I paused outside her closed door to catch my breath and gather my thoughts.
I had witnessed her decline with each hospital visit, and it was obvious that the end was approaching. She knew it, too, and had requested to speak with me that day. When I sat gently on the bed, her eyes opened. Recognizing me, her eyes revealed a faint smile underneath her mask. I reached for her hand and leaned forward so we might hear each other.
She asked a series of straightforward and thoughtful questions, each one requiring her to gasp for air. In my 33 years of medical practice, I have had countless end-of-life conversations. Yet this was the first time a patient, friend, or family member asked such direct questions.
I answered her questions as clearly, honestly, and gently as possible. But something about this moment — perhaps her quiet strength in the face of imminent death, or maybe the fact that she would be missed terribly by her family, as well as by myself — moved me unexpectedly.
When I finally said, “I’m so sorry to have to tell you these things,” I began to weep.
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To my surprise, my patient grabbed my other hand and squeezed it even tighter. “It’s okay,” she said as she comforted me. “I am going to have a good death. Please prepare my family. I am ready.”
The final stages of life are often accompanied by a whirlwind of emotions — fear, sorrow, uncertainty, and even relief. The experience of guiding individuals and families through this sacred transition offers profound insights into the importance of faith. Faith is the hope which makes the terrible, bearable.
The role of faith in facing mortality
As a Christian end-of-life doctor, the conversations about mortality are not just clinical — but can be deeply spiritual. The privilege of sitting with families during this time can teach us about the critical role of faith during life’s most challenging moments.
Before entering a patient’s room, I have just asked the Holy Spirit to give me the words that I am to share. I must discern what to say, and what not to say. The simple question, “May I pray for you?” has always resulted in a yes from anxious families whose shoulders are bunched up around their ears. Tense muscles relax with the rhythm of simple prayers given as an expression of compassion. Regardless, of their faith or lack thereof, patients and families find comfort in my faith.
While medical professionals can offer pain management, symptom relief, and practical guidance, faith offers something more: a framework for understanding and accepting the inevitability of death.
Her glorious secret
My patient’s questions were related to the dying process, but her confidence was found in her death, her good death! What possible good can be found in death? Could it be that good and death are not mutually exclusive? She was genuinely peaceful as she prepared to depart this life. She seemed to possess a great secret that might benefit those she was leaving behind.
Because of God’s mercy in my own life, I knew her secret — and it was glorious. But it was not until I began to write about it that I truly learned to live her secret. This was a woman who was confident of her destination. This was a woman who lived a life anticipating Heaven.
Most people have heard the old quip, “The only certainties in life are death and taxes.” But until that heart-stopping moment when death raps loudly on the door, barges into one’s hospital room, or whispers softly from the other end of a dreaded phone call, taxes seem like the surer reality. We indulge in fallacies: “If I don’t think about death, maybe it’ll forget about me.” Or we entertain fantasies like, “I don’t have to worry about that now. I’ve at least 30, maybe even 40 years left.”
The truth is that death brings clarity to life. The more I focused on my ending, the more I lived in my present. A good death was not an event, but a lifestyle. It is a lifestyle of Anticipating Heaven which keeps our eyes eternally fixed while living fully in our present moment. Even if our moment is drenched in suffering.
This lifestyle takes practice, and it prepares us for what may come our way. It also begins to shape a life of meaning and purpose. We can experience the reality of wisdom that dying patients gain before we are dying. My patient’s glorious secret was her faith. As she approached her final breath, her peace was discovered in her confidence of Heaven. Don’t we all want to end that way?
Faith is …
When patients confront their mortality, the question of “What comes next?” becomes unavoidable. Here, faith steps in to provide answers that science cannot — answers rooted in hope, divine promise, and the assurance of an afterlife: “Now faith is confidence in what we hope for; and assurance about what we do not see” (Hebrews 11:1 NIV). Our Christian faith frames death as a gateway to eternal life, where suffering ceases, and reunion with loved ones becomes possible. Our faith can transform fear into peace, anxiety into acceptance, and despair into hope.
For those nearing the end of life, this perspective is not just comforting — it is vital. It allows them to face death with a sense of purpose, knowing that their life continues in a different, more profound way.
Navigating the emotional and spiritual turmoil
The emotional and spiritual turmoil that accompanies the final stages of life can be overwhelming. Patients often grapple with feelings of regret, unresolved conflicts, and the fear of leaving loved ones behind. Addressing emotions is as important as managing physical symptoms for the dying patient.
The Christian narrative of redemption, where no sin is too great to be forgiven, provides a pathway to reconcile with the past. This reconciliation is not just a psychological relief; it is a spiritual cleansing that prepares the soul for its next journey.
Doctors who incorporate faith into their practice often witness remarkable transformations in their patients. A person who may have been angry, fearful, or resistant to the idea of death can, through faith, reach a state of acceptance and even anticipation. They begin to see death not as a thief, but as a deliverer — ushering them into the presence of God. This shift in perspective is profound, altering not just how they face their final days, but how they live them.
The power of prayer and spiritual practices
Prayer and other spiritual practices are indispensable tools for dying patients. Whether it’s a simple prayer for peace, a reading from Scripture, or the administration of the last rites, these acts are imbued with deep meaning and significance.
Create a sacred environment for the dying. The act of praying together — whether it’s with family, clergy, or alone — can transform a hospital room into a place of worship. It reminds everyone involved that, even amid medical interventions, there is a higher power at work. This reminder is often what gives patients the courage to let go, to surrender their earthly struggles, and to trust in God’s plan.
The significance of community and support
Faith is rarely a solitary journey, especially in the final stages of life. The Christian tradition emphasizes the importance of community — of bearing one another’s burdens and providing mutual support. Pastors, lay pastors, friends, and the church family can facilitate a loving Christian community that is supportive of the patient and the family.
The role of community is shown to be vital in helping both the patient and their loved ones navigate the complexities of death. A strong community provides not just practical support, but emotional and spiritual encouragement. It helps the dying person feel less alone, knowing that they are surrounded by people who care, who pray for them, and who will remember them long after they are gone.
Moreover, the community’s role doesn’t end with the patient’s death. They understand that the grieving process is a journey, one that requires faith, patience, and the support of a loving community.
Lessons for the living
The lessons we learn as we walk our loved one’s home are for us as well. As we witness the faith and peace with which some approach death, we are reminded of the importance of nurturing our own spiritual lives.
Anticipating Heaven encourages us to view death not as an isolated event but as an integral part of life’s journey. It challenges us to consider how our faith shapes our understanding of life and death, and how it can guide us through our most difficult moments. By learning from those who face death with grace and courage, we can better prepare ourselves for our own final stages, whenever they may come.
The legacy of faith in the final stages of life
My patient’s ending words resonate with me daily. They remind us that faith is not just a comfort, but a powerful force that shapes how we live, how we die, and how we find meaning in both. In the end, it is faith that carries us through the darkest valleys, providing light, hope, and a sense of peace that transcends even death.
As we contemplate our mortality, let us draw from these lessons, embracing the journey with a heart full of faith and a spirit ready to enter the mystery of God’s eternal love.
Dr. Pamela Prince Pyle is a Board-Certified Internal Medicine physician who studied at Oklahoma State University, North Texas Health Science Center, and completed her training at Baylor University in Houston. She was one of three physicians selected in 1992 by Carolina Health Specialists (CHS) to begin the first hospital-based internal medicine practice outside of a university setting in the United States.
