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Affection in caregiver/patient and colleague relationships
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More forgiving view of own caregiving efforts
• Less compromised affect displayed in the caregiving relationship
• Less self-blame when caregiving goals are not met
Story: An older woman asked that we support her as she was dying of a rare neurological disorder.
After some months, she disclosed that she did not want to continue living with her rapidly
decreasing capacities and her increasing pain. Over many months, we gently and firmly tried to
find ways to offer her greater love and support. But she was determined to end her life.
She tried more than once to end her life, but did not succeed. Each time she swallowed the pills,
her partner would call 911 and a rescue team would arrive and resuscitate her. Her anger at these
rescues went deep, as she had been in a psychiatric institution as a young woman and felt
profoundly angry that others were controlling her destiny. It was not a matter of love and reason
being an intervention to end this cycle of misery. All the spiritual and practical issues meant nothing
to her in the face of her history and her current suffering.
Our team reluctantly told her that we could not support her suicide, although we loved and
respected her. We were legally bound to “call for help.” She and her partner agreed to not inform
us or anyone if she attempted suicide again, and in this way, they would let things take their
course. Knowing these two women, I imagine this was a hard decision; nor was ours an easy one
either. It was a process of being realistic and blameless.
One Wednesday morning, the phone rang. Our friend had attempted suicide. This time she was
comatose and had entered a vegetative state. When her partner called me, she had been that way
for four days. I immediately drove to her house to find her unconscious and completely chaotic, her
breathing ragged, her body tossing about like flotsam in stormy waves. The hospice nurse and my
assistant, who knew her well, asked that I spend some time alone with her. “She would want this,”
they said. I sat down beside the bed and took her hands in mine. Her eyes were blank, her body
twisting and sweating profusely. I began breathing with her, telling her that she was loved and that
it was OK for her to let go. We breathed together, and gradually, almost imperceptibly, with me
quietly saying “yes” on her out-breath, her breathing slowed and became lighter and lighter, until at
last she slipped away and was gone. Maybe this story illustrates what it means to do this work.
Compassion is always the base, including compassion for one’s own limitations in the work.
This is the essence of CMC care, the ability to offer equanimity, compassion, mindfulness, and
information in a balanced way, where there is understanding and appreciation all around. Here is
another story that illustrates what we try to bring to those near death.
Story: This is a short account of Matthew who had been diagnosed with a brain tumor. When
Matthew finally died of his cancer, he had already discussed his final wishes with his family and
with me. This is a really important part of what we do as compassionate caregivers: to create an
atmosphere of trust, courage, and compassion, where difficult subjects can be explored. In a family
meeting with Matthew, we had sat in council and the question came up of how he wanted his body
treated immediately after he died. I had shared with Matthew and his family how we recommend
that the body is cared for after death. He seemed to find this guidance helpful and made the
request of his friends and family that this happen. Creating a situation of trust and ease in the midst
of the drama around dying is really important. From this base, there can be greater balance and
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Compassion for Self and Patient:
