I Really Like You

Early October brought yet another bad night with cats, this one involving the mini-blinds and an unbearable racket as I was trying to fall asleep. I kept losing my patience and tossing Duckworth and Marvin into the bathroom, followed by a loud, satisfying (to me) slam of the door. When I had to pee in the middle of the night, I let them out, and soon heard a loudish crash: a pretty blue ceramic pot given to me by my sister, falling onto the hardwood floor. Fortunately (for the cats), I could detect only one small sign of damage, and that might have been there before. Into the bathroom went the cats once again.

Before my alarm went off, I leapt out of bed to do something I’d decided would have to be done: I moved nearly all my books to the two bookshelves in the living room and moved a bunch of small items and pieces of paper to the bookshelf in the walk-in closet, which is off limits to the cats. I don’t necessarily want anyone who comes in here seeing all my books, or touching them (cooties!), let alone asking to borrow them, but I was sick of having papers knocked to the floor and then used as toys, and I could see that Marvin was very close to hopping up onto a shelf where there were a lot of little things I really didn’t want disturbed.

In my saner moments, I reminded myself: Whatever it is, it can be repaired, replaced, repainted, restored to its former condition of cleanliness, or, if all else fails, remembered.

While on call I received a request to visit a patient who had just been diagnosed with the same kind of cancer his mother and grandmother had had. The patient’s grandmother, with metastatic cancer, declined chemotherapy and lived on for many years, eventually dying of something else. The patient’s mother’s cancer was also advanced and she had survived it. My patient, alas, was just in his early 30s and said his diagnosis was completely unexpected. He knew he was experiencing some pain; that it was cancer never crossed his mind. The COVID pandemic delayed medical visits and tests.

I had two long visits with this (not spiritual or religious) patient where we talked about nothing in particular. He was determined to “fight,” and he was concerned about the effect of his diagnosis on his family. Our second visit was taken up almost entirely with discussing the feeding tube that was scheduled to be placed that same day. We did not discuss anything particularly deep or personal, but the patient seemed to appreciate having company.
 
The very next day, the patient ended up in the ICU, and when I went to see him, he was intubated and unresponsive. I learned that his team did not expect him to leave the ICU alive. The next time I went to see him, he stared out the door at me with no expression. I wasn’t sure if he even remembered me, or if he wanted me to visit or would prefer I didn’t. He was unable to speak, and also unable to shake his head “no,” but he could slightly nod his head “yes.” He could also make the “thumbs up” gesture, and used this to indicate that he would like to communicate via writing. I asked his nurse about this, and she said he had tried, but not been able to.
 
I gave the patient a pen and paper and he labored repeatedly to express himself, making a mark or two, after which his hand fell weakly away. At times he pointed at himself and then at me. Clearly he was writing “I,” which he did over and over, but I couldn’t make out anything else. A speech therapist came in and figured out that the next word was “really.” After the speech therapist was gone, I finally figured out what the patient was trying to say. I asked him, “Are you trying to say you really like me?” The patient nodded, and I nearly wept: This patient, with whom I had discussed nothing in particular, felt connected to me and was willing to expend a huge amount of his little remaining energy to express this. Even though what we discussed had seemed mundane, it had indeed mattered that I—that the chaplain—was there.

In the end, his family decided to say their goodbyes and leave, after which he would be transitioned to comfort care. If they had discussed this with me, I would have affirmed their decision. I would have said that the patient could feel their love from any distance, and I would have meant it. I would have said whatever decision they made was the right decision, and I would have meant it. But inside myself, I felt a bit shocked, and sorry that he would likely die alone, even if he didn’t know it. On his final day, I sat with him three different times, for as long as I could.