NHPCO NewsLine Summer 2020 - 39

F

or some patients, the peace
and understanding gained
at end of life is achieved
through dreams and visions that
wash over them, summoning up
images and emotions that soothe
and appease. Others attain
perspective through a more
con¬scious process of reflection
that they methodically apply
to their end of life dreams
and visions. These are
patients who are keen on
trying to understand the
mysterious process through
which death is somehow
turned into a familiar, even
welcome friend at life's end.
This was true of Patricia, for
instance, who had been so
eager to help us move our
research along. The
conclusions we reached
through the study were truly
remarkable, but it took
patients like her to give them
a human face. Patricia had
such an exceptional recall of
her end of life dreams and
visions that she became one
of our richest points of
access to the comforts
pro¬vided by these
experiences.
When she arrived, Patricia took
Hospice Buffalo by storm. She
was ninety years old, and nothing
about her past, physical
condition, or appearance could
have prepared us for the
en¬gaged, alert, and witty person
she revealed herself to be. She
had advanced pulmonary fibrosis
and often struggled to breathe at
rest despite being permanently

connected to a portable oxy¬gen
tank. Patricia's condition was so
advanced that she could not walk
across the room without
experiencing severe respira¬tory
distress, but she made up in
verbal delivery what her body
couldn't deliver in mobility. She
spoke in as uninterrupted and

fast a flow as an auctioneer.
Talking to her for any length of
time inevitably eclipsed her
physical symptoms or the medical
equipment she depended on, so
much so that someone once
re¬marked that she wore her
nose tube like an accessory. She
was so self-possessed that
anything connected to her body,
artifi¬cial or otherwise, looked
like an extension of her, no

different from the horn-rim
glasses or the butterfly hairpins
she wore. She was also
intellectually vibrant and curious,
and we found ourselves thinking
of her more as an interlocutor
than as a pa¬tient. Patricia
maintained a desire to engage
and express herself right up to
the very end, even when her
disease had progressed to
the point where she longed
to die.
Her mother had died of
pneumonia when Patricia
was nine, and at thirteen,
she'd begun taking care of
her father, who had been
diagnosed with the same
disease Patricia now had,
pulmo¬nary fibrosis. They did
not have access to the social
services that are now
available to severely ill
patients and their families,
so caring for him was a
full-time job. Patricia's
description of this period in
her life revealed how, in the
post-depression era,
ma¬turity at an early age
was not the luxury it became
for later gen¬erations of
American teenagers: "I had to be
a caretaker from the time I was
very, very young. It was a difficult
role to play at any stage but
particularly difficult when you are
thirteen. I never resented it,
though, not until I came to these
crazy dreams."
Patricia's "crazy dreams," as she
put it, fascinated her. She wrote
extensively about them in her

Newsline / Summer 2020

39
NHPCO NewsLine Summer 2020

Table of Contents for the Digital Edition of NHPCO NewsLine Summer 2020
