I arrive early at the hospice in-patient unit every Tuesday afternoon so the volunteer finishing her shift can brief me before I start mine.
“The patient in room four has visitors,” Deborah says on a early autumn Tuesday. “The one in room seven is actively dying. His wife is with him and their daughter is on the way. The woman in eight is sleeping and the man in room 10, Mr. Greene, will stand in his doorway when he wants a cigarette.”
“Wait, what? I didn’t know patients are allowed to smoke,” I said.
“Yes, of course, but outside,” Deborah replies. “His cigarettes are on the nurse’s conference table.”
Ten minutes later, I look up and see Mr. Greene standing in the doorway of his room. I don’t know how long he has been there since he is as quiet as a shadow. Mr. Greene is wearing plaid flannel pajama bottoms and navy velvet slippers. A purple hospital gown hangs like a drop cloth over his skeletal frame. The middle of his face is wrapped in a gauze mask that stretches flat across the hole where his nose should be, and his left eye is closed and bulging so far out that it looks like it could fall off his face with the slightest motion. Although I read ‘sinus cancer’ in his chart, I am startled by how grotesque he looks.
“Mr. Greene, what can I do for you?” I look down at my desk and pretend to straighten up a row of folders while I regain my composure. I flash to my dear friend Leslie who died from breast cancer after a long, bitter battle with the disease.
“Devra, get me out of here!” I can still hear Leslie’s frantic, final words, barked as though she had somewhere to go and was deathly afraid of being late. Leslie was not referring to the hospice room. I believe Leslie wanted out of her cancer-ridden body and she knew I would understand.
I felt helpless standing by her bedside as she pleaded, tugging at her oxygen line with one hand and pulling off her covers, exposing her scarred chest, with the other. The angry red criss-cross lines that marked her torso caught me by surprise and my legs started to buckle. Then she screeched again, bringing me back to her.
“I’m with you, Lester,” I said, using her college nickname, “and I want to help you get out of here.” I tried to sound reassuring even though I had no idea what I could do to relieve her struggle.
Leslie’s eyes were glassy and unfocused, but I knew she could hear me. So I took hold of her hand and talked to her—a steady stream of reassurance, jokes, and silly commentary on me and the others in the room (her husband, daughter, parents, sister)—until she quieted down and drifted into a deep, restful sleep.
I felt my fears dissolve as I focused on easing hers. And, I realized that I actually was helping Leslie by simply being there.
The year after Leslie died, I became a hospice volunteer. I reasoned if I could provide some comfort to Leslie in her final days, maybe I could help others. But right now I feel like a fraud because I am frightened of Mr. Greene, as if he were the monster he appears to be. I am also afraid that I will not be able to step outside my fear of death; the way I could with Leslie.
“I want a smoke.” Mr. Greene’s voice is soft but deep and clear.
I stand, maybe a little too quickly, and glance around for someone else—anyone else—to take him outside. There is no one.
“OK, I’ll grab your cigarettes while you take a seat in that wheelchair next to your door,” I say, my voice a little shaky. I hope Mr. Greene does not sense my discomfort.
“I don’t need to sit in no wheelchair,” Mr. Greene says in a weak protest, as though he knows he won’t get his way but has to try.
I do not want to take his pride away from him, but I stand firm. “We both know the hospice has a rule about this,” I say. “Please, sit down.”
I grab Mr. Greene’s Ziploc baggie of Newports and Tastee Diner matches off of the conference table. As I get closer to Mr. Greene, who is now sitting in the wheelchair, I notice the bandage wrapped around his concave face is leaking a thick yellowish liquid and I feel my throat get thick. My gut reaction is to look away, and I remind myself that my goal is to make him—and every hospice patient—as comfortable as possible. I recall Leslie once telling me she did not like to be stared at or treated differently when she was bald and bloated from chemo, so I take a deep breath of courage and step behind the wheelchair.
“My name is Devra. I volunteer here on Tuesday afternoons,” I say, as I start to push. The wheelchair moves easily, as though it is empty.
“Harold,” Mr. Greene says.
“Harold. It is nice to meet you.”
I guide him toward the exit and spin the chair around to back out, using my right hip to open the door. We roll onto the stone patio which is lined with low green boxwoods and benches dedicated to people who spent their last days in the hospice. Beyond the shrubs is a sloping lawn dotted with oak trees that look like they are trying to reach up to heaven. Some still have a few resistant dried leaves clinging to the upper branches. The air is crisp around the edges, and I did not remember to put on my coat, so I steer Mr. Greene over to a wooden bench in the sun.
After I make sure Mr. Greene’s chair is secure, I sit down next to him and take out the Newports. I give the pack a shake and straighten my arm in front of Mr. Greene who slowly pulls out a cigarette and places it between his lips. I strike a match and hold it up between us when I realize I am on his blind side and he can not see it. The flame travels quickly to my fingertips and dies out. There is only one match left. I strike it, this time standing in front of him as I put the flame up against the cigarette. “Here you go,” I say. He tightens his mouth and inhales. The cigarette shrinks in and glows red. Mr. Greene takes a long pull, thanks me, and crosses his legs.
I sit back down, point my face up to the sun and close my eyes while I search for a safe topic of conversation. “It says in your chart you lived in New Orleans during Katrina,” I say, turning to look at Mr. Greene.
“Yup,” he replies, staring straight ahead.
“New Orleans is a great city. Did you listen to a lot of music while you were there?”
“What did you do there for fun?”
Dead end. I am determined to bond with with Mr. Greene so I wait a beat then try a different subject.
“Have any family around here?”
Another dead end. Since Mr. Greene does not feel like talking, I close my eyes and listen to the slow beat of his inhales and exhales. When he goes quiet, I glance over. He is holding up the smoldering butt. “Got another?” he asks.
I consider telling him one is the limit, then realize that sitting outside and smoking on a lovely autumn day is one of the few pleasures available to him. I quickly hand Mr. Greene a cigarette so he can light it with the one he is holding since there are no more matches. Mr. Greene can not quite make the connection so I gently guide his hand to help him. His skin is cool, and crinkly like tissue paper. After the new cigarette starts to burn, he leans over to tamp out the old butt against the pavement. He checks to make sure it is dead before he flicks it into the bushes behind us.
I lean back and wait quietly for him to tell me he is ready to go inside. He startles me when he speaks. “Them’s nice boots. You get them around here?”
When I open my eyes and sit up, I see Mr. Greene studying my feet. “These boots? I got them in Texas about 15 years ago. They’re old favorites,” I say, delighted that he is talking to me, as though it is a signal that I am well-suited to be here.
“Yes sir, them’s nice boots. Very nice boots. I had a pair of boots once,” Mr. Greene says, holding his cigarette away from his face as he sits back and rests his elbows on the arm of his wheelchair. “Bought them in Washington years ago.” He brings the cigarette back up to his mouth, inhales, nods, and then exhales. “Didn’t take long before my stepfather stole them,” he says. A tail of ashes drops off of his cigarette and lands on his left foot. He leans over to clean off his slipper then sits back up. “Should have seen that coming.”
Now that he has opened up and seems at ease, I want him to keep talking, to tell me more about his life, but he does not. We sit in silence while he slowly finishes his cigarette. I wonder what I was so afraid of earlier and wish I could start today’s shift over.
“As much as I am enjoying sitting here with you, I think it is getting a little chilly,” I say, reluctant to break the spell, but the sun is starting to slip behind the building. “You ready to go inside now, Harold?”
“Yup. Thank you, dear,” he says, and I am glad he cannot see my eyes well up when he calls me dear.
I slowly wheel Mr. Greene back to his room and stay with him until he gets back into bed. When I ask, he says he does not need anything else. He is tired and would like to rest. So I go back to my desk and wait for him to appear in the doorway again. He does not before my shift ends.
When the next volunteer arrives, I brief him as I gather my belongings. On my way out I walk into Mr. Greene’s room to say goodbye, but he is sleeping peacefully. I do not want to wake him so I hold his hand and watch him breathe for a few moments before I leave, already looking forward to my next shift.
Some names have been changed in this story out of respect for privacy.
If you are interested in becoming a hospice volunteer, go to hospicefoundation.org/volunteering.