Shortly after walking into the nurse’s station on the Blue Ridge Hospice Inpatient Care Center, one of the nurses craned her neck around the doorway and asked, “Hey doc, would you mind meeting with room 8’s family when you get a chance?”
“Sure,” I replied, “what’s the situation?” Having not read through the patient’s chart yet, I was curious as to how I was needed.
The nurse related that the patient in room 8, Roy S., had just arrived from our hospice unit at Winchester Medical Center the day before and his family was struggling with how fast he was declining. He had entered the dying process and his wife and caregiver of over 30 years needed as much support as we could provide.
Before meeting with his family, I spent some time at Roy’s bedside. Roy had been a hospice patient for over a month; his Alzheimer’s disease long ago had robbed him of his ability to communicate aside from a fleeting glance from his gentle eyes. A faint squeeze of the hand when I asked if he was comfortable was my only connection to the man he once was.
I then dutifully met with his wife and adult children, reviewing the physical signs I was seeing and what those signs indicated. This is where the science and the art of medicine intermingle. A hospice physician needs to meet families where they are, emotionally—not only conveying information but also gathering hints and clues from the patient’s loved ones that can help us provide just the right level of care needed. What can sometimes get lost in this process, however, is the humanity of who the patient was and still is. It can be easy for a busy physician to gloss over the person and focus too much on the disease. But that’s not the hospice philosophy of care.
“Just keep him comfortable, doctor,” his wife said to me while staring down at her hands. I assured her our mission is to do just that and I said my goodbyes. I left the Inpatient Care Center that afternoon satisfied I had the information I needed not only to help care for Roy, but also to support his wife and family in the days ahead.
The next day, I gently knocked on room 8’s door and entered the room. I found Roy’s wife alone, sitting in the overstuffed recliner chair a few feet from her husband’s bed. The late-afternoon sunlight filled the room and soft instrumental music drifted out of the TV in the corner. She gave me a weak smile and, after a quick assessment of my patient, I settled down in a chair next to her. We talked about his pain medications and her worries about him no longer being able to eat. I gently prepared her for what was coming and she silently nodded her head.
She then looked me in the eye, and, with a little grin appearing on her face, she said, “He signed up to fight in the War when he was 15!”
“As in 15 years old?” I asked in amused astonishment.
“Yup. His aunt signed the papers attesting to him being 17 and his mom never forgave her,” she said, her eyes now dancing. “Just a few months after he was 16, he was jumping out of a plane over Belgium with the 82nd Airborne.”
Relying on my basic knowledge of World War II, I knew that likely meant he was at the Battle of the Bulge, one of the more horrific struggles in that great and terrible war. When I glanced back at the bed, I no longer saw a 93-year-old man dying from end-stage dementia. I saw a 16-year-old kid who risked his future, his life, to help save the free world so many years ago. I was reminded that the information I had gathered the day before was not representative of who this man truly is. Medical providers generally don’t get to read about our patient’s greatest successes or failures, greatest adventures, or heartbreaks. This is by design, of course, but when a loved one reveals those details to us, it is a gift.
The next day, I found myself thinking about Roy on my drive in to check on him. Entering the room this time, his wife was seated only inches away from him, ensuring she could reach out and touch his hand when she felt the need. His breathing had changed to a slow, irregular pattern and her proximity to him told me she sensed his final breaths were only hours away.
After offering what support I could, assuring her that he was comfortable, I sat and listened to her reminisce once again. How she had first met him after a divorce from a troubled marriage while she was eating lunch at her new job. How he “was always the life of the party” and how he cooked and cleaned the house while she was going through multiple surgeries for cancer treatment, always at her side for every doctor’s visit. Finally, after she was done speaking, she let out a sigh and looked up at me again.
“He never talked about the War for many years,” she said softly. “Later on, he opened up about being in the trenches and all the terrible things he saw. You know, he was awarded the Bronze Star and received a Purple Heart, too.” I glanced back over at the man in the bed, amazed.
She thanked me for listening and turned her eyes back to Roy. I quietly slipped out.
World War II vets are dying at a rate of more than 230 per day. Before leaving this world, Roy reminded me of the duty not only to honor the life of my patients in the present but also the life they have lived. Roy died at home on June 4, 2022.
