“Ms. Mary is very excited to spend time with you,” the nurse said on my first day of hospice volunteering.
From behind the nurse’s shoulder, I saw Ms. Mary rolling her power chair toward us, a toothless grin on her face. She looked up at me, her nasal cannula hissing with oxygen, and greeted me with her hoarse voice. I turned around to see that the nurse had dashed away, and left me alone to take care of Ms. Mary, who had heart failure, COPD, chronic pain and many other medical conditions. I just pictured her as a landmine waiting to explode, and I was terrified I would be the person to clumsily step on the trap. I cleared my throat and introduced myself, “Hello, I’m going to be spending some time with you on the weekends for … umm.” I guess the answer was till she died, but I really did not know what that word meant at the time.
I will admit, I was only volunteering for the opportunity to put it on my resume for my medical school application. I was more of a kid’s volunteer kind of guy, as I enjoyed spending my time in the children’s hospital and as a camp counselor. Hospice, on the other hand, smelled funny, looked depressing, and I truly had no way to connect with Ms. Mary or the other patients. We just sat outside and played Scrabble, and I had to help her her make the words — not very fun for me. I hate to confess, but I found myself thinking, what difference could I make if these patients are going to die soon anyway?
One time when we were sitting outside, Ms. Mary saw two other people playing chess, and told me that she could play as well. The first time we played, much to my astonishment, she beat me easily! After that, we started playing every time I visited, and our games would last over an hour. Throughout the game we would converse about our families, friends and religious beliefs. I learned how she used to work in some sort of soft drink factory, and how she absolutely loved Coca-Cola but was restricted from having any because of her diabetes. Over time I completely forgot that Ms. Mary was actually my patient because she had become my friend.
The fall in Boston brought cold weather, and, as the leaves changed from a vibrant green to a putrid brown, Ms. Mary’s health also began to decline. First came the sporadic attacks of pain. Before this, the games and conversations would keep her distracted enough from any pain, but now nothing seemed to ease it even though the doctors continued to increase her medication dosage. Then came a change in personality that I like to call “haziness” for a lack of a better term. She just did not have enough focus for chess, or to even have a normal conversation. I attempted to adjust the activities we did — reading books, showing her pictures of my friends and family, and playing videos on my laptop — but I was never sure I got through her foggy state. Lastly came the increased trouble with breathing and a complete lack of mobility. She was put in a bed, her nasal cannula’s oxygen pressure increased, and her medicines were changed. Medically she was fixed, but, truthfully, she never was the same person again.
One day, after remembering our discussion on her love of Coca-Cola, I bought Ms. Mary a few diet Coca-Colas, and replaced the wrapper with a regular Coca-Cola wrapper. When I brought the bottle to her, I saw for the first time — in what felt like forever — her eyes crinkle and the corner of her mouth twitch, a heartwarming reaction that will be forever etched in my memories. I gave her a straw and held the drink for her as she thoroughly relished the bottle. Like it was a magic potion, Ms. Mary literally sprung to life, and we were able to play chess and cards for the duration of the visit. They say that patients experience a sudden burst of energy close to when they are about to pass away. Little did I know this might have been the same thing that happened to Ms. Mary.
A couple days later, I got a phone call from my hospice coordinator asking if I would sit vigil for Ms. Mary. I obliged and made my way over to the nursing home, where I saw her lying quietly in bed, but this time her nasal cannula was replaced with a full oxygen mask and her eyes were closed. I sat there for a couple hours just staring at the floor where the coke bottle had rolled underneath her bed, occasionally looking up to see Ms. Mary stir as she drifted in and out of consciousness. I wonder if that was the last thing she had drank? I was told two days later that she had passed away.
I realized, throughout the first year of medical school, that in the medicine, there is a lot that can be done to the patient. There are medicines, surgeries, therapies and machines that can keep any living thing technically alive. But we often forget what we can do for the patient. We can ask about their feelings and thoughts, inquire about their aspirations and fears, and make sure that they are treated like human beings rather than a disease. I also realized that I still do not know what death means — and that is okay. Because death is not a medical term that we learn for patient care, but rather a process that a person goes through, where our role as a doctor is support and care for the patient.
Just maybe, we need to give someone we care about a diet Coca-Cola hidden in a regular Coca-Cola bottle.