Tuesday, March 29, 2011

The Edge of Living

I've changed names to safeguard the privacy of residents and their families at the retirement community where I work.

Ellen came home to die. Following major coronary surgery and several weeks at a respite care center, she said simply, "I am tired of all this. I'm in pain. I don't want to be a burden anymore."

I visited Ellen yesterday to deliver her a case of Ensure I no longer needed. I peered into her room and saw mottled skin stretched taut against her face. Her gray hair was brushed back atop her head. Blue veins snaked down from the back of her hands past her bony wrists and forearms.

"I brought you a present," I shouted.

"You did?" said Ellen, who is in her late 80s.

I walked into her bedroom, with eight crosses affixed on the wall above the light switch, a rosary dangling from the portable table in front of her.


She lifted her hands at me, palms up, and her eyes widened. She smiled brightly. "I'm glad you're here," she said.

"I dropped off some Ensure," I told her. "I don't need it anymore."

I gulped and held back the tears. I am not going to lose it in front of a dying woman, I thought. Ellen started mumbling about a girl who worked for her and needed to get home. Then she explained the large Impressionist painting of three girls in their Sunday best white dresses, bows in their hair, on the wall next to the crosses.

"The girl there," she said, pointing to a figure in the center of the canvas, "was a neighbor of ours, lived behind us. Her mother was the artist."

"Are you using your rosary?" I ask. "It takes a Jewish guy to make sure you are praying, Ellen."

She smiled again. "Well, yes, that is something you would do." She brought up the worker again and I just nodded. She raised her bony fingers towards me, as if she was about to make a critical point, and we clasped hands. Her fingers were warm, her life force still flowing.

Ten minutes later I visited Fay, who is also on hospice and in her late 90s. Thin oxygen tubes snaked in a V from her nose to her chest. Her eyes drooped and the skin underneath her chin wiggled.

"Hi, hon," she said as I poked my head into her room.

"Fay, you're looking good. Nice to have you back." She'd spent a night in the hospital last week after she'd had difficulty breathing.

"Thank you, hon," she said. I explained to Fay and her two children, Janet and Bob, that they she should not hesitate to order trays and let us know how we can best accommodate their needs. I reminded them that all tray services or guest meals are complimentary while a resident is on hospice.

Janet asked me, "Can I come down at 5:45 after Mom has eaten and get some food?" Dinner closes each night at 6.

"Just tell the hostess I said it was OK," I answered.

I'd first met Fay at Casino Night about a month after I started working here in late 2009. She'd been depressed about her failing body, cancer, and weekly blood treatments, but she'd dragged herself to the evening's festivities. She later told me that my associates and I helped peel away her curtain of despair. "You helped save me that night," she said.

I grabbed her hand just before I left and said we would do whatever she needed. Her eyes darted as if she were preoccupied, but I sensed she wasn't going anywhere anytime soon.

As I left her room and breathed in the stillness of the hallway, my mind focused on hospice, transporting me back to last June, when Verna's oncologist firmly suggested we contact hospice so Verna could have access to 24-hour almost on-the-spot care. The conversation, the images, and the words still imprinted on my brain, when they told us we were looking at two or three more months.

"But," the oncologist said, "I'd love for you to prove me wrong.

Verna died almost three months after her oncologist's final diagnosis and recommendations.

Ellen and Fay are at the beginning of the process, before the round-the-clock administration of pain-killers, conversations about feeding tubes, hushed words about increasing the doses of morphine or Ativan or some other narcotic. I ache for their families, for the decisions they will soon confront or mull over.

I feel sad for them and it reminds me of the anguish I endured last summer. But, on another level, I felt slightly blissful after I left Fay's apartment. Not because I may have eased their suffering (it may beyond anyone's control now), but maybe because I felt how strongly their spirits pulsed as each braved life amid what could possibly be an imminent death. Both women seemed so present, even if Ellen's mind was foggy. And they pulled me into that Zen-state and reminded me yet again that I have a role to play here: caregiver. Or I could just listen to them talk or ramble as they prepare for another journey on the edge of living.

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