“I’ve taken care of things all my life, and I’m doing the end planning, too, because that way it will be done to my satisfaction,” says my 91 year old patient.  She’s completed financial affairs, even has her funeral expenses paid in advance including placing where the ashes will go.  We are sitting in her perfectly disposed living room, which she has maintained all these years and only recently realized a housekeeper might be helpful as she has that bone weary fatigue that accompanies advanced cancer.  She doesn’t have the energy sometimes to fix a meal; her only relative now and then drops one by for her.

I, being a good hospice nurse, ask about her plan when she can no longer care for herself.  Having been a hospice volunteer, she knows what it looks like when people get close to death, lying in their bed, unable to do anything for themselves, with caregivers spooning medicine in their open mouth.  She has sat with many a dying person, and knows the effort it takes when caring for someone around the clock requires more than just delivering a meal, or sitting companionably visiting.

She doesn’t have a “plan B” yet, she says, though very aware it will be needed.  “Yesterday is gone.  Tomorrow may not arrive at all.  I am here now.  I’m just glad to be here now, and having a good day.”

“You are so right,” I reply, enlightened.  Now is all we have.  And my aged dying patient reminds me of this.  Call it denial.  Call it lack of planning.  Call it procrastinating.  I call it inspiration, and realize how lovely it is, for her to have now, and relishing now while knowing full well what is to come, but choosing to not worry about it.  She tells me she reached this state of peace about two days ago and has “slept like a baby” since then: “Just be glad for today.  It’s all we have.”  Who am I to tell her differently?

I suddenly know I am sitting in the presence of wisdom, and I don’t try to correct her with my superior hospice knowledge.  I understand, like those who survived the concentration camps,  she is experiencing something I have not yet, (losing everything that matters),and she is infinitely wiser than I, to enjoy this day and not stress over what needs to happen.  She knows we, her hospice team, will do that for her, and be fretting over the fact that no “plan B” is in place.

She is practicing being here.

She has given me my new mantra and I’m trying to pay attention.

“Everything can be taken from a man but…the last of the human freedoms…to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

              Viktor Frankl