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.

Tricks of the trade

It's easy to learn about being a chaplain. It's much harder becoming one. Applying book learning is difficult when you're sitting next to someone who doesn't respond and you're thinking, "O dear God, what do I do next?" Time seems to expand, minutes turning into hours, as you sit and think of every possible intervention. You try one. No response. You desperately try another. No response. A third. "How did the previous chaplain manage to spend 30 minutes with this person," you wonder. And then you start to learn the secrets and the tricks of the trade.

The hardest thing to learn is to do nothing. I learned it from some of my Christian colleagues - Ministry of Presence - or, as a friend explained it to me: "Don't just do something, stand there!" It's difficult to just be with someone; to stay in the moment. It's easy to have your mind wander. "What will I cook for dinner?" "Have I been here too long - what will the traffic be like when I leave?" But when I stay in the moment, I connect with patients. They know I'm there. That's one of the interesting things about dementia. A patient who can no longer talk can't be fooled by words, by a "chipper" tone of voice, by a fake smile. They read body language. They know if I'm not present. Often when I relax, they relax. When I really smile at them or laugh, they smile and laugh in return. We make a connection. In that connection, we transcend the boundaries of time. Instead of minutes turning into hours, time ceases to matter. We're just there, in the moment, together.

I've learned other "tricks" in my work. But the best, the most useful, and some days the hardest of all, is to just be there.