Authors

  1. Powell, Suzanne K. RN, MBA, CCM, CPHQ

Abstract

Case managers, instinctively, without a second thought, and multiple times every day, help others: emotionally, financially, and supportively. Rarely do we see the good come back around. This story demonstrates one instance where good coming around was revealed.

 

Article Content

The necklaces were made of coral with silver beads, unique and striking pieces that clearly had a story attached to them. Little did I know that my story would be added to those strands in the uncanny twists and turns of coincidences, leaving no doubt as to the meaning for me.

 

I saw one of the necklaces for the first time nearly 2 years ago, when it was being worn by someone I knew. The woman explained that she had bought it from a woman named Claire, who was selling necklaces that had belonged to her grandmother. Claire's brother was ill, and she needed money for food and lodging.

 

When I met Claire, she wanted to sell me a necklace, too. Reluctantly, I paid her for it but never intended to keep it. Clearly, this was a treasure that belonged to Claire's family-especially after I learned that her grandmother, according to Native American tradition, had earned each strand by running many miles over several days. Claire was willing to part with the necklaces, which she had carefully restrung, because she placed more value on being able to take care of her brother, who had been diagnosed with cancer.

 

A year or more passed, but I never forgot Claire or her necklaces. During that time, one of my loved ones suffered several health setbacks. I traveled across the country numerous times to see her and do my best to care for her. Although her death was not unexpected, it hit me hard. As part of my grieving process, I replayed her final days in my head, over and over again. Did I do the best I could? Did I do too much-not enough?

 

It would take another person's transition to ease my mind and heal my heart. It happened on December 5, 2013-coincidentally, the same day Nelson Mandela died, and the world mourned the loss of a great leader. But in my world, "Larry's" passing was far closer and more personal.

 

Larry was 45 years old, well-liked, and "dying hard," as it's sometimes described. He was in agony, according to the floor nurses. He was afraid, upset, and irritable from "air hunger." Emotions were running high; the staff wanted this stage to be more peaceful for him.

 

As sometimes happens in health care, not all agree when dying is close, and this was the case with Larry. After the head chaplain became involved, comfort measures were finally initiated. With that, Larry was able to die peacefully the next day.

 

His passing was like a balm for us all, because this is what we had wanted for him. In this desire, I found the echo of what I had wanted for my own loved one. I finally found peace in the fact that my loved one had not "died hard." Larry's death brought me to a point of acceptance-a profound and deeply personal gift.

 

Unexpectedly, in the way of all good coincidences, the next day after Larry's death I came upon Claire's coral necklace. I told a colleague that I needed to return it to Claire; I simply couldn't keep it any longer. That's when I found out the connection: Larry was Claire's brother. That coral necklace symbolized all she was willing to do to help care for her loved one. Now, my story was entwined with Claire's in that necklace-two people mourning loved ones for whom we were willing to do all we could, as best we could.

 

In her book, Remembering Mother, Finding Myself: A Journey of Love and Self Acceptance, Patricia Crisafulli (the book is written under her former name, Patricia Commins) describes the power of stories to help us find connection and meaning. As we explore our stories, she writes, "Coincidences, uncanny circumstances and surprise discoveries mark the way."

 

I was having one of those uncanny circumstances. I had helped Claire as best I could, and her brother's passing had helped me in ways I cannot adequately express. Case managers do it daily, instinctively, and without a second thought-always doing good, helping others, without any expectation. We seldom know what outcomes we wield; but rarely, just rarely, we get a glimpse of the good coming back around.

 

advocacy and case management; power of stories; serendipity and case management