Saturday, October 29, 2011

A soft place to land.

I saw a grown man weeping the other day. Sitting in his hospital bed, face bathed in the late morning sun rays.  He had clenched his jaw and remained stoic for several days throughout all of this, but finally the reality was too much.

A paper lay on the tray table before him. We'd spoken about that paper at length over the last several days, but today something clicked. Those words typed clearly across the front of it -- Do Not Rescuscitate and Do Not Intubate -- were only in two dimensions but on this day something about them rose up mightily with gnashing teeth in three dimensions.  And despite his prior attempts to avoid it, that 8 x 11 sheet stubbornly awaited his signature. It was the last step before he'd leave for hospice care.

"This means I am leaving to go and die. No matter how I spin it, that's what it means."

And what do you say to that? It was true.  With hospice care, all the focus would be on his comfort and his symptoms. The people there have committed their careers to doing just that, but he was right. Hospice is something for people nearing the end of life.  Yes, he was right.

"I wish so bad that this disease was not trying so hard to shorten your life.  But even if it has its way with the time part, we can win over how that time is spent. We can make that transition easier."

And that's when he did it. He picked up the pen with his hand wobbling and scrawled his signature across the bottom. Done.

The pen fell from between his fingers and his body began to tremble.  Like some kind of volcano he vibrated until hot, fresh tears erupted from his eyes like lava.  Each burst punctuated by baritone moaning; I grabbed his arm and did my best to be of comfort.

And so. I sat there and he wept. Between his sobs he spoke such simple truths:

"I just have so much I still wanted to do."
"I'm going to miss seeing my grandbabies grow up."
"I don't want to go home yet."

But this call was not his to make. It wasn't mine either.

So on this day, I just held his hand and patted his cheeks with tissue. I stared out of the window, marveling at the irony of autumn and the metaphor wrapped into watching seemingly perfect leaves softly breaking away from limbs. Still beautiful enough to stay on trees but for whatever reason have come to the end of their time. Just like those multicolored falling leaves, this decision was out of our hands.

I looked back at him and squeezed his hand tight. It was the only thing I had left.

"We're here for you, okay? We are."

And that was the last thing I said to him that day. Because at this point I knew I couldn't stop him from falling to the earth. But I could at least help him find a soft place to land.



  1. Ah, love. This really made me cry.
    I am so glad there are people like you helping people like him find soft places to land and then, writing about it in the way only you can write about it because we all need every bit of this sort of knowledge, of reminder. Every one of us needs every bit of it.

  2. This goes above and beyond. What an extraordinary doctor and human you are. Thank you for sharing your life with us, your wisdom --

  3. Heartbreaking, and moving. I'm tearing up a little bit. And I'll say a prayer for him.

  4. I'm familiar with the hospice care. He's going to a good and caring place. He will be much more comfortable than he is at Grady. But I have never thought about having to make the decision to go there. Very sobering.

  5. The time you spent with this patient defines the term _compassionate care_. They are so lucky to have you. x0 N2

  6. When my daughter died at 34, I didn't have that kind of comfortable experience. I wish I did.

    The decision to end life support could have be handled on their end with a little more.... umm, kindness and information.


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