The Pitt TV show is an exacting, incredibly realistic drama depicting 15 hours in a big-city emergency room.1 At times shocking in its graphic detail and at times gut-wrenching and heart-breaking in its emotional impact, it delivers a punch that lasts. This “punch” reminds us of the toll that human suffering takes on all concerned, the affected and the caregivers.
One particularly poignant episode deals with a family’s decision to withdraw life support when their father no longer can live without his breathing tube at the end of his life. The adult children are having an appropriately hard time dealing with these circumstances. The ER doctor offers some simple advice that is profound in nature and scope. He relates some counsel from a mentor to families in this situation.
For the quiet moments between family members at the end of life, he suggested a variation of the Ho’oponopono, a Hawaiian healing ritual, that expresses “I’m sorry, please forgive me, thank you, I love you” to one’s loved ones. In The Pitt episode, a variation was offered – the phrases ‘I love you,’ ‘Thank you,’ ‘I forgive you,’ and ‘Please forgive me’ are words that need to be heard when someone is at the end of their life.
Let’s pause and consider each of those phrases –
- “I love you” – this simple phrase, repeated often amongst family members, is so impactful.Those three words (a pronoun, a verb, a pronoun) require the meaningful expression of emotions directed to a loved one, in an empathetic way. When discussing love, I am always reminded of Bishop Michael Curry’s discussion about love and the opposite of love. He posits that the opposite of love is not hate.2,3 The opposite of love is selfishness, and selfishness is “a life completely centered on the self.” He further notes that “life becomes a living lie…[and that] selfishness is the most destructive force in all the cosmos, and hate is its only symptom.” He later equates faith as another word for trust, the antithesis of selfish actions. By understanding the opposite of love, I think we can better understand love itself. The selflessness of love reminds of embracing our loved ones and recognizing them above ourselves in words and deeds. How honorable to honestly tell our loved ones that “I love you” in our last exchanges. Those words glorify their mortal existence and provide promise for the future.
- “Thank you” – When we look back over the lives of our loved ones, how often have to told them that we really appreciate the sacrifice they made on our behalf?To say “thank you” lets them know that we really do now understand their sacrifices and wish to express that understanding. One might say that it might be too little too late, but I would argue that words and their accompanying emotions do provide some solace to folks. This also simple phrase can soothe the loved ones at the end of life and remind us of our responsibility to continually thank folks for what they do to improve our lives, the lives of others and the life of our communities. “Thank you” should not be perfunctory but rather sincere with appropriate humility and vulnerability. “Thank you” is never expressed from a position of authority but rather one of modesty and deference.
- “I forgive you” – With proper reflection, one can always realize that some things that occurred during the life of our loved ones offended us in some ways.We took umbrage to a few or many things that they might not have even recognized. Or perhaps they did acknowledge that they wronged you and did not apologize to the degree that you thought was sufficient. Well, it is now time to approach forgiveness in earnest, accept our common humanity and remember that our emotions often get in the way.4 Expressing one’s love to our dying loved one should be led by forgiveness for past transgressions.
- “Please forgive me” – We cannot fully express our love at the end of life without asking for forgiveness.By acknowledging our own transgressions, we are providing comfort to our loved one and using this experience (the passing of a loved one) to become better people ourselves. We are using the beauty of life and the natural pain of death to be more impactful for ourselves and our family going forward. I cannot think of a better way to honor them.
On a personal note, I was not able to use this healing ritual for my parents who both passed away in different places at different times. In retrospect, I can see how my parents and I could have benefitted from this process and how I could have benefitted going forward. Life is full of many tough lessons, especially when encountering end-of-life moments with loved ones.
“I love you,” “Thank you,” “I forgive you,” and “Please forgive me” are four phrases that are exquisitely plain yet say so much. The awkwardness of death can interfere with their transmission but let’s not be so impaired. Let’s heal our loved ones as they depart and ourselves going forward. We have the opportunity to use these blessings of life, at the moments of death, to exalt their memory and so honor them and their lives.
- https://en.wikipedia.org/wiki/The_Pitt
- Curry M. Love is the Way: Holding on to Hope in Troubling Times. Avery, 2020. 272 pp.