"I want you to give me all your attention and forget about anything else you had thought about doing."


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Help me, help me!! The anguished calls echoed down the hospital corridor as the day nurses looked at their assignments. I recognized Mrs. Brown's voice and wondered whether she had rested during the night. Almost every evening she became agitated and fearful when her husband was preparing to go home.


Settling her for the night was a combination of sitting with her for short periods and increasing her dose of medications for pain and anxiety. She was less fearful when somebody had the time to stay with her, but this wasn't always possible.


Mrs. Brown had been diagnosed with bowel cancer eight months earlier. The disease had progressed relentlessly despite surgery. Chemotherapy and radiation were not options due to the extent of metastases. She and her family had requested that she receive intravenous fluids and antibiotics, just in case she could beat this monster.


We kept her as comfortable as possible. But no magic pill would relieve the emotional pain for Mrs. Brown and her family. Her white-haired husband came daily, as did Mrs. Brown's daughter and her young baby. The daughter felt torn between wanting to be with her mother and looking after her young family. One morning I asked them if they would like to have their pastor or the hospital chaplain visit. Mrs. Brown responded, "No, thank you. We're not religious people."


While listening to the night report, I silently prayed for Mrs. Brown. After the report, I walked into the room and said, "Good morning, Mrs. Brown." Even though her head was supported by pillows, she appeared distinguished and in control. She said, "Come here. I want you to talk with me. Come here and hold my hand." I walked over and gently picked up her hand.


"I don't want you to straighten my covers or comb my hair or give me a bath or any of those other things you nurses like to do. I want you to give me all your attention and forget anything else you had thought about doing. "Then Mrs. Brown talked about her early years of marriage and how she and her husband had scrimped and saved to keep their farm. She talked about her children and their growing-up years. The children worked hard, helping to put food on the table. Little time was left to spend together. Mrs. Brown recalled times that she had disagreed with her husband regarding buying new furniture; animal feed and machinery came first.


As she shared her memories, I could see a strong woman who had faced life bravely and was facing death similarly. I felt privileged that she had chosen me as the recipient of this lesson in palliative care-to be present for our patients emotionally as well as physically, and to take the time to listen without distraction. When she finished, Mrs. Brown thanked me for listening, and I affirmed her and thanked her for sharing her life memories.


As Mrs. Brown grew weaker, she rarely responded with more than a few monosyllables and lay in bed with closed eyes. "Do you think it will be soon?" her daughter questioned. "Dad would like to be here when she goes."


I responded that her breathing pattern was changing, and her pulse was becoming weaker. She would likely go within days. Her family came and sat around the bed. The family shared the last day of their mother's life. Later that evening, Mrs. Brown died peacefully, with her family present.


This experience reminds me that my patients are my best teachers. Lord, help me to see the inner person struggling to be recognized through the haze of pain and the ravages of disease. Help me to show your love by my actions and caring, even though I may not be able to share it in words.