"Why am I still here?" Jan cried out from her wheelchair in the corner of the dining room. She repeated herself, sharper this time, in case anyone was confused: "Why am I still alive?"

The room went quiet, and I could feel every eye on me, waiting to see how I'd answer.

This was my second visit with Jan. In our first visit she told me about the thirty years she spent walking babies into the world, night shifts in the labor and delivery unit, then home by morning to raise her own three kids. Nothing but good memories that day.

But a lot had changed for Jan in the last month. Her quality of life had been slipping, week by week.

Still, I was caught off guard. It was almost like she'd had the question loaded, just waiting for me to walk in.

Matthew is a Catholic monk in his eighties, a religious scholar who has spent decades in centered prayer, contemplation, and solitude. He came to this monastery at eighteen, fresh out of high school, and never left. He's been my hospice patient a few weeks now, one of five retired monks living out their days in a wing the order converted for hospice care, inside walls built for something older and holier.

He met me in the doorway, hunched hard over a cane built for a man a foot taller than him, one hand braced against the frame. But that smile of his took up more of his face than a frame that small should have allowed.

"How are you feeling today, Matthew?"

He didn't answer right away. "Tired," he finally said. "But blessed. Blessed for a man my age who still gets to complain about being tired."

"Dad is seeing ghosts. What does this mean?"

The text came in before I'd taken my first sip of coffee, and I already knew what it meant. I didn't want to be the one to say it over text, so I wrote back, "We might be getting close. Can I come by?"

"Yes."

I drove out to the trailer park by the river, the one with no trees and no flowers in the yards, and parked next to Jim's old Ford, the one that hadn't moved in years. I let myself in through the screened patio he built with his own hands, the same patio where he used to tell me about his life. Builder. Mechanic. Digger. Truck driver. Electrician. I lost count of the jobs somewhere around six. A man who could fix anything except what was happening to him now.

Kathy was glowing.

I noticed it from forty feet away, before I even reached her table.

Some mornings I get a pull toward a name on my caseload, and I can't explain it. No report, no reason. Just a need to go. That's what brought me to her memory care unit today.

"Kathy! Hello! Good to see you!" I turned on my biggest smile, the one I save for her.

Her dementia has taken most of her words. What's left, the charts call "word salad." I've never liked that term.

I've been visiting Kathy for over a year now, long enough to learn how to hear her anyway. Before the dementia she was known for her quick wit and a laugh that filled a room.

She has outlived most of her family. Even her children are senior citizens now. She's lived here five years, since she could no longer care for herself.

"It's mom. She's taken a turn and not doing well. Can you come?"

I was off that day, and my work phone was supposed to be off too. It never is. Not because I plan on answering everything that comes through at all hours, but in case a message like this one shows up, and I need to.

I had been visiting this family for about a year. Every visit started and ended with a hug, the kind that happens naturally once you've spent enough time with people to stop being a visitor.

I texted back: "I'm sorry to hear this. I'm off today but I can come by tomorrow."

"Okay," she replied. "If she is still here."

My heart dropped. I'd been with Carol only a few days earlier, telling silly jokes, admiring her latest diamond art project. I had no idea she'd declined this fast.

Trash caught in the shrubs by the entrance. My heart sank a little before I even reached the door.

Inside, the lobby smelled like urine. I hadn't even reached the unit yet.

I sat by a small glass window and waited for someone to buzz me in. A young staff member finally came, read my badge, and gave me a short, flat look. She didn't say anything. She didn't have to.

I found the locked door at the end of the hall, entered the code, and the lock clicked open.

The day room was full. Wheelchairs everywhere, some cradling baby dolls, others stuffed animals held like they were real. A small group played a game at a table with the only staff member I could find. I didn't see my patient anywhere, so I walked over and asked for help.

"How do you handle all the death and dying?"

People ask me this more than anything else. Young chaplain me used to wonder the same thing, quietly, on the drive home some nights. I have an answer now, and it still catches people off guard: most of the deaths I witness are not the tragedy everyone braces for. There is no wailing. No suffering. There is reminiscing, life's most cherished moments told one more time. There is gratitude, the kind that surprises even the person feeling it. There is a closeness to God I have never found anywhere else, right where the veil between life and death goes thin.

Jane taught me that better than almost anyone.

I met her in an assisted living facility a few days before she died. Her room was small and full of her, photographs crowding every flat surface, a quilt someone had clearly made by hand folded at the foot of the bed. Afternoon light came through the blinds in stripes across the covers. She had been a young widow, left to raise two children alone after her husband Gary died overseas. She told me how, in the worst of that grief, God had promised her He would take care of her and her children.

Evelyn looks nothing like someone who is dying.

She is bright-eyed, quick with a laugh, always dressed like she is expecting company. She joins card games in the sunroom, sings along at music hour, and keeps a running tally of who is winning at bingo. On paper she is on hospice. You would never know it.

I visit her every couple of weeks at the memory care facility that has become her home. To me she is the woman who grew up on a Midwest farm with three brothers and three sisters, who chased chickens and rode tractors with her dad and once found barn kittens in her school lunch pail. She is not religious in any formal way, but she loves talking about God the way a neighbor might speak of an old friend they have not seen in years but still think about fondly.

The pager went off right after dinner with my family.

I looked down: 66-year-old male, motorcycle accident, life flight.

I kissed my family goodbye and drove.

The charge nurse met me at the ED doors. "Sounds bad. Unresponsive at the scene. CPR, epi, he has a pulse now but nonresponsive. Helicopter should be landing any minute. Family might be on the way."

"Good thing you are here, Chaplain."

I headed to the lobby and scanned a roomful of worried faces. I did not even have a name yet. He was still a John Doe. I asked the desk if anyone had come in for a motorcycle accident. A young woman stood up immediately.

"I am Sandy. My uncle Tom. Is he okay?"

I took her to the family room, closed the door, offered tissues, and told her what little I knew. He was being life-flighted in. I would update her the moment I knew anything. Was there anyone she needed to call?

I was recently called to the bedside of a man who was actively dying. At admission to hospice, he had declined a chaplain outright. He wasn't religious, he said, and he wanted nothing to do with spiritual care. All I really knew was that he was struggling to let go, and his daughter hoped I might be able to help.

These moments come more often than you'd think. The details change, but the ache is familiar: someone hanging on, tethered by unfinished business. I never know quite what I'll find, so I simply show up, open, and listen.

I arrived at his daughter's well-kept home, filled with antiques and stories. It had been gently transformed into a makeshift hospice room. Hospital bed in the front living room. Walker and wheelchair tucked to the side. The ever-present bedside commode standing sentinel.

I met her in a quiet corner of the nursing home. The staff adored her, but when hospice arrived she immediately waved off any offer to see a chaplain. “Not religious,” she said with finality.

Fair enough.

Then the difficult days came. Pain clawed at her body and the reality of her situation pressed in. A nurse gently asked again if she would talk to someone. “Just to talk,” she said. “No religion.” The woman sighed deeply and agreed.

I walked in expecting the classic skeptic, sharp and closed off. Instead I met a brilliant physicist whose research had taken her around the world. No children. Never married. She had lived alone most of her life, yet the staff clearly loved her like family.

When I sat down she looked at me with tired but curious eyes and said, “I believe in God actually. Just not the church version.”

Some weeks just feel heavier than others.

This week I caught myself walking around numb. Not sad, not angry, just numb. That is usually my first clue that I have racked up too much grief debt.

Grief debt is what happens when life keeps handing you losses and you keep telling yourself you will process them later. The emotions pile up quietly like laundry you swear you are going to fold. Eventually the pile gets big enough that it starts tripping you when you walk through the room.

When the numbness shows up I have learned to run through a simple four step process that helps me start digging out.

First I notice it.

I just admit something is there. No fixing, no judgment, just awareness.

Second I name it.

I try to get specific. Underneath my numbness this week was sadness. A few patients I had grown attached to had died recently and a close friend had just lost his wife. Three smaller losses had quietly combined forces and hit me like one big one. Turns out my heart was keeping better count than my head was.

Some mornings hit different before I even leave the house. That day started with a flood of messages, but one line stopped me cold: “Decline. Daily nursing visits. Family has been notified and is coping.”

I had to get there before it was too late.

On our previous visit, when I told him I’d see him again the next week, he looked at me with that half-joking, half-desperate smile and said, “You promise, right?”

I never make promises in this work. It’s one of my rules. But in that moment I held his hand, looked him in the eyes, and said yes anyway. This man has endured a brutally hard life with almost no one in his corner. I had grown genuinely fond of him. So I rearranged my whole morning and made him my first stop.

The facility smelled exactly like I remembered, thick and institutional. I found him half-propped in bed, legs dangling off the side, nothing but skin and bones, his face tight with pain. I tried adjusting him for comfort but this was as good as it was going to get. So I sat down, took his cold hands, and simply said hello.