The Graduation March - A page in a hospice social worker’s journal
by Kathrina A. Johnson, MSW
How Can I Help You Say Good-Bye, a song by Patty Loveless, continuously plays as I pull my car over to see a dying client today. I wonder: What can I do for her and for her family? How do I obtain a good psychosocial history? What would be her needs? What are the available resources to help them? These questions keep running in my thoughts as I knock on the door.
A woman greets me with a curt hello, introduces herself as the daughter of my client, and silently leads me to her mother’s room. There lies a weak, pale woman, unevenly breathing with the oxygen tube in her nose, which seems to help her chest rhythmically move up and down. I sit beside her and start my routine assessment. Her daughter joins us instantly and chimes in our conversation. My client and her daughter fondly share the client’s scholastic achievements – the schools, the speeches, the books, lectures. For what seems to be a good amount of time, my client’s educational attainment and her accomplishments are the most important things in their lives. It sounds like a dialogue between my client and her daughter, and that only the two of them know the plot of the story.
My client then suddenly gasps for air, her shoulder raised and pressed toward her ears as if someone is squeezing them together. She grabs my hand and holds her daughter’s with the other hand. She whispers softly as she tries to relax and fix her gaze upon me. Her lips utter, “Listen, I don’t have much time and you know it. If I can turn back the clock, I will give up everything I earned to be with her (daughter). Now I have nothing but longing. Instead of writing books, I wish I had been the one who taught her how to read. Instead of receiving praises and awards, I wish I had been there clapping in her school play. I wish I had more time, but I can only wish now.” I rub her arm and slowly put it down as she slowly loosens her grip. I know she is fading away. I reach out for her daughter, embracing her as she silently weeps and wipes the tears rolling down her cheeks. I say to both of them, “Thank you for allowing me to be a part of this important moment. I would like to give you the time to be with each other now, because I know this is something that both of you wish for more than anything.” I turn toward my client and say, “You are an outstanding student in this lifetime.” I see her smile for the last time.
Death makes me feel sad, empty, hollow - but it also makes me feel inspired, alive, vibrant! I know that in every instance of grief and loss is my share of purpose in the academy of life. Death is like a graduation day. After a life of learning, experimenting, discovering, racing, failing, winning, surviving, a time comes when one realizes I am done, it is the end of the line. I have seen and met many different kinds of students. Some are achievers, some are average, some are challenged. And they all graduate. In whichever case, my role as a social worker is to make each graduation day a commencement exercise. I feel a calling for me to make the end wonderful, or if not, an accepting moment making the dying experience not just flowing tears, but a fountain of gratefulness, hope, and peace to those who are left behind. As a social worker, I feel honored to watch one’s life unfold before me, to understand someone's journey, and to be a part of it. I salute all the students on their graduation march. Before the curtain closes and the marching song ends, let me thank you for allowing me to be a part of your living through, passing away, and moving on in this school of life.
Kathrina A. Johnson, MSW, is an Associate Clinical Social Worker who has a bachelor's degree in psychology from the Philippines and a Master of Social Work from California State University Los Angeles. She currently is a medical social worker with Kaiser Permanente Home Health Department and a hospice social worker with Serenity Hospice South Bay area. She does volunteer work for Lions Club International, Corregidor Island Chapter, and is the elected incoming president for 2017-2018 for this club dedicated to social and community service.