His cancer was advanced. There was no cure. His life was limited to sitting in his recliner working hard to breath. He had lost 30 pounds. He could not walk – just shuffle a couple of steps holding onto something. A couple of weeks prior, Joe (not his real name) had been told that he had incurable cancer; possibly treatments could give him more time. (Though as sick as Joe was when we met him, it would be more likely that treatments would shorten his life) In the fall – just 4 months prior, he did not have a diagnosis of cancer or any physical symptoms to suggest he was ill. Nevertheless, he knew time was limited. Wood stacking had been an integral part of his life since childhood. Growing up, his family heated with wood. He carried on that tradition. He had an outdoor furnace – burn wood outdoors while keeping the mess out of the house. He worked all year, felling trees on his land, lugging, chopping, splitting and stacking. He used 4-5 cords of wood (a 4x4x8 foot pile – about 700 pieces) a year. Each piece of that wood would have been touched, lifted by him at least 5 times. As a child, he dealt with his emotions by stacking wood. When angry, upset, he would move a woodpile – often just from one side of a sidewalk to the other. As an adult, he maintained this manner of coping though he did not speak of it as such. He was a quiet, private man. When upset, he preferred to be alone and work out his feelings. In the fall of 2020, in the midst of COVID isolation, without any physical symptoms present, he had a prescient thought. He laid the last log on the wood pile and at once he knew. “I just stacked my last woodpile.” He quietly shared this with us during our first visit to his home. As I left Joe’s home, I felt deeply touched by our encounter. This gentleman, who was at first even reluctant to have us visit, dared to share this profound experience with his family and our team. The words, “I just stacked my last woodpile” spoke deeply to my heart. I heard in them a truth I was evading for some months. It was time for me to acknowledge the same. It was 50 years prior to that visit that I had touched my first patient when I began my career path as a candystriper (I have some funny stories for that phase of my journey which I will save for another time!) As I drove down Joe's driveway, past his woodpile and wood burning furnace, I turned to the nurse with me and said, “I’ve just stacked my last woodpile.” – there’s a poem in that. Later she told me she thought it would be better as a title for a book. What both of us experienced, was the profundity of the words spoken. The wisdom Joe imparted was unintentional, as most pure wisdom is. The wisdom of the knowledge that life truly is short and can end when you least expect. I knew that – having cared for very sick and dying patients for many years. That day, though, it became personal. What I heard was, move on - Write that book you have longed to write. Dare to change your life – dare to follow your heart – instead of holding onto the safety and security of a paying job! Dare to leave the career you have loved for decades. Dare to believe in yourself and pursue the dream you have had for a time longer than memory. Joe’s sharing of this very personal truth, opened my heart to hear my own truth. Joe ended up choosing to remain at home – to live out the remainder of his natural life in the nest he had created. He chose to forego cancer treatments, knowing time was short and precious. Instead, he chose to focus on family, comfort and peacefulness. We called in hospice and he was able to have his wishes fulfilled. He needed a good bit of encouragement to take medication for his symptoms. He was a stoic NH man, who was struggling with pain, anxiety and shortness of breath (SOB) when I first met him, on a telehealth visit as he did not anyone to come out to his home. At that initial contact, he reluctantly agreed to try a little bit of morphine for the shortness of breath and pain. His quality of life improved greatly with the morphine, thus he began to trust and allowed us (palliative care and his nurse navigator) to make a home visit. When we arrived at his home - a simple ranch out in the country, we found Joe sitting in a recliner beside a large "picture window" looking out on his front yard where birds flitted from feeder to feeder. A mug of coffee and ashtray by his side, he spoke of some anxiety separate from that caused by the SOB. This was anxiety he would have treated by stacking wood, but now could barely life his coffee cup! He was open to trying a little bit of Ativan for this and found it quite helpful. When we visited next, Joe was weaker. His family was gathered in the living room. They spoke of their sadness, but support of Joe's chosen path. Tears, smiles and some laughter embodied the love filling that space. A few weeks later, having not left his home for any appointments, tests, or treatments, Joe died peacefully in his recliner in his living room with his family by his side. He did it his way. Joe was one of many patients who touched my soul. There were two others who I saw that same day who were also instrumental in my decision to change my life. I shall write about them in future posts.
Crumbs for the Journey 