The Liminal Space of Palliative Care – Karen Freeman Worstell


I am learning the role of chaplain in a large Northwest medical center in the United Sates. It’s my second year and I am specializing in palliative care – that time and season of life after receiving a life-limiting diagnosis.

I’m discovering that it can be a time of intense beauty. A time only equalled by those moments of release when we learn to seize a moment in time, even while we let go of matter and matters that  simply are no longer as important as they once were. One could perhaps call these, “last second” moments. My father used to say, “Nothing would get done if it were not for the last second!”  I thought he was speaking of my school deadlines.

The time spent in palliative care can also be called “liminal space” time.  The “event horizon” may be near or far, but it is real and undeniable.  It is a gift, really, to have a deadline, even a Final One,  as it tends to sharpen our focus.  In some ways, living with that knowledge of the deadline helps to put fear in perspective.  What could compare, in fact, to dealing with an existential threat that is not just probable, but has an anticipated arrival?

The closer we get to the final hours of life in this world, the more acutely aware we become of the sheer veil that separates what we have come to see as existence in this world and existence in the world beyond.  It is sacred ground – a place where eternity kisses mortality and brings it through the veil.

So many times, I have stood by and felt less a chaplain than a midwife, as the soul labors to be born into the kehillah – the gathering place –  of souls.  We have no good words for it, actually, this liminal space.  It is mystery, something one experiences rather than describes.


Perhaps these breathtaking sunsets of Autumn in the Northwest are gracious gifts; given to train our subconscious to see the beauty of the liminal space of life when it finally arrives.

My patient was surrounded by family and his pastor during his last hours. As I left his room, high up on the top floor of our hilltop hospital, the windows were lit with the alpenglow of sunset. The light slowly receded from pink to dusty lavender. Reflected gently on the first fresh snow on Mt. Hood, it passed, very slowly, steadily, from beauty to beauty.

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~Karen Freeman Worstell


One thought on “The Liminal Space of Palliative Care – Karen Freeman Worstell

  1. Karen, thank you for your beautiful contribution to ‘The Liminal Space’.
    It reminds me of a special blessing by poet John O’ Donohue (obm, z”l):
    “May you find words full of Divine warmth
    To clothe the dying in the language of dawn.”

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