In Hospice, Let the Lie Die

Image from “The Killing.” Actors Liam James and Mireille Enos.

Why do we lie?

Or is it fair to label the hopeful words exchanged between parents and children, between spouses, between friends, as deceitful?

Not long ago, I watched the final episodes of “The Killing,” a gloomy Seattle-based cop show. In a tense scene between Sarah Linden—a single mother and detective—and Jack, her oft-neglected teen son, she reassured him, “Nothing will ever happen to me.”

Really?

Sure, it’s only television, and grim or not, it’s over in a cleverly scripted forty plus minutes. Given that the dour Linden was a main character, she may survive every calamity concocted by the writers. Nonetheless, what a TV mom said to her son has been repeated with similar words in endless shows, plays, and movies: nothing will ever happen to me.

Have you said that . . . in real life?

Who have you reassured that nothing will harm you? Isn’t it what a parent is supposed to say to a child, whether the child is four or forty? It’s a way of saying you’ll be there for them, that your love is stronger than injury or accident. In a different setting, it may be the stereotypical gruff sergeant preparing his untested, unsettled soldiers for battle. He’s given them the pep talk, he’s shown his scars from skirmishes he survived and now he’ll lead the lads to hell and back and don’t worry, because nothing will ever happen . . .

There are other lies.

I have sat by hospital beds, holding the hand of those facing surgery. Soon, a highly trained, highly educated stranger known as a cardiovascular surgeon will open the person’s chest and dip their gloved hands deep into her or his ailing body and attempt to bring renewed life.

“You’ll be okay,” I have said.

Was it a lie? How could I possibly say that when a person is facing so many risks? What if the surgeon makes a mistake, or there’s a stroke during the operation, or the body’s ravaged by an infection after the surgery . . . oh how long the list of awful what-ifs can be.

In my twenties, I went through a divorce. There were no children, no property to divide, and only a few debts to squabble over. My divorce was an unexpected morning rain dampening my clothing and spirits compared to tsunami-like divorces that wrench apart lives. Still, I had friends tell me that I’d be okay. And maybe those with horrific, ruinous divorces were also told by their friends they would be . . .

Okay?

How can you know? The whole world is changing.

Your child scampers to school for the first day. Your kid grabs the car keys for the first time to head off to basketball practice. The pregnant thirty-something mom, who has longed to have children and has already “lost” several children by miscarriage, is wheeled into an operating room.

We hold a hand, we smile a tender fake smile, and we say—to convince them or ourselves or both—that, “You’ll be okay.”

Nothing will ever happen to you.

Nothing will ever happen to me.

How can we not lie to a loved one? Truth be told, humans are liars.

Comforting-liesWhen a patient enters hospice care, it is possible to keep voicing the loving, lovely lies. But not for long. Everyone cared for by hospice has been told they have a life-limiting illness. Doctors will guess—and I always think of it as a guess—there are six months or less before the person will die. It is a guess. I’ve seen people “graduate” from hospice after a year of care. They became stable, their health improved. They were no longer appropriate for the medical benefits. It happens. I’ve seen people, informed by wise and compassionate doctors they have many months to live, but they take their last breath less than a week after becoming a hospice patient. It happens.

Whether it’s a fictional mom on a cop show, or you and me, we tell family and friends our truth-filled lies. Hospice challenges the best and worst of those lies.

We may say (and lie), Nothing will ever happen to me . . . because my love for you is fierce and forever.

Perhaps, risking honesty, we could choose to say, Something is now happening to me . . . but my love for you is fierce and forever.

May your lie die and honest conversations begin.

(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.)

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Comments

  1. Today’s topic hits home. A long time friend from Ukiah, was just told she has pancreatic cancer. She called to tell me she is going to have a biopsy in a couple of days. After she returned she outlined the treatment of surgery they want her to undergo. At this point she hasn’t been given the “stage” of cancer yet.
    As to our conversations, indeed it is hard not to say…It will be ok. But I don’t say it, because I know the prognosis of many pancreatic conditions. It is bleak. I know it, and she knows it. So I try to focus on tangible next steps, “what does she want to do”, does she have faith in her surgeon”, “what help does she want from me”, “how does she want to proceed”. Very hard. This is a period of time when she is facing the end of her life. She now knows most likely how she will die. Yet she feels perfectly fine, is strong and healthy. It must be hard to believe.
    I visited her days before she went to the Dr. At that time she wanted to go to check out what she thought was a mild virus. We hiked and ate in Mendocino, talked all weekend long. She had no idea she was entering this final phase of her life. It would be three days before she became diagnosed. She won’t be o.k. She wants me to help her get things done…a will, give her encouragement to ask friends locally to go with her to the appointments, lawyer, tax person, etc. She wants to talk about her options to do treatment or to make the choice not to do anything. There is some degree of power for her to decide her own mind whether to spend extended time in hospitals or to spend that time being home, being visited by friends.
    Stop the lies. Be as real as possible with a person who is facing terminal illness. It makes room for real helpfulness and honest conversation.
    Thanks for your work, Larry.
    Karen Paulsen

    • Such wonderful, vulnerable thoughts Karen. Thank you for your insights. I hope you are able to spend as much time with your friend as possible. Regardless of what happens with her disease, the honesty between the two of you now will be an enduring legacy of your friendship.

  2. A family member recently passed away after a long frustrating illness and she was one of those people you mentioned, who fell in and out of hospice because her doctor’s best guess was off, in her case by 2 years. I remember the conversation with her doctor after he made that first guess based on her diagnosis. He shook his head and looked at the floor and said, ‘not much science in this.’ You could see and hear the frustration because he knew her well enough to know that this guess would be the foundation for how she and her family lived going forward until her journey was finished.
    She chose to live that final 2 years putting her life in order and for her, it was time well spent. That’s the thing, our lives and our deaths are so individual. For some it is a time of completeing all of the bits and pieces we started. For others it is a time to say all of those unspoken truths and stories. Still others spend it in solitude. Needs are hopefully met both for the person moving to the end of this part of their journey and for those left to move forward and accept the void left. Hospice was a blessing for her accepting her choices for her final transition and helping the people she touched in their choices.
    Thanks Larry for your always thoughtful inspiration.

    • Thanks so much for sharing about your family member. And I am also thankful that the hospice that supported her accepted “her choices.” It sounds like she and the doctor, along with her family, were all communicating on the same page.

  3. A writer has only one job, and that is to make the reader see the next page. You have been successful. I NEED to see more of this essay. Selah.

  4. Larry, it’s taken me almost a week to respond here; not because I didn’t have anything to say, but because you tapped into a spot inside of me that let out a flood of emotions. To say that this one hit close to home would be an understatement! I kept going back and re-reading this, trying to come up with the right response.

    You words connected with me for may reasons, not the least of which are my experiences as a former paramedic, retired cop, and now minister. But they also resonated because of my current health situation. I lie. And I lie. And I lie some more. All in the hopes of reassuring my family that everything will be alright. “I’m fine,” I tell them (and everyone who asks how I’m doing).

    Your words, the way you weave them, bring a sense of calm to an otherwise dismal topic. Please – PLEASE – keep doing what you’re doing.

    • Rusty . . . can we avoid some of our “lies?” Probably not. In certain cases, I suppose we simply don’t want to explain. Maybe it’s because we don’t feel like we have the time, or the person who has asked us looks like they are really more interested in getting to their next appointment. So, yeah, we end the “conversation” and lie about being fine, thank you very much.

      But I hope for you, and also me, that in those times of physical or emotional pain/anguish, we speak enough of the truth to let the truly loving/caring people in our lives know how we’re doing. If we bottle up our shaky reality for too long . . . well, it’s like the soda can that’s been shaken . . . pop it open and (whoa!) what an explosion.

      Take care, Rusty!

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