I'm always astonished to see photos of my patients taken before they became ill. The contrast between the pictures and the reality of the dying person is striking. It shouldn't have mattered, of course, but our team couldn't help noticing that the pre-cancer Helen was breathtakingly beautiful.
They say that every dysfunctional family is dysfunctional in its own way. The adults in Helen's life were anything but. Her mom in particular had a history of substance abuse, and in the last three weeks of Helen's life Mom was arrested twice because of loud threats and hints of violence. Our hospice staff worked tirelessly to relieve Helen's physical symptoms -- terrible pain, vomiting, double vision caused by the spread of the cancer to her brain -- and also to hold the family together. I made weekly visits, partly to keep an eye on Helen but mostly to give a booster shot of hope and confidence to Mom and her ex-husband (Helen's biological father) and her current husband. My message to Mom was simple and constant -- you have to hold it together for Helen's sake.
A couple of weeks ago, another relative who helped care for Helen told me that Helen was an angel who'd been sent to earth to fix her mom. Unable to do that, Helen had to leave. That faith, the relative told me, kept her going as she labored along with our hospice team to keep it together for Helen's sake. We all search for meaning as we confront the unspeakable. It occurred to me that I had no better explanation for this tragedy. Today at the bedside we looked down at Helen's body, now free of tubes, washed, and wearing a pretty young girl's dress. The same relative said to me: "A few days after I told you about my angel theory, I was alone with Helen and I told her what I believed. She opened her eyes, looked at me, said 'You're right,' and closed her eyes again."
What do I make of a moment like that? The rational, scientific, doctoring world I inhabit has no room for angels in its explanatory framework. Yet it seems an injustice to label Helen's comment as an expression of delirium and nothing more. As I accompany the dying and their loves ones on a journey filled with tears, it helps me to believe that, every once in a while, I'll encounter an angel.