Book Extract - Going Home

by Life Positive

My first experience of death as something other than professional failure occurred when I was director of the pediatric inpatient division at Mount Zion Hospital, an inner-city hospital in San Francisco. I had not known then that death can be a time of healing, or that sometimes, shortly before people die; their wholeness can be directly experienced by others.

Arriving for work one morning, I was alarmed to hear angry voices coming through my closed office door. Inside, several of the staff nurses and resident doctors were arguing in an uncharacteristically emotional scene. The subject of this angry interchange was one of the patients, a five-year-old boy who was in the end stages of leukemia. Apparently this morning the child had told the nurse who awakened him that he was going home today. "Help me pack my things," he demanded, pointing with excitement to his tiny suitcase in the closet.

The nurse was horrified. Who could have promised this terribly sick little boy that he could go home when he had no platelets or white cells?... "Did anybody ask him who told him he could go home?" I said. Of course, no one had wanted to talk to him about that. I felt suddenly tired, but I said, "I'll go and talk to him."

He was sitting on his bed pillow, facing the door, and colouring in a book when I entered his room. I was struck by how emaciated, how sickly he was. He looked up from his colouring, and our eyes met. In that moment things changed. The room became very still, and there seemed to be a sort of yellowish cast to the light. I had a sense of an enormous presence, and I remember thinking wildly that we had stepped outside of time. Suddenly I was aware of the overwhelming guilt I felt about this little boy. For months I had done things to him that caused him pain and still had not been able to cure him. I had avoided him then and I felt ashamed. As our eyes met, it seemed that somehow he understood this and forgave me. All at once I was able to forgive myself, not just for this little boy but for all the children I had treated and hurt and couldn't help throughout my career. It was a sort of healing.

His frailty and my tiredness fell away and we seemed to recognize each other. In that moment we became equals, two souls who had played out our difficult roles in a drama with absolute impeccability; he as a little boy and I as a doctor. The drama was complete. It had served some unknown purpose and there was nothing to forgive or be forgiven. There was just a deep sense of acceptance and mutual respect. All this happened in a heartbeat.

Then he spoke to me. In a voice filled with joy, he said, "Dr. Remen. I'm going home," By now I was speechless. I mumbled something like, "I'm so glad," and I backed out, closing the door behind me.

I returned to my office very confused and shaken by the experience. "What did he say?" the staff demanded. I told them that I hadn't asked. "Why don't we just wait a little while and see what happens." A few hours later the child said he was tired. He lay down, pulling his sheet over his head, and quietly slipped away.

The staff took his death hard. He was a love of a little boy and they had cared for him for a long time. Yet many told me privately how relieved they were that he had died before he discovered that someone had lied to him and he couldn't go home.

Perception may require certain openness. We see what our lives have made us ready to see. This child had known that he was going home in a much more profound sense than the staff was prepared to appreciate. At that time I had no way to make sense of this experience either, so I did the comfortable thing: I forgot it.