I would tell you that I wasn’t sure when it happened… if you were to ask. That moment that I hit the “off” switch and told the world and everyone in it to fuck off. I mean, the last time that I did that. Because telling the world to fuck off, well, that’s an everyday occurrence. And if I were to tell you I didn’t know when, it would be partially true. I don’t know when it began. But I do know when it slammed shut, and the door knob fell off with a “clank” on the floor.
I was at work, at my desk, in front of the computer, when this message flashed on the screen: “You are attempting to enter the chart of a patient who is deceased”.
By all accounts, she should have been just another patient. She was elderly when I met her, 84 to be exact. She looked and acted much younger than her years. She was impeccably dressed, a shock of bright white hair cut short with slivers of pepper here and there. She wore rich colors, crimsons, earth tones and pinks. She was a snappy dresser, and I told her so. It was her first time at an appointment of this kind, and she was quick to inform me that she didn’t deserve such individual attention. Her husband had died several years prior, she’d dedicated herself to caring for his every need. She’d continued on with her activities after he passed, but her soul had been empty for some time when she showed up on my couch.
She may have felt that her soul was empty, but it was clearly visible, pouring out of her bright blue eyes as she presented her bits and pieces. My task was easy, and clearly defined. I simply validated her experience and reflected her goodness back to her. She would occasionally object to this, convinced that something deep within her was bad, wrong, not good enough.
I grew to adore her. After a few sessions, she began to get better. She’d only needed to process some of her grief, and as she did it opened her experience up a bit. She was one of the few patients that would regularly ask about me and my son. I kept my answers minimal, as I always do with patients. She was always so concerned that I wasn’t married, that I didn’t have help raising my son. I suspect she feared that I did not know love like she had known, and she wanted me to.
Our relationship began to shift as she got better, we had become attached to each other in more than a therapist/patient way. Somehow we traversed any distance that existed between our physical bodies. We became family. I say “became” but it is not the right word to use, because the connection that we had on a soul level was there the first time I met her, I just didn’t recognize it as such. It became more apparent over time, and we both knew that it existed. We were as familiar with each other as family members who had spent a lifetime together. It wasn’t something that can be explained. It made no sense and yet it made perfect sense at the same time.
And so I was shocked and saddened when she came in and told me that she had been diagnosed with atrial fibrillation. I was shocked because 5 years before I met her, my father had been diagnosed with the same thing and then died from complications related to it. I watched helplessly, as she went from a vibrant energetic woman to a shadow of her former self. One by one she endured the same procedures designed to fix her unruly heart rhythm, the procedures that I knew so well because I had watched my dad go through them. Each time hoping, “This is going to be it, this is going to fix it”. I shared her hope each time, desperately wanting it to be different from what it had been with my dad. Each time I saw her, she grew more despairing about her failing health that was now preventing her from doing the things she had just started to enjoy again. It was like watching my Dad die all over again.
Finally one of the procedures took and she began to feel better for a while. But the procedures themselves have complications, and she soon experienced one of them when she had a stroke. It was a mild one and only affected her cognitions a little, but she could no longer drive and this became a huge source of frustration for her. She hated to rely on others for anything, despised asking for help. Our sessions became cheering sessions where I would encourage her to ask for help, trying all sorts of ways of saying it hoping she would allow it. She did so, begrudgingly.
I can hear her in my mind right now, chastising me for making this a sad story. She would be indignant that I not be affected by her death in any negative way. She would nudge me on; tell me to move forward, that she was just fine. She would not want me to cry. Well, she might be OK if I cried a little. But this shutting down, this hardness, this armor, she would have none of that. She would tell me, “go ahead and cry if it will help”. She would reach over and remove the vice that is clamped tightly around my vocal chords, threatening to snuff out my essence.
She had to move into an assisted living place, she hated it, and missed being in the home she had shared with her husband. She always tried to put on a brave face. She was never a complainer. I had to encourage her to complain, and even then she would apologize profusely for doing it. She got tired, frustrated, but never bitter. She drug herself into my office one day and sat on my couch and dozed for the entire session. She was pale, almost ashen. She left my office, went home and broke her hip. I feared that would be the end, but she was a fighter. She spent weeks in a convalescent nursing home. She told me horror stories about laying in her own shit for hours waiting for someone to be able to come and tend to her. But again, never bitter. Always concerned about those around her, she pointed out that the aide had been really busy. She was worried about her roommate also; who she had noticed was much worse off than she was.
The last time I saw her the circumstances were consistent with a theme that had been present for our entire relationship. There were unseen forces that cleared a space in time for us to meet, and to have this experience together. I had avoided visiting her at the place she lived because of ethical concerns related to my profession. But then I had a job transfer and she couldn’t see me anymore. I felt it was important that we see each other, especially if she were nearing death. I drove to the place where she lived, resolved in my decision to follow my hearts guidance. I walked into the lobby without knowing how to find her or even what room she was in. I needn’t have worried. There she was, sitting in the lobby, all dressed up as if she knew I was coming. She was waiting for the shuttle driver to pick her up for an appointment. She was so happy to see me, and I her. She was going to the hospital for an x-ray; she had fallen again and needed to be checked out. She looked good; for all that she had been through. She was happy that I could see the Valentine’s Day display that had been put up with pictures of married couples on it. There was a picture of her with her husband, from somewhere in the 1930’s. She was young, vibrant, infused with life in the picture.
We had talked about her death. She knew it was coming. Sometimes she wanted it, because she was tired, on one occasion she feared it. She was sad about what she would miss. She wanted to see her granddaughter grow up. I asked her for something during that session. It may be the only thing I have ever asked for from a patient. I told her that if she died and she was able to send a message to me in some form that I wanted her to do it. I told her I wouldn’t be afraid no matter what it was.
She died four days before I was sitting at my desk, working, when she crossed my mind and I decided to call her. It was my attempt at entering her chart to get her phone number that prompted the “deceased patient” message.
I have a visual of myself as she left one of our last sessions. It was spring and I had picked up a fresh bunch of pale pink tulips from a farm stand on my way to work. I gave them to her at the end of her appointment. She carried them out in her arms, her right arm bent at the elbow and looped through mine, leaning against me for support.
I don’t recognize that person walking with her as myself anymore.