That day started out like most others. I got into my office/car, slammed some espresso, and headed toward St. Louis to see some patients. First on the roster were two patients at a nursing home in Dogtown, one that I barely knew and one that had changed my whole perception of the world. As I entered Muriel’s room, it was obvious that things had taken a sharp decline since I last saw her two weeks previously. I was still choked up as it had been been exceedingly difficult to accept the inevitable–my friend had slipped into the foggy, grey area where life and death mingle and court one another, slyly negotiating until the baton is passed and the next leg of the relay begins.
Here are the facts–the room was much hotter than I’d expected and the shades were pulled shut, signs that she had neither the will nor the need to complain about such trivial, earthly matters. Her right eye (the “good” one) managed to open just briefly, but long enough for her to register that it was me and to prompt a heartbreaking smile to her tired face. There is something incomprehensibly endearing and awe-inspiring to have someone that is in such an utterly profound place of introspection tinged with unimaginable mental and physical weariness actually expend a measure of their precious energy to let you know they are glad to see you. Muriel was more than one of my patients–she was a fellow traveler and a true friend.
Born an underprivileged black woman in an era when it was even more difficult to be, Muriel decided early on that she would not participate in many of the foolish and unnecessary insecurities and fears that plagued most of the rest of us. She would tell me upon our first few visits that she had read one book that had freed her, had taught her how to understand people, how to deal with them, and how to maintain her own dignity and self-confidence. That book was “How to Win Friends and Influence People” by Dale Carnegie. I promised her I would purchase it and read it. I did so and strongly recommend it to anyone that knows how to read and wants to participate more successfully in society. For this reason alone I am greatly indebted to her, but her easy persuasion in this matter was insignificant compared to the peace and joy she brought to my life. When I first met her she was living on the 26th floor of a subsidized senior-living apartment building that I had driven past hundreds of times and had never even known was filled with residents. She was nearly bed-bound and only got up to use the restroom, to shower, and to change her clothes. Because of this she would leave the door to her apartment unlocked for visitors, and it was also because of this that I walked in on her fully naked in the process of changing her clothes one day. Far from being horrified, she just cackled hysterically and apologized profusely that I “had to see that old body”. That is just the way she was, always thinking about the other person. When the time came that her cancer had maliciously rendered her completely unable to care for herself, she refused to allow her son to bring a television or radio to the nursing home lest he have to return and pick it up after she had passed. Several years before she had required a routine eye operation that was botched by an inexperienced surgeon. After several more surgeries failed to correct the damage incurred during the first attempt, Muriel not only decided to accept the fact that her eye would never be the same, but she insisted that the surgeon receive no reprimand severe enough to permanently affect his career. Her capacity for forgiveness was astonishing.
I usually scheduled our appointments for late afternoon on Fridays as our visits were much-needed and welcome unwinding sessions after long weeks. Sitting next to her bedside, discussing the absurdities of being human on this planet, I reveled in my good fortune to have become a part of this woman’s life. Even after she moved to the nursing home her needs were few and her wants were nearly non-existent. The one thing she requested was a bird feeder to place outside her window so she could observe the behavior of the various birds she would often hear, but would usually not venture low enough to be visible from the bed of her first-floor room. About a week after installing the feeder, she excitedly told me about all of the drama unfolding around it. Furious territorial disputes were being waged. An errant woodpecker had taken to the feeder, which prompted her to laugh and state that he must have forgotten that he should have been pecking on trees. Love was in the Spring air and a pair of mating cardinals were her favorites. Muriel noticed the things that completely escaped the other residents that flocked out onto the patio next to her feeder every two hours, like clockwork, to smoke cigarettes and complain about the weather. Her outlook on life was full of compassion, empathy, enthusiasm, and curiosity, and not even her cancer could rob her of her grace and dignity. That day I saw the most beautiful smile on her face as she awoke from a comfortable slumber and mumbled something unintelligible to me. I believe she was surprised to see that I had sat next her bed the whole time she was asleep (approximately 45 minutes). Truthfully, I was in the midst of a deep, existential meditation brought on by pondering her condition. It occurred to me that there are moments in life when not even a force as powerful and all-pervasive as time itself can creep in and disturb something magical. We existed together in that room apart from the laws of physics and logic. It was a place that could only be described as sacred if it must be described by something as woefully inadequate as a word. I saw myself in her and her in myself, no separation except that thin, deceptive veil created by illusion born of ignorance and spiritual-blindness. It struck me that what was created there by circumstance was actually a refuge, a sanctuary that made far more sense than the madness and randomness going on outside in the world. An innately natural process was unfolding, albeit one that was heart-wrenching and that would ultimately rob me of the companionship of my friend. As I squeezed her hand and said goodbye, I told her that we would see each other again. We both knew that it was not true. I might see her, but by that time (within the next day or two) she would have lost all consciousness and one of the true earthly treasures I had ever encountered would be passing on into the Great Unknown. It sounds odd to say that I loved her–after all, she was a patient. But that’s the beautiful thing about hospice. When I worked in mental health, there were very strict boundaries you did not cross, and for a good reason. There you were dealing with clients from an inherent position of power, helping them face problems brought on by mental illness or their inability to cope with events beyond their control. With Muriel, there was no reason to keep up my defenses. She was the most kind, non-pathological being that I have had the pleasure to have encountered. If anything, I would hope to have not negatively affected her in any way. But I know that’s not possible, she wouldn’t stand for it. And so my eyes are a little watery tonight (I’m not a crier) as I think about the unlikeliest duo that ever shared some wonderful and interesting late Friday afternoons helping one another to figure out how to deal with whatever comes down the pike. Here’s to Muriel, my true friend.