One of our people, Oscar, died today in the hospital.  Almost everyone wants to die in our own homes, but there was no one to look after Oscar at home.  He had severe pain and shortness of breath.  He had exercised his autonomy by discontinuing one of his essential medications over the weekend; a choice we respected.  We’d referred him to hospice the day before, as Oscar hadn’t been ready to consent to hospice previously.  Because of misunderstandings about hospice, people often qualify medically for the hospice benefit long before they are emotionally, cognitively, or spiritually ready to accept this exquisite care.  Hands

At her request, I accompanied our community health worker, Sarah, to see Oscar in the hospital, where he was on comfort care.  Comfort care is just what it sounds like–care focused on the patient’s comfort.  When we came into the room, the charge nurse was sitting by the bed holding Oscar’s index finger in her fist, as a toddler might hold her daddy’s.  I was struck immediately by the contrast of that human touch with the cold, hard white plastic oxygen sensor–its vigilant red eye glowing–which usually grips a patient’s finger.  

Patch Adams once said, “When you cure the disease, you can win or lose; when you care, the person always wins!”  For Oscar, the time to fight his illness was past, but the time for compassionate care never passes.  

The charge nurse got up and deferentially gave her seat to Sarah, Oscar’s core caregiver.  Sarah took his hand, greeted him, and introduced me.  There was no apparent response.  His eyes were open and fixed, his breathing labored, his aristocratic features relaxed.  This is the stage that medicine calls “actively dying.”  Although that sounds odd, what it means is that like “active labor,” a process has begun which will result in a transition.

Sarah called Oscar’s sister, Esperanza, in Michigan, and I held the phone near his ear.  Those of us who do this work believe that even when a person is no longer responsive, touch and voice are still received by them.  Esperanza was sorry that she couldn’t be there, that her own health issues had prevented her from caring for him.  She was tearful to think that he was alone, but I assured her that Sarah had gone to see him often in his simple home, checking in with the nosy neighbor if Oscar didn’t answer his door.  I let her know that Dr. Fratkin had visited him there, too, and issued a  prescription that Sarah should put some food in his fridge, not skimping on the ice cream!  I told Esperanza that we would arrange a bedside vigil so that her brother would not die alone.  He’d told Sarah to send his drawings and artwork to his sister when he died.  I wrote down the mailing address.  Esperanza offered a simple prayer of peace and gratitude, to which Sarah and I appended “Amen.”  

I sang a Threshold Choir song, “You Are Not Alone,” and gave a blessing.  I sat in silent meditation for healing, because death is a kind of healing, a return to wholeness, the root meaning of the word “health.”

Oscar died this afternoon, safe, warm, dry, comfortable, and accompanied.  Instead of life support, he had love support.  Instead of an oxygen sensor, he had a human hand to hold.


While packing Oscar’s things to send to Esperanza, Sarah finds this poem, which Oscar wrote in 1984:

Time Depart

It’s only a matter of time

for space

to close the skies

my eyes will trace.

 

It’s only a matter of time

you know

to go, goodbye?

I sit, still try.

 

It’s only a matter of time

when I

wave at all invisible

distant lies.

 

Heartbelt love, Godly chi!

 

It’s only a matter of time

to know your eyes

so blue

joy to see trees and you.

 

It’s only a matter of time

my friend

ends of time

to see you again.

 

I know we are all here

for one God.

What does it matter what faith, what dance

what music, what drum?  

It is all still a sling stirring beat brass interconnected God hum!