A miraculous goodbye, transcends time.

It was a beautiful Sunday morning after Thanksgiving, the holiday spirit was just starting to pick up and move into full swing. I use my drive time to reflect and pray about how I can be useful today. This morning I was seeing a patient who was being discharged from the hospital system known for it's complex cases. Staff at the hospital did not think he was going to make it home yesterday, so they cancelled his discharge yesterday, and were attempting it again today. He had heart failure, had been in the hospital with pneumonia and acute respiratory distress related to both heart failure and the infectious process. He had been there for weeks.

I pulled up to the home, and surprisingly the ambulance was already there. My patient came home from an enormous healthcare system and discharges from here are notorious for being 1-2 hours late. Timing can be particularly precarious in winter when the ambulances get called out for the car accidents with wait times sometimes jumping 3-4 hours. For them to be on time, and even early, during winter was a nice surprise.

Because of the PPE it was just too much to wear your coat inside. Once you got inside, you sweat so much with just clothes on, you would not survive with a coat as well. Outside my car I was freezing while getting myself visit ready. Curiously, the ambulance driver, Lance, was quickly approaching my car. I struggled in the chilling weather, fighting the wind as I donned my blustering blue plastic gown and the rest of the full PPE. The snow and wind gusts caused my eyes to water, as Lance approached.

I looked up and greeted him. Anxiously, he greeted me, "Ma'am" he said, "he is in respiratory distress, and the hospital did not order oxygen." Oh God, I thought. I rushed to double bag my equipment, and I pictured in my mind what this meant. The chill of the day began to heat up as I carefully rushed up the icy sidewalk. Ground each step I reminded myself. Walk quickly, but in a grounded manner. My mind raced as I had seen this scenario too many times, but they at least usually had oxygen. He went on. "We can stay for a little while, but we cannot stay until oxygen arrives."

I looked at him, and I whipped out my cell phone. As the door opened, my glasses fogged immediately. Unable to see, I was already on the phone with the DME company to order STAT oxygen. God knows what that means on a Sunday morning in winter at the holidays. Hopefully they can get here quickly, I prayed. The family anxiously met me at the door, with the looks of fright, concern, and worry in their eyes. On the phone with our company, as I entered their home, I whispered, "I'm ordering oxygen now." No time for proper introductions in times like this.

I quickly struggled putting boot covers on, came in, set my things down on a sofa in the entry way, grabbed my hand sanitizer and equipment, and proceeded to my patient. Trying to navigate their home with steamed glasses, introductions were made swiftly. He was sitting at the edge of his bed, so weak and pale, yet breathing shallowly. 52 breaths a minute. His blood pressure was below 90 systolic and his pulse was 111. I reassured him we were going to get him comfortable, as I simultaneously opened the morphine, and called Dr. Zicker to get the orders for administration. He nodded weakly as he conveyed he understood. No allergies, and no objections to the medications is such a gift in times like this. The family wanted him comfortable and able to breath easier. Thank you, Jesus!

Dialing the oxygen up to 4L, on the now precious little tank we had for only a bit of time, I turned to the daughter and asked for a small fan to get air circulating. With my head cocked to hold the phone while calling Dr. Zicker, may hands were free to open the morhpine. My patient, inches from my left side was panting, and I felt his despair. I assured him "You will be more comfortable in just a few minutes." He nodded. As the phone rang, I asked the son to open a window. Fresh air does something for anyone who cannot breath especially in winter. The crisp freshness of the air, brings life to the moment. In came his sister with a fan and the family got that set up. With Dr. Zicker's orders, I administered the first dose of morphine, and Ativan.

Carefully monitoring him, it took about 30 minutes before he could attempt to lie down, but was still very restless. Unfortunately Lance and his partner had to go. They had stayed 40 minutes but had to leave and take the oxygen with them. I was so thankful to them and though my patient was still in some distress their service and patience was priceless in this situation.

As I stayed by his side, watching and waiting for the medications to settle him I called to check on when the oxygen would get here. They had no idea and his restlessness continued. Restlessness in hospice patients is usually caused by discomfort of some kind. Often pain, anxiety, the inability to breath, or commonly the need to use the restroom are sources for agitation.

With my patient, it was not only the dyspnea. (shortness of breath) There was a restlessness of spirit. As I observed him over the minutes, he was a bit more comfortable physically. He had now enough breath to speak a few words. But he was still struggling to settle down, I called Dr. Zicker again, and we increased his medications, but there was something else going on here. He struggled with the bed, then moved to a chair, then to the bathroom, and back to bed. Now sitting up, on the side of the bed, the family was starting to feel a bit helpless as they tried to get their dad comfortable. I was running through everything in my mind that I could offer, when I gently asked "Has he spoken with every one he needs to speak to? "Is there anyone he needs to talk to?"

His daughter who was at his side, gently stood up, and pulled her phone from her right hip pocket. said " Let's call Rob." Her eyes glued to her phone as she tapped, there were no objections. Within moments, everyone in the room was a part of the communion of events starting with the space created for this phone call to happen.

The speaker phone filled the room. "Hello?" said Rob. "Hello, son." he quickly said, He knew he did not have much time, breath, or energy. He was dying. He knew it. We knew it, and the acceptance of this is what makes these moments sacred. There was no casual niceties, or talk of weather. He went on immediately! "I just need to tell you how proud I am of you. I am proud of the man you have become, and what you've done with your life. I love you, son. " He continued. ' I only wish I could have been a better father."

There was not a dry eye in the room. This gentleman who had so little energy, uses his final breaths to humble himself before this son, openly in front of his family. He only had moments. And he chose to express love, joy, humility and openness.

The family members present in chorus with Rob protested. " No Dad,, You were the best father." Rob continued " I only wish I could live up to everything you taught me, dad. I fall short. " His father again, said he was so proud of him, and he was perfect as he was.

Sitting at a desk in the master bedroom, I was writing the orders when I stopped what I was doing. I could feel the Holy Spirit enter the room. And then his father said those words, in a warm, sweet, loving voice, but with a tone of finality. " Good-bye, son." This moment hung in the air, and I saw ripples run across the waves of time. We all knew this moment changed someone, and something forever. You could feel it.

There was a collective acceptance of the imperfections of mankind, and in particular this dad and son. And there was a collective acceptance that none of it mattered. Amidst those imperfections was the perfection of Love which was happening right here in front of us. The stillness of the Holy Spirit filled the room, as the Love washed over all of us, including Rob at the other end of the particle wave. Whatever transgressions had been, were no more, and there was a healing that took place. It was palpable. Rob, needed to hear from this father, and his father needed to speak. If all the parts had not come together, he would not have had the breath to speak. This entire thing was a miracle. And just as the phone call ended our oxygen arrived. I know that this moment was to be recorded in the minds and hearts of all of us collectively. The power of that experience is beyond measure and would not have been possible without the Holy Sprit. Working through the incredible heroism of the ambulance drivers, quick action by family members, and showing up when needed another beautiful hospice miracle occurred.

I do not know what the circumstances were between these two. One can surmise from the context of the conversation that it was a coming together despite _____________. Fill in the blank. I do know he was the only one who could not be present, and I do know the restlessness we were trying to manage went away after the phone call was made.

He died 2 and a half hours after I left and did so peacefully.

I was so grateful to the two ambulance drivers. He was more comfortable because of what they did. They did not have to stay, or offer the oxygen. Yet they did. They felt it in their hearts to help how they could. Even though they could not stay for the miracle, they were like the volley ball player who provides the set up for the slam dunk! Way to go. I called their management and explained what they did for this family. Their participation and supply of oxygen was every bit a part of the miracle.

What a team the Holy Spirit gathers together, when miracles need to happen.