Living By Example: A Quiet, Powerful Presence

On Sunday, Nov. 19, I received the following email from Eric Poche, Director of Volunteer Services for the Zen Hospice Project:

In hospice, it is sometimes our great, great fortune and honor to stay a course to the end of life of someone who humbly accepts our attention with style and grace, who unquestioningly with a gesture of hand, a crack of a smile, a steady gaze of inquiry or an occasional snort of a laugh, grabs our hearts and we fall forever in love. So many blessings came from you, dear Edith. May you receive them in return a thousand-fold.

My gratitude goes out to the many volunteers who simply loved and treasured this wonderful being.

Edith (her name has been changed) arrived at Laguna Honda Hospital’s hospice ward, C-2, in 2005, over a year into my service as a volunteer. Generally, it is expected that our residents have six months or fewer remaining. We count ourselves lucky if we have time to develop a relationship with each resident. So many come and pass in a matter of days.

While it is always an honor to be in their transitory presence, it somehow is a richer experience for resident and volunteer alike when relationships can kindle and grow. By all accounts, Edith was a long term resident, arriving at the age of 79 and passing six years later. During this time, she built relationships quietly, slowly, and steadily. And, to my mind, she did so unconsciously. Hers was the life of quiet, subtle, self-effacing service to others. In the end, she exemplified to me the “good life,” which inevitably concludes in a “good death,” rich in human connection and love.

Edith arrived with advanced breast cancer, having suffered a stroke, accompanied with an onset of dementia. She could no longer care for herself. She was born in Asia, married a U.S. serviceman and lived in the United States for more than 50 years, ultimately in San Francisco. She had long ago divorced. Her son and daughter lived out of state and Edith had no interest in leaving her beloved San Francisco. Her home was a tiny apartment on Market Street.

In the early days of her stay, Edith would cry, begging to be returned to her home. As the months went by and Edith became inured to the fact that C-2 likely would be her final residence, she fell into a quiet, almost Zen-like, routine of service to the ward. Always well coiffed, meticulously made up, bejeweled and elegantly dressed, she claimed the upkeep of the ward’s kitchen and dining area. Her mobility was impaired by her stroke, but she nonetheless spent hours each day shuffling from her bed, through the common room to the kitchen, sweeping the floors, removing clutter, debris, dirty plates and utensils, washing any and all dishes, wiping down the sink, cleaning the counter tops, tables, and the common areas. She made fresh coffee, refilled the hotwater urn for tea, and arranged the day-old, donated Starbucks pastries, all without disturbing her elegance and without the least call of attention to herself or her work.

Edith enjoyed cooking. In the early days, she procured ingredients to prepare Asian barbecue or kimchee, serving her dishes to the residents and staff, always declining her own share to head off to bed, exhausted from the ordeal of her service.

Even at the peak of her health, Edith spoke quietly and with very few words. Her animated face telling you everything you needed to know.

Games were a favorite pass time for Edith. The old hospital had weekly Monday night blackjack and Wednesday night bingo. If well, Edith was there. A frequent winner, it seemed to be against her nature to declare “Bingo” or “blackjack” at the appropriate occasions. As she moved from being slowly ambulatory, to moving about in a wheelchair, I began to accompany her to the Monday night black jack games. I had no reluctance in declaring wins on her behalf, when she would have preferred simply turning over the winning hand, without comment and sometimes without notice. Evening winners from the games were given “cash” for spending at the hospital “store.” Edith’s needs were few and exceedingly modest. Often, her winnings were spent in buying presents for other residents.

One day, Edith asked one of the volunteers if she could view the body of a just deceased resident with whom she’d been close. At first, she just stared, telling the volunteer that her friend was not dead, only sleeping. After a time, she grew sad and withdrew to her bed, only to return several times before the body was removed to the morgue. Over the years, as Edith witnessed the repeated death of resident friends, her resistance to death faded.

Edith was a smoker. Her smoking was modest, methodical, almost ritualized - executed with the same elegance as her makeup, hair and wardrobe. Early in her stay, Edith needed only to step a few feet out the common room door to a smoking table, which in good weather, was the ward’s social center. She would join the group, quietly revel in the sociability and return to her bed or her kitchen work, having not expressed a word.

Later, powers-that-be relocated the smoking area further from the building. The relocated area, however, was more exposed to the wind and cold, and generally much less hospitable. But Edith, nonetheless, found a way to make it home. Simply by her presence, she also made it welcoming to her fellow residents.

Edith loved to give and receive touch. It seemed that she could sit quietly, holding hands for hours on end. Touch, for Edith, was its own language. It was a way for her to silently communicate her caring and concern for others. The funny thing is how important her caring and concern was for the volunteers - particularly as we all relocated to the new hospital.

The volunteer community, as well as the C-2 staff, had been rocked by a series of abrupt transitions including the departure of Dr. Kerr, the long-term hospice ward physician, a surprise reorganization of nursing and other staff to meet the city’s perilous budget constraints, and the relocation to a new building with new architectural opportunities and impediments. I tried to stay a cheerleader for the relocation and the opportunities presented, the improved facilities and the new experiences that would await us in serving not only our hospice residents but the palliative care residents, with whom our residents were being joined. Eventually, even my resiliency faded in the face of recurring and seemingly monumental changes.

Edith maintained her poise, her equanimity, and her elegance through it all. She reminded me and the other residents that it was our work in serving others, not the facilities, the new practices, or the staffing changes, that created and sustained our community. She reminded us not through her words, but through her being.

At my first volunteer staff meeting following Edith’s passing, I listened to the comments of my fellow volunteers. From their words, it came to me how Edith had such power of presence and influence. There are three shifts each weekday, composed of three to four volunteers. Many of our residents are with us for such a short time that they cannot distinguish us, one from the other. Even after several months of service to a resident, I may continue to reintroduce myself on each encounter. Edith saw each of us for who we were, embraced us as individuals, not as a class, and had compassion for us in our work. She affirmed to us that we were loved and appreciated, that our work was valued, and that we each had a meaningful and personal relationship with her. We will miss Edith.

In my work as a lawyer, I deal with many “great” people. They are rendered great by their achievements, influence, money, and power. Many are outspoken and egotistical, even as they are “generous” and “compassionate” in their contributions to causes. But it is the rare individual, so elegant, self-effacing, humble, and compassionate, that invites you to appreciate your own worth.

I wish you the best for this Holiday Season and that you are blessed with many Ediths in your life.