by Tilda Shalof
“We went through it all together. We’re not overly religious, but we did daily readings and prayers that gave us comfort. One was about a mother eagle, pushing her baby from the nest. It was exactly how I felt. From then on, we kept spotting eagles. Each time I thought, There goes my eagle. I’ll be okay. I see so many eagles now. Were they always there but only now I see them? Perhaps. Coleman was the fixer in our life, the protector, for me, our children, but we couldn’t fix him.
“Toward the end was when the real conversations began. He said to me one day, ‘Henny, you have to realize that I’m not going to get well.’ I was still in denial. He helped me face the reality. Until then, denial had been useful, but it was time to let it go. We planned for him to go into hospice. He thought it would be unpleasant for the grandchildren and too much work for me if he died at home. He was always protecting us, especially me, and he was proud and didn’t want the children to see him like that.
“Then came a day when we had no choice; he had to go into the hospital. The pain was unbearable. They got his pain under control, but the meds made him drowsy all the time and also more confused and not with us as much. Easter was coming and I asked him if he wanted to come home that day, just for the day. So he celebrated Easter and then we made the decision that he wouldn’t go back to the hospital. ‘Can you do this?’ he asked me. He wanted to be home, but only if I could handle it. ‘I can die at home if you are able to care for me.’ I didn’t know and I was scared, but the home care nurses came in and taught me. They empowered me. Without them there was no way we could have done it. They taught my children to give the meds. They were with us every step of the way. I was a layperson – what did I know about Hickman lines and portacaths? One night the battery ran out on his medication pump. I was afraid it would block off and we wouldn’t be able to give him pain medication. I called the nurse and in the middle of the night she came over. It was so overwhelming, all of it. It was hard having so many people at the house. He was a private person and very proud. He didn’t want anyone to see him like that. I pleaded with God. Heal him or take him.
“It was November 11, Remembrance Day. Coleman was an old soldier, a veteran of the Cuban missile crisis, and he wanted to watch the memorial service on the TV in the living room. We managed to get him there, but suddenly he said, ‘I want to go back to bed.’ He was one hundred pounds but a dead weight. Just as my son and I were carrying him across the living room, to the bedroom, he stopped us. ‘Wait,’ he said. ‘Let me look around. I won’t see this living room again.’ He was right. He knew. We were all with him at the end. Rose, our daughter, read him a poem she wrote and many people came to say goodbye. The grandchildren brought written messages for him that we read aloud. Some of the children were frightened and wanted to run away, but the nurses made them feel comfortable and helped them stay, even gave them little tasks to do, like massaging his feet or suctioning the secretions in his mouth. I sat by his bed and read him the love poems that I had written to him over the past weeks. I was able to thank him for all that he was and all that he had given us. I went from loving him to cherishing him. Everyone came and said their goodbyes.
“It was November 13. He didn’t speak all day. By then, he was getting morphine ’round the clock. There were times when he was short of breath, but the nurses told us not to panic and just calmly give the morphine if they weren’t there to do it. Mostly, we knew exactly how much to give and when, but I was scared I might give the fatal dose. But when I saw it from his point of view, I realized the morphine was a kindness. It wasn’t about me, it was about what he needed.”
She pauses for a few minutes and dries her eyes with a pressed handkerchief. We sip our tea and soon she is ready – and eager – to tell me more.
“It’s so hard to stand by and not do anything, to make that switch from cure to care. Mostly, he was comfortable and alert. When I gave him a bath near the end, I knew it was his last. I used nice soap and warm water – none of that chemical stuff they put on him in the hospital. That bath helped me let him go. A feeling of peace washed over me. Later that day his doctor, Dr. Leahey, came and asked him, “ ‘Coleman, how are you feeling?’ He said, ‘I’m on top of the world.’ ‘What do you mean?’ He said, ‘You know.’ At the end, she said to me, ‘A job well done.’ It meant so much to me, coming from her, a doctor Coleman respected so much.”
“How are you doing now?” I mean both right now in this moment, having relived that painful time, and also now, in this new chapter in her life. I leave it to her to take either meaning.
“I yearn to feel his body, to hear his voice. At times I’m angry. Mostly I feel forsaken. I felt lonesome, but not for anyone. For Coleman. Friends don’t know what to say. They don’t call or come over because they’re afraid of disturbing me – or perhaps themselves. When he slept so much in the last few months, I had thoughts of all of our plans and dreams, but I knew none of that would happen.”
She shows me a picture of them, taken a few weeks before he died.
“He was handsome,” I say. As for Henrietta, she appeared tense and haggard. Coleman was smiling broadly; she, not at all. She’s looking much better now, but clearly his dying was harder on her than on him.
“His dying was agonizing for me, but I made sure it wasn’t for him. But if the nurses hadn’t prepared me, it would have been traumatic. They told me exactly what to expect, what dying actually entails, the gurgling sounds, the smells, the erratic breathing, gasping at the end.”
“It’s distressing if you’ve never seen it before.”
“It’s not easy to turn your house into a hospital, but for the comfort of having him at home and being with him all the time it was worth it.”
“I’ve cared for many dying people, but I’ve rarely seen a natural, peaceful death like that. You should feel very proud that you were able to give that gift to Coleman.”
“Afterwards, I was never more exhausted. I felt like I’d run a marathon.”
“You had. You deserve an honorary degree.”
“In what?”
“In caregiving.”
“We couldn’t have done it without the nurses. They weren’t just nurses, they were teachers. They showed us how to do everything, explained what was happening, what would happen. I’ve since learned that most people don’t have that kind of beautiful death.”
We sit quietly for a few minutes, until Henrietta is ready to speak. “I love fall. I feel him around me at this time of year. You know, I still see eagles from time to time.”
“I hope his last few months of dying isn’t all bad memories for you,” I say.
“Not at all.” She smiles. “We had laughs, even during that time. One day, I was bent down, tying his shoes. ‘I bet you never thought you’d be tying my shoes,’ he said. ‘It’s a lot better than wiping your butt,’ I said. But then the day came that I had to wipe his butt, and as I was doing that, he said, ‘I bet you wish you were tying my shoes.’ Well, we both totally lost it. We never laughed so hard.” Henrietta pauses to smile at that happy memory.
Henrietta has started volunteering at the hospital. She’s beginning to get into her new life.
There’s something else she wants to tell me.
“A few weeks after he died, I came across a note tucked into a little dollar store tray I keep on my dresser. He’d wanted me to find it after he was gone. ‘One of the greatest blessings God can give is a spouse that loves you and you love in return.’ That said it all. It was so typical of our marriage.” She dabs at her eyes and apologizes. “Then, just a few months ago, my wedding ring was tight and I’d been meaning to remove it. On our anniversary date, suddenly, the ring loosened on its own and I didn’t have to cut it off. See, he’s still looking after me.”
Now the tears flow and she lets them, and I can’t help myself – I join her. “What can I do? I’ve lost my true love. We found each other in high school and we never let go. He taught me how to love. Yes, I will live on and I will love until I can love
no longer.”
On the road to our next stop, I scan the sky for eagles before dropping off for a power nap, another of my sleeping talents. After a few minutes, I wake up refreshed and look out the window. Farmland on the left, the sea on the right.
“Oh, look,” I say, “horses.”
“Here in the Maritimes, we call them cows.”
I put on my glasses for a closer look. Peering out my window, I see that they are indeed bovines, grazing peacefully in a meadow. “Oh. I see what you mean.”
He smiles at me in his rear-view mirror. “You really are a city slicker.” He points out some black and white cows in a field. “Those are Oreo cows. You’ll only find those in the Maritimes. See how the neck and rump are dark chocolate and the middle third is vanilla?”
“In the hospital, we have cows, too,” I tease him back. “Computers on Wheels.”
Soon, we arrive at the nursing home where the chief administrator – a chic, petite blond woman, looking glamorous in a beige Chanel-type suit and high heels – meets me at the front door with a smile and a disconcerting greeting: “Hi, I’m Bertha, the Death Woman.” She leads me to her office. It’s an oasis of calm with stained glass windows on the door, polished wood floors, and the peaceful stillness of a chapel – which is, in fact, what it was before Bertha Brannen made it into her workspace.
Bertha’s specialty is death, dying, and mourning. She organizes bereavement support groups, which grew in logical sequence from the caregiver support groups that VON had already established in the area. Bertha conducts divorce groups, too, because she believes there are a lot of similarities between grieving the loss of a loved one and grieving the loss of a marriage. I ask her about how she became interested in topics most people would rather not think about.
“My sister died at the age of twenty-five. Alice was so baaaad. We all had blond hair and she alone had dark. ‘I’m Elvis’s love child,’ she’d say. Oh, she had a devilish sense of humour. My mother died a few years later, at the age of forty-seven. When you’re facing death, your own or someone you love, you are honest.
“We are a death-denying society. In the past, widows wore black. A wreath was hung on the front door. The coffin stayed in the house. The community gathered to offer support. Now, we rush it along. Drive-through grief. I asked a friend how someone whose husband had recently died was doing. ‘Not well. She’s sad, crying all the time.’ ‘She’s doing exactly what she’s supposed to be doing,’ I said. The ‘cheer up’ mentality does not help anyone. Nor does, ‘Keep yourself busy, medicate the pain, remember the good times.’ If you do that, emotions get shoved underground. You can’t go around it, or avoid it. You have to move into it and through it. You need to embrace the pain of the loss, lean into it.”
In my own experience of losing my parents and some close friends, and certainly in my own care of patients, what Bertha says is true. It is the healthiest, but also the most challenging way to deal with grief.
“Sometimes people don’t know what to say to someone who is grieving, but it’s best to avoid clichés like ‘time will heal,’ ‘be happy you had him this long,’ or ‘he’s not suffering now.’ Those stock-and-trade phrases give little comfort. Better to just be there and say nothing at all.
“If you’ve loved greatly, it stands to reason you are going to grieve greatly. Grief is a privilege of having loved.” Bertha gives me her business card, which says, “Bringing Joy and Happiness to Others.”
What would my ICU business card say, if I had one? “At Your Side During the Worst Time of Your Life” pretty much sums it up. In the hospital, we don’t offer much support to grieving families, except here’s a tissue and there’s the door. Yet, some nurses and doctors have been known to attend funerals of patients, especially if they had a special bond with them. Once, a group of ICU nurses tried to organize a committee to send out condolence cards to families of people who’d died in our ICU. Some even volunteered to go out on follow-up visits to grieving families, but the project petered out. Seeing us again made them revisit a painful time. It stirred up too many unpleasant memories, and raised questions about the treatment their loved one had received. The project was a no-go.
But goodbyes are important. I remember one patient who I felt certain was going to die within the next day or two. I had spent a great deal of time speaking with her and her husband. At the end of my shift, and after my lengthy and detailed report to the nurse taking over, I was eager to hurry out of there and get home. Later that evening, before I went to bed, I realized I hadn’t said goodbye to either the patient or her husband, both of whom I had connected with and whom I knew I wouldn’t be seeing again. It left an uneasy feeling. I couldn’t fall asleep until I phoned the ICU, asked to speak with the husband, and said goodbye. I’m glad I followed my instinct because it was, indeed, the last time I saw them.
It’s been another late night. They are “working” me hard here. The wine and cheese party Suzanne arranged for me went on until midnight. These nurses sure know how to party hearty. Good thing Darin was there to drive me home.
Back at the B and B, I tiptoe up the creaky stairs so as not to disturb Twyla and her husband. “Night-night,” Twyla calls out. Soon it will be dawn and she’ll be up, whipping up another batch of muffins and loaves of homemade bread.
I lie in bed, wide awake, not ready for sleep, just holding the day close, mulling it over.
WINE AND CHEESECAKE
PEOPLE LOVE TELLING STORIES. Fishermen (and fisherwomen) boast of the big catch (or lament the one that got away); businessmen talk about closing the big deal; soldiers recount their war stories – and VON nurses recall their fondest and funniest home visits. At the gathering Suzanne hosted last night, she invited a group of nurses, both retired and actively working, who reminisced about their years visiting clients in their homes – barns, back alleys, a fleabag motel, and even a brothel. There was the younger contingent, who are still working: Nurse Manager Suzanne, Hailey, and Colleen, who was on call that night and wore a white shirt with “RN” emblazoned on it and black pants (standard nurse uniform in Nova Scotia). And then there was the old guard – Enid, Molly, Lois, and Bernadette, who wore stretch, comfy pants and colourful loose-fitting blouses, the usual uniform of women of a “certain age.” As the wine flowed and a pumpkin cheesecake (Halloween is coming) was consumed, I got snapshots of the way it once was and the way it is now, one story flowing straight into another.
WHY HOME CARE?
MOLLY STARTS OFF AND TELLS IT STRAIGHT: I went into home care to get out of shift work.
COLLEEN: For years, home care was VON. Now, it’s a business. But not in Nova Scotia. Here, it’s still VON.
BERNADETTE: I started out working in the emergency department. I remember a woman who came in at change of shift with an arm fracture. Everyone was so grumpy. No one would take care of her – you know why – it was change of shift. That was it. I couldn’t take it anymore. I’d had enough of the hospital, so I came to home care.
HAILEY: I did the opposite. I started in home care, but after a few years, I felt I needed to conquer my fear of the hospital, so I got a job there. They had all the bells and whistles but I missed the true picture of the person. And I’d forgotten about the hospital smells!
ME: I laugh whenever I call the hospital switchboard and hear the automated message: “We are a scent-free institution.…” Right – scent free! I’ll take my chances with the nauseating Poison or migraine-inducing Opium some nurses insist on wearing. They’re better than the hospital smells!
HAILEY: In the hospital, your time is never your own. If you want to spend a little extra time with a patient, you can’t. The day is so regimented. Patients feel it, too. I would rather care for a person in their home than in a hospital bed, when I have to dictate what time you can do this or that or when this or that will be done to you. I cringe whenever I have to send a client to the hospital for something. I feel protective. They’re not going to get the personalized care that I can provide t
hem at home.
SUZANNE: I hated every moment working in the hospital, but I never identified what the problem was. Now I realize it was the lack of opportunity to get to know the patient and who they were other than a patient. When I got to home care, I realized that in the hospital, I couldn’t be myself and I couldn’t give the care I wanted to give.
ENID: I needed a change, so I decided to work for VON. Why not? They gave me a car and a bag and I could be out on the road. No doctors around. It was all up to me. In the community, patients and families place their trust in us, the nurses. They turn to us for everything. After working in the hospital for a few years, I’d had enough of the hierarchy, the rules, the regimentation. I thought, Let me out of here, I’ll go work for VON.
COLLEEN: As soon as I enter a person’s home, I’m in their world. Totally absorbed. I pride myself in treating everyone the same whether they have money or not. It could be a million-dollar home or a dilapidated shack that I was going into.
BERNADETTE: And sometimes you’re treated better in that shack than in the mansion.
LOIS: I retired only two years ago and now I sit on the local VON board. At my job interview, I wanted the position so badly. All I could think of was if I worked in home care, I’d get to drive around town, my time would be my own, and I’d go out for lunch every day. I never ate out once. I never did. I always came back to the office, where all the nurses gathered to share our day. We became known as the lunch bunch. I enjoyed day one and the last day I worked there every bit as much. The preparation they gave me was simple: Don’t sit down and don’t keep narcotics in your car.
THE GOOD OLD DAYS, THE GLORY, AND THE PERKS
ENID: A VON nurse was always the first to bathe a newborn baby, even before the mother herself. Every new mother had a visit from a VON nurse when she came home from the hospital, and then at three months to see how she was doing, to make sure baby had its immunizations.
