Today I talked with two of my patient’s family about their respective loss and impending grief. I don’t exactly look forward to or enjoy this part of the job, but if I see their pain then I won’t leave. Loss acknowledged and shared can still be bitter, but less. Neither of these dead and dying parents spoke much. I didn’t grow fond of them, sit spell bound to their stories or lap up their wisdom. One barely spoke while the other traded in monosyllables. I’d joke and chatter with them as I pulled constipated crap from the one’s rectum or bandaged the other’s pressure ulcer. I talked seriously instead with their children, the main care givers, a daughter, and a son.
So, I tell the son what I know: how his father is about to die, and what he deserves from us. That’s enough sometimes to show family caregivers that someone hears them, sees their struggle, that I’m aware of their grief. I tell him how well he’s responded, how his now-dependent parent has relied on them, their love, and how these last hours are time for reflecting on what it means to be alive, to be connected to a family, a clan, to share the burden of love. For sometimes to love means to ache with one another. It’s a life task for the sober and courageous, and I tell them so. And then I stop talking, and wait for this to sink in.
Another called me on her deceased mother’s birthday, who would have turned 80. I hadn’t erased the private number yet, so I smiled to see her weird name come up — wrong for me to print here, but “Bertha Butt” comes close — so surprised while waiting for my pharmacy call that I answer her, put her on a 3-way. I really need this medication question answered, too. Naturally, the pharmacy picks up right away, so I cancel Bertha instead and call her back. Weepy, maybe drinking, living in a new apartment close to Lake Michigan – “mom would’ve wanted me to live here so I can see the Lake.” I ask about mom’s ashes, where they’re going, and describe some of my memories caring for her – how much weight lost, how fragile and yet so sassy – making her come alive for a minute, to add some more tears. I make a mental note to call the CNA who bathed her and ask her name. Usually, I forget the family names quicker. On hearing it again I’m convinced it helps me better see her bony face, hear her voice so soft at first, then normal but squeaky and later the snappy version reserved for family. Then I call our chaplain. “Hey, kiddo. You done playing in the hospital for a minute? Call this daughter – it’s her mom’s birthday, woulda been her 80th, and she’s weepy.” She tells me she’ll call her when she gets a chance.
Two people asked me today, “How long?” and “remember?” Both uncertain what they wanted, what it means to ask, to know a little more than they guess or suspect, and afraid of the emotions that lurk under the bridge they’re crossing. To sense what’s being asked and then actually say it, speak to it, answer for them – come right out and say the words while making eye contact, steady-voiced, feet square on the earth, and then shut up, in no hurry, available – that’s a consolation, a type of assurance, a voice and a presence. The day of the man’s death his son called me, “you said something about his breathing pattern changing, well it’s happening,” to hear my voice, basically, while he keeps vigil two days beyond the expected end. I’m glad to hear his voice too, since it’s a busy on-call weekend and I’m on a frustrating visit with a fidgety customer who won’t stop falling out of bed (later I learn he’s detoxing). For a minute we’re Vladimir to the other’s Estragon (Waiting for Godot), handy for talking us out of that rope in the tree. Sometimes it’s enough to rehearse, “It’s not that bad, life goes on despite everything.”
These talks don’t occur every day, not every week, thank god, or else I’d start reciting something like the daily specials at the bistro. So, when they come, I’m glad to share some emotional space, point to some spiritual opening (and no, “They’re in heaven now and past all suffering” is a stupid thing to say, since the grieving sure-as-shit aren’t) when time allows, or circumstances bring us closer to that topic. Then we’re ready, we can stand together and stare at the ground when that’s all that’s left for us to do, but we do it together. It’s tough to do this, worse during the pandemic when hugs can’t automatically be given. But some gestures can take their place — of hanging around, looking up and making eye contact, being still, and feeling. A glance at the watch would wreck the moment, turn the scene into something from a Ray Carver story instead.
The son’s sister comes out next, asking me to check her blood pressure, then her eyes fill. She has her burden too, and a mother, a different one who’s still alive. I left her at the front porch doorway, her mistaking a gesture for a hug attempt was touching but I don’t get so close that we forget our mutual safety. If her father dies after-hours, I won’t be calling right away. Later I’d decline the wake, and not say a few words at the funeral. We do what we can, be who we know best. We’re no heroes. “No Heroics, Please” – that’s a great title of some Ray Carver poems. The rest is gravy.
Montaigne, Erasmus, Seneca – these come to mind when thinking of essays about loss and what to say. Same with the Much Ado About Nothing scene about Hero’s grieving father being impatient with philosophy. Same with Romeo in R&J, and the well-meaning perspective from his “ghostly confessor”.
But I think this is enough, for now. Sometimes you must know just when to shut the hell up.
Hospice Nursing 1 Day at a Time 