FIRST ENTRY FOR THE PALLIATIVE CARE OF TERMINAL LUNG CANCER PATIENT C.G.

THREE DAYS LEFT UNTIL PASSING

It is three in the morning when I arrive. The main hall is dimly lit and reeks of impending death.

The husband has forgotten about sleep. He rests by her side looking down at her frail thin body, caressing the mass of frizzy blonde locks around her pale face. Whenever heavy tears smudge the cheeks, a bottle of water trembles in his rusty hands. A tray with medicine bottles, painkillers and anticoagulants, lies under her multi-fold electric bed.

He is taking good care of her.

Patients like C.G., dear apprentice, whose people linger by their side, praying for a miracle, washing and changing them into clean undergarments, are the ones that I call strugglers. On the other hand, the forlorn patients, they more easily embrace human mortality. Those are the skippers.

Let me focus on the workload though—the examination of C.G.’s surroundings, the elicitation of any knowledge secreted in the walls. What might drape the flooring strips and whisper through aged curtains, what might hang from ornate rods.

I must provide my patient with the best palliative care before a cousin harvests her.

C.G. has eclectic taste in art and its derivatives. Yet, I am not certain what artistic movement she fancies the most. The walls are dressed in paintings of various movements but they all look old-fashioned and pseudo-vintage with golden or silver frames. An experienced eye would discern rural settings inspired from Bastien-Lepage or the curves and light brown palettes of Botticelli.

This is the cornerstone of our vocation, apprentice. To diligently study our patient’s world.

A particular one catches my attention—obviously from a local painter with a passion for Christian Renaissance figures. He has slightly tweaked the Descent from the Cross by bringing forth Baroque themes such as dramatic lighting and heightened sense of depth. While it has been positively influenced by Rubens’s central panel that decorates the Cathedral of Our Lady in Antwerp (I have written about caring for a death patient in the city once during the Dutch Golden Age, do you remember?) the theatrics of those unpinning the Lord from the Cross are missing.

As if everybody, John the Apostle and Virgin Mary included, have seen through Christ’s sacrifice. They have discovered serenity in the acceptance of mortality.

I am intrigued by such a decoration choice, neophyte. The emotion is not missing from this depiction—if only, it is mediated by a humbling understanding of the human condition.

What piques my curiosity next is the fervent adoration C.G has had for her younger face. Various portraits, some in greyscale and others in vivid colors, hang in multiple sizes whenever a breach appears on the walls. C.G.’s ambitious eyes and petite lips either flirt with the viewer or completely disregard them.

I commit to memory to go through her wardrobes. I count three already.

The light holders of this room are magnificent—for whichever side table or corner I am passing from, bronze statues rest nestling a cavity on their heads so they can fit bulbs inside. Standing in all their prowess, those bodies look like ancient wizards or baby angels—if I had a heart, it would beat faster.

Eccentric. Confident. Unforgettable. C.G. has an eye for the uniquely odd and painfully humane. Her taste amazes me—I have escorted so many people through their final days, and not one of them has surprised me as much.

I wish you were with me to experience the rejuvenation such a home brings to the senses, apprentice. The sheer amount of memories I can extract from this household, the exceptional pain-relief I can provide C.G with. … Mesmerizing.

The husband weeps some more but decides to assume his place on the armchair next to C.G. and get some much-needed rest. I sit by her side then, inspecting her, augmenting my gifts: the pounding of her heart, that built-in clock measuring the minutes, hours, and seconds closer to her expiration date, still holds.

Please remember: you must survey the surroundings before you begin your palliative routine. You must sit by their side and feel their life slipping away. For it is in the moments you share with your patient that their care becomes exclusive to their needs.

Three days, thirty-five minutes, and thirty-three seconds. This is when her clock will cease.

C.G.’s body enjoys number three. Why not, I humor myself. It is one of the holiest, most powerful numbers—per Pythagoras, it connotes perfection and harmony. Shakespeare’s witches in Macbeth come in three. We do not call it the Holy Trinity for an arbitrary reason. I hope you will be able to discover odd connections between your patients and their last days too. To find meaning in the arbitrary—it makes our work so much easier.

C.G.’s existence, packed within the walls of her house, supplies me with all the details I will use to approach and ease her pain. Three memories to correspond to her three-day beating heart—only these are necessary.

This is why strugglers constitute my favorite type of patients. They always have something to say to me and I always listen—the type of work we perform needs cooperation. After all, we are not magicians as some of our superiors would like to think.



SECOND ENTRY FOR THE PALLIATIVE CARE OF TERMINAL LUNG CANCER PATIENT C.G.

TWO DAYS LEFT UNTIL PASSING

You are already aware, dear apprentice, how we are often mistaken for the Grim Reapers, but death is not as easy and convenient as many peoples around the world entertain. Death does not exist only as a force of nature. Once God gave life to our cousins, He understood the carelessness of harvesting. A great deal of them exploited their station and reaped with the violence and bloodthirstiness a mortal army would. Souls are not meant to suffer, He had told us while molding us from extraterrestrial ether and presolar stardust—do you remember? You are the ones that will help their crossing. Life after death begins with you, Treasurers. This, young pupil, you mustn’t forget.

You might have noticed that I prefer the term “palliative care specialist” in my writings. It is much more relevant to the telos, the purpose of our species, for we do not treat the Soul solely as the contents of a vessel. We scrutinize a patient’s life, reveal objects they cherish through an extreme research of their favorite fabrics, textures and decorations. Those objects weave memory after memory, which we slither out from the walls that encompass them. We appease them to alleviate their passing.

C.G. is resting against me now as I hold one of her sister’s golden necklaces. When I mimic S.G.’s voice, she smiles, showing gums instead of teeth.

This is my first gift to her.

It is then that the husband wakes up, alarmed by C. G addressing her sister.

“Que cosa?” Ah. An Italian—so focused I was on my patient I did not truly notice her guardian. (Please, do not make the same mistakes, apprentice. I am adding this note here, so untypical of mine, to make sure you do not neglect those that remain behind.) His accent comes from the Northern part of the country; softer than those in the South and a bit more staccato. Of Lombardy, perhaps?

He wipes saliva from his mouth which has been gaping open. It is noon so little specks of dust dance around the duvet that he quickly throws on the floor and rushes to her side. “What is it, tesoro?”

C.G. repeats her earlier words but instead of looking at me, she turns to him.

He lowers his head in an attempt to make out the words. His mouth falls.

“No, tesoro. Your sister is not … with us.” Tears well up and his voice breaks. “It’s been forty years.”

Is the pain of those left behind palpable like the bump of a tumor? Or instinctual like the mortal body jerking when dreaming of falling down while fast asleep?

When you collect enough experience in the field, I would like to discuss this with you.

I shake the necklace once more gathering C.G.’s attention away from her husband. He peers at my spot, of course seeing nothing but empty air, yet he lingers for a moment. His eyes darken; the grim truth that C.G. is close to the end lurks inside.

When he walks back to his armchair, a sob escapes him.

C.G. needs more than her sister’s voice or family heirlooms. I muster all my strength, conjuring the image of the locked baby room I discovered earlier, upon searching the house. I recreate the mirage of her unborn baby, cooing and gurgling and wrapped from head to toe in a soft blanket. He comes alive and I hand him to her as she raises shaky arms to cradle his tiny body. Humidity gathers in her filmy brown eyes. She places him on her chest. Her son smiles and snot comes from the nose but C.G. kisses his cheeks and rests her forehead on his.

And that is my second gift to soothe her soul.

As I weave this new reality by her side, the husband bites his lips and stifles back tears, turning his head away.



THIRD ENTRY FOR THE PALLIATIVE CARE OF TERMINAL LUNG CANCER PATIENT C.G.

ONE DAY LEFT UNTIL PASSING

If I could describe C.G.’s house with one word it would be: a shrine. The woman has been a collector of relics, moments, and clipped dreams her entire life. Photos of her parents’ school dates and of their wedding rest by her bedside table. Drawings of S.G’s childhood obsessions—the seaside which they visited every summer and even the small coffee shop on Pavlou Mela Street where they would have their coffee and snacks before C.G. got to work—all of these I have uncovered neatly placed inside drawers. The letters C.G. exchanged with her husband before they officially became husband and wife leisurely lie under tablecloths and stacks of books.

How much of a person’s world can be stacked inside their house?

The husband is outside now, talking to the doctor. I am weaving a surplus of warm moments by abusing the fabric of time—her first day at school, the moment she decided to move away from her mother and study fashion modeling in Athens, the day she held her godchild in her hands. She had cried and whispered “you’re like a son to me.”

Today, her heart will grow silent—gone are her restless nights and violent jerks I witnessed before. She is also used to my presence; to my holding of her hand and wiping away the sweat on her face.

She accepts now. It is okay to let go.

She does not need a third gift, neophyte, can you imagine? She did prove me wrong. Perhaps, I could conjure another visage, my rendering of what comes after, since she has only been wonderful so far, my most cherished patient …

No, apprentice, I must restrain myself. it is not in our area of knowledge to truly fathom what lies in the afterlife realms. We must remain objective with all our patients. We have a purpose and by this we abide. Do not make the mistake of caring for secrets that are locked even to us. Even to our cousins, the Reapers.

A note to whomever checks these writings: what scientists call signs of approaching death, our kind calls a Treasurer’s entry. Still, I have been working so long in this station, it is not my intention to bog down my future apprentice with lists of symptoms of near-dying patients. My purpose is to fill these entries with the impressions mortality leaves on us in order for my student (and those after them) to become better Palliative Care Specialists. Please excuse my writing taking some liberties—Treasurers are widely known for their excellent creative spirit and imagination. Otherwise, our vocation would not survive.

*     *     *
The curtains move. Footsteps drag and suddenly the husband is holding C.G.’s hand.

“Amore mio, oggi sei bellissima.” He kisses her on the forehead, listening to the way she is breathing, seconds pass before her chest goes up again.

He knows she’s in limbo.

Then, he does something unexpected, something I will never be able to fathom. Not in retrospect when scribbling this, not if you ever ask me, dear apprentice.

His brow shifts and he sits straighter, the hands tucked in the pockets of his black trousers, the white tufts of hair draping his black-as-coal eyes.

He turns to the void I occupy and asks, “When are you taking her?”

*     *     *
Our kind is not supposed to be seen, felt, or heard by any living person apart from our patients—who still, most often, do not understand who is it that eases their fear of letting go. Our kind, future Treasurer, is made with intention: we are not angelic messengers or omens of bad luck. Neither dream symbolism to be explained.

The husband repeats the question and I force borrow C.G’s voice, forming words I never thought I would.

“Can you see me?”

He is taken aback by my voice, for it is C.G.’s younger one. What he first heard by that beach, that 1963 summer in Halkidiki when C.G. fought with him for so openly flirting her.

“I’ve felt plenty of Mortes in my life. My family hasn’t been so lucky.” He repeats the question. “When will she go away?”

Mortes. Plural for the latin noun, mors. Thanatos. Death. The Grim Reaper.

The husband has been researching about our own kin.

Impressed is the least I am. More like in admiration of his persistence.

“I am not Mors but a Treasurer. A Palliative Care Specialist.” Speaking to a living human being, exchanging words that I expect would be challenged both scares and thrills me. “My work is to ease the fear of mortality and help her soul transcend.”

I shall write this even if some might consider it hubris: I could get used to speaking in a mortal voice. The feeling is … humble. Warm.

The husband walks closer, searching all over the emptiness for any signs of my entity but finds none. Instead, he raises his finger at random and clocks an invisible spot close to where I stand.

“You stink. This is why I know. And you give her false hopes. Nothing comes after this life.”

“How can you be so certain?” I ask.

I decide that it feel less lonely to speak to someone alive and I will persist.

When you spend so much time with humans, young pupil, it is natural for you become like them. To an extent. I always feel their anguish or pain when they walk away or their remorse for leaving behind unfinished goodbyes. But I have never been as shocked or merciful as I am now.

Would God consider this a sin?

I will not see this as hubris, student. But proof that I am growing as a Specialist. Caring for your patients, truly caring, means you will have pieces of them left in you.

This is the goal of palliative care.

The purpose that has been breathed into me. Into us.

“Get out of my house. She doesn’t need you.”

“I cannot go away. It will be over tonight. You can watch if you want,” I say, expecting the husband to leave the house.

His eyes bulge open and mutters to himself, retreating back to the armchair.

“Lavanda e limone, lavanda e limone. You reek of it.” He repeats and I take a moment to examine myself. My energy.

No mortal has ever paid attention to my existence. Being noticed feels unexpected. Accommodating.

The husband is right. The freshness of lavender fields marries to the citrusy smell of sliced lemons if I move on the floorboards, if I swerve left and right. Which reminds me of C.G.’s clothes on the back of her wardrobe, those she hasn’t worn in years. Or the pair of lemons that is shoved back in one of her fridge drawers. Ingredients for a pie she never got around to baking.

I must smell differently for each relative, I realize. God has made us with the goal to assimilate with our patients. We borrow their memories and their voice. Why not make us borrow their smell too?

The husband has not taken his eyes away from where I am.



LAST ENTRY FOR THE PALLIATIVE CARE OF TERMINAL LUNG CANCER PATIENT C.G.

MINUTES BEFORE PASSING

The husband is awake when my cousin arrives. Clad in their favorite nebulous robes, they hold the scepter with which they divide body from soul. Suddenly, the husband turns towards where we stand, sensing a churning in the air.

“No!” He runs, fists punching into emptiness.

It is done. C.G. will breathe her last in a few moments. Her hair remains the washed-away blonde of the last months, but the texture has turned rougher than when I first arrived. Her jaw slacks open even if she was able to hold it shut earlier today. Her fingers have turned more rigid—they do not cling around her husband’s anymore.

“It’s not her time yet!” The husband screams.

My cousin’s presence tethers with mine, as it does when they question me about the patient, a much-needed link for the patient’s soul to let go. This is how I send all information I have collected over the span of my visit.

This time instead of asking about fears or inhibitions they should evaporate before the scepter catches the soul, they simply ask. He sees us?

He’s lost too many, I reply but I cannot say whom and how many or how because I am not his Treasurer and it is not his time yet.

My cousin places the staff on C.G.’s forehead. She trembles. A raspy sigh. The chest breaks open one last time to breathe. The husband turns to her and cups her face, kissing her everywhere, on the lips, on the cheeks, on her hair, on her neck. Begging us to keep her safe where she goes, apologizing if he ever hurt her.

Golden and silver like the frames she has chosen for her favorite paintings and slick like the weaving of the cashmere headscarves she used to wear, C.G’s soul is sucked into the scepter and the husband holds her tight against the bedframe, her head lolling on the side.

When the ritual ends and my cousin leaves, I visit his side. He hasn’t let go yet even if she is nothing but a husk.

The Descent of the Cross hangs in the distance, the tired face of a half-dead Christ staring down on us.

Minutes pass. Finally, he places her on the mattress and looks up to where he thinks I am. “She must be cold where she goes. She was only dressed in her night clothes.”

She did not prove me wrong, young apprentice. I was simply immature to spot the third gift I am to give her. Please understand that the following decision is not made out of weakness or defect. For if I am to provide relief, let it be for the kin of my patients as well. Let me be the balm that covers their festering wounds.

Palliative care for the loss of someone lost should not limit itself to one body. Because the pain of the Grim Reaper spreads and pollinates.

Humans are not created to mourn over a dead body. Humans are not created to comprehend death and its aftermath.

They are the apple’s eye of our Father, apprentice, and I must love them too.

I must care.

With every ounce of the power C.G’s personal space has offered me, I will myself into her mold. If I can borrow her voice, why not her body. The scraggly arms and brittle legs he was used to tending for months now. The wild hair he washed and brushed for weeks. The soft lips he kissed at night. Another C.G stands in front of him, one that moves and embraces him, one that rests her head where his heart beats.

We stay like this for a while until my power fades away and I turn into a void forged with purpose. When the time is right, I flutter away and perch on the soul of my next patient.


In memory of Chryssa Ghionni