Today, I visited Mrs. H. We sat on the patio under the shade of three tall redwoods. The afternoon air was soft and warm. Mrs. H enjoyed a cookie and a glass of fruit punch while I read to her from an illustrated storybook. We exchanged a few words about the delights of the overgrown, late summer garden—flowers, stones, hummingbirds, moving shadows.

hummingbird-300x450Mrs. H suffers from Alzheimer’s dementia. On a good day, she responds to my friendly questions with single words, short phrases. On a very good day, she generates a little conversation, but more often than not she gets halfway through a sentence and then falls silent because she has lost track of her destination. She is the sort of patient we like to call “pleasantly forgetful.”

So I was taken by surprise when Mrs. H looked up, fixed her pale blue eyes on mine and asked, “How come? How come I talk to you the way I do?” She continued, “Very few times in your life do you meet someone who responds to whatever it is that I am.”

In hospice, we treat symptoms. We relieve pain and anxiety and constipation. But in hospice, we also respond to whatever it is our patients are. We—our entire hospice team—quiet ourselves into what T.S. Eliot called “the stillpoint of the turning world,” and lend our complete focus to the soul behind the diagnosis.

I’ve seen Nancy do this, when she gestures with her hands to convey a point to someone who is almost exclusively a visual-spatial learner. I’ve seen Rob do this, when he summarizes an hour’s conversation among six people with a single sentence that tells the patient’s absolute truth. I’ve seen Shari do this, when she rubs lotion into a patient’s hands in a way that is almost sacramental.

We can quiet ourselves into the stillpoint and try to respond to whatever our patients are. In the end, it is not for them to join us. It is for us to join them, and with courage and respect, lead them onward, lead them outward, lead them beyond.