Friday, October 28, 2005

"I wish you enough"

We had a party this afternoon for a young woman who I have worked closely with for the past few months, who is leaving this weekend for a transplant. We tend to throw lots of parties where I work: we have “end of chemo parties”, we have parties for birthdays, and last week we had a “Cinderella party” in an effort to lift the spirits of a newly diagnosed little girl.

But this party was different; it was not so much a celebration as much as it was an attempt to skirt around saying goodbye. If you think about it, we do this a lot in life, we have "going away parties," and graduations that are focussed around drowning any potential sorrows with music and alcohol. But parties eventually have to end, and the tears that were intended to be avoided become inevitable. At the end of such a party, people almost instinctively form a line to offer their goodbyes, and quickly depart so that there is little time for awkwardness over not knowing what to say.

Such a line was formed this afternoon at my patient's party. This young woman’s doctors, her social workers, palliative care team, nurses, all whom had taken care of her for years of her life, seemed to breeze through this line, offering their prepackaged goodbyes. “It’s not goodbye, it’s just see you soon,” and “we’ll miss you, hurry back!” were offered, accompanied by saccharine smiles.

I finally made my way to the front of the line, and was at a loss for words. I have been preparing to say goodbye to this young woman for months, her departure has been inevitable, and I have had all the time in the world to rehearse my monologue, to rehearse the precise articulation of what she has meant to me. And yet the words that I had so delicately laid out were abandoned upon stepping in front of her. I couldn’t even find it within me to draw forth “hurry back,” or “I’ll miss you.” I just gave her a hug, and took a step back in an attempt to digest the moment, to hold on to what I needed, and throw out the excess.

Just when the silence between us was becoming too heavy, my young patient wispered "I wish you enough." She was referring to a story by Bob Perks which she so graciously shared with me a few weeks ago. The story is of a man who is in an airport when he hears these words exchanged between a father and his daughter. When he inquires about what the phrase means he receives the following explanation:

I wish you enough sun to keep your attitude bright.
I wish you enough rain to appreciate the sun more.
I wish you enough happiness to keep your spirit alive.
I wish you enough pain so that the smallest joys in life appear much bigger.
I wish you enough gain to satisfy your wanting.
I wish you enough loss to appreciate all that you possess.
I wish you enough hellos to get you through the final goodbye.

The paradox of these situations is that I spend my days coaching kids through painful procedures and treatments to battle their diseases, and yet when it comes to saying goodbye, I am the one who needs the coaching. While they’ve usually come to terms with their deaths, I’m the one who’s not ready to let them go.

I can divide my life into distinct segments, the perforation points being “goodbyes.” Saying goodbye to my dad when I was a little girl, saying goodbye to friends home when I left for college, and friends from college when I moved here. Goodbyes are difficult because they are indicative of the realization that you will never be in that specific time or specific place again. Today, while saying goodbye to my patient, I had such a realization. I was acutely aware of the “perforation point,” the point that divided the piece of my life that was blessed by this young woman’s presence, and the piece of my life that will begin tomorrow in which she is visibly absent.

I am reminded of Aspazia's post a few months back about such "untranslatable moments", moments such as the one I experienced today with my young patient. Others who were in the room raised an eyebrow to her utterance of "I wish you enough" and yet that phrase, so delicately simplistic, served as something so incredibly profound for me in that moment. It encompasses beautifully everything that I wish for her, for all of my patients, for my friends... I wish that you always have "enough."