One day I got an unusual call from Blue Ridge Hospice. They had just enrolled a lung-cancer patient, a man from El Salvador who spoke not a word of English. I had indicated in my patient volunteer application that I spoke Spanish and Portuguese. Even though he was not a military veteran, would I consider taking him on as a patient?
Of course, I accepted, and went to visit Don Pepe. Following his children who were already established here, he had immigrated to the US, and was staying with his son and daughter-in-law, who was his caregiver. Besides them, there was no one he could converse with, and he was severely homesick for El Salvador and deeply depressed. When I met him the first time, he was in a wheelchair on oxygen.
He was delighted to find someone new to talk with, and the fact that I had visited his country and knew his hometown (an obscure suburb of San Salvador) thrilled him. The following week when I called the daughter-in-law to confirm my visit, she said my visit was all he had talked about the entire week.
When I arrived for my second visit he was still in the wheelchair, but not on oxygen. He told me he knew he had killed himself by smoking cigarettes since he was nine, but everyone has to die from something, and cigarettes had given him a lot of pleasure in his life. Right after I arrived, the daughter-in-law went out shopping, so we were alone. He told me how much he missed El Salvador and his friends back there. He had never married his children’s mother, who was still back there. I asked whether he wished they had married, and he said, no, he didn’t really like her very much.
The next week he was sitting in an armchair, and his hospice bed had been moved out of the living room and upstairs. The daughter-in-law was gone for the whole day, so we were alone for the entire visit. He told me things he never would have told his family, about things he had done and women he had been involved with. He talked about his broken dreams for himself and his children, and of all the things in his life he wished he could have changed.
On my next visit, he asked me about my dog Ike, who was staying out in my minivan at the curb. Did I ever take him for walks? Would I like to go for a walk with him now? Grabbing a hat, Don Pepe said, “Let’s go.” To my astonishment he headed out the front door, so I got Ike’s leash and away we went.
We made it about half a block before Don Pepe was gasping for breath, and I worried that I had allowed him to hurt himself, but we rested a bit, and slowly made our way back to the house.
The next week, Don Pepe already had his hat on when I arrived, ready to go again. We walked Ike down the block, and to my surprise, Don Pepe crossed the road and kept going. When I asked where we were going, he replied, “You’ll see,” and led us into an open field. When I asked him whether he had been here before, he replied sheepishly, “I have started going on walks each day. They don’t know.”
From that day on, we went on ever longer walks each visit, talking and joking and really enjoying ourselves. Don Pepe became comfortable talking with me, and told me some of his most private thoughts.
Then one day I called the daughter-in-law to confirm my weekly visit, but with sadness in her voice, she told me, “He’s not with us anymore.” Dreading the news, I asked her when he had died. “Oh, he’s not dead. He went back to El Salvador.”
It seems Don Pepe had gotten to feeling so much better under the hospice regime that he went down to Dulles International Airport and bought himself a ticket home. He told his family that if he was going to die, he wanted to do it in his own country where the people spoke his language, with his friends. And that was just how it was.
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The most moving patient experience I ever had was with Mr. Sam. When I met him, he was dying of cancer and had only one week to live. Seems he had had just one week left for eleven weeks and counting, and his doctors were amazed at how he just kept hanging on. He was in pretty bad shape, but we could visit OK. His wife always stayed around the corner in the kitchen while we talked.
Mr. Sam had enlisted in the Navy during the 1930s, and was there for Pearl Harbor in 1941. He never talked about his Navy service to me or any of his family. We visited a couple of weeks, and he became more comfortable talking with me as time went by. Finally, one visit, his wife left to go to the store. As soon as she was down the street, in a faltering voice Mr. Sam began to tell me his story.
The morning of December 7, 1941, he was aboard his ship, a cruiser in Pearl Harbor.
She was the only American warship to get under way during the attack. His duty station was in the ammo bunker below the anti-aircraft guns. For three hours that morning he passed hundreds of 3” AA cannon up to the guns that were engaging the two waves of Japanese aircraft attacking our warships at anchor. Up and up went his rounds, blasting non-stop toward the attacking enemy aircraft. His ship survived the attack and returned to port afterwards, ready to take the war to the enemy.
The next day, he told me, the Honolulu newspapers carried the headline, “42 CIVILIANS KILLED DURING JAPANESE ATTACK.” With tears streaming down his cheeks, Mr. Sam sobbed to me, “Those were my shells.” He fell silent, and I realized there was absolutely nothing I could say to comfort him.
That night Blue Ridge Hospice called me to say that Mr. Sam had passed earlier in the evening. For seventy years he had carried the horrible secret of his guilt, a secret he had never been able to tell anyone. Defying the doctors’ predictions, he had kept holding on and on, waiting until he could finally share his burden with someone who would understand. He had finally given himself permission to let go.