Final Journeys (Electronic book text)

"Chapter One "Tools, Not Tissues"" How beautiful these leaves were just last week, I thought. How ironic that they're the most vibrant right before they fall and die. Now all we're left with is big piles of wet drabness and this bone-chilling weather. This is how so many patients feel, I thought. One moment your life is going along beautifully, and the next your doctor walks in with your tests in his or her hand and says, "I have bad news." Once you or someone you love receives that diagnosis, your lives will never be the same. A good friend, diagnosed with cancer, told me, "The disease took away life's innocence. I always feel like there's a stranger lurking in the shadows now, ready to jump out and do me harm again. The shadow person--that negative presence--is always there." Jake Jake was barely sixty years old, diagnosed with pancreatic cancer just three months before, and already terminally ill. He and his wife of many years had two married children, both living nearby, both with babies of their own. How sad, I thought: just as life was getting easier--kids launched, retirement around the corner, time to travel and enjoy the benefits of all those years of hard work, grandbabies to spoil--this happened. How unfair Even after so many years as a hospice nurse, I'm still in awe of the raw courage it takes to open the door and let someone like me in for the first time. Most of the patients and families that I work with have clung to the hope of a miracle, a medical breakthrough, or even a misdiagnosis until the eleventh hour. My presence means that the end is unavoidable. Those who have acknowledged the truth often feel that the limited time they have left together is private and fear that my visits will be an intrusion. I know that everything I represent is frightening. Nobody ever wants to have to deal with me. Yet I knock on front doors again and again because in my heart I know I can make these last weeks or months better and more meaningful. Julie introduced herself and escorted me into a sun-filled kitchen decorated with blue Delft tiles. "Tell me about your husband," I said to Julie as we sat down at the kitchen table. It always interests me what people do with that question. It's like asking someone you meet, "What's going on in your life?" instead of "How are you?" The first question allows for real information to be shared; the second almost always elicits a perfunctory response. My first goal when I visit a new patient and his or her family is to connect in a