Saturday, February 23, 2013

Being Present to Now

Chatter and laughter filled the living room. I finished  setting out cookies and coffee. I paused and realized, in a new way, I am inside. I smiled. For many years, I lived on the outside. Radar fully engaged, scanning for danger. Social danger: who is talking to who, am I dressed right, who is the bore, who is best, who is lonely, who is anxious, what will I say if, when will this be over, do I fit in, will I be accepted, what do I want, who am I, does it matter?

So many questions, all the while gathering information and making meaning and sense so I could be safe.
It has been a long process to get to the present. It came when the pain of being outside became too much to bear. I gave way to vulnerability.

The cost would be the knowing, the near mystical power to predict, and the safety of the illusion of being better, being right, and being safe. Confronted with the question: " Will I lose my ability to see? " I took the leap into living. I risked being known, being loved, being hurt, being wrong. This leap has yielded the fruit of being connected to others and of being connected more fully to myself.

Being present to now is the gift of life itself. I see differently, but I still see. My passions remain and I am valued for my seeing and giving, but now I also receive. In my work, I am thinking about this as the human exchange model and relationship as a healing modality.

Presence is the only modality that matters in the final minutes of life. I was reminded of this, as I went to make visits on the day after the snow storm. My seeing, made it important to see a frail woman and her daughters before the ice arrived and made it urgent to return when the snow had passed. I arrived to a dying frame, exhausted caregivers whose faces were marked by the strain of waiting, and the turbulent sound of breathing through water. Not a death rattle, but foaming accumulation in the chest. I felt helpless.

I scanned the room for tools to ease this discomfort. None were found. I paused. I panicked. I called the doctor. I checked the heart rate. I couldn't hear. I touched a hand. I adjusted the pillows. I explained. I watched. I remembered: no oxygen please. Then I attempted to get some new medication, a better solution.
As I called on the phone, the eyes changed. The rose pink of the cheeks began to fade. I stopped. I called to the daughter in the next room. She returned and sat with her sister. I spoke gently. I was quiet. I touched and so did they. We watched and held our own breaths. The life faded away with a last effort of strength and resilience that echoed into the heart of this family and yet was frightening.

The expected loss was harder than they had imagined. Grief swelled. We sat together. We were present to the now of death. Safe together.

Sunday, February 10, 2013


I reached for the door and paused.This is the door of finality.This wife's husband has now left home forever on a gurney in a velour bag with a quilt laid on top. I will never return here again. My work is done.

I entered by another door. I rang the bell and paused. The sister opened the door, "Come this way." I walked through the country kitchen to the living room. The classic scene. Dining room table pushed aside. Room made for the hospital bed. Supplies heaped on the no longer used bedside commode.

The widow, with eyes downcast said that he passed around 3AM. I acknowledged with a solemn look of understanding. I walked near to the head of the bed and looked at his face. Mouth flaccidly open. I reached out in a gesture of comfort touching his arm. I spoke to his wife. " I am going to confirm what we already know." She returned my solemn glance.

In that sacred moment when I place the head of the cold stethoscope on the chest, death is pronounced as if it is a discrete moment in time. When did death first enter? Perhaps when he couldn't remember how to get home from the local hardware store. The one he has frequented since he was a young man. Or maybe when he couldn't remember his wife's name. Or how to dress or eat any longer. In this home, death came slowly over weeks and months and years. It culminated as the door opened and the gurney went through.

Tears filled her eyes and I waited with her in silence. She stepped across the threshold and watched. I remained present, moved by her devotion. Stepping back into the house she reached for the door and closed it. My heart paused. We moved through the final motions: discarding narcotics, assuring her that equipment would be removed,  her regular nurse and the doctor would be notified. I offered my sympathies again. The sister kept me for a moment to tell the story in her words. I gathered my bag and computer and left through the door I had come in by.

Now I reached for the door and pulled it closed. I heard it latch and wondered what death is like after we leave.