Knocking On The Door

“Helen, does she know I am here? Can she hear me?” Questions like this abound when a loved one is close to crossing the vast divide. Tasking me, a simple hospice nurse with providing the answer to such a profound question, is something that always shakes me to my core. You see, the truth is, I didn’t know

I see you reaching in the air – grasping for something that my Earthly eyes can not see. You tell me, with a soul nurturing calmness, that you are ready for your passing. Sometimes, I hear you talking to a long passed loved one and your voice is as peaceful as a spring breeze. How do these things happen? I don’t know.

Recently, an incredible patient was very close to her end. She had not eaten solid food for months, surviving until a week before her death on one Ensure shake and sips of water. Her face was gaunt and her eyes sallow. So painfully thin that providing care meant moving so gingerly, like I was balancing an armful of Faberge eggs. The last days were full of restlessness which was minimal because she was devoid of energy. She slipped in and out into the unclaimed land of having breath in this life yet starting to see clarity the next. As the days passed, I was at a loss as to how she was still with us. There was no communication – no expressions and no real responses of any kind from her in many days. Her family, emotionally exhausted from the rollercoaster that they didn’t have a choice in riding. But, as I stayed late one evening because I had that sense, my eyes were opened.

Her son came running in… he fell on top of her, wailing with such a primal cry that it caused uncontrollable tears to trickle down my face. “Mom, I am here.”, he sobbed…. “I need you to know that I love you and will always love you”. His mom, who had not had a purposeful response in weeks, moaned loudly. She inhaled sharply, as if she was trying to take in more air than her fragile lungs could hold. “We are here mom.. all of your kids are here.” Then began the guttural groan of agonal breathing. She did this for almost an hour as her children and husband took turns holding her hand and stroking her face. They assured her that it was time to go and that they would be ok. But, she fought so hard, as if she just couldn’t allow herself to leave her children. The maternal instinct is present, even in the face of death. Everyone had told her it was ok to let go, except that one son, whose pain ripped through everyone present.

“I can’t do it! Does she even hear me? She isn’t here”. Everyone has their own beliefs, but, I truly believe that hearing is the last sense a dying patient loses. His siblings pleaded with him to give her the words which would allow her to pass. 20 minutes of her loud and groaning breathing, despite copious amount of medications to calm her, convinced him much more than his siblings could.

He knelt next to her bed. His tears falling on her dry skin.. his hand caressing her cheek and hair. The words failed him more than once. It was like he was stuck in neutral and could not find the way out. With his siblings behind him, mama’s sweet boy gave her his blessing to go. The words had not rolled off of his tongue when she moaned one loud last moan… she was free now to pass on. Her face drained of color, as is the norm, but, her lips curled into a small smile. She needed to hear those words from her dear son. She was listening.

“Does she know I am here? Can she hear me?” Yes. She can hear you. Yes. She knows you are there. Can it be explained? No. But, sometimes, the most magical things cannot be.

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