I Am Present

| By Casa de la Luz

There are many adorable quotes about one’s presence being a present to others.  My gift of presence is neither adorable nor cute.  However, my patients, families, and friends have taught me that my presence is one of the greatest gifts I can give, especially in hospice care.  For me, it is one of the more challenging gifts to give fully.

When I am present, I am fully attentive to the person I am with.   I am listening with my ears, my heart, and my spirit. 
When I have done everything I know to do for someone, I stop doing and simply look at the person.  I open my spirit so I can know what else the person may need and to receive guidance for what to say or do next.  Sometimes it is as simple as offering another drink of juice, or holding a hand.  Once in a while an unexpected statement or question springs to my lips.  As surprised as I am by what I’ve said, I am equally pleased with how heartfelt the person’s response is.
Years ago, the question “What’s it like to die?” slipped out before I could stop myself.  The man, who appeared to be suffering, said in a voice full of peace and wonder, “It’s so beautiful, all the colors and lights.  If I’d known how beautiful dying is, I wouldn’t have been afraid.  The colors are ones I’ve never seen before.”
It is most difficult for me to be present when I want to do, to fix, to change things, yet when a person is dying, sometimes there is nothing left to do, fix, or change. 
One Christmas I entered a family home filled with the bustle and smells of a holiday.  When I went to the young woman’s bedroom off of the kitchen, I knew she would be dead by day’s end.  Rejoining her mother and sisters in the kitchen, I told them, first with my tears, just how soon she would die.  We cried together in one another’s arms in the kitchen—mother, daughters, and nurse.  I was present.
Imagine being with family whose beloved grandmother has just died.  The body has been washed and dressed.  The mortuary is delayed by a storm and will not come for two hours.  There is little more one can do, and feeling the anxiety of ‘wanting to do something’ adds to the emotional chaos.  What is needed is presence.  It is difficult, but it is not impossible. I found myself in such a situation once, sitting in a corner between the toaster and the potato chips, and said a prayer, “Show me what to do.”  After a few minutes I went to a family member and asked about his relationship with the dead woman.  He started to reminisce about his sister.  For the next two hours I quietly moved between small groups, asked the simplest of questions, and then listened with an open heart.  I was present.
Sitting with a comatose patient is more difficult than it sounds.  Immersing oneself in a book or a video game keeps one from being fully present with the patient.  Sitting in silent meditation is something few of us can do.  If I know the person’s beliefs, I’ll say a prayer aloud.  More often, I read a thought provoking book, and imagine myself reading to the patient.  I look up frequently to “see” their reaction.  I imagine a conversation of spirits.  I “listen” for needs and wipe a hot forehead or hold a cool hand as I am moved.  It is the kind meditation that I can do, and I leave the room with a greater sense of peace.
Each person’s presence is their own.  Mine is neither cute nor adorable.  It does not fit clichés.  But it is mine, and when I have given it fully, I am blessed with peace.
Mary Toren, RN, BSN
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