Keen eyes, open ears & empty hands: Recently, I had a bit of a surgical procedure and a 3 night hospital stay. I want to share with you what I learned from the 4 room mates I had during those 3 days. All were women in their 90's.
The first was a person of color in acute respiratory distress who had been dumped and shuffled between facilities often enough over a weeks time that her family could not find her. Me, weeping on my side of the curtain as I listened to her frantic daughter (who had been calling hospitals all over the place for hours, searching) finally reuniting with her mom, alerting family over the phone, and then skillfully advocating for her mother's care. She was moved to the ICU an hour later.
The next elderwoman in the bed next door had advanced dementia, was perpetually disoriented in space and time, wanted to know how she'd get home. Reciting the address, asking again and again for the bus schedule from Everett to Saugus, explaining that her dad had a car and her parents would surely come get her. No matter how many times she was told where she was and reassured she'd be provided a ride to her own front door, she remained distressed. She kept trying to get out of the bed, and I'd have to ring for someone to come keep her safe. The social worker was still looking for a family member to assist with decision making. They moved her to a room closer to the nurses station and provided a watcher.
The third elderwoman came and went in about three hours, they took her for surgery to set bones fractured in a fall and she did not return. Then, in the hours before I was released, yet another very old lady in the bed next door. She was deaf, her native language was Portuguese but she managed English too. After a shift change I had to remind nurses and med techs struggling to communicate to make sure she could see their lips when they were speaking. She was (heroically) able to communicate that she was not trying to leave but preferred a chair to the bed. She seemed so tiny, waving to me with a toothless smile as I headed out the door for home.
The hospital rodeo is rough n' tumble, even when the skilled hands caring for a person's body are gentle and kind. I came home with odd sore places, strange bruises, and scabs from the device they used to pin my head still for an almost 5 hour surgery. An ordeal I am recovering well from. But please! I never want to be a very old lady whose family can't find me, who is alone and terminally disoriented, unable to speak the language of my care givers or hear the decisions being made on my behalf.
From the perspective of an end-of-life navigator this was eye-opening. All of these patient's stories had potential for what I call a 'shit-show-death,' the kind of suffering one is blessed to be released from, and that wounds a family. Hospitals are underfunded and cutting corners. Medical professionals involved in our care (cna's, med techs, nurses, the folks who clean, PT's and OTs, the docs and med students, chaplains, social workers, security, and the food service folks) are all at the pointy end of cutbacks that impact patient care. If a doula's dying person has had a hospital stay, they and their people have endured stress, fear, uncertainty, and both physical and bureaucratic trauma. If they make it home and into your circle of care then untangling the residual effects of this involves close listening and the creative and intentional capacity for cultivating safety, for everyone.
And there is another thing in this experience that stands out for me. The doula heart beats strong, and we never know who will come into the shelter of our care, even if we are also a patient in the bed next door. Twice during this hospital stay I was able to be of substantive assistance. Once by (first) asking if I could offer unsolicited advice from behind the curtain... reframing the ICU as a place where the best possible care can happen (for a frightened patient with air hunger and a family that was already in trauma). I suggested she'd get significantly more attention because the nurse to patient ratio is profoundly better than on a general surgical unit. And ICU nurses are fierce in their care. The second time I could help happened in the wee hours when the med tech who came to assist me to the bathroom carried a weariness and ache, so I asked if she was ok. She needed someone to ask. She was working full time through her last semester of nursing school. But what really burdened her soul was her mother, alone and 'not safe' in Haiti, and her struggle trying to secure a visa so her mom could live here and be cared for by both of her daughters. She told her story to the doula heart, and before she left to care for other patients I handed her a phone number to access pro-bono legal support from an immigration lawyer.
None of us are promised a good life or a good death. We get what we get. I'll never know how any of these people fared on their journeys. I only know that, in a moment when I was the patient with my ass hanging out of a hospital johnny, I learned from them. And at least twice could offer some sort of solace. I've said it before and I'll say it again and again. We don't need a doula kit full of tools and treasures to do the work we do. The doula heart with keen ears, open eyes, and empty hands: this is the blessing of enough.
