Tales of the shofar

The shofar's out of the cupboard and into my workplaces. So far:

My patient's eyes are open when a greet her - a rarity - perhaps due to the lunch-time visit. I greet her and mention the New Year. Her eyes close. I sound the shofar - the whole series - loudly. No reaction from her; her eyes remain closed. But the gentleman next to her turns to me and asks: "What the hell was that??!!"

I do a "service" for a nursing home with a younger population. Some sing along with "Avinu Malcheinu." Some "talk back" at me during the story (I love that!) We listen to Kol Nidre. And during the course of the service I sound the shofar. They are so appreciative. I get to go around the room afterward and everyone wants to shake my hand and wish me a "happy new year." And I shake all of their hands and wish them a "happy and blessed year" as well. It's a good thing that State isn't here to chastise me for not washing my hands in between every handshake. It may not meet universal precautions, but the moment and the touch far outweigh the benefit of trying to follow the letter of the law in this case.

I ask one of my facilities if they have any Jewish residents who would like to hear the shofar. "The only people we've ever seen in the building with a yarmulke are you and that examiner from the State. He hasn't been around lately." "Ok, thanks. I didn't think you had any Jewish residents, but I always like to ask." "What does it sound like? Will you blow it for us?" So I do.

I give the activity director of another facility a CD of High Holy Day music for her Jewish resident (not one of my patients.) "Thank you so much. I'll put it in her room. Her family will be so glad to hear you came by." So . . . out comes the shofar and with a few introductory remarks to the staff, family and patients present, I blow the shofar. The Jewish resident gives me a little smile. "Please let her family know that I also brought in the shofar so she could hear it."

My office thinks of it as good PR and outreach. I think of it as a mitzvah and my preparation for entering the Holy Days.

שנה טובה ומתוקה

May we all be blessed with a sweet and good New Year.

The unexpected . . . or what teenagers taught me about conversation

Some days hospice work bears a certain resemblance to working with teenagers. Anyone who has worked with (or had) teenagers knows that some of the best conversations you have are the ones that take place in the car. Whether it's the forced intimacy or the lack of eye contact, or just serendipity, a car ride can turn into an unexpected opportunity for sharing. Something special can take place in that moment. You can't plan for it or expect it or extend it. You can only experience it and give thanks for it.

Some days you have moments like that in hospice. Again, you can't plan it and you can't force it. And just because you had that special moment once with a patient or family, you can't expect it to happen again.

Much like moments in the car, some of these moments happen when I am not looking at my patient. This week I was sitting with a patient who does not talk a lot. He does like it, however, when the social worker or I sit quietly next to him and do our paperwork. He likes the company and the companionship.

The other day I sat next to him with a big afghan on my lap. The afghan belonged to another patient. It had been lost and then found in the laundry by a facility CNA. The yarn had broken in some places, been pulled out in others, and had open stitches that were unraveling. I had told the CNA that I would try to fix it. (Fortunately I usually carry knitting and had both a crochet hook and a yarn needle in my car.)

So I sat next to my patient and focused my attention on the yarn and the open stitches. I don't know whether it was my attention to the task, my awareness of some of his issues and concerns, or my thoughts focusing on Elul,  but as I talked with him about what I was doing it turned into one of those unplanned, special moments.

I commented that it could be a challenging task to try to fix something that had been torn or broken. "Yes," he said. I sewed some more and said, "I know I can't make this perfect, but at least I can mend some of the holes and keep it from getting worse." He agreed. Although he's not much of a talker, I realized he was very focused on my words and actions. So I continued to mend the afghan and talk about repairing the things we could, letting go of the things we couldn't, and forgiving ourselves for not being perfect. He would listen, make a tiny comment or a sound of acknowledgment. This continued until there was no more yarn to reattach.

I know that I got a great deal out of this unexpected moment and conversation. I think that he did as well, for I have an invitation to visit again . . . and to bring my knitting.

Sitting & knitting

We have a new patient. She's in her 90's. The family says she's "given up," she's "ready to go." The family is clearly not ready to let her go. They're willing to talk hospice, but they are hoping that the extra attention and services will tip her back on the side of living. I ask about volunteers. "She knits," they say. "Do you have someone who could come knit with her and maybe also pick up the stitches she drops?" "I knit," I say. "I'll see what I can do."

At my initial, and as it turns out, only, visit with the patient, she's curled up in the middle of her bed with the covers pulled up to the top of her head. She doesn't respond to my greeting or presence. So I sit down next to the bed, pull out my knitting, and knit. Eventually she says a word or two. As I sit there, a younger woman comes in. She's the daughter of another resident, a friend of my patient, a knitting companion. The younger woman and I talk about knitting. And then a voice comes from under the covers: "I think I'm dying."

Before I can even open my mouth to respond, possibly faster than the speed of light, the other woman says, "Oh no. You're not dying. You just need to eat more." My thoughts are unprintable. Eventually the other woman leaves. I continue to knit. And knit.

Finally I say, "So you think you're dying. What makes you think that?" She says, "I just don't feel well." She's silent and I knit some more.

Finally she says, "Am I dying?" I take a deep breath. "Everyone dies sooner or later . . . I think for you it will be sooner. You're not eating and you tell me that you just don't feel well." More silence. I've answered her question. I've told her what she needs to hear. She doesn't say anything else.

And a few days later she dies.