If we ask ourselves what is so helpful or so meaningful that such a high percentage of terminally ill patients are willing to share this experience with us, we have to look at the answers they give when we ask them for the reasons of their acceptance. Many patients feel utterly hopeless, useless, and unable to find any meaning in their existence at this stage. They wait for doctors' rounds, for an X-ray perhaps, for the nurse who brings the medication, and the days and nights seem monotonous and endless. Then, into this dragging monotony a visitor comes who stirs them up, who is curious as a human being, who wonders about their reactions, their strengths, their hopes and frustrations. Someone actually pulls a chair up and sits down. Someone actually listens and does not hurry by. Someone does not talk in euphemisms but concretely, in straightforward, simple language about the very things that are uppermost in their mind—pushed down occasionally but always coming up again.
Someone comes who breaks the monotony, the loneliness, the purposeless, agonizing waiting.
Another aspect which is perhaps more important is the sense that their communications might be important, might be meaningful at least to others.There is a sense of service at a time when these patients feel that they are of no earthly use to anybody anymore. As more than one patient put it: "I want to be of some use to somebody. Maybe by donating my eyes or my kidneys, but this seems so much better, because I can do it while I am still alive."
Some patients have used the seminar to test their own strength in peculiar ways. They have used it to preach to us, to tell us about their faith in God and their readiness to accept God's will while fear was written all over their face. Others who had a genuine faith which enabled them to accept the finality of their life have been proud to share this with a group of young people in the hope that a little of it may rub off. Our opera singer with the malignancy on her face asked to come to our class as a last performance, a last request to sing for us before returning to her ward where they were ready to pull her teeth before radiation treatment.
What I am trying to say is that the response was unanimously positive, the motivations and reasons different. A few patients may have wished to decline but were concerned that such a rejection might affect their future care. A certainly much higher percentage used it to ventilate their anger and rage at the hospital, the staff, the family, or the world in general for their isolation.
To live on borrowed time, to wait in vain for the doctors to make rounds, lingering on from visiting hours to visiting hours, looking out of the window, hoping for a nurse with some extra time for a chat...this is the way many terminally ill patients pass their time. Is it then surprising when such a patient is intrigued by a strange visitor who wants to talk to her about her own feelings, her own reaction to this state of affairs? Who wants to sit and share some of the fears, fantasies, wishes she thinks of during these lonely hours? Maybe it is this alone, a little attention, a little "occupational therapy," a break in the monotony of things, a little color to the whiteness of the hospital wall, that this seminar offers to these patients. Suddenly they are all dressed up, put in a wheelchair, asked if their response can be tape-recorded, and aware that a group of interested people are watching. It may just be this attention that helps and that brings a little sunshine, meaning, and perhaps hope into the life of a terminally ill patient.