Dr. Ana Luisa Neal

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strength redefined. . .

I first met Bob while working as a hospice nurse in a rural part of Oregon. Bob had metastatic prostate cancer, rendering him weak and mostly confined to a hospital bed. He lived with his family on a small farm and as I pulled up to their property each week, I was greeted by sheep and the wide open spaces I was otherwise unaccustomed to, having spent most of my years growing up in Los Angeles.

I entered his room for the first time, eager to help yet unprepared for the scowling man that lay before me. I cheerfully introduced myself as he avoided eye contact and barked his discontent about me being in his room. Each week as I drove through the countryside back to his home, I marveled at the beauty around me, simultaneously nursing a knot in my stomach over how angry Bob would be once I arrived once more. I soon came to realize that to Bob, I was not the benevolent helper I envisioned myself to be. Rather, I was a reminder of his weakness and imminent decline. To many, hospice care is a grim concept, antithetical to the first stage of grief. To others, it is a sacred respite. For me, it represented the soul of medicine - to care equally for the one’s emotional suffering as you would physical suffering. For many weeks, we went on this way - routine visits with me asking how he was doing and him giving me brusque answers interspersed with harsh comments about my inefficacy in providing him with any sort of relief from a suffering he could not otherwise articulate. He began to develop pressure sores along his heels, which required me to see him more frequently, and our therapeutic relationship began to shift.

I am a huge proponent of using Manuka honey for wound care and began to treat Bob’s wounds on a daily basis initially, and then a little less frequently as his wounds began to heal. There are many sacred acts within medicine, tending to wounds is no exception. I think there was something particularly special about using honey that somehow transported both of us to a time when house calls were the norm and it was not unusual to use herbal salves. As I gently cared for Bob’s wounds, removing dead tissue to allow new tissue to take its place, I came to see that much of medicine is tending to dying and diseased parts so space can be created for something new to emerge. I don’t know if it was the additional time together, the vulnerability inherent in exposed skin and tissue, or perhaps it was the intimacy of tending to an open wound, a balance that required both patience and precision, but Bob slowly stopped greeting me with scowls and began to share his world, even as it diminished.

As he became weaker still, I would measure the circumference of his arm to gain a sense of how much weight he was losing. I had not considered how inextricably linked the perception of our physical strength could be to the deeper parts of us. I grieved with him as he told me about how physically strong he was while in the navy, his muscular arms chiseled from wear, never imagining he would ever lose the ability to hold himself up in bed or transfer to the toilet unaided. He shared of the secret missions he was part of, the unique gifts he was sought after for, only to now be reduced to his failing body and fading memories. Each chance I got, I reminded him of the ways he continued to exude strength and power, albeit in a quieter way, as he navigated the remaining time in this life. More and more, he stared lovingly at his late wife’s black and white photograph, yearning to be joined with her again.

In his final days he would take my hands in his, hold my gaze with softness, and thank me for being his “doctor, nurse, priest, and friend”. It was in that sacred moment of many, that I came to understand how special and unique it truly was to be witness to each phase of the healing process.

Healing does not always mean getting better or eliminating disease, or even eliminating symptoms. Healing can mean deeper understanding, a newfound peace, greater tolerance, or simply acceptance. The root of the word heal means “to make whole”, which I believe is quite fitting. I don’t seek to define this process for anyone, but I do commit myself to nurturing a sense of profound curiosity and respect for and towards each person’s version of wholeness. From Bob, I learned a deep and lasting lesson - may we all be less defined by any title we might carry, but by our efforts towards cultivating wholeness in ourselves and in one another. May illness and disease be a gateway to a new perspective as we each work our way towards individual and collective wholeness.

*This is a work of creative nonfiction. The events are portrayed to the best of my memory. While stories are true, some names and identifying details have been changed to protect the privacy of the people involved.