Life in the Heart Lotus Ward

By Yeh Wen-ying
Translated by Norman Yuan

The calendar is getting thinner and thinner.
Life is getting heavier and heavier.
There will be the last page of the calendar, and there will be the last day of life.
Happy days have not been reduced.
Memories have increased.
Things that happened in the Heart Lotus Ward have blended into the stream of time.

Heart Lotus Ward

The Heart Lotus Ward is the official name of the palliative care ward in the Tzu Chi Hospital. The patients in this ward have several things in common:

They agree that there is no need for doctors to try to cure them. Such treatment will only make them suffer more.

They need to reduce their pain. Psychologically or spiritually, they need some kind of help.

The patients and their families approve of the way the ward looks after the patients.

The Heart Lotus Ward provides terminal cancer patients with "whole body, whole family, whole course, and whole team" care in a home-style environment, so that the patients can lead their lives in dignity and good quality. Their sorrow can be reduced to a minimum, and their families can face the parting with open minds and pass through their grief peacefully.

The Happy Bathing Machine

Merged in water, you were lying there
Like a buddha.
We rubbed your body, producing colorful bubbles,
Like a column of water bursting out from a spring,
Like a boy skipping and running,
Hiding under your arm, turning around.
To make the atmosphere happy, I sang a song
Of Pai-kuang, who doesn't belong to my time.
I just wanted to sing the glory of your youth.
Then you joined in the song
Like those brave Greek sailors entranced by the siren's singing.
Let youth go by and never return.

"My greatest wish right now is to accomplish three things each day: to eat well, to sleep soundly and to relieve myself without any problem." For a feeble cancer patient, such basic physical functions are only a wish. To a healthy person, it is food for thought. Bathing is a kind of enjoyment. Taking a shower in summer or soaking in hot water in winter not only cleans our bodies but also makes us feel relaxed and refreshed. However, terminally ill patients may be too weak to have such enjoyment. They have to rely on the ultrasonic bathing machine.

The bathing machine is placed in a separate room. Patients in the Heart Lotus Ward can use it at any time. In addition to their own family members, nurses stand by to help them. With the automatic machine, the patients can once again enjoy the happiness of bathing in a tub.

There was a man with lung cancer. Sometimes he had high fevers, and afterwards he would perspire heavily. The nurse would use a hot towel to wipe him, which helped him feel better. He used to bathe himself in the bathroom in his ward. However, as he got weaker and weaker, he found it more and more difficult to wash himself. Then nurse Su-yu suggested that he try the ultrasonic bathing machine.

"Yesterday, another patient used it for the first time and he said it was really great." Anything Su-yu could do to make the patient more comfortable would make herself feel that she was doing the right thing. "The next day it was the lung cancer patient. I filled the machine with water first. Then I asked Yin-hua to help me bathe him. When the patient was lying in the machine, he had a big smile on his plump face. I can't describe his expression. The water was whirling and whirling. It reminded me of the Buddhist ceremony of 'bathing Buddha.' Really, it was like we were bathing a big buddha."

Su-yu has liked to sing since her childhood. She knew that the patient liked to listen to Teresa Teng (a famous Taiwanese singer). So Su-yu sang "When Will You Be Back Again?" and "The Story of a Small Town." She said that when she sings while bathing a patient, they both feel more relaxed.

Another time, Su-yu was washing an aged patient from mainland China. She happened to sing a song made famous by Pai-kuang, a singer of long ago. "That old, skinny, frail patient who was often choked by phlegm chimed in and started to sing, 'Let Youth Go By and Never Return.' His voice was so loud that everybody outside the bathroom could hear him. They were surprised because they had never seen him so happy before."

Su-yu reminded us of the sirens in Greek mythology who entranced sailors with their beautiful songs. The patient flew back to his youth on the wings of Su-yu's song, reviving his old dreams and letting him forget about himself.

Form and Shadow

A poet says, "I will dry your shadow in the wind;
When I get old, I will chew it with the wine I drink."
I don't have such lofty sentiments.
But I say, "My old sweetheart,
After I die, I'll transform myself into a puffy pillow.
When you miss me, just hold me.
Let us embrace and kiss each other again.
For you, I have thousands of tender sentiments."

Nurse Mei-hui asked for a picture from an elderly patient. She had originally intended to use the photo to make him a card, but she changed her mind when she passed by a store. She had his picture printed on a pair of pillows, which she gave to the old patient and his wife.

The small gifts surprised and delighted the old couple. The wife caressed the pillow gently and said to her husband, "When I miss you after you're gone, I'll just hold the pillow like this, all right?" The old man firmly approved. He would leave the world soon, and it was nice that his wife had gotten such a gift to console her. That nurse was really thoughtful.

Another young couple not only had pillows printed with their family picture, but each of the four members of their family had a T-shirt with the picture. That memorable photo was also taken by Mei-hui.

Mei-hui said that the young couple had had a hard time and were unable to enjoy life. When they first came to the Heart Lotus Ward, both of them were under a great deal of pressure and they tried to hide from each other the real condition of the wife's illness. Mei-hui just couldn't bear to see them suffer like that. The medical team encouraged them to speak out what was on their minds and to discuss what should be done, such as how the husband would find a job to pay for the medical and living expenses, whether he would be able to bring up their two children by himself, etc.

Encouraging terminally ill patients to spend their remaining time with their families and friends, to share their feelings and to recall their memories makes all of them feel warmth and love. Mei-hui said that if patients feel up to it, she takes pictures of them and their family members so that they can keep good memories. The nurses help dress the patients, fix their hair and apply makeup to help make them look more spirited.

Originally, that young female patient was worried that she might not have the strength to pose for pictures, but Mei-hui told her to relax and rest if she felt tired. Once they were outdoors, Mei-hui pressed the shutter quickly to catch the most natural postures, especially when the patient's husband stretched out his hand to help her stand up from the lawn. That picture contained unlimited warmth.

A Bridge of Forgiveness

Before the date of sailing,
Like fishermen mending a net, they carefully mended
The net of love,
Which had been ripped by misunderstanding.
Forgiveness had caught in their throats.
Please return to my side. Listen...
Forgiveness calmed the rage of the sea and love came ashore.

In TV soap operas, death and parting are indispensable scenes. A life without regrets and pains can never be completely fulfilling. Just before her death, a 74-year-old woman suddenly realized that she had to end the confrontation with her ex-husband, which had been caused by her strong character.

She voluntarily left the Heart Lotus Ward and went back to her familiar, old-fashioned home. Lying on her own bed, she stared at the ceiling as if watching a movie screen, reviewing her past life.

Shiu-ju, one of the nurses in the Heart Lotus Ward, came to her home to see whether her family had made proper arrangements for her funeral. She also explained to them the symptoms of death. The old woman was breathing very hard, unable to speak.

Shiu-ju wondered if the patient had any unfulfilled wishes. She had already collected some background information about the patient and her family. At that moment, she thought of the old woman's husband. She was told that they had been separated for nearly forty years. They lived in the same town, not far from each other, but never had any contact. We could see how deeply he had hurt his wife and daughters when he left home forty years ago. Nevertheless, the old woman was dying. There had to be an end to the unhappiness. Perhaps when misunderstandings were cleared up, she would leave the world more peacefully.

Shiu-ju asked the old woman's daughter if she should ask her father to see her mother. "Impossible!" the daughter insisted. She rejected the suggestion on behalf of her mother, but she also showed her own resentment toward her father. Ever since their mother had fallen ill, the idea of inviting their father to visit their mom had never come across these two daughters' minds. Even at this time, they didn't believe their mother would go for the idea.

However, with an indescribable intuition, Shiu-ju did not drop the idea. She leaned close to the old woman's ear and asked, "Should I ask your husband to come see you?" Surprisingly, she nodded.

The old man did come. He stayed by her side until she passed away the following day. Shiu-ju had built a bridge that let the old couple stride across forty years of hatred and meet for the last time in peace.

Later on, Shiu-ju received a letter of gratitude from the daughter saying that Shiu-ju had not only fulfilled the old woman's last wish, but had also helped the daughter to release herself from her bitterness against her father. Her mother had taught her how to forgive with love.

Tell It to the Mountains

Standing on the top of the mountain
Facing the wind on the shoulder of a giant,
You told your feelings to the mountain.
Then the wind began to search for your shadow,
Twisting and circling between the mountains.
Your smile, your scent, your voice,
The way you squinted your eyes and called me softly.
Rustling under the trees in late autumn
Memories were scattered on the ground.
It was too late to pick them up.

"When I was in third grade, the old family dog delivered five little puppies. I picked one which was plump and short. I named him Blackie. Our house was by the side of a highway. There were too many cars passing by. One day, Blackie ran out to the highway and was immediately run over by a car." Hsiung-lan, a social worker in the social service division of Tzu Chi Hospital, recalled this sad experience. Her voice got lower, as if her childhood loss were still happening in front of her eyes.

"I was so sad that I cried the whole day and I couldn't eat anything. The adults laughed at me. They said: 'Why are you crying so hard? It's only a dog.'" At that time, she grieved alone. Even today when she thinks about it, it still hurts. The effect of that experience is that she does not dare to raise any pets, even though she still likes dogs very much. She is afraid that the same thing might happen again.

Hsiung-lan observed that sad experiences in the past influence our attitudes toward grief now. We all lose things, such as lovers, toys or pets. Reviewing our old sad experiences will help us pass through grief and understand ourselves better now. When similar things happen again, we will be better prepared to face the reality. If we fail to deal with our sorrow or if we pretend to be tough, then when our emotions accumulate to a certain point, the old wounds will break open and be very painful.

While studying abroad, Hsiung-lan once visited an organization that took in AIDS patients. The staff there had to face several deaths each week. They decided to write letters addressed to deceased patients which would be put into a special basket. Or they drove far out to the mountains to yell out their feelings. When they heard the echoes from the valley, they believed the other party had heard them.

Being a member of the medical team of the Heart Lotus Ward, Hsiung-lan believes that all the team members should have the ability to sense grief and to handle it properly. Their ability to assess the sorrow of the patients and their families comes from their own experiences of handling sad events in the past. Hsiung-lan emphasized that they would be unable to feel others' sad emotions if they failed to get in touch with their own losses or to deal properly with their own emotions.

The achievements of the medical team in the palliative care ward are not measured by how successfully they cure patients. On the contrary, since local people have the custom of passing away at home, the team members often have to send home patients who are taking their last breaths or who are beyond all hope.

It is not only the patients who have to face the sorrow of illness and death. Their families must also learn to accept reality and to rebuild their lives after the deaths of their beloved. The medical professionals are also flesh-and-blood human beings and can also be infected by a patient's depression. Thus, grief counseling is very important in palliative care.

Each person has a different reaction toward loss, depending on his personality, family background, culture, etc. Therefore, when we help patients and their families deal with their grief, we have to find out whether they encountered any sad events or serious losses in the past. Even children have feelings of separation. Some terminally ill patients don't know how to reasonably explain their approaching deaths to their little children, and so they won't let them come to the hospital. Actually, they are also afraid they won't be able to bear the pain of parting with their children.

Under such circumstances, Hsiung-lan suggested that children should be allowed to come to the hospital. They have a need to maintain warm contact with their loved ones. Children are not so insensitive as not to understand anything. They should be allowed to know that a parent will leave them soon. If the children have any bad feelings or emotions, the adults can deal with them promptly. If necessary, they can get help from a professional counselor.