Being Observant

by Janie Rakow

Part of being a doula is keeping our eyes and ears wide open. With that way of being present, we can often find a simple change in the environment of a dying person, which will increase their quality of life, sometimes quite profoundly. Just recently, as I visited Tiffany, a 53-year old woman dying with metastatic breast cancer, I re-experienced this truth of the doula approach.

Tiffany had requested a doula through a hospice program that I volunteer at when I can. Her sister Jasmine, who was the primary caregiver, brought me into the living room to meet Tiffany. She was propped up in a hospital bed watching a rerun of the TV series NCIS. Tiffany gave me a weak smile as Jasmine introduced me. Even though her hair was almost nonexistent and she was bone thin, she was beautiful.

After sitting down on the couch next to Tiffany’s hospital bed, I asked her to tell me about herself. The first thing she told me was that she had one child, a daughter, who lived in another state. Her face lit up when she spoke about her daughter; it was clear that she adored her.

As Tiffany talked, I looked around the cramped living room. Tiffany’s bed was pushed right up to the front of the TV so she could see it more clearly. With the hospital bed, couch, several chairs on either side of the bed, and a grand piano there was hardly enough room to maneuver. Tiffany was very weak and all the obstacles in the room made it unsafe for her to get out of bed. Her world had shrunk to a few feet of space, dominated by the TV in front of her.

The grand piano, which was behind the hospital bed, held a large collection of photos and cards. I thought they would be a good way to prompt Tiffany to tell me more stories about her daughter, other people, and the memories of what I suspected was a full life. I went and picked up a pile of the photos and brought them over to the bed. Excited to share her memories, Tiffany explained each picture in detail. She told me who each person was, what they meant to her, and what was happening when the photo was taken. After about an hour of talking, she began to tire, and closed her eyes.

At that point, Jasmine came into the room. Seeing Tiffany quiet and resting, she picked up the framed pictures to put them back on the piano. It suddenly occurred to me that the pictures were too meaningful to Tiffany to have them on the piano where she couldn’t see them. So, I suggested that Jasmine put the photos and cards on the TV stand, where they would be in Tiffany’s line of sight. Jasmine thought this was a wonderful idea, so that’s what we did. 

I had to leave before Tiffany woke up. But I imagine her delight, upon opening her eyes to see all the people who love and cherish her. A simple change like this—as the result of being observant and focused on quality of life—can make the time a dying person has left much more cheerful. Now, when she’s tired of watching NCIS or some other TV program, Tiffany can look at the loving faces of her family and friends and connect to the richness of her life.