Suzanne Macan knows that taking care of the dying isn’t for sissies.
In the darkened room, the atmosphere crackles with tension and the weight of words unsaid. There is an air of finality in this house, where Beverly Harlow has lived for 20 years. The 70-year-old cancer patient is leaving her modest home in Falcon, Colo., for Pikes Peak Hospice–and it’s likely she won’t come home again.
Suzanne Macan has witnessed this kind of scene many times, yet it never fails to move her. Macan, a home nurse for Pikes Peak Hospice, has been caring for Harlow since October; during that time, she’s seen Harlow’s condition deteriorate. Now Harlow’s daughter can no longer take care of her. She needs round-the-clock care.
This phase of Harlow’s life–living at home–is about to end. Everyone in the room is keenly aware of this.
Macan considers herself privileged to witness this most intimate of moments in Harlow’s life. Dying, as Macan tells you, is as private as birth. It is messy. It is profound. Macan sees the living and the dying peeled back to their truest selves. “People, they usually die like they’ve lived,” says Macan, 54.
She believes families have an inherent need to care for a dying relative. Her job: to teach them how to do that with dignity and love. The work also has given her a different perspective on the dying.
“They’ve taught me patience and courage and just to savor every moment you have,” says Macan, who has taken care of terminally ill people for more than a decade. “I don’t sweat the small stuff anymore.”
Macan says that her work–comforting angry relatives, teaching people how to cope with terminal illness, participating in the deathbed vigil–sustains this short, energetic woman like no other job.
Pressed for an explanation, Macan fumbles. The answer, of course, is complicated, and it slowly surfaces on a blustery day, as Macan visits Beverly Harlow and two other patients. The answer isn’t revealed just by her words, but by the little things–hugging Harlow’s daughter, trying to console Harlow, even Macan’s own tears.
This is an emotional day for everyone, especially Harlow’s daughter, Carolyn Rotz, who has been taking care of her mother for months. Today, she’s exhausted. She and her brother, Allen Harlow, have been wrestling with the decision to place their mother in the hospice residence. It’s a charged decision, especially for Rotz, who has been caregiver, laundress and nurse to her mother. Now she’s tired. She would just like to be her mother’s daughter.
“How’d it go last evening?” Macan asks Rotz.
“She fell out of bed,” Rotz replies wearily, nodding toward her mother, who is dozing fitfully in a recliner in the living room.
Macan kneels down by Harlow’s chair. “How’s the pain today?” she asks gently. “Are you having a lot of pain?”
“Yes,” Harlow mumbles.
The daughter hovers near her mother. “It took half an hour to wake her up today,” she says.
“So, well, the plan today is what?” Macan asks, straightening up. The question is aimed at all of them.
“To feel better,” the older woman murmurs.
“And you’ve talked it over about the residence. Are you OK with that?”
Harlow shifts restlessly in her chair. “As long as I get to come home,” she says after a few moments. “I’ll want to come home and stay a night or two. I don’t want to just visit.”
Macan bites her lip. Rotz, red-eyed, retreats to the kitchen and leans against the refrigerator. The kitchen table is covered with more than a dozen vials of pain pills–the special medications her mother must take because she’s allergic to morphine. “I’m exhausted, anxious and guilty because she doesn’t want to go,” Rotz confides. “This is her home. But I can’t take care of her anymore.”
Macan calls ahead to the hospice to let administrators know her patient is on her way. As she and Rotz go over the list of Harlow’s medications, Harlow dozes again. A minute later, she awakens with a start and says she’s worried about Bobby, her parakeet.
“I hate to leave him because he will ask for me,” she says with a quavery voice.
Macan says she’ll check with the hospice. Maybe there’s a way she can keep Bobby with her.
“I don’t know why I had to fall last night,” Harlow says.
Macan tries to reassure her. “These things happen because you’re a little bit weaker and a little bit sleepier.”
There’s not much more to say. Macan takes the woman’s hand in hers. The living room falls silent. Harlow’s daughter stands in the doorway, hugging herself.
Macan wants to say a few more words to Harlow, but she has drifted off to sleep again. Macan hugs her anyway, then hugs Rotz and Allen Harlow too. She steps outside into the brisk sunshine, blinking hard.
