Saying Goodbye

Posted by Dr. El - August 17, 2010 - Anecdotes, Common Nursing Home Problems and How Psychologists Can Solve Them, End of life, Transitions in care - 4 Comments

“I never say goodbye,” Mr. O’Hara told me, “because that’s what my mother said when she left me as a child. Then she died and I never saw her again.”

At 91, Mr. O’Hara was slim and getting slimmer. He began our next session as usual, discussing the procedures he was receiving from the doctors to save his fingers. “It feels like the knives are still in me.” He grimaced, gently caressing his bad hand with his good one. “They want me to come back in two weeks.”

Mrs. O’Hara appeared in the doorway, wearing her trademark red lipstick and bright suit. We spoke for a while about his health, her health, and their 65-year marriage. She came every day at lunchtime, bearing his favorite foods and spending an hour coaxing him to eat before they headed to the afternoon’s recreational activities.

On the way off the unit, I spoke to the nurse at the front desk. “Mr. O’Hara looks awfully thin lately.”

“Yeah,” she said, “the doctor wants him to go on hospice, but the family refuses.”

Alone with him a few weeks later, I asked Mr. O’Hara if he’d ever discussed dying with his wife.

“Oh no, we never talk about it. That’s a big good-bye.”

“I suppose it is. What do you think happens after people die?”

Mr. O’Hara was silent for a moment. “I’ve been taught that we’ll all meet in Heaven, and I sure hope so. I’d like to see my mother again.”

“That would be some reunion, wouldn’t it?” I glanced at the framed photo on the dresser of a stern-looking woman in a flowered dress. “Can we talk to your wife about this the next time I see her?”

“Yes. I guess that would be all right.”

“Okay then. Take care,” I told him as I left.

Two weeks later, Mrs. O’Hara arrived carrying her home-cooked meal, and I motioned for her to sit down on the bed. “Your husband and I were talking the other day, and he said he thinks we’ll see the people we love after we’ve died. Is that what you believe?”

Mrs. O’Hara didn’t even blink at the question. I was talking about the elephant in the living room.

“Oh yes, I believe that too.”

“That must be a great comfort, to know you’ll see each other when you pass on.”

Mr. O’Hara spoke up. “At 91, there are a lot of people waiting there for me. I’m going to be busy.”

“Well, you’d better make time for me!” Mrs. O’Hara joked, and we all laughed.

A few weeks later, Mr. O’Hara went to the hospital and I stopped at the nursing station to see when they expected him back. “He’s not coming back,” the nurse told me. “His family decided to do hospice at the hospital.”

“Oh,” I said, happy and sad at the same time.

Goodbye, Mr. O’Hara. Goodbye.