My name is Richard Width and I have an important story to share.

Over the past 20 years, I’ve experienced Hospice both as layperson and nurse. I began chronicling my experiences as a way to provide education and illumination for the general public about this natural part of the human journey.

Help me get over the finish line and complete my book of observations and anecdotes!

Your generous donation will allow me to go Part Time at my current Hospice nursing job for the next 4 months in order to devote weekly time to completing the manuscript. In the past two years, I’ve managed to get myself 2/3 of the way to completion while working full time. Now I find myself financially stalled yet with the same fire and desire to get this deeply needed information out to the general public!

If I am able to raise the necessary funds in total, in return for your generous donation, no matter how large or small, I will send you a signed copy of the completed book.

The money raised will provide the extra income needed in order to take 2-4 days off in every 2 week pay period over the next four months to focus solely on the completion, editing, self-publishing, and marketing of the project. Any extra funds will be channeled into the self-publishing and marketing.

To further encourage your aid in this project, here is a free taste of one of my Hospice anecdotes….

Shelley

“You should write a book.”

The upward inflection on the word ‘book’ made her statement sound like a question even though it was delivered as an emphatic proclamation. Removing one of my stethoscope’s earpieces, I glanced up from the blood pressure cuff I was slowly inflating and met Shelley’s piercing, demanding eyes.

“I think people would be very interested.”

Seemingly satisfied with her pronouncement and my apparent unspoken agreement, she raised her glare to the bedroom wall, and with a slight smile I returned to listening for her blood pressure.

A book? When would I have time for that? Amidst my ridiculously high caseload assigned by the agency (significantly more patients than I could see in a week) and the endless charting requirements, I barely had time for my own life let alone a new writing project!

At 101, possessing a sharp-tongued wit and even sharper intellect, Shelley looked a good fifteen years younger and behaved as if she was forty; albeit an often irate forty. She did not suffer fools gladly and in her estimation, most people were fools. During one of our first few visits, I walked in on her ripping some poor soul to shreds on the phone. As she hung up, her gaze found mine and she admitted, her mouth hard even as her eyes twinkled, “I have a temper.”

I demurred, “You have opinions,” dragging a reluctant smile out of her. Thus, a friendship out of our clinical relationship was born.

In the weeks I'd been her nurse, despite a king-sized bed dominating her bedroom, I’d never seen her anywhere else but perched on the edge of her Medicare provided, twin sized, hospital bed with her swollen feet raised on a small stool. Her diminutive, rounded, pink pajama clad figure was propped upright by an ever-increasing mound of pillows. Her face was always framed by the nasal cannula delivering oxygen around the clock to help the ongoing shortness of breath caused by her terminal congestive heart failure.

Surrounding her on every inch of available bed space, as well as on three small foldout tables beside the bed, were ever increasing piles of papers. Months of newspapers and newsletters, multiple manila folders waiting to be addressed, mounds of loose correspondence, magazines, tax statements, junk mail. When questioned about this organized chaos, she aggressively stated the bed was her “desk” and even though it made finding anything “utterly impossible” it was

still “better than nothing.” I’d never once seen her in her actual bed despite the fact she was still able to walk to and fro with her walker. When I asked, she dismissively replied that king was “only for sleeping.”

She was one of my rarer patients; one whose wits were intact and after a long, productive life sat without flinching with her keen awareness she was dying. She’d been a practicing psychologist with several books to her name who still provided weekly phone sessions to three or four long time patients. Yet, despite all her intellectual wisdom, she could instantly boomerang into an anxiety attack and insist on reviewing the facts her disease process as if there was some overlooked way to avoid death.

Yes- you are dying. No- I don’t know how long, but probably in a couple weeks. Yes- I suspect dying will be quick. No- you won’t suffer because we have medication here for you. Yes- probably in your sleep.

These responses, provided from the breadth of my experience and knowledge of pathophysiology, satisfied her until she remembered she might have symptoms along the way.

Pain. Anxiety. Shortness of breath. What then? Then oxygen, morphine, lorazepam, more morphine...

But how much? And when? And who would give it if she were in the midst of dying and couldn’t heave herself to the medication to self-administer?

My first response- your husband, Merton.

“He’s as old as me and can barely remember to take his own medications!”

I reminded her, she also had Julia, the live-in aide who had been hired for just such purposes.

“Does she even know what to do?”

To which, I repeated that I had again gone through the comfort medications with Julia, and she knew exactly what to do.

The entire back and forth ended the same way, always, with Shelley’s dubious “Well... I don’t know…”

It wasn’t until later in another visit, after we had finished my list of clinical tasks; heart rate, oxygen saturation, temperature, edema, lung sounds and the litany of questions: how’s your pain? Your appetite? Are you sleeping? Did you poop? and I was seated across from her typing the results of my assessment into the agency issued laptop that she barked-

“Well?”

“Well, what?” I replied lifting my eyes from the screen, again meeting her direct, dark eyes with my own unfazed blue.

Shelley nonchalantly adjusted the nasal cannula in her nose which had slipped out with the force of her question and repeated slowly, as if I were hard of hearing, “You should. Write. A book. About all the people you see. You can call it ‘Conversations.’ You’ll have to change all the names, of course. But…” her eyes glinted with mischief- “you can leave mine.”

“Really, Shelley? I’m sure Merton would have something to say about that.”

Not missing a beat, she stridently answered, “Merton will do what I tell him.”

From the room across the hall, Merton’s faint voice warbled, “Yes, Shell?”

“What?”

“What…?” The voice teetered into form as first the walker and then Merton shuffled into the bedroom.

Shirley demanded, “What?”

Merton swayed above his walker, “Did you need something?”

“I wasn’t talking to you!”

“I thought I heard my name.”

“I Wasn’t. Talking. To YOU.”

With a broadening smile, Merton shifted slightly to face me, still seated in my chair.

“I hope she’s not running you ragged.”

“No more than usual, Merton.”

“You can leave, Merton. I am talking to MY nurse,” Shelley intoned with finality, staking her claim to both my attention and my time.

As he shuffled back out with unwavering affability he said, “I’m just down the hall if you need anything.”

“We know!” Shelley announced with exasperation. Shelley waited until he had vanished from sight. “So.” She faced me again with her penetrating gaze. “Will you do it?”

“Write a book? I’ve certainly thought about it.”

“With all the things you see, all the conversations you have… people would want to read about it.”

I set my computer aside and leaned forward in my seat. “Do you think?”

“Yes! People need to read about it. We don’t talk about it. Ever. It’s the one thing no one ever talks about- and they need to!”

“Why don’t you write it?”

“I haven’t the time. And besides,” elaborating with more than a hint of superiority, “I’ve already written MY book.”

We went back and forth in this manner for many more visits. Shelley inquiring if I’d started (not yet) and incentivizing me with blunt assessments of my time management and prioritizing skills

(do it now).

After about a month had passed, one early morning in late September the agency received a panicked call from Merton that Shelley was having trouble waking up, was slurring her words, was too weak to get

out of bed.

I arrived quickly and Julia led me upstairs. For the first time ever, I saw Shelley in the king-sized bed, lying at its center, askew. Abandoned was her pillowed post and piles of papers. In her

place on the hospital bed at sea amidst the stacks was Merton, small and overwhelmed.

Her eyes were unfocused, and she lay at an odd, crooked angle as if, having been caught in mid-rise, froze and fell back into the tangled sheets. Her breath came in irregular gasps, her nasal cannula out of place and lay next to her amidst the bedclothes. I stooped down to eye level, placing one hand in her open, cupped palm while the other reached for her oxygen tubing.

“Shelley? It’s Richard. Your nurse.”

Her eyes swam, shifted toward me, her words tumbled haltingly from her gaping mouth, “…what… happening… to me?”

“Shelley? Your heart gave out in your sleep. You’re dying.”

Her breath hitched in her throat, and I knew she understood. I continued, “Are you in any pain, Shelley? Are you short of breath?”

“…can’t… can’t catch… breath,” she half muttered, half slurred.

Already in motion, I gently spoke, “Shelley, I’m going to put your oxygen back on and give you a dose of morphine. It’s going to help. Ok?”

A brief nod and after returning her nasal cannula oxygen to her nose, I shifted myself to the bedside table and drew up an oral syringe of morphine. I gently placed the tip between her lower gum line and cheek emptying the five-milligram dose into her mouth. Replacing the syringe, I took her hand again as her gaze shifted upward. Her breathing began to even out, the ragged gasps slowed and her face relaxed.

“…strange.”

Softer now, I simply stated, "It’s ok to go whenever you need to. Merton will be ok. Your kids; they’ll all be ok.”

I heard Merton suppress a deep sob behind me. It was the sound of absolute desolation, but I kept my face soft and focused on Shelley. This was not a time to address the boundless sorrow of those left behind. This was the time to ‘hold the space’ in the room for Shelley, for Merton, for Julia. Hold the space for the grief, the loss, the mystery; to be the grounded energy keeping the emotional and spiritual environment steady, accepting, and still. Hold us all, calmly, in the eye of the death’s hurricane.

Her eyes began to glaze over as the medication eased her symptoms away and she fell asleep. It wasn’t much longer when, as I’d predicted, sleeping, she “shuffled off this mortal coil.”

Some small amount of time later, after I had completed the pronouncement, filed the beginnings of her death certificate with the state, comforted the heartbroken Merton, and explained to Julia what would happen next with the funeral home, I left Shelley's house for the last time.

A true Northeast Autumn seemed to have sprung up overnight. Wet, windy, chilly with a slick, gleaming array of orange, red and brown fallen leaves coating the driveway. As I made my way toward my car, a breeze stirred the trees behind me, and I thought I heard a fierce, familiar whisper...

“Write the book.”