I’ve had many interesting conversations with patients over the years, some of whom had rather different backgrounds from me to put it mildly. I remember one man in particular, much taller than me, mid forties, arms covered in gang tattoos, missing teeth, and thin as a rail. “You wouldn’t have liked the old me, Katarina” he said. “You would have been afraid to walk by me on the street, and that’s the way I would have wanted it… I’ve done some bad things in my life, Katarina….” But on that day he was leaning against the door frame to his room, still holding on to the med cup holding his afternoon pain pills. And there we were, the small hospice nurse and the tall, former gang member, sharing space and time, sometimes laughs and tears, in the halls of a hospice care center. It was not unusual for him to give me a hug in the mornings as I started my shift, one of those side hugs where I just barely came to his arm pit. He told me that ‘this cancer changed my life, but I never would have thought it would have given me this whole new life. I like this new me. I think I was a warrior in my past life but maybe I’m changing for the next one coming.’
This is what I appreciate most in being a hospice nurse, the opportunity to accept someone, regardless of what kind of person you may have been in the past, to accept you in the now, to give you the love and care everyone deserves when they are dying. I don’t know your past, you haven’t hurt or damaged my relationship with you. Even for the broken families, where too many memories hold them back from risking their offering of love and support, we were there to offer it for them. That’s not to say that everyone becomes sweet, loving people when they die like my friend. Sometimes nasty, mean people remain mean and nasty but they are all offered love and support too.
As far as I know, there are 75 prison hospices in the United States. Dying doesn’t give a prisoner a get out of jail card, nor does becoming elderly with dementia and Alzheimers. Many of the prison hospice programs use inmate volunteers to care for their dying patients. Just as in the care centers I worked for, dying patients who may have lost the love and respect of family members through their horrible acts of selfishness, cruelty, violence, neglect, and abandonment are allowed to be embraced and accepted for who they are now, a dying person in need of care and compassion. Another patient of mine once described himself to me as a hardcore convict upon his admission, and he had the tattoos, scars, and attitude to prove it. His attitude and surliness certainly did not improve as he progressively lost his independence. His emotional pain was as agonizing as the physical pain he endured. He had no family or friends that visited in that two week period. He turned away the chaplain and any volunteer that braved offering up a chat with him. At the end, when he had become bed bound, and totally dependent, he told me with tears in his eyes “I don’t deserve this.” He wasn’t referring to his dying, but rather the gentle care he was being given. To be able to be a part of, and witness to, the transformation of giving love to someone who had given up on themselves as being worthy before their dying is what I found transformational in my own life as a hospice nurse.