Instructions Before Leaving Earth
I recently read James McCrae’s poem Instructions Before Visiting Earth, and something in me immediately recognized it.
Perhaps because I have spent so much of my nursing career at the other end of the journey.
I landed in hospice. I certainly didn’t set out to be here.
This was fate.
The story of how I arrived in hospice is uncanny in its own right. Looking back, I sometimes wonder whether hospice was simply one of those places I was always going to find or that was always going to find me.
Over the years, I have sat at countless bedsides as people approached the end of their lives. And every so often, there comes a moment when they know and I know:
The return is about to happen.
Something changes.
It can be subtle. A page turns in the soul. A layer seems to fall away. The concerns of ordinary life begin losing their importance: the house, the bills, the arguments, the disappointments, the things we collected, the things we thought we needed to accomplish.
And underneath all of that, sometimes I get a glimpse of what feels like the real person.
The one beneath the roles.
Not the mother, father, husband, wife, executive, teacher, laborer, patient or even the body lying in the bed.
Just them.
I have watched people meet this realization in every imaginable way.
Some become extraordinarily relaxed and graceful. Some are sad. Some are frightened and fraught. Some begin speaking less to those of us standing in the room and more to people we cannot see. Some seem to begin their departure days before their bodies finally follow.
And some simply become quiet.
Hospice would have you believe death is a community event.
It is not.
Death is personal.
We can surround a person with an entire village. Family can gather around the bed. Nurses can manage symptoms. Chaplains can pray. Social workers can comfort. Music can play. Stories can be told. Old grievances can be forgiven or not. There can be laughter, tears, apologies, confessions and declarations of love.
But there comes a point where the crowd can go no farther.
There is a threshold that belongs only to the person crossing it.
After years of hospice nursing, I have developed a deep respect for that privacy.
Death is not always frightening.
Sometimes it is silent.
Sometimes it is sweet.
Sometimes it is difficult.
And sometimes, after a body has endured everything it can endure, death seems to be the only resolve.
I don't know exactly what happens after that threshold. Nursing has taught me many things, but it has not given me that answer.
Hospice has, however, allowed me to stand near the doorway.
Again.
And again.
And again.
And what I have witnessed there has changed me.
When you spend enough time around dying people, you begin to understand how much energy the living spend carrying things that cannot come with us.
Titles cannot come.
Possessions cannot come.
Resentments cannot come.
The body itself cannot come.
Whatever the return is, we eventually travel light.
Perhaps that is why McCrae’s poem touched me so deeply. It describes our arrival here as though we are visitors, entering a body, acquiring an identity, forgetting something of where we came from, and then experiencing this strange and magnificent business of being human.
Hospice has allowed me to witness what sometimes looks like the remembering.
The shedding.
The return.
And although death is personal, personal does not have to mean alone.
You may still want a hand to hold.
That is where I come in.
I cannot make the journey for you.
I cannot cross the threshold with you.
I cannot tell you what you will find when you get there.
But I can sit beside you while you process.
I can be quiet while you remember.
I can listen while you unload.
I can help make your body comfortable while something deeper prepares to leave it.
I can hold space while you gear up for the return.
And if there is nothing left to say, I can simply stay.
Maybe that has been one of hospice’s greatest lessons for me.
Not every moment requires an intervention.
Not everything needs to be fixed.
Some moments are too sacred for fixing.
They require only our willingness to witness them.
To remain.
To stay.
To hold a hand at the edge of the known world and, when the time comes, to let it go.
By Kimberly!