Lifeline

She is sick. Thirty years old. Widely metastatic lung cancer. Of course, she is happily married with a daughter only two years old. Three months from now, she will be dead, leaving behind a grieving husband and a child who cannot understand why her mother is not coming home. As I sit with her, I can feel my despair rise like flames around my chair. Smoke begins to fill the air and I find breathing just a little more difficult.

After more than 20 years working in hospice and palliative medicine, how can I listen to another heartbreaking story? And when I have borne witness to this tragedy, won't there surely be another? Perhaps a young man with a failing heart. A wife with progressive dementia. A father with a raging leukemia. Why not?

I have worked in this field long enough to no longer have any illusions. Coming to the end of life is often a time of great suffering and loss. Not all deaths are peaceful. Not all families resolve their conflicts. In his book, Mortally Wounded, Stories of Soul Pain, Death and Healing, Michael Kearney writes:

Despite all we might say and all we might do, the process of dying involves suffering and painful separations and unfinished business. Death cannot be tamed. Death is unknown. Death is death. ¹

As hospice and palliative care providers, we simply do our best. Sometimes it is enough. Sometimes not.

As I enter the latter years of my career, I find myself wrestling with this question. What is my role in all of this, this endless parade of suffering and dying?

In his essay, “The Man in the Water,” Roger Rosenblatt describes the heroic actions of a man who kept giving the helicopter's lifeline to five of his fellow passengers while clinging to an ice flow in the Potomac River after a terrible plane crash. When the helicopter finally returned for him, he had gone under. When describing this man, he wrote:

For its part, nature cared nothing for the five passengers. Our man, on the other hand cared totally. So the timeless battle commenced in the Potomac. For as long as that man could last, they went at each other: nature and man: the one making no distinctions of good or evil, acting on no principles, offering no lifelines; the other acting wholly on distinctions, principles, and, one supposes, on faith. ²

Perhaps my role is something like the man in the water, to care totally. There is no meaning to disease or dying or death. Nature follows its rules with no regard for our hopes, fears, or desires. Through simple compassion and clinical skill, maybe I can offer a lifeline of meaning and hope.

In the end, it is not a perfect answer, but for me, it is enough. The flames begin to recede. I can breathe easier. She and I begin to talk.