The Problem with Angels: Confronting Racism in Hospice Care

Raffaello, 16th century, courtesy of Wikimedia

Under the daybed in my office is a large hat box full of angel-themed cards, bookmarks, and charms people have given me throughout the years, with some variation of the sweet message:  “Thank you for being my angel in my time of need.” Several of the cards are of the Precious Moments variety, blond cherubs with huge, blue eyes and outstretched hands. Others are embossed with golden outlines of trumpeting angels soaring across the card stock. Still others are abstract renderings of feminine figures, all halos and harps. I don’t look through the box often and when I do my brown hands are stark against the cards’ pearly white. After almost a decade of being a hospice chaplain, I am still uncomfortable being called an angel.  

When I was a child, my mother vehemently rejected the depictions of cherub-like angels in our illustrated Bibles and picture books. To her, beaming baby-faced angels were just plain wrong. She fussed: “Biblical angels always start their interactions with humans by saying ‘Do not be afraid.’ Do you really think folks would have been terrified of a flying baby? Come on now. Angels were fierce and imposing beings bringing life-changing messages. I assure you they were not naked, chubby-cheeked white infants.” I cannot think of angels without her exasperation playing in my head.  

“Do you really think folks would have been terrified of a flying baby? Angels were fierce and imposing beings bringing life-changing messages. I assure you they were not naked, chubby-cheeked white infants.”

Despite my mother’s correct assertions about the Bible’s frightening depictions of angels, the sweeter, cuter angel is ubiquitous in hospice work. In the popular imagination, the angel is a shorthand way of representing a good death, without actually talking about death. In our culture, where death is often seen as a failure of medicine, caregiving, or faith, even hospice workers tend to euphemize it. People don’t die; they expire, transition, pass away. Patients often want to talk about death, while loved ones are much less comfortable naming that reality. Many hospice workers choreograph elaborate dances straddling uncomfortable conversations and customer satisfaction.  Because, ultimately, the customer, the patient’s loved one, is the one who will leave the review after we have finished our work.  

As a chaplain, I get to be more cherub-like than anyone else on my hospice team of physicians, nurses, nursing aides, and social workers. I don’t have to prod or stick patients with needles. I don’t have to collect insurance information or discuss money matters. I typically don’t have to deliver difficult news. I’m there to provide support after all those things have already been done. I get to pray, anoint, listen, hold hands, and hold space. I make coffee, fluff pillows, and bring warm blankets. I sing, though not well, when my patients tell me the hymns that they love. I call every soul food restaurant in the metro Atlanta area to find chitlins for a patient’s last meal request. I have lively theological discussions about the likelihood of sex and marijuana in the afterlife with my patients who ponder such matters. Essentially, I flutter around trying to effect a sacred and meaningful death experience for both my patients and their loved ones.  

I do my work in America, and in America race complicates even the most holy and precious of moments.

But I do my work in America, and in America race complicates even the most holy and precious of moments. Hospice work is no exception. There was the time, for example, when during a routine mental orientation assessment, a Black nurse asked a dying white woman who was the president of the United States and she responded, “That nigger Obama.” And the time, just moments after a Black woman’s death, that a white nurse said the patient’s designer purse must have been stolen because she couldn’t imagine that anyone “like her” would be able to afford something so exclusive and expensive. And the countless times when I showed up in a home or hospice inpatient room and the occupants let me know through comments and body language that I wasn’t the race they expected. So how does a Black angel respond in those situations? Too often, I faltered and flew away, deceiving myself into thinking that it wouldn’t be appropriate to respond as I wanted to when someone was dying. 

How does a Black angel respond in racist situations? Too often, I faltered and flew away.

When I began my first hospice residency, I asked a spiritual director to help me develop practices to navigate the vicarious grief and burnout common in the role. I understood that I would have to be intentional about spiritual wellness while comforting the dying and grieving. I created daily rituals to affirm life while honoring death. But it wasn’t the relentless death that strained my spirit. While incomprehensible and difficult, death was often holy and beautiful, marked by startling signs and wonders. But racism was something else. No amount of contemplation, chanting, or prayer will make it holy.   

In the wake of George Floyd’s murder, a national conversation about systemic racism erupted across the nation. Black Lives Matter signs popped up on lawns throughout my neighborhood and I was called on to participate in panel after panel about the church’s faithful response to systemic racial violence and injustice. Even my email inbox filled with retailers signaling their commitment to diversity and inclusion efforts. The conversation was everywhere except for my workplace. I opened hospice agency staff meetings with litanies and prayers to address this lack. But after the “amen,” it was business as usual. And my agency wasn’t alone in this. The industry in general was largely silent on these matters. And any statements made acknowledged the problem “out there” while ignoring the racism at the deathbed.  

It wasn’t the relentless death of hospice work that strained my spirit. … No amount of contemplation, chanting, or prayer will make racist encounters holy.   

So, the question for me has become: How do you hold “angels” (and those they minister to) accountable for the ways they inflict harm? For the ways they reinforce dangerous stereotypes about people of color? For the ways they weaponize words like “difficult” and “non-compliant”? For the ways they imply that some people’s expressions of pain are drug-seeking behavior? How do you demand that they not pathologize a person’s mourning and grief rituals? How do you ask them to educate themselves about individual cultural practices? How do you explain to them the heightened importance of a dignified and peaceful death when a person has been denied peace and dignity in life?   

My box full of thank you cards haunts me, making me feel like I could have said and done so much more. Yes, I challenged hospice staff in the quietest and most passive of ways. Yes, I nudged. Yes, I told stories. Yes, I have prayed. But I didn’t want them to be afraid. I resolve to do better. The biblical angels weren’t afraid to be frightening in their holiness. They understood that they represented God and their message was sacred. I want to be holy in the same way, to reassure without blunting the truth. To bring peace, while fearlessly speaking the transformative power of God. 

The biblical angels weren’t afraid to be frightening in their holiness. They understood that they represented God and their message was sacred.

Note: This is the first essay by one of our 2021-22 Emerging Writers Program participants. Zeena Regis and four other writers will publish their work periodically on Bearings Online while working with mentors Michael N. McGregor and Sophfronia Scott. We are delighted to have such an engaged, dedicated, and interesting group of women working with us this year.

Like this post? Subscribe to have new posts sent to you by email the same day they are posted.