by Guy E. Miller
When I lost my late wife, Kay, in 2009 following seven years as her caregiver, I cast around for activities to give some renewed purpose to my life. After completing a group bereavement therapy course at the regional hospice organization in Winchester, Virginia, I requested to become a hospice patient volunteer. As my bereavement year neared its end, the hospice organization enrolled me in their training program, which was meant, in part, to apprise volunteers of the many horrors they were likely to encounter. Many dropped out upon realizing what they might be getting themselves in for, but I had been through it all before and I wanted to help.
I told the hospice organization that I wanted to focus totally on military veterans, and that I would gladly travel anywhere in the seventeen-county area of the Shenandoah Valley region to serve the vets. Military service is a towering landmark in people’s lives. They were away from home, many for the first time, immersed in a culture built around honor, loyalty to their buddies and sacrificial dedication to an ideal far bigger than themselves. They mastered complex and dangerous machinery and systems, and most earned promotions that entrusted them with the training, safety and well-being of others.
Those who served in combat witnessed selfless valor and experienced losses that can haunt them the remainder of their lives. This often marks the high point of their entire lifetime, against which every situation or experience is measured and found wanting. Many bear the scars of secrets and guilt which they have never been able to share with anyone who hasn’t “been there.”
But I’ve found that every veteran has a story to share, especially with a comrade who understands things that he may be unable to articulate. They want to know that someone has heard their story, someone who can truly appreciate and validate their service and sacrifice. I know this from my own Army experience in combat, and operations with other services, and I wanted to be there to listen to them.
Over my two years as a hospice volunteer, I would visit and get to know twenty-three patients. They came in an irregular pattern – sometimes weeks would elapse between patients, and I had as many as three patients at one time. By far, the greatest tragedy in the world of hospice happens when doctors, families and patients wait far too long to agree to begin hospice. It broke my heart each of the several occasions when a patient I was assigned died after just a single visit, or on two occasions, before I had even been able to make my first visit.
My first patient, call him Mr. Bob, had debilitation and dementia, with impaired speech. I was visiting him to give his caregiver wife some respite, two hours in a week that she could have some time to herself. Every time I visited, he was always in his recliner in the living room. On my first visit, his wife sat beside him so we could get to know each other a bit.
The hospice paperwork had indicated that Bob was a World War II veteran. His wife said he had been in the Army Air Corps in India. Trying to include him in the conversation, I turned to him and asked, “How did you like serving in India?” He looked me straight in the eye and gave me a huge raspberry.
His wife, sitting beside him and clearly embarrassed, turned to him and said, “No, dear. He asked you how you liked your time in India.” He turned his defiant face to her and repeated his raspberry.
She told me he survived the war unscathed, earned a degree on the GI Bill at Wake Forest University, had a career as a teacher, and they had four children and nine grandchildren. My own efforts to engage him in dialogue usually were fruitless, more so because his meds made him drowsy. But as my weekly visits rolled on, I learned that he was a fanatical fan of his alma mater, Wake Forest, and that his favorite activity was his weekly trip to McDonald’s for french fries and chocolate ice cream. The living room walls were covered with Wake Forest memorabilia and framed diplomas and awards he had earned.
Usually when I arrived for a visit, his wife would immediately go to her back bedroom, stretch out on the bed and watch soap operas until it was time for me to leave. As time wore on, Bob simply slept in his recliner more and more during my visits. One day his wife gave me a book to read during my visit, self-published by one of the men in his unit, describing their wartime experiences in India. As ground support troops for the Army Air Corps, they supported the supply airlift “over the hump” to Chinese troops fighting Japanese occupation. From that I gained an appreciation of his wartime service and realized the honor I had in serving him in his final months.
As time went on, Bob slid deeper and deeper into lethargy, until one day the hospice organization called me to say he had passed overnight. The loss and grief I felt in losing my first patient was surprising to me, since I had known all along that it was inevitable. I told them I wanted to attend his funeral, but they strongly recommended against it. Based on their experience, they said I wasn’t part of the family circle and my presence could be disruptive or unwelcome. Instead, I wrote them a long card of condolence, highlighting things I had learned or enjoyed about Bob. Thus for me was the completion of the hospice cycle, which was what I had decided I wanted to do. I found enormous satisfaction from having played a beneficial role for this wartime veteran and his wife.
My grief was short-lived, because four days later I was assigned a new patient, Mr. Glenn. A terminal cancer patient, he lived with his grandson in a small house perched on a mountainside two valleys distant from my home. Glenn was articulate and ambulatory, though in considerable pain, and I thoroughly enjoyed our time together. His was my introduction to the heart-breaking family dynamics so often involved in end-of-life situations.
Glenn was divorced, living in his remote house alone when his cancer was diagnosed. Since his two grown daughters each lived at considerable distance, and couldn’t be troubled to assist their dying father, the caregiving role landed squarely on his grandson. Butch was a bachelor who ran a home-improvement business in the county, but he gave up his business and moved in with his grandfather to tend him in his final days. To be able to stay at home, Butch converted his trade into making wooden wishing wells, playhouses and lawn ornaments to support himself and his grandfather from their home.
The maturity and good spirits of this young man always impressed me enormously. Whenever I arrived for my weekly visit with Glenn, Butch would cheerfully greet me in the driveway, standing beside his truck, ready to go down the mountain for his weekly grocery shopping trip. He never gave any indication that he felt imposed upon by the situation, the burdens of caring for his grandfather, or the abandonment of responsibility by the rest of his family. Our time together was limited to his departure and return from his weekly supply run, but I always saw in him a degree of love and caring rare for someone so young.
My visits with Glenn were always enjoyable. Even in his pain, his sharp mind clearly showed through. He had been a chemical engineer who joined the Navy in 1940. His first project was to perfect a process to stabilize red phosphorous so it could be used as a primer for explosives. He turned his patent over to the US government and was rewarded with a commission in the US Navy. Following Pearl Harbor, he was rushed to the Aleutian Islands as a brand-new Lieutenant Commander to command a tiny outpost “defending” his microscopic island from Japanese invasion.
Glenn always spoke of the Aleutians in derogatory terms, declaring that the worst thing we could have done to the Japanese Empire was to let them have the useless damned islands, and spend their own resources defending them from invasion. He seemed disappointed that the attack never came, so he could have abandoned his rock to their hapless troops. In his wry wit he told me the Japanese were way smarter than the US government when it came to defending islands from invasion, in the far north at least.
I remembered enough inorganic chemistry to be able to ask occasional intelligent questions, and Glenn delighted in telling me more than I ever imagined I could know about phosphorous and the remarkable phosphate ion. Following the war, he had spent a career as a research chemist with Kodak, earning numerous patents, and he was a wealth of information about photochemistry. Every week I found myself anticipating my sessions with this marvelous veteran.
I never did learn much beyond the basics about the family dynamics that led to his dying of cancer on a remote mountainside with only his grandson attending him. But he never showed any sort of bitterness or resentment. The mutual love between Glenn and Butch was clear in everything I saw.
Every visit, Glenn needed to rise from his recliner and use his walker to get to the bathroom. As a patient volunteer, my job was to assist him up and down, and with his walker, but nothing else. But when somebody needs more help than that, you do what needs to be done without regard to the rules.
As time went by, he needed more and more help with this procedure, and I could tell that his energy was slipping away, so it was not really a surprise when the hospice organization called to say that he had finally passed. I wrote a card of several pages to Butch, and hoped, perhaps, that a part of it was shared with at least someone who would have cared. We were losing these World War II heroes at an alarming rate, and I was honored at least to have played a part in serving one in his final days.
Like Glenn, many of my patients had wartime experience, usually in World War II but also Korea. Others served stateside in peacetime but the common denominator for them all was that they had raised their right hand and sworn to serve their nation, and that their military service deserved to be recognized by someone who could appreciate what they had done for their country.
Mr. Jerry had a diagnosis of “debility,” with six months or less projected to live. He was a retired Federal civil servant who had risen extremely high in the Defense Department. Upon receiving his diagnosis, his daughter had moved him into a luxurious apartment in an assisted living compound a half hour from the city where she lived and ran her business.
Jerry was resentful of his diagnosis, and his daughter’s decision to put him in assisted living, and his severely reduced mobility, and the whole lousy hand that life had dealt him. His daughter drove over to check on him every morning before work, and again every evening when she dined with him in the facility. She took off work the day I met him, to introduce us and tell me about him. He just glared at us both the entire time I was there.
I began my weekly visits with him, but they were a complete disappointment to me. I started off by asking him about his military service, about funny things he remembered from that time, about memorable people he recalled, but he just sat in his leather armchair in stony silence. So I began to tell him about some of the crazy things I had seen in my military service, but still no response whatsoever.
For three weeks we just sat there in silence. Finally, on my fourth weekly visit, about ten minutes in, apparently he just couldn’t stand the silence any longer.
“When I was in the Army, I did a lot of KP,” he said. “In fact, I did so much KP that they gave me a special job, washing pots and pans. That was the only thing I was supposed to do – wash pots and pans. One day the mess sergeant told me to wash out several dozen big glass jars, the ones the mess hall meat came in. I told him that was not my job, that I only washed pots and pans. He said, ‘Those jars are the same as pots and pans.’ I said, ‘They are not the same. Let me show you.'”
And with a giant gesture of his arm, Jerry said “I swept the glass jars off the counter and they all smashed on the floor. ‘See,’ I said, ‘not pots and pans.’ They never again asked me to wash anything besides pots and pans.”
And with that, he began to tell me about his Army days. Jerry served in World War II on an Army outpost in Greenland. “For some reason they made me a supply sergeant,” he said. He His supply room was absolutely perfect, so beautiful that every time some visiting dignitaries or generals came through the installation, they were always brought by to marvel at the immaculate supply room. Every shelf was labeled with its contents, and everything was perfectly folded and aligned. The counters and floors shined, and the windows all sparkled. It was magnificent.
“What they never knew,” he told me with a sly grin, “is that the real supply room was two blocks over.” From that time on, Jerry could not stop talking about his life. I really looked forward to our visits, because he told me delightful stories about his time in the service, and about his work later in the Pentagon. Every visit, he was getting stronger and more vigorous.
One day, he paused and gave me a funny look. “Want to see my M-16?” he asked, and directed me to a closet down the hall, where I found, in fact, an M-16 rifle, or more accurately, half of an M-16. In the early 1960s, Jerry told me, the manufacturer made six M-16s sliced down the centerline, to show the Pentagon the inner workings of their marvelous weapon. And he had kept one of the six, as his souvenir.
A few months into my time with Jerry, his daughter wanted some medical tests run on her father, but the hospice rules would not pay for it. She decided to check him out of the hospice program, and he returned to normal life. I like to believe he is alive and well to this very day.
The most moving patient experience I had was with Mr. Sam. When we met, he was dying of cancer and had only one week to live. It seems that he had had just one week left for eleven weeks and counting, and his doctors were amazed at how he just kept hanging on. He was in pretty bad shape, but we could still visit. His wife always stayed around the corner in the kitchen, listening while we talked.
Sam had enlisted in the Navy during the 1930s and was at Pearl Harbor during the Japanese attack in 1941, but he had never talked to his family about his Navy service. We visited over a couple of weeks, and he became more comfortable talking with me as time went by. Finally, one visit, his wife left to go to the store. As soon as she was down the street, in a faltering voice Sam began to tell me his story.
The morning of December 7, 1941, he was aboard his ship, a cruiser in Pearl Harbor. She was the only American warship to get under way and out of the harbor during the attack. His duty station was in the ammo bunker below the anti-aircraft guns. For three hours that morning he passed hundreds of 3-inch AA cannon rounds up to the guns that were engaging the two waves of Japanese aircraft attacking our warships at anchor. Up and up went his rounds, blasting non-stop toward the attacking enemy aircraft. His ship survived the attack and returned to port afterwards, ready to take the war to the enemy.
The next day, he told me, the Honolulu newspapers carried the headline, “42 CIVILIANS KILLED DURING JAPANESE ATTACK.” With tears streaming down his cheeks, Sam sobbed to me, “Those were my shells.” He fell silent, and I realized there was absolutely nothing I could say to comfort him.
That night the hospice organization called me to say that Sam had passed earlier in the evening. For seventy years he had carried the horrible secret of his guilt, a secret he had never been able to tell anyone. Defying the doctors’ predictions, he had kept holding on and on, waiting month after month until he could finally share his burden with someone who would understand.
He had finally given himself permission to let it go.