Palliative Care Reflective Portfolio

by Jonathan Bennett

Jonathan Bennett is a novelist and poet. He is the author of six books, the most recent of which is The Colonial Hotel (ECW Press, 2014). His previous work includes the critically acclaimed novels, Entitlement and After Battersea Park, two collections of poetry, Civil and Civic, and Here is my street, this tree I planted, and a collection of short stories, Verandah People, which was runner up for the Danuta Gleed Literary Award. He is a winner of the K.M. Hunter Artists’ Award in Literature. Born in Vancouver, raised in Sydney, Australia, Jonathan lives in the village of Keene, near Peterborough, Ontario. Visit his website.

 

—for PJ

 

i.

Do I? Admit to the neighbour I need help?
She’ll offer impatience, weak Earl Grey.
So I get admitted, impatiently, instead
to an off-grey medicine ward with
Hospitalists who chart my chest rattle.
I suffer no fear for I am the recipient
of patient-centred, evidence-based, care.
This promise made to me, and me alone,
on a wipe-able poster reinforced by
a tenderly chosen stock photo, paired
with a font inspired by Cezanne’s cursive.
I curse the machine hum, the urine pain,
the C. diff sour smell, the pump noise,
the infection control, latex-free signage.
Only last summer the lake removed such
anguish, or else it was the icy three gin
and tonics, the wind, your beautiful neck.

I presented to the ER with severe pain
in my lower, well—does it really matter
where this began? Things have evolved.
Let’s keep up, I say. But he presses me.
Read the chart I bark. He does, and utters,
back, left flank. There. I am incapacitated.
Last summer I was myself, that recently,
really, independent, with plans in place.
I golfed. Was a snowbird. I hear this,
my evaporating life as chart notes.
The biography that no one considered
worth penning—bit late for sad thoughts.

You dear, are elsewhere, gone in that
peculiar way—off the wall, in a facility
with advanced dementia. At the lake
last summer your dress removed one
afternoon for no reason and we stared
at one another until we remembered
the way it was done, by us. That was the last
time our bodies knew their lines. First?
Another century. Same lake. We giggled—
poke, poke, poke. The results of
investigations indicate—no wait for it,
I require a biopsy of the ilium lesion
for a definitive diagnosis, but a working
one: metastatic renal cell carcinoma.
It’s explained to me in grave tones,
with colourful grace notes—because
some do not know, I know, the meaning.

 

ii.

Before a doctor dies, he becomes a person.
Mortality being a pre-requisite for death,
this occurs to me. My goals: pain relief,
symptom control. Not curative. I do not
speak but agree by blinking to this plan.
My son has arrived. He is a doctor too.
He has a new wife. Younger, a prototype
of the previous, luxurious version.
Their language is useless here because
I still understand it, even if I can no longer—

The resident’s mind is so fresh it’s still setting.
What are the words for the thing I want to say?
I try whisper to him, and he leans in,
I try to whisper to him: Give me an overdose.
He looks aghast. Did I manage to speak?
He says, what I am about to share is going
to be difficult to hear. My son and the resident
are speaking. I am still, listening. The cancer.
Likely metastatic. Left kidney. Multiple locations.

My next steps are to determine I cannot walk.
My son’s first steps—that rock ledge at the lake.
Radiation might be an option for symptom control.
It is not a cure. They discuss goals for my care.
My son takes the news hard. He is emotional.
He is relying on his child-wife for comfort,
condolence, I use my eyes to indicate Kleenex
without meaning, it has a tone of reprimand.
Comfort is assured. Remembering questions
can be hard. Try to write them down.
Pain and symptom teams get involved
and former colleagues in Radiation
Oncology and Orthopedics are called upon.
Or maybe they are just visitors. They see
themselves in me. Smile. The first week
the pain begins to modestly improve,
I am told.
I walk a length of the hospital
ward with discomfort, I am told.

Options for care outside of the hospital
are discussed, I am told. I cannot return
home. I cannot not be cared for, at my son’s
home—for a reason never explained.
I wish to be reunited with my wife,
but I cannot speak. A social worker
I once was rude to intuits what
no one else can and applies for spousal
reunification on compassionate grounds.
I apologize to her all night.

The resident finished his rotation today.
Dictated, in all seriousness, into his small
machine final thoughts for his Palliative Care
Reflective Portfolio: The patient is optimistic
he might be discharged to his demented wife
.

 


Jonathan Bennett is a novelist and poet. He is the author of six books, the most recent of which is The Colonial Hotel (ECW Press, 2014). His previous work includes the critically acclaimed novels, Entitlement and After Battersea Park, two collections of poetry, Civil and Civic, and Here is my street, this tree I planted, and a collection of short stories, Verandah People, which was runner up for the Danuta Gleed Literary Award. He is a winner of the K.M. Hunter Artists’ Award in Literature. Born in Vancouver, raised in Sydney, Australia, Jonathan lives in the village of Keene, near Peterborough, Ontario. Visit his website.

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