boy playing flute
Music Is Hope

One Patient Discovers the Secret

C. Gourgey Ph.D.

I see music therapy as very much a form of spiritual caregiving. In hospice, the same issues that arise in other forms of pastoral care arise in music therapy: the same fears, the same restlessness, the same struggle for peace. Often people who work in hospice - whether they are nurses, chaplains, or music therapists - think of themselves as “midwives,” people whose job it is to ease the patient’s transition to another stage of existence. We may not be able to cure the patient’s disease, but we have performed a valuable service if in any way we can help shepherd the patient toward a peaceful death.

But what does this mean, and how does one get there? I remember patients whose fears I could not calm, whose memory haunts me still. A woman who thrashed in her bed screaming that she was afraid to die, her fears an impenetrable wall between herself and those who tried to help her. A man who was crying from terror at the idea of his approaching death: I stayed with him as long as I could, let him squeeze my hand hard to try to forget his thoughts. I had many words for him but not one of them eased his fear, and when finally I had to leave him I felt as though I had betrayed him.

Fortunately there are many who do find peace. I learned a great deal from one in particular.

Lillian had been a nurse when she was healthy. Now she was suffering from a very rare form of cancer with a name so long I had no chance of remembering it. As she said herself, it was never like her to do anything the usual way.

I met Lillian when she was admitted to the hospice unit. At that time she could still walk, and would visit all the other patients, asking them how they were and what she could do for them. Except for her bathrobe, one would have thought her not a patient but a volunteer.

I remember one patient we had when Lillian was there, a very tiny, frail woman 104 years old. She spent all her time in bed covered by thick blankets. Her feet bothered her the most; she could never get them warm enough. Lillian would enter her room, and in her thick European accent ask her, “How are your feet today? Is there anything I can do for your feet?” Then she would try to find an extra little blanket to cover the woman’s feet. I watched this from a distance. She asked a simple question, but something in her voice - a certain kind of love - rendered me unable to speak.

In a few days Lillian went home, but several weeks later she was back. This time she could no longer walk, and it was clear that the end was approaching. I was with her on the day she died.

Lillian knew she was dying. She raised her hands toward the air above her in a gesture of embrace. She kept saying how happy she was, how grateful for her life. I could almost see the radiance surrounding her, and I definitely felt it and still feel it when I remember. She had a strength of presence one rarely encounters even among the most charismatic: a strength that comes only from a peace beyond the world of our senses. And she was aware of it: she kept saying she could see the face of an angel.

Lillian found the secret of a peaceful death. In fact, she practiced it all her life. The love that filled her, that she kept giving to others, came back to help her in the end, present in the room like a friend waiting and holding her while she took one last difficult step.