Ceremony for Receiving a Bone Marrow Transplant

In preparing to write this ritual, I interviewed Aubrey Hughes, a woman who is becoming a BMT nurse after a BMT saved her life. She explained that bone marrow transplants offer a unique opportunity for ritual because the recipient is awake and alert while the bone marrow transplant is happeningfamily and friends may be in the room during the initial 45- to 90-minute procedure. The patient won’t know if their body will reject or accept the new blood and marrow until later.

This ritual attempts to make space for the recipient’s uncertainty, the experience of facing mortality, and the hope for medical success, and is dedicated, with gratitude, to Aubrey Hughes, for sharing her story with me and for inspiring this ceremony, and to Lyndsay Knutson, a nurse who brings love and support to bone marrow transplant patients every day.

Setting and materials:

This ritual should take place in the hospital room where the patient is receiving the bone marrow transplant. Family and friends who are willing to participate should be present. Ritual items include a jar with a lid that closes, with a battery-operated tea light with a closed bag of flower seeds inside, as well as paper of any kind (craft paper recommended) cut into squares (large enough for one word on each square), and a pen.



Welcome, everyone. I am glad we are all here together to support (name) in this powerful moment of change. Medical experiences can bring a lot of different feelings to the surface, many of them intense, and all of them valid. To begin, I’m going to invite everyone to share some of what’s on our hearts. First, let’s all take a deep breath. I invite you to close your eyes, or cast your gaze downward. One more deep breath, and then, popcorn-style, you may call out a word or a feeling that’s inside of you, right now. I’ll get us started: Hope. Others may include: fear, anger, anxiety, gratitude, etc. If people are only sharing positive feelings, clergy should open the space for hard ones by sharing “fear” or something similar. If people are only sharing negative feelings, share positive examples. This can continue for up to a minute.

Thank you, everyone. Let’s take another deep breath to acknowledge the depth of emotion we’re holding in this space together.

In Hebrew, the words for blood, human, and earth are deeply connected. Blood is DAHM, human is Ah-DAHM, and earth is Ah-dAHm-AH. The Hebrew word for red is ADOM. In Genesis 2:7, we learn that God formed the first human, Ah-dahm, “from the dust of the ground.” God “breathed into his nostrils the breath of life, and the man became a living being.”

Contemporary science teaches us that when we breathe, oxygen enters our blood, and our blood cells carry the oxygen throughout our bodies. To patient: Through this bone marrow transplant, you will receive blood stem cells from [your own body/name of donor/a generous donor] which will travel to the bone marrow, producing new cells and promoting growth of new marrow. Like Ah-dahm, you will be connected to all life on earth through your blood, through oxygen, and through the holy exchange of breath.

As the stem cells flows into your body, I’m going to invite you to participate in a guided meditation that will bless the blood flowing to different parts of your body. Is that all right? If yes, say:

Before I begin, is there anything you would like to say to the new marrow on its journey?

If patient shares, say:

Amen. Thank you.

If you’re ready, please close your eyes. Everyone may join if you wish.

Guided Meditation

Clergy, to patient: With your eyes closed, envision the cells entering your body as nothing but pure, healing light. It’s warm, and bright, and gentle.

Feel it flowing through your capillaries, delivering cells that are rich with your own breath to every part of you. Feel the cells in your scalp, feel its light behind your eyes, and in your throat. Feel it at your fingertips, the light of these healing cells shining through all that you touch, and through all that touches you.

Now envision the light traveling to any part of you in need of healing. The tightness in your shoulders, the anxiety you may feel in your stomach. The new cells are steadying in your back, tender in your knees, strong at your calves, and alive with light in your heels and toes.

Envision the cells combining with your blood returning to your lungs to retrieve more oxygen. This is your own nishmat kol chai, your breath of life, the oxygen you receive in return for carbon dioxide, which you give to the trees standing tall in the earth.

Elohai neshamah she’natata bi, tehorah hi, the soul God has given to you is pure, a soul made of breath, the words for breath and soul linked, like blood and earth, by their Hebrew roots.

May these cells bring for you a complete healing. And let us say together, Amen.

[Name of patient], you may open your eyes.

The Blessing Jar

Clergy: Now I’ll invite everyone to offer your own words of blessing. We will start with [name of patient] and the rest may follow.

To patient: As everyone is speaking, I will write one word from each of their blessings on these slips of paper. At the end, you can read the words out loud as you add them to the jar, so that you can keep our blessings beside you on this journey.

To the family/friends: If anyone is more comfortable sharing a blessing and writing a word in private later, they may add to the jar at another time.

To the patient: Inside the jar, I have included a battery tea light so that our words of blessing may be illuminated, and I’ve included a bag of seeds, which you may plant upon release from the hospital. Seeds represent hope for new life, and represent our connection to the earth through our blood and our breath. To start, I invite you to share your own prayers.

When finished: Now anyone who is ready may offer the next blessing.

Clergy writes one word from each participant’s blessing on a square of paper. After participants finish, clergy hands the squares of paper to the patient.

I invite you to read each word as you drop them into the blessing jar. If you do not want to share out loud, you may add it to the jar without reading.

After all words are added, clergy turns on the tea light and closes the lid.

We will conclude today’s ceremony with a song, in which we ask Shekhinah, God’s nurturing, feminine presence, to spread over you shelter of peace and wholeness. But first, I will offer you my own blessing.

[Name of patient], I recognize that this bone marrow transplant is only part of a long journey, one that has been filled with pain, fear, and uncertainty. While none of us knows what will happen nextwhether the cells you are receiving today will heal you or harm you further, whether your illness will return or another one will appear, whether you will die, or arise each day to a greater and richer life, filled with gratitude—I do know that you are deeply loved, and you are not alone. When you look at this jar filled with blessings, I hope you can feel all of the love and light that surrounds you in this moment, no matter what tomorrow holds.

May you be blessed with r’fuat haguf, a healing of body, r’fuat ha’nefesh, a of healing soul, and r’fuah shlemah—a healing that is complete, bringing all of you to wholeness.

All invited to sing: U’fros aleinu sukkat sh’lomekha

May Shekhinah spread over you and over all of us a shelter of peace and wholeness. And let us say, amen.

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