“Elena” was very sad that morning. Her enormous watery eyes, framed by lush eyelashes stuck together with tears, stared starkly into mine as she lay sweaty and pale in her bed. I said, “You’re feeling a lot of sadness today Elena?” She responded with a simple, “Yes.” Sitting at her bedside I said, “I see your sadness. You must have a lot to be sad about. I’ve had a lot of sadness too, I understand what it’s like to feel very sad.” She perceptively responded in her slow, soft voice, “I think that in order for you to do this job you would have to understand sadness.” We sat together, our candid eyes meeting in that moment as tears ran down her face.
She continued to gaze into my eyes with the frank, unblinking stare I’ve received from many people as they approach their death in my work as a Certified Nursing Assistant at the Zen Hospice Project’s Guest House in San Francisco. As is my practice is these moments, I relaxed my body and let my heart be in my eyes but without thrusting it upon her, just being with her sadness, and with my own, in gentle presence, caring and connection. Nothing to do, nothing to fix, just being together in reality. This is not easy, not comfortable, yet it is a deeply fulfilling honor, and a kind of relief and form of nourishment to strip away all surface and just be together as human beings alive and real, sitting together on the precipice of living and dying.
Only in her late 50s, Elena was a powerful, complex, beautiful woman. In my months of caring for her, bathing her, feeding her, listening to her, she shared some of her process with me with great articulation, intelligence, frankness, humor, anger, biting sadness, pain and kindness. Her words and her striking eyes shared, with all who cared for her, her raw and remarkable humanity.
One morning, weeks into her time with us, she suddenly awoke with a sense of alarm, startling me and her family in the room. “Where am I?!” she called out, sitting up abruptly, her huge eyes wide open with panic. I told her she was safe in her bed at the Zen Hospice Project’s Guest House. Stricken, she loudly cried, “Am I dying?!” Everyone in the room froze, her words stinging the air. “Well,” I said slowly, “Not right this minute, but yes, your illness is taking you in that direction.” We all stood motionless, holding our breath, as we watched her take in this information. “Oh,” she said simply, and seemed to remember and accept this reality. She relaxed and lay back, and began chatting with her husband.
We repeated this experience several times as her illness progressed and affected her memory. Each time Elena waking with the panic of disorientation and forgetting in her vivid eyes, then acceptance upon being reminded of her condition, and then moving forward with living. It was incredible to watch this process of fear, discovery and acceptance lived over and over again.
One night, late into my nightshift, Elena was struggling to breathe. She was literally drowning in the fluid that had rapidly accumulated in her lungs. Again she stared at me, her eyes wild in terror as she fought to take in air; I held her hand and sat close to her. The nurse had already given her medication to dry up the excessive secretions and calm her yet it hadn’t taken effect yet – there was nothing more we could medically do at that point but wait for the medication to work. Delusional and regressing in the direness of her illness and fear, she weakly grasped at my hand and managed to gurgle wetly: “Mommy don’t leave me!” I could feel my own anguish at her distress fill my heart; it’s horrible to watch someone drowning in their own fluid and to be totally helpless.
I did not turn away. Internally, I acknowledged my own fear and horror, and quieted my body and mind, and moved closer to her, holding us both tenderly in my heart. I told her that I wasn’t going anywhere, that I’d stay right there with her. “You promise Mommy?” “Yes Love, I promise,” I reassured her. I could only be with her, let her know that I care, and that I would not leave her as we waited for the medication to take effect. I stayed with her throughout the night, her eyes clinging desperately to mine, until she finally fell asleep, breathing much more easily.
She died about 30 hours later and again I was with her. Thankfully she was peaceful at the end. In her final minutes, her enormous, expressive eyes were still open, and she continued to move them very slowly, tracking movement around her. She was clearly drifting peacefully away, and yet she was awake and seemed to be aware and observant. Again she stared right into my eyes through her very last quiet breath. It was like I was falling into those fathomless eyes as her life retreated from them to somewhere I could not go, like following a vapor trail that dissolved into nothingness. She was gone; I remained, but touched forever by her eyes, gifted by the openness of her intense and vulnerable humanity.
In life, Elena evinced a close and compassionate understanding of suffering, and a gentle, sometimes sharp, sense of humor and irony. In death, her beautiful face settled into what, to me, looked like a subtle, wry half smile – as if she was saying, “Well, THAT happened.” Witnessing her living, dying and death, Elena showed me a very real process of continually integrating reality as it happened, and facing it head on with kindness, humor and honesty. She was a great teacher that I am profoundly honored to have been with – and I can still see her extraordinary eyes.
Celeyce Matthews is Certified Nursing Assistant at Zen Hospice Project’s Guest House, frequent contributor to Legacy.com and a Mindful Caregiver Education facilitator.