My team and I take care of at least ten patients a day who are actively dying and are approved by the algorithm of their insurance provider to be within six months of their death. They come from all walks of life. Some look like junkyard dogs whose bodies have been through absolute hell: old burns, deep, separated scars, and blemishes of infections that have been scratched and picked at for decades. Perhaps from this life of survival, they’ve developed the ability to sniff out insincerity and dishonesty.
A few days ago, I was trying to get a formerly homeless forty-five-year-old man named Dan to allow my team to give him a shower. He was super combative when we tried to bathe him while he was in his bed. He would waken from a deep narcotic and tranquilizer induced sleep and try to bite and punch anyone who got close to him.
I thought I’d try a soft touch. I pulled up a metal folding chair and sat next to him. “Hi Dan, this is Nina, the nurse. Can you open your eyes for me? I need to ask you a question.”
He snarled his mouth and squinted. His expression said, “What the eff do YOU want?”
“Thanks. I know you want to be clean and that you are a clean man. You’ve been in bed for five days and we want to help you feel better! We want to gently help you into the chair and them our wonderful nurse aides will suds you up and make you feel better!” (I sounded all cheerleader-ly and hated myself.)
He glared at me and locked right onto my eyes. “Who the hell are you? You sound like a five-year-old child!” Then he clamped his eyes closed and went back to sleep. I started laughing, realizing how stupid and condescending I must have sounded. The nurse aides were outside his room in the hallway laughing too. I deserved it.
Dan died a couple of weeks later. The social worker was able to counsel his two lovely children. They hadn’t seen much of their father throughout their life and when I first met them they described Dan as “always a mean S.O.B.”
I realize that most of my caring for the dying is about owing the living–their descendants- a fair experience so they can get on with their life no matter what the mess of their loved ones’ life choices had created.
He died the way he lived. He created his death. He fell on his sword.