In my line of work I often meet people for the first time when they are already diminished by whatever disease challenges them. And their close people are also often diminished by the demands of caring for a dying person. No one is particularly looking their best, or able to be their most charming or well-functioning self. Before covid I could meet with these folks in person, on their porch or at the kitchen table, with tea and plenty of time. There was so much I was able to glean from their body language and surroundings that filled in the gaps and gave me a richer sense of their personhood and history. It is much harder at a distance on a flat screen, when I can only see them from the shoulders up and don't have the benefit of noticing their choice of socks or even how they hold their hands in their lap.
Today 'at the office' I was meeting with two people leaning in to be seen through their shared phone screen, trying to connect on facetime for an hour. And the whole wibbley-wobbley time I was aware that this is not conducive to helping someone navigate their rage and anguish. There are so many things I cannot intuit from a distance. Or fix. I got off the phone thinking of better questions I could have asked. What do you need today? There is so much to be angry about right now. And there is no point trying to talk people out of raging at fate, or at arrogant physicians, or at what they remember from that consult 2 years ago when they were never led to expect this.
There is no escaping the role that childhood and other personal life traumas play in the emotional knots I see people get tied up in as they journey towards death. There is a note on the wall by my desk to help me remember this, a question another death walker asked in a workshop on Zoom that has really resonated with me. “How tight does the kid you hug you?” I answer, “Sometimes we casually hold hands, sometimes we hug hard and hold on for dear life.” To remedy my own trauma I imagine reading my kid self a story while we snuggle up. I wonder what kinds of good juju I'll need from my kid self when I am facing death. I'll put a question on my 'better things to ask' list about how people self comfort, and then figure out how I can best support the peculiar both/and physics of holding on ~ so you can let go.
Today at the office so many of my questions are terrible, either too close to the bone or banal, they swing both ways. I can tell I'm uncomfortable when I hear myself talking too much. Next time I will come prepared with a cheat sheet of better questions and experiment. And I'll stick a note on my screen reminding myself to shut up. I will try not to be one more tel-appointment for the spouse to get through in the day. Between now and then I'll learn, again, what I can about the nature of rage and anguish when there isn't time for a hail mary pass. I will show up, offering support for resolving obstacles and reducing suffering as they navigate the shoals of life transition.
I don't want to be another name on the list of potential helpers who have let this person down, or another thing they've tried along the way and found not as useful as hoped or promised. They want a second medical opinion even though they expect the same result and prognosis. It is clear to me that this bit of due diligence is part of how they are helping themself let go. They have no expectation of defying the odds and they also don't want to cheat themself of a remote possibility. This not-quite-hope intrigues me, but Hospice won't sign them up until they've exhausted this enquiry for life prolonging treatment. I want to ask their spouse what would be most supportive to them but feel constrained by not being able to read their body language from the half a face I can see on my screen. I ask the wrong question, what result are you wishing for from the second opinion? It is the wrong question because it loops too easily back into their anguish. This week they will get the new consult. Next week we will meet again and I will wade in more pragmatically. We will assess their support systems and advance directives. And I will ask again, and again, how do you want to spend this precious time? How can I support your holding on and letting go? Both~And.