Housecalls to drama and irony

In time, all will come to an end,

And be mourned, if at least by a friend

      Don’t bring on your death    

      With tobacco or meth,

There’s no need to hurry a trend.

Every hospice program has to have a medical director; I took on the responsibility for Care Initiatives Hospice in Sioux City a year ago.  The patient load doesn’t justify a full-time physician; in general I work for them eight hours a month.  My duties include attending a weekly meeting, signing papers, and taking phone calls from the nurses when patients come on to the program or die.

As of this year, 2011, if a patient has survived on Hospice for more than six months, the doctor has to visit the patient face-to-face.  I called on such patients Thursday.

Because of confidentiality, I cannot write about details of patient cases, nor where they live.

Some of those born long ago approach their finality without vision or hearing or awareness; some have all their faculties.  Those over ninety who maintain clear contact with the world as we know it rarely object to their demise. 

Few half that age come to hospice with equanimity. 

I entered houses where death will soon visit.  Each person has uniqueness and I cannot write about identifying details.  I can mention a clock that plays Amazing Grace at noon.  Or the beautiful grandfather clock which has not been wound, next to a table supporting a very good dry wall hammer; I did not ask what repairs were underway.

 I can write about alcohol, drugs, anger, grief, and the natural tendency people have to love.

I have a few words in a lot of esoteric languages, and I used all of my vocabulary in one of them. 

If a person dies at a young age because of bad decisions, the people who love him or her will suffer from a large emotional backlog of unfinished business.  The grief stemming from the time during and after death will ripple through the family and community and bring unintended effects.

Even under the best of circumstances, when a parent dies the children find a rift.  I have seen otherwise sane people use the smallest of excuses so that one thing leads to another until both sides nurture a grudge so bitter that it justifies silence for decades, or forever.

Long ago I invented the acronym DOCS, the Distant Obstreperous Child Syndrome.  When the death of a parent nears, the offspring who has been the most distant geographically (and, hence, emotionally) will focus the most anger at the healthcare team.

Drama and irony weave in and out of the human condition, and the ultimate drama comes with the ultimate irony.  We will all come to an end; no one gets out of this game alive.  Some approach finality at half the years of others; some of those held the self-destruct button down too long, some had plain bad luck.


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One Response to “Housecalls to drama and irony”


    Steve – please send me your email address. I am reading your blogs with a great deal of interest. I was completely unaware of your blog.

    My email address is –


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