Caring for the dying: my patients, my work, my faith

Friday afternoon at the hospice center. I punch in and eye the "white board," looking for empty white strips and unfamiliar names, quickly piecing together who has died, who is still living in this eighteen-bed facility. I start at the bottom of the list, Room 19 (no Room 13 here--these folks have had their fair share of bad luck). Room 19 is the stomping ground of the Delgado family. Miguelito, five years old, with his bald pate and big eyes, is speeding up and down the hallways in a motorized Big Wheel. His two older sisters will be coming "home" from grade school soon, and his younger sister, Lily, is being her cute, showboat self, hanging out once again at the nurses' station while mom naps on the extra bed in Miguelito's room.

In Room 18 is Faye Niesen, whose family complains about the Delgados, then feels badly about complaining, and then complaining, and then complains some more.

In Room 17 is petite Eleanor Kempe with the gimlet eyes and the protruding abdominal tumors that make this eighty-two-year-old look oddly pregnant as she sits and watches Mother Angelica on EWTN. Eleanor keeps a pocketbook tucked just so at her left hip, under the sheets, and Kleenex tucked just so up the right sleeve of her thin bathrobe. Second only to Mother Angelica in Eleanor's mind is the Food Network's Emeril, whose trademark exclamation "Bam!" pops out like bullets from at least five or six rooms on the unit, each night. The Food Network is big here, very big.

In Room 16 is the John Roth family, with Miles Davis on the CD player and pale ale in the cooler. They were hanging out last night, and they'll be hanging out tonight and through the weekend, spirits never flagging, manners always impeccable, their love for their husband and father and brother deep and wide and joyful.

In Room 15 is Franklin Schuebel, ninety-five years old. Mr. Schuebel desperately misses his wife, who died last year. Each night he waits patiently as I listen to his heart and lungs. As soon as I remove the stethoscope earpieces from my ears, he pops the same disconcertingly hopeful questions about being reunited with his wife. "How do they sound? Are they bad? Do you think tonight might be the night?" "No, Mr. Schuebel, everything sounds pretty good in there. Probably not tonight." He sighs a resigned, tired sigh. He pats my hand. "Some day," I say. He smiles broadly.

In Room 14 is Steve Wilkins, forty-eight years old, who will die tonight, and whose seventeen-year-old daughter will scream when he does. It will unnerve everyone, because we're not used to screamers. Friends imagine that where I work there must be a constant drone of keening and sobbing. There isn't much of that. This seventeen-year-old will cause me to think back, over six years of work on two coasts and in three cities, to the last time I witnessed wailing at a deathbed. The emotion most prevalent here when death comes, as it does almost daily, is relief.

In Room 12 is "Airman" Mike Grable, an African American and former professional wrestler, whose seven children will one day soon accompany his barrel-chested body down the long corridor, past the nurses' station, through the lobby, and out the front door, singing "Amazing Grace" as they go.

The north-wing patients are present and accounted for.

The evening nurses and aides go to listen to the taped report left by the day shift. It is both relentlessly sad and unfailingly hopeful, peppered with facts about vital signs taken, symptom-control efforts made, new physician orders received. A day-shift staff nurse, Mary, the preacher's wife, comes in and interrupts our listening to announce a new admission. Her first words: "Can we just stop admitting the patients with wingnut families, just for a few days? My Lord and Savior, I just cannot handle one more." After the chuckling dies down, we listen closely to what Mary has to say. We don't take the wingnuts lightly, because memories are still fresh of one of our favorite patient's sons being caught in a supervisor's office trying to heist a laptop. Police were summoned, restraining orders rendered. As a result, a Post It note went on the receptionist's computer identifying another family member not permitted entry to the ward. That note is still there, sitting above the other Post-It listing all the relatives not allowed to receive information about one patient or another. That list is always present--sometimes short, sometimes impressively, depressingly long.

It is a quiet but lively place, this unit. Periodically, ambulance drivers come with their bright orange stretcher contraptions, bearing sedated patients whose pale faces look tiredly out over white sheets and blankets, a small passel of family members bringing up the rear. And while many of these patients end up being discharged to their homes after short stays, a great many of them leave on the black stretchers maneuvered down the corridor by funeral-home attendants, the same small passel of family members bringing up the rear.