What Really Matters?

Jeffrey and I have been close friends for well over 30 years. We recently sat together in a Denver hotel cafe, taking a break from our activities at the Urban Land Institute conference being conducted at the Colorado Conference Center across the street. Jeffrey is an architect and a very fine one at that. Our friendship developed out of our various professional collaborations over the years in entitling office, residential, mixed-use and retail projects throughout San Francisco. While conversations in our early years tended toward design and planning, policy and politics, we now generally talk about matters of greater meaning and substance. Although the distance between our San Francisco offices is a matter of 10 minutes and a few blocks, we were having lunch in Denver. There, relatively unscheduled and undistracted by our daily routines, it was easier to say, “Let’s go to lunch” and actually do it.

One of the things that I notice about our times together is how we put away our distractions. Both of us probably would be categorized as “type A” personalities. And each of us accepts that trait in the other. Yet, somehow we are able to suspend our “A-ness,” to quiet down and settle into meaningful conversation. And that is a rare thing.

Three years and three months ago, Jeffrey and I had met for a similar lunch at Perry’s in San Francisco. On this occasion, because we had not had the opportunity to enjoy one another’s company several months, we chose to turn off our electronic devices. After our usual “comparing notes” of what was new in our respective lives, we settled into more profound conversation. We talked about our sense of what was now offering our lives the greatest meaning. Jeffrey began to talk about Debra, his wife. Debra often came up in our conversations, as she also was involved in real estate consulting. She had shared clients and projects with both Jeffrey and me; she too was a force of nature, extraordinarily intelligent and gaining a national reputation in her field. But, over the course of the last several years, she had suffered from a chronic neurological illness, which had eluded diagnosis. Consequently, she had gone through a host of medications, some of which were as debilitating to her as the illness itself. Her condition had begun to affect her career. And, her pain and weakness became an unwanted intruder in their relationship.

But that afternoon Jeffery told me, in an uncharacteristically soft and compassionate tone, that Debra and he believed they had “gotten their arms around” her illness. They now had a diagnosis and a course of treatment. There was a path. It never would lead to a full recovery. But things were looking up. Jeffery told me that he was looking forward to years of quiet comfort with Debra, as the illness moved more into the background of their lives. And, Jeffery added, “You know how you sometimes wonder whether found the right person to be with? After all this, I know that Debra is the right one for me.”

As we wrapped up our conversation, paid the bill and prepared to depart, we each turned on our respective communications devices. Jeffrey, putting his glasses up on his forehead, squinted into his screen and turned it in my direction. “Would you look at that?” he said. “I must’ve gotten more than 15 messages during our lunch. What the hell is going on?” We exited the restaurant, executed a “perfect 10 ‘man hug’” and headed off in our respective directions.

A few moments later I got a call from Jeffrey. I answered and said “hello,” I could hear the open line, but there was no response. In a moment, Jeff replied, “I can’t talk now. Call me later.” In our worlds of distraction, that was not necessarily an unusual response. I went on with my day and tried to reach him later in the afternoon, but went directly into voicemail.

Early the following morning, I boarded a flight to Denver to then drive over to Crested Butte for a two-week vacation. As I stepped out of the terminal, I received a call from my colleague, Jen, who asked whether I had heard that Debra had died the previous day. I went into mild shock. “That is impossible,” I said. “I just had lunch with Jeffrey yesterday.” Then the pieces began to fall into place — the many phone calls, Jeff’s inability to speak, his chronically busy phone in the afternoon.

Shortly thereafter, I was able to confirm that Debra had died in her sleep at a hotel, while traveling for a speaking engagement. I also was able to reach Jeffrey later that day. I told him that I would return immediately to help. But he insisted that there was nothing to do and I should enjoy my vacation.

Thirty-nine months later, sitting in Denver, well into our meal, Jeff asked, “From your experiences with the dying, what is it that really matters at the end of life?”An interesting thing happens when a true friend asks you such a question. Because such friends tend to listen better and judge less, you find yourself responding from a deeper level.

This was not a new question for me. Indeed, I probably have answered it hundreds of times over recent years. And, my first book, “#DEATHtweet, Book01, A Well Lived Life through 140 Perspectives on Death and its Teachings,” was premised on a response to this very question. But, sitting at a Denver Café with Jeffrey that day, I began to discern new ways of responding, perhaps emanating from the uniqueness of our relationship and history together.

In my nine year history of working with the dying at Laguna Honda Hospital, I have learned to trust more than my cognitive intelligence. Many of those for whom I care do not speak English, or because of the morphine (or other pain killers) or the progression of their illness, are only semi-conscious. Others are comatose, unconscious, spend most of their days asleep, or are cognitively impaired. Even with those who are awake and alert, we don’t spend a great deal of time talking about life’s meaning directly.

But you hear things - stories of estranged families, lost loved ones, friends from the past whose whereabouts are unknown, or friends from the present who rarely visit. Or you witness the resident’s elation at the arrival of a family member, a friend or even a relative stranger who attends the same church. You see joy, as only the eyes can reveal. You see a blush of “aliveness” in the coloring of the face. You witnessed the “touching” that appears involuntarily. Even the most cognitively impaired seem to know intimates. They may not know the person’s name or relationship, but they know that they are connected. Even those that we have inadvertently labeled as “unconscious” know when a loved one or friend is near. They hear a voice and, even as their eyes remained closed, a hand flutters reaching toward a familiar contact.

Another rather extraordinary phenomenon arises occasionally when a resident, in the last few days of life, receives “visitations” from family and friends, who passed long ago, but “return” for some final visits. It is extraordinary to witness conversation between someone for whom you have cared and those long deceased, who also once cared for that same individual. All of the physical manifestations of connection that you witness with a mortal visitation are undifferentiated when the “immortals” appear. One of the happiest moments I witnessed in the last day of my mother’s life was when she engaged her long departed parents. I only wished that I could have seen them too.

So, I told all this to Jeffrey, “At the end, what really matters is relationship. It’s about making and sustaining connections with other humans, with other species, and even nature itself. When there is sadness, it usually arises because the resident regrets having turned away from a relationship or having let it go too easily. I never once have heard that money, power or status plays any role whatsoever in life’s meaning. Yet that’s where so many of us waste our precious time.”

As our conversation drew to a close, I had an insight about my role as a hospice volunteer. My “service” suddenly appeared to be more fundamental than I previously understood. It wasn’t about my service as a conversation partner, a reader of stories or poetry, a musician and singer, a “people mover” or solace provider. My willingness and ability to accept the residents, how and where they are on each visit, allows me, and my like-minded colleagues, to be the relationship which so many of our residents truly need. Because they can trust us, because we work at being nonjudgmental, because we seek to be open and available, we are their “intimates.” And, that is what really matters.