Sunday, February 6, 2011

A visit with Death

The comments from "anonymous" on my previous post prompted me to reread some things that I had written during my first healthcare job, before I had a blog, where I worked as a caregiver in a nursing home. I've been rereading my blog, and realize I do sound a lot less compassionate now than I used to. I can't decide if I'm bothered by this. I really don't think that I lack empathy, and I definitely don't act or think cruelly of towards the patients I work with. I used to wear my heart on my sleeve, though, and that was not sustainable for me. If being extremely compassionate meant that I was too distraught to do my job (or to get completely burnt out in a matter of months), then it also wasn't something that was good for my residents. I think it is extremely important to offer someone whatever kindness you have, to always give a person the benefit of the doubt, but I don't think it's usually practical to experience a person's troubles on a deeply emotional level. It would be an excessively painful existence, I think, to fully immerse oneself in the pain, suffering, and death that inevitably we are exposed to.

Here is something I wrote not too long after starting that first job as a caregiver:

Dr. Schechter stood no taller than five feet, a likely contributor to her height being the pillow of white wispy hair formed into a bun on top of her head. Permanently misplaced dentures lent to her immediately endearing incisor-framed toothless grin. She seemed like the present-day manifestation of the old-fashioned tiny, cackling witch from Hansel and Gretel (the cackling probably due to her asthma).

I used to bring Dr. Schechter a cup of tea and sit on her bed where we would have looping and nebulous philosophical conversations. I left her always feeling that we had spoken about something profound, but being unsure about exactly what it was. A retired Viennese psychotherapist, she was one of the more interesting and magnetic residents, but her loneliness made me sometimes avoid putting away the laundry in her room or bringing up her lunch because I hated to leave her.

She used to walk into the hallway hunched over and confused, thinking that she was reliving her time as a refugee during the holocaust. I would gently take her arm and walk her back to her room, where she would sit on her bed rocking and moaning. I once asked her why she moaned all the time. She told me she liked to listen to it. I never knew Dr. Schechter as the person who she used to be, and maybe for that reason it is not difficult to accept her as she was.

She eventually became so confused and maybe desperate for interaction, that she would smear her excrement onto herself, the walls, and onto the furniture in her room. I would clean her up and comfort her for forty-five minutes or an hour, but it was never really enough; she was never really peaceful when she was by herself.

Aging seems terrifyingly lonely. Sometimes I wonder if it isn't so lucky to live into old age -- to see everyone you love die; to either lose your independence and watch your body decay while you still understand what's going on, or to have your mind deteriorate as you struggle to recognize your own children.

We knew she was dying. When I sat beside her bed on her last night, it seemed out of character to see that charming little old gingerbread witch so silent. I brought her morphine every hour and lorazepam every two. She didn't open her eyes or moan anymore. She couldn't talk or swallow anymore, so I had to crush the pills and mix them with a little water and use a syringe to squirt them into her mouth.

I don't know if she could hear me that night. I read to her from a book of German poetry I found on her bookshelf. When I picked up the book to thumb through it and read her a little, it opened to Der Tod und das Maedchen: a poem that was immediately familiar to me because Schubert
famously set it as a lied. The poem is dialogue between a young woman and Death: she begs him not to come for her, but Death tells her to be unafraid, that she will sleep softly in his arms.

I stopped reading after a while and just sat quietly by her. When she stopped breathing, I didn't believe that she was dead. I kept thinking that maybe I saw her chest rise a little bit. I insisted on listening for a heart beat again and again, but could only hear my own body. After the funeral home came to take her body, I went upstairs to her room.

Her bookshelves still held Beethoven symphonies, Mozart operas, Brahms songs: recordings that would have made me like her before I had even met her. I turned on her CD player, wondering what she had listened to last. I was rather proud of myself for staying so calm and composed throughout all of this. But as I bent to make her empty bed and the Strauss waltzes began to play, I realized that all day I had just been maintaing a facade.


  1. Ms. Greene,

    You have a talent. I only wish I could write as you do.

  2. Wow, that is so beautifully written.
    Your patient is very lucky to have had you with her during her last hours.

  3. now you're on the right track. :) I knew you had it in you. good luck

  4. Believe yourself lucky to have met her. Not many of your generation will get a gift like that. Very beautifully written, by the way.

  5. Wonderful writing, as usual.