TO BE WITH ONE WHO IS DYING: The Seeker as a Young ManDr. Charles A. Garfield

Spring 1974 saw me on my way to Shanti’s second client, Luis R. An ex-marine, twenty years old, Luis was dying of pediatric leukemia which today he’d likely survive. From our initial meeting, he’d tested me with his no nonsense questions. “Do you believe in a life after death and, if you do, what form does it take?” “Do you think we’ll ever meet again, in another time and place, and recognize each other?” Luis and I spent hours discussing the purpose of his life and mine. We spoke about loving people, relationships, the pain caused by confusing roles (such as patient, psychologist, or physician) with human beings. Luis’ limited life span and his precocious maturity gave our exchanges an immediacy and vitality often absent in everyday life.


This was a dark time for Luis, but our dark-adjusted eyes began to see farther and deeper. Here we were, two representatives of the attitudinally odd and physically vulnerable species Homo sapiens grappling with life’s thorniest conundra while sitting (or, in his case, lying) on an oblate spheroid whirling somewhere in the Milky Way galaxy. We were in search of “the great perhaps”, to use the mathematician Pascal’s evocative phrase, trying to reason our way to answers of unreasonable questions. The content of our conversations was but a part of what I found meaningful and memorable about our time together. Whether consciously or not, Luis and I were also protecting each other from a fear of the void, from the dread of “the eternal silence of those infinite spaces” (Pascal again), like children huddling in the dark…perhaps…perhaps…perhaps.

As his disease progressed, Luis grew weaker and his family, ever more afraid and sensing the outcome, withdrew from him. While I, too, braced myself for the worst, for the tragedy of someone dying far too soon, I continued to visit Luis, discussing whatever was uppermost in his mind. On one low energy day, he whispered a barely audible, “Remember me”. On several teary-eyed occasions, Luis reminded me to “take notes so you can use my story at Shanti and with your medical students.” He was grateful that his tale would live on as a kind of an immortality project.

As his leukemia progressed, he spoke more about pain, both emotional and physical, loneliness, and the sadness he felt about his family’s recent abandonment of him. Luis was also hurt by the withdrawal of his physician and his favorite nurses, who were visiting less often. One day, he asked if there was “any way I could pay you back for staying with me”. Without thinking, I asked him to be my teacher and explain his experience to me.

“When you’re alone, Luis, what thoughts and feelings do you have? What makes you most afraid? Does anything seem hopeful? What’s most important to you now? What’s the best way for me to help you?” For a while, Luis relished the deep questioning. As the days wore on, he grew weaker and began to drift in and out of waking consciousness. When he was lucid, he’d welcome my probes, and respond to them insightfully for a man so young. Later, he’d drift off into a sleepy stupor.

One Friday, I sat watching Luis, his sunken eyes, yellow skin, and black and blue body attached to his intravenous “life support”. I remembered my grandfather Harry Friedman who’d died a year earlier, and thought about Auschwitz and Viet Nam. As if sensing my sadness, Luis awoke and looked straight at me. “I have something to say to your students.”

“What is it, Luis?” I said, startled by his calm, clear voice. “Dying alone is not easy,” he replied. Then he smiled sweetly and closed his eyes, adding to my uneasiness.

Luis’ words and strange lucidity haunted me the entire weekend. On Monday, I drove to the University Medical Center early and hurried to Luis’ room. His bed was empty. I felt dizzy as I walked slowly to the nurses’ station where the charge nurse told me that Luis had died on Sunday night. I was shocked, sad, relieved, confused. As I walked the streets, I could hear my father singing “Sunrise, sunset, sunrise, sunset, swiftly go the years.” Periodically, dad’s tune morphed into the Tibetan mantra “Om Mani Padme Hum”, my fifth grade teacher’s attempt at “America the Beautiful” or Mick Jagger shrieking “I can’t get no satisfaction.” Luis was dead and the surreality of his disappearance had hit hard.

This was the first time in my work I’d confronted the death of someone I’d gotten to know well. It seemed an affront to the natural order of things that everyone I saw near the Medical Center was carrying on as usual. “Didn’t they understand that a tragedy had recently occurred?” Finally, having long since lost track of time, I left for home feeling guilty.

“I should have known that Luis was saying ‘goodbye’ on Friday. It didn’t feel like ‘goodbye’. I should have stayed with him. His face looked dreamy not sad. He wasn’t wracked with pain like so many other times.” I believe (and hope) that Luis’ last lesson that spring day in 1974 was, “Dying isn’t easy, but the job is almost done. I’ve reached a place of inner peace. Thanks for being with me, for what we’ve shared, and if, by chance, we meet again…”

© Charles A. Garfield 2009