Trumpets

Critical care physician Dr. Laurin Bellg writes in her book Near Death in the ICU: Stories from Patients Near Death and Why We Should Listen to Them:

I had my own strange experience of observing what seemed to be a bedside visitation when my grandmother was dying. She’d had a gradual descent into vascular dementia over the years leading up to her passing, and was nearly totally withdrawn toward the end. She wouldn’t interact, she wouldn’t eat, and with her increasing failure to thrive, she was clearly dying.

A few weeks before my grandmother’s death at age ninety-one, hospice became involved and spent a great deal of time in her home, both caring for her and comforting my grandfather. When her decline accelerated, I flew in from my home in the upper Midwest to spend whatever time I could with her. I remember my grandfather, knowing I was a physician, sitting at her bedside when I arrived at the house, looking at me helplessly and saying through thick tears, “Is there anything you can do to save her?”

“No, Grandpa,” I replied. “It’s her time.”

He nodded sadly and turned his attention back to her wrinkled hand, which he held and caressed with such love and tenderness that it broke my heart. By this time she was totally unresponsive, and it was not clear to us what she did and did not understand. Could she hear us when we told her we loved her? Was she suffering in ways she couldn’t tell us? With the help of the hospice nurses, we gave her morphine under her tongue if she moaned, and we repositioned her periodically, trying to guess at what would make her most comfortable – but we couldn’t know for sure, and we frequently found ourselves feeling quite helpless to meet her unspoken needs.

One night I was up late with one of the hospice nurses, who were by now staying in shifts around the clock. We chatted quietly now and then, but mostly we sat in the dim silence of my grandparents’ old Southern farm home, not saying a word. Suddenly, my grandmother began talking. It was hard to understand, but it seemed as if she was carrying on a conversation. All that we could understand was when she gazed softly with a faraway look in her eye and said, “Almost there. Almost.”

“She must be getting close,” the hospice nurse said. “She’s starting to talk.” I knew what she meant, having had patients of my own who had apparent discourse with a presence none of us could see.

It was tough seeing my grandmother dying. Although by all appearances a simple farmer’s wife, she was one of the most naturally elegant people I knew, and I had always admired her for her calmness and grace. Even with drama erupting all around her, she seemed to maintain a cool and centered calm – one I sought to emulate but never quite succeeded in doing. Not the way she did, anyway. Having witnessed my patients’ beside visitations, I was deeply moved to be able to experience this with someone I was so close to.

What happened next was strange. Had I not experienced it first hand, I would have harbored skepticism, but because I was witness to it, I can only report my experience. At the risk of reading meaning into something that was a natural occurrence and strictly coincidental, I chose then to embrace a way of understanding it that brought me the most comfort. In doing so, I gained insight into why my patients and their families might do the same, believing with their whole heart that what they experienced was real. What happened was meaningful and real to me. I now understand that similar events are meaningful and real to them.

A day before my grandmother died, we noticed two doves right outside her window, perched on the back of the pale green metal glider that had been on their front porch for years and was now partly rusted from the ever-present humidity of the deep South. Those doves never left. More often than not, they were looking at the window of my grandmother’s bedroom, seeming to try to peer through it from time to time. Occasionally there was a soft peck at the window, and we would look up to see one or both of the gray birds ruffling their feathers and pacing back and forth along the back of the glider. Glancing through the window and cooing softly, they seemed to be watching her.

After a day of tending their perch outside my grandmother’s window, just hours before she died they became very agitated, pacing up and down along the back of the settee – roosting, fluffing, then settling over and over. They seemed restless. Around the same time, my grandmother’s conversations seemed to pick up. She talked and gestured with her eyes closed, quietly, but very purposefully. Occasionally, we would understand a word here and there, especially on the occasion that she would reach her hand out and say, “Almost. Almost.”

We would also hear her talking about roses. “Oh, look, a rose,” she would say, or “A rose, so beautiful.” My grandmother loved her roses and tended to them faithfully. It seemed so fitting that in her dying moments she would somehow be presented with the image of roses, and it was a great comfort to us.

Moments before she took her last breath, the doves became especially active. One in particular kept flying off a short distance, and then coming back. We were fascinated. Aunts, uncles, cousins, my mom and grandfather all took notice. Once, when my grandmother had a very long pause in her breathing, both doves flew away a short distance, only to return when her breathing resumed.

Then after several moments of her taking long pauses, stopping breathing, then starting again, she took her final breath. At that moment, when it was certain she would not breathe again, the two doves took off in a flurry and flew away. We never saw them again, and my grandmother never took another breath. She was clearly gone, and we mused among ourselves that perhaps she’d had company on her way – escorted by two gray doves that had kept vigil for those long hours. It comforted us to think so.

None of us had ever seen doves there before – not the children of my grandparents who had grown up in that house, nor the grandchildren who had spent many lazy summer days playing on that front porch. And since my grandmother’s passing, we’ve not seen them again. Ever.

What happened next, though, truly defies logic. Keep in mind that my grandparents were farmers, as were their parents and ancestors before them. They were intimately familiar with their land. In fact, my grandfather inherited the land from his father, and had been farming it since his father’s death when he had to drop out of the small grade school not far down the red dirt road to support his family. There wasn’t an inch of that eighty-acre plot of land my grandparents and our entire family weren’t familiar with – an area in northern Florida where generations of Registers, Carswells and Outlaws had farmed peanuts, cotton and occasionally sugar cane. In fact, tucked right up against the borders of Alabama and Georgia, along a vast network of winding red dirt roads, they knew every sound and wind shift that occurred on that land.

So it amazed us that a few moments after my grandmother died and the doves had flown away, we all heard what sounded like a horn play several sweet notes in the field right behind the house. The field was totally empty for the season – the bare cotton stalks had only a smattering of white cotton remnants still lingering in the few pods that had resisted the harvester several weeks earlier – but the sound of the trumpet-like horn was very close. Even younger cousins who had been playing in the back yard came running in to tell us they had heard a horn playing in the field near them but couldn’t see anyone. No one could explain it. There were no radios or televisions on. We had all been quiet and reverent before and at the time of my grandmother’s passing. No vehicle had passed the remote dirt road outside their modest farmhouse. It’s the kind of story that had I not experienced it personally, I would be tempted to discount it as made up, thinking that “you hear what you want to hear.”

Yet we had all heard the horn, and we could only just stare quizzically at one another and contemplate what had just happened – the doves, the horn sounding. No one said a word. Finally, it was a hospice nurse, a gentle black woman, who broke the silence and said, “Now that is only the second or third time in all my years that I have heard that trumpet right after somebody died.” She was so matter of fact about it. I admit it was comforting to have her validate our experience, her simple words reinforcing its meaning for us.