I am passionate about hospice care because I know it works.
One of my colleagues is speaking to our learning group.
When we knew my father was dying, we took him to my house. He was there for three weeks - in a hospital bed in our living room - and the family took turns sitting with him. In that last day, we all gathered in a circle around his bed. He'd been unresponsive for a long time, but there was one moment when he opened his eyes and looked at us - and he saw us. He knew we were there. He knew we loved him. He took a deep breath and closed his eyes again, and he died a few hours later. That's the way it should be.
The way it should be.
I don't know about that.
My father died on the driveway. He was not surrounded by his family; he was about to get into the car to go to work, as he had on thousands of other mornings. He wore a coat and tie, and his stethoscope was in his pocket. He ate breakfast, read the paper, kissed my mother, told her to have a good day, and then he went out the back door and died.
Later that day, I heard from my mother and my brother that Dad had been weaker and more tired for a while; he'd taken a week off work and spent much of it sleeping, which wasn't like him. I'd seen him last a month earlier, and some time in between, it was clear, something had happened. My internist brain tells me he probably had a heart attack and developed congestive heart failure. My daughter's heart tells me that my father knew that, and chose to ignore it, just as he knew that his legs wouldn't really hold him, and his hands were growing weaker, and everything was becoming more difficult.
My mother, the day he died, said "You know, I don't think he could have gone on any longer the way things were". I know she's right. And I also know that he could not have tolerated opening his eyes to see his entire family gathered around his bed. The closest we ever came to that was the day after Dad had surgery, two years before he died, and my brother and I were with him in the hospital room. I don't know what was harder - seeing my father weak and in pain, or listening to him apologize to us for what he'd "put us through". Dad never wanted anyone - especially his kids - to know he was suffering.
Death is part of life's journey. Those of us who work in hospice think we know what a "good death" is, and that's what my colleague was describing. For that family, it was a good death. For my father, it would have been torture. Dad had the death he needed. I am also passionate about hospice, and I know how much we can do for patients and families, but I also know that it's not for everyone.
Dad, you always wore a tie when you went to the hospital, and I know how important it was that you were well-dressed for that last journey. I miss you every day, but I'm glad you went your own way.