November 11, 2001

Dear Diary,

            I’ve never seen anyone come here so alone. It seems fitting that they brought him in the middle of the night; shortly after midnight, transferred by ambulance on a collapsible steel gurney. It was so cold; one of those nights where it seems the only thing between you and the stars are the wispy clouds of your breath. I felt, standing outside as they unloaded the patient, like I could fall upward into the sky.

            We had the room set up and ready for him, of course. The thick comforter on the bed was freshly washed and I could smell the Downy from three feet away. I had pulled the drapes on the big windows open so he could see the stream down below, lit up by the bright star shine. The lamp on the bedside table was turned to a soft warm glow and the dresser held a large vase of baby roses, heather and carnations that volunteers had gathered from the donated arrangements sent that afternoon from Tobias and Son.

I couldn’t believe it when they transferred him from the gurney and took the blanket away. He had nothing but the skinny thread poor hospital gown on, not even underwear or socks on his old brown feet.

The only thing he seemed to come with was his own dignity. He was awake and looked deliberately at each of us as if calculating the combined weight of our souls. His stare seemed to ask for compassion, but not for sympathy. I’d bet he was once a man of pride and position, just by the way he held himself. How he came to be here without the usual family and friends around, I can’t hardly imagine.

 

November 12, 2001

Dear Diary,

Joyce, the head of our nursing team, spoke with my new patient’s doctor for a long time today. It’s clear the cancer is eating him up quickly. He was starting to refuse food or drink before he even left the hospital. He is getting ready to die. He won’t be with us long. A mixed blessing for me: I won’t get overly attached: I won’t suffer when he is gone. People think we don’t feel these deaths, but we do. Knowing that death is coming doesn’t make you not care about your patients!

            What the doctor at the hospital didn’t tell Joyce was that our patient spoke no English. We were all surprised when he began to speak clearly and insistently in Spanish last night. He looked at each of us in turn as we stared; no doubt our mouths were hanging wide open.  It has been awhile since one of our patients was still able to speak coherently, let alone so forcefully. If we’d known ahead of time we could’ve arranged for one of the Spanish-speaking volunteers to be present when he arrived. There are volunteers for everything one can imagine that a patient might need. I knew that even at that hour, if we called, some one would come out but I hate asking too much of our volunteers; they give so selflessly already.

Unfortunately, none of us night shift nurses knew enough Spanish to translate for him.

            After a bit, he seemed to tire and resign himself to the fact that we couldn’t understand or talk with him. He settled back into the down pillows that we arranged behind his head and slept. With most new patients we have a lot to do: arranging and putting away their belongings, bathing and dressing them, taking care of their teeth, hair, skin and nails, keeping track of their meds and treatment programs, consulting with their doctor and comforting their family and friends. But with this man, there’s almost nothing to do for him after his short nightly bath. Sometimes I feel slightly anxious; as if I’ve failed him in some important way.

 

November 13, 2001

Dear Diary,

            When I arrived last night, the halls were already hushed and shadowed. I took a minute to pet Arlene and her daughter Farrah, the pet therapy Collies, and to say “hello” to their trainer Marie, then I went straight to my new patient’s room. As silently peaceful as the halls had been, my patient’s room, in comparison, seemed to hold a party. Three people were standing around his bed. Two were volunteers. One, named Howard, I know quite well since he is one of our most active and usually works at the center several days a week. The third man I had never seen. He stood, as I entered the room, and introduced himself as a representative of the local Cuban association. “This,” he said with a proud flourish of his arm toward the bed, “is Sir Enrique Manez; he was an esteemed doctor in our great country.”

            Despite my surprise, I was pleased to take the patient’s hand and shake it. How does it happen that a man who is loved and honored in his native country turns up in a hospital in Dayton with dirty bare feet, no clothes on his back and not a penny to his name?

“Mr. Manez,” the man continued, “has been in America searching for his grown son and I’m happy to say that our organization has located him in Tallahassee, Florida. Soon, Mr. Manez will be on a plane to Florida.” I was surprised to hear that the mysterious man was leaving so suddenly but I could see a glimpse of contentment had settled behind his eyes and I was happy for him.

             Howard explained, as the Cuban representative left, that one of the Spanish speaking volunteers had translated for our patient that morning and Carol, the volunteer coordinator, had reached the Dayton Cuban Association early in the afternoon.  By evening, the man’s son had been located and the organization had purchased, with funds from their treasury, a single plane ticket. “Pretty smart guy, that Cuban man, he didn’t tell me they booked the red-eye flight until after I said I would drive up there,” Howard laughed and winked at me. I knew Howard well enough to know that he didn’t really mind. His time was his own and Howard was always saying that this volunteer work was his true calling. He claimed he received far more in return than he gave.

            The patient was unusually alert the rest of the night, dozing off briefly only once or twice. About two in the morning, I roused Howard from his nap in the patient’s lounge chair and took from the bag the clean underclothes, slacks, shirt and shoes the other volunteer had purchased for Mr. Manez. Together, Howard and I washed and dressed our patient and combed his hair, telling him as we worked how handsome he looked and what a fine time he would have. I always talk to my patients when I bathe them even if they can’t hear or understand a word. It just doesn’t seem right not to. As he was ready to be wheeled out, Mr. Manez took my hand and though he couldn’t speak to me, the warmth of his gratitude was clear in his gaze.

 

November 27, 2001

Dear Diary,

            I went in early last night; I always enjoy Thanksgiving on the ward. The whole downstairs smells and feels like coming in the back door of Grandma’s warm fragrant kitchen in the dead of winter. The families of all our patients are there, just happy to be pilling their plates high with Maxine’s tremendous pecan stuffing and mashed potatoes and, most of all, to be able to spend one more holiday with their loved ones. Each and every minute is precious for them.

            When all the excitement is over and all the little grandchildren, nieces and nephews dressed in Sunday finest are home sleeping in their beds; all that’s left is the sweet lingering scent of Maxine’s specialties. That is the time I love to walk from room to room. The patients, those that aren’t worn plum out from all the excitement are replete, sleepy and satisfied with the enjoyment of seeing their friends and family lovingly content and stuffed full of holiday goodies. It is usually a good time for them; a chance to spend time with relations that can’t always visit. Most patients are rallied enough that I find few are really in a bad way that day.

            I really think the best part for me last night though was when Carol told me that she’d received a call from Tallahassee on Wednesday morning. Come to find out, Mr. Manez had only lived a few days after arriving in Florida but according to his son, they were very good ones. His son was overjoyed to be with him in his final days and to have the chance to make peace and “say his goodbyes.”

            Mr. Manez was leaving this world the same way he entered it, with nothing but the love of family. In the end, what I have learned from working here, and from my patients, is that this is all that matters: the only thing that really counts for anything. It gives me a lot of joy to know that we helped Mr. Manez when he had nothing and no one else to help him.

People are always asking me why I want to work at Hospice. With the nursing shortage, they say, I could go anywhere. They’re probably right but what they don’t understand is the joy that we get when we are able to help patients like Mr. Manez. It is not that I never question or doubt my work. You can’t see that horrible white face of death without feeling scared and doubtful. People always think that patients die with a peaceful look on their face but many look scared, hurt or bewildered. Still, for me, working here has a reward of its own. Tomorrow night, Joyce told me, we will have three new patients on the ward. ²⁵