The patient was restless.
An ambulance brought her to our hospice’s home—a renovated suburban house with several rooms—for pain management. She was also close to death. The only local family for the seventy-something woman was a granddaughter, overwhelmed by raising her kids and trying to be her grandmother’s caregiver. The patient’s siblings had already died. The patient’s daughter was, again, in rehab. A son, an Army officer, was traveling from somewhere in Europe, hoping to see his mother before she died.
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Right now, in the hospice home, in the middle room with its two beds, there was only the dying, restless patient, a nurse, the doctor, and the chaplain. One bed was empty. But the second bed, where the patient lay, shifted with her unsettled body, with her soft random moaning, with her eyes opening and closing.
The doctor had tried all the drugs she thought might calm the patient. To certain extent, the dosages had worked, for her agitation had lessened. Barely.
The doctor knew the granddaughter planned to visit that night. The son would likely make it tomorrow. Would he arrive, only to see his mother unsettled and in pain? Would his final images be someone with a grimace on her face and moaning filling the room?
The doctor and nurse felt they’d tried everything. This drug. That drug. Not every hospice patient experiences a “perfect death.” Even with an array of modern medications and research providing detailed knowledge about the progression of illnesses, the medical staff will sometimes hit the proverbial brick wall. When “everything” has been tried and “nothing” succeeds.
The doctor was frustrated.
The patient shifted and groaned.
The nurse sighed. Shook her head.
Partly resigned, partly desperate to try anything, partly having no other options, the doctor retreated a step from the patient’s bed. After making eye contact with the chaplain, the doctor said, “I’m not sure what else to do. Maybe it’s up to you now.”
I know this chaplain a little. He’s a nice guy. He’d do anything for his patients. He also knows some of his assigned patients will never meet him because they don’t want “religion” or “spirituality” in their hospice care. Or, they have their own pastor, priest, rabbi, or imam.
This patient was his assigned patient, but he hadn’t met her. She’d entered hospice care only days before and the chaplain had twenty or so other patients. She was Christian. She hadn’t been part of a church for a long time. He didn’t know much else.
He settled into a chair by the second bed. The patient shifted and groaned.
Would the medication never work? Would she never relax? Would a granddaughter and son see their beloved grandmother and mother in misery until the end?
The chaplain held her hand. For the longest time, that’s all he did. Just two hands intertwined. Maybe the air conditioning softly grumbled on. Maybe an oxygen tank in another patient’s room rhythmically stuttered. Maybe the doctor and nurse, now by the door watching, cleared their throats or whispered details about another patient’s needs. But for the most part, the room became silent . . . except for the woman’s random groans, and the creaking of the bed—like branches rattling in the wind—as she shifted back and forth, back and forth.
The chaplain quietly prayed.
He softly spoke Psalm 23. And then repeated it.
Lips barely moving, he sang several hymns.
The doctor and nurse only heard snatches of the chaplain’s words and songs. Focused on the patient, his every word, and every pause between words, was directed at the woman in the bed. And then, maybe after five minutes, or perhaps it was longer, she began to settle, to become calm. Her movement slowed. The moaning ceased. The eyes remained closed. The face relaxed.
The chaplain kept holding her hand. He sang another hymn.
The patient rested. Breathing in; breathing out.
She lived another day or two. The granddaughter, raised by her grandmother, was able to bring her children for one last goodbye. The son, bone weary and caffeine riddled, was able to say his final hello and farewell to his mom.
I recall when the doctor spoke about these events in the middle room of the hospice home. (And yes, I’ve changed a fact or ten, but not the truth.) There’s no guarantee of a “perfect death.” Enough of the time, the right combination of medications will work. An uncomfortable patient achieves comfort; a family has an opportunity to spend final, peaceful moments together. But there are times, steeped in mystery, reflecting the enigmatic, essential bonds between two people, when what makes the most difference is simple prayer, familiar hymns, and a firm hand holding onto another.
As a person of faith, I don’t think what the chaplain did involved a miracle. Except that all of life, from birth to death, is a miracle. And I also believe everyone, the least or most “religious” of us, can settle beside another and offer a hand.
(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)by