Neighborly

My 71-year-old patient with a history of hypertension and Alzheimer's dementia (whom I shall call “Ana”), had nobody. No children, no partner, siblings. needed to find somebody make the decision about whether she would want be placed on ventilator since recurrent aspiration event that left her acutely dyspneic so was relieved when found John's name listed as healthcare proxy. It unclear who he was, thought myself, maybe is friend—and called him. John, learned, lived three flights above Ana in an old Manhattan walk-up for most their adult lives. imagined them waving they crossed paths hallway, making small talk weather or lines at corner store. Maybe saw each other go through various phases lives, new partners, haircuts, jobs, births, deaths. They were good neighbors by New York standards, but just acquaintances. Calling friends have been stretch.Years passed. became more forgetful. John heard from one home health aides dementia. He besides caregivers, not many people coming into home. wondered times how doing.Acquaintances, neighbors; relationship. And told him designated medical decision-maker, shocked. kept repeating “What! Me? What?” me did know personal thing her. acknowledged what feeling explained extremely short breath next step put breathing machine. we help immediately die. Without even realizing already started answering question, stated utter certainty, “Ana wouldn't that; someone spend whatever time has home.” Relief washed over say these words. voice calmer now imagine some shock worn off. “I brought dying mother instead being hospital,” reflected. shared stories much loved apartment, bringing huge shopping bags decorate it cozier never really vacationed.When order get home, there risk might shorter, knew his core willing take risk. There question. quickly made enroll hospice agreed cover any could care lucky you,” said. mentioned said her, slight laugh “you may only person world knows did.” hear chuckling quietly; began understand why chose can't believe I'm choices think doing right same herself.” direct conversations important them, simply passed hallway allowed see grow become today. realized best if best. cry quietly thanked phone. On my way us window full lives lead, little other, yet such sense familiarity. When entered apartment building evening, waved do daily doorman smiled neighbor both got our mail, woman whom elevator numerous carried ingredients prepare meals. often cooked.