Monica was just twenty-seven. She was single. She called herself a born-again Christian. She had no family who came to visit her as I recall. This hospice would be her final home. She was dying of cancer. She asked for me.

I would come to her bedside, and we would talk. Well, she did the talking. She talked incessantly, almost fearfully. She talked about her childhood and adolescence. She talked about both of her marriages. She talked about her two miscarriages and one abortion. She owned a lot of unresolved grief and a load of guilt that clashed with her beliefs.

But throughout all her conversations, she kept reminding me, or herself, how she had come to know Jesus and the conversional moment when she accepted Christ in her life. It was just after she had been diagnosed with fourth stage Lymphocytic Leukemia.

She shared with me the extensive and painful treatment she had undergone. She said, "My fellow church members had been so supportive in the beginning, but now that I have been diagnosed as terminal, they seemed less so. They don't know what to say to me, and so, they stay away."

She was not the same Monica they had known. She now had no hair, emaciated with open sores and in constant need of blood transfusions. There would be no more remissions. She said, "When people look at me, I could see their fear." Her visitors' registration book was nearly empty.

She seemed dismayed, unsure, anxious. I continued to counsel her on her current state, and I remained committed to assisting her in staying in the moment; staying in the present; knowing her death was imminent. She continued each session with her confidence in Jesus, and he would save her so she could go on a missionary trip around the world. Because of this "deal" she had made with God, it became more and more difficult to keep her in the present.

She continued to be in terrible pain, but she refused all pain medication. The pain medication could manage the pain without rendering her unconscious, but she felt the need to stay alert and wait for one more round of chemotherapy that would save her life. But there would not be one more round.

Late one weekend afternoon, when many of the patients in the hospice were out visiting family or going for a walk, Monica used that time to talk to the staff about her faith and how she was ready, as she said, "...to go be with Jesus." Her ability to thrive was declining rapidly and early that same evening, she collapsed.

She was put into her bed and the hospice team did everything they could to make her comfortable. She was close to death, and she asked for me. When I arrived, she began to cry. It was a frightened cry, like a small child who was lost and there was no one to help her.

"Dr. Bill, is it time for me to die? I'm not ready. I'm not ready. I don't want to die! I don't want to die. Please! Hold me! I'm so scared!"

I reached down and took her in my arms and held her. But she continued to sob, and her distress now became known by everyone around us. It was as if no one could understand what needed to be done. Monica suddenly hemorrhaged. She began to expel blood from every orifice. She went unconscious and died soon after.




I don't remember much of what transpired after that. Nurses said I was covered in her blood. They tried to speak to me, but they could tell I was not able to hear them. They said I was unable to speak or respond to any voice for nearly three days. Weeks went by and I had night terrors that disrupted both my personal and professional life. Sleep meant nightmares. I wasn't fit to see clients. I lost weight.

Group therapy helped me get past what I had judged to be my biggest failure. I would have other "failures" who would challenge my commitment to this work I had chosen for myself. But Monica's death was my "teachable moment." I learned that I had to take each assignment separately and avoid "glopping" them all into my "caseload."

In therapy, I set my ego aside so that my heart could have a larger role. My capacity to counsel clients who were terminally ill, no matter what their age, was not going to be my epitaph or on my gravestone. I also learned that I needed someone or a way of working through my grief that I kept denying.

All this was learned from this death, and more. My hope descended into despair, but through counseling I found a new understanding of a hope that will never abandon me, and a hope I could model for others. It was a teachable moment;


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