Spending time with folks who are in the last short strokes of life sometimes can be very funny, sometimes very educational and sometimes outright heart-tugging. If not anything else, watching the compassion that the patients show to each other and the employees there show to the patients, is singularly educational.

I had a memorable moment day before yesterday. First let me set the context. One of my patients – a octogenarian lady – is more or less physically functional – however her short term memory is pretty much non-existent. She does move around in a wheel chair but she is able to move herself.

She has three kids but I am under strict instructions not to bring the topic of two daughters up unless she happened to mention it and even then I am to just acknowledge and move on. There is a particularly painful history she has with her daughters but let me spare you of that.

The son, on the other hand, is a completely different story. It was her son, as I understand, who moved her from a pretty bad situation and put her in the hospice that is very close to her house. He visits her often with his wife and kids and takes her to their place once a month. She absolutely lights up whenever anybody talks about her son.

My last visit this year to any hospice was this Friday and she was my last hospice friend that I had to visit. I was expecting a 20 minute experience. Turns out, we talked for nearly an hour. She was in a very good mood.

So, you ask yourself – what can you possibly talk for an hour with a stranger? First, you will be surprised how people want to tell their story if you let them. In this case, I did not have to bother about that either. She is so devoid of short term memory that an hour of conversation is pretty much twelve re-runs of the same five minute conversation.

I must have answered her standard questions about my family, my daughters, where I work and so on a clear ten times or more. Similarly, she made sure I had heard about ten times about her grandchildren, their ages, her original place of birth and such other things.

To break the monotony, at times, I would press further on the topic of her son – since I knew she is very proud of her.

“Your son, Mrs Valerie, is a gem of a guy”. (names changed to protect piracy)
“He is. He is an absolutely great son. I am very proud of him.”
“As you should be. You should be also proud of yourself how you raised him.”
“Thank you. I had friends help me.”

I was not sure how to avoid broaching another sensitive topic – her husband. So, I just smiled and was wondering what to ask next when she dove into the topic herself.

“My husband left me after my son was born. I needed my friends to help me”.
“I am sorry to hear that. But I am sure glad your friends were around.” Trying to veer away from her husband, I continued “You chose some real great friends”.

She was not to be deterred. “My husband ran away with a floozie”.

Okay, I do not know how you would react, but I was stumped. At that point I was hoping that she will ask me again the same questions about me that I had already answered for a few times.

“Did you re-marry?”
“No”
“So, you raised the kids all by yourself?”
“My husband left us. I had no choice. But I had friends help me.”

“I have to say this, Mrs. Valerie. I am very proud of you and what you have done. I think I have a lot to learn”
“Why, thank you!”
“They say that a great mother raises a great son”
“That is not true”
“That is not true?”, I asked somewhat confused.
“No. A great mother raises not just a great son. A great mother raises a great father”.

It took me a minute or two to realize what she was trying to say. Then it dawned on me. Her pride in her son was not how he has treated her – but how he has treated his own kids. It is not the son in him but the father in him that she feels so proud of.

She immediately interrupted my thoughts with the same old “How many kids do you have?”, “Are you retired?”…

On the drive back from my last hospice visit of the year, I could not help think of a young lady with three kids suddenly deserted by her husband. Somehow, somewhere, she picked up her broken pieces of life and must have made a promise to herself. Although the newborn son she had was going to be bereft of a father figure in his life, she will work the hardest to make him the absolute greatest dad in the world. For sure, she would make him – in her own eyes – far superior to the man who hurt her.

Boy! Did she come thru on that promise!! “A great mother raises a great father”!!!

Long time back, I had read a book “Top Five Regrets of a Dying Man” by an Australian hospice nurse – Bronnie Ware who had distilled her 51 years of being around people who were waiting to die in 5 simple truths on what we regret about when we look back at life. Sometime around then, working at a hospice became an entry in my my bucket list after reading that book.

First, I reasoned that it would help me set perspective for the years I have left. But more importantly, I thought there was a second part of that book Bronnie meant to write some day – what the postitive reflections are that people have once they realize that their days are numbered.

Getting the opportuinity to work at three hospices for the last three months (started with seven patients, lost four of them and added six more), I am starting to get some glimpse of those reflections. Specifically, I have come to two realizations…

Lesson 1: People take great pride in their children

Without exception, every patient – at least the ones that can hold a rational discussion – is very proud of their children. Even the most quiet ones can become animated if you just ask them “What do your kids do?”

You probably remember the gentleman who kept his daughter’s phone number in his hat. You may also remember the blind gentleman who was very proud of how much his kids do for him. I even have a patient who has a picture of herself with her three kids on her shelf – but I am not allowed to talk about the daughters (who as I understand are fighting unsuccessfully drug addiction and swindled their mom of a lot of money). Try talking to her about her son though and she will hold court for at least half an hour before she will come up for breath.

The general sense I get is that in your last days, you realize that your kids are one of the very few things that are absolutely your own creation. Nobody else could have create exactly they way they are. And in any which way you have influenced them – your effects in this world is going to outlive you by about 30 years or even more.

Lesson 2: Everybody has a story. And they want to tell it.

Once a patient starts opening up, almost always it is about their past life. It is like they just want somebody to listen to their reflections. Most are very proud of what their life has been.

The other day, as I was walking from the parking lot of one of the hospices to the building itself, I saw an old lady walking along with her walking stick enjoying the sun. No sooner than had I greeted her and asked her how she was doing (I did not know her at all), she stood there for thirty five minutes and gave me a synopsis of her life story. With a great sense of humor too!

One of those patients who is no more (in fact, he passed away when I had gone to India to tend to my dad), used to wait for me to come the next time to tell me one more of his chapter of life. Same with the blind gentleman.

Now, realize that some of those stories were not very consisten. For sure, they were biased. But the accuracy of the story is not my point.

My point is, I think before they die, they want their story to be heard. They want to leave their story behind. They are proud of the unique achievements they have had and most look back with some satisfaction. But there are no avenues for them to let the world know of their story. And perhaps, they realize that with them, their story will die too. Not too many of them are going to write down autobiographies.

Giving them an avenue to narrate their story the way they saw their life is an interesting “service” I have stumbled upon. One thing is for sure – each and every one of them has a story. And they are in a hurry to get it out… if you have the time to listen.

Those are the two lessons for now.

Would love to exchange notes with any of you who might have had similar or contrarian experiences.

I will certainly keep you posted as I learn more from my association with hospice patients.