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A hospice visit: We will sing together again some day

Rick Boulay, MD
Physician
January 28, 2013
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I mustered up the courage to visit Mary today.

Pulling into her driveway, I was greeted with the majesty of autumnal brilliance—golds, rusts, and crimsons set against a brilliant azure sky. A bold display of nature’s defiance against the upcoming long winter’s sleep. Not to be ignored, those leaves that had flamed out early chattered against my every step as I slowly ambled toward the doorway.

I took a deep breath and let myself in.

It has been several weeks since I had last seen Mary. I celebrated with her the joys of a successful surgery, the first step toward overcoming her recently diagnosed brain tumor. The next phase in treatment—radiation and chemotherapy—however, proved futile. As the tumor regrew, Mary lost the ability to walk and the use of some language.

Like anyone visiting a dying friend, I go with strong reservation; unsure of what I will see, uncomfortable of what my reaction may be, and unknowing of what exactly to say. My years as an oncologist have lessened some of these fears, yet I still approach this scenario with a great deal of apprehension—the apprehension that keeps many close friends away.

I found Mary in a deep sleep as I entered her room. Barely recognizable, she had aged a thousand winters in a few short weeks. While contemplating whether in fact I was in the right room, Mary’s bright blue eyes gently opened and fluttered; and her broad toothy smile stretched across her swollen cheeks beckoning me to her side.

“Hello” she whispered. “Nice to see you.”

I was instantly comforted by Mary’s warmth, grace and gentility. Gifted with hospitality, Mary had always given me the impression that while in her presence, you are the only thing that really mattered. Her intense gaze, comforting touch, and motherly advice were as welcoming as hot chocolate on a cool day. Despite her obvious limitations in movement and speech, her innate grace prevailed allowing me to overlook the dramatic physical changes.

Heartbroken, I choked over the large lump in my throat, “Nice to see you, too.”

For the next twenty minutes, we reminisced and exchanged pleasantries. Speaking of nothing consequential but all that was important—we talked of children and grandchildren, church, choir, and the change of seasons. Our friendship, forged while tripping through choral masterworks each Wednesday evening and Sunday morning of the past five years, hadn’t changed really; our time to share that relationship had been cut dramatically short. Our conversation was full of smiles, well contained tears, and very long pauses which some may consider awkward. My annoying habit of finishing others sentences came in handy that day as I offered Mary the words to complete her fragmented thoughts.

“We all missed you in choir, yesterday. We started practicing the Christmas Cantata,” I recounted. “It was a mess. We had three different printed versions; nobody knew what page we were on—let alone the right note to sing; and the conductor was frantic. The piece was nice though. It was somebody’s ‘Gloria’.”

“Vivaldi,” Mary whispered.

“Yeah, that’s right, Vivaldi,” I repeated. “I think it will be nice.”

After a long silence, I asked if she was comfortable. “I have no pain,” she replied.

“How are you doing?” I pried, looking for some recently discovered wisdom.

“I go day to day. Some days are better than others,” she volunteered through a strained smile.

“Anything important that you still need to do?”

After a minute, she said, “The checkbook doesn’t balance.”

In my earlier years of hospice visits, I always expected this moment to be an epiphany—flashes of brilliance that transcend time and space. I hoped that the answers to life’s illusive questions such as “Is there a God?” and “Why are we here?” would be revealed and that somehow, for a brief moment, a deeper understanding of the mysteries of life could be grasped. Yet unlike to splendor of the leaves in autumn that go out in ablaze of glory, we quit this life without fanfare or flourish. We die as we live: simply, unadorned, and unknowing with little more true understanding of deeper meanings than that with which we entered this world. I have long since understood that the more important questions in life are best left to the philosophers and poets to ponder and explore while we mere mortals struggle to update our driver’s licenses and balance our checkbooks.

“Mary, I need to tell you that you are loved more deeply than you could ever know.”

Mary smiled warmly, “Thank you. That’s so nice.”

Mary’s hospice nurse, an angel whose work is to comfort the dying, breezed in and offered to help Mary clean up.

“I should be getting back to work anyway,” I said, “but I need a hug before I go.” I reached down and gently cradled her shoulders.

“We will sing together again some day,” Mary whispered.

I quickly walked from the hospice unit out toward my car. The crisp air soothed my flushed face and musty odor of fallen leaves jolted me out of my inwardly focused thoughts. Now, back in the ease of daily life, I was able to look back and cherish the conversation that had just occurred. Letting Mary know how important she was, as difficult as it was under the circumstances, was very important to me. For it is likely that the next time we meet, I will only be able to talk about Mary and no longer with her … until that time when we can sing together again.

Rick Boulay is a gynecologic oncologist who blogs at Journey Through Cancer.

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A hospice visit: We will sing together again some day
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