Last night I said my final goodbye to a beloved patient.

I’ve had my fair share of loss of family members, close friends, and patients but somehow this was a bit different. This was a sweet 86-year-old woman with a lovely daughter who was always present by her side diligently taking notes. The patient was one of the first to welcome myself and my (at the time) fiancé to their small town. She told me about her years working at the local Catholic school where her children and grandchildren attended. She was excited for me when I got married and was ecstatic hearing that my wife became a teacher at that little Catholic school she spoke so highly of. She showed up when we moved our clinic across the street from our ancient 1950’s building into a brand-new building.

As I walked into the hospital and made my way towards the elevator, I began to feel unprepared. What would I say to her family? How would I console her crying daughter. What prolific last words do you leave with a patient crossing over to the other side? Maybe she had already passed.

I walked into a dark room seeing my patient fast asleep with her daughter by her side. She was under hospice care with comfort measures in place. The patient had suspected metastatic esophageal carcinoma and elected not to undergo surgery. Solid foods were discontinued 4 days ago, intermittent confusion was setting in and now it was only a matter of time. She was in the active phase of dying. 

Her daughter saw me and immediately embraced me. She proceeded to tell me how well her mother was taking things. It’s almost like she bypassed the whole Kubler-Ross grief cycle. The patient had made her rounds seeing all of her children and grandchildren. As her condition deteriorated, she decided to spend her final days in the hospital so she wouldn’t burden her loved ones. “She is ready to go Dr. Daniel”, her daughter said. “Mother has been singing songs and laughing with us. She has planned her whole funeral and even picked out the songs we will sing. She’s going on her own terms and even told the Chaplain this morning she was ready to meet Jesus.”

I held tears back as her daughter explained to me how fond the patient was of me. She wagged her fingers and warned me that her mother would hush anyone who cried in her presence and demanded they step outside. This was a sobering experience. In any other world, our paths would have never crossed. I am a young African American male, city boy and she is an elderly Caucasian woman of a different generation who grew up in a small town. It’s kind of cool when barriers like this are broken. 

Medicine allows us to intimately know other human beings. To be by their side from cradle to the grave. Medicine exalts humanity and has the ability to unify. It is interesting to see one’s soul before leaving this world. They can’t take anything with them but they can leave a lasting impression and a legacy. I learned no matter how many times you say goodbye you can never prepare yourself to say that final one.

I told her daughter it was a great privilege caring for her mother over the past few years. I held my patient’s hand and told her I hope to see her again in heaven one day.

May she rest in perfect peace.

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