Photo by Flynn Larsen
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Going Home
By Barry Yeoman, January & February 2005
The hospital couldn’t save Jack’s life. But hospice gave him something to live for
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Jack Smith looked up from the evening news to see two old buddies bounding
down the steps to the basement den of his northeast Philadelphia home. At once
his tired face broke into a wicked smile. "There's beer behind the
bar," he called out, pointing to the refrigerator full of Meister Braus.
Then he turned to his daughter, Danielle Carpenter. "Get me a drink,"
he said good-naturedly. "A whiskey and water. No ice."
Brews in hand, the two men plopped on the sofa, all shouts and laughter.
This was where Jack held court: a cavernous clubhouse for overgrown boys, its
low ceiling plastered with triangular pennants. Notre Dame. Chestnut Hill
College. San Jose Sharks. Philadelphia Eagles. A glass case displayed an
"Archie Bunker for President" mug, and laminated certificates honored
the Cardinal Dougherty High School soccer team, which Jack had coached during
its championship streak in the 1970s. Jack's friends were guys whose
histories, like his own, were intertwined with Philadelphia's Catholic
schools. Florian Kempf had been one of his star players—he'd gone on
to kick for the Houston Oilers. Father Ron Ferrier, a science teacher at
Dougherty, had presided over the weddings of both of Jack's daughters.
More recently, Father Ferrier had administered last rites to Jack. But
instead of succumbing to esophageal cancer, Jack had come home from the
hospital, climbed into his blue terry cloth robe, cranked up the space heater,
and opened the basement to visitors.
Everyone in the room knew Jack was dying. But the retired coach and
maintenance supervisor had decided he wouldn't spend his final weeks in the
hospital chasing an unlikely cure. Instead, he would make his remaining time as
joyful as possible. He'd settle into his basement. He'd surround
himself with family and friends. Back when Jack and his wife, Peggy, were
engaged, they would listen to the Beatles sing "Will you still need me,
will you still feed me, when I'm 64?" Jack's 64th birthday was
coming up, and he intended to be needed and fed—at home.
For all of the hospice movement's growth, it still
reaches only one in four dying Americans.
What made this scenario possible was the hospice program at
Philadelphia's Fox Chase Cancer Center, whose care team focused on
maximizing Jack's comfort. Nurses, an aide, and a social worker visited
regularly, making sure that all problems—pain, nausea, sleeplessness,
even despair and family grief—were addressed. So were the tasks of daily
living, like bathing. That freed Jack to do what he really wanted: sit in his
den with his loved ones, talking about old times.
"I tell our families that the goal of hospice is to help a patient
live—underline live—as best they can with their illness," says
Debbie Seremelis-Scanlon, hospice liaison for the Fox Chase program and a
registered nurse. "If you're having a good day, great. If you're
having a bad day, call us and tell us what's making it bad."
That's a revolutionary concept in this country, where death too often
comes in a hospital room filled with machines and tubes—desperate and
often futile attempts to eke out a few more weeks. Knowing no alternative to
this decades-old model, many patients believe hospice is a euphemism for giving
up treatment—and hope. "The first question I always ask is,
'What's your understanding of what's happening now?' "
says Fox Chase hospice social worker Rhoda Goldstein. "A lot of times they
say, 'They sent me home to die.' Well, maybe they sent you home to
live."
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