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Patient gives hospice RN an unexpected gift

Tuesday May 1, 2012
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Most of our patients donít look forward to dying; they struggle to survive against daunting odds. I never had heard anyone complain about being alive until I met 92-year-old Esther, a hospice patient.

Bedridden and near tears, she angrily told me: "I am no good to anyone. All my life I have taken care of everybody else, and look at me now. Iím just so useless." Lifting an arm a few inches off the top sheet, she let it drop to demonstrate her wasted condition. "Why canít I just die? Every day I ask the Lord to take me home," she cried. "Why does God keep me here? I canít do anything for anybody."

I wanted to help her, but how? It would have been ludicrous to tell her, "Everything is fine, Esther. You will be dead in no time." She had been a productive farm wife who kept busy with family, church and volunteer work. Although her mind was still sharp, she physically had deteriorated to dependence for every ADL.

I decided to appeal to her strong faith. "Perhaps God is not finished with you, Esther," I said. "Maybe you have a job left undone. After you complete it, then he will take you home."

My wife and I recently had sent our oldest son off to the war in Afghanistan. On my next visit with Esther, my sonís departure was very much on my mind. Since hospice patients have enough problems of their own, I had resolved I would not share my personal difficulties with them.

Near the end of our visit, I violated my code and asked, "Have you ever had to send a son off to war?" I regretted saying those words as I spoke them.

"Yes, twice," Esther said. "One died in the war, the other a little later." I was shocked. I do not remember what I said, or how I ended our visit, but I recall feeling great embarrassment. Instead of making her feel better, I just brought back painful memories.

About six weeks later, there was a knock on my door at home. The soldiers in Army uniforms said our son was killed in the war. They said something about his being a hometown hero. My wife and I plunged into a whirlpool of grief that will continue as long as we can still feel love.

When I was able to return to work after three weeks, Esther was the first patient on my list. She was still alive, but this time she was calm. "I heard about your son," she said. She proceeded to tell me about the nightmarish tortures she faced as a mother who twice lost sons.

She told of her grief, how much she missed them, that their lives made her so proud. She spoke of her faith, where she found comfort in her distress. She expressed how, instead of anger at their loss, she came to feel gratitude for the years she had with them. She told of looking forward to seeing them again in eternity.

Esther explained grieving in a way I never had heard or imagined. We talked, cried, laughed and remembered our sons. It was a visit where time did not matter. Only a parent who lost a child could have spoken like Esther.

At the end of our visit, while I was thanking her for what she did for me, she suddenly lifted her head off the pillow. Looking at me she said, "You! You are the reason I am still alive. This was a job only I could do. To think that in my condition I could actually help someone."

As her head settled back, she said, "My work is done; now I can go home." Iíll never forget the beam of satisfaction — the feeling of a job well done — on her face.

A few days later I got a phone call. She passed away in her sleep. Peacefully.

Thank you, Esther. •

Mike Barry, RN, MA, is a former hospice case manager who now works on the oncology unit at St. Josephís Medical Center in Kansas City, Mo. The patientís name was changed for this article.Write to editor@nurse.com or post a comment below.