Cell 2 Soul: The Humane Health Care Blog

The Hospice Nurse

by Kathryn Norcutt email author

I saw Agnes, one of my first hospice patients, die before my eyes.  It sounds more dramatic than it actually was, but there was no last minute speech peppered with coughs, or a slow death. It was more like one minute she was there, and the next you could just tell she wasn’t.  She had terminal breast cancer, which she had beaten six years earlier and then it resurfaced, all too quickly. She decided not to go through with any treatment and enjoy what life she had left. I was there in her last of month of life to handle her quality of life, and it disappoints me to know that such a wonderful spark of humanity had been snuffed when she still had years left.

  It was because of her that I became acquainted with the same phrase I now see many hospice organizations use on their sites: "When you cannot add days to your life, add life to your days."

For entire essay see: Download The Role of Hospice Nurse-C2S

Photo credit: will add later

Death with Dignity

The Last "Haku Mo'olelo"

Virginia Tanji sent us this a couple of months back and she and her husband, Andy, graciously allowed us to publish it.

My brother-in-law Ed, the youngest of four brothers, passed away in home hospice care in early September and we were there.  He was cadaverous when we arrived, but amazingly lucid.  He would sit up for about an hour at a time three to four times a day working on his columns, reading, checking email, etc. We arrived on Labor Day, but by the weekend he was considerably weaker...he was taking very little by mouth...his wife, an amazing woman and a retired nurse, administered drugs from the hospice "comfort care" box.  It was a privilege to be there to see the loving care that he got from his wife, son, and two daughters. Another brother and his wife also came.  Andy and I ran the kitchen...Andy cooked, I helped with the shopping, menu planning, and was one of the willing scullery maids. 

Edwin had throat cancer, and even with treatment it continued to metastasize.

He left letters for his seven grandchildren, instructions for his services, and a couple of final columns.  He was a retired journalist and was beloved by the Maui community he covered so well.

It was quite a beautiful experience, and I told his wife that it was really a privilege to be allowed to stay and be there for his final days on this earth.

I thought you might enjoy the last Haku Mo'olelo column he wrote for the Maui News.*

Author:  Virginia Tanji has been a membver of Cell 2 Soul for eons.  You can reach her at V. Tanji.

*The link to the Maui News column gives you access to  Edwin Tanji's final "Haku Mo'olelo" column.  It is the parting words of  a writer contemplating his own death.  Ed Tanji was a former city editor of The Maui News. "Haku Mo'olelo," "writing stories," is about stories that are being written or have been written.  Ron Youngblood, Ed's colleague at the Maui News, wrote this moving obituary.  Lucky too live and maki on Maui!

My Child: A Poem by Phil Delrosario

Note:  Because of formating concerns, this poem is better viewed as a pdf: Download My Child

The jaws of silver monsters found you,
disemboweled you, ferocious forceps leaving your tiny
chest eviscerated; mutilated your precious
head, and maybe brain asunder, you wonder
why you were squandered. Curetted craters of flesh reveal
unknown thoughts blackening, festering in quiescent
blood, lost postmen with nowhere to deliver. I quiver
as I purse my lips and blow a gentle wind to fill
your nose. And though your breaths are still,
I still want you to feel how tender air can be
as she caresses the recesses of your empty throat
with a gentle tickle. But life, like the wind,
is fickle. Yet somehow still, we will take
a million more breaths. And this, this is what
breathing feels like, my child.

In my hands, I envelop your disembodied arms, skeletal and torn.
I try my best to caress what’s left of your flesh so you
know how warmth lingers after fingers have touched you,
and not how silver, slivered serpents have rent you.
I don’t know why I try to put you back together,
you’re not a Barbie to be fixed. This isn’t playtime,
there are no fixes for the existence I’ve nixed.
Into your hips, I dumbly bump the stumps of
your legs as I shift them, animate them,
giving them motion, locomotion with my imagination,
granting them a shade of life. But I’m not a god
and God knows the days and days have pained me. Yet
somehow still, we will ourselves forward to take
a million more steps. And this, this is what
walking feels like, my child.

As I hold your head close to mine, my tears fall to places
in the spaces above your face, where they trace out
rivulets of silent cries and sighs onto eternally
lidded eyes. I imagine you cooing, sincere with cheer with
a voice that the world will never hear -- an unfinished
melody, a song that I penned, but ended before the impending
chorus. Crimson drops fall into my lap, from living rivers no
longer coursing. My coarse hands rutilant, ruefully stained by
your darkened Spring. I bring you closer, our foreheads nearly
touching. And I touch my lips to your lips so you’ll know how I wish
I could kiss you ‘good night’ every night. But Life is full of
heights and bottomless dips for it knows no scripts, and now you know
that living hurts. Yet somehow still, we will keep trying
a million more times. And this, this is what
love feels like, my child.

****************

Author’s Note: Dilation & Evacuation (D&E) refers to a specific second trimester abortive procedure. The fetus is first terminated with a lethal injection. Instruments such as forceps, vacuums, and curettes are then used to remove the fetus from the uterus. Since the baby may be too large to remove through the cervix, forcible dismemberment of the body is sometimes necessary. This poem is inspired by a true mother’s story, but remains a piece of poetic fiction.

Author Bio:  Phil Delrosario is a senior in Human Biology with a concentration in Psychological Development in Children and Adolescents at Stanford University in California.  He enjoys writing, making short films, and playing his violin/piano/ukulele and is a protégé of Professor Larry Zaroff.  Phil can be reached at pdelATstanford.edu.

 

Conference About Spirituality of Death and Dying

Conference Announcement
Spiritual Views of Death and the Afterlife

Sponsored by: 

Where? Berkshire South Regional Community Center, 15 Crissey Street, Great Barrington
When? Sunday, February 3, 2013 1:30 – 4:30 p.m.
How Much? A $10 contribution to cover basic costs.
For more information contact: Rabbi Stern-Kaufman or Deborah Alecson

The Rimon (Resource Center for Jewish Spirituality) is presenting an interfaith forum on the spiritual beliefs and rituals related to the process of dying, death, and the afterlife as understood by many of our world religions.

The Forum will take place at Berkshire South Regional Community Center in Great Barrington on Sunday, February 3, 2013, 1:30 – 4 pm. Topics to be explored will include: customs surrounding care for the deceased; the journey of the soul after death; the relationship between the living and the dead; and what these traditions teach regarding preparation for this ultimate transition.

The presenters and their respective traditions or congregations are as follows:
The Rev. Mr. Charles Van Ausdall (Congregational Church)
Ann-Elizabeth Barnes (Sacred Undertaking)
Iman Salim Chishti (Islam)
Sharon Coleman, Ph.D. (Buddhism)
Sister Colette Hanlon (Catholicism
The Rev. Liza Marcato (Christian Community Church, Movement for Religious Renewal)
Rabbi Kaya Stern-Kaufman (Judaism).

The moderator for the forum is Deborah Golden Alecson, M.S., adjunct faculty for the School of Health Sciences, Excelsior College, where she teaches, among other courses, “Death, Dying and Bereavement” and “Spirituality in Life Transitions.”

This conference is an opportunity to address one of the greatest existential concerns for each of us; and to learn more about our own faith tradition and those of others to help us find meaning in our mortality.  Our distinguished panel of presenters will first talk about their spiritual views and rituals as understood by their specific faith tradition, to then be followed by questions from the audience. 

This event is co-sponsored by First Congregational UCC, Great Barrington, Hevreh of Southern Berkshires, HospiceCare in the Berkshires, Sacred Undertaking, Women’s Interfaith Institute, and the Christian Community Church Movement for Religious Renewal.  The fee for this program is $10.

Please contact either Rabbi Kaya Stern-Kaufman, (413) 274-1034, info@rimonberkshires.org or Deborah Golden Alecson, (413) 881-4065, DAlecson@msn.com. 

Reservations are not necessary. We look forward to what we will learn from our presenters and from the attendees.

Leave a Message

When the wind died, there was a moment of silence
for the wind. When the maple tree died, there was always a place
to find winter in its branches. When the roses died, I respected the privacy
of the vase. When the shoe factory died, I stopped listening
at the back door to the glossolalia of machines.
When the child died, the mother put a spoon in the blender.
When the child died, the father dug a hole in his thigh
and got in. When my dog died, I broke up with the woods.
When the fog lived, I went into the valley to be held
by water. The dead have no ears, no answering machines
that we know of, still we call.

 — BOB HICOK, the author of the forthcoming “Elegy Owed,”
which includes this poem  This appeared in the NY Times Sunday Review, December 16, 2012.  It can be viewed better there.

A Refusal to Mourn the Death, by Fire, of a Child in London

Never until the mankind making
Bird beast and flower
Fathering and all humbling darkness
Tells with silence the last light breaking
And the still hour
Is come of the sea tumbling in harness

And I must enter again the round
Zion of the water bead
And the synagogue of the ear of corn
Shall I let pray the shadow of a sound
Or sow my salt seed
In the least valley of sackcloth to mourn

The majesty and burning of the child's death.
I shall not murder
The mankind of her going with a grave truth
Nor blaspheme down the stations of the breath
With any further
Elegy of innocence and youth.

Deep with the first dead lies London's daughter,
Robed in the long friends,
The grains beyond age, the dark veins of her mother,
Secret by the unmourning water
Of the riding Thames.
After the first death, there is no other.

Dylan Thomas

Far Side of the Styx

"Soon your life will have flown like a bird from a branch!"

"A man in your fifties—and you still would be young?"  – Yehuda Halevi

You can cry in heaven if someone kills you against your will
You can take time to mourn before visiting your loved ones
back on earth to tell them you're ok.  It takes time
to come to terms with death even on the far side of the Styx
if it is you who has been killed.  "I wouldn't have it
any other way" reserved for those whose deaths were innocent

I have a lot of company here, you say, now that I have accepted my fate
kept apart ‘til then lest the other souls start remembering. . .
and couldn't leave the clouds to comfort you myself in pain
not of the bodily kind but of the soul but now I count my blessings

too and not just the mistakes and carelessness that brought me here
no more pain and I can move freely about the earth without my power chair
I don't have to hold on for the next medication or nurture false hope

It's done.

– Martha Deed
The Last Collaboration, p. 197

See PDF:  Download Martha Deed Selected Poems

The Last Collaboration, a chaos narrative, is a re-construction of Millie Niss's life and death in a community hospital ICU. Because Millie was intubated but alert, her side of every conversation was recorded in a series of notebooks she sent home with her mother, Martha Deed. Millie's notes, emails, the daily diary she sent home, and posts to her blog are set into frames constructed from her mother's log.  The Last Collaboration is a powerful document from which we can all learn.

Illness narratives (pathographies) may be broken down into three categories:  quest, restitution, and chaos stories.  The latter is the rarest and perhaps most important since there is much to learn from our mistakes.  The two former ones can be “feel-good” narratives.  For more on these types of narratives see: “From narrative wreckage to islands of clarity,” a fine article from Canadian Family Physician.  The Last Collaboration is a true “chaos story” and a narrative we can all learn much from.

 

Miracle Boy

Today's NY Times has an important Op-Ed piece by Ben Mattlin: Suicide by Choice? Not So Fast.  Our role here is not to swing anyone's vote -- but just to give voice to others.

Mr. Mattlin's book: Miracle Boy Grows UP looks interesting and his promo video is worth viweing.

 

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Cavano Trio

I.  Fear Itself

Walking on tree trunks, pounding the wooden walkway until it shrieks, a pair of senior ladies discuss ways to improve their health, where to buy a good tomato and evening dinner plans. Behind them, walking on sticks, two men, slim with cardiac concern, worry about taxes and the hurricane season and argue about which liquid establishment makes the best dirty martini.

A bit farther back, an elderly couple turtles along helping each other, old bones groaning, take one sad step at a time while planning still another European trip and believing they will not pass from this orb with plans made and the trip not taken.

Ahead on a bench, pocket full of bottled pills, soft cervical-collared-me watches the parade of fears and denials snake through the morning on the wooden walkway. I greet them with empathic smiles and waves knowing I but see myself.

II.  James and Jude*

James and Jude, sadly gone of a sudden Sunday.
Crash. A lovely leaving as one, father and son.
Still, in this world of raging roulette we who
remain ever long for their ghosts.

Ah, but Heaven shall wipe away all tears when we
meet again, soul to soul, somewhere
somewhere out there in Rumi’s field.

III.  Bench Talk

On the bench where he had been sitting with the Live Oak late in the afternoon she took a seat. He nodded kindly. She began to talk: of the exquisite texture of the Magnolia blossom; of the Spanish Moss above their heads; of the lump in her breast, the biopsy and the waiting for the doctor’s verdict; of She-Crab Soup and her son’s close call at Virginia Tech where the mass killings had taken place; of how lovely the sun felt on her skin this day; of two marriages, now history, and her fear of another relationship.

With soft, soft eyes he answered each pain and with twinkling eyes each veneer of pleasure. She continued to speak going backwards in her memory: her first love, who loved her not; an unexpected pregnancy and how she disposed of it. To their left a Snowy Egret landed to fish at the edge of the lagoon. She pointed and commented on its white perfection. He nodded kindly. The Egret swallowed and she did likewise as she told of her daughter’s passing from a brain tumor before her twentieth year. Again he smiled kindly and knowingly. There were other things to tell and she told them, her story punctuated by the singing of birds, the wind in the trees, his smile and the ever-so-gentle nodding of his head.

When she had told it all she took a very deep breath and, for the first time, looked him straight in the eye. “It's been a long, long, hot summer”, she sighed. “Yes”, he smiled. And now, her burdens reduced at last, she thought as she left: “that man is a brilliant conversationalist.”           

Download PDF: Download Three Pieces by Frank Cavano

Author Bio:  Frank Cavano is a retired psychiatrist who writes because it is an enjoyable experience and, often, a healing one as well. His poems and other writings are often of a spiritual/inspirational/metaphysical nature. He tries to be a faithful, empathic observer of the human condition in all his efforts. Email.                                          

* James was my wife's nephew and Jude his son. They went out for ice cream on a Sunday about three years ago and were killed in an automobile accident. Imagine.