The Dying Need Dose of Compassion
- Share via
The tumor had split my Uncle Bob’s thigh bone from the inside.
He was in pain beyond comprehension. The trip from his apartment door to the elevator was a torture; the ambulance ride to the hospital was a screaming nightmare. In just months, the cancer had spread throughout his body. Within days, he would die.
Yet, for hours he was denied the morphine he so desperately needed. Hospital policy, the administrators explained briskly: We can’t risk giving this patient a dosage that could addict him.
The story is now a part of mostly unspoken family lore. Dwelling on it only raises the blood pressure. It does no one any good.
But when Harold Kushner paints the identical scene for an attentive group of nurses and doctors, he can do a world of good.
For Kushner is not merely some outraged relative threatening lawsuits and fuming about managed care. A rabbi who has written such bestsellers as “When Bad Things Happen to Good People,” he is a persuasive humanist, a practitioner of compassion, a voice of common sense for healers shackled to the senselessness of the bottom line. Where I come from, he is what is known as a mensch.
Sponsored by the Cephas Bard Society--a new medical offshoot of United Way--and the medical staff of Community Memorial Hospital, Kushner appeared before 1,200 people at Ventura High School on Tuesday night.
The next morning, he spoke to the staff at Community Memorial Hospital about dying--a subject they know all too well. Not a person in the packed auditorium hadn’t attended a patient on the far edge of life, hadn’t tried to explain some dismal pathology to stricken family members, hadn’t wondered what more they could do for the terminally ill.
Kushner, a tall white-haired man who looked as if he’d be at home on the budget committee of a state legislature, let them know.
“Treat them with with concern, care and attention,” he said. “Take them seriously as sentient people, as living human beings. Give them your loving presence.”
The message seems so obvious it needn’t be spoken. But anyone who has ever worn one of those demeaning, watch-my-rear hospital gowns knows it bears repeating, and in 10-foot neon letters. A “loving presence” can be just as elusive amid the bedpans and heart monitors as it is in a newsroom or police station.
Kushner’s crowd--nurses in their whites, doctors in Dockers--was rapt. Death is part of the routine for them but a critique of their humanity in dealing with it is not--particularly from a biblical scholar who knew more than he wanted of hospitals after losing his 14-year-old son to congestive heart failure.
“If your patient dies, drop a note to the family,” advised Kushner. “It can be computer-generated. Your secretary can send it. But it would mean so much.”
He said he’s consoled the grieving in homes where a sympathetic letter from the doctor would be passed around gingerly, like a sacred relic. “But I’ve also been in homes where they say, ‘The only time we heard from him is when he sent the bill.’ ”
For terminal patients, take time to do the little things, he said. Just sit for a while. Show that you like them. Ease their two most harrowing fears--the fear of crushing pain and the fear of dying alone, abandoned to the machines.
Kushner cited studies showing that physicians spend less time with dying patients--partly because they must help those who can get well but also because they tend to view the dying as a blow to their “win-loss record.”
“You feel helpless before them, and nobody likes to feel helpless,” Kushner said. “But they need so little from us--and they need it so much.”
Compassion, a kind word, a joke: Kushner acknowledged the goods can be tough to deliver because the terminally ill can be a tough crowd.
A dying person can draw his last breath stewing over a curt word from a nurse or a cold glance from a doctor. Smokers with lung cancer can torment themselves for putting their families through hell. AIDS patients can steep themselves in guilt--a condition for which Kushner recommends a colleague’s reassuring logic: “If AIDS is God’s punishment for homosexuality, then is diabetes God’s punishment for eating chocolate?”
*
After Kushner finished, only three of the more than 100 professionals on hand asked questions. A doctor told me he thought his colleagues had been awed into silence.
It’s heartening to think that Kushner could accomplish that with the simplicity of the message he has offered medical groups across the country: Be kind. Don’t hasten death a la Kevorkian but do what you can to ease its sting.
Of course, even that can be overdone.
“It’s like the story about the couple who died and went to heaven,” Kushner said.
Heaven, it turned out, was a wonderfully sunny place with a lovely hotel and an emerald-green golf course.
“What did I tell you?” the man said. “If we hadn’t quit cigarettes and eaten all that oat bran, we’d have gotten here 10 years ago!”
My uncle would have liked that.
*
Steve Chawkins is a Times staff writer. His e-mail address is [email protected].
More to Read
Sign up for Essential California
The most important California stories and recommendations in your inbox every morning.
You may occasionally receive promotional content from the Los Angeles Times.