In the Room Overlooking the Bougainvillea

A Mystery unfolded . . .

The patient was restless . . . to the extreme.

Years ago, I remember when an ambulance transported her to our hospice’s inpatient facility—a renovated suburban house—for pain management. The only local family for the dying eighty-something woman was a granddaughter, overwhelmed by raising her own kids while serving as her grandmother’s sole caregiver.

The patient’s siblings had already died.

The patient’s daughter was, again, in rehab in Florida.

Her son was an Army officer stationed in Germany, scrambling to organize a plane flight to be with his mother before she died.

At the hospice home, in a room with a window overlooking the bougainvillea adorning a fence, the restless patient, a nurse, the doctor, and the chaplain were gathered. One bed was empty. But the second bed by the window, where the patient lay, shifted with her unsettled body, with her soft random moaning, with her eyes opening and closing.

The doctor had tried several medications that she thought might calm the patient. To a certain extent, the dosages worked. Her agitation had lessened. Barely.

The doctor knew the granddaughter planned to visit that night. The son would likely make it late tomorrow. Would he arrive, only to see his mother unsettled and in pain? Would his final images be someone with a grimace on her face and moaning filling the room?

The doctor and nurse felt they’d tried everything. This drug. That drug. Even with an array of modern medications and research providing detailed knowledge about the progression of illnesses, the medical staff sometimes hits the proverbial brick wall. It is frustrating when “everything” has been tried and “nothing” succeeds. What could be a Plan B or C or any other desperate letter to address the disease’s pain and agitation?

The patient shifted and groaned.

The nurse sighed. Shook her head.

Partly resigned, partly anxious to try anything, partly having no other options, the doctor retreated a step from the patient’s bed. After making eye contact with the chaplain, the doctor said, “I’m not sure what else to do. Maybe it’s up to you now.”

I knew this chaplain a little. He’s a nice guy. He’d do anything for his patients. He also knew that some of his assigned patients would never meet him because they don’t want “religion” or “spirituality” in their hospice care. He’ll be a name on their charts, but will never be in the same room as them. With other patients, their families have their own pastor, priest, rabbi, or imam.

This dying woman was his assigned patient, but he hadn’t met her. She’d entered hospice care only days before and the chaplain had just called the granddaughter to make a first appointment. He knew she was Christian, but hadn’t been part of a church for a long time. He didn’t know much else.

He settled into a chair by the woman’s bed.

She shifted and groaned.

Would the medication never work? Would she never relax? Would a granddaughter and son see their beloved grandmother and mother in misery until the end?

The chaplain held her hand. For the longest time, that’s all he did. Just two hands intertwined. Maybe the air conditioning softly grumbled on. Maybe an oxygen tank in another patient’s room rhythmically stuttered. Maybe the doctor and nurse, now by the door watching, cleared their throats or whispered details about another patient’s needs. But for the most part, the room became silent . . . except for the woman’s random groans, and the creaking of the bed—like branches rattling in the wind—as she shifted back and forth, back and forth.

The chaplain quietly prayed.

He softly spoke Psalm 23. And then repeated it.

Lips barely moving, he sang several hymns.

The doctor and nurse only heard snatches of the chaplain’s words and songs. Focused on the patient, his every word, and every pause between words, was directed at the woman in the bed. And then, maybe after five minutes, or perhaps it was longer, she began to settle, to become calm. Her movement slowed. The moaning ceased. The eyes remained closed. The face relaxed.

The chaplain kept holding her hand. He sang another hymn.

The patient rested. Breathing in; breathing out.

She lived another day or two. The granddaughter, raised by her grandmother, was able to bring her children for one last goodbye. The son, bleary-eyed and caffeine-riddled, was able to say his final hello and farewell to his mom.

I recall when the doctor spoke about these events that occurred in the room with the view of a bougainvillea at our hospice home. (And yes, I’ve changed every single fact, but not the truth.) There’s no guarantee of a “perfect death.” Often, the right combination of medications does work. An uncomfortable patient achieves comfort; a family can spend final, peaceful moments together. I wish that “perfect death” always happened. It doesn’t.

And then there are times, steeped in Mystery, reflecting the enigmatic, essential bonds between two people, when what makes the most difference includes simple prayer, familiar songs, and a firm hand grasping another hand.

As a person of faith, I don’t think what the chaplain did should be deemed “a miracle.” Except that all of life, from birth and living to dying and death, seem miraculous. I also believe that everyone, the least or most “religious” of us, can settle beside another and offer a hand.

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Photo by Morgane Le Breton on Unsplash

My book, A Companion for the Hospice Journey is available at Amazon.