Dr. Monika Renz’s work with dying patients is unusual if not unique in the way she appropriates and applies insights from Jungian depth psychology, practices available in patients’ faith traditions, and musically guided meditation to invite and support the spiritual experiences that so often come, bidden or unbidden, near the end of life.  An experienced oncologist, Dr. Renz offers carefully amassed data to support her advocacy of focused practices of spiritual care as a dimension of palliative care, but is also quite comfortable with the fact that “neither the frequency nor the visible effects of experiences of the transcendent prove that such experience is an expression of grace” because “unverifiability is intrinsic to grace.”  Still, her long experience leads her to assert not only that “grace” can be a useful, practical, operative word for what professional caregivers may witness and mediate but also that affirmation and support of patients’ spiritual, religious, or transcendent experiences in the course of dying can amplify and multiply moments of grace, which manifest as sudden, deep peace in the very midst of pain, profound acceptance, openness to reconciliations, or significant awakenings from torpor that allow needed moments of closure with loved ones.  Describing herself as “an open-minded religious person and a practicing Christian,” she reminds readers that God is a loanword, whose basic form in Germanic was gaudam, a neutral participle.  Depending on the Indo-Germanic root, the word means “the called upon” or “the one sacrificed to . . . .”  Openness to the divine in both patients and caregivers, Dr. Renz argues, can and does make end-of-life care a shared journey of discovery and offer everyone involved a valuable reminder that medicine is practiced, always, at the threshold of mystery.


Though the book offers accounts of data-gathering and method, its greatest strength lies in the plethora of brief stories the writer compiles from her long work with patients in end-of-life care.  The writer offers them with clarity and restraint, her main purpose apparently simply to advocate more openness toward and attention to spiritual experiences—to the ways music and other arts can invite and enhance those experiences, and how acknowledging them can bring about moments of extraordinary relief and even, by some definitions, healing.  That she is Swiss, though an international speaker and teacher, means that her frame of reference lies in the Swiss healthcare system, but most of what she suggests might be creatively imported into even the busiest North American hospital by those willing to notice and support those moments of mysterious encounter that challenge—but could also complement—the constraints of empirical science.


Jessica Kingsley Publishers

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