I Chose to Care, Not to Question

The day I met him, I sensed the gap between us before  I uttered a single word. He was a tired  elderly man, thin and frail, with pale skin, eyes sharp with something hateful that displayed anger and dislike towards me. Unfortunately, I was the nurse assigned to care for him this afternoon in this busy ward that never seemed to settle. It seemed that my name badge, uniform, accent, and more importantly my skin colour were  everything he needed in order to get annoyed with me before I could even speak to him.

Throughout my shift, he seemed uncomfortable whenever I attended to him or just went near . For instance ,he would look away when I introduced myself to  him and flinch when I tidied his pillows and bed. And  when he asked for water or medication, his voice carried a sense of rudeness,  an edge that was obvious to those around.

Still, I did not take offense to his behaviour since I told myself that illness can sometimes cause people to change their moods or temperaments easily. And that pain can be displayed  through hostility. However, there was something unpleasant in his gaze  that was not hospital related  or his current health troubles.

I could have escalated this issue to the departmental senior/matron, since there was always someone ready to swap patients or document incidents of verbal abuse as per hospital protocol. But I didn’t. And could not say as to why.  Maybe I was stubborn, although deep down I have learnt to work quietly without allowing other people’s bitterness define me. Furthermore, there were other patients to attend to, charts to complete, families to call and interdepartmental collaboration. All these needed my attention. Needless to highlight that time on the ward moved fast  and his behaviour towards me , though unpleasant, was just another handle to jump during my shift.

Each day, I would monitor his vital signs, give him the prescribed medications, and asking the same questions we ask all patients.  ‘’Are you in  pain today?” “Have you been able to eat well, have you opened your bowels?” His answers were short, sarcastic, followed by inappropriate body language but I carried on. This was in spite of me treating him as I would any other patient. And even though I felt the sting of his tone of voice, I reminded myself that compassion is unconditional.

Over time, towards the beginning of his second week as an inpatient, I noticed the way his eyes would occasionally soften when I adjusted his pillows or hospital pajamas  or tidied his bedside surroundings, although he never thanked me. Without a doubt I could sense gratitude in his silence, though It wasn’t much, but it was at least it was something.

Then came the afternoon when his condition suddenly deteriorated and I knew what was coming. He had progressively deteriorated since admission, and the doctors had already informed his family about palliative care. I checked his breathing, his pulse, and immediately  realized I had to call his family.

Soon after, a young woman arrived about an hour later. She couldn’t have been more than twenty-five years old. She had soft brown skin and curly hair pulled back, with a face full of worry and exhaustion. Immediately she walked in, I saw the resemblance. She greeted me politely, introducing herself as his granddaughter.

We sat together by his bedside, in silence. She told me she had been taking care of him for the last few years, visiting him every day ensuring that he never felt completely alone, especially after the death of his wife of 60 years. She also informed me that she did his laundry and house keeping. Her voice was steady, but there was sadness in it too.

She explained to me that her mother, who was  this man’s daughter, had passed away not long before, along with her grandmother.  Grief upon grief, I thought to the family. As we talked, I could feel the weight of the years of awkwardness in the family history lingered like an unspoken in the air.

When I asked about her father, she hesitated. Then, slowly,   said, “He’s from Africa ‘’ and that her  granddad ‘’never forgave him.”

And  suddenly, so many things  now made sense regarding her granddads behaviour towards me. The resentment, rudeness and the unspoken tension I had felt every time I entered his room. I realised that  apart from being a nurse, I was a living reminder of something unpleasant in his recent past,  a reminder of a decision his daughter had made long ago, one he had never accepted but also that brought division in the family.

The granddaughter went on to tell me that she had a mixed-race brother, whom she called immediately. He lived some distance away, caught between his own responsibilities. She also mentioned a close friend who had supported her through it all, a young woman of mixed Chinese and Black heritage, someone who, she said, understood what it meant to live between worlds, to carry identities that others didn’t always accept nor appreciate.

Apparently her father  left when she and her brother were children below five years of age. To make matters worse, the grandfather’s relationship with his own son had soured years ago over money.

The son, the young woman’s uncle, told the old man that his daughter had wasted his(son) inheritance on “a foreign  African man” while he himself had been left to struggle. That misunderstanding, fed by resentment, had deepened and the son had not come to see the old man (his dad)in a long time.

It was therefore not surprising that when the granddaughter called her uncle  to tell him that the situation was critical, he sounded detached, and uninterested. “He works and lives in London,” she said quietly. “He’s not in a hurry to come.”

It was heart-breaking to watch her try to hold everything together at her tender age of 25years. She was mourning even before he was gone.

I stood beside her as the evening wore on, making sure the old man was comfortable. By now, the hostility that had once filled the room was gone. He was quiet now, his face calm, and peaceful.

After making phone calls, the granddaughter looked at me with a strange expression and then asked. “You’ve been looking after him, haven’t you?” .

“Yes,” I said. “For a while now since he was admitted to this ward.”

She nodded, and after a long pause, said, “He didn’t always say much about the nurses. But… I have a feeling that he knew you cared.”

Something inside me shifted then. I knew I didn’t need an apology from him, nor did I expect one. But, as I stood  there with his granddaughter, I felt a sense of unexplained understanding that words could never articulate.

Later on during that shift, after the doctor confirmed his passing, I completed the necessary paperwork and checked on the granddaughter whom I had offered a drink(Tea). She thanked me, her eyes red but could still smile. Before she left, she touched my arm lightly and said, “I’m glad you were here.” By  this time her brother and the African- Chinese mixed race friend had arrived and they were all by the bedside.

After they left, I sat in the award break room as it was my break time by then, where I  replayed the events of the past 2 weeks whilst looking after this man who had recently died under my care in my mind. I thought about the choices  available to the nurses, caregivers and one of them is to respond with empathy instead of defensiveness, looking beyond the surface of people’s words and behaviours. In this case It would have been easy to label his behaviour as racism which I think it was. It would  also have been easy to file a complaint , to protect myself by creating distance. And I would have been justified in doing so. But I didn’t.

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 Nurses meet people at their most vulnerable, when they are  stripped of their control, their dignity, sometimes even their reasoning capabilities. And  it is not always easy to see the individual  behind the behaviour. However, I have learned that it is always important to try. This is because, whilst compassion does not mean excusing bad behaviour, it does means understanding that individuals  are rarely at their best..

I will never know whether he recognised his poor behaviour and judgement in his final days. That person caring for him  reminded him of everything he had spent years resenting. But I do know this: he died with dignity, and he did not die alone.

In the days that followed, I thought often about his granddaughter, the young woman who carried the burden of two worlds, trying to make peace with a history she didn’t create. I admired her quiet strength, her grace in the face of loss. In her, I saw a reflection of resilience that felt familiar.

I still think of this family and how easy it would have been to close myself off, due to hostility. But instead, I chose to care, even when it wasn’t easy, even when it went unacknowledged.

And in doing so, I learned something I will carry with me always:
Empathy is not a sign of  weakness but the courage to care unconditionally

That’s why I chose to care, not to question. And I have never regretted that choice.