Listening

Yesterday (Christmas) I visited a sick man in a hospital. It reminded me of a time I saw Isaac in the hospital.

The date is May 31, 2010, the day after Isaac had his colostomy. He looked an Isaac-shaped doll, small and emaciated. It was the worst I would ever see him; when I saw him later, up to the day he died, he did not look as bad as he did that day.

He was in pain. He was in despair. To be blunt, he was suicidal. “I’ve got thousands of people casting healing spells on me. Why can’t I get better?”

We now know the answer to that question. Isaac had stage 4 cancer; it had metastasized and was spreading throughout his body. Isaac’s oncologists knew this, but they had not yet told Isaac or Phaedra. There was no healing, medical or magical, that could have saved him.

But there was a magic of another kind. I was not alone when I visited him. One of Isaac’s “grand-students” (a student of a student) was with me; let’s call them “N.” N had many years of medical training. N sat by Isaac’s side, took his hand, and listened.

When I say that Isaac was suicidal, I mean it literally. He had a plan and said he had the means to carry it out. N listened to him, showed sympathy for his, did not try to explicitly contradict him.

As this was going on, a nurse came into the room. N asked about Isaac’s pain medications. It was meaningless to me. After the nurse listed them, both N and Isaac (who by that time was familiar with pain medications) said that there was a more effective medication that could be used. The nurse said that she needed to speak with Isaac’s pain-management doctor. It would take time and there’d likely be no changes until the next day.

After the nurse left, N and Isaac continued their conversation. I don’t remember exactly what N said, but Isaac gradually agreed to wait until the new pain medication would arrive, that there was some hope, and to dispose of the materials for his suicide plan.

As this conversation was wrapping up, the nurse came in again. She had reached the doctor, and he had immediately agreed to the new pain medication, which she administered. It was ‘s “social capital” in action: N was part of the medical community, and knew the questions to ask and how to motivate the nurse to action. Instead of a day, it took fifteen minutes to make a change.

By the time we left, Isaac’s pain and despair had been significantly reduced. I shall be forever grateful to N for what they did for Isaac; I could not have done it.

I’m taking care to hide N’s identity, even in a private LJ post, because strictly speaking what N did (and what I did, through inaction) was wrong. According to medical protocol, when Isaac expressed the idea of suicide and went over his plan with us, we should have reported it. He would have been put under restraint until he could be psychologically evaluated. Instead, N took action and helped the patient to feel better. It’s easy to make a sarcastic or ironic remark here, but I won’t; I’ll just note that medical ethics are complicated.

Given Isaac’s fate, it might be asked whether N did Isaac any favors. Again, remember what we knew at the time: We were told that if Isaac went through this procedure he’d have a good chance of recovery, that his form of cancer had a 95% cure rate. Also, it’s one thing to violate medical protocol to help someone feel better, it’s quite another to violate it through inaction to allow someone to commit suicide.

What if N had not been there? What would I have done? I could not have done what N did, since I did not have N’s social capital nor experience. What I would have done was the essence of what N did:

I would have listened.

Let’s get back to yesterday. I went to visit R along with a group of members of R’s family. R’s situation has some similarities with Isaac’s: R has stage 4 cancer, and had had a medical procedure performed on him the previous day to prolong his life. There are significant differences: R is 94, a tough wiry WWII veteran who spent decades doing hard work that kept him fit (in contrast to Isaac’s two decades of suffering from EMS); he and and his family knew the severity of his cancer; he had lived for several years with cancer, but only recently had a combination of Alzheimer’s and treatments required him to have extended stays in a hospital.

I’ve known R’s family for years. I’ve spent many holidays with them. R knew me from those gatherings. He didn’t have much formal education, but he enjoyed watching science-based reality TV shows and liked to talk with me about them. Or rather, he talked while I listened. To be blunt again, he was a garrulous old man, and his family had grown somewhat tired of listening to him talk. I didn’t mind; it’s good practice for someone who claims to be clergy to actively listen, especially for someone like me who likes to talk too much.

The family went into R’s hospital room en masse and started talking to him. When I saw him, I couldn’t help but be reminded of Isaac on that day: small, emaciated, looking like a caricature of himself. They showed him all the Christmas presents he’d received. They offered him food; he drank some egg nog and ate a banana.

It seemed to me that they weren’t really listening to him. He tried to speak a couple of times, but apart from direct responses (“Do you want the other half of the banana?”) what he tried to say was overridden by someone else talking.

He didn’t seem to be in pain or despair, as Isaac had been on that day. He did seem to be confused. A lot was going on all at once, and it seemed to me that they were giving him information faster than he could absorb it.

R saw me, smiled at me, recognized me. He even joked with me a couple of times; I don’t recall him doing that with anyone else (though that may be a trick of my self-centered memory). It may be that he joked with me because I was the only one who took the time to listen to what he said.

To be fair to R’s family, I was a visitor, not a member of their family. I had not known R for the decades they had known him. I had not experienced his behavior outside of holiday parties, during the times he was being difficult or obstinate. This was a large group of visitors arriving all at once, under time pressure because of all the Christmas-Day activities going on. This was just one visit, and I cannot judge how typical it was compared to their all the other visits.

I still wished that they would have listened to him more.

When that times comes when I am lying in a hospital bed, looking like a Bill Seligman doll, I pray to the Goddess for someone who’ll be able to listen to me, and for the wit and ability to say those things that are important.