In his The New York Times article “What Our Cells Teach Us About a Natural Death,” Haider Warraich writes, “We humans spend much of our lives denying death. Death, however, is not the enemy. If there is an enemy, it is the fear that death arouses.” I felt this enemy besiege my family as my great grandmother approached her life’s end. A fit and fiery woman most of her life, she began to show signs of serious decay by age 90. While my grandmother approached this time with tenderness and perception, my great aunt turned her disorientation into cynicism. She was angry at the doctors for not healing my great grandmother’s heath conditions, the nurses for not providing enough care, my father (a doctor) for not using his medical influence enough, and the world for bringing this torment upon her mother. By the time my great grandmother died, my great aunt viewed most of her familial life with anguish while the rest of my family felt strained and fatigued. In response to her anger, she separated herself from much of my family for 2 years.
Going into this hospice experience, I was undoubtedly nervous and slightly apprehensive. Due to my experience with my great grandmother’s passing, I did not fear death itself, but more what death made people become. Would I have a patient who was cynical like my great aunt, poised like my grandmother, or somewhere in between? Similarly, in what way would I respond to a patient’s death? Would I be able to respond to my patient in the “right” way?
When I met my patient for the first time, she immediately reminded me of my great grandmother. She is a petite woman of Asian descent with short grey hair and a slender frame. She is witty, observant, and cheerful, and I quickly learned that we had much more in common than I thought I could have with a patient. At first, these similarities stood surface-level, with conversations centered around our mutual love for dogs, nature, and fitness. One day, about 2 months into our time together, she unexpectedly opened up about her family. As she narrated her childhood in the Philippines, I sat mostly hush with occasional cues to signal that I was receiving her words with open and earnest ears. At the end of the visit, she said, “I have not talked about my family in years. I never thought anyone wanted to listen. Thank you.” From here, our friendship blossomed, as we shared more intimate stories about our families, cultures, and homes. Instead of a patient, I viewed her as a wise companion. Instead of a volunteer, she regarded me as “the daughter she never had.”
One visit, after discussing my patient’s worldly travels as a missionary, I asked her how recounting all these memories made her feel now, so many years later. She replied, “Of course I miss it. But I am one of the lucky ones. I can sit here and talk to you and thank God for all these good things, and I am happy.” This response represented a perception of death I previously found difficult to realize. Before, I feared that death made others feel dejected and debilitated, creating sadness and struggle. Though still difficult, I now know that death does not always have to follow this path. Instead, with listening and loving company, death can present an opportunity to reminisce on life with appreciation and joy and create positive connections that extend far beyond a person’s passing.
This past winter holiday, my great aunt came to my home to celebrate Christmas. She had heard I was volunteering for a hospice organization and sat down with me to ask about my experience. I described Holisticare’s mission, my relationship with my patient, and the new impression I had on death. At first, my great aunt was skeptical, restating her doubts about elderly care and medicine. However, as we continued to talk throughout the holiday season, I noticed a change in her responses. Instead of with doubt, my great aunt began responding to my stories with interest in understanding. After one conversation, my great aunt even said, “I wish great grandma had something like this.”
I was never resentful of my great aunt’s response to my great grandmother’s decline. I knew her actions came from a place of love and fear, a junction I think everyone faces at a time of death. However, my experience with this program and my friendship with my patient have provided me new means for responding to this crossroad. I now know the end of one’s life can hold just as much meaning, joy, and affection as any other point of living. This sense is not achieved through some aggressive therapy or expensive treatment. It instead stems from a place of comfort and reflection, a place that I can help flourish just by offering attentive ears and loving companionship.