By Markus Starklauf
Patient: female, born 1972
Diagnosis: metastatic colon cancer
After a short stay on the palliative ward she is cared for at home by her parents and friends.
Bianca had decided that her son should live with his father so he would not have to witness her dying. In a team meeting, the physicians and nurses ask the chaplain to visit her at home. Very quickly the conversation turns to Felix, guilt and the fear that nobody could forgive her for leaving her child behind.
Bianca also wants to know what comes after death, but she does not want easy answers. Starklauf offers to speak not from certainty, but from what he believes and hopes. He tells biographical stories of people who loved him unconditionally and helped him experience God as one who accompanies human beings.
He also recalls a ritual from his grandmother: every morning before school she marked a cross on his forehead with the words “God protect you, my boy.” Bianca asks him to do the same for her. He sits at her side, slowly traces a cross on her forehead and says, “God protect you, Frau P.”
The next day the team receives two messages: relatives say the conversation may have upset her because she cried afterward, and later they hear that Bianca has died. The discussion notes that relatives’ loving desire to protect a patient can sometimes make palliative care more difficult. In this case, the conversation and the tears were necessary.
The article reflects on spiritual care: it must happen at eye level, never from above or in a missionary mode. Rituals from church tradition can be meaningful, but individual biographies often call for creative, situational forms. Spiritual care responds to total care and to the social, psychological and spiritual pain described by Cicely Saunders.
