Hostname: page-component-745bb68f8f-d8cs5 Total loading time: 0 Render date: 2025-02-11T02:28:16.146Z Has data issue: false hasContentIssue false

Dignity pills: One at a time

Published online by Cambridge University Press:  13 October 2015

Miguel Julião*
Affiliation:
Hospital-Escola da Universidade Fernando Pessoa, Gondomar, Portugal and Center of Bioethics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
*
Address correspondence and reprint requests to Miguel Julião, Hospital Escola da Universidade Fernando Pessoa, Avenida Fernando Pessoa, No. 150, 4420-096 Gondomar, Portugal. E-mail: mjuliao@ufp.edu.pt.
Rights & Permissions [Opens in a new window]

Abstract

Type
Essays/Personal Reflections
Copyright
Copyright © Cambridge University Press 2015 

She stood in the storm, and when the wind did not blow her way,
She adjusted her sails.
— Elizabeth Edwards (1949–2010)

I remember it well. It was 2011.

Why write it now? … Is there a time for relevant, joyful, and life-teaching memories? No.

Why write it now? Why not? That's the beauty of human memories. They last forever, they truly last forever.

It was September. Warm outside. Warm inside, too.

I was walking down a hospital corridor, not a very long one—wondering what to do next … floating within my thoughts. A nurse appeared from a door on my right and blocked my path.

“Straight to the point, doctor,” he said. “We need your help with a patient. She won't eat, drink, or take her pills. One more day, and we're thinking of intubating to feed, hydrating, and smashing her pills.”

Very much straight to the point, indeed.

“Don't. I'll see her today,” I said. And, all of a sudden, in the back of my mind a voice spoke: “You've been invited. This is a special invitation from a special person in need.”

“Thanks. Please tell her that she has someone very interested in visiting her today,” I said to the departing nurse.

Later that afternoon, there I was. As I looked over this lady's chart, I noticed something: we had a name in common. “This could be a bridge,” I said to the nurse beside me.

As I approached the room, I caught sight of her. After a few seconds, I could tell that Miss L was a very sad lady. In her 80s, sitting in a wheelchair (abandoned, by herself). Her head was nodding, falling, her eyes cast down onto the gray floor. The left side of her body was paralyzed. Her hair was gray, the color of rice. Her eyes were a deep green.

I stood by the door. “Good morning. May I come in?”

She gestured with her right hand as if to say, “Go away now!”

“Okay. I understand. I'll go away. I just wanted to sit next to you and perhaps share a very interesting thing with you. See you tomorrow. I'll be here at the same time.”

As I was turning my back to leave, she knocked hard on her wheelchair. She now gestured in the opposite direction. I knew this meant “Come in. You're allowed!”

I pulled a chair up next to her. I presented myself and gave her the “special” news, that we had a common name that referred back to a particular region of Portugal. And this did turn out to be a kind of bridge. She took my hand, as if we shared something truly familiar—almost like I was a visiting relative. So we shared a common name, and, without noticing it, something much more: our humanity.

After a long eye-talk, a silent exchange that lasted at most a couple of minutes, I proposed a deal. I would come every day and sit with her, at the same hour. In exchange, she would promise to take a pill and a glass of water proportional to the days of companionship: on the first day, one pill and one glass of water; on the second, two pills and two glasses of water; and so on. She agreed with her right hand. I then took a glass of water and a pill—the smallest one (not wanting to abuse her trust). She drank. She drooled, and I took a napkin and cleaned her. She looked at me, and her eyes spoke of embarrassment, shame, and demoralization.

“That's all right. You're still worthy of my care and respect,” I said.

This was an exercise in being there, stepping aside perhaps, but returning and giving assurance of a true, full, and efficacious presence—maintaining a bearable distance, one that doesn't abandon but allows “fresh air” into a relationship as needed. Such a presence allows the other to safely be the other person.

Our deal lasted for a month. This was Miss L's journey, on which I was invited to “sail.” She was discharged at that point, in her wheelchair, but with her eyes facing forward. She was herself now. I had accomplished what many of us can: to be human, to be there.

On her journey, during the storm that was now her life, the wind had changed, and had not blown her way.

So she had changed her sails.

I just sat with her—in compassionate silence most of the time—stretching the boat's ropes once in a while when she tired of tacking through the harsher currents of her disability.

Much of our time together was about silence—a warm, embracing velvet moment. Words? Why? Feelings, gestures can overbrim hard brick walls.

When Miss L was discharged, I was there to say, “See you tomorrow, as always.” Then I said something else—“Dignity pills: one at a time”—and she smiled.

Dignity. Undetectable?

Let us stop and think about the concept. Let us feel it, practice it, give it.

ACKNOWLEDGMENTS

A special word of gratitude goes out to Dr. Michael Tapley.

References

REFERENCE

Edwards, E. (2009). Resilience: Reflections on the burdens and gifts of facing life's adversities. New York: Broadway Books.Google Scholar