“Reflections”

 

By Ezra Ochshorn, MSW

American Journal of Nursing

August, 2013

The bone cancer hurts so badly he’s often reduced to tears, but he usually refuses the narcotics offered by the nurses. He knows he doesn’t have long to live and wants to spend as much time as possible awake and clearheaded. In his mid-50s, he has no family to offer comfort or assistance. His few friends have vanished. The phone never rings. He’s alone and struggling to comprehend a death approaching with accelerating speed.

 

As a hospice volunteer for the past two years, I always take a deep breath before knocking on a patient’s door and stepping across the threshold. I never ask the nurses for medical details, just who might like a visit. Focus on the person lying in bed, not the terminal illness—on of several aphorisms I regularly whisper each Sunday afternoon at the local hospice house.

 

These aren’t always the most comfortable hours. It isn’t easy to see bodies ravaged into painful biological prisons. It isn’t easy to hear anguished regret about past deeds and decisions, with no time left to change course or make amends. And then there are the questions. Why did this terrible disease strike me out of the blue after a lifetime of perfect health? How will my family survive without me? Where are my siblings when I need them most? Faced with such torment, all I can do is sit and listen and not pretend to know the answers.

 

But all is not pain and misery. I have shared many laughs with patients and family members. I have watched NASCAR races, my companion for the afternoon kindly tolerating my total ignorance of the sport. I have watched ridiculously risqué movies on cable TV, sharing snickers with the person confined to bed. I have heard patients recite self-penned poems good enough to mesmerize a hardened poetry hater like myself.

 

My motivation for volunteering centers on a basic hope, a hope that overrides any cultural, political, or personal differences I encounter. I simply offer what I would want if I were dying: someone who bothered to show up. Someone to talk with about whatever I wanted, to watch TV with me, to keep me company while I ate dinner—or just sit silently at my bedside and let me know I wasn’t alone.

 

Perhaps the fundamental requirement for hospice volunteers is an open mind. Assumptions and first impressions rarely predict reality. I met a soft-spoken woman who was once a nun, then later a theme park belly dancer. I met an ex-Marine officer and small-town police chief, a self-described “soldier by nature,” who denounced all wars after 1945 as senseless bloodbaths. I met a former civil rights activist upset that minorities were moving into his neighborhood.

 

Religious reactions are particularly unpredictable in this setting. Some folks express a deep spiritual peace with what lies ahead; others feel betrayed by their faith. Some welcome death as a heaven-sent release from illness that has drained their body, mind, and soul for years or decades. Others are still reeling from a sudden diagnosis that destroyed a story-book existence. God is praised, cursed, questioned, implored.

 

I’ve encountered patients overwhelmed with anxiety about their condition. Others barely mention disease and death. Some are so effervescent and chatty I wonder if they understand how sick they really are. Is this just a brave mask for an unexpected visitor? Are they afraid that displaying their true emotions will send me bolting for the hills? Or are they simply far more accepting of their fate than I imagine I will ever be?

 

Although most patients are elderly, some are middle-aged or younger. Personality and attitude often shape the encounter more than age. I envy anyone, young or old, who can look back with no second-guessing about the decisions they made, the paths they chose. Conversely, it’s difficult to respond to someone scrutinizing their life with bitterness and regret. Lost opportunities, broken relationships, and unrealized ambitions are difficult final pills to swallow. While words often escape me in such situations, the lessons do not. Life is short, perhaps shorter than anticipated; connections to loved ones are the ultimate gift; pursuing dreams today beats banking on the luxury of endless tomorrows.

 

Above all else, volunteering with hospice has expanded my awareness of the here and now. My habitual tendency to dwell on the past or future is challenged by living, breathing reminders of how little time we are granted on this planet. Shopworn cliché though it is, embracing each day to the fullest appears the only sensible response. But I still struggle to put this noble philosophy into daily practice. Which is why I return to the hospice house Sunday after Sunday—to learn how to better live.

 

Ezra Ochshorn is an academic writing consultant in Tampa, FL. Contact author: eochshorn@gmail.com. Reflections is coordinated by Madeleine Mysko, MA, RN: mmysko@comcast.net.

 

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