fully at peace with her mother’s passing. She is tormented by a sense of regret at her perception of how hard and harshly she treated her mother in encouraging her to perform the necessary self-care, seek the necessary training and information regarding blindness, diabetes, pain management, not to mention the household chores Joy could manage in maintaining her domestic independence.

Lietta says she badly wants a do-over, believing that in encouraging her Mom to do as much self-care as possible, she (Lietta) gave up her desired role as a daughter and unwillingly became a care-giver in the absence of professionals to whom Joy would not give attention.

I’ve witnessed her sense of loss and the greater sense of alienation from some members of her own family who have misread and misunderstood the actions she took in asking her mother and the rest of her family to take the illnesses seriously; who expected them to be able and willing to prepare for that time when the finality of Joy’s mortality was  unavoidable.

I see her pain daily.

I weep for her weeping, and grieve for her grieving. She has become over the past month, a monument to personal courage, grace under fire and her own fierce and unyielding commitment to the honoring of a life and integrity of dying.

Arguments and Illness

Is what made me ill what afflicted you too?
Have you been where I’ve been, do you do what I do?
Is all illness a blight with but one common source
and the consequence meted to all in its course?
Does affliction with symptoms reflecting dis-ease
and the payment of pain and discomfort to tease

come upon us in ways quite the same unto all
with a sense that the sickness is blind in its fall?
Illness doth strike in dis-similar ways
tho the same by its label, it’s impact quite plays
different tunes in each person whose lives aren’t the same,
who’s choices are moves in life’s ongoing game.

Disagreement is sickness that’s blind in its prime
like disease, lack of harmony lives for a time
between souls in dispute who do struggle to win
what’s perceived as a victory though small as a pin.
We will learn by our feelings when we disagree
and find understanding to greater degree

in knowing our opposites, how we compare
when agreement is wanting or even quite rare.
If I know where you stand and the place is amiss
in my own set of values, your thoughts are not bliss.
They’re in contrast and emphasize clearly a split
in our thinking, reflecting that all does not fit

in a tidy container where values are set
in a limit of rightness or wrongness, but let
Mother Wisdom come forth in her powerful gown
of perception that differences don’t mean we drown
in a sea of our discord where winning is king
but where learning brings harmony, living and being.

© 2000 Arthur Ruger

21st-Century Parenting, church, goodness and personal virtue

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What is it that draws people to religion?

We hear contemporary couples with young children expressing the idea that if church is to be part of family life, they want to find one that teaches lots of goodness morality and a lot less about a judgmental and punitive god that expects the same from believers.

Some of these couples have not set foot in a church since they themselves were children. Other folks come to churches seeking an alternative to spiritual and psychological attitudes that have not served them well. Some are drawn to religion and to churches after some sort of personal trauma or loss, seeking answers to questions to which they’d never given conscious prior attention.

There are also those who seek an opportunity to teach families and children in particular about giving service, expecting that the social circle within a church congregation will provide that opportunity as well as one for greater social contact and interaction. Opportunities to give service in contexts other than church congregations are abundant and I would not suggest that the primary appeal of religion is an opportunity to perform some good work in a formalized moral setting.

Just what is it that our church congregations offer in their communities – and does that offering have a real potential of satisfying the needs or hungers of those looking through the doors and windows?

The enduring power of religion is not as a social club. Rather, it lies in the realm of the needs for meaning and purpose in living. The venue in life that seems to require endurance is more in the perceptive realm of mind and spirit and is not better countered by an approach of moralizing and exhortation to conscious believing with strict conformity to tradition and doctrine.

When our non-physiological internal hungers flare up, the void to be filled is not satisfied by lasagna, a hot bath or a good night’s sleep. These hungers generate not a weakness in body, but a powerful uneasiness or restlessness with life.

Often we think we are just worried about things, wanting things we don’t have, dissatisfied with work, with marriage, with friends, our community, the economy or even our favorite pro team that’s never going to win a championship.

We may even mislabel internal spiritual restlessness as being the above those particular kinds of dis-satisfactions or perhaps as something worse, some sort of depression. TV ads now tempt us to a kind of self-diagnosis where we are encouraged to take a predisposition toward depression to a medical provider in hopes of a prescription of the advertised “feel-better-medicine.”

Religion ought to hold out the possibility to the internally restless that there is something available that fills the void – something more than just Sunday worship, potluck suppers, and cliched generalities around believing.  It should be no surprise that a hunger for something more powerful arouses not just laity, but the clergy as well.

If being spiritual  means more than just going through weekly motions and repeating worn out slogans then what ought to be offered is something responsive to that internal hunger, what Alan Watts called a “non-verbal experience of the divine.” However, such an objective currently seems out of place. In Watts’ words (written in 1947 but absolutely true today), “The Church is still overwhelmingly didactic and verbose.”

The power behind our beliefs is not our ability to become educated in what scripture SAYS, thereby permitting us opportunities to publicly display how well we can read or memorize famous verses. Power lies in what scripture, prayer, tradition and reason prompt within and I’m not talking about being prompted to obey, conform and donate.

The non-verbal experience of the divine lies within the potential of every spiritual congregation but remains somewhat elusive – even perhaps hidden. The more common emphasis seems to be more on social behavior and an effort to cause or resist change by religious rhetoric.

What about a belief system that acknowledges the mystical in our psychologies of perception? Working in a mystical venue has always been a part of living. Farmers plant corn because in their minds eye they see a field of ripe corn. Buildings are constructed because an architect visualized in his mind what he later designed on paper. Meals are prepared from scratch by mothers who know recipes by heart, bring together separate materials and turn them into tasty and satisfying dishes. What is visualized internally is the source of what is created externally.

Martin Buber, referring to a non-verbal experience of the divine, wrote,

“God is the mysterium tremendum that appears and overthrows, but he is also the mystery of the self-evident, nearer to me than my I.”

That which we have labeled “mystical” is in reality a part of most everything we ourselves create and accomplish. Can we not truly say that the Mysterium Tremendum is the ultimate end we seek in actively involving ourselves in a spiritual life?

Without a mystical sense and approach to both worship and daily living, do our congregations busy themselves as social clubs more concerned about public opinion and conformity, perceiving themselves as an island surrounded by a sea of hostile, stupid or indifferent waters?

So long as our active participation is limited to a purely social venue where participation is mentally easy, almost a lazy alternative to a personal pursuit of the kind of intimacy with God portrayed by Jesus, we will go through life running the risk of doing what we do out of social habit.

Perhaps even worse, we will ultimately suffer a church-social burnout.

Clergy – all ministers – ought to openly seek a growth of independence from themselves within their congregations. Publicly telling God what to do and the people how to behave is a poor substitute for teaching and modeling spiritual independence and spiritual self-sustenance.

Telling congregations that “God has a plan for you!” Followed by some behavioral and ritual formula by which a pleased God then activates some ephemeral plan for you and your loved ones, you are invited to enter into a literalistic interpretation of a religious reality that has very little to do with the reality defined by our own intuitively activated senses.



To give with pain brings its own reward
for virtue seems won when the giving is hard.
A baptism cult-like that glory’s the pain,
pretending to goodness, but virtue will stain
and baptize with fire til a pride takes the place
where virtue once dwelt but leaves only a trace.
Find someone who gives yet does not feel a pain
who seeks not self-virtue as purchased like gain,
but gives of his wealth without virtue in mind
but for goodness, from goodness — with no debt to bind.

Arthur Ruger © 2000