Puhpowee, she explained, translates as “the force which causes mushrooms to push up from the earth overnight.” As a biologist, I was stunned that such a word existed. In all its technical vocabulary, Western science has no such term, no words to hold this mystery. You’d think that biologists, of all people, would have words for life…What lies beyond our grasp remains unnamed. (Robin Wall Kimmerer in Braiding Sweetgrass, p. 49.)
I could train for a thousand years and never be prepared, fully, for what awaits me in the hospital room. The element of humanness, of vulnerability, both theirs and mine, of the magic of the angle of daylight, the walls of odor that greet my masked nose, and the chorus of which machines beep when–it is all an amalgamation that defies predictability or set-ness. And as such, the space sets the table for the sacred and temporal, entangled, holding each other. As a chaplain, I receive, know, and contribute to this dance.
On that particular day, I visited a woman who emanated a beauty and strength that her chart, her body, and her room overlooked. One of my first observations was that she was not reclining, not leaning towards a bedrail, nor sweating against thin sheets over the plastic mattress. She was erect, sitting up with posture that would delight my childhood piano teacher, with thin legs crossed and bobbed, silvering hair pinned back around her beaded face. It almost hurt my tailbone to see her slight frame so boldly poised upon what must have been a worn, burdened spot in the always-occupied bed.
Our conversation began. With words, and without, she allowed me to enter her space and join with her exhaustion. I helped her drink water, we listened to a Korean worship song she loved. She tried to lean back for a few minutes, the idea of resting all her weight against the bed appealing to her depleting energy well, but quickly returned to her prior stature; this was best for her now. She would face the day perched and ready. I wondered how many hours of her middle-aged life had been spent eating, meditating, or watching in that same position.
No visitors were allowed in this time of exposure: the Covid-19 pandemic was heavy upon us. Labored organs, accidents, tumors and genetics paid no mind to the collective burden of the crisis; for these patients the loss of control culminated in a timing nightmare. The inestimable reach of the virus was profound just a hallway away from its most devastated victims: the Covid-negative but nonetheless isolated patient.
Responding to codes was especially important in this period. Reliance on interdisciplinary sharing of humanizing information, coordinated family conversations over the phone, video calls to support the patient, caring for the nurses and doctors, and the presence of emotional and spiritual support in the absence of family were all elements that built the dedication of chaplains. A code returned me to her room later that day, as numbers had escaped beyond acceptable parameters. Her body was read by the professionals and her mind was still alert enough to understand dusk. A severe bravery, she accepted that her dying time had come and turned her attention to the end.
With the adoption of a focus on comfort and the conclusion of heroic and life-prolonging methods of treatment, conversations took place that allowed for two pairs to come up and say goodbye. She could not say much, or did not have much to say, but she allowed herself to be seen by those whose polished style, sincere love and breaking voices must have reflected her own. She led them into their grief, even as she needed to go, and the silent force of a woman pushing through and into that darkness is one of the most life-full feats I’ve seen.
As the code responders and visitor energy dissipated, I stayed with her. Another doctor came by and recruited my help to align the pillows to her desired posture, moving the bed towards her, not vice versa, in case the nearness might relieve any of her work. The patient desired fanning, and the Korean worship songs hung in the background, their electric, fog-machined church stage visuals ignored on a shelf in the background of this sacred scene. The packet designed to order and record her precious calories became the impetus for her cooling and our arm exercise. The crisis response nurse circled back, and the three of us stood around our lady, the beautiful one, laboring into her death and sweating out some of her final hours. The doctor gently patted her face with a cloth, and stroked the patient’s endearing hair. At times the patient leaned towards the credentialed small frame, and the weight of her exhausted head rested against a mother’s chest. It was quiet and calm, divine and delivering. Nearly a statue, she still sat upright, her body finishing its time in a time like no other. She seemed royal. We were doulas, unnamed witnesses to her transition majesty.
Vast amounts of vocabulary, awareness, and attention in the western world are given to human experiences other than this one, often in avoidance of it. Death is the inevitable and universal. I would argue that on the same plane of puhpowee, the force that supports the mushroom bursting into open air, is the fortitude necessary for a living thing to also lean into its death. It is cousin to that final interest in a conversation or a meal, before the last decline. It whispers that we are innately capable of embracing the unknown, accepting finitude and exercising goodbye, despite all our training. It pulls the curtain on the unspoken and subtracts the adrenaline from dying: what if, when all indicates it is time, we entered death on purpose. What if faith and religion not only gave us a framework for stewarding life but also freedom from running from death. What if the best care, when the organs are finished and our bones and muscles settle into an old familiar position, when the stage is completely useless and the diet is old news, was fanning, stroking, humming and watching.
A year later, I joined that doula-ing doctor’s team, contributing as a chaplain to a palliative care department dedicated to whole-person care, honoring goals, and explaining the wilderness of hospitalization. I still would never be prepared for what awaited me behind each name on a chart, or numbered hospital doorway, nor do I hope to be. I carry these holy moments, like agate stones in my pocket, shaping me as I shape them, gladly bearing witness to the heroes in gowns and those who hold their heads.