I have worked as a hospice nurse for about ten years now. I have seen a lot of death in that time, including during the holidays. I have worked with many patients and families, but there are a few that stand out. I would like to share my story of one of those who stood out, and deserved my utmost admiration.
For the sake of privacy, I will call my patient Bob. Bob and his wife had been married quite a long time and seemed like the perfect couple. Though it’s been a few years, and the details are a bit fuzzy, I know he was admitted to the hospice program in November with a cancer diagnosis. It may have been esophageal or gastric, as he had many issues with eating and nausea. We had to do multiple medication changes to insure his comfort.
Bob was determined to make it through the holiday. He told me how his wife had lost not just one, but eventually both parents around the Christmas holidays, with one of them on Christmas day. Bob was determined not to die around this same time; this was his number one goal. As the weeks went on, I noticed more and more of a decline. Bob was less able to eat enough to sustain him, and suffered the resultant weight loss and fatigue. He eventually became bedbound, couldn’t eat, and could barely drink. He knew it, his wife knew it, and I knew it: his end was approaching. I was beginning to fear he might not make it past the holidays.
But he did. It must have been so hard for him, but I believe it was that sheer will or determination, and maybe Divine Intervention that helped him; he lasted into the first or second week of January. I truly feel that this was his final gift to his wife, to prevent her from feeling yet another loss right on or around Christmas. I also think that sometimes people are able to work out with God when the time is right for them. I have seen people hang on until their loved one comes in from out of state—and twice in my career, from out of the country. Then it’s as if they have their final goodbye and leave this world. I have also seen people hang on until their loved ones leave, instead dying when that loved one goes to the bathroom, gets something to eat, or goes home to shower and change clothes—or just takes a mental break. The family is usually disappointed that they weren’t there, but I believe the patient often feels they have to hang on for the family, and can finally relax and let go once the family is out of the room. And finally, I have known patients to say, “I won’t be here tomorrow,” or next week, etc., and they have been right; somehow, they seem to know when their time will come. Everyone is different, everyone is unique, and just like so many other things we handle in our own way, death is no different.
Though it was difficult for his wife to see Bob go, it might have been even more difficult had he not had the will to hang on until later. To me, that is the ultimate sacrifice, especially with as much weakness as he had. As a hospice nurse, my role was to support both of them through this, and also to keep him comfortable, though sometimes people are afraid to take the very medications that will help them become more comfortable, especially if they think it might hasten their death. This is also true for family members who are in charge of keeping their loved ones comfortable. I can’t recall if he was one of the stoic ones, but it would not surprise me. To me, sacrificing one’s own comfort to make things easier for a loved one is one of the noblest things anyone could ever do; and that is exactly what he did.
If there is one thing I’ve learned in nursing, and particularly in hospice, it is that people surprise me a lot. Even when I’m seeing signs that the person is getting close to the end of life, and have been accurate in my prediction of “when”, I can also recount many times that I’ve been wrong- on either end of that spectrum. Some people I doubt will make it past the hour, day, or week, and they hang on for quite a long time. Then there are others who I think will be with us awhile, and they take a sudden and drastic decline. I think it’s God’s way of keeping me humble, saying, “you don’t know everything”. In another light, I think it has to do with a person’s will, which has no amount of predictability,