1. Reincarnation was one of the topics of conversation in the first room this morning. Our patient was a believer and had told his wife that she would come back as a dog. Unfortunately one of their daughters had died only a few years ago. It is always difficult for parents to deal with, as it goes against nature’s order to have a child die before a parent. One of the tragedies in life that elderly people would like to avoid if at all possible. Their daughter had died but had left her traces everywhere.

She had always loved butterflies, and had grown lots of swan plants in order to provide food for her favourite Monarch butterflies. She had a keen eye for their caterpillars and could see them from a distance, their yellow, black and white lines indicating their presence. She especially loved the pupae/cocoons that would form as the caterpillars went through the biggest changes in their lives, metamorphosis. Coming out the other side of the process transformed, with a new outlook on life and the ability to fly. Looking so different in colour scheme and features. She had always loved to have butterflies around. In some cultures it is believed that butterflies are visiting dead friends and family members who have come to see you from the other side of the grave. This is a comforting thing to have your ancestors come to see how you are.

Our patient had been steadily deteriorating over the past week, and he and the family had derived some comfort in being visited by Monarch butterflies. It was thought that their late daughter/sister was visiting their father as he entered his final cocoon state, just before dying.
I told them that when people die in our hospice we would affix a butterfly to the door.

I have often drawn cocoons on our patient list board to indicate that people are undergoing the final transformation in their life, the dying process. One in which everything starts to wind down, the heart, lungs and other organ functions change. A person becomes sleepier, and less clear in their mind, Nature or a higher power’s way of protecting the dying person from the full experience of dying.

“Please keep on talking to him, he can hear you, but might not be able to respond to you.”
Family members were considering leaving for home to come back again soon, but I advised that he could die at anytime, and that traveling under lockdown restrictions was not as easy as usual. Probably better to hang around and support each other for a few more days.

2. Another patient told us about her and her daughters love of monarch butterflies, that they were both planning to have something permanent tattooed on to their bodies. The daughter had already had hers done and the artist had kindly offered to do the mother’s tattoo for free.
They wanted something that would stay on their skin forever that would mark the special bond that they had. Things had been changing very quickly over the past weeks. Her scan results had shown worsening cancer spread throughout her whole body. Her mind was still strong and she was trying her best to be independent but she had reached her physical limit.

No matter how hard she tried, she realised that she now needed help, and she was not too proud to receive it. She said that some times that she wouldn’t mind just falling asleep and never waking up again. Dying suddenly had its appeal for her. She knew that her cancer was making her sicker, and that she would only get worse from now on. She was not scared of dying, and had been making preparations for having limited time left to live. Treasured family memory times were recounted, the fun traditions that had coloured their lives, had produced many stories that they could tell each other.

Metamorphosis, where the caterpillar becomes a butterfly, from one state of matter to another. It happens at the end of life too. Like the caterpillar the external body becomes all mushy, and friable, preparing to become something different. The death of the caterpillar becomes the birth of the butterfly. If we stagnate then we will not develop or grow at all. Everything has its purpose in our worlds. We are all different and that is to be celebrated not to be quashed. We do not want to all be clones of each other in this world full of differences that we inhabit. Transformation of the mind needs to continue if we are ever going to fly.