Reiki and the Plastic Mask

I work on a Hospice in patient unit, and every day know we have taken to making rounds as a Team. We see about 100 new patients a month on this unit, and we are a symptom management and stabilization unit. While often, patients come to us "to die," many patients come for pain stabilization, and some that come to die ......well ......don't do what is expected.

There is a wonderful book, written by the late Art Buchwald, "Too Soon to Say Goodbye." Buchwald refused dialysis and was told that he had a week or less to live. He enrolled in hospice, lived almost a year, and wrote this book.

At one point he had a vision, he was standing in line at the airport waiting for a flight to heaven, when a loudspeaker voice said, "Because of the inclement weather, today's flight to heaven has been canceled. You can come back tomorrow and we'll put you on standby."

Many times we see patients with numbers that suggest they "should" die - but they don't. The creatinine is too high and they need dialysis, they refuse; the cancer is everywhere, there is nothing else to do; the blood gases won't support life; the CD 4 count is too low. Whatever it is, conventionally, we often treat numbers, and we are not correct 100% of the time. Sometimes, the flight to heaven is delayed and people are put on "standby."

This week we were making rounds and I came upon a man in a plastic mask. It was Bi-Pap, which is a device that helps people breathe, it is strapped tightly around their faces, and forces air and oxygen under pressure into the lungs. It is a step between a respirator, and well, breathing on one's own.

If a device like this is used on a temporary basis, let's say as someone recovers from pneumonia, or on a limited basis, let's say at night for folks with sleep apnea. It can be life saving. For others, as hours lead to days lead to weeks, it can be a sort of prison, just like a respirator.

In this case, I felt that with the Team present we could try taking the plastic mask off for a short period of time, and replace it if needed. We were right there, and as well, it would give us a chance to talk with the patient, with it on he could not hear us or speak to us. With the mask off he started to talk, and we started to listen. The patient was a high level professional, very bright, very much understood what he faced.

We negotiated. He hated the mask, but wasn't ready to give up on it, so being a Hospice, we empowered him to make decisions. He would wear it sometimes and not other times. "What if?" "I am ready to go," he said, "but I don't want to suffer or be gasping for air." "We can give you medication to prevent pain."

After half an hour of talking (he was on nasal oxygen only), one thing became obvious. The dire prediction by the lung specialists had not come to pass, and one of my nurses showing me "the numbers" asked "how can this be?" As with Art Buchwald, sometimes, the numbers don't tell the whole story.

The patient looked at us, and thanked us. He was at the least, now "in control" of some things. He was able to talk and be heard, people cared what he had to say. And here is what he added, "you are the first ones to talk with me about life and death. I'd been in the hospital a long time and no one talked about it. I think for doctors and nurses to talk about death, they need to face the idea of mortality, and of their own eventual mortality, and they have trouble doing that."

When I was learning Reiki, with my first master teacher Robin Hannon, I had a vision of being in a place of complete equaniminty. In Reiki terms we called it "Upekkha." Robin drew a picture of my vision, a tree with the leaves falling off, but coming through the tree an incredible light. Prior to learning Reiki, I had perceived this light, in 30 years of helping people nearing transition (or what we often call death).

Rarely we find something treatable, something which everyone else has missed (these are wonderful moments), often we relieve pain and suffering, and often we are just present in a compassionate way to share the moment, caring when we cannot cure.

We learn that sometimes, the creator of the universe sends a storm that forces the plane to heaven to be delayed, that we neither control nor know exact moments. But that the journey does not need to be faced with fear.

I think most people working in Hospice understand this, I think Reiki training helps us focus and share the moments. In thanks to those co workers who share the moments, and in thanks to those patients who continue to teach us, as long as we are open to learn.