Her room is across the corridor from my office, the big family room in our inpatient unit. I keep my door open to allow the air conditioning in on hot summer days like today. The temperature is not high compared to a lot of areas but the humidity level makes everything feel much hotter. I am sensitive to sound and noise which is why I usually keep my door closed as I become easily distracted. From the room opposite to mine many waves have vibrated through the airspace between us leading to electrical stimulation of some of my nerves and registering as different activities.

I have heard laughter at least 20 times. There has been a constant hubbub of active conversation in the background, I cannot discern what words or even what language is being used but I can tell from the tone how connected the people in the room are. I have heard the cries of a little baby. There are toddlers talking to their uncles, aunties and grandparents. Older cousins are hanging out with each other during an unexpected day away from school. Was that  guitar I heard just before? I haven’t heard them sing yet, but I am sure they will at some stage. I have heard new visitors being greeted enthusiastically, the sound of people hugging with many kisses to cheeks. A lot of people have brought food.

I am the most distracted in the hour before lunchtime. Over the last two years of intermittent fasting, 11 am is one hour before I break my fast. From my neighbour’s room I can hear and sometimes smell  people sharing food with each other. A shared family meal can be a difficult logistical exercise in the adult life of New Zealanders. Where to meet, how to meet, when to meet, what kind of food to bring? All of these questions require answers and solid plans in order to make things happen. From my position it sounds like my neighbours are having a good time. The warmth in the room is not just the ambient temperature but it represents the shared feelings of love. The people have gathered because their loved one has needed them.

My patient is dying  and there is nothing we can do  to stop it. We have tried over the past week. We stopped medications that were no longer helping. We hoped her deterioration was due to medication side effect but it wasn’t. Was it a reactive depression to the bad news she received two weeks ago? We started her on a fast-acting antidepressant  but it made no difference. Last week I said hello but she didn’t answer me.  The dullness in her eyes told me everything . Time would be short. She was not going to make it home ever again, her family would have to bring a bit of home  into her hospice room. I can hear upbeat music being played in the language of her family’s place of origin.  Now it’s Josh Groban’s You Raised Me Up.                                                                                       
“I am strong, when I am on your shoulders…”

Even after working 16 years full-time in palliative care the stark contrast still hits me. My patient is dying in her room but she is surrounded by so much life. Her little baby, who is vocalising a lot, is in there with a lot of the people who will be bringing her up after her mother dies. Another tragic case but life will go on, another case where we have made a difference.