Anxiety shadowed me as I prepared to ring the doorbell, and I wondered, as I always did before meeting new patients, why I had chosen to be a hospice volunteer.
I don't think I flinched when I saw Diane, but I can't swear to it. Her face was ashen and so bloated it appeared ready to burst. There wasn't a hair on her head.
Then I saw her eyes. They were a striking, luminous blue.
I introduced myself and asked if I could visit for a few minutes. "Sure," she said, "if you can stand it. I look so ugly."
Diane's comment caught me off-guard. I wanted to comfort her, but I had no idea what to say. I took a deep breath.
"You have beautiful blue eyes and great taste in nightgowns. I can work with that."
Diane smiled, and I sensed we would be OK.
During the next six months, Diane and I cheered for the Baltimore Orioles, watched cooking shows on television, played X-rated Scrabble and listened to opera music. When Diane was hungry, I morphed into a short-order cook who catered to her craving for sweets. When she wanted to be alone, I waited downstairs.
Diane had few visitors, but she prepared for them with painstaking care. With shaking hands, she would apply lipstick and blush. Then she would ask me if her nightgown and scarf matched her sheets. Only after being reassured that they did could Diane wait for her visitors with relative ease.
Her concern with her appearance never waned; her emotions weren't as predictable. Mostly, Diane accepted the limitations cancer imposed on her life. Some days, though, sadness and anxiety undermined her fortitude. That's when Diane withdrew into the safety of her dreams and slept until she felt renewed. Like a loyal canine companion, I sat by her bedside, waiting and watching and willing her to stir. Sometimes I feared she never would.
I never asked Diane what she dreamed about during those long, deep slumbers. It seemed too private. But I imagined her unconscious was helping her prepare for death, a reality she tried hard to ignore.
She wasn't the only one in denial. I enjoyed the time I spent with Diane so much that I began visiting her four times a week. Somewhere along the way, I "forgot" my friend was dying. Then one day, seemingly out of the blue, Diane mentioned how much she would miss her home and I was jolted back to reality.
"What will it feel like to die?" she asked.
"I wish I knew the answer to that question, but I don't," I replied. "But I can promise that you won't be alone and you won't be in pain."
My words seemed to reassure her. "Thank you for talking with me about this," Diane said. "I wish more people did."
Me, too. I knew many well-intentioned families and doctors who thought discussing death would be too upsetting for everyone concerned. Too many people die in pain and fear because of that silence.
Diane was luckier. Hospice care gave her the gift of life, even as she prepared to die.
Weeks before her death, Diane celebrated her 62nd birthday. To mark the occasion, she donned a mint-green warm-up suit and a coordinating cabbage-rose-patterned scarf. Afraid of falling, she gripped the wrought-iron handrail and inched her way down four stairs that led to the dining room.
Diane smiled as she saw the table, set with her best china and crystal candlesticks. She inhaled the scent of the freesia-filled centerpiece. Her companion stood next to the table, bearing balloons and chocolates, shy as a teenager on his first date.
They asked me to join them for a toast. I protested, but just enough to be polite. "L'chaim," Diane said as we clicked our wine glasses together. "To life," I translated.
I have a photograph of Diane taken that memorable night. At first glance, her face appears pale and bloated, just like the first time we met. When I look more closely, though, I see a striking difference. There is no fear or shame in Diane's brilliant blue eyes. There is only joy.
Every time I see that photograph, I remember why I chose to be a hospice volunteer.