A woman in her early thirties, whose father had died just 2 weeks ago, declared that she was too upset to talk and if I could just write her prescriptions and end the session. Then added that she had the strangest dream last night about her father but could not be persuaded to tell it.
Soon the reason for being upset - besides the father's death of course - emerged. She felt that the hospice people who were entrusted with his care were more interested in seeing him dead than restoring his health. She felt she had been robbed of her father by them.
"I am so angry at myself for not being able to help him. He still had life left in him and did not want to die yet. He would frequently get fully alert and did respond with warmth when his life long buddy Joe came to see him the day before he died.
"He had a heart attack in 2002, had COPD and bad knees, periodic blood clots in his calf muscles, and he could not walk because of the peripheral neuropathy. But none of these conditions were bad enough to kill him. I think there was something more to his death than natural causes. How in the world could that woman tell us that he was going to die in two weeks with such surety unless she was secretly engineering it? And when I asked her as to what was she seeing in his condition that made her so certain about the exact time of his death she got really nasty. And then suddenly the prediction was changed from 2 weeks to 48 hours. And when I reexpressed my doubts, she went ballistic and told me to stop asking her such questions for she was a professional hospice nurse who had overseen the death of countless people, and it is very humiliating for her to be questioned like that. And I could do nothing about the callousness of those evil people. For even my mother sided with them, and so did my brothers and sisters who were like 'well it is time for him to go, let us not interfere with what is going on'. They are such cowards when it comes to confronting authorities. They would not let me take him to hospital and ask some real doctors at the ER as to why he must die in 48 hours. There was nothing going on to explain his rapid decline except for that morphine drip which I think that bitch was ratcheting up every few hours. And then her prediction changed from to 48 to 24 hours, though she managed to kill him in 18."
I commented that in my experience whoever goes under the care of Hospice never comes out of it alive. Perhaps they are paid a fixed sum to take care of someone presumed to be terminally ill and therefore earlier the person dies the more money they make. And perhaps they are penalized if a person is admitted into their facility as terminally ill and later this assumption is proven wrong. This impression of Hospice I had formed based upon seeing every single patient, with the exception of two, sent by to me to Hospice dying in matter of days to weeks. And even these two could only be saved because I was requested by the family to intervene. One was an 82 year old lady who was terminally ill because they had had her comatosed with excessive amounts of morphine and antipsychotics. Simply stopping her medications not only brought her back to normalcy but such a dramatic improvement that today, eight years later, she is still alive and, believe it or not, went on a Caribbean cruise on her 88th birthday.
Another incident that convinced me of of the lethality of hospice was the untimely death of a friend of mine. He suffered from pulmonary fibrosis, a medical condition which leaves very little capacity to breath. He was undoubtedly going to die but in my judgment still could hang on to dear life for an year or two. He went into the hospital walking, gasping for breath of course,, but still walking. Once stabilized I thought he would go home. But his internist, instead, referred him to a hospice. They came over and took charge of his care even before he was discharged because there were no beds available in hospice and managed to kill him with their morphine drip in less than 24 hours.
On hearing with what contempt I hold Hospices a floodgate of anger was opened in the patient enabling her finally to tell the dream.
I was at the funeral home in which his viewing had taken place. There were a number of mangy cats crowding the parking lot, strangely some resembled my father. Next scene was of his being laid out in the coffin. I was kneeling down before him. The coffin was rather high as if on stilts. I saw him move. He looked alive. I thought to myself that he must be thirsty and therefore he is moving like that. [Just before dying he was thirsty and I gave him juice and water on a sponge which he drank greedily. Those hospice people were so focused upon his death they had no time to quench his thirst.] Then he started walking out of the coffin as if he had a surge of energy. I was worried how he will get out from that height. But he was strong and vigorous, just the way he had been all his life. But as he made his way out of thet room, the hospice people and my mother went in to action. I noticed that he was still embalmed. I was in pains for him to not notice it. I tried to stand in front of the coffin to hide it from his captors and prevent him from realizing that he was dead. But they managed to force him back into it and he died all over again.
The dream was obviously an attempt to undo her father's death to whom she was very tenderly attached. The mangy cats were the hospice people and her siblings ( who resembled her father). They were mangy for they hastened his death. But it was also a projection of her own ambivalence towards her father, which is present in all children towards their parents. "She is the one who is doing everything possible to keep her father alive while the siblings, the mother and the hospice people are trying to kill him." His coffin being high up, almost unreachable, was exalting his status to such heights that it would prevent her and others from doing him any harm (desecration) now that he lay dead and helpless.Seeing his father strong and vigorous as he moved out of the coffin was of course the desire to bring him back to his former self that she had loved all her life and undo his death. Preventing him from seeing the coffin and noticing that he was embalmed was to prevent him from noticing her wishes for him to be dead (the ambivalence) .With hospice people and her family bringing him back into coffin and killing him again was absolving herself from all guilt for his death. For much of her day time now is being spent upon feeling guilty for not fighting enough on his behalf with the Hospice folks. A guilt which all of us feel no matter what the cause of the parent's death and whose roots lie in the invariable presence of unconscious death wishes towards one's parents.