Goodbyes

Emergency room goodbye

As a Polish language interpreter for several Boston-area hospitals, Joanna Bereaud has often conducted her work by phone, helping translate medical information for patients and families who don't speak English.

But a Christmastime "gig" this past December was like none she had ever before experienced, and it left her pondering the meaning of life and death.

Joanna recently described this remarkable conversation as we sat in the lobby of Children's Hospital Boston, where she is a music therapist who travels to different units with guitar in hand to help kids heal through song.

Shortly before Christmas 2008, Joanna -- who grew up in Poland -- was home washing dishes on a Saturday night when the phone rang. Her husband was upstairs putting their two young children to bed, so Joanna took the call. It was a staff member from a local emergency room looking for an interpreter right away for a man they couldn’t understand.

"We are not sure what language it is, either Polish or Portuguese," the caller explained. A doctor got on the line and said, "We want to find out what the patient is saying." Someone told Joanna that the man was in critical condition -- but the situation was very chaotic, and she knew nothing else about him: his name, why he was in the hospital, or even whether someone was holding the receiver for him. As soon as he started talking, though, she knew he was speaking Polish. He seemed to be in his 60s or 70s.

"Basically, he confessed his sins to me," Joanna recalled. "He must have known that he was dying. I can't remember how long the conversation took, but it must have been shorter than half an hour. He said how much he loved his wife and that he was regretting that he never made up with his son –- but exactly why I didn't know. He had a list of things that he wanted to spill out and take off his chest.

"Then he stopped talking, and I didn't know what to say. The only instinct I had was to sing him 'Silent Night' in Polish. My kids go to Polish Saturday school, and my brother and I co-lead a singalong in the morning, and I had been there that morning. We were practicing 'Silent Night,' so I had it fresh in my head. I sang to him one verse, and then I couldn't hear anything; at the beginning I had heard his breath. Then someone picked up the phone and said he was gone."

"I couldn't believe it was happening," Joanna told me. "It was a complete blur and nothing like I've experienced before. It was interpreting in the moment."

The encounter touched Joanna profoundly. She could barely fall asleep that night, and she desperately wanted to share the man's last words with his family and let them know about the song. But he remained, and still remains, anonymous.

Instead, Joanna has shared the story with friends and colleagues and has reflected on what it taught her about expressing yourself at the end of life. 

"It made me think about how much of a gift it is to have somebody you can call at any moment, and the disability of not being able to communicate, and how fragile life can be and how important it is to say 'I love you' to somebody. It made me think about how tragic it can be when a father and son are not able to agree -- and that even though we may fight with our parents, we have to make up as soon as possible.

"It doesn't have to get to the point where you don't talk," she said. "You might not have enough time to say goodbye."

Consider this . . .
Tell your loved ones how you feel before it's too late.
Helping someone say goodbye is a gift.

You can hear Joanna's gorgeous voice on this video taken at Children's Hospital in December 2008.

On a precipice

As a rabbi and a hospital chaplain, David had presided over many funerals and counseled numerous bereaved families over the years.

But when he was diagnosed with a life-threatening illness, David didn't talk much about his eventual death with his family –- and his wife didn't want to dash his hopes for a medical miracle.

David did, however, confide in a fellow clergy member.

Laura was a lay Catholic chaplain at the same hospital where David provided pastoral care to Jewish patients when he was not leading his own congregation. They had known each other for several years and were accustomed to comparing spiritual notes.

On Thanksgiving Day, David called Laura and told her that he had been hospitalized and needed to talk right away. She wasn't entirely surprised, as David had been feeling disoriented and off balance lately. Laura left her turkey in the oven and went over to see him. The doctors had discovered a mass with a grim prognosis.

"He said, 'I'm going to need a chaplain.' And I said, 'Don't you want to ask one of your Jewish colleagues?' He replied, 'No. I know you, I know what I'm going to get.' It was a big challenge, because I had never done that kind of pastoral care with somebody from another faith. I couldn't use my Christian terminology, like the crucifixion or resurrection."

Over the next eight months, the pair met nearly every week and talked about what was on David’s mind: his family, his health, and the meaning and purpose of his life.

They also did some healing work using imagery, as Laura explained to me one day in the lobby of the hospital. "The first time we met I said, 'We're going to experiment with this. Why don't you close your eyes and we'll do this visualization. Tell me where you are geographically, the topography of your landscape.' He said, 'I'm in a very cold, dark place. It's wet, like it's raining. I'm standing on a precipice, and it's dark and raining.'" The setting was particularly striking, given David’s extreme fear of heights.

At each session, Laura would ask David to describe where he was, and eventually the darkness in his image waned. "Initially he was too afraid to get close to the precipice, so he stood far away in the dark. As time progressed, he got closer and closer to the edge and found that instead of staring into nothingness, he discovered a panorama of verdant valleys. Even though he was on this precipice, it stopped raining and it got lighter, and it was hopeful and green."

During the last two months of his life, David grew more dependent on others to take care of him physically. This was not easy for a rabbi who, by virtue of his profession, was used to guiding and consoling others and being at the center of attention. "To lose that persona is a tremendous unmasking, and few people can tolerate it," Laura reflected. "But David had an incredible sense of acceptance and gratitude."

In the spring of 1999, David took a medical turn for worse and went into a coma. Although he had shared tender moments toward the end with his wife of more than 40 years, she wished they had spent more time talking about "things that matter," like his legacy, his wishes for his three grown children, and what was in his heart.

David died just two days shy of his 68th birthday, and his colleague Laura delivered one of the eulogies at his funeral.

Although they had not openly discussed his impending death, David's wife knew, thanks in part to the two chaplains' conversations, that he was at peace.

Consider this . . .
A chaplain can help individuals and families confront their fears, wishes, and expectations about dying.
Don't put off talking about things that matter with your loved ones.