At 22, working at a large New York City hospital, I was an Oncology Nurse assigned to a unit that one might call “the floor where Cancer patients end their days”. It was the place where the worst of the worst, the most intractable cases (patients) were admitted, most of whom never made it home. It was 1979 and treatments were nowhere close to what they are in present day, so most were repeat admissions until they passed. Many nurses would never choose to work on a floor such as this and it certainly wasn’t what I had hoped for. However, it was the only place that I could get a job in New York City that would guarantee me mostly day shift work. Later I would understand how important this job would be in my career and in my life.
I wasn’t from the city…I had come from a small town in Northwestern Pennsylvania with the dream of New York living that I possessed since I was a child. Well, that desire, that prayer came true but it didn't take long before I discovered it was tough being a girl from “not the city” working along side those who were. So many adjustments had to be made. I had to toughen up. I had to get over myself. I was in unknown territory and I was scared.
My supervisor was a tough English woman who supported her nurses by instilling confidence in us. She did this with her gentle yet surgical "parenting" skills. She protected us from those untenable physicians whose confidence in us was lacking at best. Her modus operandi was proving to these disbelieving practioners that we were, in fact, quite competent...even though some of us were'nt so sure of that. She was formidable and I liked her but we had to earn her respect, and if accomplished we became worthy of her "protection". There were many incidences where she placed me and other lightly experienced nurses in charge of certain “difficult” patients and their families along with their often "difficult" Oncologists. It tried us…tested us, but it grew us up. I have long since become aware of my tendency to being intractably, internally challenged when given a seemingly impossible task to perform. I was compelled to prove my disbelievers wrong, and I, being the biggest disbeliever of them all. This personality trait has been both friend and foe to me but this time it would prove a useful, stubborn tool. I stepped up to the challenges set before me, followed through and was successful which invariably lead to a certain level of self-confidence in my capabilities as a professional and as a human being. This confidence seeded courage that would grow into a knowing that I could and would effect the lives of my patients and their loved ones in a positive way no matter the level of difficulty. I knew that this objective must be first and foremost in my work no matter where my career took me.
One such "difficult" patient that was assigned to me stands out of thousands that would not punctuate my memory until many years later after having retired from my clinical career. This patient, a not-so-elderly woman, and the story of what happened to her would in my later life, revolutionize how I thought about death, its process and how I thought about God. The memory of her and her story has become evidence to me that much more occurs between here on planet Earth and on the “other side of the veil” when one is in transition. Much more than I was raised to believe. Much more than some will ever believe.
I was assigned to Ms. Schwartz (not her real name) for the rest of her stay with us on our dreary unit. She was diagnosed with end-stage esophageal cancer. She was a trying patient in that she was in isolation where anyone who was caring for her had to wear a gown, gloves and masks. She had no family, declared herself an atheist and was restrained (tied to her bed). The delirium she was experiencing, I now know is a common indicator that death is imminent. She was not coherent and certainly not effectively medically managed with respect to her psychiatric issues by our medical team. So she bit, scratched and spat at me as I cared for her. I dreaded going into her room. This lady brought me to tears most days, drained me of my empathy and instilled overwhelming feelings of futility and begged the question, "what good am I doing her? What good is this hospital doing her?" She was suffering indeed and I had no control over it.
There’s a type of breathing called “Cheyne stoking” that we in the medical field and those who have witnessed it at the bedside know as the last breaths of physical life. It’s not pretty to behold but it is a natural process and provides a peaceful way of transitioning if we leave our patients be and intervene only when facilitating their comfort. Well, after 3 weeks of caring for Ms. Schwartz, her time of last breaths was upon her. She was semiconscious and on her way out of this Earth plane. She was, for the first time since I stepped into her room, peaceful. I had known from many other death experiences that the last senses to go were the senses of touch and hearing, so I took the opportunity to meet her there in her wavering consciousness. For the first time, I felt I could do her some good. It was here where I experienced the most satisfying part of my job.
I held strong Christian beliefs at the time but knew if I mentioned the name of “Jesus” I would be, in this facility, considered proselytizing and risked being thrown out on my ear. But I could say God and light and other neutral words that worked just the same. So I stroked her hair and whispered close, “it’s your time to go home. Go to the Light. Go to God. You are not alone”. I wasn’t there for her last breath but I knew she would pass very soon. When Cheyne-Stoking ensues, it isn’t expected that a person would live more than 12 to 24 hours. I had 3 days off after this shift ended having worked 10 days straight, so I knew she would would be gone soon after I left the floor.
My three days came and went and soon I was back at the hospital for morning report. Not long into the meeting, one of the Nurses' Aides from the night shift came running breathlessly into the room, apologetic for for interrupting report saying, “Ms. Healey, you must come with me now, Ms Schwartz is asking for you...please come quickly.” Needless to say…and here is where I get the title for this entry, I exclaimed rather loudly and excitedly, “what do you mean? She's still here??
“Yes she is and she’s been waiting these 3 days for your return. You must go to her...Now!" Permission granted by the head nurse, I bolted from the meeting room and quickly transported myself down the south corridor. As I entered Ms. Schwartz’ room, I was struck immediately with the change in the environment, the feeling…calm and serenity replaced chaos and anxiety. I breathed deeply knowing I was walking across the threshold onto sacred ground, experiencing one of the many times I would feel the glorious golden chills of knowing something profound and significant was about to happen.
My trying patient of 3 weeks lay peacefully and lucidly in repose. She extended her hand with a sweet smile that I had never witnessed on her face in her prior suffering state. She motioned for me to sit beside her on her bed, calling me by my name which she had never done before. I did so even though such behavior is absolutely forbidden by any hospital or agency, even to this day. I was compelled however to ignore those rules just this one time. She grabbed my hand and weakly held it in her grasp and said, “Jan, thank you for being with me. I want you to know I felt the warmth of your touch and the sound of your voice. I want you to know I am going to God today. I want you to know this so you don’t worry”.
Well, we two had tears running down our cheeks. Mine in gratitude for her waiting for me to deliver this incredible message and witness this miracle. Hers, to have been granted permision to linger in between worlds and then to re-emerge to communicate gratitude for me being with her at the end. She acknowledged my desire to view her as a human being who deserved what all human beings deserve…a good death. And though her's I would not have considered “good”, she did. She passed within the hour. Her peace realized. My mind and heart opened to such an extreme that I would never be the same again.
I am telling this story publicly for the first time. Not to sell you on my skills at the death bed…far from it. I was just a fledgeling nurse honored to have had these experiences. I am humbled by the enormity of this process…the physical dying process. I have learned through my many “teachers” that a good death is possible if we allow it. However, God’s Grace is sufficient and we would do well to not bully or force patients, families, loved ones and their clinicians into a process that they are not ready for.
My intention is to educate those who wish to know the Truth about death. I want to eradicate the fear of it. For if the fear is absent, we humans would live with intention, with honor, with unconditional love. It may take a lifetime or ten, but it will come. There will be a day when we are willing to speak honestly about the natural process of physical death. It must happen if we are to experience the joy of living a full and happy life. For I believe, with all my heart and soul, that we are here not to toil, but to embrace and claim our birthright which is…joy, happiness, faith, trust, prosperity and…peace. And so I go forward asking my fellow human citizens of the planet, to consider our responsibilities to one another as we each meet our physical transitions, and do what is right with what is possible here and now...to allow the experience of a "good death" in. We can only do so by acknowledging the naturalness of this inevitable physical transition...we must talk about it, research it and acquaint ourselves with it. It is a perceived "enemy" that we must befriend if we are to live the lives we desire. We must openly talk to each other about it and yes, even to our children. I believe that it is the most important of responsibilities, for it is in death that we will truly live, for all eternity.
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