“The Man and Death” 

The man was lying within the colourless night,
Falling asleep and a noise gave him fright.
Not a hard blow, but nevertheless,
Something in of ominous made him guess.
He got up and went to the door.
“Who’s there,” he asked.
“It’s me,” someone answered.
Who’s me?” “Well, then. I’m Death.”
A shape he knew well went through his mind:
A skeleton with a scythe that his mother had once shown him.
He didn’t open the door, but went back to bed,
And he covered up his shivering, shaking limbs in it.
But the door was softly, softly opened and there he saw
“A woman or an angel?”
A figure bathed in a soft inner light.
The light that has seen all in this life has forgiven all.
An ineffable gaze like that of who raised him at her breast.
A smile like that of his most beloved loved one.
“You are Death?” he asks.
And the angel replies: “I am Death!
I bring you rest from the life that humiliated you.”
“I imagined you to be ugly. I was terrified of you …
Are you really Death?” he insisted.
“Yes,” says the angel, “I am Death,
The mistress who is never wrong. Your best friend.”
And the angel came close and touched him on the forehead,
With infinite sweetness, his weak hands closed around her …
The ineffable tenderness of the one who raised him at her breast.

The Masters course in Pain Sciences, of which I was an assiduous student, and that of Palliative Care, which I am currently attending, arose from listening to and empathy for the suffering of oncology patients and the immense need to reduce it.

I worked as a nurse for seven years in the Department of Otorhinolaryngology, Voice and Communications Disorders at the Santa Maria Hospital of Lisbon. I thus came across patients who suffered from head and neck tumours. This pathology brings great alterations to the functions of the organs it affects, as well as to one’s self-image and self-esteem, as well as social, family and professional alterations.

Palliative Care is an integral and almost total part of the Department. Thus I felt the need to deepen and apply my knowledge in order to provide total support to the patient and to their families, and to reflect on the problems that existed, seeking to solve them. Investment in training is the only way to manage to combat and refute the personal and professional imperfections inherent to the team.

Working with oncological and terminal patients was a gift for me. I believe that nothing happens by chance in this life, and working with them made me grow, not only in Professional terms, but particularly in personal terms.

Living with death changes people, and it changed me. The feeling of immortality that has stood out all through our lives is buried in order to give way to lethalness. Death makes us meditate and listen to our fleeting life. It makes us ask questions about many fears: of pain, of losing our material things, of losing our dignity, of the unknown and of separation. It makes us think about our past life and, often, face up to our feeling of guilt about what has not yet been done during our lifetime.

The terminal patient, like all of us, is going to die, but is still alive, still breathing, feeling and hearing. It is up to health professionals to decide whether to let the patient die still in lifetime or to help them embrace their final moments.

As Morrie Schwartz stated: “Am I going to live or am I going to die?”. The patient’s body, even when weakened, is still a part of what we are. Comments like, “What do you want me to do? The patient is dying!” when one is looking for help to alleviate the patient’s discomfort are completely mortifying, obtuse and incomprehensible nowadays.

We are all the same when we look death in the face and death is our most faithful friend.

Life should be lived on a daily basis, we should learn from our mistakes and grant importance to that which is truly worthwhile: looking after other people, whether this is by doctors, nurses or other health professionals, we all train to look after other people.

I am not perfect, neither professionally nor personally, but I always try to learn from the mistakes I make. The specialisation courses in Pain Sciences and in Palliative Care are a way to learn more and smooth out my defects.

It was with great joy and will to learn that I studied, that I study and have discovered, over these years of work, the need to reflect on patients’ needs.

More than being a Masters centred on the discovery of pain and of palliation, the courses have allowed me to discover myself and the people I care for.

We health professionals should never give up, because when we try to be better than we are everything around us becomes better also.

Continuous training in the area of palliative care is the key to helping other people and to helping ourselves.

For the good fortune of the patients and for our science of care, I hope that we can face up to our own fears and never give up caring.

I intend to never stop learning and reflecting, and therefore helping to place myself in a clearer and more learned position as to this great mystery of human existence.

In the name of my personal discovery and of human dignity.

Ana Catarina Sanches Infante
(Nurse )
Service: Burns Unit of Santa Maria Hospital of Lisbon
infante.sanches@gmail.com