INTERSECTIONS

PART 4

No, I Didn’t Have Favorites, but . . .

The need for hospice care knows no boundaries. We cared for families of every description and in every situation. They lived in mansions and in cars. They were Father Knows Best and Maury Povitch’s Worst. They were quietly accepting and railing loudly. One day, I was called by a physician, who was referring his patient to hospice. His final comment was, “And good luck to you guys!” This physician was an experienced oncologist who had referred many, many patients but had never said anything like that before. His comment gave me pause.

The patient’s wife let me in. She looked exhausted. From the entryway, one could see through the dining room into the living room. It was like looking at a stage with a living room set and a play in progress. There was a hospital bed positioned in a bay window, a very thin middle-aged man in bed with pumps and IV poles nearby. He was gesturing wildly, yelling, swearing, and tossing the sheets about. Two men, his best friends, stood by the bed trying to talk to him. “Good luck to you guys,” indeed.

Greg was reacting to his dire situation in a completely understandable way. I have no idea why this isn’t more common, but in fact it isn’t. Some people have occasional angry episodes, but Greg was on a tear day and night from all reports. He was furious with his doc for “giving up on me.” He had made quite the scene in the hospital and not just when he was told that his treatments were not working. He had been taking on the entire health care team from receptionists to physicians since his diagnosis. His family and friends were completely spent, saturated with his anger and tantrums. You can imagine how Greg felt about meeting a hospice nurse.

Greg had a feeding pump unlike any I had encountered. There are so many kinds of pumps. We just learn to figure one out, and then they come out with a new one. As I made a few attempts to change the bag on this pump, Greg honed in on me like a sharp-shinned hawk on a limping mouse. He took me out. He questioned my ability to do anything. His friends attempted to calm him. I worked to become calmer as he revved up his fury. Inside, I went all Cuisinart, but I didn’t let it show.
When I walked into the social workers’ office, they looked at my face and raised all six of their eyebrows. This was one case I was happy to hand to them and to our chaplain. Another nurse would be Greg’s primary nurse. They all were in for a ride.  

Over the months, the social workers and chaplain performed a miracle with Greg; not on Greg, but with him. He did his work with their expert guidance and patience. In my twenty years as a nurse, I had never seen such a transformation. He became a calm, accepting, grateful man. His family was thankful to the point of tears. What this team did will affect Greg’s wife and children and his friends forever.

After Greg’s death, I received a note from his referring physician, a man was exceptionally dedicated to his patients, but he was not easy to work with. He was patient with his patients but reserved a difficult side for his colleagues, including us. Almost every call from him was a complaint. He was one of those people who could give a compliment and somehow tag on a little dig at the end. But this note. This note. It is one I kept taped on the back of my door for my entire tenure at hospice. “I want to thank each of you at hospice for what you did for Greg. I would not have believed it was possible. Nothing short of a miracle. What you do is important. Keep up the good work.” This doc went to see many of his patients at their homes, something unheard of in a major medical center. He had stopped to see Greg and received a heartfelt apology for past behavior and a completely unexpected expression of gratitude. Greg had bestowed a gift of peace on this  man that left him stunned and profoundly moved. It erased the angst their past encounters had buried in this physician’s chest.

Social workers and chaplains, I wish I could make each of you a superhero cape. Quiet little miracles take place every day at your hands, and this one was especially sweet.