A Day on the Hospice Unit

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In the hospice unit, I stood opposite one of our nurse aides. Indicating one of the rooms, she said, “I think he’ll be next.”
We lost five the first week of August, but only one the second week. Three more are actively dying as I write this. One of them won’t make it to the weekend. The other two will probably not see another Wednesday.

This is our normal.

“He’ll go quick once he starts.”

“He’s a fighter. He’ll probably still be here on Monday.”

Sometimes we talk this way as if we’re discussing the weather. Sometimes we talk this way, and the emotional weight of our common mortality hits us. Most of the time we don’t talk about it at all. We focus on the next med pass, the next meal we’ll help someone eat, or the next prayer or shower.

But every time we go away, we wonder who’ll be left when we get back.

In my other unit, the dementia unit, half the men are wearing helmets because they forget they need wheelchairs or walkers, so they fall. One man tries to seem normal, so you get one- or two-word responses alluding to something you both remember, just like you’d get when you sat together at the bar. Another tells me about the bugs he sees as he carefully arranges napkins on the table to keep them at bay. Then there’s the one who is just angry because he’s here. He doesn’t know where or what “here” is, but he knows he isn’t home and that infuriates him. Mr. G will repeat whatever you say to him as if he’s hypnotized. Every time I go into the unit, I have the same conversations I had the last time.

Admirals, laborers, musicians, business owners, police officers, tradesmen—whoever they were, this is who they are now.

Twenty-five years, maybe less, and that’s who I’ll be, too.

People talk of progress. But there isn’t any. Not really. It’s an illusion. I can’t escape Ecclesiastes: “As you do not know the path of the wind, or how the body is formed in a mother’s womb, so you cannot understand the work of God, the Maker of all things. Sow your seed in the morning, and at evening let your hands not be idle, for you do not know which will succeed, whether this or that, or whether both will do equally well. … However many years anyone may live, let them enjoy them all. But let them remember the days of darkness, for there will be many. … So then, banish anxiety from your heart and cast off the troubles of your body, for youth and vigor are meaningless” (Eccles. 11:5-6, 8, 10).

It’s depressing, yet I’m not depressed. I read Ecclesiastes and the burden is lifted; vexation is truly banished. God will finish the race. I’ll just take the next step until someday a different young nurse aide says to another chaplain, “I think he’ll be next.” And that will be OK, too.

About the Author

Eric Verhulst is the chaplain in the Hospice and Geriatric Dementia Unit at the Martinsburg (W.Va.) Veterans Affairs Medical Center.

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Thank you for the difficult work you do. May God bless you richly and grant you peace and grace as you serve those who face the end of their days. 

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