Ohio's Hospice of Dayton

This quote from Knowlton (1990, “October 7”) best describes the gifts and lessons we receive from our patients each day. It is in the setting of a patient’s home that I have the greatest privilege—seeing patients in their own special life. It was in this unique setting that I met Jillian. Jillian was a 32-year-old patient with end-stage cervical cancer who had been treated surgically and had an ileoconduit and colostomy. Jillian no longer responded to multiple chemotherapy regimens and was experiencing increased abdominal pain from extensive pelvic and spinal metastasis, bilateral leg edema, and a draining vaginal fistula. Jillian resided in a housing project. Her former job was listed as “street walker” or, in other words, a prostitute. I was overwhelmed by three things when I first met Jillian: the starkness of her apartment, the overwhelming odor of Jillian’s extensive draining pelvic wound, and, most strikingly, Jillian’s violet blue eyes and magnificent smile which dominated her ever so cachetic face. I also was intrigued by the large, unshaded, undraped window that dominated the room and asked her if the vastness and light disturbed her. Jillian said, “The window is my life! Through that window, I see all of the street, the people, and feel the world around me and manage to survive.” Jillian introduced me to the window and its characters. Each person on the street had a name; she knew their routine, what they wore, and where they went. She knew when they got new suits or coats. She knew all the small animals, squirrels (like one she named Nutterbutter), the blue jay, robins, and pigeons. She knew the trees, their leaves, and how they changed. From books borrowed, she became a wizard of the environment. She knew all the businesses in the area and who ran them. Her family was all around her. It was at this time that I began to call her “the window watcher,” and soon started bringing the world to her: pine cones, leaves, bird feathers, small stones, cups of snow, and even a Mason jar filled with rainwater from the street. At each visit, we talked of life and what it meant to each of us. Filled with pain, but ever so eager to talk, Jillian struggled to remain at the window until it was time to leave. Jillian gave me a gift that can not be purchased in any store nor wrapped in a package. She gave me the gift of “presence in the moment.”