My patient, whom I will call Doris, was estranged from one of her children for 30 years. This is the story of the final chapter of her life and what led to their reconciliation.
By the time Doris was 86, she had more than her share of medical problems. She had been hospitalized many times for emphysema, and she came into the clinic complaining of trouble breathing. Her oxygen level was dangerously low. I told her she would have to go to the emergency room. She was not pleased, but there was no alternative if she wanted to live.
In the ER, things went from bad to worse. A blood test revealed her clotting time was prolonged. She needed an injection of phytonadione, a form of vitamin K, to counteract the effects of Coumadin, which she was taking to prevent a stroke.
Then a near-fatal medical error occurred. Instead of injecting phytonadione, a nurse grabbed the medication right next to it called physostigmine, an antidote that can be lifesaving in a certain type of poisoning. In this case, the drug worsened her lung condition. She was intubated, rushed to the intensive care unit and placed on a respirator. Doris’ daughter, with whom she had a relationship, was notified of the error. Although the ER staff was apologetic, the daughter was furious. As it was conveyed to me, she warned, “You haven’t heard the end of this!”
After a week in the ICU, Doris was able to come off the respirator. Too weak to return home, she was discharged to an assisted-living facility. When she failed to recover there, her daughter enrolled her in hospice care and brought her home. When I learned Doris was on hospice, I went to visit her.
A hospice aide led me into the living room, where a bed had been set up. Doris was curled into a fetal position, her daughter wrapped around her. I greeted them. Her daughter raised her head, but Doris did not respond. She appeared moribund, and it took me a minute or two to determine whether she was breathing. She was, but barely. It was clear there would be no meaningful conversation. So I asked, “How about if I play some music for you on my viola?”
I wrote in a recent column about the first time I played my viola for a hospice patient. Other stories are just as poignant.
This time, I chose a piece called “Liebesleid” by Fritz Kreisler. The title translates to “Love’s Sorrow.” Then something remarkable happened. Doris disentangled herself from her daughter, sat up in bed and began laughing and clapping along to the music. Her daughter watched, tears streaming down her cheeks.
When I finished playing, I put my viola in its case, waved goodbye and made a beeline for the front door. Having witnessed this intense emotional display of mother and daughter, I felt I was about to drown in a flood of tears.
Less than 48 hours later, Doris’ daughter called to tell me her mother died. She invited me to the funeral. A highlight of the service was a relative singing “Somewhere Over the Rainbow.” Afterward, I scanned the room for Doris’ daughter to offer my condolences. I saw her walking arm in arm with another woman. To my shock, she introduced me to her sister, who I didn’t know existed.
The sister, who had been long estranged from her mother, explained that they had reconnected just before her death. Immediately after I had left Doris’ home, Doris felt compelled to call her. Sensing that the time was short, she and her mother forgave each other and expressed their love.
There is a moral to the story here. Because none of us knows when we or those we love will die, don’t let expressions of forgiveness, gratitude and love go unsaid. An ancient Hawaiian ritual of reconciliation called Ho’oponopono offers a simple script: “I am sorry. Please forgive me. Thank you. I love you.”
Note: As a result of that ER medication error, the hospital revised its procedure for dispensing medication to prevent a similar mistake from happening again.