The Show’s Over

August 9, 2012 |

Author Phil Cox- Chaplain

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I was called to the hospital room of an elderly gentleman who had died rather suddenly. His daughter arrived about the time I did. I spoke briefly with her, as she began making necessary arrangements for her father, who had Alzheimer’s disease. She had been caring for him for some time, and had been used to his not making sense.

That morning, though, he had said something several times that only now made sense.

“The show’s over,” he had muttered several times.

Whether he knew it or not, he was telling her it was time. Maybe it’s just that simple, though we usually don’t allow it to be so. We tend to complicate and make things more than they need to be. Life to him could have signified that play being acted out on a great stage, and he knew when his time was up. I can’t see any reason to read more than that into it.

From him: I heard you can tell the ending any way you want. It’s yours to tell. If we listen, we will learn things in advance. If not, we learn them later, maybe.

Chaplain Phil Cox,

JPM Panelist.

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Posted in Death, Dying, Geriatrics, Reflective practice, Spirituality

http://esseinstitute.com/ Vlseno

Yes. Has anyone seen a patient who *didn’t* know? They know, we should listen. If we do, we’ll learn something important to our living. Something new from every dying person. Thank you for writing this, Phil.
VJ Periyakoil, MD

Phil- great vignette!

We know when we have a minor cut. We know when we have a simple headache. We know when we have the flu. How can we not know when we are dying? I believe that most patients do have an inner sense when they are getting closer to the end. What is intriguing about your vignette is that this person had “Alzheimers”. While we think of dementia as an irreversible, global cognitive impairment and decline, I agree that often dementia patients have amazing pockets of lucidity.

VJ
http://esseinstitute.com/ Dr Seno

Yes, VJ! We observed my father in late Alzheimer’s become very lucid in the last 9 days — I remember wondering whether he *had* the disease anymore. He could even answer, with a slight shake or nod of his head, and his eyebrows lifting, whether or not he wanted more morphine. It was amazing!!

Observing hundreds of deaths as a hospice nurse, and then my husband’s death — the glory and clarity is almost always there. We have to pay attention to that.

I recently spoke to a group of physicians in MN on communication at the end-of-life. They were full of stories of witnessing that the patient ‘knew.’ What question can there be that we know?

Journal of Palliative Medicine

The Show’s Over

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