A text about what really matters in the last minutes of life

In the same way that it is uncommon for people to talk about death, on our website it is rare for you to read an article that talks about it.

But the awesome.club I couldn’t pass up this text that brings an important and powerful reflection on a fact that sooner or later will happen to all of us.

See below the transcription of the speech by the director of the State Budgetary Public Healthcare Facility — Center for Palliative Care and founder of the Vera Hospice Charity Foundation fond-vera.ru (a philanthropic entity that works in psychiatric hospitals in Russia), Nyuta Federmesser, offered at TEDxSadovoeRing. This is a slightly reduced version of her presentation, but it contains some strong and sincere words that, in addition to being emotional, will leave you with goosebumps.

We want you to stop for a few minutes and read this text carefully and reflect a little on the things that really matter.

At the Foundation where I work, concerts are held. Small, the kind patients are taken to the common room and some musicians start playing. They are not known artists; the important thing is that the music is familiar and pleasant, so that people are calm, sitting and listening. Because obviously most people there know that that might be the last song and the last show of their lives.

At one of these concerts there was a couple. The husband was in his last moments of life and the wife, ever so loyal, was standing beside him, holding his hand. She was a kind woman, well-groomed and thin. She held his hand throughout the entire show. When she finished, they went to the bedroom together and, for some reason, I said to her: “Come by my room later, just to talk”. About an hour later she came to see me and from the look on her face I knew immediately that her husband had left us.

She wasn’t crying and she didn’t seem distressed. In fact, she seemed to be relaxed. She told me: “Alexander died”, to which I replied: “How did he die? He was just now on the show.” “You know what, we got to the room, I sat on his bed, he held out his hand and didn’t want to get up anymore. I took his hand (many patients are very weak and just getting his hand up is quite a challenge) and he told me he couldn’t take it anymore. He put his hand on my shirt and started to unbutton my jacket. His hand slipped down and he died”.

At these times, people think of the people they love, the woman they love, the people they once loved and are about to see.

Dona Maria was an important character in my life.

She is a lady from a village I have always visited and continue to visit every summer. She died at the age of 104, as we read in the books: at home, next to her also elderly daughter who took care of her and stayed by her side until the end.

Sometimes he said interesting things. When she was over 90 almost nobody listened to her. She said things about her farm, the war and the revolution. One day I stopped next to her because she was telling me something really interesting. The accent of the region where she lived was very interesting. Well, she said the following: “Nyuta, my dear, my André died. I was 21 and pregnant. He went to war and died. I was young and had a braid.” She was sitting in huge boots that made her thin legs look even thinner. Her dress was old and she had a rustic, country style. From the scarf she wore on her head, strands of fine hair, completely white, came out. “I had two things: a braid and my André. I didn’t have another man. Nyuta, what do you think? When I see my husband will I be young again or will I still have this saggy skin?”

People think about loved ones and how they will be remembered.

A short time ago, a 16-year-old boy was taken from the Dima Rogachev Center to the Palliative Care Center because there was no way to cure him, only to help him.

He quickly realized that the conditions were not like those in a hospital. Everyone knows what will happen. But with him there was no frank conversation. I would say to him: “Dani, what do you want?” He would reply, “Well, what do you think? Smoke and drink beer”. Those things were easy to arrange, but then things got really complicated, mainly because his mother was in the room, crying.

He developed a trusting relationship with one of the doctors. On the eve of a weekend he told her that he really needed to do something important. What could be so important? Buy a heart-shaped chain and pendant. So, several people from the Palliative Care Center, in fact all the doctors, started looking for what he had asked for during the weekend. Many models were taken: a heart, a heart with an arrow, a heart broken in two, etc. He chose the whole heart. When he died, his mother took the heart with her to give to the girl he was in love with.

I think this girl probably lives in a rural area, is poor and simple. A place where men tend to be alcoholics at 30, 32 years old. Her husband will probably be one of them and she will wear this pendant for the rest of her life. She will remember this boy for her whole life and this romantic story will never be experienced by anyone else. She will never forget her Dani.

All of our employees will remember Dani, because helping a patient by buying a heart-shaped pendant is good, simple palliative medical help. Certain conditions are also necessary for a person to be able to lay his hand on the chest of his beloved woman. At these times, the person can be himself, without pain, without being scared, without feeling alone.

Before, all this was natural: people were preparing to die. Families rarely talk about death now. What is the correct way to act? Is there a correct way? No, it doesn’t exist, but it’s very good when those who leave think about those who stay.

For that to happen, we shouldn’t be afraid to ask questions and we shouldn’t be afraid to give answers. Because if someone asks or says: “Look, if I die, bury me there” and someone else replies: “Stop it, you’ll live longer than me”, it’s nice, but it’s useless.

During an honest conversation, such preparation gives a person the opportunity not to feel guilty, to be himself, to speak honestly about his desires and fears.

The word ‘honestly’ it’s very important. Only when we know the facts can we correctly determine what is important to us. This happens with everything: when we know the date of a trip, we have time to program everything calmly, without mistakes. When we know the date of a test, we have time to study; when we don’t know, everything ends up going wrong. If we know the diagnosis and we know we have three months or three years to go, chances are we can set our priorities right. At the Foundation, where medicine connects with the person, unites with the person, where everything is done to not hurt, not to frighten, so that no one feels alone. We offer the unexpected opportunity to be honest with ourselves and our loved ones by being able to honestly say what we mean.

The important thing is that there is no pain, fear or loneliness. That way, there’s plenty of time, wonderful time. Sometimes there is very little time left: days, hours or even minutes.

But it is the brief space of time in which we say the five most important things: “I admire you a lot”, “I love you a lot”, “I forgive you”, “I forgive you” and “until one day”🇧🇷 Our desires and the possibility of fulfilling them are these five things. Everything can be summed up in a heart pendant or in a woman’s hand resting on the chest of a beloved man.

If everything is clear and people can be sincere, everything is easier in this difficult time and in this life full of conventions. To the point where a blind woman who is about to die can say: “You know what, I’ve dreamed of something my whole life, but I’ve never had the courage to do it… I want to paint one nail in every color, all of them brilliant. It might be?” And she is blind.

Nails were painted while she lay in bed. Each family member or nurse who entered the room said what color they were going to paint their nails.so that she felt that she had each nail in a different color.

Time and help eliminate the fear we feel before dying. It is true that before death we do not think about death, we think about life. At the Foundation, we give people the opportunity to distance themselves from bad things. If we prepare ourselves correctly, we stop being afraid of the inevitable, such as the birth of children, marriage, divorce and everything else that happens in our lives. In this way, fear is eliminated. And this is possible. Thanks.