Let me give you some additional background for this answer. My first Practicum (1986- in my Ph.D. program, where you see patients face-to-face) was at Hospice of Pasadena where I saw patients who were on Hospice care secondary to a life-threatening illness. I also saw those who had recently experienced the loss of a loved one who was on Hospice Care.
After my Fellowship at Yale University School of Medicine Department of Psychiatry in Consultation/Liaison Medicine, I returned to Hospice of Pasadena as the Director of Counseling Services from 1992–1998. I had six Practicum Students under my supervision with H. William Worden, Ph.D. International Author & Harvard Researcher on the Tasks of Bereavement and a pioneering study on bereavement and children.
I have led a Parents of Murdered Children’s Support Group from 1995-Present. One of my specialties is Hospice Care and Complicated Bereavement. I have full disclosure to share the following events from my first Hospice patient and her only daughter. Names and circumstances have been altered to fully keep this case confidential.
My first Hospice patient had a progressive liver & colon cancer with metastasis to the spine. When I saw her she was a 69-year-old Caucasian female, oriented to time, place and person. She was on a Morphine drip for pain and had been on Hospice Care for only one month. The Dodger’s were in the play-offs in 1986 my first Practicum Year. I had a Master’s Degree in Clinical Psychology from Xavier University; this was not my first patient contact.
I came into her room and started to ask her some “intake questions” and sat at the edge of her bed. The only chair was filled with IV’s, clothing, magazines, etc., and I didn’t feel that I should move it. She didn’t look at me nor did she answer my initial questions. At the commercial she sternly said: “Why do you G.D. S.O.B. shrinks think you can come in here and sit on my bed and interrupt the play-offs. Who the f__ck do you think you are? Shut up! Game’s back on.”
I moved all of the crap in the chair and sat down and did not say a thing. I believe the Dodger’s lost and I heard another string of expletives! Peggy finally turned to me and said, “So what the hell are you doing here?” I explained my role as a Hospice Intern. She rolled her eyes. “Well I guess you won’t sit on my bed again!” “No Ma'am.” “No Ma’am, listen my name is Peggy and you call me by my first name. Got it?” I almost said: “Yes, Ma’am!”
“Larry?” OMG she was listening enough to get my name! “Can you go to the fridge and get me some sparkling water, the Colon Cancer is a son-of-a gun on my insides?” I brought her a glass of sparkling water and she took the glass in her shaking hand and I realized how weak she was. It was hard for her to hold onto a glass. “I’m sorry I didn’t mean to be such a bitch it’s just I know this will be the last potential World Series for me and my Dodgers. Can we meet at the same time next week?”
“Yes, of course!”
Thus began a short four-month course of my work with Peggy. Cancer in the Colon and the Liver had done its damage to her system. The metastasize to her spine effected her gait, her ability to hold onto objects, and many different neurological sequelae. Each week from 1pm–2pm I would meet with Peggy at her home. Two months into our time together she was once again admitted to the City of Hope. She needed to be stabilized because the Cancer had gone into the portal vein of her liver and she was beginning to have a systemic (total system shut down). I met her daughter (Donna) and husband early on in my work with Peggy. We developed a close relationship because as the Cancer spread, I found myself spending more time with Peggy, her daughter and her son-in-law. During the last month of Peggy’s life I was introduced to her “grandfather.” Peggy’s “grandfather” was an older man (not related) who had pursued Peggy for years. It was only in her latter years of coping with cancer that she allowed herself to spend time with him.
Peggy was transferred to a Hospice bed at the City Of Hope. Donna and I had spent hours at her bedside because the Hospice nurse told us that she could go “at any time.” My role as a Hospice therapist extended to more than one hour per week. With the approval of my supervisor, I knew that Peggy and the family wanted me to be there more frequently. Donna and her husband were exhausted. I told them to go home and get some sleep and I would follow shortly.
They left and I took just a few moments to say “Goodbye for now” to my first hospice patient. Those were my words as her “Grandfather” came into the room. I told him I had not eaten all day and I was going to the coffee shop and get something to eat. I would be back in less than a half of an hour. He nodded and I left.
I came back to Peggy’s room in less than 15 minutes and she had died! I turned to “Grandfather” and I said, “But I was only gone for 15 minutes.” He looked at me and said, “I don’t know, but I know she had a special place in her heart for you! Maybe . . . it was her final gift to you so that you did not have to see her take her final breath. I can assure you my friend, she turned away from me and had a peaceful death.”
Death is a mystery, sometimes people will wait for months for a loved one before they release their spirit, others, like Peggy wait and die in their own time and space, sometimes a final gift to those they love.
“Just one more for the road before I go!”-Peggy
Peace and healing!
Be Well!
Lawrence J. Schulte, Ph.D. C.Ht.
Ph.D. Clinical Health Psychology (1990-Present)
Registered Hypnotherapist (2016-Present)
