hospice (beginning)

I'm a week into my rotation at Connecticut Hospice, the first hospice established in the States. It's located in Branford, about twenty minutes north of New Haven, and overlooks the Long Island Sound. The water is a wide expanse, with a wide expanse of ground from the building to the water, and every room has this view. Currently the ground is piled upon with snow, and unlike the snow of city and of routine living, this snow has remained white since its fall one week ago. There's little to disturb it other than the few who walk out from the building to the black fence outlining the beginnings of the water, and these steps add not color but a faceless depth. The sun rising and setting seeps into crevices of the water and clouds, in increments of half seconds, such that you get a sense of change without any motion.

With that backdrop, we have morning rounds, where the nurses (the heart of hospice) report on their patients and their daily plans are discussed. With that backdrop, we visit the patients and write notes on those visits. With that backdrop, we watch people die.

I hesitate with that line, hesitate to dramatize, but when thinking of the actual fact of things, that's just what it is. And some of it is as heavy as it sounds, and some of it floats away without much notice. As not just newbies seeing things for the first time, but as students whose role is to absorb as much as possible, the experience as a whole is quite a bit to take in.

In this short time, I've been struck by a number of things. For example, of how scared I was to see someone physically transition from life to death. Not out of empathy for the person who had not much life before that transition than after, but out of an instinctual aversion to seeing it happen and an awkward, sad sense of trivializing something by being there for the last breath of a person I didn't know.

I've been struck too by resilience, by how people give more at their most difficult times than I can at my best. At a time when I imagine people might feel compelled to turn inwards, they are instead touchingly sensitive to others. They continue on as the people they were--they want to take care of the families they've raised, they are insecure about how others perceive them in hospital beds,

And I've been struck by the variety of burdens, in quality and quantity. There's a lot to consider, besides the sufficient issue of absence. There's a man whose wife donated her kidney to him, there's an unresponsive woman whose 14 year old son reads her stories she'd read him, there's a man whose son and wife don't know how to speak to each other about the same thing, there's a 98 year old woman who says she feels full of emptiness like a room where sound echoes on and on, there's a woman whose understanding of her husband's pain is a more meaningful transition than his from life to death, there's an artist whose wife never let him draw her portrait until now and he draws a black and white picture of her face with her eyes closed. There is a 46 year old man who without telling his wife bought a sports car, who then crashed it while speeding, who then dies after months of his family tracking the movements of his left eye.

And I've been struck by the humor, and conventional routes to warmth paved in a place one might imagine as cold. I wrote my first prescription for a daily beer, frailty quickly turns into feist when a woman wants her nails polished and thinks you're the one who promised them to her, and you find that innocence doesn't need to be young, that the sweetness of wanderings renews itself with dementia. And it's things like all of these that bring awareness from knowing logic to feeling realness, like the sense that maybe death is an emptiness but one that's full.