I returned from a brief vacation, and as is the case with hospice nurses everywhere I suspect, I looked at my work emails very late in the night when I finally got home. I saw Ben Nelson’s name and the time of death. Even though my patient was getting weaker and had increasing respiratory symptoms prior to my leaving, he was not the person I expected to be gone when I got back.
Although I can “leave work at work”, the relationships that develop over time when caring for a patient on hospice means that hospice nurses worry and fret a little, and sometimes a lot, long after their shift is done.
I had seen Ben and his wife the day before my vacation; even though I had concerns regarding a number of disheartening changes in his condition, I had sprightly said “See you next week”. His wife, so diligent in her care giver role, reported him having more difficulty being active as cancer weakened his body, but they still enjoyed many good days and had plans for upcoming projects. Sadly for them, their retirement years together never had an opportunity to begin before Ben’s cancer took a firm hold of his days.
I know how hard it is to be the caregiver, to watch a loved one slowly lose ground, to see the diminishing of the person you can’t imagine being absent in your life. I have loved my own family members and watched their chest no longer rising, as their heart quietly stopped.
Even though I know what approaching death looks like, and try to prepare families for what appears to be imminent death, there are times when we all are stunned at how suddenly life changes. Hospice nurses explain that we don’t have a crystal ball, and our best guess can be far from accurate. Life begins and ends outside of our determination. Not too long ago, my newest grandchild announced his entrance into the world; though we all expected his arrival, it came a month earlier than planned. He surprised us, and for his parents life is forever altered.
Ben’s wife reviewed with me the events of those last 24 hours, having had no idea this would be his last day. They had enjoyed a movie in the evening, after a family dinner which he didn’t eat, but was part of the gathering. He had gone to bed as usual. He’d awakened with some breathing difficulties early in the morning hours. And two and a half hours later he was gone.
We think: We can be prepared.
We can know what to expect. We can anticipate. But, as his wife told me quietly, “Dying is a lot like birthing, even though you expect it; you are still taken by surprise.”